title: Tympanic membrane temperature in adopted children associated with sleep problems and pre-adoption living arrangements: an exploratory study.
abstract: BACKGROUND
  Tympanic membrane temperature (TMT) has been proposed as an indicator of cerebral activation and TMT asymmetry may indicate lateralization, which has been associated with specific (problem) behaviors in children and adults. The current study explored the relations between pre-adoption living arrangements, TMT, and behavior and sleep problems in a sample of adopted toddlers.
  
  
  METHODS
  Ninety-two families who had adopted a Chinese girl who had previously been placed in an institution or foster care reported on behavior problems using the Child Behavior Checklist and TMT two months (Time 1) and six months (Time 2) after adoption.
  
  
  RESULTS
  Structural equation modeling revealed that institutionalized children had significantly higher left than right TMTs compared with foster care children at Time 2. A higher left than right TMT was associated with increased sleep problems and total behavior problems at Time 1, but not at Time 2.
  
  
  CONCLUSIONS
  Our findings with regard to pre-adoption living arrangements, TMT asymmetry, and sleep problems suggest that TMT is sensitive to early environmental influences and may be a biological marker of vulnerability to the development of sleep problems in children from adverse backgrounds.
authors.affiliation: Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands.
authors.forename: Rani C
authors.initials: RC
authors.lastname: Damsteegt
authors.affiliation: Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands.
authors.forename: Marinus H
authors.initials: MH
authors.lastname: van IJzendoorn
authors.affiliation: Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Out
authors.affiliation: Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands.
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Bakermans-Kranenburg
keywords: Adoption; Behavior problems; Sleep problems; Tympanic membrane temperature