Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder

Res Dev Disabil. 2017 Jun;65:127-139. doi: 10.1016/j.ridd.2017.04.012. Epub 2017 May 14.


Background and objective: Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD.

Methods: The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n=30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n=24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment.

Results: After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment.

Conclusions: Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.

Keywords: Adenotonsillectomy; Autism spectrum disorder; Behavior; Child Behavior Checklist; Pediatric obstructive sleep apnea.

MeSH terms

  • Adenoidectomy / methods*
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / physiopathology
  • Autism Spectrum Disorder* / psychology
  • Behavior Observation Techniques / methods
  • Case-Control Studies
  • Child
  • Child Behavior / physiology
  • Child Behavior / psychology
  • Child, Preschool
  • Cognition / physiology*
  • Female
  • Humans
  • Japan
  • Male
  • Polysomnography / methods
  • Postoperative Period
  • Problem Behavior*
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / psychology
  • Sleep Apnea, Obstructive* / surgery
  • Tonsillectomy / methods*
  • Treatment Outcome