Parent-reported Behavioral Problems Research Articles

Early childhood executive function predicts concurrent and later social and behavioral outcomes: A review and meta-analysis.

Executive function (EF), the set of mental processes and skills involved in goal-oriented planning, organizing, and controlling behavior, is believed to support child development across many domains of life. However, although ample evidence suggests a relation between childhood EF and academic skills, it is less clear what its role is in domains beyond academics. We report a meta-analysis of relations between early childhood EF (assessed at 36-60 months of age) and social, health, and behavioral outcomes assessed concurrently and longitudinally (1,459 effect sizes, 158 studies, n = 144,642). No significant relations were found between EF and health outcomes. EF was concurrently associated with emotion understanding and regulation, prosocial skills, peer acceptance, and skill at lying. Both concurrently and longitudinally, EF was positively associated with peer acceptance, adaptive classroom behavior, and social competence, and negatively associated with internalizing and externalizing problems, and inattention and hyperactivity. For adolescent outcomes, only the relation between EF and internalizing could be meta-analyzed, and no significant relation was found between these variables. The magnitude of effect sizes varied, with absolute values ranging from r = .02 to .30. Moderator analyses indicated the relation between EF and behavioral outcomes varied by outcome, but there was no such finding for EF and social or health outcomes. EF was more strongly associated with teacher- versus parent-reported behavioral problems. There was little evidence that quality indicators affected effect sizes. There was also little evidence of publication bias. Overall, our results are consistent with the possibility of broad relevance of EF for child development; yet, future research should provide stronger causal tests of hypothesized relations between EF and outcomes to better understand the nature of EF and whether fostering it can promote healthy development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Does insulin pump therapy offer benefits for behaviour, mood, cognition and HbA1c in children and adolescents with type 1 diabetes? A randomised controlled trial with observational follow-up

AimsImproved behaviour, mood, cognition and HbA1c have been reported with short-term use of continuous subcutaneous insulin infusion (CSII) in youth with type 1 diabetes (T1D). We sought to re-examine these...

Investigating Trajectories of Negative Emotionality in Early Childhood and First-Grade Outcomes

This study investigated Korean children’s negative emotionality trajectories from infancy to age 4 and their learning (i.e., executive functioning), behavioral, and self-esteem outcomes in first grade. Using nationally representative data from the Panel Study on Korean Children, negative emotionality trajectories were explored to determine whether patterns emerged over time (N = 2,149, boys = 50.7%) and whether different negative emotionality patterns were associated with specific first-grade outcomes (i.e., teacher-reported executive function difficulties, parent-reported behavioral problems, and child-reported self-esteem). According to latent class growth analysis, Korean children developed one of three negative emotionality patterns from infancy to age 4: Low stable (28.0%), moderate (57.9%), and intense and increasing (14.1%). First-grade outcomes, including executive functioning and behavior problems, were associated with negative emotionality trajectories. No association was found between the negative emotionality trajectories and child-reported self-esteem. First graders who developed and maintained intense negative emotionality until age 4 were regarded as the most vulnerable group in executive functioning difficulties and risk of behavioral problems. Impact Statement Negative emotionality in early childhood is an important predictor of future difficulties, and more research is needed in terms of patterns of emotionality, stability over time, and associated outcomes for different patterns. In this study, children developed one of three negative emotionality patterns from infancy to age 4: Low stable (28.0%), moderate (57/9%), and intense and increasing (14.1%). First graders who developed intense negative emotionality until age 4 were the most vulnerable group for executive function difficulties and risk of behavioral problems.

Measuring the impact of deprivation on learning difficulties and behaviour among infants born preterm: A cohort study.

