Pediatric Autism Insomnia Rating Scale (PAIRS)

Application

Brief parent rating scale for researchers and clinicians to evaluate insomnia severity in children with autism spectrum disorder (ASD) age 3 to 12 years.

Key Benefits

• Concise 21-question rating scale for caregivers of children with ASD.
• Internally consistent and reliable across severity levels.
• Highly correlated with existing tests.
• Usable for research and clinical trial inclusion.

Market Summary

3.2% of children in the United States have autism spectrum disorder (ASD). 40-80% of children with ASD have persistent problems with insomnia compared to 20% of children in the general pediatric population. Existing pediatric insomnia assessment tools used in general pediatrics include the Children’s Sleep Habits Questionnaire (CSHQ), Pediatric Insomnia Severity Index (PISI), actigraphy-based sleep assessment, and non-standardized sleep diaries. These approaches may not be suitable for children with autism spectrum disorder.

Technical Summary

Emory researchers led a multisite effort to develop and test the PAIRS. Investigators sampled 1100+ caregivers of children with ASD age 3 to 12 years. Using contemporary statistical methods to the survey data, investigators demonstrated the reliability and validity of the 21-item PAIRS for assessing insomnia severity in children with ASD. The PAIRS showed a wide range of insomnia symptom scores from little or no insomnia to severe. It also showed high correlation with existing scales, and insensitivity to random fluctuation. This research tool can be used for screening in clinical settings and as an outcome measure in clinical trial inclusion, and standardized insomnia measurement in research.

Development Stage

This research tool has been developed, tested, and published after peer review.

Publication

• Scahill, L., Lecavalier, L., Edwards, M.C., Wenzell, M.L., Barto, L., Mulligan, A., Williams, A.T., Ousley, O., Sinha, C.B., Taylor, C.A., Kim, S.Y., Johnson, L.M., Gillespie, S.E., Johnson, C.R. (2024). Toward better outcome measurement for insomnia in children with autism spectrum disorder. Autism, 28(12): 3131-3142
• Scahill, L., Johnson, C.R., Wenzell, M.L., Barto, L.M., Mulligan, A., Williams, A.T., Johnson, L.M., Gillespie, S.E., Lecavalier, L. (2025). Clinical and Demographic Correlates of Insomnia Symptoms in Children with Autism Spectrum Disorder, J Autism Dev Disorders, Online ahead of print.