Poster #34 - How do Children Adopted from Foster Care Sleep? Comparison with a Community Sample of Children

• In Event: Poster Session 19

Abstract

Introduction: There is an abundance of evidence that poor sleep predicts a wide range of negative outcomes in children. Sleep disruption is particularly common among children who experience early adversity and maltreatment, including children placed in foster care (Alfano et al., 2022). What is less known however, is whether children adopted from foster care continue to exhibit elevated rates of sleep problems after permanence is achieved. We therefore examined rates of total and specific types of sleep problems among a large sample of children from across the US adopted from foster care within the past two years.
Methods: N=234 U.S. Caregivers of children, 4–11 years (M=5.94, SD=1.97) recently adopted from foster care were invited to participate in an online Qualtrics survey about the sleep habits of their children. Participants were recruited through private online groups for foster, kinship, and/or adoptive caregivers. The validated Children’s Sleep Habits Questionnaire (CSHQ; Owens et al., 2000) was completed by caregivers to assess total child sleep problems and specific types of sleep problems, including bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night waking, parasomnias, sleep disordered breathing, and daytime sleepiness. An age-matched group of 469 children (M=7.6 SD=1.5) included in a previously validation study of the CSHQ (Owens et. al, 2000) was used as a comparison group.
Results: On average, the adopted group had significantly higher total sleep problems scores (M = 81.13, SD =10.45) than the CSHQ clinical cut off score of 41 (t(224) = 57.61, p ≤ 0.001). Similarly, children adopted from foster care had significantly higher scores on each of the CSHQ subscales, including greater sleep onset delay, t(212) = 17.37 p < 0.001, night awakenings, t(230) = 24.35 p < 0.001, daytime sleepiness t(231) = 49.06 p < 0.001, parasomnias t(229) = 52.40 75 p < 0.001, sleep disordered breathing, t(229) = 52.40 75 p < 0.001, sleep anxiety t(229) = 26.20 p < 0.001, and bedtime resistance, t(228) = 37.75 p < 0.001.
Discussion: Our findings suggests that early adversity including prior placement in foster care significantly and adversely impacts children’s sleep health even after permanence (i.e., adoption) is achieved. These findings align with a wealth of research to underscore the potential lasting deleterious effects of early maltreatment/neglect and trauma on sleep-wake regulation. Notably every type of problem examined, including both behavioral (e.g., bedtime resistance) and physiological (e.g., disordered breathing) sleep problems, was elevated in the adopted sample. Findings suggest that greater attention toward sleep health is necessary both while and after children are placed in foster care.

Authors

• Sirine Harmouch, University of Houston
  Presenting Author

• Anthony Cifre, University of Houston

• Candice A Alfano, University of Houston