Convergent Validity Between the Motor Domain of PediaTracTM and Ages and Stages in Term and Preterm Infants at 2, 4, 6, and 9 Months of Age.

The primary aim of this study was to evaluate the convergent validity of the Motor domain (MOT) of PediaTracTM v3.0, an online developmental tracking instrument based on caregiver reports, with fine and gross motor domains (ASQ-FM and ASQ-GM) of the Ages and Stages Questionnaire (ASQ-3) in infants between 2- and 9 months of age. Participants were caregivers of 571 infants born term or preterm (gestational age <37 weeks) enrolled in a multi-site psychometric study of PediaTracTM. Findings revealed significant correlations between MOT and ASQ-3 scores at 2, 4, 6, and 9 months across time periods, term-preterm status, and biological sex. A significantly higher percentage of infants born preterm, compared with those born at term, was identified as a moderate or high risk on both the ASQ-3 and PediaTrac. Future investigations are warranted to further examine the psychometric properties of the MOT domain, including sensitivity, specificity, and positive and negative predictive value.

Measuring Early Relational Health Using PediaTrac TM in a Diverse Sample of Infant-Caregiver Dyads.

OBJECTIVE: Early relational health (ERH) is a key developmental predictor and outcome in infancy and early childhood that reflects social-emotional well-being and promotes resilience throughout childhood. Currently, there is no gold-standard developmental screening tool for ERH in pediatric care settings. This study examined the psychometric properties of items assessing ERH that are part of a web-based, caregiver-report screening tool called PediaTrac TM . It was hypothesized that ERH could be reliably estimated and that second-order factors would be revealed within the latent construct ERH. METHOD: Participants included 571 caregivers of term (n = 331; ≥37 weeks) and preterm (n = 240; <37 weeks) infants recruited shortly after birth from several academic medical centers and a community health clinic. Caregivers completed PediaTrac modules at birth and 2, 4, 6, 9, 12, 15, and 18 months; data for this study are from the newborn through 12-month periods. RESULTS: Results from Item Response Theory Graded Response Modeling revealed excellent reliability for the PediaTrac ERH domain at all time points, ranging from 0.96 to 0.98. Exploratory factor analyses revealed 4 to 5 second-order factors, representing Parent-Child Relationship, Parent Distress, Parenting Stress, Parenting Efficacy, Sensitivity, and Perceptions of Child, depending on period. CONCLUSION: The caregiver-report developmental screening tool, PediaTrac, reliably measures ERH during the first year of life. The measure has promising clinical utility in pediatric clinic settings for tracking ERH over time to ensure early social-emotional well-being and to identify concerns as early as possible.

Caregiver-reported infant motor and imitation skills predict M-CHAT-R/F.

Altered motor and social-communicative abilities in infancy have been linked to later ASD diagnosis. Most diagnostic instruments for ASD cannot be utilized until 12 months, and the average child is diagnosed substantially later. Imitation combines motor and social-communicative skills and is commonly atypical in infants at risk for ASD. However, few measures have been developed to assess infant imitation clinically. One barrier to the diagnostic age gap of ASD is accessibility of screening and diagnostic services. Utilization of caregiver report to reliably screen for ASD mitigates such barriers and could aid in earlier detection. The present study developed and validated a caregiver-report measure of infant imitation at 4, 6, and 9 months and explored the relationship between caregiver-reported imitation and motor abilities with later ASD risk. Participants (N = 571) were caregivers of term and preterm infants recruited as part of a large multi-site study of PediaTrac™, a web-based tool for monitoring and tracking infant development. Caregivers completed online surveys and established questionnaires on a schedule corresponding to well-child visits from birth to 18 months, including the M-CHAT-R/F at 18 months. Distinct imitation factors were derived from PediaTrac at 4, 6, and 9 months via factor analysis. The results supported validity of the imitation factors via associations with measures of infant communication (CSBS; ASQ). Imitation and motor skills at 9 months predicted 18-month ASD risk over and above gestational age. Implications for assessment of infant imitation, detecting ASD risk in the first year, and contributing to access to care are discussed.

