title: External validity of children's self-reported sleep functioning: associations with academic, social, and behavioral adjustment.
abstract: OBJECTIVE
  Several child-report measures of sleep functioning have been developed but very few studies have examined the external validity of child self-reported sleep in relation to daytime functioning. This study examined child-reported sleep in relation to teacher-rated psychopathology symptoms and also tested the hypothesis that child-reported sleep would be associated with poorer child- and teacher-reported functioning after controlling for demographics and psychopathology symptoms that are known to be associated with adjustment.
  
  
  METHODS
  Participants were 175 children (81 boys, 94 girls) in 1st-6th grades (ages 6-13) and their teachers. Children completed the Sleep Self-Report. Teachers completed a measure of attention-deficit/hyperactivity disorder (ADHD), oppositional/conduct, and anxiety/depression symptoms. Children and teachers completed multiple measures of academic, behavioral, and social/peer functioning.
  
  
  RESULTS
  Child-reported sleep was significantly associated with teacher-rated inattentive and internalizing symptoms, even after controlling for child demographics, hyperactivity-impulsivity, and conduct problems. Multilevel modeling analyses further indicated that, after controlling for child demographics and psychopathology symptoms, child-reported sleep problems were significantly associated with poorer child- and teacher-reported academic, behavioral, and social functioning (including increased reactive aggression, peer rejection, loneliness, and lower friendship satisfaction and self-worth).
  
  
  CONCLUSIONS
  Findings provide initial support for the external validity of children's self-reported sleep functioning. Results of this study suggest that it may be clinically useful to screen for sleep problems by assessing for children's own perceptions of their sleep. Future studies should include both child- and parent-reported sleep functioning to further examine the utility of children's ratings of sleep functioning.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. Electronic address: stephen.becker@cchmc.org.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Becker
mesh_terms: D000124:Achievement; D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012650:Self Disclosure; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology; D012917:Social Adjustment; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
keywords: Anxiety; Assessment; Attention problems; Depression; School functioning; Self-esteem; Sleep problems; Social functioning