The effects of a Bedtime Pass integrated with an extinction procedure in the treatment of a 9-year-old girl with Bed Resistance

Valentina Tirelli, Fabiola Casarini, Francesca Cavallini

The study evaluated the use of a procedure called the Bedtime pass, a strategy based on the principle
of differential reinforcement associated with Extinction in order to reduce Bedtime Resistance in
a 9-year-old girl. Resistance to bedtime is one of the most common child problems addressed in
outpatient paediatrics. Prevalent forms of bedtime resistance include crying out from and leaving
the bedroom (Ferber, 1985; Blum & Carey, 1996). An ABAB experimental design was implemented,
the Dependent Variable was the number of times the child called out and had tantrums while the
Independent Variable was the Pass plus Extinction. During the baseline (A), parents were instructed to
respond to bedtime behaviour problems in their usual fashion such as doing what the girl wanted or
giving her a telling off. During the intervention (B), they gave her a pass she could use once a night
for a pleasant activity. Bedtime resistance was eliminated for the participant and follow-ups show
maintenance of results. Furthermore, treatment did not produce extinction bursts, as is common when
using extinction procedures alone. Further investigation is needed in order to establish the importance
of the components.

Keywords
Bedtime resistance, Pass, Extinction, Intervention.

Back