The Sleep and Settle Questionnaire for parents of infants: Psychometric properties

Objective: To determine the psychometric properties of a parent-report questionnaire (Sleep and Settle Questionnaire (SSQ)) assessing: (i) the infant's sleep and settling behaviour, and (ii) the parent's level of concern with such behaviours. Methodology: Test-retest reliability was determined by administering the SSQ to 20 mothers on two occasions, 7-14 days apart. Validity was determined by comparing SSQ responses between mothers with 6-week-old infants who, on a semistructured questionnaire, reported no sleep or settling difficulties (n = 56-60) with those who reported they were experiencing difficulties (n = 133). Further comparison was made with a sample of mothers (n = 34-36) attending a community class on sleep and settling difficulties with infants. Sensitivity to change was determined by comparing mothers' SSQ responses at 6-weeks and 6-months postpartum. Results: The SSQ was found to have low test-retest reliability on items referring to the infants' sleep and settling behaviour, but moderate reliability for the extent that such behaviour bothered the parent. Comparison across the different samples showed good discriminant and concurrent validity. Conclusions: Parental reports on the SSQ indicates that over a short period (1-2 weeks) the infants' sleep and settling behaviour can change considerably, but that the extent to which such behaviour bothers the parent is more stable. Good validity demonstrates the SSQ is sensitive to differing infant behaviour. It is recommended as both a clinical and research instrument, and could be used to complement assessments focusing on the parent's psychosocial adjustment in the early postpartum period.