Sleep and self-regulation in early childhood

Influence of lifestyle and family environment factors on mental health problems in Hong Kong preschoolers

BACKGROUND AND AIMS

Existing studies that simultaneously consider the effects of lifestyle and family environment factors on mental health problems (MHPs), particularly in preschoolers, are limited. This study aims to explore lifestyle and family environment factors associated with MHPs, externalising problems (EPs) and internalising problems (IPs) in preschoolers.

METHODS

This territory-wide, school-based study conducted from 2020 to 2022 involved 1926 preschoolers. MHPs, EPs, and IPs and factors such as sleep duration, sleep latency, entertainment screen time, educational screen time, parent-child recreation and learning activities were assessed. Linear and logistic regression analyses were used to explore the relationships between these factors and MHPs, EPs, and IPs.

RESULTS

The average sleep duration was 9.94 h per day, average screen time of 2.53 h per day, and 42.6 % experienced sleep latency exceeding 20 min per day among preschoolers (mean age: 4.39 years, 49.1 % female). Adjusted analyses showed that decreased parent-child recreation activities, prolonged sleep latency and excessive entertainment screen time were associated with increased MHPs, EPs, and IPs (β: 0.05 to 0.20, all p < 0.05). Weekend sleep duration of <10 h per day, sleep latency of >20 min per day, and educational screen time of >30 min per day were identified as risk factors for MHPs, EPs, and IPs, with an adjusted odds ratio ranging from 1.32 to 2.32 (all p < 0.05).

CONCLUSIONS

Preschoolers' lifestyle and family environment factors are associated with MHPs, EPs, and IPs respectively. Ensuring adequate sleep duration, avoiding sleep latency exceeding 20 min per day, reducing entertainment screen time, limiting educational screen time to 30 min per day, and increasing parent-child interactions may help to minimise mental health problems.

Effects of movement behaviors on preschoolers' cognition: a systematic review of randomized controlled trials

BACKGROUND

Movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep, are fundamental to early childhood development. These behaviors interact dynamically within a 24-hour period, creating a complex balance that influences not only physical health but also cognitive and emotional well-being in young children. While the physical health benefits of movement behaviors are well-documented, systematic evaluations of how interventions targeting these behaviors affect cognitive development in preschool-aged children remain limited.

METHODS

This review was guided through PRISMA 2020 guidelines. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the impact of interventions targeting PA, SB, and sleep on cognitive outcomes in preschool-aged children. A comprehensive search was performed across five databases: PubMed, PsycInfo, Web of Science, Embase, and CINAHL, covering studies published between January 2000 and December 2023. Eligible studies were those that focused on at least one movement behavior, had a minimum intervention duration of four weeks, and assessed cognitive development as a primary outcome. The cognitive outcomes evaluated included executive function, attention, memory, and other key domains critical to early childhood development, such as language, processing speed, and social cognition.

RESULTS

Twenty-two RCTs (14 individual, 8 cluster) met the inclusion criteria. Of these, 21 studies focused on PA, while only one targeted SB, and none specifically addressed sleep or combined movement behaviors. PA interventions, particularly those involving cognitively engaging activities, significantly improved cognitive domains such as executive function, inhibition, and attention, with effect sizes ranging from moderate to large (Cohen's d > 0.5). The SB-focused study did not report significant cognitive improvements. A clear gap exists in understanding the effects of sleep and multi-behavior interventions on cognitive outcomes.

CONCLUSIONS

Cognitively engaging PA interventions demonstrated the largest effects, while motor skill-focused and general PA programs produced moderate to smaller gains. Evidence on SB and sleep interventions remains limited, with no studies exploring the combined effects of these three movement behaviors. Future research should focus on integrated interventions that address PA, SB, and sleep to achieve a more comprehensive understanding of their collective impact on cognitive development in early childhood.

TRIAL REGISTRATION

This study was registered with PROSPERO under the registration number CRD42023479156.

Adherence to the 24-h Movement Behaviors Guidelines and Associations With Cognitive and Behavioral Self-Regulation Among Brazilian Preschoolers

BACKGROUND

Adherence to 24-h movement guidelines has been associated with early health benefits, including neurodevelopmental outcomes. However, the associations between these guidelines and Cognitive (CSR) and Behavioral (BSR) self-regulation in preschoolers are underexplored. This study investigated the associations between adherence to 24-h movement guidelines and CSR and BSR in Brazilian preschoolers.

METHODS

A total of 223 preschoolers (4.76 ± 0.32 years old; 50.67% boys) participated. Physical activity (PA) was assessed with Actigraph wGT3X. Parents reported children's sleep and screen time. CSR was evaluated through iPad games, and BSR was assessed using the Head, Toes, Knees, Shoulders test revised.

RESULTS

Boys showed higher adherence to the PA recommendation than girls (52.2% vs. 32.7%, χ2 = 0.003), whereas a higher percentage of girls did not adhere to any recommendations (23.6% vs. 12.4%, χ2 = 0.029). Positive association was found between adherence to combined PA and screen time with cognitive flexibility (β = 4.091 [95% CI: 0.699, 7.754]). Adherence to PA was associated with lower BSR scores (β = -7.104 [-13.52, -0.623]), as was adherence to combined PA and sleep duration (β = -8.813 [-15.794, -1.397]).

CONCLUSION

This study highlighted differences in adherence to movement behavior guidelines between boys and girls, as well as demonstrated that different combinations of these behaviors can affect preschoolers' cognitive and behavioral levels of self-regulation in distinct ways.

