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Key points
- Families with limited financial resources may have challenges in providing a healthy sleep environment.
- Professionals should be aware that some parents feel blamed for their child's poor sleep.
- Despite many challenges, sleep interventions hold much promise for success.
Many studies have been done recently and more are underway to help parents and children attain better sleep health. These programs have the ultimate aim of helping children achieve better emotion regulation and mental health, better classroom attention and learning, and in some cases, better nutrition and weight control.
Because there are sleep health disparities in families who are relatively impoverished and marginalized, the interventions hold out hope for reducing those disparities. All of the interventions are admirable and have considerable promise for helping in both the short and long term as children grow into adolescence and adulthood.
Some professionals who have developed interventions for families with limited financial resources may not realize that they are extending the kinds of anti-poverty initiatives that have been ongoing for decades in the U.S. As sleep interventions are planned and implemented, it is wise to recall the historical context of anti-poverty programs that have targeted parents and children. We may be able to learn from the successes and failures that have preceded us.
As a graduate student in the 1960s, I worked for a Project Head Start program in my hometown. Head Start was a central component in the Lyndon Johnson administration’s War on Poverty, which began in 1964. Johnson and the architects of the programs were optimistic, as reflected in a quote from Johnson: "Our aim is not only to relieve the symptom of poverty, but to cure it and, above all, to prevent it."
Sixty years later, poverty has not been “cured” but substantial government resources have been committed to prevention and amelioration. The most enduring and successful of all of the programs is Head Start.
Head Start programs have served more than 38 million children since 1965, growing from an eight-week demonstration project to include full-day/full-year services and many program options. Currently, Head Start grants are administered by the U.S. Department of Health and Human Services, Administration for Children and Families. Head Start programs serve more than 1 million children and their families each year in urban, suburban, and rural areas in all 50 states, the District of Columbia, Puerto Rico, and U.S. territories, including American Indian and Alaska Native and Migrant and Seasonal communities.
In 1971, William Ryan published a small book titled Blaming the Victim, a critique of a philosophical basis of many of the anti-poverty programs of the time. The book was a rebuttal to the 1965 Moynihan Report, authored by Senator Daniel Moynihan, who was then Assistant Secretary of Labor in the Johnson administration and later Senator from New York.
The report had placed the blame for much poverty on deficiencies in African-American families, including the high number of children born out of wedlock and children being raised by only one parent. Further, the clear implication was that such parents had poor parenting skills, failing to provide children with the kinds of social and physical environments that would provide a foundation for their success in school and afterward.
Ryan’s book elegantly and forcefully pointed out that the vast majority of poor people in the U.S., particularly racial minorities, had been victims of deliberate actions by individuals, groups, and government to keep them impoverished. Inequality was built into, and preserved by, the American political and economic system. Ryan’s point was that placing the blame on deficiencies within individuals was naïve and misguided. Shamefully, financial inequality is worse today than it was in 1964 or 1971.
Financial resources include not only income but wealth. Wealth consists of income plus other accumulations such as land and property, which is often passed down through families. Wealth can also be indirect, as when families have parents, grandparents, and other relatives, or even close friends, who could be called upon when needed. Think, for example, about a family whose relatives can offer a low- or no-interest down payment or long-term home loan vs. those who must pay market prices.
What does more income and wealth have to do with parenting? Quite a bit, obviously. Wealthier families can afford to buy more educational toys and books and can afford to take children on trips to museums and libraries and on vacations where they can learn about other cultures. Wealthier parents may be more likely to have professional and advanced degrees that have given them knowledge and skills that can enhance parenting.
They can afford to hire household help, freeing parents to spend more time with their children if they choose. They can afford to hire babysitters and nannies to give the parents a needed break from parenting. They can often afford to have one stay-at-home parent while one is employed. They can afford better housing, better nutrition, better opportunities for exercise, and participation in sports. They can afford private tutors and private schools.
Thus, as beneficial as parent training programs and programs providing remedial and supplementary education for children, they are not even close to being enough to “level the playing field” to use an overworked sports metaphor.
That is not to say that all parents should not take personal responsibility for providing a nurturing environment for their children. They should, and there are some parents who fail to do so. But it is often difficult for privileged people to appreciate the challenges of raising children with inadequate resources. Further, it is unfortunate that many would say “Why did you have these children if you can’t take care of them properly?”—“properly,” meaning how privileged people do it.
Well-meaning educational and health professionals who have lived lives of relative privilege sometimes cannot understand how someone would not appreciate their offers to help. But just the fact that parents are in need of assistance is embarrassing for many of them, and they assume that we as professionals are judging them—even when we believe sincerely that we are not.
Turning finally to sleep interventions, it is important to recognize that some parents may be skeptical of efforts that imply or directly say that they have been doing it all wrong when it comes to providing a healthy environment and good supervision of their child’s sleep. They may think, “Here we go again. They're telling us that we're doing it wrong, that it's our fault our children aren't getting sleep."
And even if we are successful at getting parents to set regular early bedtimes, monitor screen use, and do numerous other things they can control, we must remember that a large set of conditions related to sleep hygiene is beyond parent and child education about sleep. Specifically, parents with more financial resources can afford to have larger houses, with more bedrooms, better HVAC systems, and more insulation against household noise, which are more likely to be located in safer and quieter neighborhoods. They can afford to have their houses cleaned frequently (to cut down dust that can affect breathing as it relates to sleep) and can afford better bedding.
To conclude on a positive note, teaching parents of all social classes how they can help their children attain better sleep is likely to be successful to a considerable degree. Unlike many efforts to improve circumstances and opportunities for children, there is little specialized training required, as opposed to say, trying to train parents to use best practices in discipline or use best practices in talking and interacting with children to optimize their cognitive development or use better judgment in providing nutritious foods. Sleep hygiene programs can be implemented with no special equipment or special skills beyond what parents already have.
Sleep has been called the third leg of a three-legged health stool, the other two being diet and exercise. Parents should be given the opportunity to help their children sleep more and sleep better.
