Response to “Self Settling – What really happens”

Sarah Ockwell-Smith wrote a deep, well researched article on self settling here. I agree with a lot, but not all that she says. Here are my thoughts:

Although I think the bike analogy is a good one, my reasons are different. Self settling or self soothing is a specific form of emotional regulation usually used in the context of settling to sleep. Like riding a bike, regulating emotions is a skill that needs to be learned. Imagine going straight from never riding any form of bike, to trying to ride unassisted. An older child, with good general coordination and balance, may learn fairly quickly, but there could be some falls along the way. Younger children, with less developed skills, would take longer with more falls.

Emotion regulation is similar. Older babies, with more experience with fluctuating emotions are likely to learn to self settle faster than younger babies.

Most parents don’t expect children to ride unassisted the first time they get on a bike. Most children start with training wheels or a balance bike. This is similar to teaching emotional regulation. Children with better emotional regulation at the same age, tend to have parents who are more responsive to their emotions. Your response, hugs, warmth, and affection are like training wheels for emotional regulation (see my post here, and relevant research here). By providing comfort you are not completely regulating their emotions for them. If you were babies would never cry or whimper in arms or when feeding… but they do.

Training wheels and balance bikes allow children to glide unassisted with less likelihood of falling but they don’t prevent wobbles. Your assistance with self settling can work in a similar way. You can provide opportunities to self-settle by lying your baby in his or her cot on those odd occasions when your baby is sleepy but calm. Then, like training wheels hitting the road, you assist when needed, and to the degree needed. Same with emotional episodes during the day as discussed in Teaching emotion management: Helicopter parenting and sleep and The Dream Baby Guide Summary.

Although I agree with this, I think Sarah generalises too far. Controlled crying in research circles is a variant of the “extinction” method. This is a psychology term for the phenomena where a behaviour stops when it is no longer being rewarded. I’m not sure that crying should be considered a single behaviour though, given that it communicates so many needs and wants. I suspect that the first kind of cry that would stop would be the cry of “Mum? Dad? Come back please”. Cries of pain, including emotional anguish may not be extinguished because they are an innate reaction to the pain and not an operational behaviour. In learned helplessness studies, the dogs who could not escape an electric shock stopped trying to escape (an operational behaviour) when they learned that they couldn’t, but they continued to whine (an innate reaction to the pain; 1).

This research (2) did show that after a controlled crying intervention, when a mother’s stress decreased because she thought her baby was asleep, her baby’s stress remained elevated. In comparison, before the intervention stress rose and fell together in mother and baby pairs. This does indicate that the babies were not as soothed or settled as they appeared after the intervention, but it cannot say whether the distress was overwhelming. Babies experienced the same level of distress on the third night as they did on the first night of the sleep routine, even though their behaviour was vastly different. However, we cannot know from this study whether they fell asleep without crying because they were now able to handle that level of distress, or had just learned that it was no use crying about it.

As I suggested earlier, learning not to call out to Mum and Dad, is not the same as learning to stifle an innate response to pain and anguish. I cannot imagine any creature could stifle a cry of pain or fear because of a learning intervention if they were aware of a danger great enough to kill them, just as the dog continued to whine during the electric shock. Besides, 90% of SIDS cases occur before 6 months of age (3) and few experts recommend controlled crying prior to 6 months.

The thinking part of the brain does contribute significantly to a child’s ability to regulate their emotions (4,5). It facilitates self-instruction and problem solving. However, I don’t agree that it is necessary for self settling to sleep. Even infants avert their gaze when they are getting overstimulated, and make rhythmic sounds as they fall asleep (6). These are rudimentary forms of emotion regulation. I would argue that a fully equipped emotional regulation toolbox requires all brain areas that Sarah mentions, but babies are born with a very limited set of tools that can be enough to self settle from very low levels of emotion. As babies grow they learn new comforting skills such as sucking their hand, their thumb, or playing with cloth, and they also get accustomed to feelings such as tiredness. With each new tool, babies become better able to regulate their emotions. Emotional tool kits (to use a phrase from the Dream Baby Guide) have limits at any age. Even adults can struggle to calm down from intensely emotional experiences.

This research observed how much mothers nurtured their children of ages 3 to 5, and how this related to hippocampal volume at school age. It is not fair to lump nurturing, caring, loving parents who try controlled crying, in with mothers who are rarely nurturing. In fact, lack of sleep is related to depression, which is associated with a lack of responsiveness. Therefore, controlled crying, assuming it improves parental sleep, may result in more nurturing behaviours overall. A 2010 review of the literature finds no evidence that controlled crying is harmful. Some studies even show benefits (for details and reasons why I still don’t think controlled crying is a good idea see Research-Based Sleep Training Methods). My take on the research is that controlled crying can improve sleep for parents, and possibly children. Improved parental sleep, and the effects this has on parental wellbeing, and family harmony, are beneficial. However, I do not believe that controlled crying is the only, or best, way to achieve parental sleep and associated benefits.

In my view, learning to self settle via controlled crying is like learning to ride a bike without training wheels. Most experts agree that you shouldn’t try controlled crying until your baby is at least 6 months old. Just as you wouldn’t expect a child to ride before they can walk. Even after 6 months I still prefer to start with training wheels to minimise the distress, even if it takes a bit longer. There is support for many alternative approaches as detailed in Research-Based Sleep Training Methods, A Sensible Sleep Solution with Associate Professor Sarah Blunden, and The Dream Baby Guide Review. Unlike Sarah, I don’t consider pick up put down methods such as gradual withdrawal to be the same as controlled crying. I also think that changing how you respond to cries depending on what they communicate makes sense (Dream Baby Guide). Different methods fit different ages, individuals, and families. If you would like an online tool to help you find solutions that might fit you, please check out my Sleep Options Wizard.

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References

1. Seligman, M. E. P. (1972). Learned helplessness. Annual Review of Medicine, 23(1), 407-412. doi:10.1146/annurev.me.23.020172.002203

2. Middlemiss, W., Granger, D. A., Goldberg, W. A., & Nathans, L. (2012). Asynchrony of mother–infant hypothalamic–pituitary–adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early human development, 88(4), 227-232.

3.Baby Center: http://www.babycenter.com/408_when-can-i-stop-worrying-about-sids_1368538.bc.

4. Cole, P. M., Armstrong, L. M., & Pemberton, C. K. (2010). The role of language in the development of emotion regulation. In S. D. Calkins & M. A. Bell (Eds.), Child development at the intersection of emotion and cognition. Human brain development. (pp. 59-77). Washington, DC, US: American Psychological Association.

5. Roben, C. K., Cole, P. M., & Armstrong, L. M. (2013). Longitudinal relations among language skills, anger expression, and regulatory strategies in early childhood. Child development, 84(3), 891-905.

6. Stifter, C. A., & Braungart, J. M. (1995). The regulation of negative reactivity in infancy: Function and development. Developmental psychology, 31(3), 448.

Link Ups

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