Preterm birth and social deprivation are known risk factors for learning difficulties. However there has been little work looking into the interaction between these two risks. We aimed to identify if children born preterm to families with higher levels of social deprivation are disproportionately more likely to have learning difficulties than those with lower levels of social deprivation. Data from the RANOPS (Respiratory And Neurological Outcomes in children born Preterm Study) was used to assess prevalence of learning difficulties. The effects of preterm birth and deprivation were reviewed. Multi-level logistic regression models were used to examine if gestational age and deprivation impacts interacted after adjustment for possible confounders. Primary outcome measure was parent-reported learning difficulties. Secondary outcome measures were parent-reported behavioural problems and a statement of special educational need. We investigated the developmental outcomes of 6,691 infants with a median age of 5 years at time of survey (IQR 5). Deprivation decile (OR 1.08 (1.03,1.12)) and preterm birth (OR 2.67 (2.02,3.53)) were both associated with increased risk of learning difficulties. There was little evidence for any interaction between preterm birth and deprivation (p = 0.298) and the risk of learning difficulties. Deprivation and preterm birth have significant associations with learning difficulties. While deprivation does not appear to have potentiated the impact of preterm birth, preterm infants in the most deprived areas have the highest risk of learning difficulties with almost 1 in 3 extremely premature infants with a learning difficulty in the most deprived areas.

Brief Parenting Seminars for Preventing Child Behavioral and Emotional Difficulties: a Pilot Randomized Controlled Trial

Early parenting programs can prevent the development of child behavioral and emotional difficulties. Despite the high prevalence of these difficulties in Greek children aged 2 to 12, no evidence-based parenting programs have been tested in randomized trials in Greece. We pilot-tested the efficacy of a brief parenting intervention for universal prevention of child behavioral and emotional difficulties. Parents from the general population (N = 124) were randomly assigned to receive the Triple P (Positive Parenting Program) Seminar Series (n = 83), or leaflet information on child health (n = 41). Most participants were highly educated mothers with boys and girls aged 2–12, from middle-income, inner-city households. Participants reported on child behavior, parenting style and parenting adjustment, before and after the intervention and six months later. At post-intervention, parent-reported behavioral problems were reduced in the intervention group, but increased in the control group (p = 0.001); these differences remained at 6-month follow-up. Of those in the clinical range (28%) at baseline, significantly more intervention children than control children moved to normal range six months later. Disrupted parenting practices were reduced more in intervention parents at post-intervention but were not maintained at follow-up. No significant differences were found in secondary child behavioral difficulties, child emotional difficulties, parenting confidence and distress over time. This Seminar Series is a brief, easily replicable and likely cost-effective early intervention leading to significant medium-sized reductions over six months in behavioral difficulties, and improvements in disrupted parenting. These findings broadly support other evidence about effective transportability of parenting interventions across countries.

Associations of prenatal triclosan exposure with parent-reported behavioral problems in 2- and 3-year-old children

Associations of prenatal triclosan exposure with parent-reported behavioral problems in 2- and 3-year-old children

Resting-State Cerebral Hemodynamics is Associated With Problem Behaviors in Pediatric Sleep-Disordered Breathing.

Untreated sleep-disordered breathing (SDB) is associated with problem behaviors in children. The neurological basis for this relationship is unknown. We used functional near-infrared spectroscopy (fNIRS) to assess the relationship between cerebral hemodynamics of the frontal lobe of the brain and problem behaviors in children with SDB. Cross-sectional. Urban tertiary care academic children's hospital and affiliated sleep center. We enrolled children with SDB aged 5 to 16 years old referred for polysomnography. We measured fNIRS-derived cerebral hemodynamics within the frontal lobe during polysomnography. We assessed parent-reported problem behaviors using the Behavioral Response Inventory of Executive Function Second Edition (BRIEF-2). We compared the relationships between (i) the instability in cerebral perfusion in the frontal lobe measured fNIRS, (ii) SDB severity using apnea-hypopnea index (AHI), and (iii) BRIEF-2 clinical scales using Pearson correlation (r). A p < .05 was considered significant. A total of 54 children were included. The average age was 7.8 (95% confidence interval, 7.0-8.7) years; 26 (48%) were boys and 25 (46%) were Black. The mean AHI was 9.9 (5.7-14.1). There is a statistically significant inverse relationship between the coefficient of variation of perfusion in the frontal lobe and BRIEF-2 clinical scales (range of r = 0.24-0.49, range of p = .076 to <.001). The correlations between AHI and BRIEF-2 scales were not statistically significant. These results provide preliminary evidence for fNIRS as a child-friendly biomarker for the assessment of adverse outcomes of SDB.

