Parenting, self-regulation, and sleep in young children at-risk for attention-deficit/hyperactivity disorder

Young children at-risk for attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, which may exacerbate ADHD symptoms and related impairment. Yet, little is known about modifiable factors associated with the maintenance of sleep problems. This study examined the relationships among parenting practices, behavioral self-regulation skills, and sleep functioning in young children at-risk for ADHD.

Caregivers (94.2% female; 82.6% White) of 121 young children at-risk for ADHD (Mage = 4.04 years; 70.2% male; 71.9% White; 20.3% Hispanic) completed measures of parenting practices and child sleep. Children completed a lab-based task that measured behavioral self-regulation skills. Only pre-treatment data (before the delivery of behavioral parent education) were used for the study.

Greater use of adaptive parenting strategies, but not child behavioral self-regulation, was associated with decreased bedtime resistance after controlling for caregivers' marital status and education level. Additionally, adaptive parenting strategies moderated the relationship between child behavioral self-regulation and sleep distress, such that children with low behavioral self-regulation experienced less sleep distress when caregivers utilized more adaptive parenting strategies compared to caregivers who utilized less adaptive parenting strategies.

For pediatric health providers working with families with young children at-risk for ADHD presenting with sleep problems, psychoeducation on adaptive parenting practices as well as encouraging parents to utilize these strategies may potentially improve child sleep functioning.