Purpose: This study examined sleep problems in Flemish (Dutch speaking part of Belgium) school-aged children (4–12 years) placed in family foster care. Research design: Foster parents (n = 197) completed an online questionnaire consisting of: (1) characteristics of foster child, foster family and foster placement, (2) behavioural problems of foster child, and (3) sleep problems of foster child using the Dutch version of the ‘Children’s Sleep Habits Questionnaire (CSHQ)’. Higher scores indicate more sleep problems. Results: Based on a cut-off value used in an American sample, 71.1% of the foster children in our sample screened positive for clinically significant sleep problems. In general, foster children scored significantly higher than children from different community samples and significantly lower than children from different sleep-disordered samples. Multiple regression analysis showed that sleep problems were significantly associated with internalizing problem behaviour, externalizing problem behaviour, and household composition. The likelihood of experiencing/perceiving sleep problems in foster children was higher in case of more internalizing or externalizing problem behaviour and in case of single parenthood. Conclusion: These results highlight the importance of screening, assessment and intervention in foster children with sleep problems by health professionals.
AlfanoC. A. (2020). Foster agency workers’ perceptions of sleep health among children in foster care. Children and Youth Services Review, 117(10), Article 105316. https://doi.org/10.1016/j.childyouth.2020.105316
2.
AlfanoC. A.ValentineM.NogalesJ. M.KimJ.KimJ. S.RigosP.McGlincheyE.RippleC. H.WolfsonA. R. (2022). How are the sleep problems of children in the US foster care system addressed?Journal of Developmental and Behavioral Pediatrics, 43(8), 525–532. https://doi.org/10.1097/dbp.0000000000001090
3.
AlvaroP. K.RobertsR. M.HarrisJ. K. (2013). A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep, 36(7), 1059–1068. https://doi.org/10.5665/sleep.2810
4.
BayesD. M.BullockB. (2020). Sleep problems in school aged children: A common process across internalising and externalising behaviours?Clocks & Sleep, 2(1), 7–18. https://doi.org/10.3390/clockssleep2010002
5.
BeebeD. W. (2011). Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatric Clinics of North America, 58(3), 649–665. https://doi.org/10.1016/j.pcl.2011.03.002
6.
BosmanD. J.VerhagenC. E.UitenbroekD. G. (2018). Slaaptekort en schoolverzuim bij jongeren: is er een relatie?Tijdschrift voor Gezondheidswetenschappen, 96(2), 79–89. https://doi.org/10.1007/s12508-018-0111-8
7.
CarterK. A.HathawayN. E.LettieriC. F. (2014). Common sleep disorders in children. American Family Physician, 89(5), 368–377.
8.
ChowC. M. (2020). Sleep and wellbeing, now and in the future. International Journal of Environmental Research and Public Health, 17(8), 2883. https://doi.org/10.3390/ijerph17082883
9.
CohenJ. (1988). Statistical power analysis for the behavioral sciences: Lawrence Earlbaum Associates.
10.
DewaldJ. F.MeijerA. M.OortF. J.KerkhofG. A.BögelsS. M. (2010). The influence of sleep quality, sleepiness, and sleep duration on school performance in children and adolescents: A meta-analytic review. Sleep Medicine Reviews, 14(3), 179–189. https://doi.org/10.1016/j.smrv.2009.10.004
11.
Dubois-ComtoisK.CyrC.PennestriM.-H.GoboutR. (2016). Poor quality of sleep in foster children relates to maltreatment and placement conditions. Sage Open, 6(4), Article 21582440166. https://doi.org/10.1177/2158244016669551
12.
GregoryA.van der EndeJ.WillisT.VerhulstF. (2008). Parent-reported sleep problems during development and self-reported anxiety/depression, attention problems, and aggressive behavior later in life. Archives of Pediatrics and Adolescent Medicine, 162(4), 330–335. https://doi.org/10.1001/archpedi.162.4.330
13.
GregoryA. M.RijsdijkF. V.DahlR. E.McGuffinP.EleyT. C. (2006). Associations between sleep problems, anxiety and depression in twins at 8 years of age. Pediatrics, 118(3), 1124–1132. https://doi.org/10.1542/peds.2005-3118
14.
GregoryA. M.RijsdijkF. V.EleyT. C.MoffittT. E.OconnorT. G.PoultonR. (2005). Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood. Journal of Abnormal Child Psychology, 33(2), 157–163. https://doi.org/10.1007/s10802-005-1824-0
15.
