Validation of the Chinese Version of the Children’s ChronoType Questionnaire (CCTQ) in school-aged children

ABSTRACT

The Children’s ChronoType Questionnaire (CCTQ) is a valid and reliable measure for assessing prepubertal children aged 4–11 years. The CCTQ is a parent-reported, 27-item questionnaire consisting of sleep-wake parameters for scheduled and free days (16 items), a morningness/eveningness scale (M/E, 10 items), and a five-point, single-item, chronotype score. The CCTQ has been translated into different languages, but a Chinese version is not available. In the present study, we aimed to produce a Chinese version of the CCTQ and test its validity and reliability on school-aged children. A total of 555 children aged 7–11 years were recruited from five primary schools. The parents were told to complete the CCTQ and record their child’s sleep pattern in a 7-day sleep diary. Sixty-six children and their parents were invited to participate in determining the test-retest reliability of the CCTQ over a 2-week interval, and their sleep patterns were assessed using a sleep diary. The internal consistency of the Chinese CCTQ M/E score as measured by Cronbach’s alpha was acceptable (0.74). Regarding the test-retest reliability of the instrument, moderate to strong Spearman’s correlation coefficients were found for most of the CCTQ – sleep-wake items (ρ = 0.52–0.86) and for the CCTQ-M/E total score (ρ = 0.78). For the concurrent validity, Spearman’s correlations between the sleep-wake parameters of the CCTQ and the sleep diary were moderate to high on both the scheduled days (ρ = 0.54 to 0.87) and free days (ρ = 0.36 to 0.60). For the correlations measured with actigraphs, significant correlations were found in the CCTQ sleep-wake parameters, including bedtime, get-up time, sleep latency, sleep period, time in bed, and mid-sleep point on both the scheduled (ρ = 0.31 to 0.76) and free days (ρ = 0.27 to 0.52), but not in sleep latency and sleep period on free days. The results of the present study suggest that the Chinese version of the CCTQ is a reliable and valid tool for assessing chronotypes in Chinese school-aged children in Hong Kong.

KEYWORDS:

• Circadian rhythms
• chronotype
• sleep
• children
• validation
• school-aged
• Hong Kong Chinese

Acknowledgments

We thank the parents who participated in this study, as well as the principals and teachers of the five primary schools in the Hong Kong SAR, China that were involved in this study (C.N.E.C. Lui Ming Choi Primary School, The Mission Covenant Church Holm Glad Primary School, T.W.G.Hs. Wong See Sum Primary School, Baptist Rainbow Primary School and Queen Elizabeth School Old Students’ Association Branch Primary School). This study is supported by the Start-up Fund for New Recruits, the Hong Kong Polytechnic University (Project no.: 1-ZE7V).

Declaration of conflicting interests

The authors declare that they have no competing interests.

Supplementary Material

Supplemental data for this article can be accessed here.