ClinicalTrials.gg
Active, not recruitingNCT04824989PATHUpdated Aug 19, 2026

Parents Advancing Toddler Health

An interventional study of Sleep Health in Preschoolers (SHIP) and Family Check-Up (FCU) in Sleep Problem and Behavior, Child, sponsored by Boston University Charles River Campus. Active, not recruiting at 2 sites in United States. Open to participants aged 18 Months to 48 Months, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Boston University Charles River Campus · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
305
Allocation
Randomized
Ages
18 Months to 48 Months
Sex
All
01

Study summary

Although early interventions can improve health equity in young children living in poverty, this promise often is not realized because of barriers to family engagement. The proposed study will target co-morbid behavior and sleep problems in early childhood, comparing child outcomes and family response to sleep and behavior interventions and investigating the novel strategy of letting families select their intervention.We will enroll 500 low-income toddlers with co-morbid sleep and behavior problems, randomized to 4 parent coaching interventions: sleep, behavior, family choice (sleep or behavior), and an active control. At baseline and at 1, 5, and 9 months post- intervention, we will assess child sleep and behavior and family functioning. We will measure family preference, engagement, and perceived value of each intervention. The goals of the study are: (1) to examine effects of evidence- based sleep and behavior interventions in young low-income children with co-morbid sleep and behavior problems on child sleep and behavior and family functioning; (2) to determine whether parents prefer, engage with, and value a sleep or behavior intervention more; and (3) to examine if giving families a choice of intervention results in higher engagement, higher perceived value and better family and child outcomes than assignment to intervention. By informing best practices for engaging low-income families to treat co-morbid sleep and behavior problems, results will be critical to reducing health disparities for children living in poverty.

Read the detailed description

Children living in poverty have a high incidence of early-developing sleep and behavior problems, which are often co-morbid. Early sleep and behavior problems are prevalent and persistent risk factors for lifelong poor mental and physical health outcomes, and may be key mechanisms underlying early and enduring socioeconomic health disparities. While effective interventions exist, low-income families have low enrollment and retention in these interventions. Stigma of treating behavior problems creates an additional barrier to treatment. This RCT aims to address these barriers to treatment for low-income children with co-morbid sleep and behavior problems. Sleep and behavior problems and family dysfunction transact across time, increasing in severity, while healthy sleep, positive child behaviors, and effective parenting can support each other across development. Thus we posit that intervention in one domain, either sleep or behavior, may improve outcomes both within and across domains.

The proposed study is a parallel randomized controlled trial of behavioral treatments for sleep problems and behavior problems in early childhood. The current study will test our three key aims: that evidence based sleep and behavior interventions each will improve trajectories from early comorbid sleep and behavior problems to healthier outcomes (Aim 1); that family preference, engagement, and value may differ for sleep vs. behavior interventions (Aim 2); and that families who choose between sleep and behavior interventions will have a more positive family response and better outcomes than those assigned to an intervention (Aim 3). This study will enroll 500 low income children ages 24 to 48 months with comorbid sleep and behavior problems. Children will be recruited at Boston University and the University of Denver. Eligible participants will be randomized to one of four intervention arms, Behavior (FCU), Sleep (SHIP), Choice (FCU or SHIP, as selected by primary caregiver), and active Control (Oral Health, Child Safety, and Environmental Health). For those assigned to Choice, the primary caregiver will be provided information about FCU and SHIP and will select their preferred intervention.

At the baseline evaluation (T1) all participants will undergo the following procedures: a) An evaluation of child behavior b) an evaluation of child sleep c) an evaluation of family functioning. Following the baseline evaluation all participants will engage in 8 sessions of parent coaching intervention over a 2 month period, with the content of the intervention varying by intervention arm, see descriptions below. The SHIP and FCU have similar structure, emphasizing motivational interviewing and support for parent goals. Paraprofessional staff at each site will be trained to deliver the FCU, SHIP, and Control interventions.

The measures included in the T1 baseline evaluation will be repeated at 1 and 5 months post intervention, T2 and T3. At T4, 9 months post intervention, primary caregiver report of child behavior and sleep symptoms and family functioning will be collected via telephone interview.

02

Conditions studied

  • Sleep Problem
  • Behavior, Child

Keywords

  • sleep problems
  • behavior problems
  • parenting interventions
  • early childhood
  • poverty
03

In context

Child Behavior

224 studies on the registry are indexed under Child Behavior; 41 are open to participants now.

