Posts Tagged ‘ cry it out ’

Red-Hot Parenting Recap (Sept 2012): Play, DNA, And Sleep

Sunday, September 30th, 2012

Three big themes in the world of parenting stimulated discussion this past month. Here’s a recap of these along with links to posts that take them on. 

(1) The critical role of pretend play – long cherished in the academic literature and embedded in childhood education – was, to a degree, challenged by a somewhat provocative review paper. To some, it seemed like the article’s primary goal was to suggest that pretend play may be overrated as a promoter of cognitive development in general and creativity in particular, and hence should be reconsidered in a school’s curriculum. My take was a little different.  I thought the paper did a good job of highlighting the aspects of development that are positively influenced by pretend play – especially social skills – while suggesting that the cognitive aspects may in fact not be the primary benefit:

“Is Pretend Play Overrated?: The Take-Home Messages From The New Provocative Review”

The big thing for me was that, contrary to what you might have read about this paper, there was support for different types of play in the educational (and home) lives of young children (rather than suggesting to eliminate play). To wit, I also discussed a new study which revealed how drawing (particularly copying shapes) in toddlerhood predicts reading achievement in kindergarten even after accounting for traditional indicators of cognitive maturity:

Try This With Your Toddler: How A Particular Type of Drawing Is Associated With Reading Achievement In Kindergarten” 

(2) DNA was in the news in a number of ways. There was lots of interest in the recent link made between paternal age and risk for autism in offspring. Much was made of the idea that men, as well as women, have a biological clock. In response, I described what that may mean biologically, and how men (like women) may have to factor in rather inconclusive probabilities when making complex choices about having children at different ages:

Dads, DNA, And Choices

DNA and moms was also a hot topic. A study was characterized in the media as identifying “the mom gene” – implying that a woman either has, or hasn’t, a gene which would make her want to be a mom. I pointed out that genetics doesn’t typically work like this in humans, along with the, um, difficulties in making the jump from a study about female mice who had the function of a gene experimentally disabled to the human female:

Is There A Mom Gene?

(3) Sleep was also a big topic. While you may have read that a new study showed that it’s okay to let your baby “cry-it-out” the actual take-home messages were more fine-grained. In particular, the study was really about 2 types of sleep training methods, their utility in reducing infant sleep problems, and their lack of effects – positive or negative – 5 years later:

That “Cry-It-Out” Study: 5 Important Take-Home Messages You Should Know

I especially encourage you to check this out because we are finally seeing actual scientific studies on sleep training, rather than just debate. And the implications for parents are quite reasonable and, to my way of thinking, very important to know, given that all parents wrestle with figuring out how to get their babies to sleep.

 

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That “Cry-It-Out” Study: 5 Important Take-Home Messages You Should Know

Sunday, September 30th, 2012

In response to the publication of the recent study on sleep training methods in Pediatrics, many of the headlines focused on the conclusion that the cry-it-out method does not harm kids. In reality, the implications of this are more nuanced than those headlines would lead you to believe. Here are 5 things you should know: 

1) This paper was important because there are few studies that have evaluated sleep training methods using scientific designs. This one is especially interesting because the research team followed 225 7-month-olds – reported by their parents to have sleep issues – for 5 years. This longitudinal design permitted the researchers to examine short- and long-term effects of sleep training.

2) The study examined 2 types of sleep-training methods – controlled comforting and camping out. Controlled comforting is a variation on what you might think of as cry-it-out (or pure extinction). In contrast to pure extinction (which is let baby cry until they fall asleep – however long that is), controlled comforting involves settling a baby in to sleep, leaving the room, and establishing short intervals of tolerated crying (say, 2 minutes) before going in to soothe the baby. These intervals can be increased slowly with the idea being that baby will stop crying and fall back asleep. Camping out involves starting off in the room with baby – typically next to or near baby – and waiting until baby falls asleep before leaving. After a period of success, the parent then changes the routine by sitting in the room, but not right next to baby, and again staying until baby is asleep. And here the idea is that parent can get to the point of leaving the room before baby falls asleep. In the study, 3 conditions were used. Some parents could choose to be trained (by a nurse) in either controlled comforting or camping out (conditions 1 and 2) – and some parents were offered just general advice but received no sleep training.

