Toddler sleep behaviour questionnaire - Validation and utilisation

… of Developmental & …, 2008

Current Problems in Pediatric and Adolescent Health Care, 2017

Sleep problems are common, reported by a quarter of parents with children under the age of 5 years, and have been associated with poor behavior, worse school performance, and obesity, in addition to negative secondary effects on maternal and family well-being. Yet, it has been shown that pediatricians do not adequately address sleep in routine wellchild visits, and underdiagnose sleep issues. Pediatricians receive little formal training in medical school or in residency regarding sleep medicine. An understanding of the physiology of sleep is critical to a pediatrician's ability to effectively and confidently counsel patients about sleep. The biological rhythm of sleep and waking is regulated through both circadian and homeostatic processes. Sleep also has an internal rhythmic organization, or sleep architecture, which includes sleep cycles of REM and NREM sleep. Arousal and sleep (REM and NREM) are active and complex neurophysiologic processes, involving both neural pathway activation and suppression. These physiologic processes change over the life course, especially in the first 5 years. Adequate sleep is often difficult to achieve, yet is considered very important to optimal daily function and behavior in children; thus, understanding optimal sleep duration and patterns is critical for pediatricians. There is little experimental evidence that guides sleep recommendations, rather normative data and expert recommendations. Effective counseling on child sleep must account for the child and parent factors (child temperament, parent-child interaction, and parental affect) and the environmental factors (cultural, geographic, and home environment, especially media exposure) that influence sleep. To promote health and to prevent and manage sleep problems, the American Academy of Pediatrics (AAP) recommends that parents start promoting good sleep hygiene, with a sleeppromoting environment and a bedtime routine in infancy, and throughout childhood. Thus, counseling families on sleep requires an understanding of sleep regulation, physiology, developmental patterns, optimal sleep duration recommendations, and the many factors that influence sleep and sleep hygiene.

Perceptual and Motor Skills, 1989

Summay.-A 22-item Likert-type rating scale for parents was developed for screening a broad range of specific sleep-related behaviors of elementary school children. The prevalence of these behaviors was reported by parents for boys (n = 459) and girls (n = 4 1 1) in three age groups, less than 8.5 yr., between 8.5 and 11.5 yr., and greater than 11.5 yr. For all agc groups, the most prevalent behaviors were restlessness, waking up at night, pleasant dreams, getting up to go to the bathroom, talking while asleep, and complaints about not being able to sleep, while the least frequent were rhythmical movements and crying while asleep. The self-reports suggest that many of the behaviors are underestimated in the literature. Some sex and age differences were found, but the number of siblings, birth order, change in family structure, and educational status of father and mother were unrelated to the sleep variables. Test-retest reliabilities of self-reports by these parents to individual items were adequate.

Sleep, 2000

To present psychometric data on a comprehensive, parent-report sleep screening instrument designed for school-aged children, the Children's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total score and eight subscale scores, reflecting key sleep domains that encompass the major medical and behavioral sleep disorders in this age group. Cross-sectional survey. Three elementary schools in New England, a pediatric sleep disorders clinic in a children's teaching hospital. Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disorders in a pediatric sleep clinic completed the CSHQ. N/A. The CSHQ showed adequate internal consistency for both the community sample (p=0.68) and the clinical sample (p=0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 (Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and from 0.56 (Parasomnias) to 0.93 (Sleep-Disorde...

Sleep

To present psychometric data on a comprehensive, parent-report sleep screening instrument designed for school-aged children, the Children's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total score and eight subscale scores, reflecting key sleep domains that encompass the major medical and behavioral sleep disorders in this age group. Design: Cross-sectional survey. Setting: Three elementary schools in New England, a pediatric sleep disorders clinic in a children's teaching hospital. Participants: Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disorders in a pediatric sleep clinic completed the CSHQ. Interventions: N/A Measurements and Results: The CSHQ showed adequate internal consistency for both the community sample ( =0.68) and the clinical sample ( =0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 (Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and from 0.56 (Parasomnias) to 0.93 (Sleep-Disordered Breathing) for the sleep clinic group. Test-retest reliability was acceptable (range 0.62 to 0.79). CSHQ individual items, as well as the subscale and total scores were able to consistently differentiate the community group from the sleep-disordered group, demonstrating validity. A cut-off total CSHQ score of 41 generated by analysis of the Receiver Operator Characteristic Curve (ROC) correctly yielded a sensitivity of 0.80 and specificity of 0.72. The CSHQ appears to be a useful sleep screening instrument to identify both behaviorally based and medicallybased sleep problems in school-aged children.

