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Journal of Pediatric Psychology Advance Access originally published online on August 9, 2006
Journal of Pediatric Psychology 2007 32(3):283-287; doi:10.1093/jpepsy/jsl025
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Brief Report: Evaluating the Bedtime Pass Program for Child Resistance to Bedtime—A Randomized, Controlled Trial

Brie A. Moore, MS1, Patrick C. Friman, PhD2, Alan E. Fruzzetti, PhD1 and Ken MacAleese, MA, BCBA1

1 University of Nevada and, 2 Girls and Boys Town and The University of Nebraska School of Medicine

All correspondence concerning this article should be addressed to Patrick C. Friman, PhD, Clinical Services, 13603 Flanagan Boulevard, Boys Town, Nebraska 68010. E-mail: frimanp{at}boystown.org.


  Abstract

Objective To evaluate the Bedtime Pass Program (BPP), an extinction-based procedure for treating bedtime resistance in typically developing children. Methods A randomized, controlled trial in which nineteen 3- to 6-year-old children demonstrating bedtime resistance were randomly assigned to a Bedtime Pass or Monitoring Control group. The experimental condition involved parent monitoring plus the Bedtime Pass: a card exchangeable for one parental visit or excused departure from the room after bedtime, with parents ignoring subsequent bids for attention. Results Children in the Bedtime Pass condition left their rooms and called and cried out significantly less frequently than controls. They demonstrated significant reductions in the time required to quiet each night. Treatment effects were maintained at 3-month follow-up. Parents reported high levels of satisfaction and treatment acceptability. Conclusions BPP is a noncomplex, socially acceptable, effective treatment for bedtime resistance. It retains the powerful effects of extinction-based procedures without the "extinction burst."

Key words: bedtime resistance; behavioral pediatrics; extinction; sleep disorders in children; social validity.

Received September 1, 2005; revision received December 20, 2005; revision received April 4, 2006; revision received June 27, 2006; accepted July 13, 2006


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