Journal Abstract
AMERICAN JOURNAL OF FAMILY PSYCHOLOGY
Relationship of Children’s Daytime Behavior Problems with Bedtime Routines/Practices: A Family Context and the Consideration of Faux-ADHD
AUTHORS: Robert M. Pressman, Ph.D., ABPP,* and Steve C. Imber, Ph.D**
*Director of Research, New England Center for Pediatric Psychology, Providence, Rhode Island and **Professor, Dept of Special Education, Rhode Island College, Providence, Rhode Island
Key Words: ADHD, FAUX ADHD, Assault, Bedtime Routines, Bed-sharing, Behavior, Child Diagnosis, Fears
Acceptance Date: June 13, 2011.
Presentation Date:: August 6, 2011. American Psychological Association, Grand Hyatt Washington Hotel, Washington, D.C.
Publication Date: September 20, 2011
Copyright: © 2011 American Journal of Family Therapy.
WHAT THIS STUDY ADDS: There are clear links between two bedtime habits—bed sharing and non-specific bedtimes—and several problem daytime behaviors that include ADHD-like behavior and assault by a child against a parent. We posit the existence of Faux ADHD, consisting of a group of daytime behaviors that look like ADHD, but are strongly linked to bedtime routines rather than the neurology of the child.
WHAT’S KNOWN ON THIS SUBJECT: Except in reference to a narrow range of medical issues, there is limited evidence published regarding the specific effects of bedtime routines on daytime behavior. The most studied variables regarding bedtime routines/practices are the physical arrangements, or more specifically, where and with whom the child sleeps. Parental rating questionnaires most commonly used for assessment, diagnosis, and treatment planning are generally devoid of items that appraise bedtime routines/practices. There is no evidence to indicate that bedtime habits are routinely assessed during intake procedures.
OBJECTIVE: Our study was initiated to confirm or reject a relationship between bed sharing and non-specific bedtimes with daytime behavior problems of children.
METHODS: Our study consisted of 704 parents of children ages 2-14 who were being seen in pediatricians’ offices. Selection of offices was made by cluster sampling in Providence, RI, resulting in 14 data collection sites. Data were collected by a questionnaire constructed to assess categorical responses.
RESULTS: Using the chi-square test for analysis of categorical responses, the following were clearly (p-values <.0001) determined:
- Children who did not sleep in their own beds had ADHD-like behaviors 7 times more frequently than children who always slept in their own beds.
- Children who did not sleep in their own beds hit, pushed, or kicked their parents 13 times more frequently than children who always slept in their own beds.
- Children who did not have a regular bedtime had ADHD-like behaviors 8 times more frequently than children who had a regular bedtime.
- Children who did not have a regular bedtime hit, pushed, or kicked their parents 10 times more frequently than children who had a regular bedtime.
In addition, our study showed clear relationships between bedtime habits and tantrums, self confidence, and notes home from school about behavior problems. Data collected indicated that approximately 33% of children are recommended ADHD medication, although prevalence rates of actual ADHD are only reported between 3%-10%.
CONCLUSIONS AND RECOMMENDATIONS: There is a clear link between bed sharing and non-specific bedtimes with many daytime problem behaviors of children, most disturbingly ADHD-like behaviors and hitting, pushing or kicking behaviors against parents. We strongly recommend that:
- Bedtime habits be assessed at intake.
- Bedtime problems identified in this study be eliminated before ADHD medication is considered.
