0183 Bedtime Routine Stability in the Context of Developmental Risk

Abstract

Abstract Introduction Consistent bedtime routines are an important promoter of child sleep health. This is particularly true for children developing at elevated risk for sleep and developmental challenges. Consistent and calming bedtime routines are associated with fewer parent-reported night wakings, shorter sleep onset times, and (for some) longer nighttime sleep bouts. However, few studies systematically address bedtime consistency within the context of developmental risk. To inform future sleep promotion in children with developmental concerns, this study assessed bedtime routine consistency. Methods Across two video-recorded bedtimes, this study assessed the consistency of routines for children (n = 40) with social communication concerns from ages 8-61 months, M(SD)= 28.14(11.76). Each child was enrolled in an eight-session Family Routines Intervention (FRI). The goals of this intervention were to improve family social communication scaffolding within family routines. Bedtime routines were coded for caregiver involvement, sleep onset location, and dyad actions. Results Mothers were the most common bedtime caregiver (93-95%) and her involvement was consistent for most children (96%). Father involvement was less common (present for 25-38% of recordings) and was less consistent at 56%. Other caregivers were present for roughly 18% of dyads, but their involvement was not as consistent (13%). Sleep onset location varied widely with only 33-38% sleeping in a crib, yet crib placement was moderately consistent (64%). Roughly 20% of children slept in an adult bed, with similar consistency (63%). Book reading was the most common (40-43%) and consistent (73%) bedtime action. Bedtime media use was uncommon (8-15%) but surprisingly consistent (44%). Conclusion For children at elevated risk for sleep and developmental concerns, bedtime routines were notably diverse and inconsistent. Although bedtime routines were not the focus of the FRI study, it afforded a unique opportunity to objectively assess how families prepare their child for bed on distinct nights across a relatively short time (8-12 weeks). Not surprisingly, mothers were the primary caregiver, highlighting her potential role in future interventions. The variability in sleep onset location and bedtime actions were notable. These areas reflect clear targets for future interventions designed to promote relatively short, calming, and consistent bedtime routines. Support (if any) Purdue Research Foundation and the Gadomski Foundation