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How Are the Sleep Problems of Children in the US Foster Care System Addressed?
Candice A Alfano1, Madeline Valentine2, Josefina Muñoz Nogales2
1Department of Psychology, University of Houston, Houston, TX.
Insights
Few foster caregivers receive sleep health education, leading many to seek external help or use melatonin. Establishing bedtime routines and ensuring a safe environment are key to improving sleep for children in foster care.
Area of Science:
- Pediatric Sleep Health
- Child Welfare Research
- Foster Care System
Background:
- Growing evidence indicates poor sleep health in children within the foster care system.
- There is a lack of information regarding the availability and implementation of sleep support services for these children.
Purpose of the Study:
- To investigate the extent to which sleep problems are addressed for children in foster care.
- To identify caregiver-reported needs, interventions, and effective strategies for improving sleep in this population.
Main Methods:
- A survey was administered to 485 foster caregivers across the United States.
- Caregivers provided quantitative and qualitative data on sleep health education, services received, and perceived important factors for child sleep.
Main Results:
- Only 13% of caregivers received sleep information from agencies; 55% sought help from health providers.
- Nearly half (46%) of caregivers reported administering melatonin to their child.
- Key factors for good sleep included bedtime routines, reassurance, and a calming environment; a need to address child fear/anxiety was noted.
Conclusions:
- Children in foster care exhibit sleep issues linked to various risk factors, necessitating increased clinical and research focus.
- Replication studies are recommended, especially given data collection during the early COVID-19 pandemic.
Objective:
Evidence of poor sleep health among children in foster care continues to mount, but information about whether and how sleep problems are addressed is unavailable. The goal of this study was to begin to fill these significant knowledge gaps.
Methods:
Four hundred eighty-five foster caregivers from across the United States completed a survey focused on the sleep health of one child, 4 to 11 years ( M = 6.4; SD = 2.2) currently in their care. Caregivers provided quantitative and qualitative responses to questions regarding training, information, and services received in relation to their child's sleep. Caregivers also reported on the factors and strategies they perceived as most important for helping children in their care sleep well.
Results:
Only 13% of caregivers reported receiving any information/education about sleep from agencies or case workers, whereas 55% had sought help from a health provider related to their child's sleep. Nearly half of all caregivers (46%) reported giving their child melatonin. Caregivers reported that a bedtime routine/consistency, reassurance of safety/love, and a calming environment were most important for helping their child sleep well. A recurrent theme in qualitative responses was a need to mitigate child fear/anxiety at night.
Conclusion:
Children in foster care face a range of risk factors that increase the likelihood of poor/insufficient sleep, but these findings suggest this critical aspect of health requires greater clinical and research attention. As these data were collected during the initial months of the COVID-19 pandemic, replication studies are necessary.
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