HambrickE. P.RubensS. L.BrawnerT. W.TaussigH. N. (2018). Do sleep problems mediate the link between adverse childhood experiences and delinquency in preadolescent children in foster care?Journal of Child Psychology and Psychiatry, 59(2), 140–149. https://doi.org/10.1111/jcpp.12802
16.
HashJ. B.AlfanoC. A.OwensJ.LittlewoodK.DayA.PandeyA.OrdwayM. R.WardT. M. (2022). Call to action: Prioritizing sleep health among US children and youth residing in alternative care settings. Sleep Health, 8(1), 23–27. https://doi.org/10.1016/j.sleh.2021.10.002
17.
HendriksD.de BruinE. (2022). Slaapproblemen bij kinderen tot 12 jaar. Protocollaire behandeling. In BraetC.BögelsS. (Eds.), Protocollaire behandelingen voor kinderen en adolescenten met psychische klachten-deel 3 (pp. 41–98). Boom uitgevers.
18.
HopeP.NogalesJ. M.EndleinM.WolfsonA.AlfanoC.RippleC. (2023). Developing and implementing sleep health education for foster personnel: A qualitative analysis. Sleep, 46(Supplement_1), A110. https://doi.org/10.1093/sleep/zsad077.0247
19.
LehmannS.Gärtner AskelandK.HysingM. (2020). Sleep among youth in foster care: Associations with potentially traumatic events, PTSD and mental health. Child & Family Social Work, 26(1), 111–121. https://doi.org/10.1111/cfs.12794
20.
LionettiF.DellagiuliaA.VerderameC.SperatirA.BodaleG.SinelliM.FasoloM. (2021). The Children’s sleep habits questionnaire: Identification of sleep dimensions, normative values, and associations with behavioral problems in Italian preschoolers. Sleep Health, 7(3), 390–396. https://doi.org/10.1016/j.sleh.2021.03.002
21.
LiuJ.GlennA. L.CuiN.RaineA. (2021). Longitudinal bidirectional association between sleep and behavior problems at age 6 and 11 years. Sleep Medicine, 83(3), 290–298. https://doi.org/10.1016/j.sleepe.2022.100039
22.
LiuJ.MagielskyJ.GlennA.RaineA. (2022). The bidirectional relationship between sleep and externalizing behavior: A systematic review. Sleep Epidemiology, 2(1), 100039. https://doi.org/10.1016/j.sleepe.2022.100039
23.
LiuX.LiuL.OwensJ. A.KaplanD. L. (2005). Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics, 115(1), 241–249. https://doi.org/10.1542/peds.2004-0815F
24.
LoureiroH. C.PintoT. R.PintoJ. C.PintoH. R.PaivaT. (2013). Validation of the children sleep habits questionnaire and the sleep self report for portuguese children. Sleep Science, 6(4), 151–158.
25.
MancinelliE.Dell’ArcipreteG.SalcuniS. (2021). A systematic review on foster parents’ psychological adjustment and parenting style—an evaluation of foster parents and foster children variables. International Journal of Environmental Research and Public Health, 18(20), 10916. https://doi.org/10.3390/ijerph182010916
26.
McDowallP. S.GallandB. C.CampbellA. J.ElderD. E. (2017). Parent knowledge of children’s sleep: A systematic review. Sleep Medicine Reviews, 31(1), 39–47. https://doi.org/10.1016/j.smrv.2016.01.002
27.
McGlincheyE. L.RigosP.KimJ. S.NogalesJ. M.ValentineM.KimJ.RippleC. H.WolfsonA. R.AlfanoC. A. (2023). Foster caregivers’ perception of children’s sleep patterns, problems, and environments. Journal of Pediatric Psychology, 48(3), 254–266. https://doi.org/10.1093/jpepsy/jsac087
28.
MeijerA. M.ReitzE.DekovicM.van den WittenboerG. L. H.StoelR. D. (2010). Longitudinal relations between sleep quality, sleep duration, and adolescent problem behavior. Journal of Child Psychology and Psychiatry, 51(11), 1278–1286. https://doi.org/10.1111/j.1469-7610.2010.02261.x
29.