Activism, Coping, and Hopefulness Among Parents of Children With Cancer.

Background: Coping styles employed by parents of children with cancer have significant implications for parents' and children's well-being. To supplement the minimal literature in this area, activism (participation in activities that serve to benefit children with cancer as a group) was investigated as a potential coping strategy. Method: Parents (N = 67) of children with cancer completed an online survey that included measures of COPE inventory (COPE), hopefulness (Adult Hope Scale), and depression (Patient Health Questionnaire-9-item). Participants retrospectively reported their engagement in activism to benefit children with cancer and to benefit other causes, including actions that were taken before and after their child's cancer diagnosis. Relations between activism, overall styles of coping, hopefulness, and depression were assessed. Results: Activism was positively correlated with hope and active coping, but not associated with depression. Participants reported a significant increase in childhood-cancer-related activism following their own child's diagnosis, with 100% of parents endorsing engagement in such activism. Postdiagnosis childhood-cancer-related activism uniquely explained 17% of the variance in hopefulness after other forms of activism had been accounted for. Discussion: Childhood-cancer-related activism is a common activity among parents of children with cancer that has significant implications for parental hopefulness. Parents who endorse an active, solution-focused approach to coping with the childhood cancer experience may be more likely than others to engage in activism. Further research is needed to clarify the role of activism in the lives of families of children with cancer.

Longitudinal caregiver-reported motor development in infants born at term and preterm.

AIM: To examine the extent to which estimates of a latent trait or underlying construct of motor ability differ in infants born at term and preterm, based on caregiver ratings of the motor domain of PediaTrac v3.0. METHOD: The sample consisted of 571 caregiver-infant dyads (331 born at term, 240 born preterm), 48% female, with 51.7% of caregivers identifying as an ethnic minority. Latent trait of motor ability was estimated based on item response theory modeling. Gestational group differences (term and preterm birth) were examined at the newborn/term-equivalent, 2-, 4-, 6-, 9-, and 12-month time points. RESULTS: Caregiver ratings of latent trait of motor ability were reliably modeled across the range of abilities at each time point. While the group born preterm exhibited significantly more advanced motor abilities at the term-equivalent time point, by 6 months the group born at term was more advanced. Biological sex difference main and interaction effects were not significant. INTERPRETATION: Caregivers provided reliable, longitudinal estimates of motor ability in infancy, reflecting important differences in the motor development of infants born at term and preterm. The findings suggest that significant motor development occurs in infants born preterm from birth to the term-equivalent time point and provide a foundation to examine motor growth trajectories as potential predictors in the early identification of neurodevelopmental conditions and needs.

Caregiver-reported development in term and preterm infants from birth to nine months of age: Psychometrics of the PediaTracTM social/communication/cognition domain.

Term and preterm neonates were assessed at the newborn (NB) period (term, term equivalent) and at 2, 4, 6, and 9 months in a study of the psychometric properties of the Social/Communication/Cognition (SCG) domain of PediaTrac™ v3.0, a novel caregiver-based developmental monitoring instrument. Item response theory (IRT) was used to model item parameters and estimate theta, an index of the latent trait, social/communication/cognition. Exploratory factor analysis (EFA) was conducted to further clarify the dimensionality of the domain. In a cohort of 571 caregiver-infant dyads (331 term, 240 preterm), mean theta values could be reliably estimated at all time periods, with term infants demonstrating significantly more advanced social/communication/cognition abilities at 9 months of age. Item discrimination and item difficulty of the 15, 15, 35, 47, and 57 items at the NB, 2-, 4-, 6-, and 9-month periods, respectively, could be reliably modeled across the range of ability. Total Information for the SCG domain was high and the reliability ranged from 0.97 to 0.99 (NB = .98, 2 month = .97, 4 month = .98, 6 month = .99 and 9 month = .99). EFA revealed second-order factors at each time period, with two factors at the NB period (affect/emotional expression, social responsiveness) accounting for 43% of variance; three factors at 2, 4, and 6 months (affect/emotional expression, social responsiveness imitation/emerging communication), accounting for 43%, 34%, and 34% of the variance, respectively; and four factors at 9 months (imitation/communication, nonverbal/gestural communication, affect expression, and social responsiveness), accounting for 34% of the variance. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Children's Sleep and Externalizing Problems: A Day-to-day Multilevel Modeling Approach.

