MANAGEMENT OF SLEEP PROBLEMS: THE CHILD WHO RESISTS GOING TO BED
This technique applies to toddlers and older children.
1. Decide on a reasonable bedtime for the child. There are no rigid rules for this. It depends on a number of factors, including the number and length of his daytime naps, the amount of sleep the child seems to need at night, the time of awakening in the morning and so on.
2. Establish a set routine that begins 30 minutes before the actual bedtime. Tell the child that it will be bedtime in 30 minutes. Each routine will vary according to child preferences, family routines and so on, but it must be adhered to. A typical routine may involve the child changing into pyjamas, brushing teeth, playing a game with a parent, reading a bedtime story, then saying goodnight to various toys and pets and kissing family members. All of these activities should be quiet so as not to overstimulate the child. Strenuous physical activities are not a good idea.
3. At bedtime, take the child into his bed, tuck him in, say goodnight (Til see you in the morning’), turn off the light (apart from a night light, if the child has one), and leave the room. Some children may like to take a cuddly toy to bed — this is fine.
4. If the child calls out, ignore it. Do not reason in any way. Resist the temptation to call out ‘Go to sleep’. You should not say anything, no matter how desperate the calls and pleas become (and they will become increasingly desperate — young children have an amazing and endless repertoire of wishes and requests designed to tug at the heartstrings of even the most hardened parent).
5. If the child cries, ignore it. The crying may sound as if the child is verydistressed, and persist for a very long time, but the parents must ignore it. To allow the child to cry for a long time and then go in will simply teach him that if he cries for long enough then eventually the crying will be rewarded by the appearance of a parent.
6. If the child comes out of his room take him straight back, without saying a word. Talking to the child or explaining what or why is taken by the child as a form of reinforcement, and will guarantee that the behaviour will continue. It may be necessary to take the child back literally dozens of times initially. Again it is important not to weaken in this resolve — if parents give up in the middle of such an intervention, the child learns that as long as he keeps coming out of the room, sooner or later the parents will weaken and allow him to stay out.
Sometimes a gate can be placed across the bedroom door to prevent the child from leaving the room. This is less frightening for parents and child than locking the door.
7. The next morning, if the child has gone to bed with a minimum of fuss, he should be praised for being ‘such a good/big/grownup boy’. Sometimes a material reward may be given, though there is a danger that the child may come to expect a treat every time.
Sometimes extinction or controlled crying is used for the child who resists going to bed, but this is generally not as successful in this situation as it is for the child who wakes during the night.
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Tags: General health