MesmanG. R.JohnS. G.DoughertyE. H.EdgeN. A.PembertonJ. L.VanderzeeK. L.McKelveyL. M. (2021). Sleep as moderator of young children’s traumatic stress and behavior problems: A treatment referred sample. Journal of Child & Adolescent Trauma, 14(3), 311–319. https://doi.org/10.1007/s40653-020-00318-w
30.
NogalesJ. M.ValentineM.RigosP.KimJ.KimJ.AlfanoC.McGlincheyE.RippleC.WolfsonA. (2021). Qualitative analysis of bedtime challenges and parental interventions in foster care children. Sleep, 44(Supplement_2), A243. https://doi.org/10.1093/sleep/zsab072.616
31.
OwensJ. A.DalzellV. (2005). Use of ‘BEARS’ sleep screening tool in a pediatric residents’ continuity clinic: A pilot study. Sleep Medicine, 6(1), 63–69. https://doi.org/10.1016/j.sleep.2004.07.015
32.
OwensJ. A.SpiritoA.McGuinnM. (2000). The Children’s sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1–9. https://doi.org/10.1037/t33022-000
33.
Pleegzorg Vlaanderen. (2024). Pleegzorg in cijfers 2022. Pleegzorg Vlaanderen vzw.
34.
SadehA.GruberR.RavivA. (2002). Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Development, 73(2), 405–417. https://doi.org/10.1111/1467-8624.00414
SchlarbA. A.SchwerdtleB.HautzingerM. (2010). Validation and psychometric properties of the German version of the Children’s sleep habits questionnaire (CSHQ-DE). Somnologie, 14(4), 260–266. https://doi.org/10.1007/s11818-010-0495-4
37.
ServotS.St-AmandA.RousseauM.SimardV.TouchetteE. (2021). Sleep ecology, sleep characteristics and behavior problems in young maltreated children: A scoping review. Child Abuse & Neglect, 122(12), Article 105364. https://doi.org/10.1016/j.chiabu.2021.105364
38.
ShahidA.WilkinsonK.MarcuS.ShapiroC. M. (2011). Children’s sleep habits questionnaire (CSHQ). In ShahidA.WilkinsonK.MarcuS.ShapiroC. (Eds.), STOP, THAT and one hundred other sleep scales (pp. 119–122). Springer. https://doi.org/10.1007/978-1-4419-9893-4_21
39.
SmedjeH.BromanJ.-E.HettaJ. (2001). Associations between disturbed sleep and behavioural difficulties in 635 children aged six to eight years: A study based on parents' perceptions. European Child & Adolescent Psychiatry, 10(1), 1–9. https://doi.org/10.1007/s007870170041
40.
TininenkoJ. R.FisherP. A.BruceJ.PearsK. C. (2010a). Sleep disruption in young foster children. Child Psychiatry and Human Development, 41(4), 409–424. https://doi.org/10.1007/s10578-010-0177-2
41.
TininenkoJ. R.FisherP. A.BruceJ.PearsK. C. (2010b). Associations between sleep and inattentive/hyperactive problem behavior among foster and community children. Journal of Developmental and Behavioral Pediatrics, 31(8), 668–674. https://doi.org/10.1097%2FDBP.0b013e3181f1773b
42.
VanderfaeillieJ.GypenL.WestD.Van HolenF. (2020). Support needs and satisfaction of Flemish foster parents in long-term foster care: Associated characteristics of foster children, foster parents and foster placements. Children and Youth Services Review, 113(6), Article 104990. https://doi.org/10.1016/j.childyouth.2020.104990
VanderfaeillieJ.Van HolenF. (2018). En chemin vers la parentalité d’accueil en Flandre. In ChaponN.PremoliS. (Eds.), La parentalité d'accueil en Europe: Regards théoriques et pratiques professionnelles (pp. 143–166). Presses Universitaires de Provence.
45.
van LitsenburgR.WaumansR.BergL.GemkeR. (2010). Sleep habits and sleep disturbances in Dutch children: A population-based study. European Journal of Pediatrics, 169(8), 1009–1015. https://doi.org/10.1007/s00431-010-1169-8
46.
WaumansR.TerweeC.Van den BergG.KnolD.van LitsenburgR.GemkeR. J. B. J. (2010). Sleep and sleep disturbance in children: Reliability and validity of the Dutch version of the sleep habits questionnaire. Sleep, 33(6), 841–845. https://doi.org/10.1093/sleep/33.6.841