3) The results were that either sleep training method was successful in improving the babies sleep and reducing levels of maternal depression – both conditions produced better results than no sleep training. So in the short term sleep training worked.

4) The positive effects on sleep did not extend out for 5 years. This is not surprising, as each developmental period raises new sleep challenges. In terms of kids’ outcomes – behavioral and emotional – there were also no differences across all 3 groups. Sleep training (either method) had no positive or negative effects. The headlines here were that “cry-it-out” didn’t harm kids. Well, not exactly. Controlled comforting did not have negative consequences 5 years later – and neither did camping out. The camping out part of this was typically left out of many news stories.

5) The key takeaway is that when parents are trained in reputable methods, they work to reduce sleep problems and indirectly help parents sleep better and feel better. Parents can feel comfortable choosing either controlled comforting or camping out, based on the results of this study. What didn’t work so well was not receiving instruction in sleep training – in the short term, these families continued to experience all the negative stuff that happens when baby won’t sleep at night. Keep in mind the point made above – the sleep training will certainly take for awhile, but sleep problems could happen again during different developmental periods (e.g., age 2, age 5). The inference to be made, however, is that sleep training will work again, but it will of course be somewhat different and tailored to the age of the child.

This study is a welcome addition to the scientific literature and also to the endless debates about sleep training that we all have. Modern sleep training methods work – especially if parents are trained to use them properly and stick with them. And you can feel comfortable picking a method that suits your style. Just remember to talk to your pediatrician (or other experts) when you are ready to start – and also remember that these kinds of sleep training methods are typically recommended for infants at least 6 months of age.

Image of adults sleeping – via Shutterstock – as a reminder that when baby sleeps, parents sleep too! 

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Sleep Outcomes – Not Sleep Methods – Matter Most

Thursday, June 30th, 2011

childsleepingIn my last two posts, I presented recent evidence that, on average, kids today are getting an hour less sleep per night than prior generations, and that shortened sleep in toddlerhood leads to metabolic changes that increase fat gain and signal risk for type 2 diabetes.

The accumulation of study after study documenting sleep loss in childhood and risk for serious physical disease suggests to me that we (experts and parents alike) have been debating the wrong issue when it comes to sleep. So much emphasis is given to debating the pros and cons of the various sleep methods, I think we are all missing the big point: what really matters is not the method, but rather the outcome of getting our children enough sleep.

The reality is that there is a wide spectrum of sleep training methods — cry-it-out, co-sleeping, and nearly infinite variations that combine some elements of each. Rather than debate the finer points of these approaches, I suggest that parents try whatever methods seem to suit them and their children best, and then determine if the chosen method is getting their child the required amount of sleep (graded by age group) on a consistent basis. If it is, then a parent has found the best method for them. If it isn’t, then the method should be revisited and revised. The only thing that matters in the end is the outcome, because we are in the midst of a sleep epidemic that can be observed in toddlers, children and adolescents. And the many potential consequences of sleep deprivation do not bode well for our children’s long term health.

I remember when we used to call sleep methods “bedtime routines.” I still like this phrase — it sounds soothing and purposeful. Rather than debate sleep methods, I’d love to know what parents are doing for their children’s bedtime routines, especially if they are finding that it is getting their children enough sleep. Remember, the issue is not to critique other parents’ routines - I want to know what works in your household. The fact is that if we can get as many parents as possible to find their own ways to ensure their children are well-rested, then we can start to combat the sleep epidemic that is putting more and more children’s health in jeopardy. And, by the way, if you evaluate your own situation, and determine that your child is not getting enough sleep, I suggest you do what I did when my then 2-year-old daughter rebelled and resisted sleep (night after night and then week after week) — I sought out the expertise of a sleep clinic, which worked wonders (and was covered by insurance)!

Image by Arvind Balaraman via FreeDigitalPhotos.net

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