Exploring the Relationship Between Age at Nap Cessation and Social-Emotional Functioning in Children

OBJECTIVE

The objective of this study was to examine variations in age at nap cessation and identify whether there is an association with social-emotional functioning (SEF) as measured by internalizing/externalizing behavior, child temperament, and social skills in a sample of early childhood education and care-attending children.

METHODS

The sample comprised 1117 children from the Australian Effectiveness Early Educational Experiences for Children longitudinal early childhood study. We used children's age at nap cessation as retrospectively recalled by caregivers in 2011 or 2013 when children were between ages 2 and 7 years. Each child's SEF was reported by a caregiver using the Strengths and Difficulties Questionnaire, the Short Temperament Scale for Children, and the Social Skills Inventory Scale. Associations between children's age of nap cessation and SEF were tested using linear regressions.

RESULTS

The children's age at nap cessation ranged from 6 months to 6 years. For each additional year of napping, children's total , conduct , externalizing , and peer behavior problems decreased by 0.39 (95% confidence interval [CI], -0.70 to -0.09), 0.11 (95% CI, -0.21 to -0.01), 0.11 (95% CI, -0.51 to -0.06), and 0.11 (95% CI, -0.20 to -0.02) units on the Strengths and Difficulties Questionnaire scale, respectively. No further significant associations were found.

CONCLUSION

This is the first study reporting the age range of nap cessation and its associations with social-emotional functioning. Our findings demonstrate earlier cessation ages in Australian children attending Early Childhood Education and Care programs than previously reported and a small association with externalizing and peer problems.

More frequent naps are associated with lower cognitive development in a cohort of 8-38-month-old children, during the Covid-19 pandemic

Background

How often a child naps, during infancy, is believed to reflect both intrinsic factors, that is, the need of an immature brain to consolidate information soon after it is acquired, and environmental factors. Difficulty accounting for important environmental factors that interfere with a child's sleep needs (e.g., attending daycare) has clouded our ability to understand the role of intrinsic drivers of napping frequency.

Methods

Here we investigate sleep patterns in association with two measures of cognitive ability, vocabulary size, measured with the Oxford-Communicative Development Inventory (N = 298) and cognitive executive functions (EF), measured with the Early EF Questionnaire (N = 463), in a cohort of 8-38-month-olds. Importantly, because of the social distancing measures imposed during the Covid-19 Spring 2020 lockdown, in the UK, measures of sleep were taken when children did not access daycare settings.

Results

We find that children with more frequent but shorter naps than expected for their age had lower concurrent receptive vocabularies, lower cognitive EF and a slower increase in expressive vocabulary from spring to winter 2020, when age, sex, and SES were accounted for. The negative association between vocabulary and frequency of naps became stronger with age.

Conclusions

These findings suggest that the structure of daytime sleep is an indicator of cognitive development and highlight the importance of considering environmental perturbations and age when investigating developmental correlates of sleep.

Associations between behavioral self-regulation and external food cue responsiveness (EFCR) in preschool-age children and evidence of modification by parenting style

Decreased behavioral regulation is hypothesized to be a risk factor for excess weight gain among children, possibly via reduced appetite-specific regulation. Little research has specifically focused on behavioral regulation and food cue responsiveness, a conditioned precursor to eating, at a young age. This study examined the association between behavioral regulation and external food cue responsiveness among preschool-age children and explored if a more structured parenting style moderated that association. Baseline data from a prospective study on media use among preschool-age children (n = 83) in Northern New England were used. Parents reported on three domains of children's behavioral regulation (attentional focusing, inhibitory control, and emotional self-regulation), the children's external food cue responsiveness (EFCR), and their parenting styles (authoritative and permissive) via validated questionnaires. Mean age among children was 4.31 (SD 0.91) years, 57% of children were male, 89% were non-Hispanic white, and 26.2% had overweight or obesity. In a series of adjusted linear regression models, lower attentional focusing (standardized β, βs = -0.35, p = 0.001), inhibitory control (βs = -0.30, p = 0.008), and emotional self-regulation (standardized beta, βs = -0.38, p < 0.001) were each significantly associated with greater EFCR. In exploratory analyses, a more structured parenting style (more authoritative or less permissive) mitigated the associations between inhibitory control and EFCR (Bonferroni-adjusted p-interaction < 0.017). Findings support that lower attentional focusing, inhibitory control, and emotional self-regulation relate to greater ECFR in preschool-age children. The association between inhibitory control and EFCR may be modified by parenting style. Further research is needed to understand if children's responsiveness to external food cues may account for reported associations between lower behavioral regulation and adiposity gain over time.

Neighborhood influences on the development of self-regulation among children of color living in historically disinvested neighborhoods: Moderators and mediating mechanisms

We present a conceptual model of the ways in which built and social environments shape the development of self-regulation in early childhood. Importantly, in centering children of color growing up in historically disinvested neighborhoods, we first describe how systemic structures of racism and social stratification have shaped neighborhood built and social environment features. We then present evidence linking these neighborhood features to children's development of self-regulation. Furthermore, we take a multilevel approach to examining three potential pathways linking neighborhood contexts to self-regulation: school environment and resources, home environment and resources, and child health behaviors. Finally, we consider how racial-ethnic-cultural strengths and multilevel interventions have the potential to buffer children's development of self-regulation in disinvested neighborhood contexts. Advancing multilevel approaches to understand the development of self-regulation among children of color living in historically disinvested neighborhoods is an important step in efforts to promote equity in health and education.