Impact of sleep on attention in primary school-aged autistic children: Exploratory cross-cultural comparison between Singapore and UK children

There is a growing body of research studying the impact sleep has on attention among typically developing (TD) children, but research is lacking among autistic children. The present study aimed to explore, for the first time, differences in (1) attention, (2) sleep parameters among primary school-aged Singaporean autistic children (N = 26) and Singaporean TD children (N = 20), and with UK autistic (N = 11) and UK TD children (N = 16), and (3) the impact of sleep on attention. Actigraphy was used to objectively assess sleep, and a Continuous Performance Task was used to measure attentional domains. There were inconclusive findings indicating that autistic children had poorer sustained attention than TD children. Although autistic children did not display more sleep difficulties than TD children, they showed shorter actual sleep duration (Singapore ASD = 7:00 h, UK ASD = 7:35 h, p < .01) and longer sleep latency (Singapore ASD = 30:15 min, UK ASD = 60:00 min, p < .01) than clinical recommendations. Sleep difficulties were also present among Singaporean and UK TD children. Both TD groups had less actual sleep duration than recommended (Singapore TD = 6:32 h, UK TD = 8:07 h). Singaporean TD children had sleep efficiency below recommended criterion (78.15%). Sleep impacted attention across all groups, but effects were different for autistic and TD groups. The study highlighted the importance for practitioners and carers to adopt a child-centred approach to assessing sleep and attentional difficulties, especially among autistic children due to the high variability in performance within the group. The impact of cultural and school-setting differences on sleep was also raised. •Autistic children presented variability in sustained attention performance.•Longer sleep latency and lower sleep efficiency were present among Singaporean and UK autistic children.•Singaporean and UK TD children had short sleep duration. Singaporean TD children also showed poor sleep efficiency.•Sleep impacts attention differently across autistic and TD groups, and across culture.