Investigating the Effect of Enhancing Understanding of Embodied Metaphors on Sleep Status in Children with Autism and Sleep Problems
,
Abstract
Background and Objective: Children with autism spectrum disorder (ASD) often suffer from language disorders; however, those who experience sleep problems usually have more severe impairments in various domains of language and communication. Given the essential role of language in communication, this study aimed to investigate the effect of enhancing understanding of embodied conceptual metaphors on the sleep status of children with autism experiencing sleep problems.
Materials and Methods: This study employed a within-subjects design. The study population consisted of boys with autism aged 7-12 years. A total of 34 children with sleep disorders were selected using purposive sampling. Pre-test data were obtained using the Children's Sleep Habits Questionnaire (CSHQ), which includes items related to the cognitive, emotional, and communication difficulties in children with autism, such as sleep anxiety, sleep onset delay, bed-time resistance, and daytime sleepiness. Participants then underwent 20 sessions designed to enhance their understanding of conceptual metaphors. The CSHQ was readministered as a post-test and follow-up to evaluate the effect of language-based intervention on sleep problems.
Results: Repeated-measures analysis of variance (ANOVA) demonstrated a significant positive effect of enhancing understanding of embodied conceptual metaphors on sleep improvement in children with autism experiencing sleep problems (P < 0.0001).
Conclusion: Enhancing understanding of embodied conceptual metaphors may be effective in improving sleep prob-lems in children with autism, potentially through reducing sleep anxiety and increasing communication abilities.
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38. Khazaei T, Portaghali P, Jamali O, et al. Sleep pattern and common sleep problems in primary school students in Birjand. Modern Care, Scientific Quarterly of Birjand Nursing and Midwifery Faculty 2012; 9: 257-63. [In Persian].
39. Adams HL, Matson JL, Cervantes PE, et al. RETRACTED: The relationship between autism symptom severity and sleep problems: Should bidirectionality be considered? Res Autism Spectr Disord 2014; 8: 193-9.
40. Van Litsenburg RR, Waumans RC, Van Den Berg G, et al. Sleep habits and sleep disturbances in Dutch children: a population-based study. Eur J Pediatr 2010; 169: 1009-15.
41. Verma D, Chakraborti B, Karmakar A, et al. Sexual dimorphic effect in the genetic association of monoamine oxidase A (MAOA) markers with autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 50: 11-20.
42. Deuschle M, Schredl M, Schilling C, et al. Association between a serotonin transporter length polymorphism and primary insomnia. Sleep 2010; 33: 343-7.
43. De Faria Poloni J, Feltes BC, Bonatto D. Melatonin as a central molecule connecting neural development and calcium signaling. Funct Integr Genomics 2011; 11: 383-8.
44. Mayes SD, Calhoun S, Bixler EO, et al. Sleep Problems in Children with Autism, ADHD, Anxiety, Depression, Acquired Brain Injury, and Typical Development. Sleep Med Clin 2009; 4: 19-25.
45. Hollway JA, Aman MG, Butter E. Correlates and risk markers for sleep disturbance in participants of the Autism Treatment Network. J Autism Dev Disord 2013; 43: 2830-43.
46. Norbury CF. The relationship between theory of mind and metaphor: Evidence from children with language impairment and autistic spectrum disorder. Br J Dev Psychol 2005; 23: 383-99.
47. Botting N, Baraka N. Sleep behaviour relates to language skills in children with and without communication disorders. Int J Dev Disabil 2017; 64: 238-43.
2. Amin Yazdi SA. Cognition and treatment of autism Introducing a new approach to integrated human development. Mashhad, Iran: Mashhad University of Medical Sciences; 2016.
3. Rafie T. Autism, Evaluation and Treatment. Tehran, Iran: Danjeh; 2006. [In Persian].
4. Soltanzadeh S, Shefaroudi N, Khalafbeigi M, et al. The effect of musical activities on the participation of autistic children 6 to 12 years old in Tehran in formal and informal activities. J Rehabil Med 2012; 1: 31-5. [In Persian].
