Atypical behaviors in children with autism and children with a history of language impairment

https://doi.org/10.1016/j.ridd.2006.02.003Get rights and content

Abstract

The frequency, course, and inter-relationships of atypical eating, sleeping, self-injurious behavior, aggression and temper tantrums in children with autism and children with a history of language impairment (HLI), was investigated using a parent interview that was created to examine these problem behaviors. The relationships between these behaviors and language, IQ, severity of autistic symptoms and depression were also assessed. Atypical eating behavior, abnormal sleep patterns, temper tantrums, and self-injurious behavior were significantly more common in the children with autism than those with HLI. Within the autism group, children who exhibited more atypical behaviors tended to have a lower nonverbal IQ, lower levels of expressive language, more severe social deficits and more repetitive behaviors. No relationship between the number of atypical behaviors and measures of cognitive or language ability was noted in the HLI group. However, having more atypical behaviors was related to increased restricted, repetitive behaviors in children with HLI. The atypical behaviors could be divided into two groups: abnormal eating and sleeping, which were independent and tended to begin early in life; and self-injury, tantrums and aggression, which began later and were inter-related. Sleep abnormalities were more common in children (groups combined) diagnosed with major depression.

Section snippets

Atypical eating behavior

Atypical eating behavior occurs so frequently in children with autism (Raiten & Massaro, 1986) that at one time it was included among the diagnostic indicators (Ritvo & Freeman, 1978). The most common feeding problem is excessive food selectivity, by type and texture (Ahearn, Castine, Nault, & Green, 2001; Field, Garland, & Williams, 2003; Williams, Dalrymple, & Neal, 2000). Other abnormalities are rituals surrounding eating and food refusal (Field et al., 2003, Schreck et al., 2004; Williams

Abnormal sleep patterns

Sleep problems are more common in children with developmental disabilities than in typically developing children (Richdale, Francis, Gavidia-Payne, & Cotton, 2000). Among developmentally disabled children, sleep problems tend to be more common in younger children and are associated with self-injury, aggression, screaming, tantrums, noncompliance, and impulsivity (Clements, Wing, & Dunn, 1986; Wiggs & Stores, 1996). It is unknown whether these associations occur in children with autism as well.

Self-injurious behavior

Self-injurious behavior has been studied extensively in children with mental retardation, but less research has been conducted on children with autism (Oswald, Ellis, Singh, Singh, & Matson, 1994). McClintock, Hall, and Oliver (2003) found that self-injurious behavior was related to both receptive and expressive communication in a meta-analysis of studies on challenging behaviors in individuals with intellectual disabilities. Among people with mental retardation, autistic features may be

Aggression

In children with mental retardation, aggression is related to gender, age and expressive communication (Ando & Yoshimura, 1978; McClintock et al., 2003). There are numerous anecdotal reports of violence and aggression in people with autism spectrum disorders, particularly Asperger's syndrome, but little systematic research concerning its frequency and character has been published (Baron-Cohen, 1988, Kohn et al., 1998; Mawson, Grounds, & Tantam, 1985). The limited studies suggest that among

Temper tantrums

Research on typically developing children has shown that temper tantrums are most common in young children and decrease in frequency with age (Bhatia et al., 1990; for review, see Leung & Fagan, 1991). Few studies have addressed temper tantrums specifically among children with autism, as most of the research on problem behaviors in individuals with autism or mental retardation has focused on aggression and destruction of property (e.g., Applegate, Matson, & Cherry, 1999; Dawson, Matson, &

Participants

Participants in this study included 107 children: 39 children with a history of HLI and 67 children with autism spectrum disorder (ASD). All the children were recruited and tested at the Boston CPEA site, as part of a larger program project. Children in both groups ranged in age from 4 years 2 months to 14 years 2 months.

