Assessment of chronotype in four- to eleven-year-old children: reliability and validity of the Children's Chronotype Questionnaire (CCTQ)
Open accessAbstract
Individual differences in circadian phase preference ("chronotype") are linked to sleep schedule variability, psychosocial functioning, and specific properties of the circadian clock. While much is known about the development, distribution, and variability of chronotype in adolescents and adults, assessment in prepubertal children has been hindered by a lack of appropriate, reliable, and valid measures. This study presents a detailed description of the assessment of children's chronotype by the Children's ChronoType Questionnaire (CCTQ). The CCTQ is a parent-report, 27-item mixed-format questionnaire resulting in multiple measures of chronotype in 4- to 11-yr-old children: the midsleep point on free days (MSF), a morningness/eveningness scale (M/E) score, and a five-point chronotype (CT) score. The study provides validity data using actigraphy as well as test-retest reliability data for all three chronotype measures and sleep/wake parameters. Overall, the findings indicate moderate to strong agreement between the three measures, adequate associations between chronotype measures and sleep/wake parameters assessed by actigraphy, and excellent temporal stability (reliability).
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The few studies that have investigated chronotype in young children, through the use of the Children's Chronotype Questionnaire or DLMO, all have repeatedly observed a greater prevalence of morning chronotype in young children.
“The few studies that have investigated chronotype in young children, through the use of the Children's Chronotype Questionnaire or DLMO, all have repeatedly observed a greater prevalence of morning chronotype in young children (5, 94, 95).”
From Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health (2019) · cites this paper as [95]
The timing of sleep onset and waking and other biological rhythms is earlier relative to adults during early childhood and shifts later during adolescence.
“In general, the timing of sleep onset and waking and other biological rhythms (for example, fluctuations in melatonin levels) is earlier relative to adults during early childhood8,9 and shifts later during adolescence, and this shift in timing may be conserved among rodents and non-human primates (NHPs)10.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [8]
Most infants, toddlers (2-3-year-olds) and young children (4-11-year-olds) display earlier sleep-wake patterns and a stronger morning preference than do adults, according to the Children's Chronotype Questionnaire, even when considering high variability in sleep measures.
“Most infants, toddlers (2–3-year-olds) and young children (4–11-year-olds) display earlier sleep–wake patterns and a stronger morning preference than do adults, according to the Children’s Chronotype Questionnaire — even when considering the high intra-individual and interindividual variability of sleep onset, mid-points and wake times measured by parental report questionnaires and actigraphy8,9.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [8]
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References 58 · Cited by 240
- Authors
- Werner, H., LeBourgeois, M. K., Geiger, A., & Jenni, O. G.
- Affiliations
- University Children's Hospital Zurich (CH)
- Brown University (US)
- University of Zurich (CH)
- Corresponding author
- Jenni, Oskar G.
- Venue
- Chronobiology International
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 26
- Issue
- 5
- Pages
- 992-1014
- ISSN
- 0742-0528 (ISSN-L)
- 1525-6073
- PMC
- PMC2988284
- OpenAlex
- W2056543382
- Cited by
- 240
- References
- 58
- Citations by year
- 2026: 25 · 2025: 27 · 2024: 21 · 2023: 23 · 2022: 14 · 2021: 16 · 2020: 22 · 2019: 8 · 2018: 10 · 2017: 8 · 2016: 9 · 2015: 14 · 2014: 9 · 2013: 12 · 2012: 7
- FWCI
- 9.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Chronobiology International (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- National Institute of Mental Health (K01MH074643)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- chronotype, children, actigraphy, test-retest reliability, questionnaire validity, prepubertal children
- MeSH terms
- Biological Clocks, Child, Child, Preschool, Circadian Rhythm, Female, Humans, Male, Psychometrics, Puberty, Surveys and Questionnaires, Sleep, Time Factors, Wakefulness, Reproducibility of Results, Photoperiod
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