This experiment is part of the Adolescence Challenge Grant. Browse more projects

How does Sleep Impact Attention and Behavior for Teens in Foster Care?

Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio
MedicinePsychologyGrant: Adolescence
Raised of $5,000 Goal
Ended on 12/14/16
Campaign Ended
  • $109
  • 3%
  • Finished
    on 12/14/16

About This Project

We are interested in whether sleep relates to attention and behavior for teens in foster care. Teens in foster care have significant attention and behavior problems. Sleep deficits in teens not in foster care result in attention and behavior problems. We don’t know how problematic sleep is for teens in foster care. We will measure teens' sleep, attention, and behavior to understand how they are related, which could help us understand their attention and behavior problems.

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What is the context of this research?

Ultimately we want to know whether sleep is linked to attention and behavior problems for teens in foster care. Sleep is a significant health concern for all teens, and research shows that sleep deficits result in attention and behavior problems.1 This is particularly troubling for youth with mental health diagnoses,2 which are common for teens in foster care.3 Data from teens with ADHD who are not in foster care suggests that sleep is associated with attention and behavior problems.2 In typical teens, improved sleep contributes to improvements in attention, behavior, mood, and academics.4,5 Researchers have not objectively measured sleep in foster youth, so we do not know how problematic sleep is for these teens or whether sleep is related to attention and behavior problems.

What is the significance of this project?

Teens in foster care have significant health deficits, including sleep problems 6 and higher rates of mental health issues than their peers.7,8 Foster teens also have increased behavior and academic problems that lead to suspension, expulsion, school failure, and dropping out.9 Psychiatric treatment is often the first line of intervention for teens in foster care, resulting in the use of psychotropic medications at rates of up to 66%, almost doubling health-related expenditures for these teens.10,11,12 No studies have examined sleep as a potential target for intervention for foster youth. If sleep is linked to attention and behavior problems and can be improved, then sleep could be an ideal target to address some of the problems for teens in foster care.

What are the goals of the project?

Twenty teens in foster care ages 16 and older and their caseworkers will participate in this study. We will collect baseline self-report measures of sleep (e.g., reports of time spent in bed, sleep routine and habits), attention, and academic behavior (e.g., time spent studying, grades in school, standardized math and reading scores). Once baseline data is collected, participants will wear actigraphs to measure sleep objectively and complete sleep diaries for 14 nights. Then we will re-assess self-report measures about sleep, attention, and behavior. We will use the data to examine associations between sleep, attention, and behavior. Findings will provide preliminary data for an investigation of sleep problems and intervention among teens in foster care.


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Funding for this study will cover the cost of the actigraph used to objectively assess sleep. Participants will complete measures at baseline and after a two-week sleep observation period so we can determine exactly how normal sleep patterns are associated with attention and behavior. We also need to provide incentives for teens in foster care to attend their study visits ($25 per study visit), complete their sleep diaries ($40 for a complete diary), wear the actigraphs that measure their sleep ($40 for complete actigraphy data), and return the actigraphs at the end of the study ($10 bonus incentive). Without participant incentives, teens in foster care are challenging to recruit for research. Finally, we need a research assistant who can help us gather the data and visit participants in their homes to complete study measures (85 man-hours at $15 per hour plus benefits).

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Attention and behavior are one of the leading causes of poor outcomes for teens in foster care, resulting in academic problems and failed placements, which ultimately can lead to joblessness and homelessness. If changing sleep habits can alter these behaviors and improve focus, this could change that trajectory to improved education, employment, and long term success. Based on the results of this work, there maybe be important implications for sleep for all children in foster care that might significantly improve long term outcomes.

Meet the Team

Sarah J. Beal, PhD
Sarah J. Beal, PhD
Assistant Professor


Cincinnati Children's Hospital Medical Center
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Stephen P. Becker, PhD
Stephen P. Becker, PhD
Assistant Professor


Cincinnati Children's Hospital Medical Center
View Profile

Team Bio

This research team, comprised of a developmental psychologist and clinical psychologist, is uniquely positioned to conduct a study examining sleep among foster care teens. Dr. Beal has experience in conducting research within the foster care system, as well as expertise in advanced statistical methods. Dr. Becker has complementary expertise in attention and sleep. Both Drs. Beal and Becker have successfully used pilot funds/findings to secure additional funding for larger-scale studies.

Sarah J. Beal, PhD

I am a developmental psychologist and research faculty member at Cincinnati Children’s Hospital. I completed my graduate work studying adolescent development and foster care at the University of Nebraska-Lincoln and a postdoctoral fellowship in Adolescent Medicine at Cincinnati Children’s. I am interested in research addressing the transition to adulthood, and what aspects of involvement in foster care contribute to poor developmental outcomes for adolescents.

Ultimately, I am fascinated by the social mechanisms and interventions that we construct to help young people prepare for adulthood, and how those mechanisms help or do not help to support success in adulthood. This happens frequently for teens in foster care. The aspects of foster care that are intended to support independence (e.g., living in your own apartment, receiving money to budget on your own) should be helpful for young people gaining independence, but often teens still struggle and I want to understand why and how we can do a better job to help them with that transition.

Stephen P. Becker, PhD

I am a clinical psychologist and member of the research faculty in the Center for ADHD at Cincinnati Children's Hospital Medical Center. Much of my research focuses on the intersection of attention problems, sleep functioning, and impairment in children and adolescents. I am especially interested in understanding risk and protective factors that impact trajectories of youth development and mental health. I aim for my research findings to inform prevention and intervention efforts that can improve youth outcomes. Toward this end, I have conducted research in developing and testing interventions and regularly disseminate research findings at conferences and in publications. My research is currently funded by the National Institute of Mental Health (NIMH) and the Institute of Education Sciences (IES). Web Bio

Project Backers

  • 5Backers
  • 3%Funded
  • $109Total Donations
  • $21.80Average Donation
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