BACKGROUND: Sleep problems and externalizing problems tend to be positively associated, but the direction of this association is unclear. METHOD: Day-to-day associations between sleep and behavior were examined in children (N = 22) ages 3-8 with clinical levels of externalizing problems. These children were enrolled in Parent Management Training and behavioral sleep intervention. During assessments before and after treatment, children wore actigraphs for seven days and parents concurrently completed sleep diaries and daily tallies of noncompliance, aggression, and tantrums. Multilevel modeling was used to account for the nested structure of the data, at the day-to-day level (level 1), within assessment points (level 2), and within children (level 3). RESULTS: Late sleep timing and fragmentation were predictive of next-day noncompliance and tantrums, respectively. There were fewer associations for a given day's behavior predicting that night's sleep, although children who showed more aggression and noncompliance at baseline tended to have later bedtimes and sleep onset times compared to other children.

Longitudinal changes in term and preterm infant night wakings: The role of caregiver anxious-depression.

Changes in infant night waking during the first year of life are associated with individual (e.g., prematurity) and family (e.g., caregiver psychopathology) factors. This study examined the association between infant night waking and caregiver anxious-depressive symptoms during the first year of life in preterm and term infants. We considered between-person differences and within-person changes in caregiver anxious-depressive symptoms in relation to changes in infant night waking from 2- to 9-months. Racially (30.0% Black, 60.4% White, 9.5% multiracial/other) and socioeconomically (40.0% below median household income) diverse caregivers (N = 445) of full term (n = 258) and preterm (n = 187) infants were recruited from hospitals and clinics in two midwestern states. Caregivers completed measures of anxious-depression and their infant's night waking at four sampling periods (2-, 4-, 6-, and 9-months). Infant night wakings declined from 2- to 9-months. Between-person differences were observed, such that caregivers with higher average anxious-depressive symptoms or infants born full term reported more night wakings. Within-person effects of caregiver anxious-depressive symptoms were not significant. Caregiver anxious-depression is closely associated with infant night wakings. By considering a caregiver's average severity of anxious-depression, healthcare providers can more effectively plan infant sleep interventions. If caregiver anxious-depressive symptoms are ameliorated, night wakings may also decrease.

Los cambios en el despertar nocturno del infante durante el primer año de vida se asocian con factores individuales (v.g. nacimiento prematuro) y familiares (v.g. sicopatología de quien presta el cuidado). Este estudio examinó la asociación entre el despertar nocturno del infante y los síntomas de depresión por ansiedad de quien presta el cuidado durante el primer año de vida de infantes nacidos prematuramente y de ciclo completo. Tomamos en cuenta las diferencias entre las personas y los cambios dentro de las personas en los síntomas de depresión por ansiedad de quien presta el cuidado con relación a los cambios en el despertar nocturno del infante de los 2 a los 9 meses. Se reclutaron en hospitales y clínicas de dos estados del medio oeste cuidadores (N = 445) racial (30.0% de raza negra, 60.4% blancos, 9.5% multirraciales o de otra raza) y socioeconómicamente (40.0% por debajo del promedio de ingresos caseros) diversos, de infantes de ciclo completo (n = 258) y prematuros (n = 187). Los cuidadores completaron medidas de depresión por ansiedad y el despertar nocturno de sus infantes en cuatro períodos muestra (a los 2, 4, 6 y 9 meses). El despertar nocturno del infante declinó de los 2 a los 9 meses. Se observaron las diferencias entre personas, de tal manera que los cuidadores con un promedio mayor de síntomas de depresión por ansiedad o infantes nacidos en el ciclo completo reportaron más despertar nocturno. Los efectos de dentro de las personas de los síntomas de depresión por ansiedad del cuidador no fueron significativos. La depresión por ansiedad del cuidador se asocia cercanamente con el despertar nocturno del infante. Por medio de considerar el promedio de la severidad de la depresión por ansiedad del cuidador, quienes ofrecen el cuidado de salud pueden planear más eficazmente las intervenciones en cuanto al sueño del infante. Si se mejoran los síntomas de depresión por ansiedad de quien presta el cuidado, el despertar nocturno también podría disminuir.

