Dissertation Defense: The Pulse of a Child’s Day: Understanding Sleep, Physical Activity, Nutrition, and Fatigue in Children with Developmental Disabilities
Dissertation Defense: The Pulse of a Child’s Day: Understanding Sleep, Physical Activity, Nutrition, and Fatigue in Children with Developmental Disabilities
Kavya Iyer
Graduate Student, Translational Biology, Medicine, and Health
Graduate Research Assistant, DeLuca Lab, Fralin Biomedical Research Institute at VTC
April 21, 2026, at 2 p.m.
Virtual Only
About this Dissertation
The pediatric population that have been diagnosed with developmental disorders are more likely to be diagnosed with other diseases across the lifespan. These can include serious conditions such as heart disease and other cardiovascular complications, diabetes, or even asthma and other breathing complications. While a lot of these may be due to some challenges associated with the primary developmental disability diagnosis, the medical and research communities have been advocating for the importance of healthy lifestyle habits in childhood to potentially lower the chances of developing these other diseases. To promote longitudinal change in these populations, it is critical to understand everyday habits to promote health. Thus, the goals of this study were to elucidate three primary constructs that strongly influence long-term health: sleep, physical activity, and nutrition and its relationships with fatigue which is a motivating factor and a chronic symptom that many children with disabilities face. To understand these unique and complex relationships, we enrolled children who were diagnosed with Cerebral Palsy, who were typically developing and those diagnosed with Down Syndrome and their families. The study was designed to take 3 consecutive days. We had both the parents and children complete daily questionnaires separately about sleep, fatigue, and physical activity to gather different perspectives. We also had parents complete a diet log every day for their child. Every child also wore a child-friendly smartwatch throughout the study to amount of time spent in various nightly stages of sleep. Parents of children with disabilities did report an increased amount of daily fatigue or tiredness, while children weren’t quite able to recognize or internalize this variable. Children with developmental disabilities did also consume more ultraprocessed food and less protein than typically developing children. While there weren’t any distinct differences in impacts due to physical activity in this study, parents of children across diagnoses did suggest that as the amount of physical activity increased, their child’s fatigue decreased. Additionally, children with developmental disabilities had varying body composition that aligned with current standards of development for those conditions. Overall, this project supports the possibility of a multimodal and multi-perspective approach to collect detailed health information for families. It is critical to support healthy habits early in childhood. Understanding experiences is a key step towards building better, more personalized health strategies for the future.
More About the Candidate and Project
Education
Virginia Tech, Translational Biology, Medicine, and Health, Ph.D. Candidate
Roanoke College, B.S., Biochemistry
Training
Graduate Research Assistant, DeLuca Lab, Fralin Biomedical Research Institute at VTC
Mentor
Stephanie DeLuca, Ph.D., Associate Professor, Fralin Biomedical Research Institute at VTC; Co-Director Neuromotor Research Clinic
Committee Members
- Brittany Howell, Ph.D., Assistant Professor, Fralin Biomedical Research Institute at VTC
- Vydia Permashwar, MD, MBBS, Pediatrics, Carilion Clinic; Vice Chair & Associate Professor, Pediatrics, Virginia Tech Carilion School of Medicine
- Richard Stevenson, MD, Developmental-Behavioral Pediatrics, UVA Health
Publications
Iyer, K., Stevenson, R., Permashwar, V., Howell, B., & DeLuca, S. (manuscript in preparation for submission). Beyond Bedtime: Characterizing Sleep-Fatigue Dynamics in Children with Developmental Disabilities
Iyer, K., Stevenson, R., Permashwar, V., Howell, B., & DeLuca, S. (manuscript under review). The Work Behind the Play: Exploring Physical Activity Demands and Associated Fatigue in Children with Developmental Disabilities
Iyer, K., Stevenson, R., Permashwar, V., Howell, B., & DeLuca, S. (manuscript in preparation for submission). Measuring More than Meals: Understanding Dietary Intake, Growth Outcomes, and Fatigue in Children with Developmental Disabilities