5. Hill EL. Executive dysfunction in autism. Trends Cogn Sci 2004; 8: 26-32.
6. Białecka-Pikul M. Metaphors in preschool child thinking about the mind. Psychol Lang Commun 2003; 7: 37-47.
7. Gowen E, Hamilton A. Motor abilities in autism: A review using a computational context. J Autism Dev Disord 2013; 43: 323-44.
8. Gidley Larson JC, Bastian AJ, Donchin O, et al. Acquisition of internal models of motor tasks in children with autism. Brain 2008; 131: 2894-903.
9. Lee D. Cognitive Linguistics: An Introduction. Oxford, UK: Oxford University Press; 2001.
10. Lakoff G, Johnson M. Metaphors We Live By. Chicago, IL: University of Chicago Press; 1980.
11. Gibbs RW. Embodiment and Cognitive Science. Cambridge, UK: Cambridge University Press; 2005.
12. Rapin I, Dunn M. Update on the language disorders of individuals on the autistic spectrum. Brain Dev 2003; 25: 166-72.
13. Lee RF, Kamhi AG. Metaphoric competence in children with learning disabilities. J Learn Disabil 1990; 23: 476-82.
14. Boucher J. Language development in autism. Int Congr Ser 2003; 1254: 247-53.
15. Fadini CC, Lamônica DA, Fett-Conte AC, et al. Influence of sleep disorders on the behavior of individuals with autism spectrum disorder. Front Hum Neurosci 2015; 9: 347.
16. Davignon MN, Qian Y, Massolo M, et al. Psychiatric and Medical Conditions in Transition-Aged Individuals With ASD. Pediatrics 2018; 141: S335-s45.
17. Elrod MG, Hood BS. Sleep differences among children with autism spectrum disorders and typically developing peers: a meta-analysis. J Dev Behav Pediatr 2015; 36: 166-77.
18. Biggs SN, Lushington K, Van Den Heuvel CJ, et al. Inconsistent sleep schedules and daytime behavioral difficulties in school-aged children. Sleep Med 2011; 12: 780-6.
19. Baker E, Richdale A, Short M, et al. An investigation of sleep patterns in adolescents with high-functioning autism spectrum disorder compared with typically developing adolescents. Dev Neurorehabil 2013; 16: 155-65.
20. Goldman SE, Richdale AL, Clemons T, et al. Parental sleep concerns in autism spectrum disorders: variations from childhood to adolescence. J Autism Dev Disord 2012; 42: 531-8.
21. Hodge D, Carollo TM, Lewin M, et al. Sleep patterns in children with and without autism spectrum disorders: developmental comparisons. Res Dev Disabil 2014; 35: 1631-8.
22. Cortesi F, Giannotti F, Ivanenko A, et al. Sleep in children with autistic spectrum disorder. Sleep Med 2010; 11: 659-64.
23. Taylor MA, Schreck KA, Mulick JA. Sleep disruption as a correlate to cognitive and adaptive behavior problems in autism spectrum disorders. Res Dev Disabil 2012; 33: 1408-17.
24. Diomedi M, Curatolo P, Scalise A, et al. Sleep abnormalities in mentally retarded autistic subjects: Down's syndrome with mental retardation and normal subjects. Brain Dev 1999; 21: 548-53.
25. Christodulu KV, Durand VM. Reducing Bedtime Disturbance and Night Waking Using Positive Bedtime Routines and Sleep Restriction. Focus on Autism and Other Developmental Disabilities 2004; 19: 130-9.
26. Davis KF, Parker KP, Montgomery GL. Sleep in infants and young children: part two: common sleep problems. J Pediatr Health Care 2004; 18: 130-7.
27. Cortesi F, Giannotti F, Sebastiani T, et al. Controlled-release melatonin, singly and combined with cognitive behavioural therapy, for persistent insomnia in children with autism spectrum disorders: A randomized placebo-controlled trial. J Sleep Res 2012; 21: 700-9.
28. Grigg-Damberger M, Ralls F. Treatment strategies for complex behavioral insomnia in children with neurodevelopmental disorders. Curr Opin Pulm Med 2013; 19: 616-25.