Early childhood parent-reported speech problems in small and large for gestational age term-born and preterm-born infants: a cohort study

Objective(1) To assess if preterm and term small for gestational age (SGA) or large for gestational age (LGA) infants have more parent-reported speech problems in early childhood compared with infants...

Executive function and behaviour problems in school-age children born at risk of neonatal hypoglycaemia.

To examine the relationship between neonatal hypoglycaemia and specific areas of executive function and behaviour in mid-childhood. Participants in a prospective cohort study of infants born late preterm or at term at risk of neonatal hypoglycaemia were assessed at 9 to 10 years. We assessed executive function using performance-based (Cambridge Neuropsychological Tests Automated Battery) and questionnaire-based (Behavior Rating Inventory of Executive Function) measures and behaviour problems with the Strengths and Difficulties Questionnaire. Data are reported as adjusted odds ratio (aOR) with 95% confidence intervals, and standardized regression coefficients. We assessed 480 (230 females, 250 males; mean age 9 years 5 months [SD 4 months, range 8 years 8 months-11 years 0 months]) of 587 eligible children (82%). There were no differences in performance-based executive function between children who did and did not experience neonatal hypoglycaemia (blood glucose <2.6 mmoL/L). However, children who experienced hypoglycaemia, especially if severe or recurrent, were at greater risk of parent-reported metacognition difficulties (aOR 2.37-3.71), parent-reported peer (aOR 1.62-1.89) and teacher-reported conduct (aOR 2.14 for severe hypoglycaemia) problems. Both performance- and questionnaire-based executive functions were associated with behaviour problems. Neonatal hypoglycaemia may be associated with difficulties in specific aspects of parent-reported executive functions and behaviour problems in mid-childhood.

Secular trends and social inequalities in child behavioural problems across three Brazilian cohort studies (1993, 2004 and 2015).

Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019. The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n=633), 2008 (2004 cohort, n=3750) and 2019 (2015 cohort, n=577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019. Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change=-2.75; 95% confidence interval [CI]: -3.56,-1.94; P<0.001), aggression (mean change=-1.84; 95% CI: -2.51,-1.17; P<0.001) and rule-breaking behaviour (mean change=-0.91; 95% CI: -1.13, -0.69 P<0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019. Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.

Implementation and Mental Health Outcomes of a Service Cascade Linking Child Welfare and Children’s Mental Health Systems: A Case Study of the Gateway CALL Demonstration

The mental health needs of children and youth involved in the child welfare system remain largely unmet. Service cascades are an emerging approach to systematizing mental health screening, assessment, and treatment referral processes. However, evidence is minimal and inconsistent regarding the effectiveness of such approaches for improving mental health service access and outcomes. In an effort to address this gap, this study presents a case-study of the implementation fidelity and treatment outcomes of the Gateway CALL service cascade. Study analyses involved longitudinal data collected as part of a larger evaluation of Gateway CALL. Specifically, descriptive and linear mixed model analyses were conducted to assess the implementation of service cascade components, and changes in mental health outcomes (behavior problems) among 175 children placed out-of-home during the study. Study analyses found that although fidelity was strong early in the service cascade, implementation began to break down once components involved more than one service system (child welfare, mental health). However, results also indicated that parent-reported child behavior problems decreased significantly over time, despite later cascade components being implemented with poor fidelity to the Gateway CALL service model. For children and youth involved in child welfare systems, service cascades like Gateway CALL have the potential to significantly improve both mental health service receipt and outcomes. To maximize the effectiveness of such approaches, later phases of implementation may require increased attention and support, particularly regarding processes and outcomes that cross child welfare and mental health service systems.

