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However, both contribute independently to sleep problems. Children with fetal alcohol spectrum disorder (FASD) have PAE and significant sleep disturbances. What is not clear is the relative contribution to these disturbances of exposure to early life adversity. This study examined how exposure to such adversity impacts frequent insomnia symptoms and nightmares in children with FASD and \u201cAt Risk\u201d designations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared two approaches to modeling adversity in children who had undergone a diagnostic assessment for FASD: a cumulative risk approach that sums adversities to create a total score and an approach that treats exposure to threat and deprivation as independent dimensions. Data on caregiver\u2010reported exposure to adversity and sleep problems for 63 children (aged 3\u2009years 4\u2009months to 7\u2009years 8\u2009months) were extracted from clinical archives. Cumulative risk, threat exposure, and deprivation exposure scores were computed and were tested as predictors of insomnia symptoms and nightmares. All analyses controlled for age and gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were high rates of caregiver\u2010reported sleep problems with 60.3% (<jats:italic>n<\/jats:italic>\u2009=\u200938) of children having nightmares and 44.4% (<jats:italic>n<\/jats:italic>\u2009=\u200928) having a frequent insomnia symptom. The cumulative risk analysis showed that for every additional exposure to adversity, the odds of having a caregiver\u2010reported insomnia symptom increased by 38%. The dimensional analysis showed no relationship between deprivation and sleep problems. However, every additional exposure to threat increased the odds of nightmares by 93%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exposure to postnatal adversity contributes to sleep disturbances in children with FASD, with unique roles for cumulative risk and the threat dimension of adversity. The implications of these findings for the etiology and treatment of sleep disturbances in children with FASD are discussed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15152","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T01:04:05Z","timestamp":1689296645000},"page":"1702-1712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Understanding the impacts of childhood adversity on sleep problems in children with fetal alcohol spectrum disorder: A comparison of cumulative and dimensional approaches"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2052-3456","authenticated-orcid":false,"given":"Ned","family":"Chandler\u2010Mather","sequence":"first","affiliation":[{"name":"School of Applied Psychology Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Betts","sequence":"additional","affiliation":[{"name":"School of Applied Psychology Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Donovan","sequence":"additional","affiliation":[{"name":"School of Applied Psychology Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Shelton","sequence":"additional","affiliation":[{"name":"Community Child Health Gold Coast Hospital and Health Service  Southport Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Dawe","sequence":"additional","affiliation":[{"name":"School of Applied Psychology Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Manual for the ASEBA school\u2010age forms and profiles","author":"Achenbach T.M.","year":"2001"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2020.105316"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.08.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583\u2010200001000\u201000016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_7_1","volume-title":"Census of population and housing: socio\u2010economic indexes for areas (SEIFA), Australia","author":"Australian Bureau of Statistics","year":"2016"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs9100108"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.09.008"},{"key":"e_1_2_8_10_1","first-page":"158","article-title":"Investigating the convergence between actigraphy, maternal sleep diaries, and the child behavior checklist as measures of sleep in toddlers","volume":"5","author":"B\u00e9langer M.\u2010\u00c8.","year":"2014","journal-title":"Frontiers in Psychiatry"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579421001826"},{"key":"e_1_2_8_12_1","unstructured":"Bower C.&Elliott E.(2016)Australian guide to the diagnosis of fetal alcohol spectrum disorder (FASD). 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