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Introduction This study aimed to assess parental sleep goals, comparing younger (12-23.9-month-olds) and older toddlers (24-35.9-month-olds) in consideration of developmental differences. Methods Parents (98.0% mothers) of 401 toddlers (12–35 mos; M=22.49 mos; 49% male) in the US completed an online survey, including an abbreviated Brief Infant Sleep Questionnaire and a list of 58 desired areas of change (DACs). There were 230 one-year-olds (1yos; M=17.42mos) and 171 two-year-olds (2yos; M=29.30mos), with no difference in parent age between groups (M=34.41 years). Results 25.7% reported a perceived sleep-problem, whereas 94.8% indicated at least one sleep-related DAC. Parents of one- and two-year-olds reported similar rates of DAC for overnight sleep (58% vs. 49%), morning sleep (55% vs. 52%), and naps (70% vs. 64%), p>.05. Parents of 2yos, however, reported bedtime as a DAC at a higher rate (59% vs. 79%), p<.001. Twenty-five percent of specific bedtime DACs (n=8) were endorsed by ≥10% of parents. Parents endorsed falling asleep without an adult (17% of 1yos vs. 22% of 2yos) and falling asleep without nursing (10% vs. 9%) at similar rates, p>.05. Parents of two-year-olds were more likely to endorse: getting through bedtime routine quickly/easily without stalling (10% vs. 30%,), earlier bedtime (10% vs. 24%), falling asleep faster at bedtime (24% vs. 10%), falling asleep without a pacifier (11% vs. 19%), falling asleep faster while alone (8% vs. 16%), and falling asleep without stalling/making requests (3% vs. 18%), p<.05. Conclusion The majority of parents of toddlers endorsed a sleep-related desired area of change, with two-thirds wanting to change something about bedtime and naps, and over half wanting to change something about overnight and morning sleep. Parents of older toddlers (2yos) were more likely to desire changes at bedtime than parents of younger toddlers (1yos), especially related to stalling and discontinuing pacifier use. As toddlers age, bedtime problems are more likely. Health care providers should be aware of developmental changes, such as increased language and assertions of independence, that seem to mostly affect bedtime when addressing sleep issues in toddlers. Support (if any) Johnson & Johnson Consumer Inc., Skillman, NJ, USA.

Introduction Mothers’ sleep is positively associated with positive parenting (e.g., responsiveness) — what has not been established is how mothers’ executive function (EF) could mediate this association, and how, in turn, mothers’ parenting could influence the development of their toddlers’ EF. Methods Mothers and toddlers (N = 351) were followed at child ages 30, 36, and 42 months. Mothers were M = 32.70 years old (SD = 5.03); 49% of toddlers were male. The sample was largely middle class and 90% White. Fifteen percent of mothers were single. Thirty-one percent of mothers did not work outside the home, and 28% worked full time. Mothers’ sleep was measured via actigraphy. Mothers’ positive parenting was measured both in the home and the lab. At home, the toddlers’ bedtime routine was observed and rated for mothers’ responsiveness and involvement. In the lab, mothers’ positive affect during free play with their toddler was coded (with independent, inter-rater reliability of ICC = .80). The lab measure was correlated with the home visit measure (r = .22, p < 0.01). Mothers’ EF was measured via self-report on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF), which assesses everyday metacognition, behavior regulation, and emotion regulation. The average, where higher scores reflect worse EF, was used. Toddlers’ EF was measured by coders’ ratings of toddlers’ ability to sustain focused attention during independent free play in the lab visit (ICC = .83). Results Cross-sectionally, mothers’ sleep was associated with their EF (B = .12, p<.05). In a structural equation model across time, mothers’ actigraphic sleep that was shorter, later, and more variable predicted worse EF (B = 0.07), which in turn predicted less positive parenting (B = - 0.08), at levels trending towards significance. Mothers’ positive parenting was associated with toddlers’ observed sustained, focused attention, both within (r = .13, p < 0.05) and across time (r = .13, p < 0.05). Conclusion These findings suggest that a mother’s sleep can affect her EF and parenting, which can then support toddlers’ sustained attention development, an important aspect of executive function. Support (if any) Grants MH099437 from NIMH and HD073202 from NICHD

