Augmenting behavioral interventions for infant sleep problems

Graduated extinction- this behavioural technique is based on psychological learning theory. Parents are instructed to put their child to bed at night and then leave the room, and return at scheduled progressively increasing intervals (e.g. every 2 minutes, then every 3 minutes etc.) to check or reassure the infant in case he or she cries or signals distress. The four following variations of Graduated Extinction will be compared in this study: (1) Control group, receiving Graduated Extinction alone. (2) Music distraction group receiving Graduated Extinction with a music distraction technique. In addition to the Graduated Extinction guidelines (i.e., delaying response to the infant at scheduled intervals to facilitate acquisition of self-soothing skills), participants in this group will be asked to listen to their choice of music during the intervals in which they wait and delay their response. (3) Distraction via gaming group, receiving Graduated Extinction with a gaming distraction technique. In addition to the Graduated Extinction guidelines (i.e., delaying response to the infant at scheduled intervals to facilitate acquisition of self-soothing skills), participants in this group will be asked to play to their choice of game on their phone or other media screen-device during the intervals in which they wait and delay their response. (4) Reappraisal group receiving Graduated Extinction with a reappraisal technique. In addition to the Graduated Extinction guidelines (i.e., delaying response to the infant at scheduled intervals to facilitate acquisition of self-soothing skills), during the intervals in which they wait and delay their response, participants in this group will be asked to practice telling themselves that “it’s nothing very serious, this baby is not sick or hurt, they are learning to self-soothe”. Each of the four variations described above will be provided in two face to face sessions (45 minutes each) with a provisional or clinical psychologist (postgraduate level) at the Flinders University Child and Adolescent Sleep Clinic. The second session will be held 1 week after the first. Families will be asked to implement the interventions with their infants for all sleep episodes during the week between the first and second treatment session. During this week, they will monitor their adherence to the intervention using a daily diary.