Ngo, K., Permashwar, V., Iyer, K., Lewis, P., Sharkey, C., Zhang, M. (manuscript in preparation for submission). Assessing health needs of underserved pediatric patients: a cross-sectional study at a free clinic
Oral Presentations
Iyer, K., Permashwar, V., Thiagarajan, T., Miller, K. Say Cheese! Creating a Community-Focused Medical-to-Dental Integrated Pipeline Program to Improve Pediatric Oral Care. Oral Presentation Presented At: Virginia Public Health Association Annual Conference; 26 September 2025; Richmond, VA
Iyer, K. Understanding Relationships Between Nutrition, Sleep, Physical Activity Participation, and Perceptions of Fatigue for Children with Developmental Disabilities: Preliminary Results. Oral Presentation Presented At: Roanoke College CHeCPoint Seminar; 28 October 2025; Salem, VA
Iyer, K. Understanding Relationships between Nutritional Profiles, Sleep Characteristics, and Daily Perceptions of Fatigue for Children with Neuromotor Disabilities: A Prospective Study. Oral Presentation Presented At: 2024 Fralin Biomedical Research Institute Annual Retreat; 14 June 2024; Roanoke, VA
Iyer, K., DeLuca, S.C. Development of a Self-Report Questionnaire to Assess Physical Activity Preference and Participation amongst Youth with Neuromotor Impairments. Oral Presentation Presented At: 16th Annual Carilion Clinic Research Day; 4 April 2023; Roanoke, VA
Conference - Poster
Stolarchuk, C., Iyer, K., Altice, K., Thiagarajan, T., Zhang, M., Miller, K., Permashwar, V. Open Wide: Tackling the Tooth Troubles of Medically Underserved Families. Poster Presented at: 2025 Virginia Public Health Association Annual Conference; September 2025; Richmond, VA
Iyer, K., Stevenson, R., Howell, B.R., Permashwar, V., DeLuca, S.C. Assessing Variations in Nutrition, Sleep, and Fatigue Amongst Children with Neuromotor Disabilities: A Prospective Study. Poster Presented at: American Academy of Cerebral Palsy and Developmental Medicine 78th Annual Meeting; October 2024; Quebec City, Quebec, CA
Iyer, K., Lewis, P., Haymete, M., Ngo, K., Wu, N., Porras-Nielsen, G., Khatiwada, P., Permashwar, V. Investigating Accessibility of Language Interpretation Services for Underserved and Minoritized Refugee and Immigrant Families. Poster Presented At: American Academy of Pediatrics National Conference & Exhibition; September 2024; Orlando, FL
Edokobi, N., Lavallee, C., Iyer, K., Howell, B.R. Human Milk Growth Factors and Hippocampal Growth During Infancy. Poster Presented At: International Milk Genomics Consortium 2022; 2022 Oct 18-20; Davis, CA
- National Honor Society of Phi Kappa Phi | Virginia Tech | Spring 2026
- TBMH Hokie Pitch 2nd Place Award Winner | Virginia Tech Translational Biology, Medicine, and Health Program | Fall 2022
- Graduate Student Mentor | Our Future is Science | Fall 2025-Spring 2026
- Fralin Biomedical Research Institute Co- Presenter (DeLuca Lab) | Fralin Biomedical Research Institute | Spring 2025, Spring 2026
- Invited Graduate Student Panelist | Graduate and Medical Student Panel | Virginia Tech Minority Association of Pre-Health Students | Fall 2025
- Invited Graduate Student Panelist | Summer Undergraduate Research Fellowship Graduate Student Panel | Fralin Biomedical Research Institute | Summer 2025
- Invited Graduate Student Panelist | Navigating Research as an Undergraduate | Virginia Tech Carilion School of Medicine | Fall 2024
- Graduate Student Instructor | Virginia Summer Residential Governor’s School for Medicine & Health Sciences Program | Summer 2024
- TBMH Teaching Assistant | Virginia Tech Translational Biology, Medicine, and Health Program | Fall 2023-Spring 2024
- TBMH Hokie Pitch Graduate Student Mentor | Virginia Tech Translational Biology, Medicine, and Health Program | Fall 2023, Fall 2024
- Roanoke Graduate Student Association (RGSA) Executive Chair | Virginia Tech Health Sciences & Technology Campus | Fall 2023-Spring 2024
- Refugee and Immigrant Medical Association Co-President & Student Liaison | Virginia Tech Carilion School of Medicine | Fall 2023-Spring 2026
- Virginia Tech Graduate Honor System Panelist | Virginia Tech Graduate School | Fall 2023-Spring 2026
- Pediatrics Interest Group Student Liaison | Virginia Tech Carilion School of Medicine | Fall 2023-Spring 2026
- TBMH Student Mentor | Virginia Tech Translational Biology, Medicine, and Health Program | Fall 2023, Fall 2024, Fall 2025
- Clinic Volunteer | Bradley Free Clinic, Roanoke, VA | Spring 2023-Spring 2026
- Child Life Volunteer | Carilion Children’s Hospital, Roanoke, VA | Fall 2022-Spring 2025