Previous research has highlighted the need to improve teacher education programs with the intent of preparing infant–toddler professionals as working with infants-toddlers and families requires a unique skill set. The following mixed methods research study supported these assertions by examining the early childhood education (ECE) undergraduate teacher preparation course content in a large northeastern state, through document analysis and a survey of faculty. The findings indicated that very few of the research-based, best practices (relationship-based practices, family-centered practices, creating environments, reflective and ethical practices, and fieldwork experience in high-quality classrooms with children under three), identified for working with infants and toddlers were the main-focus of any of the ECE undergraduate teacher preparation courses. This research offers recommendations for ways that undergraduate ECE teacher preparation programs can support the infant–toddler workforce. The recommendations include adding dedicated infant–toddler courses and supervised fieldwork opportunities with children from birth to 36 months into ECE undergraduate coursework.

This study examines the prevalence of cognitive delay among infants and toddlers in rural China and its relationship with one of the potential sources of the observed delay: low levels of stimulating parenting practices (SPPs). Data were compiled from five distinct studies, resulting in a pooled sample of 4436 caregivers of 6-29-month-old infants. The sampling sites span five provinces in rural China. According to the data, on average, rates of delay are high-51 percent. The low rates of SPPs among our sample demonstrate that this may be one source of the high prevalence of delays. The results of the multivariate regression analysis reveal that reading books and singing songs are each significantly associated with an increase in infant cognitive score by 1.62 points ( = 0.003) and 2.00 points ( < 0.001), respectively. Telling stories to infants, however, is not significantly associated with infant cognitive scores. Our findings indicate that caregivers with different characteristics engage in various levels of stimulating practices and have infants with different rates of delay. Specifically, infants of better-educated mothers who have greater household assets are in families in which the caregivers provide more SPPs and have infants who score higher on the study's cognitive abilities scales.

Background: This study delves into the interplay between sleep quality and sensory processing in infants and toddlers in underserved rural areas in the U.S. Despite established links between these variables in typically developing children, limited research explores this relationship in communities facing elevated rates of mental, behavioral, and developmental disorders. Methods: We aimed to examine the connections between sensory processing at 10, 14, and 18 months postpartum and sleep quality at 18 months in a rural and medically underserved setting. A total of 44-53 participants completed the questionnaire and survey measures at the specified time points. Results: Utilizing the Infant Toddler Sensory Profile-2 and the Infant Health and Sleep Questionnaire adapted from the Pregnancy Risk Assessment Monitoring System, our analysis revealed that infants within the majority range for registration at 10 and 18 months displayed enhanced sleep quality at 18 months, with the 14-month analysis showing a trend towards statistical significance. Conclusion: These findings underscore the need to further explore the sensory processing domain of registration, given its consistent relationship with sleep outcomes across different ages in the sample. Infants in the majority range for sensation avoiding at 18 months exhibited improved sleep quality, suggesting that appropriately limiting exposure to noxious stimuli may contribute to more restorative sleep or vice versa. Comments The authors declare that they have no competing financial, professional, or personal interest that might have influenced the performance or presentation of the work described in this manuscript. Keywords infants, toddlers, sensory processing, sleep, neurotypical

Introduction: Mothers have a role in caring for and fulfilling toddler nutrition which is very important to prevent stunting in toddlers. Mothers’ skills in carrying out their roles are influenced by mothers’  knowledge through health literacy, namely the capability to access, assess, and process health information. Prevalence of stunting in East Java was 26.8% in 2019, exceeding the limit set by WHO. Jember is the second area contributing to the largest prevalence of stunting in East Java. Aims: This study aimed to analyze the relationship of mothers’ health literacy with stunting incidence of toddlers. Methods: This study used a case control design. The respondents were mothers with stunting toddlers (n=51) and mothers with non-stunted toddlers (n=51). The secondary data sources were the stunting data of the Kalisat Primary Healthcare in February 2022 and the primary data sources were the results of interviews used the HLS-EU-16 Indonesia Questionnaire. Data analysis used chi-square test. Results: There was a relationship between mothers’ health literacy and  stunting incidence of toddlers with a p-value of  0.001 (p-value < 0.05 so that the two variables have a significant relationship. Conclusion: Mothers’ health literacy has a strong association with stunting incidence of toddlers.

