(PS6-92) The Moderating Role of Parental Competence on Sleep in Preschoolers At-risk for ADHD

Approximately 70% to 85% of parents report sleep disturbance in their young children with ADHD (Sung et al., 2008). Sleep problems, in addition to behavioral difficulties, exhibited by preschoolers with ADHD can adversely impact parents’ sense of competence. Past studies found that parents of children with ADHD report lower parental self-efficacy and competence when compared to those of children without ADHD (McLaughlin & Harrison, 2006; Primack et al., 2012). Given the importance of parental competence in fostering young children’s well-being (Albanese et al., 2019), the current study aimed to examine the moderating role of parental competence in the relationship between ADHD symptoms and sleep problems.

Participants included 137 caregivers of preschoolers at-risk for ADHD (M_age = 4.04 years; 70.8% male; 73.7% White; 21.2% Hispanic/Latinx). Data were collected as part of project Promoting Engagement with ADHD Pre-Kindergartners (PEAK), a behavioral parenting training program (authors, 2018). Pre-treatment data were utilized: Conners Early Childhood Rating Scale - Inattention/Hyperactivity (Conners, 2009), Family Empowerment Scale (Koren et al., 1992), the Children’s Sleep-Wake Scale - Going to Bed subscale (LeBourgeois & Harsh, 2016) to measure bedtime resistance, and Children’s Sleep Habits Questionnaire-Toddler (CSHQ-T; Sneddon et al., 2013) to measure behavioral and medical-based sleep problems. Moderation analyses were conducted using SPSS PROCESS version 4.2 macro (Hayes, 2022) to examine parental competence as a moderator between ADHD symptoms and sleep problems.

As expected, increased parental competence predicted significantly less bedtime resistance, B = .54, SE = .22, p = .024. Interestingly, increased ADHD symptoms were associated with less bedtime resistance, B = .17, SE = .08, p = .038. Parental competence significantly moderated the relationship between ADHD symptoms and bedtime resistance, B = -.01, SE = .002, p = .024. Simple slope analyses revealed that increased ADHD symptoms were associated with significantly less bedtime resistance only when parental competence was high (B = -.04, SE = .02, p = .008), but not when parental competence was average (B = -.02, SE = .01, p = .109) or low (B = .01, SE = .02, p = .480). Alternatively, neither ADHD symptoms (B = -.75, SE = .61, p = .219) nor parental competence (B = -2.41, SE = 1.60, p = .135) significantly predicted CSHQ-T sleep problems. No interaction effects emerged between ADHD symptoms and parental competence on CSHQ-T sleep problems.

Overall, ADHD symptoms and parental competence were significantly related to bedtime resistance but not behavioral- and medical-based sleep problems (i.e., sleep duration, sleep transition, sleep initiation, and sleep distress). Notably, preschoolers with increased ADHD symptoms experienced less bedtime resistance when parental competence was high. This highlights the potential benefits of targeting parents’ sense of competence in behavioral parent training to improve bedtime resistance in preschoolers at-risk for ADHD.