Les changements dans le réveil nocturne du bébé pendant la première année sont liés à des facteurs individuels (par exemple la prématurité) et familiaux (par exemple la psychopathologie de la personne prenant soin de l'enfant). Cette étude a examiné le lien entre le réveil nocturne du bébé et les symptômes anxieux-dépressifs de la personne prenant soin de l'enfant durant la première année de vie de bébés prématurés et à terme. Nous avons considéré les différences entre les personnes et les changements au sein de la personne dans les symptômes anxieux-dépressifs de la personne prenant soin de l'enfant, en lien aux changements dans le réveil nocturne du bébé de 2 à 9 mois. Des personnes (N = 445) prenant soin d'un bébé à plein terme (n = 258) et prématuré (n = 187), divers du point de vue de leur race (30,0% noirs, 60,4% blancs, 9,5% multiracial/autre) et de leur statut socioéconomique (40,0% en dessous du revenu moyen d'une famille) ont été recrutés dans des hôpitaux et des cliniques des états au centre nord des Etats-Unis. Les personnes prenant soin du bébé ont rempli des mesures de dépression anxiété et de la nuit de leur bébé à quatre périodes de prélèvement des renseignements (2-, 4-, 6-, et 9- mois). Les réveils nocturnes du bébé ont décliné de 2- à 9- mois. Des différences entre les personnes ont été observées, au point que les personnes prenant soin du bébé avec la moyenne de symptômes anxieux-dépressifs la plus élevée ou des bébé nés à terme ont fait état de plus de réveils nocturnes. Les effets au sein de la personne des personnes prenant soin du bébé avec des symptômes anxieux-dépressifs n'étaient pas importants. La personne prenant du bébé avec une dépression anxieuse est fortement liée aux réveils nocturnes du bébé. En considérant la sévérité moyenne de la dépression anxieuse de la personne prenant soin du bébé, les prestataires de santé peuvent planifier les interventions concernant le sommeil du bébé de manière plus efficace. Si les symptômes anxieux-dépressifs de la personne prenant soin du bébé sont améliorer, alors les réveils nocturnes pourraient aussi diminuer.

Caregiver-reported newborn term and preterm motor abilities: psychometrics of the PediaTracTM Motor domain.

BACKGROUND: Approximately 5-10% of children exhibit developmental deviations in motor skills or other domains; however, physicians detect less than one-third of these abnormalities. Systematic tracking and early identification of motor deviations are fundamental for timely intervention. METHODS: Term and preterm neonates were prospectively assessed at the newborn (NB) period in a study of the psychometric properties of the Motor (MOT) domain of PediaTracTM v3.0, a novel caregiver-based development tracking instrument. Item response theory graded response modeling was used to model item parameters and estimate theta, an index of the latent trait, motor ability. Exploratory factor analysis (EFA) was conducted to examine the dimensionality and factor structure. RESULTS: In a cohort of 571 caregiver/infant dyads (331 term, 240 preterm), NB MOT domain reliability was high (rho = 0.94). Item discrimination and item difficulty of each of the 15 items could be reliably modeled across the range of motor ability. EFA confirmed that the items constituted a single dimension with second-order factors, accounting for 43.20% of variance. CONCLUSIONS: The latent trait, motor ability, could be reliably estimated at the NB period. IMPACT: The caregiver-reported Motor domain of PediaTrac provides a reliable estimate of the latent trait of motor ability during the newborn period. This is the first known caregiver-reported instrument that can assess motor ability in the newborn period with high reliability in term and preterm infants. Item response theory methods were employed that will allow for future characterization of developmental subgroups and motor trajectories. The PediaTrac Motor domain can support early identification of at-risk infants. Including caregivers in digital reporting and child-centered monitoring of motor functioning may improve access to care.