Patterns of adverse childhood experiences among Chinese preschool parents and the intergenerational transmission of risk to offspring behavioural problems: moderating by coparenting quality

ABSTRACT Background: Although intergenerational transmission of ACEs among parents and their offspring have been extensively studied in the West, few studies have been conducted in China on preschool children and their parents, and explore the protective fact for the intergeneration transmission. Objective: Using latent class analysis and moderation model, this study examined the associations between patterns of adverse childhood experiences of Chinese preschool parents and behavioural problems in their children and whether coparenting quality plays a protective role in this relationship. Method: A retrospective study was conducted on 3091 parent–child dyads from 11 kindergartens in the northern, central, and southern Anhui provinces in China. Online questionnaires were used to collect the data. Parents reported adverse childhood experiences (ACEs) and provided information on their children's behavioural problems and perceived coparenting quality. Latent class analysis and a moderating model were used to examine the associations between patterns of adverse childhood experiences of Chinese preschool parents and behavioural problems in their children, and the moderating role of coparenting quality. Results: Four classes were identified: a high ACEs group, a violent victimisation group, a child abuse and physical neglect group, and a low ACEs group. Increasing levels of co-parenting quality were associated with reduced parent-reported child behaviour problems for all classes, and that potentially buffering effect was significantly stronger for the low ACEs class than for children whose parents in high ACEs class. Conclusions: Exposure to high ACEs increases the risk of developing behavioural problems in offspring, and coparenting quality may serve as a protective mechanism for intergenerational transmission. Future research should develop and implement interventions to support disadvantaged, at-risk parents and promote coparenting quality.

An Internet-Based Parent Training With Telephone Coaching on Managing Disruptive Behavior in Children at Special Family Counseling Centers During the COVID-19 Pandemic: Feasibility Study.

There is growing concern about the short- and long-term impacts that the COVID-19 pandemic will have on the mental health and psychosocial well-being of children and families. There are no existing studies about feasibility and outcomes using internet-based parent training programs with telephone coaching for disruptive behavioral problems in childhood during the COVID-19 pandemic in clinical settings. This study explored how the Strongest Families Smart Website (SFSW) parent training program, with telephone coaching, provided support during the COVID-19 pandemic at specialist family counseling centers in Helsinki, Finland, when restrictions made face-to-face counseling impossible. This study followed the success of a randomized controlled trial (RCT) and its implementation study of the SFSW parent training program by primary care child health clinics. The aim was to improve parenting skills, so that parents could tackle disruptive behavior by developing positive parent-child relationships. It started in May 2020, when the COVID-19 pandemic was at its height in Finland. In total, 8 family counseling centers in Helsinki identified 50 referrals aged 3-8 years with high levels of parent-reported disruptive behavioral problems. Child psychopathology and functioning and parental skills and well-being were measured at baseline, posttreatment, and 6 months later using a range of tools. The data were extracted from questionnaires completed by the parents. We found that 44 (88%) of the 50 families completed the whole 11-session parent training program. Most of the children (n=48, 96%) had definitive or severe behavioral problems when they were initially screened by the centers, but with those assessed at the 6-month follow-up (n=45, 90%), this dropped to 58% (n=26). There were significant changes from baseline to 6-month follow-up in most of the child psychopathology measures, including the Child Behavior Checklist-Parent Report Form (CBCL) total score (mean change 16.3, SE 3.0, 95% CI 10.2-22.3; P<.001) and externalizing score (mean change 7.0, SE 1.0, 95% CI 4.9-9.0; P<.001). When parenting skills were measured with the Parenting Scale (PS), they showed significant changes from baseline to 6-month follow-up in total scores (mean change 0.5, SE 0.1, 95% CI 0.4-0.7; P<.001). Parents showed significant change in the stress subscore (mean change 3.9, SE 0.8, 95% CI 2.2-5.6; P<.001). Of the parents who filled in the satisfaction questionnaire (n=45, 90%), 42 (93%) reported high satisfaction in the skills and 44 (98%) in the professionalism of the family coaches. The program proved to be an effective method for improving parenting skills and child psychopathology and functioning. The parents were satisfied with the program, and the dropout rate was exceptionally low. The study shows that the training program could be implemented in specialist clinical settings and during crisis conditions, such as the COVID-19 pandemic.