Sleep Medicine Reviews, 2011

An extensive list of published and unpublished instruments used to investigate or evaluate sleep issues in children was collected and assessed based on the fundamental operational principles of instrument development (11 steps). Of all the available tools identified, only a few were validated and standardized using appropriate psychometric criteria. In fact, only 2 fulfill all desirable criteria and approximately 11 instruments seem to adhere to most of the psychometric tool development requirements, and were therefore assessed in greater detail. Notwithstanding, in the rapidly developing scientific world of pediatric sleep, there are too many tools being used that have not undergone careful and methodical psychometric evaluation, and as such may be fraught with biased or invalid findings. It is hoped that this initial effort in categorizing and assessing available tools for pediatric sleep will serve as recognition of the relatively early developmental stage of our field, and provide the necessary impetus for future tool development using multicentered approaches and adequate methodologies.

Journal of the American Academy of Child & Adolescent Psychiatry, 2011

2005

Background Behavioural sleep problems in young children are relatively common with between 20% and 40% of those aged 1 to 5 years being affected. This paper describes the development of a simple questionnaire to assess disorders of initiating and maintaining sleep (DIMS) in children aged between 1 and 5 years for use as a selection tool for research purposes or as a screening instrument in primary care. Methods A subsection of the Sleep Disturbance Scale for Children was adapted and piloted with a small sample of children in two inner city GP practices ( n = 81). Face and content validity were initially established by expert review. Discriminant validity was assessed qualitatively using interviews with mothers of identified cases and non-cases. The validity of the cut-off score was assessed by blinded case note reviews off known cases; inter-rater reliability was also calculated. Following modifications, the final questionnaire was posted to a representative sample of parents across the region with children in the appropriate age band ( n = 1023). Internal reliability was assessed using Cronbach's alpha and factor analysis was undertaken to identify significant factors within the questionnaire. Results The response rate to the population questionnaire was 61.5% ( n = 628) with 218 of the children having sleep scores that were indicative of DIMS (35%), echoing other figures reported in the literature. There was good internal consistency for the items (Cronbach's alpha = 0.85) with two main factors accounting for 58% of the variance. Conclusion The Tayside Children's Sleep Questionnaire (TCSQ) is an easy-to-read and reliable tool that could be used both as a clinical and research instrument to assess the severity and prevalence of DIMS in young children.

Sleep Medicine Reviews, 2011

Questionnaires are a useful and extensively used tool in clinical sleep medicine and in sleep research. The number of sleep questionnaires targeting the pediatric age range has tremendously increased in recent years, and with such explosion in the number of instruments, their heterogeneity has become all the more apparent. Here, we explore the theoretical and pragmatic processes required for instrument design and development, i.e., how any questionnaire, inventory, log, or diary should be created and evaluated, and also provide illustrative examples to further underline the potential pitfalls that are inherently embedded in every step of tool development.

Sleep Medicine, 2019

Objective: To explore the correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in a sample of Australian toddlers. Methods: Participants were 173 toddlers (average age 19.7 ± 4.1 months) from the GET UP! Study. Nocturnal sleep duration, nocturnal sleep variability, nap(s) and physical activity were measured using 24-hour accelerometry (Actigraph GT3X+) over 7 consecutive days. Nocturnal sleep problems were assessed using the Tayside Children's Sleep Questionnaire. Screen time was reported by the parents. Logistic regression models were used to examine the associations between potential correlates (ie, age, sex, socio-economic status, weight status, physical activity, screen time, nap(s), bedtimes, and wake-up times) and nocturnal sleep characteristics. Results: Older children were more likely to have greater sleep variability (OR: 1.97; 95% CI: 1.08-3.61). Less physical activity (OR: 2.38; 95% CI: 1.27-4.45), shorter nap(s) (OR: 2.42, 95% CI: 1.29-4.55), and later wake-up times (OR: 4.42; 95% CI: 2.32-8.42) were associated with higher odds of having longer nocturnal sleep duration. Late bedtimes were associated with shorter nocturnal sleep duration (OR: 0.09; 95% CI: 0.04-0.18) and with greater nocturnal sleep variability (OR: 1.97; 95% CI: 1.06-3.68). None of the potential correlates were associated with nocturnal sleep problems. Conclusion: The present study identifies several correlates of nocturnal sleep duration (total physical activity, nap(s), bedtime, and wake-up time) and nocturnal sleep variability (age and bedtime), whereas no correlates were identified for M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 4 nocturnal sleep problems. The association between late bedtimes and shorter nocturnal sleep duration and greater nocturnal variability suggests that these may be modifiable targets for future sleep interventions in early childhood.