This study's enrollment of 305 is above the median of 140 across 197 interventional studies indexed under Child Behavior.

Browse Child Behavior studies →

Lead sponsor

Boston University Charles River Campus is the lead sponsor of 159 studies on the registry; 33 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 9 (64%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Months to 48 Months
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • child age at enrollment of 18-48 months;
  • household income at or below 300% of the federal poverty line
  • a parent fluent in English or Spanish
  • child behavior problem as indicated by a score > 60 on the Emotionally Reactive, Anxious/Depressed, Withdrawn, Attention Problems, or Aggressive Behavior subscales of the Child Behavior Checklist 1 ½ - 5 years (CBCL 1 ½ - 5)
  • child sleep problem as indicated by at least one of the following: score 1 standard deviation above community means on any subscale of the Children's Sleep Wake Scale or on the Sleep Anxiety subscale of the Children's Sleep Habits Questionnaire; nighttime sleep latency longer than 30 minutes; score >40 on the Children's Sleep Habits Questionnaire (CSHQ); bedtimes or wake times varying by more than 2 hours from day to day; and/or nighttime sleep duration ≤ 9.5 hr.

Exclusion criteria

Exclusion Criteria:

  • Diagnosed developmental disabilities
  • Serious chronic medical conditions such as disorders or cancer
  • A positive screen on the Sleep Disordered Breathing or Parasomnia subscales of the CSHQ or parent-reported diagnosis of obstructive sleep apnea
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
305 participants (actual)

Study arms

  • Experimental
    Sleep Health

    Family receives the Sleep Health In Preschoolers parenting intervention to address toddler sleep problems.

    Behavioral: Sleep Health in Preschoolers (SHIP)

  • Experimental
    Behavior Health

    Family receives the Family Check-Up parenting intervention to address toddler behavior problems.

    Behavioral: Family Check-Up (FCU)

  • Experimental
    Choice

    Family is given the opportunity to select either the Sleep Health in Preschoolers intervention to address toddler sleep problems or the Family Check-Up intervention to address toddler behavior problems.

    Behavioral: Sleep Health in Preschoolers (SHIP) · Behavioral: Family Check-Up (FCU)

  • Active comparator
    Control

    Family receives a safety and hygiene active control intervention.

    Behavioral: Oral Health, Child Safety, and Environmental Health Intervention (Active Control)

Interventions

  • BehavioralSleep Health in Preschoolers (SHIP)

    SHIP is an 8 session home visiting intervention to reduce child sleep problems using a framework that draws from motivational interviewing and social cognitive theory, and effectively improves sleep timing, duration, and quality. Following ecological assessment of child sleep and sleep routines, feedback is provided on family strengths and challenges in the child sleep domain, with motivational interviewing to increase parent knowledge of sleep, correct misperceptions, and raise outcomes expectations. The remaining sessions are targeted modules that give tailored feedback and education, and coach the parent in setting manageable goals, identifying action steps, anticipating barriers, and supporting positive behaviors. Targets: bedtime scheduling, consistency, and routines; media use, independent sleep onset, nightmares and fears, night wakings, and early waking; sleep location, nap issues, engaging other caregivers.

  • BehavioralFamily Check-Up (FCU)

    FCU is an 8 session home visiting intervention to reduce behavior problems for children through improved parenting. Over 30 years of research establishes its efficacy in reducing behavioral and emotional problems, including in low income toddlers. Following ecological assessment of behavior management and child behavior, family receives feedback on family strengths and challenges within the behavioral domain via a motivational interviewing approach. The remaining sessions are targeted modules drawn from the Everyday Parenting curriculum, individualized based on parent goals and identified challenge areas. Each session begins by establishing a collaborative skill set, involves teaching the rationale for a skill, teaching and modeling effective use of the skill, and then role play and experiential practice to coach the parent to success. Targets can include Positive Behavior Support, Limit Setting and Monitoring, Family Routines, Communication, and Problem Solving.

  • BehavioralOral Health, Child Safety, and Environmental Health Intervention (Active Control)

    This intervention serves as an active control condition to ensure that observed effects are due to the intervention content, rather than to study processes, staff attention, or general support and problem solving. The intervention is designed to be comparable to SHIP and FCU in intensity, personal contact, session structure and approach, but focused on Oral Health, Child Safety, and Environmental Health, domains which should not immediately affect study outcomes.