Prevalence of atypical behaviors

Table 4 presents the frequency of each atypical behavior among the ASD and HLI children. All of the atypical behaviors examined in this study occurred more frequently in children with ASD than in children with HLI. The difference in frequency was significant for atypical eating behavior (χ2 = 32.3, p < 0.001), abnormal sleep patterns (χ2 = 4.9, p = 0.03), temper tantrums (χ2 = 19.5, p < 0.001) and self-injurious behavior (χ2 = 6.4, p = 0.01). The groups were not significantly different in the frequency of

Discussion

In this study, we asked parents of children who had either autism or a history of HLI about five abnormal behaviors that are common among children with autism. Four of the five behaviors (i.e., atypical eating behavior, abnormal sleep patterns, temper tantrums, and self-injurious behavior) were significantly more common in the children with autism than those with HLI. Rates of aggression were increased in the ASD children, but group differences did not reach significance. It is possible that

Acknowledgements

This research was supported by grants from and the National Institute on Deafness and Other Communication Disorder (U19 DC 03610, Boston University School of Medicine; PO1 HD35476, University of Utah) which are part of the NICHD/NIDCD Collaborative Programs of Excellence in Autism, as well as by the National Institute of Neurological Disorders and Stroke (F30 NS048615). We are grateful to Robert Joseph, Susan Bacalman, Gail Andrick, Anne Lantz Gavin, Shelly Steele, Laura Becker, Margaret

References (54)

  • H. Ando et al.

    Prevalence of maladaptive behavior in retarded children as a function of IQ and age

    Journal of Abnormal Child Psychology

    (1978)
  • H. Ando et al.

    Effects of age on communication skill levels and prevalence of maladaptive behaviors in autistic and mentally retarded children

    Journal of Autism and Developmental Disorders

    (1979)
  • H. Ando et al.

    Speech skill levels and prevalence of maladaptive behaviors in autistic and mentally retarded children: A statistical study

    Child Psychiatry and Human Development

    (1979)
  • A. Baghdadli et al.

    Risk factors for self-injurious behaviours among 222 young children with autistic disorders

    Journal of Intellectual Disability Research

    (2003)
  • S. Baron-Cohen

    An assessment of violence in a young man with asperger's syndrome

    Journal of Child Psychology and Psychiatry and Allied Disciplines

    (1988)
  • L. Bartak et al.

    Differences between mentally retarded and normally intelligent autistic children

    Journal of Autism and Childhood Schizophrenia

    (1976)
  • M.S. Bhatia et al.

    Temper tantrums. Prevalence and etiology in a non-referral outpatient setting

    Clinical Pediatrics (Phila)

    (1990)
  • J.W. Bodfish et al.

    Varieties of repetitive behavior in autism: Comparisons to mental retardation

    Journal of Autism and Developmental Disorders

    (2000)
  • J. Clements et al.

    Sleep problems in handicapped children: A preliminary study

    Journal of Child Psychology and Psychiatry and Allied Disciplines

    (1986)
  • R.A. Collacott et al.

    Epidemiology of self-injurious behaviour in adults with learning disabilities

    British Journal of Psychiatry

    (1998)
  • E. Courchesne et al.

    Evidence of brain overgrowth in the first year of life in autism

    Journal of the American Medical Association

    (2003)
  • L.M. Dunn et al.

    Peabody picture vocabulary test—third edition (PPVT-III)

    (1997)
  • C.D. Elliot

    Differential ability scales

    (1990)
  • D. Field et al.

    Correlates of specific childhood feeding problems

    Journal of Pediatrics and Child Health

    (2003)
  • M. Ghaziuddin et al.

    Brief report: Violence in Asperger syndrome, a critique

    Journal of Autism and Developmental Disorders

    (1991)
  • E. Hering et al.

    Sleep patterns in autistic children

    Journal of Autism and Developmental Disorders

    (1999)
  • R.D. Honomichl et al.

    Sleep patterns of children with pervasive developmental disorders

    Journal of Autism and Developmental Disorders

    (2002)
  • Cited by (308)

    View all citing articles on Scopus
    View full text