The bedtime pass - An approach to bedtime crying and leaving the room

Objective: To evaluate a novel intervention for bedtime problems. Design: We used an ABAB withdrawal-type experimental design. Setting: The intervention was prescribed in an outpatient primary health ca re context and evaluated in the home setting. Participants: Two normally developing boys aged 3 and 10 years were the pri mary participants. Twenty parents and 23 practicing pediatricians rated the acceptability of the intervention. Intervention: A bedtime pass, exchangeable for 1 excused departure from the bedroom after bedtime. Main Outcome Measures: For both primary participants, instances of crying a nd/or coming out from the bedroom after bedtime; for the 20 parents and 23 pediatricians, comparative ratings of acceptability for the pass and 2 othe r commonly used approaches to bedtime problems (ignoring crying and letting children sleep with their parents). Results: Crying and coming out from the bedroom reduced to zero rates in bo th children. Pediatricians rated using the pass as significantly more accep table than letting children sleep with parents and equivalent to ignoring. Parents rated the pass as more acceptable than either alternative. Conclusion: The bedtime pass provides pediatricians with a readily usable, potentially effective, and highly acceptable novel intervention for bedtime problems, one of the most common complaints in outpatient pediatrics.