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Journal of Pediatric Psychology 29(5) pp. 389-396, 2004
Journal of Pediatric Psychology vol. 29 no. 5 © Society of Pediatric Psychology 2004; all rights reserved

Brief Report: A "Storybook" Ending to Children's Bedtime Problems—The Use of a Rewarding Social Story to Reduce Bedtime Resistance and Frequent Night Waking

Raymond V. Burke, PhD1, Brett R. Kuhn, PhD2 and Jane L. Peterson, MS3

1 Girls and Boys Town, Nebraska, and University of Nebraska, Lincoln; 2 Munroe-Meyer Institute, University of Nebraska Medical Center; and 3 Behave'n Day Center

Address correspondence to Raymond V. Burke, 14100 Crawford Street, Boys Town, NE 68010. E-mail: R. Burke, burker{at}girlsandboystown.org; B. Kuhn, brkuhn{at}unmc.edu; J. Peterson, janiep{at}behavenkids.com

Objective To evaluate the efficacy and acceptability of a social story with tangible rewards to reduce children's disruptive bedtime behavior and frequent night waking. Method Four children (ages 2 to 7), with clinically significant disruptive bedtime behavior, received the intervention, which consisted of a social story (The Sleep Fairy) that sets forth (a) parental expectations for appropriate bedtime behavior and (b) rewards for meeting those expectations. Results Parent sleep diaries indicated that children had a 78% average decrease in frequency of disruptive bedtime behaviors from baseline to intervention, with another 7% decrease at 3-month follow-up. Night wakings, a problem for 2 children during baseline, were not a problem during intervention and follow-up. Parents reported improved daytime behavior for 3 of the 4 children. Parents gave the intervention high acceptability ratings and maintained a high level of treatment fidelity. Conclusions Use of a social story helped parents implement a multicomponent intervention using a familiar bedtime routine, thereby increasing the likelihood that implementation and effects occurred. The book format makes this intervention widely available to parents and professionals, with minimal costs and inconvenience.

Key words: bedtime; behavior; children; reinforcement; sleep; sleep disorders; social story.


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