Reciprocal Relations Between Conflicted Student-teacher Relationship and Children’s Behavior Problems: Within-person Analyses from Norway and the USA

Current evidence suggests that conflicted student-teacher relationships may increase behavior problems in children and vice-versa, but this may be due to confounding. We therefore analyzed their relation applying a within-person approach that adjusts for all time-invariant confounding effects, involving samples from Norway (n = 964, 50.9% females) and the USA (n = 1,150, 48.3% females) followed from age 4–12 years with similar measures. Increased parent-reported behavior problems forecasted increased student-teacher conflict to a similar extent in both countries (β = 0.07, p = .010), whereas teacher-reported behavior problems predicted increased student-teacher conflict more strongly in Norway (β = 0.14, p = .001) than in the US (β = 0.08, p = .050). Increased teacher-child conflict also predicted increased parent-reported (β = 0.07, p = .010), but not teacher-reported, behavior problems in both countries. Findings underscore the reciprocal relation between behavior problems and a conflictual student-teacher relationship.

Postnatal maternal depressive symptoms and behavioural outcomes in term-born and preterm-born toddlers: a longitudinal UK community cohort study

ObjectivesTo examine the association between maternal depressive symptoms in the immediate postnatal period and offspring’s behavioural outcomes in a large cohort of term-born and preterm-born toddlers.Design and participantsData were drawn...

Temporal stability of parent-reported behavior problems in late talkers over 2 years: a prospective case-control study from toddlerhood to preschool age

BackgroundLate talking (LT) in toddlers is a risk factor for language weakness that may interfere with the development of using language to regulate behavior and emotion and contribute to the development of behavior problems from early childhood. This study examined the temporal stability of parent-reported behavior problems among Mandarin-speaking LT toddlers from ages 2 to 4 in Taiwan.MethodsThirty-one LT and 31 typical language development (TLD) toddlers were assessed for their vocabulary production at age 2 with the Words and Sentences Forms of the MacArthur-Bates Communicative Developmental Inventories Toddler Form (Taiwan version). Additionally, participants’ receptive and expressive language abilities were assessed using the receptive and expressive language subscales of the Bayley Scales of Infant and Toddler Development, Third Edition. At age 4, the Child Language Disorder Scale-Revised was applied and included the two core subtests for auditory comprehension and expressive communication. At ages 2 and 4 years, behavior problems were assessed with the Child Behavior Checklist.ResultsThere was a higher percentage of participants with persistent behavior problems among LT toddlers than among TLD toddlers. Moreover, toddlers with larger vocabularies were less likely to develop withdrawal behaviors by preschool age.ConclusionsThis study supported the temporal stability of parent-reported behavior problems among LT toddlers across early childhood. Early identification of and intervention for behavior problems associated with LT in toddlerhood is essential to alleviate their behavior problems later in preschool years.

Parent Training for Dental Care in Underserved Children With Autism: A Randomized Controlled Trial.

Children with autism spectrum disorder (ASD) have difficulty participating in dental care and experience significant unmet dental needs. We examined the efficacy of parent training (PT) for improving oral hygiene and oral health in underserved children with ASD. Families of Medicaid-eligible children with ASD (ages 3-13 years, 85% boys, 62% with intellectual disability) reporting difficulty with dental care participated in a 6-month randomized controlled trial comparing PT (n = 60) with a psychoeducational dental toolkit (n = 59). Primary outcomes were parent-reported frequency of twice-daily toothbrushing and dentist-rated visible plaque. Secondary outcomes included parent-reported child behavior problems during home oral hygiene and dentist-rated caries. Dentists were blind to intervention assignment. Analyses were intention to treat. Retention was high at posttreatment (3 months, 93%) and 6-month follow-up (90%). Compared with the toolkit intervention, PT was associated with increased twice-daily toothbrushing at 3 (78% vs 55%, respectively; P < .001) and 6 (78% vs 62%; P = .002) months and a reduction in plaque at 3 months (intervention effect, -0.19; 95% confidence interval [CI], -0.36 to -0.02; P = .03) and child problem behaviors at 3 (-0.90; 95% CI, -1.52 to -0.28; P = .005) and 6 (-0.77; 95% CI, -1.39 to -0.14; P = .02) months. Comparatively fewer caries developed in children receiving the PT intervention over 3 months (ratio of rate ratios, 0.73; 95% CI, 0.54 to 0.99; P = .04). PT represents a promising approach for improving oral hygiene and oral health in underserved children with ASD at risk for dental problems.