Sleep and Negative Affect Across Toddlerhood in the Context of Stress.

Negative affect is associated with both high stress and poor sleep, but questions remain about the direction of these associations across time and interactions between stress and sleep, especially in early childhood. The present study examined sleep deficits, family stress, and observed negative affect in a sample of toddlers at 30, 36, and 42 months (N = 504). Negative affect was observed during a parent-child free play task. Sleep was measured via actigraphy. Stress was measured using a cumulative risk index of socioeconomic status, single parent status, household chaos, role overload, parenting hassles, social support, and stressful events. Findings showed few associations between sleep and negative affect, except for toddlers experiencing high levels of family stress. Toddlers experiencing both high stress and poor sleep demonstrated the highest levels of negative affect in the lab at 30 months. Adequate sleep may serve as a protective factor for children in high-stress families.

Cumulative risk, infant sleep, and infant social-emotional development.

The effect of cumulative biological, psychosocial, and demographic risk and infant sleep on infant social-emotional functioning in 12-month-old infants (46% female) was examined in data from racially (30% Black, 60% White, 10% multiracial/other) and socioeconomically (41% below median income) diverse caregivers (N = 468, M = 30.42 years old, SD = 5.65) recruited from two midwestern states in 2019-2020. Due to the major changes in sleep patterns during infancy and the reported association between sleep and social-emotional functioning, this study also examined whether sleep moderates the association between risk and infant social-emotional functioning and potentially promotes healthy social-emotional functioning despite risk. Greater cumulative risk was associated with poorer sleep efficiency and more social-emotional problems, but was not associated with the general acquisition of social-emotional milestones. Results also suggested that poorer sleep efficiency was associated with more social-emotional problems and poorer social-emotional milestone acquisition. No significant interaction effects were found between cumulative risk and infant sleep. Risk and sleep appear to have unique associations with infant social-emotional problems and development; thus both could be targeted in early intervention to promote social-emotional functioning during infancy and early childhood.

The physical home environment and sleep: What matters most for sleep in early childhood.

The physical home environment is thought to play a crucial role in facilitating healthy sleep in young children. However, relatively little is known about how various features of the physical home environment are associated with sleep in early childhood, and some of the recommendations clinicians make for improving child sleep environments are based on limited research evidence. The present study examined how observer and parent descriptions of the child's physical home environment were associated with child sleep, measured using actigraphy and parent's reports, across a year in early childhood. The study used a machine learning approach (elastic net regression) to specify which aspects of the physical home environment were most important for predicting five aspects of child sleep, sleep duration, sleep variability, sleep timing, sleep activity, and latency to fall asleep. The study included 546 toddlers (265 females) recruited at 30 months of age and reassessed at 36 and 42 months of age. Poorer quality physical home environments were associated with later sleep schedules, more variable sleep schedules, shorter sleep durations, and more parent-reported sleep problems in young children. The most important environmental predictors of sleep were room sharing with an adult, bed sharing, and quality of both the child's sleep space and the wider home environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A 1-year longitudinal study of the stress, sleep, and parenting of mothers of toddlers.

OBJECTIVES: The present study, building on cross-sectional research showing links between mothers' sleep, stress, and parenting, used a longitudinal design to consider (1) the temporal direction of links between mothers' sleep and stress, (2) whether mother sleep deficits predict change in parenting across time, and (3) whether mother sleep deficits mediate the inverse association between stress and positive parenting. DESIGN: The study used repeated measures of stress, mother sleep, and positive parenting at toddler ages 30, 36, and 42 months. SETTING: Data were collected at 2 sites, one in the Midwest and one in the East. PARTICIPANTS: Four hundred thirteen mother-toddler pairs were followed. Mothers were mostly married, college educated, and middle class, but there was also considerable variability between families. MEASUREMENTS: Stress was measured via parenting hassles, CHAOS, and role overload scales. Mother sleep was measured via actigraphy. Positive parenting was observed during the bedtime routine and rated using the HOME scale and other items. RESULTS: Mother stress and sleep were inextricably linked across toddlerhood, and worse sleep was predictive of less observed positive parenting, even when controlling for prior levels of stress and parenting. CONCLUSIONS: Improving mothers' sleep may be important in efforts to improve their parenting.

