Journal of Pediatric Psychology 32(3) pp. 283–287, 2007 doi:10.1093/jpepsy/jsl025

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. Bedtime resistance, manifested by children crying, call-ing out, or leaving their rooms after bedtime, is one of the most frequent presenting complaints in primary care pediatrics (Blum & Carey, 1996). Among the methods often prescribed, the most effective, in terms of sheer reductive potency, involve variations on a procedur