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Updated: Jun 1, 2026
Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood
Published on: February 11, 2017
Assessment of brief interventions for nighttime fears in preschool children
1The Adler Center for Research in Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Tel Aviv, Israel.
Insights
Two brief Huggy-Puppy interventions significantly reduced nighttime fears (NF) and sleep problems in young children. These positive effects on children
Area of Science:
- Child Psychology
- Pediatric Sleep Medicine
- Clinical Psychology
Background:
- Nighttime fears (NF) and associated sleep problems are prevalent issues in pediatric clinical services.
- Existing interventions for childhood anxiety and fear often require significant resources or time.
- Parental behaviors in managing children's fear also contribute to the maintenance of sleep disturbances.
Purpose of the Study:
- To evaluate the efficacy of two brief doll-based interventions in reducing nighttime fears (NF) in children aged 4-6 years.
- To assess the impact of these interventions on children's sleep problems and parental fear-reducing behaviors.
- To compare the effectiveness of the interventions against a waiting list control group.
Main Methods:
- One hundred and four children with significant NF were randomized into two groups: Huggy-Puppy Intervention (HPI) and Huggy-Puppy Intervention-revised (HPI-r).
- HPI involved caring for a puppy doll; HPI-r used a protector story for the doll.
- Data on NF, behavior problems, and sleep were collected at baseline, 1 week, 1 month, and 6 months using parent and child reports.
Main Results:
- Both HPI and HPI-r significantly reduced nighttime fears with comparable effects.
- Intervention groups showed significantly greater improvement in NF at 1 month compared to the waiting list group.
- Parental fear management behaviors and children's sleep problems were also significantly reduced and maintained at 6 months.
Conclusions:
- Simple, cost-effective Huggy-Puppy doll interventions effectively decrease nighttime fears and related sleep issues in young children.
- The observed reductions in NF and parental fear management strategies were sustained for at least 6 months post-intervention.
- Further research should explore the applicability of these interventions for other childhood anxiety disorders.
Unlabelled:
Nighttime fears (NF) and sleep problems continue to be major problems in clinical services. The aim was to assess the effects of two brief interventions on NF, and related sleep problems and parental fear-reducing behaviors in children. One hundred and four children aged 4-6 years with significant NF were randomly assigned into two intervention groups: the Huggy-Puppy intervention (HPI), which is based on providing children a puppy doll with a request to take care of the doll, and a revised version (HPI-r) which is based on providing the same doll with a cover story that the doll will serve as a protector. At baseline, the domains of NF, behavior problems, and sleep disruptions were assessed. Data were collected from parents and children using objective and subjective measures. The effects of the interventions were assessed by comparing four time points: baseline, first week of intervention, 1 month, and 6 months after initial intervention time. A waiting list comparison group (WL) was used as spontaneous recovery comparison group. Both interventions significantly reduced NF with similar impact. The improvement after 1 month was significantly higher than in the WL group. Furthermore, both interventions significantly reduced parental fear management behaviors and children's sleep problems. Finally, the reduction in NF and parental fear management strategies were maintained 6 months post-treatment.
Conclusions:
Relatively simple and cost-effective doll interventions can reduce NF and their associated sleep problems. Further research is needed to implement these interventions for other anxiety disorders in childhood.
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