The influence of sociodemographic factors and response style on caregiver report of infant developmental status.

Caregiver report is the most feasible way to assess early childhood development but is susceptible to the influences of response style and sociodemographic factors. In a sample of 571 caregiver-infant dyads (47.8% female; 48% White), we compared caregiver reports on the Ages and Stages Questionnaire-Third Edition (ASQ-3) with reports on a novel, web-based assessment, PediaTrac™. Ratings on PediaTrac correlated with ratings on the ASQ-3 at all time points (2, 4, 6, and 9 months). Caregiver age, response style, and sociodemographic factors accounted for significant variance on both measures. Developmental reporting of early childhood skills is influenced by caregiver response style and sociodemographic factors. These influences must be considered in order to ensure the accurate identification of infant developmental status.

Heterotypic continuity of inhibitory control in early childhood: Evidence from four widely used measures.

Inhibitory control has been widely studied in association with social and academic adjustment. However, prior studies have generally overlooked the potential heterotypic continuity of inhibitory control and how this could affect assessment and understanding of its development. In the present study, we systematically considered heterotypic continuity in four well-established measures of inhibitory control, testing two competing hypotheses: (a) the manifestation of inhibitory control coheres within and across time in consistent, relatively simple ways, consistent with homotypic continuity. Alternatively, (b) with developmental growth, inhibitory control manifests in more complex ways with changes across development, consistent with heterotypic continuity. We also explored differences in inhibitory control as a function of the child's sex, language ability, and the family's socioeconomic status. Children (N = 513) were studied longitudinally at 30, 36, and 42 months of age. Changes in the patterns of associations within and among inhibitory control measures across ages suggest that the measures' meanings change with age, the construct manifests differently across development, and, therefore, that the construct shows heterotypic continuity. We argue that the heterotypic continuity of inhibitory control motivates the use of different combinations of inhibitory control indexes at different points in development in future research to improve validity. Confirmatory factors and growth curves also suggest that individual differences in inhibitory control endure, with convergence among inhibitory control measures by 36 months of age. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PediaTrac V.3.0 protocol: a prospective, longitudinal study of the development and validation of a web-based tool to measure and track infant and toddler development from birth through 18 months.

INTRODUCTION: The need for an efficient, low-cost, comprehensive measure to track infant/toddler development and treatment outcomes is critical, given the importance of early detection and monitoring. This manuscript describes the protocol for the development and testing of a novel measure, PediaTrac, that collects longitudinal, prospective, multidomain data from parents/caregivers to characterise infant/toddler developmental trajectories in term and preterm infants. PediaTrac, a web-based measure, has the potential to become the standard method for monitoring development and detecting risk in infancy and toddlerhood. METHODS AND ANALYSES: Using a multisite, prospective design, primarcaregivers will complete PediaTrac V.3.0, a survey tool that queries core domains of early development, including feeding/eating/elimination, sleep, sensorimotor, social/sensory information processing, social/communication/cognition and early relational health. Information also will be obtained about demographic, medical and environmental factors and embedded response bias indices are being developed as part of the measure. Using an approach that systematically measures infant/toddler developmental domains during a schedule that corresponds to well-child visits (newborn, 2, 4, 6, 9, 12, 15, 18 months), we will assess 360 caregiver/term infant dyads and 240 caregiver/preterm infant dyads (gestational age <37 weeks). Parameter estimates of our items and latent traits (eg, sensorimotor) will be estimated by theta using item response theory-graded response modelling. Participants also will complete legacy (ie, established) measures of development and caregiver health and functioning, used to provide evidence for construct (discriminant) validity. Predictive validity will be evaluated by examining relationships between the PediaTrac domains and the legacy measures in the total sample and in a subsample of 100 participants who will undergo a neurodevelopmental assessment at 24 months of age. ETHICS AND DISSEMINATION: This investigation has single Institutional Review Board (IRB) multisite approval from the University of Michigan (IRB HUM00151584). The results will be presented at prominent conferences and published in peer-reviewed scientific journals.

