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Bedtime routines, development, and caregiver educational attainment in toddlerhood

Joey Tsz Ying Lam1,2, Ariel A Williamson3,4, Zainab Salih5

  • 1Department of Psychology, Saint Joseph's University, Philadelphia, PA, United States.

Frontiers in Sleep
|December 22, 2025
PubMed

Insights

Establishing a consistent bedtime routine in toddlers is linked to better social-emotional development and fewer behavioral problems, particularly for families with lower educational attainment. This supports recommending routines for improved child well-being.

Area of Science:

  • Child Development
  • Pediatric Health
  • Behavioral Science

Background:

  • Consistent bedtime routines are proven to improve toddler sleep.
  • Limited research exists on their impact on social-emotional outcomes, especially in lower socioeconomic status (SES) contexts.
  • This study addresses this gap by examining longitudinal associations.

Purpose of the Study:

  • To examine the longitudinal associations between bedtime routines and social-emotional development in toddlers.
  • To investigate the role of caregiver educational attainment in this relationship.
  • To provide evidence-based recommendations for pediatric primary care.

Main Methods:

  • Longitudinal study of 40 toddlers from primary care.
  • Caregiver questionnaires assessed sociodemographics and bedtime routine consistency at 12, 15, and 24 months.
  • Social-emotional development assessed using the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) and Ages and Stages Questionnaire (ASQ-3).

Main Results:

  • Most families (63-86%) implemented consistent bedtime routines.
  • Consistent routines at 12 months predicted less dysregulation at 15 months.
  • Lack of consistent routines at 15 months was associated with more behavioral problems (externalizing, internalizing, dysregulation) at 24 months.
  • An interaction showed that toddlers of less educated caregivers with inconsistent routines had the most internalizing problems.

Conclusions:

  • Clinicians should recommend consistent nightly bedtime routines for toddlers.
  • Routines can promote positive social-emotional and behavioral trajectories.
  • This recommendation is particularly important for families with lower educational attainment to support child well-being.
Abstract

Keywords:
bedtime routinesbehavioral interventioneducationsocial-emotional developmenttoddlers

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