246 Copyright © American Occupational Therapy Foundation Sensory Processing, Physiological Stress, and Sleep Behaviors in Children With and Without Autism Spectrum Disorders Stacey Reynolds, Shelly J. Lane, Leroy Thacker key words: hypersensitivity, neuroendocrine, electrophysiology ABSTRACT Sleep problems have been frequently identified in children with autism spectrum disorders (ASD). It has been proposed that some sleep problems are due to sensory sensitivity. The purpose of this study was to examine the relationship between physiologic responses to sensation and sleep in children with and without ASD. Fifty-five children participated in the study (ASD, n = 27; typical, n = 28). All children participated in a sensory challenge laboratory protocol. Electrodermal reactivity and salivary cortisol were used as physiological indicators of sensory responsivity. Behavioral data were collected using the Sensory Profile and the Child Behavior Checklist. Results confirmed that children with ASD have a higher prevalence of atypical sensory behaviors and sleep disturbances than typical children. Behavioral and physiological measures were able to predict good sleepers versus poor sleepers with 85.7% accuracy, suggesting that atypical sensory behaviors are important to consider in relation to sleep deficits in children. Stacey Reynolds, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia, and Assistant Professor and K12 Scholar, Department of Occupational Therapy, School of Public Health and Health Professions, University of Florida, Gainesville, Florida. Shelly J. Lane, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, and Assistant Dean for Research, School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia. Leroy Thacker, PhD, is Assistant Professor, Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia. Originally submitted October 18, 2010. Accepted for publication March 14, 2011. Posted online May 20, 2011. The authors have no financial or proprietary interest in the materials presented herein. Address correspondence to Stacey Reynolds at reynoldsse3@vcu.edu. 10.3928/15394492-20110513-02 C hildren with autism spectrum disorders (ASD) are known to demonstrate both physi- ological and behavioral responses to sensory stimulation that are different from typically develop- ing peers (Ben-Sasson et al., 2009; Reynolds & Lane, 2008; Schoen, Miller, Brett-Green, & Nielsen, 2009). In addition, a high percentage of young children with ASD experience sleep disorders in the form of frequent night-wakening or difficulty getting to sleep (Krakowiak, Goodlin-Jones, Hertz-Picciotto, Croen, & Hansen, 2008). Although the interaction between sensory modulation and sleep has not been studied in children with ASD, sensitivity to sensory stimuli has been suggested as a contributing factor to sleep problems (Milner, Cuthbert, Kertesz, & Cote, 2009; Shani-Adir, Rozenman, Kessel, & Engel-Yeger, 2009). Both sleep and sensory modulation have been linked to overall arousal and release of the stress hormone cortisol (Dahl, 2007; Dahl & Lewin, 2002; Reynolds, Lane, & Gennings, 2010; Scher, Hall, Zaidman-Zait, & Weinberg, 2010; Schoen, Miller, Brett-Green & Nielsen, 2009). This study investi- gated the relationship between responses to sensory stimuli and sleep quality in children with ASD, and explored variables predictive of good sleepers ver- sus poor sleepers. We posited that higher levels of sensory sensitivity, higher physiological arousal, and higher nighttime levels of salivary cortisol