Sleep-training technique: Gradual withdrawal

Another sleep-training technique is gradual withdrawal (1), which is similar to the camp out method, but allows more interaction when Baby is distressed. Gradual withdrawal involves 3 steps:

  1. Distinguish needs (e.g. Nappy change), from wants (e.g. Comfort sucking). Attempt to meet needs not pander to wants.
  2. Prepare a series of alternative comforting methods, with a plan to gradually decrease intervention. For example each night:
    a. Put Baby down more and more awake.
    b. Provide less and less patting as Baby falls asleep.
    c. Sit further and further away as Baby falls asleep.
    d. Sooth with voice only.
  3. Respond before Baby becomes distressed as required using minimal intervention first, pick up if necessary to calm, then start over.

This intervention was used with 33 babies and toddlers 8 months to 4.25 years and took 5 weeks. It was effective in a pre-post comparison. Specifically, babies and toddlers had longer night sleep duration, faster sleep onset, and fewer night wakings 6 weeks after the intervention compared to before it. However, there was no control group, so it is possible that regular consults with the private sleep clinic, or other factors, produced these results.

The researcher behind this research, Associate Professor Sarah Blunden, has a lot of useful tips on her website, and has her own book out called the Sensible Sleep Solution. You can buy it here: http://www.sensiblesleepsolution.com/, or on Amazon, or borrow it from a library of course.

To hear Sarah Blunden talking about her research and experience with the method go to https://practicalresearchparenting.com/2015/07/02/prp007-a-sensible-sleep-solution-with-associate-professor-sarah-blunden-part-1/

The gradual withdrawal method (Now known as the Sensible Sleep Solution) is less rigorously tested compared to other interventions but appears effective. On a theoretical level, this approach could be supportive of learning because the self settling requirements increase gradually, requiring incremental learning and not a leap in learning. On the other hand, the change in parental intervention could be seen as inconsistency making the settling routine unpredictable and scary. I suspect whether this approach aids learning or creates unpredictability depends on how fast you try to progress through the steps and how easily your baby copes with change. If your baby has really bad separation anxiety, this may be a good approach, because you don’t require them to settle without you until they are very practiced at falling asleep in their cot with only your presence.

Have you tried gradual withdrawal? Did it work for you? Please add your experiences below.

References

Blunden, S. Behavioural treatments to encourage solo sleeping in pre-school children: An alternative to controlled crying. Journal of Child Health Care. 2011; 15(2): 106-17.

 

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