Background: Sleep problems are common among children with autism spectrum disorder, and these problems are closely related to physical activity. This study aimed to investigate the prevalence of sleep problems and physical activity (PA) levels among children with autism spectrum disorder (ASD) and to analyze the correlation between these factors. Methods: A cross-sectional study was conducted involving 312 children with ASD (aged 2.5–12 years) recruited from the Children’s Hospital of Zhejiang University School of Medicine between January and December 2024. Their guardians or primary caregivers completed a general information questionnaire and the Children’s Sleep Habits Questionnaire (CSHQ). Results: More than 40% of the school-aged children (4–12 years) engaged in moderate-to-vigorous physical activity (MVPA) for less than one hour per day. Significant differences in bedtime habits were observed across different daily exercise durations (F=3.898, P=0.02). Furthermore, the average daily exercise duration was positively correlated with bedtime habits (r=0.144, P<0.05). Conversely, the average daily moderate-intensity exercise duration was negatively correlated with both daytime sleepiness (r=−0.156, P<0.001) and the total CSHQ score (r=−0.114, P<0.05). Conclusions: Sleep problems are highly prevalent and assessment of PA levels are generally low among children with ASD. A significant correlation exists between sleep problems and PA. Therefore, close attention to the PA status of children with ASD is essential for addressing sleep-related issues.

Background: Child Life Services (CLS) provide developmentally appropriate psychosocial support to reduce children’s fear, pain, and distress during medical care and to enhance family-centered pediatric care. Although CLS have been gradually introduced in China, their implementation remains uneven, and multi-institutional evidence on service models, staffing, organizational support, and barriers to development is limited. Objectives: This study aimed to describe the development and current status of CLS among participating medical institutions in China and to provide evidence to inform service management and policy planning. Methods: In December 2025, a cross-sectional survey was conducted using convenience sampling at 36 medical institutions participating in the CLS Collaborative Innovation Network, which is coordinated by the National Clinical Research Center for Children and Adolescents' Health and Diseases. Data were collected using a purpose-designed questionnaire covering organizational support, service content and formats, staffing patterns, perceived effects, barriers, and future development plans. Results: Among all participating institutions (n = 36), 19.4% had established systematic CLS programs, 63.9% had implemented non-systematic CLS, and 16.7% had not implemented CLS. Among institutions that had implemented any CLS (n = 30), services were mainly affiliated with nursing or pediatric departments; 83.3% employed fewer than 2 full-time staff members, and only 36.7% had a regular training system. Emotional support, disease education, and psychological preparation were the most commonly reported service components. More than 90% of respondents from institutions with CLS reported improvements in children’s pain, emotional status, and parental satisfaction. Conclusions: This study provides a multi-institutional overview of CLS development among participating institutions in China. CLS implementation remains variable across these institutions. Strengthening policy support, workforce development, and sustainable funding mechanisms is essential to facilitate the integration of CLS into routine pediatric care.