The link between sleep problems in infancy and early childhood and attention problems at 5 and 14years: Evidence from a birth cohort study

Griffith University, Gold Coast, Australia.
Early human development (Impact Factor: 1.79). 07/2010; 86(7):419-24. DOI: 10.1016/j.earlhumdev.2010.05.020
Source: PubMed


Little research has examined the associations between early sleep problems and attention problems over several developmental periods.
To examine whether sleep problems in infancy and early childhood are independently related to attention difficulty at 5 and 14 years, and to the continuity of attention difficulties from 5 to 14 years.
The study was a prospective, population-based birth cohort study.
7223 women who delivered a live, singleton child between 1981 and 1983 were recruited at the first antenatal visit. Of these, 4204 had complete information on all key measures.
Attention problems were assessed with items from the Child Behaviour Checklist (CBCL) and were classified as adolescent onset (i.e. problems at 14 but not at 5); early remitter (problems at 5, no problem at 14); and persistent (i.e. at both 5 and 14).
At 6 months, sleep problems 'sometimes' were associated with the early remitter group in boys. For sleep problems between 2 and 4 years of age, findings were generally similar for boys and girls with strong associations with adolescent attention. Sleep problems 'often' were independently associated with early remitter and persistent attention problems, and 'sometimes' with early remitter and adolescent onset attention problems.
Sleep problems in early childhood are an indicator of subsequent attention problems that may persist into adolescence. Whether these associations are causal requires further research, however their presence provides an opportunity for early intervention and monitoring.

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Available from: Frances V O'Callaghan, Feb 23, 2015
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    • "Takentogether,thisworksuggeststhattempera- mentprofilesininfantswhogoontoADHDmaybe differenttothoseininfantswhogoontoASD.Inthe twostudiesthatusedverysimilarmeasures(Arnett etal.,2013;DelRosarioetal.,2014),6-montholds withlaterASDshowedbetteradaptabilityandmore approach(DelRosarioetal.,2014),while6-month oldswithlaterADHDshowedloweradaptabilityand lowerapproach(Arnettetal.,2013).Temperamental riskfactorsforASDandADHDseemtobedifferentin veryearlydevelopment. Atypicalitiesinphysiologicalregulatoryprocesses mayalsobeapparentinearlyADHD.Forexample, sleepdifficultiespredictlaterdiagnosisofADHD (O'Callaghanetal.,2010;Thunstr€om,2002;thereis lessevidencetosupportthisforASD–Jaspersetal., 2013).Gurevitzetal.(2012)alsofoundpoorersleep "
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    ABSTRACT: Background Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neurodevelopmental disorders, with a high degree of co-occurrence.Methods Prospective longitudinal studies of infants who later meet criteria for ASD or ADHD offer the opportunity to determine whether the two disorders share developmental pathways.ResultsProspective studies of younger siblings of children with autism have revealed a range of infant behavioral and neural markers associated with later diagnosis of ASD. Research on infants with later ADHD is less developed, but emerging evidence reveals a number of relations between infant measures and later symptoms of inattention and hyperactivity.Conclusions We review this literature, highlighting points of convergence and divergence in the early pathways to ASD and ADHD.
    Full-text · Article · Sep 2014 · Journal of Child Psychology and Psychiatry
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    • "The aetiology of ADHD is still unclear. However, multiple or persistent early regulatory problems (RP), such as excessive or prolonged crying (N 3 months of age), feeding, and/or sleeping difficulties [6] [7] [8], have been reported to be predictors of attentiondeficit/hyperactivity and associated problems during preschool and school years [9] [10] [11] [12] [13]. Wolke et al. [9] found that persistent infant crying associated with sleeping or feeding problems at 3 to 6 months of age was a precursor of lower academic achievement and more hyperactivity problems at 8 to 10 years of age. "
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    ABSTRACT: Background: Early regulatory problems (RP), i.e., excessive crying, feeding, and sleeping difficulties, have been reported to be predictors of cognitive and attention-deficit/hyperactivity problems. However, previous studies had limitations such as small sample size or retrospective design. Aim: To investigate whether persistent RP from infancy until preschool age are precursors of ADHD problems and cognitive deficits at school age. Study design: A prospective study from birth to 8.5years of age. Subjects: 1120 infants born at risk. Measures: RP were assessed at 5months (i.e., excessive crying, feeding, and sleeping problems), 20, and 56months (i.e., eating and sleeping problems) via parent interviews and neurological examination. At 8.5years of age, IQ was assessed by a standard test (K-ABC), and ADHD problems by direct observations in the test situation and by the Mannheimer Parent Interview (MPI, DSM-IV diagnosis of ADHD). Results: 23.8% of the sample born at risk had RP at least at two measurement points until preschool age. Persistent RP predicted lower IQ (β=-.17; 95% CI (-.21; -.10)), behaviour problems (β=-.10; 95% CI (-.15; -.03)), attention (OR 2.43; 95% CI (1.16; 5.09)) and hyperactivity problems (OR 3.10; 95% CI (1.29; 7.48)), and an ADHD diagnosis (OR 3.32; 95% CI (1.23; 8.98)) at school age, even when controlled for psychosocial and neurological confounders. Conclusions: Early persistent RP increased the odds of ADHD and associated problems at school age, indicating a cascade model of development, i.e., infant behaviour problems provide the starting point of a trajectory of dysregulation through time.
    Full-text · Article · Aug 2014 · Early Human Development
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    • "At five years, a measure of maternal perceptions of sleep problems was derived from two questions regarding the frequency and severity of child sleep difficulties, each rated from 0 (never/no difficulties) to 3 (every day/severe difficulties ). Previous studies have found equivalent, brief, indices to have validity and predictive utility [32] [35]. "
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    ABSTRACT: Objectives: To investigate whether sleep disturbances previously found to characterise high risk infants: (a) persist into childhood; (b) are influenced by early maternal settling strategies and (c) predict cognitive and emotional/behavioural functioning. Methods: Mothers experiencing high and low levels of psychosocial adversity (risk) were recruited antenatally and longitudinally assessed with their children. Mothers completed measures of settling strategies and infant sleep postnatally, and at 12 and 18 months, infant age. At five years, child sleep characteristics were measured via an actigraphy and maternal report; IQ and child adjustment were also assessed. Results: Sleep disturbances observed in high-risk infants persisted at five years. Maternal involvement in infant settling was greater in high risk mothers, and predicted less optimal sleep at five years. Poorer five year sleep was associated with concurrent child anxiety/depression and aggression, but there was limited evidence for an influence of early sleep problems. Associations between infant/child sleep characteristics and IQ were also limited. Conclusions: Early maternal over-involvement in infant settling is associated with less optimal sleep in children, which in turn, is related to child adjustment. The findings highlight the importance of supporting parents in the early development of good settling practices, particularly in high-risk populations.
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