Introduction Institution of a nightly bedtime routine is a key component of sleep health and is likely to foster positive early childhood development. The current study investigated the longitudinal and concurrent relationships between a bedtime routine and sleep, social-emotional development, and parenting stress in toddlers living in lower income homes and/or neighborhoods. Methods Caregivers of 78 toddlers (56.4% female; M=12.87 mos; 67.9% Black; 73.1% WIC) reported on their child’s bedtime routine at their 12-month well-child visit. At their child’s 15- and 24-month well visit, caregivers completed the Brief Infant Sleep Questionnaire–Revised (BISQ-R SF), the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the communication and personal-social subscales of the Ages and Stages Questionnaire (ASQ), and the Parenting Stress Index (PSI-SF). Results were considered significant at p<.05. Results Toddlers with a consistent bedtime routine (5+ nights per week) at 12 months had significantly earlier bedtimes (20:54 vs 21:24) and waketimes (7:21 vs 8:48) at 24 months compared to those without a consistent routine. At 15 months, a more frequent bedtime routine was associated with fewer concurrent social-emotional problems (r = -.32) and decreased bedtime difficulty (r = -.34). At 24 months, toddlers with a consistent bedtime routine (33.3%) were less likely to exhibit concurrent BITSEA social-emotional competency concerns (66.7%). Caregivers also reported better nighttime sleep in toddlers with a consistent routine at 24 months. Additionally, caregivers whose child had a consistent routine at 15 and 24 months perceived their child as less difficult (PSI) at 24 months. However, no associations emerged between bedtime routine frequency and consistency at 12, 15, and 24 months with ASQ communication and personal-social concerns. Conclusion Bedtime routine frequency and consistency in toddlers was associated with better caregiver-perceived sleep, social-emotional development, and lower parental stress regarding their child being perceived as difficult, but not communication and personal-social concerns. A bedtime routine may be a cost-effective strategy to promote toddlers’ sleep, overall development, and family’s functioning. Support (if any) This study was partially funded by the Simms/Mann Institute

Introduction Sleep is cited as a prominent concern by many caregivers of children with epilepsy. Few studies have examined this issue systematically. Methods Caregivers of 11 toddlers (12-36 months old) were recruited from two academic Pediatric Neurology clinics and responses were compared to children without epilepsy (n=343). Caregivers responded to a novel questionnaire being developed for infants and toddlers. Two domains were analyzed (Caregiver/Child Behavior and Comfort Object/Bedtime Routine). The domain score equaled the sum of the scores for each item divided by the number of items answered. Items in the Caregiver/Child Behavior domain were: 1.“My child’s total sleep time and sleep routine are problematic for me”; 2.“I am frustrated by my child’s sleep problem”; 3.“I worry about my child’s health due to their sleep problem”; 4.“My child wakes up shortly after they have fallen asleep”; 5.“My child wakes up distressed in the middle of the night”; 6.“My child’s sleep is restless”; 7.“My child does not seem well rested during the day”; 8.“My child requires a parent/caregiver's presence to fall asleep (e.g. in the room, in the bed)”; 9.“My child moves their legs in a cycling pattern, or kicks and moves their legs excessively in the middle of the night”. Items in the Comfort Object/Bedtime Routine domain were: 1. My child requires a parent/caregiver's presence to fall asleep (e.g., in the room, in the bed)”; and 2.“My child requires the presence additional comfort measures (e.g., aromatherapy, noise machine, weighted blanket, music) to fall asleep”. Results The Caregiver/Child Behavior score was higher (worse) in toddlers with epilepsy (3.40; SD 0.72) compared with controls (1.94; SD 0.93) p< 0.0001. Yet, toddlers with epilepsy had lower (better) scores in the Comfort Object/Bedtime Routine domain (2.23; SD 1.25) compared with controls (3.20; SD 1.25) p=0.01. Conclusion Sleep behavior is complex in toddlers with epilepsy and can lead to parental frustration and worry in comparison to toddlers without epilepsy. Further investigation into this relationship could provide opportunities for effective interventions to improve sleep and quality of life for children with epilepsy. Support (if any) NIH2T32HL110952-06