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Part #1:  Initial Progression
First, let’s discuss initial progression. Pamela and Brad, ages 24 and 27, were the parents of 13 month old Chelsea. Pamela and Brad were referred to me by their family therapist for Chelsea’s sleep problem. Chelsea was typical for a 13 month old child in that she tended to cry when she was put down for a nap. Brad stated, “Whenever Pamela tries to put Chelsea to bed, she cries and cries. We are up with her for half the night sometimes.”

How might you have responded to Brad and Pamela’s problem? Would you agree that Chelsea may have simply been receiving too much attention from her parents?

To describe the initial progression of behavioral sleep therapy for children, I stated, “The idea is to desensitize Chelsea to the fear of being alone in her own bed by using a tapered separation schedule.” Pamela asked, “What type of separation schedule?”  I responded, “For example, on the first day wait five minutes before going into Chelsea’s bedroom if she is crying and cannot sleep.  Comfort Chelsea for two to three minutes and then leave. If more visits are necessary due to continued crying, wait an additional five minutes for each of the next two visits before going into the room. After the third visit, wait at this level, fifteen minutes, before entering for each later visit until Chelsea falls asleep alone.”

Brad stated, “Ok, but Chelsea wakes frequently during the night.  What do we do then?”  How might you have responded to Brad?  I stated, “If the child wakes during the night, begin again at the original level for the night, five minutes, and continue increasing time in five minute increments as before.” What other information could your clients use to implement the initial progression of behavioral sleep therapy for children?  Perhaps sleeping tips as discussed on the rest of this course may benefit your client.

For Part #2: Subsequent progression go to Sleep Disorders Course