Sustained attention across toddlerhood: The roles of language and sleep.

The present study examined individual differences in the development of sustained attention across toddlerhood, as well as how these individual differences related to the development of language and sleep. Toddlers (N = 314; 54% male) were assessed at 30, 36, and 42 months using multiple measures of attention, a standardized language assessment, and actigraphic measures of sleep. Toddlers were 80% White. Family socioeconomic status (SES) was calculated using the Hollingshead Four Factor Index and ranged from 13 to 66 (M = 47.59, SD = 14.13). Aims were (a) to examine associations between measures of attention across situations, informants, and time; (b) to consider the independent and interactive effects of language and sleep on attention; and (c) to test potential bidirectional associations between sleep and attention. Findings showed attention measures were stable across time but were only weakly linked with each other at 42 months. Attention was consistently linked with language. More variable sleep and longer naps were associated with less growth in sustained attention across time. Nighttime sleep duration interacted with language in that sleep duration was positively associated with attention scores among toddlers with less advanced language, even when SES was controlled. The findings describe an understudied aspect of how sustained attention develops, involving the main effect of consistent sleep schedules and the interaction effect of amount of sleep and child language development. These findings are relevant to understanding early childhood risk for developing attention problems and to exploring a potential prevention target in family sleep practices. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Presleep Arousal and Sleep in Early Childhood.

Research suggests that arousal during the transition to sleep-presleep arousal-is associated with sleep disturbances. Although a robust literature has examined the role of presleep arousal in conferring risk for sleep disturbances in adults, substantially less research has examined the developmental origins of presleep arousal in early childhood. The authors examined presleep arousal using parent report and psychophysiological measures in a sample of preschoolers to explore the association between different measures of presleep arousal, and to examine how nightly presleep arousal is associated with sleep. Participants included 29 children assessed at 54 months of age. Presleep arousal was measured using parent reports of child arousal each night at bedtime and using a wearable device that took minute-by-minute recordings of heart rate, peripheral skin temperature, and electrodermal activity each night during the child's bedtime routine. This yielded a dataset with 4,550 min of ambulatory recordings across an average of 3.52 nights per child (SD = 1.84 nights per child; range = 1-8 nights). Sleep was estimated using actigraphy. Findings demonstrated an association between parent-reported and psychophysiological arousal, including heart rate, peripheral skin temperature, and skin conductance responses during the child's bedtime routine. Both the parent report and psychophysiological measures of presleep arousal showed some associations with poorer sleep, with the most robust associations occurring between presleep arousal and sleep onset latency. Behavioral and biological measures of hyperarousal at bedtime are associated with poorer sleep in young children. Findings provide early evidence of the utility of wearable devices for assessing individual differences in presleep arousal in early childhood.

Mothers' sleep deficits and cognitive performance: Moderation by stress and age.

There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers' age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women's performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance.

Screen use before bedtime: Consequences for nighttime sleep in young children.

There is increasing interest in the relation between screen use and sleep problems in early childhood. In a sample of 30-month-old children, this study used observational measures of screen use during the hour or so leading up to bedtime, parent reports of screen use during the child's bedtime routine, and actigraphic measures of toddler sleep to complement parent-reported sleep problems. Whether screen use was observed during the pre-bedtime period or was reported by the parents as part of the nightly bedtime routine, greater screen use in either context was associated with more parent-reported sleep problems. Additionally, more frequent parent-reported screen use during the bedtime routine was also associated with actigraphic measures of later sleep, shorter sleep, and more night-to-night variability in duration and timing of sleep. These associations suggest the negative consequences of screen use for children's sleep extend both to aspects of sleep reported by parents (e.g., bedtime resistance, signaled awakenings) and to aspects measured by actigraphy (e.g., shorter and more variable sleep).