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In addition to the core symptoms that define autism spectrum disorder (ASD), many individuals experience broader problem behavior at a level significant enough for families to seek further clinical assessment and intervention. We define “problem behavior” as any significant emotional or behavioral issue captured by the Child Behavior Checklist (CBCL) including anxiety, depression, withdrawal, somatic complaints, problems with socialization, thought or attention, rule-breaking, and aggression. While greater ASD symptom severity and accompanying sleep disturbance have each been linked with more severe problem behavior, there is little understanding about how these two key factors interact; that is, it is unclear whether the severity and type of sleep disturbance an individual experiences differentially influences the relationship between ASD symptom severity and problem behavior. The aim of the current study was, thus, to explore whether the link between greater ASD symptom severity and clinically elevated problem behavior is moderated by the presence/degree of accompanying sleep disturbance. Forty males with ASD, aged 5–12, participated in the study. The Social Responsiveness Scale, CBCL, and Children’s Sleep Habits Questionnaire were administered to obtain information about ASD symptom severity, problem behavior, and sleep habits, respectively. Results indicated that the relationship between ASD symptom severity and problem behavior differed among individuals with ASD depending on the degree of sleep disturbance they experienced. Specifically, there was a significant positive relationship between ASD symptom severity and problem behavior for individuals with no sleep disturbance or milder sleep disturbance (i.e., in these cases, individuals with severe ASD symptoms experienced clinically elevated problem behavior, while those with milder ASD symptoms experienced milder problem behavior). In contrast, there was no significant relationship between ASD symptom severity and problem behavior for individuals with moderate-to-severe sleep disturbance; rather, clinically significant problem behavior was apparent across all individuals irrespective of ASD symptom severity. Follow-up analyses indicated that disturbances in sleep duration, disordered breathing, and daytime sleepiness were related to clinically elevated problem behavior even among those with milder ASD symptoms. These findings emphasize the importance of routinely assessing for accompanying sleep disturbance in this population regardless of whether individuals present with mild, moderate, or severe ASD.

The current study aimed to qualitatively explore parent and clinician perspectives on the factors influencing participation in a community-based Australian-Rules Football program for five to 12-year-old children with cerebral palsy (CP) in a regional setting. Six allied-health clinicians and two parents of children with CP participated in focus groups exploring factors influencing participation. Thematic analysis indicated seven key factors influencing participation-of which, six were environmental factors and one was related to child characteristics. Environmental factors included resources, communication, knowledge and previous experience, attitudes and expectations, game factors and community relevance. Child characteristics included age, preferences, confidence, as well and cognitive and physical functioning. Notwithstanding limitations, the current study highlights the central role of 'people factors' in the child's environment, in facilitating participation in community-based physical activity.

In a mixed-methods design, the current study aimed to evaluate the acceptability of a junior Australian rules football program across two 'AllPlay Pre-Learn' days for children aged 5-11 years with disabilities, based on parent and child responses. Three online surveys were created by health professionals based on existing participation models. Surveys were completed by parents immediately before (n = 23), after the 'Pre-Learn' days (n = 15) and following the conclusion of the community version of the program (n = 13). Quantitative findings indicated significant improvements in child ratings around enjoyment of the sport. Qualitative analyses generated three themes around enjoyment in a low-stress environment; the education provided around the sport for parents/children; and, contemplation about playing the football program within their community. Four families (22% of the original attendees) went on to play the sport within a community setting. Despite acknowledged limitations, this study demonstrates preliminary evidence in support of an 'AllPlay Pre-Learn' day as a stepping stone to facilitate later participation in a football program within a child's community. Increased participation would allow children to experience the benefits associated with sport participation, such as motor and social skill development.

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