Child Sleep Training Methods
What is the "Ferber" or "Rapid Extinction" method of sleep training?
The quote-unquote "Ferber Method" is a behavior modification program which involves extinction, but it's very aggressive, okay? In other words, when you try to change a child's behavior, you will put the child, say, in the bed or crib and you will withhold whatever they were used to and let them cry it out; that's essentially what it is. Then, it requires repeated visits back to the child's room, in a very careful way, to A) make sure that they are safe that they haven't got their arms twisted in the bars of the crib or something terrible has happened to them. But not in any way to give the child a false hope or expectation that you are going to come back and do what you did before, so that you can help them fall asleep. So, it's a very aggressive thing and what one does is you will leave the child for a period of time – and again, there are no fixed rules. So, in what we call the rapid-fire extinction method, you'll leave the child in the bed or crib and go out for, say, three minutes – and they will cry and scream and fuss and do whatever they can do to try and get you to come back and do what you did to them before to help them fall asleep. You'll go in briefly – and the key is briefly – and make sure they are safe and to show them that you still exist. It's a good idea not to talk to them, not to interact, not to touch them, not to hold them, just “Time to go to sleep” –that's it, and out you go. And, then you wait, maybe four minutes and then you go back in briefly, for seconds only, then you wait, say, five or six minutes. Basically, every time you go out, you increase the amount of time that you stay out of the room before you go in. And, as you increase the time – you just do that until the child falls asleep. So the child, essentially, in a harsh kind of way, is learning to go to sleep on their own. That's really what you're doing and that's essentially, if you want to call it, what the Ferber technique is.
What is the "Gradual Extinction" method of sleep training?
The Gradual Extinction method is putting a, setting up a normal sleep routine and getting a child to go to bed without you doing anything to help them; without you doing anything. You then stay in the room with the child, but when you stay in the room with the child while they're lying in the bed or fussing, I might add, or standing up at the rails and banging on the rails, the point is you stay in the room, but you do not interact with the child. You just are there so that they can see that you're there, and they will be fussing and crying to try and get your attention. The important thing is you do not give them attention. The only thing they're getting is that you are there and they can see you, that's the only benefit that they're getting from you being there. And you have to stay there until that child falls asleep. Now that can be anything from thirty minutes to two hours or more. It takes, that's why it's a much longer process and once they fall asleep then you can leave the room. Then when they will invariably wake up during the night naturally looking for you because looking for their old habit, you have to go back into the room so that they can see that you're there- sit in the chair or sit on the floor, whatever you do, sit in the room, sit quietly, do not interact with the child until they fall asleep: then you can leave. So you'll do that however many times in the first night. The next night what you do is you simply move the chair one or two feet further away from the crib and you'll repeat exactly the same process that you did the night before. So the goal is that on succeeding nights you will have to go back into the room less frequently and for less length of time and you will eventually migrate to a chair or whatever way you sit, out of the room.
Which method of sleep training should I use?
The method of sleep training that you choose on a child depends on what you feel the parents can successfully implement. I don't believe in prescribing a particular training method without getting the understanding consent of the parents, because ultimately they're the ones that are going to execute the sleep training program. If you can't get them on your side or you can't get their cooperation, you're failing before you start. So, in interviewing the parents and in preparation for the behavior modification, part of the process is to see what their parenting style is. If you're talking about a two-parent family, it's very common for parents to have different parenting styles. Some parents are more tolerant of leaving their child alone and letting him or her cry. Some just can't cope with that. So it's very important for families, once they agree that something absolutely has to be done, that they just can't live like this and absolutely have to fix their child's sleeping patterns, the next step is to look at their parenting styles, look at how they function together, and to customize an approach that you know that they can execute.
