Parent Reports Versus Objective Behavioral Measures in Pediatric Sleep-Disordered Breathing.

Area of Science:

• Pediatric Sleep Medicine
• Neuropsychology
• Child Psychology

Background:

• Sleep-disordered breathing (SDB) in children can impact behavior and executive functions.
• Parental reports of behavioral problems are often used to guide clinical decisions in pediatric SDB.
• The relationship between parent-reported behaviors and objective measures of executive function, like response inhibition, is not well understood.

Purpose of the Study:

• To investigate the association between parent-reported problem behaviors and objectively measured response inhibition in children diagnosed with SDB.
• To determine if parent reports align with objective performance on tasks measuring inhibitory control.
• To inform clinical decision-making by clarifying the concordance between subjective and objective behavioral assessments in pediatric SDB.

Main Methods:

• A prospective observational study involving 84 children aged 5-11 years with SDB symptoms.
• Parent-reported problem behaviors were assessed using the Behavior Rating Inventory of Executive Function (BRIEF), focusing on the inhibit T-score.
• Objective response inhibition was measured using the Flanker Test of Inhibitory Control and Attention.
• Pearson correlation and linear regression analyses were employed to examine relationships, adjusting for covariates.

Main Results:

• A small, statistically significant correlation (r = -0.23, p = 0.04) was found between parent-reported inhibitory problems and objective response inhibition in unadjusted analyses.
• This association was attenuated after adjusting for demographic and socioeconomic factors.
• Parent reports explained minimal variance in objective scores (adjusted R² = 0.14–0.16), indicating limited concordance.

Conclusions:

• Parent-reported behavioral problems demonstrate limited agreement with objective measures of response inhibition in children with SDB.
• Relying solely on parent-reported behavioral symptoms for treatment decisions in pediatric SDB may be insufficient.
• Integrating objective assessments alongside subjective reports is recommended for comprehensive evaluation and effective clinical management of pediatric SDB.