Why does behavioral fading work when “cry it out” doesn’t?

Many families come to me after attempting some form of sleep training on their own.  Who can blame them really?  Why would someone pay to hire me when they can do it on themselves?  In most instances, when families have done some sleep training, they have either tried extinction (cry it out/CIO) or graduated extinction and either had no success at all or have seen some progress but then a regression that has landed them back where they started.  After trying these methods, they often realize that they need help and that there might be other ways of going about teaching their child this skill.  Working with families to help them change their children’s sleep is a very individual process and leads me in different directions with almost everyone I come in contact with.  There is not one approach (or one book) that works for all children.  Even after several years and working with hundreds of families, I still can’t say I have worked with any two children who have responded identically to sleep training.  I nearly always present all methods as options to families (I only don’t when a family has up front expressed a desire to use a specific method).  I have, however, seen unbelievable changes when using behavioral fading with children of all ages that I work with(mostly ranging from 6 months to 6 years old).

What is behavioral fading, you may be asking?  This is a method that is often referred to as The Sleep Lady Shuffle, as coined by my fellow licensed clinical social worker and mentor, Kim West.  I will fully admit, until I started using this method with families and understanding all the nuances of it, I wasn’t a believer myself.  The premise of the method is that parents offer a lot of support and comfort to a child in the beginning of the process (both by what interventions they do and their proximity to their child within the room) and then gradually begin to do less and less over the subsequent days to weeks so that their child no longer needs the interventions to fall asleep.  The method uses a parent’s presence as the child’s “secure base” (an attachment term that means that your child feels comforted and secure in learning a new skill because he/she knows a parent is nearby) to help the child learn how to fall asleep independently at bedtime and back to sleep throughout the night.

Behavioral fading offers a consistent and predictable way for parents to respond to their children throughout the whole night.  It also requires that you do respond.   This builds your child’s trust that if he needs something, you will be there.  I frequently hear, “So isn’t this cry it out with me in the room?”  Yes, there will still be crying, but there is a difference in what your child is actually experiencing with attended crying versus unattended crying.  Crying is your child’s way of telling you he is frustrated that you are not doing all the things you did before to do the work of getting him back to sleep.  So often, we are inconsistent when our children wake because we are just trying to survive and to figure out what will be the fastest way to get him to go back to sleep.  By having a plan and knowing what to do at bedtime and for the wake ups, you will be able to be much more consistent and avoid all the pitfalls of intermittently reinforcing the behavior you are trying to end.  This will not be the quick and easy way of getting your child back to sleep in the beginning because it involves your child learning how to do this himself.  Over time, you will see your child start to learn how to go back to sleep and the wake ups will shorten and then disappear.  This takes time, it takes patience and it takes perseverance.   The rewards, however, will be well worth it.

The response I hear most often from families after the first night of sleep coaching is that they are surprised that it was easier then expected and that they felt empowered by the process.  If you have never watched a young child go through the learning process and successfully acquire a new skill, it is truly a sight to see.  Teaching your child how to sleep is something he will use for his entire life.  If you would like help teaching your child this skill, please contact me to schedule a free 15 minute phone consultation to discuss your family’s sleep challenges.