Journal of autism and developmental disorders · 2026
Problematic Screen Exposure and Sleep Disturbances in Children With Autism Spectrum Disorder: The Mediating Role of Sensory Processing.
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Altun Varmis Dilek, Bozduman Çelebi Seda
Аннотация
INTRODUCTION: Sensory processing abnormalities are core features of Autism Spectrum Disorder (ASD) and may contribute to sleep problems. This study tested whether sensory processing mediates the between problematic screen exposure (PSE) and sleep disturbances in children with ASD.
METHODS: This cross-sectional study included 108 children (6-12 years old) diagnosed with ASD according to the DSM-5. Autism severity was measured using the Childhood Autism Rating Scale (CARS). The caregivers completed the Dunn Sensory Profile, Children's Sleep Habits Questionnaire (CSHQ), Seven-in-Seven Screen Exposure Questionnaire, Autism Behavior Checklist (ABC) and Aberrant Behavior Checklist (AbBC). Group comparisons, and mediation models were also used.
RESULTS: Children with PSE scored significantly higher on the AbBC and ABC scales and experienced more severe sleep disturbances than those without PSE. No differences emerged as regards autism severity in the non-problematic PSE and PSE groups. Significant sensory deficits were observed in the visual, vestibular, and tactile domains (p < 0.001). Mediation analysis accounted for the total indirect effects through visual (β = -0.067, p = 0.022) and multisensory (β = -0.055, p = 0.016), although the direct effect of the screen exposure on sleep disturbance was not significant.
CONCLUSION: PSE is associated with sleep disturbances in children with ASD, with this association appearing to be statistically mediated by sensory processing dysregulation. These results highlight sensory regulatory mechanisms as a key pathway linking PSE to sleep difficulties and imply that both screen exposure patterns and sensory modulation may be appropriate targets for clinical consideration.
METHODS: This cross-sectional study included 108 children (6-12 years old) diagnosed with ASD according to the DSM-5. Autism severity was measured using the Childhood Autism Rating Scale (CARS). The caregivers completed the Dunn Sensory Profile, Children's Sleep Habits Questionnaire (CSHQ), Seven-in-Seven Screen Exposure Questionnaire, Autism Behavior Checklist (ABC) and Aberrant Behavior Checklist (AbBC). Group comparisons, and mediation models were also used.
RESULTS: Children with PSE scored significantly higher on the AbBC and ABC scales and experienced more severe sleep disturbances than those without PSE. No differences emerged as regards autism severity in the non-problematic PSE and PSE groups. Significant sensory deficits were observed in the visual, vestibular, and tactile domains (p < 0.001). Mediation analysis accounted for the total indirect effects through visual (β = -0.067, p = 0.022) and multisensory (β = -0.055, p = 0.016), although the direct effect of the screen exposure on sleep disturbance was not significant.
CONCLUSION: PSE is associated with sleep disturbances in children with ASD, with this association appearing to be statistically mediated by sensory processing dysregulation. These results highlight sensory regulatory mechanisms as a key pathway linking PSE to sleep difficulties and imply that both screen exposure patterns and sensory modulation may be appropriate targets for clinical consideration.