06

What researchers measure

Primary outcomes

  1. Change in Child Behavior Checklist (CBCL) from screening to one month

    This parent report for ages 1.5-5 assesses clinically significant behavior problems and yields age-normed subscales

    Time frame: Change from screening to one month post-intervention

  2. Change in Child Behavior Checklist (CBCL) from screening to five months

    This parent report for ages 1.5-5 assesses clinically significant behavior problems and yields age-normed subscales

    Time frame: Change from screening to five months post-intervention

  3. Change in Child Behavior Checklist (CBCL) from screening to nine months

    This parent report for ages 1.5-5 assesses clinically significant behavior problems and yields age-normed subscales

    Time frame: Change from screening to nine months post-intervention

  4. Change in Emotion Regulation Checklist (ERC) from baseline to one month

    Parent report assessing intensity, flexibility, and appropriateness of child emotions

    Time frame: Change from baseline to one month post-intervention

  5. Change in Emotion Regulation Checklist (ERC) from baseline to five months

    Parent report assessing intensity, flexibility, and appropriateness of child emotions

    Time frame: Change from baseline to five months post-intervention

  6. Change in Emotion Regulation Checklist (ERC) from baseline to nine months

    Parent report assessing intensity, flexibility, and appropriateness of child emotions

    Time frame: Change from baseline to nine months post-intervention

  7. Change in Children's Sleep Wake Scale (CSWS) from screening to one month

    Parent report assessing child bedtime resistance, sleep quality, and daytime sleepiness

    Time frame: Change from screening to one month post-intervention

  8. Change in Children's Sleep Wake Scale (CSWS) from screening to five months

    Parent report assessing child bedtime resistance, sleep quality, and daytime sleepiness

    Time frame: Change from screening to five months post-intervention

  9. Change in Children's Sleep Wake Scale (CSWS) from screening to nine months

    Parent report assessing child bedtime resistance, sleep quality, and daytime sleepiness

    Time frame: Change from screening to nine months post-intervention

  10. Change in nighttime sleep minutes from baseline to one month as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of nighttime sleep minutes. Data are analyzed using Actiware software.

    Time frame: Change from baseline to one month post-intervention

  11. Change in nighttime sleep minutes from baseline to five months as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of nighttime sleep minutes. Data are analyzed using Actiware software.

    Time frame: Change from baseline to five months post-intervention

  12. Change in sleep onset from baseline to one month as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of sleep onset. Data are analyzed using Actiware software.

    Time frame: Change from baseline to one month post-intervention

  13. Change in sleep onset from baseline to five months as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of sleep onset. Data are analyzed using Actiware software.

    Time frame: Change from baseline to five months post-intervention

  14. Change in sleep consistency from baseline to one month as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of sleep consistency (consistency in sleep timing from night to night). Data are analyzed using Actiware software.

    Time frame: Change from baseline to one month post-intervention

  15. Change in sleep consistency from baseline to five months as measured by actigraphy

    The Actiwatch Spectrum Plus actigraph will be worn on the child's non-dominant wrist for one week at each assessment to provide continuous recording of state via motion detection, and will yield an index of sleep consistency (consistency in sleep timing from night to night). Data are analyzed using Actiware software.

    Time frame: Change from baseline to five months post-intervention

Secondary outcomes

  1. Change in Children's Sleep Hygiene Scale (CSHS) from baseline to one month

    Parent report assessing sleep inhibiting and sleep facilitating behaviors

    Time frame: Change from baseline to one month post-intervention

  2. Change in Children's Sleep Hygiene Scale (CSHS) from baseline to five months

    Parent report assessing sleep inhibiting and sleep facilitating behaviors

    Time frame: Change from baseline to five months post-intervention

  3. Change in Children's Sleep Hygiene Scale (CSHS) from baseline to nine months

    Parent report assessing sleep inhibiting and sleep facilitating behaviors

    Time frame: Change from baseline to nine months post-intervention

  4. Change in Parenting Sense of Competence (PSOC) from baseline to one month

    Parent report assessing parental perceived efficacy, a dimension of family functioning

    Time frame: Change from baseline to one month post-intervention

  5. Change in Parenting Sense of Competence (PSOC) from baseline to five months

    Parent report assessing parental perceived efficacy, a dimension of family functioning

