Presented at the National Association of School Psychologists Annual Meeting New York City

1. Effect of Symptoms of Sleep Problems on School Behavior, Academics and Quality of LifeErin E. Ax, Ph.D. & Kathy L. Bradley-Klug, Ph.D.University of South Florida Presented at the National Association of School Psychologists Annual Meeting New York City March 27, 2007

2. Overview of the Presentation • Statement of the Problem • Research Questions • Participant Characteristics • Results • Implications/Directions for Future Research

3. Statement of the Problem • Sleep problems are experienced by approximately 25% of all children (Mindell & Owens, 2003) • Sleep problems are inadequately addressed (Owens, 2001) • School based prevalence rates are unknown • Sleep problems can impact behavioral and academic success at school (e.g., Gozal, 1998) • Sleep problems are treatable

4. Research Questions 1. What is the prevalence of symptoms of sleep problems/disorders in one school district in the Northeast?

5. Research Questions Is there a difference between students with and without symptoms of sleep disorders as measured by the Sleep Disorders Inventory for Students – Child Form (SDIS-C) 2. on teacher report of student behavior determined by high scores on the Behavioral Assessment System of Children, Second Edition (BASC-2)? 3. on academic achievement related to reading as determined by Curriculum-based Measurement Reading (R-CBM)? 4. on academic achievement related to mathematics as determined by Curriculum-based Measurement Math (M-CBM)? 5. on student self-report of quality of life determined by high scores on the PedsQL™ 4.0 and low scores on the Students’ Life Satisfaction Scale (SLSS)?

6. Participants • 216 2nd and 3rd graders • 36.9% total eligible population • One school district • Suburb of large city in Northeast

7. Participant Characteristics Gender Grade 56% 39.8% 44% 60.2%

8. Participant Characteristics (cont’d) Sleep Disorder Category 17.1% 82.9%

9. Participant Characteristics (cont’d) Ethnicity by Sleep Disorder Category No Sleep Disorder Symptoms of Sleep Disorder 6.1% 16.2% 21.6% 46.9% 45.9% 30.7% 32.4%

10. Instruments • Sleep Disorders Inventory for Students (SDIS-C) • Behavior Assessment System for Children, Second Edition (BASC-2) • Externalizing Scale • Internalizing Scale • Curriculum-based Measurement (CBM) • Reading (R-CBM) • Math (M-CBM) • PedsQL™ 4.0 • Students’ Life Satisfaction Scale (SLSS)

11. Procedures • IRB approval sought and granted • Endorsement letter, explanation letter, consent form and SDIS-C sent home to all students • PI recruited parents attending conferences • PI explained the research study to teachers and offered incentives • Complete packet sent home second time and third time

12. Procedures (cont’d) • Teachers completed TRS • PI provided refreshments to thank teachers • PI accessed R-CBM data archivally • Teachers administered M-CBM probes • PI administered Peds QL™ 4.0 and SLSS to study participants

13. Data Analyses • Descriptive statistics calculated • Assumptions tested • MANOVA • Follow-up tests

14. Research Question One 1. What is the prevalence of symptoms of sleep problems/disorders in one school district in the Northeast? • 17.1% had symptoms of a sleep disorder

15. Research Question Two 2. Is there a difference between students with and without symptoms of sleep disorders as measured by the SDIS-C on teacher report of behavior?

16. Research Question Three 3. Is there a difference between students with and without symptoms of sleep disorders as measured by the SDIS-C on reading achievement?

17. Research Question Four 4. Is there a difference between students with and without symptoms of sleep disorders as measured by the SDIS-C on math achievement?

18. Research Question Five 5. Is there a difference between students with and without symptoms of sleep disorders as measured by the SDIS-C on quality of life and subjective well-being?

19. Limitations • Threats to internal validity • Instrumentation • Selection bias • Threats to external validity • Population validity • Ecological validity • Specificity of variables

20. Implications for School Psychologists • Early identification of sleep disorders • Early intervention for sleep disorders • Pre-service • Educate future practitioners on pediatric health issues • Collaboration • Practitioners • Continuing professional development • Education – educators, parents, policy makers

21. Directions for Future Research • Continue sleep research using teacher reports • Further investigate • Relationship between hyperactivity, aggression, conduct problems and sleep • Relationship between internalizing symptoms • Conduct research on state achievement test and sleep • Follow-up with current cohort using PSG

22. Conclusion • Symptoms of sleep disorders occurred in nearly one-fifth of the sample • Difference between students with and without symptoms of sleep disorders on school behavior, academic achievement, and quality of life was significant • Students with symptoms of sleep disorders performed significantly worse on • Reading • Internalizing behaviors • Externalizing behaviors