What is the extinction method for sleep training?

The Extinction Method for Sleep Training

The extinction method for sleep training involves allowing a child to cry until they fall asleep without parental intervention, with the goal of teaching independent sleep onset by removing reinforcement for crying behaviors. 1

What is the Extinction Method?

The extinction method (sometimes called "cry it out") is a behavioral sleep intervention that:

• Requires parents to completely ignore their child's cries at bedtime and during night wakings until the child falls asleep independently 2
• Works by eliminating the reinforcement (parental attention) that maintains the child's crying and bedtime resistance 3
• Is considered one of the most empirically supported behavioral sleep interventions with rapid results 4
• Is typically implemented after establishing a consistent bedtime routine 1

How the Extinction Method Works

The extinction method operates on behavioral principles:

• It follows learning theory where behaviors that are not reinforced will eventually decrease and stop 1
• Parents place the child in bed awake and then leave the room without returning, regardless of crying 2
• The child learns that crying does not result in parental attention and eventually develops self-soothing skills 3
• During implementation, parents can expect an "extinction burst" where crying initially increases before decreasing 4

Variations of the Extinction Method

There are several variations of the extinction method:

• Pure extinction: Parents completely ignore crying until the child falls asleep 3
• Graduated extinction: Parents ignore crying for progressively longer intervals before briefly checking on the child (also called "controlled crying" or "Ferber method") 2
• Extinction with parental presence: Parents remain in the room but do not interact with the child 5

Effectiveness and Considerations

Research shows that extinction methods can be effective but come with important considerations:

• Studies show 60-70% improvement in sleep onset and night waking in children with sleep problems 1
• Extinction methods typically produce more rapid results than more gradual approaches 4
• Common side effects include extinction bursts (temporary increase in crying), spontaneous recovery (reappearance of crying after initial improvement), and morning sleepiness 1, 4
• Many parents (30-40%) report difficulty implementing extinction methods due to the emotional challenge of ignoring their child's cries 5, 6

Challenges and Parental Concerns

Parents often struggle with extinction methods for several reasons:

• Emotional difficulty hearing their child cry without responding 2
• Practical considerations such as disturbing other family members or neighbors 2
• Fear of potential negative effects on the child's emotional development or attachment 6
• Incongruence with personal parenting beliefs or cultural practices 2
• Parental wellness factors including exhaustion, anxiety, or depression that make implementation difficult 2

Alternative Approaches

For parents who find extinction methods challenging, alternatives include:

• The "Excuse Me Drill" which teaches children appropriate replacement behaviors rather than just eliminating unwanted behaviors 4
• More responsive methods that allow for parental presence and comfort while still promoting independent sleep skills 5
• Consistent bedtime routines with good sleep hygiene practices 1, 3
• Scheduled awakenings where parents wake the child before their typical spontaneous awakening 3

Implementation Tips

For successful implementation of the extinction method:

• Establish a consistent and calming bedtime routine before starting 1
• Choose a time when parents can be consistent (not during travel, illness, or major life changes) 3
• Prepare for the extinction burst by understanding that crying may initially increase 4
• Consider using a video monitor to observe the child without entering the room 2
• Ensure the child's room is safe, comfortable, and at an appropriate temperature 1, 3

The extinction method remains one of the most studied and effective behavioral sleep interventions, but parents should be aware of the challenges and consider their own comfort level with the approach before implementation 4, 2.