Brief report: evaluating the Bedtime Pass Program for child resistance to bedtime--a randomized, controlled trial

Area of Science:

• Pediatric sleep science
• Behavioral psychology
• Child development

Background:

• Bedtime resistance is a common issue in young children.
• Existing treatments may have drawbacks, such as extinction bursts.

Purpose of the Study:

• To evaluate the efficacy of the Bedtime Pass Program (BPP) for treating bedtime resistance.
• To assess BPP as an extinction-based procedure for typically developing children.

Main Methods:

• A randomized controlled trial involving 19 children aged 3-6 years with bedtime resistance.
• Children were assigned to either the Bedtime Pass group or a Monitoring Control group.
• The Bedtime Pass involved a card exchangeable for one parental visit, with subsequent bids for attention ignored.

Main Results:

• Children in the Bedtime Pass group exhibited significantly less room-leaving and vocalizations (crying/calling).
• A significant reduction in the time required for children to settle each night was observed.
• Treatment benefits were sustained at a 3-month follow-up, with high parent satisfaction.

Conclusions:

• The Bedtime Pass Program is a simple, acceptable, and effective treatment for childhood bedtime resistance.
• BPP leverages extinction principles without the typically associated extinction burst.
• This program offers a practical solution for managing sleep-related behavioral issues in children.