29. Klusek J, Martin GE, Losh M. A comparison of pragmatic language in boys with autism and fragile X syndrome. J Speech Lang Hear Res 2014; 57: 1692-707.
30. Grange CN. A Literature Review: How Language Parameter Deficits Impact Social Interaction in Children with Autism Spectrum Disorders during Middle Childhood, and Intervention Strategies. McNair Scholars Research Journal 2012; 5: 63-77.
31. Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 2000; 23: 1043-51.
32. Wang G, Xu G, Liu Z, et al. Sleep patterns and sleep disturbances among Chinese school-aged children: prevalence and associated factors. Sleep Med 2013; 14: 45-52.
33. Fagnano M, Bayer AL, Isensee CA, et al. Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma. Acad Pediatr 2011; 11: 493-9.
34. Shoghy M, Khanjari S, Farmany F, et al. Sleep habits of school age children. Iran J Nurs 2005; 18: 131-8.
35. Winkelman JW. Overview of the treatment of insomnia in adults. Benca R, Eichler A, Editors. Waltham, MA, USA: UpToDate; 2023.
36. Soltani V. Development of Rehabilitation Plan to Enhance Comprehension of Abstract Concepts Using Embodied Conceptual Metaphors in 5- to 7-year-old Hearing Impaired Persian Speaking Children 2019.
37. Tudor ME, Hoffman CD, Sweeney DP. Children with autism: sleep problems and symptom severity. Focus Autism Other Dev Disabil 2012; 27: 254-62.
38. Khazaei T, Portaghali P, Jamali O, et al. Sleep pattern and common sleep problems in primary school students in Birjand. Modern Care, Scientific Quarterly of Birjand Nursing and Midwifery Faculty 2012; 9: 257-63. [In Persian].
39. Adams HL, Matson JL, Cervantes PE, et al. RETRACTED: The relationship between autism symptom severity and sleep problems: Should bidirectionality be considered? Res Autism Spectr Disord 2014; 8: 193-9.
40. Van Litsenburg RR, Waumans RC, Van Den Berg G, et al. Sleep habits and sleep disturbances in Dutch children: a population-based study. Eur J Pediatr 2010; 169: 1009-15.
41. Verma D, Chakraborti B, Karmakar A, et al. Sexual dimorphic effect in the genetic association of monoamine oxidase A (MAOA) markers with autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 50: 11-20.
42. Deuschle M, Schredl M, Schilling C, et al. Association between a serotonin transporter length polymorphism and primary insomnia. Sleep 2010; 33: 343-7.
43. De Faria Poloni J, Feltes BC, Bonatto D. Melatonin as a central molecule connecting neural development and calcium signaling. Funct Integr Genomics 2011; 11: 383-8.
44. Mayes SD, Calhoun S, Bixler EO, et al. Sleep Problems in Children with Autism, ADHD, Anxiety, Depression, Acquired Brain Injury, and Typical Development. Sleep Med Clin 2009; 4: 19-25.
45. Hollway JA, Aman MG, Butter E. Correlates and risk markers for sleep disturbance in participants of the Autism Treatment Network. J Autism Dev Disord 2013; 43: 2830-43.
46. Norbury CF. The relationship between theory of mind and metaphor: Evidence from children with language impairment and autistic spectrum disorder. Br J Dev Psychol 2005; 23: 383-99.
47. Botting N, Baraka N. Sleep behaviour relates to language skills in children with and without communication disorders. Int J Dev Disabil 2017; 64: 238-43.
| Files | ||
| Issue | Vol 8 No 3-4 (2023): Summer-Autumn | |
| Section | Original Article(s) | |
| Keywords | ||
| Autism; Sleep disorders; Metaphor; Children | ||
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How to Cite
1.
Madanifard M, Bahrami-Khorshid S, Ameri H, Akbari Chermahini S. Investigating the Effect of Enhancing Understanding of Embodied Metaphors on Sleep Status in Children with Autism and Sleep Problems. J Sleep Sci. 2026;8(3-4):72-81.