    Time frame: Change from baseline to five months post-intervention

  6. Change in Parenting Sense of Competence (PSOC) from baseline to nine months

    Parent report assessing parental perceived efficacy, a dimension of family functioning

    Time frame: Change from baseline to nine months post-intervention

  7. Change in Peds QL Family Impact Module from baseline to one month

    Parent report assessing family functioning

    Time frame: Change from baseline to one month post-intervention

  8. Change in Peds QL Family Impact Module from baseline to five months

    Parent report assessing family functioning

    Time frame: Change from baseline to five months post-intervention

  9. Change in Peds QL Family Impact Module from baseline to nine months

    Parent report assessing family functioning

    Time frame: Change from baseline to nine months post-intervention

07

Study locations

2 sites
08

References and documents

Publications

  • Garrison MM. The feedback whirlpool of early childhood sleep and behavior problems. JAMA Pediatr. 2015 Jun;169(6):525-6. doi: 10.1001/jamapediatrics.2015.0356. No abstract available. PubMed 25868054 ↗
  • El-Sheikh M, Buckhalt JA, Mark Cummings E, Keller P. Sleep disruptions and emotional insecurity are pathways of risk for children. J Child Psychol Psychiatry. 2007 Jan;48(1):88-96. doi: 10.1111/j.1469-7610.2006.01604.x. PubMed 17244274 ↗
  • Campbell SB. Behavior problems in preschool children: a review of recent research. J Child Psychol Psychiatry. 1995 Jan;36(1):113-49. doi: 10.1111/j.1469-7610.1995.tb01657.x. PubMed 7714027 ↗
  • Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to disparities in cardiovascular health. Annu Rev Public Health. 2015 Mar 18;36:417-40. doi: 10.1146/annurev-publhealth-031914-122838. PubMed 25785893 ↗
  • LeBourgeois MK, Harsh JR. Development and psychometric evaluation of the Children's Sleep-Wake Scale<sup/> Sleep Health. 2016 Sep;2(3):198-204. doi: 10.1016/j.sleh.2016.04.001. PubMed 28066802 ↗
  • Shields A, Cicchetti D. Emotion regulation among school-age children: the development and validation of a new criterion Q-sort scale. Dev Psychol. 1997 Nov;33(6):906-16. doi: 10.1037//0012-1649.33.6.906. PubMed 9383613 ↗
  • Wilson KE, Lumeng JC, Kaciroti N, Chen SY, LeBourgeois MK, Chervin RD, Miller AL. Sleep Hygiene Practices and Bedtime Resistance in Low-Income Preschoolers: Does Temperament Matter? Behav Sleep Med. 2015;13(5):412-23. doi: 10.1080/15402002.2014.940104. Epub 2014 Sep 15. PubMed 25221914 ↗
  • Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M. Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr. 2015 Jun;169(6):575-82. doi: 10.1001/jamapediatrics.2015.0187. PubMed 25867179 ↗
  • Shaw DS, Shelleby EC. Early-starting conduct problems: intersection of conduct problems and poverty. Annu Rev Clin Psychol. 2014;10:503-28. doi: 10.1146/annurev-clinpsy-032813-153650. PubMed 24471370 ↗
  • Mulraney M, Giallo R, Lycett K, Mensah F, Sciberras E. The bidirectional relationship between sleep problems and internalizing and externalizing problems in children with ADHD: a prospective cohort study. Sleep Med. 2016 Jan;17:45-51. doi: 10.1016/j.sleep.2015.09.019. Epub 2015 Oct 23. PubMed 26847973 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Mar 2021 (actual). Primary completion is estimated for Feb 2027, 71 months after the start.

Of 140 non-industry interventional studies with no phase under Child Behavior, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 42. This study's planned 71 months is above that.

Counting every sponsor, half of 141 studies reached it within 20 months; a quarter within 8 and three quarters within 41.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 10, 2021
First posted
Apr 1, 2021
StartActual
Mar 22, 2021
Primary completionEst.
Feb 2027
CompletionEst.
Feb 2027
Last update
Aug 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04824989
Collaborators
University of Denver, University of Michigan, Denver Health and Hospital Authority, University of Colorado, Boulder, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Responsible party
Sponsor
First posted
Apr 1, 2021
Start date
Mar 22, 2021
Primary completion
Feb 2027 (estimated)
Completion
Feb 2027 (estimated)
Last update
Aug 19, 2026

Study contacts

Amanda R Tarullo, Ph.D.
principal investigator · Boston University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion