My academic work adopts both quantitative and qualitative approaches to understand how we can ameliorate the quality of life for individuals with neurodevelopmental disorders. In 2022, I was named a Top 40 under 40 researcher to watch by Spectrum News.
Sleep and Neurodevelopment
I have trained in sleep and child development for almost 8 years. My research interest in sleep began as a master's student at The Douglas Mental Health Institute where I investigated the link between sleep and daily functioning in typically developing children and youth with Attention Deficit Hyperactivity Disorder (ADHD). During my PhD at McGill University, and as a visiting doctoral fellow at The University of Montreal, I extended my work in sleep to focus on individuals with Autism Spectrum Disorder (Autism). You can read about my PhD work below.
Why did you study sleep and autism?Many individuals with neurodevelopmental disorders, like autism, have sleep problems. Some estimates suggest up to 80% of autistic youth may have sleep disturbances. Disturbances like troubles falling asleep and night awakenings are documented as early as infancy in autism and continue into adulthood. Despite sleep issues being one of the most common health complaints in neurodevelopment disorders, it is understudied. My PhD research focused on why these sleep problems frequently occur in individuals with neurodevelopmental disorders and how they impact their day-to-day functioning.
What projects did you work on?1) I turned to genetic approaches to investigate potential biological reasons for frequent sleep disturbances in autism. The genes we inherit from our parents carry instructions to produce different traits, like our eye colour. I study large genetic variations where individuals have one or more genes missing or multiple copies of the same gene— like removing or adding ingredients to a recipe. Sometimes the deletion or addition of genes has no detectable impact, other times it has serious health consequences. I've led a few projects to uncover genetic variations that impact both neurodevelopmental disorders (like autism) and sleep disturbances. 2) I led the first longitudinal study in the autism field investigating if sleep problems early in childhood would be linked to difficulties developing crucial cognitive skills during later school-age, like executive functioning. Executive functioning is a cognitive process that enables us to plan, focus our attention on multiple tasks and inhibit our behaviours. These cognitive skills are crucial for successful social development, yet executive functioning difficulties are documented in autistic youth and adults. My project demonstrated that autistic toddlers who had difficulties falling asleep and shorter sleep duration in early elementary school compared to their autistic peers had greater difficulties developing executive functioning in middle school(like regulating behaviour). My research suggests early sleep interventions could be one way to ameliorate executive functioning difficulties in autism.
Have you discussed your work with the media?I disseminate my work to the public as much as possible. I'm specifically interested in getting my research out to autistic individuals and families, hence always value the opportunity to work with community groups to translate my research. Below is some recent coverage of my research in various media outlets. For any media inquiries feel free to contact me here. Article 1: Autistic people at increased genetic risk of sleep problems Article 2: Autistic children’s sleep problems linked to behavioral regulation issues Interview with the Montreal Neurological Institute, 2021 The Autism Advocate Parenting Magazine recently created an infographic of our 2022 study published in Translational Psychiatry. To read the full article you can download a PDF or subscribe.
Do you have any future work you are excited about?Although I have finished my PhD and will slowly be exiting the sleep world, I have a few projects that i'm excited to wrap up soon: Insomnia Book Chapter: I wrote my first book chapter about the history of insomnia and genetics with Dr. Philip Gehrman from the University of Pennsylvania. This chapter is part of a commissioned book series summarizing the landscape of genetic discoveries related to sleep in human and animal models. The book is currently in press and will be available to download shortly. Article on the interplay between sleep, cognition and CNVs in the General Population: The final chapter of my PhD is my largest study yet. Using data from the UKBiobank, I was able to analyze how large genetic variations (CNVs) were related to physiological and self-reported sleep in over +500,000 adults in the general population. I was also able to detect if sleep problems exacerbated cognitive functioning difficulties that were related to known genetic risk scores. This work is currently under journal review and my preliminary findings were presented at the 2022 World Sleep Conference in Rome. Multidimensional sleep profiles project: There are many cognitive, health, behavioural and lifestyle factors that are related to sleep problems. But how can we determine which group of factors are most related to each other and specific sleep disturbances? This is a major gap in sleep research. I am super excited to be working on a team led by scientists Dr. Aurore Perrault and Dr. Valeria Kebets, who are using machine-learning approaches to detect how hundreds of factors and multiple sleep problems relate to one another. Using these data-driven methods we can uncover distinct profiles of people who are less or more at risk for developing various sleep issues and how their brain functions may differ. In the future, we hope this multidimensional approach can enable us to detect individuals at risk for sleep problems more quickly and prescribe tailored treatment. Preliminary research from this project was presented by Dr. Aurore Perrault at the 2022 Organization for Human Brain Mapping Conference and the European Sleep Research Society conference.
Research involving autistic youth has not often focused on their lived experiences, especially, youth who are minimally verbal and/or have cognitive challenges. Moreover, many autistic youth are not directly involved in their own transition planning between school to adulthood. Regardless of ability, all youth have the right to be involved in decisions that impact them (United Nations Convention on the Rights of the Child, 1989). Moreover, these youth are valuable experts who can provide guidance on academic research and protocols. Their input can also inform the delivery of health services and current policies concerning them. Hence, they're valuable stakeholders that should be engaged throughout the research lifespan.
In parallel to my PhD work, I was invited to co-lead a project that would create a new approach to interviewing and collaborating with autistic youth, so their lived experiences could be captured regardless of their language and cognitive abilities. To read more about the project entitled Autism Voices, see below.
A video explainer of the Autism Voices project was created by the Spectrum News Team, which I consulted on. The accompanying article can also be found here.
The Autism Voices project captures the lived experiences of autistic youth aged 11-18 with various language and cognitive abilities. The main goals were to create new methods that enabled youth to communicate their lived experiences and to use these methods to interview autistic youth about their perspectives on their future and different environments (e.g., home, school and community). The project included an interdisciplinary team of clinicians, autism researchers, ethicists, families and autistic youth.
The Autism Voices project had three phases. The first phase involved a scoping review and parent focus group to understand what potential methods could be used with autistic youth in interviews. The second phase piloted an interview protocol using various method modalities (e.g., oral and non-oral communication techniques). The third phase integrated feedback from experts, including autistic youth, parents and clinicians. The final protocol was then used to interview 30 autistic youth participants from the largest and longest running longitudinal autism study in Canada—Pathways in Autism Spectrum Disorder.
Sur le spectre, 2022
Published Peer-Review Articles
1. Tesfaye, R., Huguet, G., Smiliovich, Z., Loum, M. A., Douard,E., Jean-Louis, M., ... Elsabbagh, M & Jacquemont, S. (2022). Investigating the contributions of circadian pathway and insomnia risk genes to autism and sleep disturbances. Translational psychiatry, 12(1), 1-10.
3. Courchesne, V., Tesfaye, R., Mirenda, P., Nicholas, D., Mitchell, W., Singh, I., ... & Elsabbagh, M. (2022). Autism voices: A novel method to access first-person perspective of autistic youth. Autism, 26(5), 1123-1136.
4. Tesfaye, R., Wright, N., Zaidman-Zait, A., Bedford, R., Zwaigenbaum, L., Kerns, C. M., ... & Elsabbagh,M. (2021). Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism. Sleep, 44(9), zsab122.
7. Tesfaye, R., Courchesne, V., Yusuf, A., Savion-Lemieux, T., Singh, I., Shikako-Thomas, K., ... & Elsabbagh, M (2019).Assuming ability of youth with autism: Synthesis of methods capturing the first-person perspectives of children and youth with disabilities. Autism, 1362361319831487.
In Press or Under Review
9. Tesfaye, R & Gehrman, P. (2023). Genetics of Sleep and Sleep Disorders. In P.German, A. Keene, & Grant, S (Eds.). Human Sleep and Sleep disorders: Insomnia, (In Press).
10. Tesfaye, R., Huguet, G., ... Jacquemont, S. (2023). The interplay between sleep, cognition, and copy number variations in the general population. (Under journal review)