Poster #4 - Sleep, Sustained Attention, and the Development of Attention Problems Across Toddlerhood

• In Event: 1-061 - Poster Session 02
  In Poster Session: PS 02 Section - Attention, Learning, Memory

Integrative Statement

Research suggests that restricted sleep results in worse sustained attention (Kahn et al., 2014), which is broadly associated with attention problems (Barkley, 1997). A number of studies have examined links between sleep and attention problems because sleep disorders and disturbances can result in inattentive, impulsive, and hyperactive behavior, leading to misdiagnosis of ADHD, and at the same time, children with ADHD often have comorbid sleep disorders (Yoon et al., 2012). Longitudinal studies using multiple methods to measure sleep and attention are necessary to clarify the direction of these links. The present study used actigraphic sleep indexes, a structured observation measure of sustained attention, and parent reports of attention problems. Structural equation modeling in cross-lagged panel model analyses tested 1) bidirectional links between children’s sleep and attention, and 2) a longitudinal mediation model in which deficits in sustained attention may mediate the proposed link between early sleep problems and later attention problems.

Children (N = 331) participated at ages 30, 36, and 42 months. The MicroMini Motionlogger from Ambulatory Monitoring, Inc. was worn on the wrist for 14 days. Actigraphic data were scored using the Sadeh algorithm, which has been validated for children (Sadeh et al., 1989). Sleep components reflecting duration, timing, variability, and activity were examined, based on previous research (Staples et al., under review). To measure sustained attention, toddlers were asked to play independently for 5 minutes with a set of toys. Videos were coded for three levels of attentiveness: 1. “Eyes on”: child only looks at toys, 2. “Settled”: child touches and looks at a toy without fully engaging with it. 3. “Focused”: child displays intent facial expression, minimal talking, and slower, fine-motor movements with no extraneous activity while looking at and touching a toy (Ruff & Capozzoli, 2003). A composite was formed using the proportion of time spent in each level multiplied by a weight, with time focused multiplied by 3, settled by 2, and eyes on by 1(ICC = .88 across coders). Primary caregivers rated child attention problems using the Child Behavior Checklist (CBCL; Achenbach, 2000).

As depicted in Figure 1, children who experienced more variable sleep at 30 months showed less sustained attention and more attention problems concurrently, less growth in sustained attention 6 months later, and more growth in attention problems 6 and 12 months later compared to peers. We also found evidence for the reverse association, with less sustained attention and more attention problems predicting increased sleep variability 6 months later. These findings show additional evidence for bidirectional links between sleep variability and attention problems, but we found no evidence for sustained attention mediating the association between sleep variability and later attention problems. Nevertheless, the present results confirm prior work showing the importance of consistent sleep timing and duration for positive child outcomes (Bates et al., 2002; Hoyniak et al., 2015). More consistent sleep appears to promote more sustained attention development and fewer attention problems, which in turn is linked downstream with better sleep and potentially better social and academic adjustment.

Authors

• Maureen E. McQuillan, Indiana University
  Presenting Author

• Lucy E. Moreman, Indiana University
  Non-Presenting Author

• Angela D. Staples, Eastern Michigan University
  Non-Presenting Author

• John Bates, Indiana University - Bloomington
  Non-Presenting Author