224 - A Socioecological Approach to Understanding Sleep Challenges in Preschoolers with Developmental Delays

Publication Number: 3216.224

Hanna Ghalyoun, University of Illinois College of Medicine, Naperville, IL, United States; Emily Terlap, University of Illinois College of Medicine, Chicago, IL, United States; Pranshu Adavadkar, University of Illinois College of Medicine, chicago, IL, United States; Nada Youssef, University of Illinois College of Medicine, Chicago, IL, United States; Caroline Skolnik, UIC, Chicago, IL, United States; Kathleen R. Diviak, University of Illinois At Chicago, Chicago, IL, United States; Raphael D. Kinney, University of Illinois Chicago - Institute for Health Research and Policy, Chicago, IL, United States; Sarah C. Bauer, University of Illinois College of Medicine, Chicago, IL, United States; Alan Schwartz, University of Illinois College of Medicine, Chicago, IL, United States; Tina Schuh, univers, Chicago, IL, United States; Reshma Shah, University of Illinois College of Medicine, Chicago, IL, United States

Background: Sleep is essential for healthy childhood development, however, approximately 25% of children experience sleep disturbances. Among children with neurodevelopmental disorders (NDD), the prevalence of sleep disturbances is around 40–80%. Literature suggests that sleep disturbances in children with NDDs are associated with various consequences, including child emotional and behavioral difficulties and parental challenges. Yet, little is known about the impact of sleep disturbances in preschool-aged children with developmental delays and disorders (PCw/DD), a critical period for cognitive, emotional, and behavioral growth, and formation of healthy sleep routines.

Objective: Utilizing a socioecological systems framework, the present study examined associations between sleep challenges, child quality of life (QOL), parent stress, and parent–child relationships in PCw/DDs.

Design/Methods: Participants were 275 preschoolers with suspected or confirmed DDs enrolled in a longitudinal study of a healthcare-based community-clinical linkage (CCL) model to increase access to school-based services. At baseline, caregivers completed questionnaires on child sleep, global health, positive affect, caregiver strain, parent–child conflict, and key protective factors (e.g., resilience).

Results: Children were on average 48.2 months (SD = 9.5); 63.6% male, 58% Black, and 37.9% Latine. Additionally, 46.2% were enrolled in school and 32.2% had a diagnosis of autism spectrum disorder (ASD). Based upon a parent-reported sleep problem survey (PROMIS), almost 50% of parents reported child sleep disturbances (13% as mild, 23% moderate, 12% severe; M=54.9, SD=12.3). Adjusted regressions showed greater sleep disturbances were linked to lower global health (B = –.21, p < .001), reduced positive affect (B = –.30, p < .001), higher parental stress (B = .16, p < .001), and poorer parent-child relationships (B = .05, p < .001).

Conclusion(s): Sleep challenges in PCw/DDs were associated with poorer outcomes across multiple ecological levels, including lower child health and positive affect, greater parental stress, and poorer parent–child relationships. Results highlight the importance of early identification and intervention for sleep disturbances within healthcare and early education systems. Integrating family-centered and multi-level approaches to address sleep may support both child and family well-being during this critical developmental period.