THE RELATIONSHIP BETWEEN SELECTIVE EATING AND SLEEP DISTURBANCE IN CHILDREN WITH AUTISM SPECTRUM DISORDER

Selective eating and sleep disturbance frequently co-occur in children with autism spectrum disorder (ASD), yet whether gastrointestinal (GI) symptoms link them has rarely been examined in Indonesia. This study aimed to analyze the association between selective eating and sleep disturbance and to test the mediating role of GI symptoms in children with ASD aged 6–12 years. This cross-sectional study included 66 children from five special schools in Bandung through total sampling. Parents completed the Brief Autism Mealtime Behavior Inventory (BAMBI), the Gastrointestinal Symptom Rating Scale Parent Report (GSRS-PR), and an adapted 22-item Children’s Sleep Habits Questionnaire (CSHQ). Analyses used Spearman correlation and PROCESS Model 4 (5000 bootstraps) adjusted for age and sex. Bivariately, selective eating correlated positively with sleep disturbance (rs=0.477; p<0.001). After adjustment for age, sex, and GI symptoms, the direct effect remained significant (B=0.331; p=0.003). The indirect effect through GI symptoms was 0.0122 (95% bootstrap CI −0.0192 to 0.0524), so mediation was not supported. Selective eating was associated with sleep disturbance independently of GI symptoms. This null mediation does not exclude a role for GI symptoms, and the cross-sectional design supports statistical association only, not causality. Nurses should assess eating, sleep, and GI symptoms together.