01 Jul Evidence-based Sleep Training for Babies & Toddlers
There’s lots of strategies to help younglings settle, including “crying it out” (where the child is left to cry until they have exhausted themselves) or controlled crying (where parents gradually respond to crying over a series of scheduled minutes). These techniques have been able to reduce night time crying and involvement by the parents (i.e., less crying for the baby, more sleep for the both of you)1.
But some of the evidence and public opinion about these “extinction-based” techniques can vary widely. Some of the critics of these methods argue that ignoring crying, even graduated ignoring (as in controlled crying), can have negative consequences for the child’s sense of attachment (their ability to feel attuned to and feel secure that their needs will met by a parent figure)2, important for healthy development and interpersonal functioning. Not to mention, parents often report tolerating these kinds of sleep training interventions with intense difficulty because of concerns about their child’s stress when ignored and a low adherence rate to these kinds of techniques3.
A lesser known but equally effective4-5 technique for settling babies and young children to sleep is known as the ‘Cue-based’ Sleep Solution (also known as the Sensible Sleep Solution). In this method, crying is not ignored but instead, the ‘cues’ babies receive to help them fall asleep (things like rocking, cuddling, parent’s voice) are gradually reduced in intensity in order to help the baby gradually depend less and less on the parent to fall back to sleep. For a detailed example, see the table below from the research4 on this technique, developed and studied by Dr. Sarah Blunden, the Director and Founder of the Australian Centre for Education in Sleep:
To learn more about Dr. Blunden’s Cue-based Sleep Solution (Sensible Sleep Solution) and for tips on how to help your children sleep better, check out the Australian Centre for Education in Sleep website. You can also buy Dr. Blunden’s book at http://www.sensiblesleepsolution.com/ and can listen to her talk about the method in a series of 3 podcasts: Part 1, Part 2, and Part 3.
1 Mindell, J. A., Kuhn, B., Lewin, D. S., Meltzer, L. J., & Sadeh, A. (2006). ” Behavioral treatment of bedtime problems and night wakings in infants and young children”: Erratum.
2 Teti, D. M., Kim, B. R., Mayer, G., & Countermine, M. (2010). Maternal emotional availability at bedtime predicts infant sleep quality. Journal of Family Psychology, 24(3), 307.
3 Blunden, S., & Baills, A. (2013). Treatment of behavioural sleep problems asking the parents.
4 Blunden, S. (2011). Behavioural treatments to encourage solo sleeping in pre-school children: an alternative to controlled crying. Journal of Child Health Care, 15(2), 107-117.
5 Douglas, P., & Hill, P. (2011). Managing infants who cry excessively in the first few months of life. BMJ, 343, d7772