Sleep patterns and creativity in children and adolescents with and without high functioning autism (HFA): a descriptive study and an intervention trial

Sleeplessness is common in childhood especially in some clinical groups and it has negative effects on child and family functioning. There is limited data suggesting a link between lack of sleep and impaired creativity and more studies are needed especially with children with autism for whom creativity is compromised and risk of sleeplessness is high. The adverse affects on children's neurobehavioral functioning caused by insufficient sleep might be reversed by removal of the sleep disturbance as a means of improving overall function of the child. The treatment of choice for childhood sleeplessness problems are behavioural approaches however they have not been sufficiently evaluated with school age typically developing children (TC) or with children with high functioning autism (HFA) and further, parents often have limited access to such treatments. Therefore this study aimed to explore the relationship between sleep and neurobehavioral functioning and creativity of children (with and without HFA) and maternal mental health by means of a descriptive study (n=65) and to evaluate the efficacy of booklet behavioural intervention for sleeplessness problems, via a multiple baseline design (n=9), and its indirect effects on children's creativity. Sleep was assessed by parent and child sleep reports as well as by actigraphy. Children's creativity was measured using the Torrance Test of Creative Thinking and newly developed tests of creativity. Measures of child neurobehavioral functioning and parental mental health were also employed. The results suggested that sleeplessness was associated with impaired child neurobehavioral functioning and maternal mental health and with reduced creativity in TC only. The booklet-based behavioural intervention appeared to be effective for the treatment of sleeplessness in TC although no associated changes in creativity were consistently found. The booklet was less useful for children with HFA. The thesis argues that sleeplessness impairs high level cognitive ability in children and affects maternal mental health. The results are clinically useful as they support the use of booklet-based behavioural interventions for sleeplessness in school age TC. The efficacy of such approach with children with HFA needs to be further explored. Nocturnal mental over-activity appeared responsible for the maintenance of sleeplessness in TC and HFA. This has important clinical implications when considering appropriate intervention approaches for this age group