Child behavior problems during COVID-19: Associations with parent distress and child social-emotional skills

The COVID-19 pandemic and associated government-mandated shutdowns disrupted schooling, socialization, and family life for school-aged children during spring 2020. These disruptions may have contributed to increased child behavior problems. Thus, we examined behavior problems in 247 children aged 7 to 9 years during Ohio's shutdown period. We investigated whether differences in parent-reported child behavior problems were associated with concurrent parent distress during spring 2020 and/or children's social-emotional skills measured via teacher-reports from the previous year (spring 2019). Parent distress significantly predicted behavior problems, such that more distressed parents also reported more child behavior problems. Child pre-pandemic peer social skills also significantly predicted behavior problems, such that more skilled children exhibited fewer behavior problems. There were no interaction effects between parent distress and children's social-emotional skills on child behavior problems. Further research is needed to understand how children's social-emotional skills impact their ability to cope during times of epidemiological crisis.

Favorable parental perception of behaviour at two years' corrected age in very preterm-born children

Problems in behavioural and emotional outcome are amongst the long-term sequelae of preterm birth. The exact prevalence and associations with perinatal risk factors are unknown. Minimal research has been performed in pre-school aged children, compared to school age. The primary aim of this study was to determine the prevalence of parent-reported behavioural and emotional problems at the age of two in children born at less than 30 weeks' gestational age and/or birth weight less than 1000 g. The secondary aim was to determine whether perinatal factors were associated with the behavioural and emotional outcome.Perinatal characteristics of 144 preterm-born children from the NeoLiFeS cohort were collected retrospectively. Of these children, 101 parents filled out a Childs Behaviour Checklist (CBCL) at the corrected age of two. The results of the CBCL tests were presented as Z-scores, a Z-score of 0 indicating the mean of behavioural scores in the norm population. A Z-score higher than zero indicates less behavioural problems than average, a negative Z-score indicates more problems. Associations between perinatal risk factors and CBCL-scores were analysed using linear regression analyses.Prevalences of clinically relevant CBCL scores were low, 4%, 2% and 5% for total score, internalizing score or externalizing score, respectively. Being part of a twin was associated with higher internalizing Z-scores, indicating less problems in emotional behaviour. Bronchopulmonary dysplasia was associated with lower Z-scores in total and externalizing behaviour. In conclusion, in our cohort generally very few problems in behavioural and emotional outcome were reported at the age of two.

Sleep, Function, Behaviour and Cognition in a Cohort of Children with Down Syndrome.

Objective: To describe the sleep problems experienced by children with Down syndrome attending a tertiary sleep clinic and relationship with behaviour, function and cognition. Methods: Data were collected from children with Down syndrome aged 3–18 years old. Carers completed the Abbreviated Child Sleep Habits Questionnaire, Child Behaviour Checklist and Life-Habits Questionnaire at enrolment. Cognitive assessment (Stanford-Binet 5) was undertaken by a trained psychologist. Children received management for their sleep problem as clinically indicated. Results: Forty-two subjects with a median age of 6.8 years (Interquartile Range-IQR 4.5, 9.8) were enrolled. A total of 92% were referred with snoring or symptoms of Obstructive Sleep Apnoea (OSA), with 79% of those referred having had previous ENT surgery. Thus, 85% of all participants underwent a sleep study and 61% were diagnosed with OSA (OAHI ≥ 1/h). Based on questionnaires, 86% of respondents indicated that their child had a significant sleep disorder and non-respiratory sleep problems were common. Non-respiratory problems included: trouble going to sleep independently (45%), restless sleep (76%), night-time waking (24%) and bedtime resistance (22%). No significant correlations were found between sleep measures (behavioural and medical sleep problems) and the behavioural, functional or cognitive parameters. Conclusion: Sleep disorders were very common, especially non-respiratory sleep problems. OSA was common despite previous surgery. No association was found between sleep-related problems (snoring, sleep-study-confirmed OSA or non-respiratory sleep problem) and parent-reported behavioural problems, functional impairments or intellectual performance. This may reflect limitations of the measures used in this study, that in this population ongoing problems with daytime function are not sleep related or that a cross-sectional assessment does not adequately take into account the impacts of past disease/treatments. Further research is required to further evaluate the tools used to evaluate sleep disorders, the impact of those disorder on children with Down syndrome and interventions which improve both sleep and daytime function.