Pediatrics ·
SNAKE questionnaire validated for key sleep domains in infants at risk of cerebral palsy
A prospective, multicenter observational study assessed the SNAKE sleep questionnaire in 174 children younger than 2 years with or at high risk for cerebral palsy. The tool showed acceptable reliability and validity for sleep initiation, maintenance and arousal, but not for daytime sleepiness or behavior.
- Study included 174 children younger than 2 years.
- SNAKE reliability was acceptable for three sleep domains.
- Daytime sleepiness and behavior domains performed poorly.
- Sleep disturbances in key domains affected 28–38%.
Sleep disturbances are common in children with cerebral palsy (CP) and can affect children and families. Researchers assessed the psychometric properties of the Sleep Questionnaire for Children With Severe Psychomotor Impairment (SNAKE), which had not previously been validated in children younger than 2 years with or at high risk for CP. Caregivers at six US high-risk infant follow-up programs completed the SNAKE and the Brief Infant Sleep Questionnaire–Revised (BISQ-R); analyses included internal consistency, inter- and intrarater reliability, and convergent validity.
The study included 174 children. SNAKE showed good overall internal consistency (Cronbach α=0.85). Reliability was acceptable for sleep initiation, maintenance and arousal (α=0.67–0.80), with moderate-to-good inter- and intrarater reliability (intraclass correlation coefficients 0.60–0.79). Convergent validity with the BISQ-R ranged from acceptable to substantial. Daytime sleepiness and behavior domains had poor reliability. Sleep disturbances in initiation, maintenance and arousal were reported in approximately 28–38% of participants.
The findings support caregiver use of SNAKE to assess these three sleep domains in this population, but not its daytime sleepiness or behavior domains. This was a psychometric assessment, not a trial of screening or intervention, and the results do not establish that using the questionnaire improves outcomes.
In practice
For clinicians assessing sleep in children younger than 2 years with or at high risk for cerebral palsy, these findings support using caregiver-completed SNAKE scores for sleep initiation, maintenance and arousal. The study found acceptable reliability and validity for those domains in 174 children across six US programs, but poor reliability for daytime sleepiness and behavior. This observational psychometric study did not test whether questionnaire use improves detection or outcomes, so it supports assessment rather than a change in treatment or screening practice.
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Pediatric Research: A sleep questionnaire’s psychometric properties in infants with or high risk of cerebral palsy ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.