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Managing the problem gradually - example of graduated extinction

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The parents must agree the procedure, tell the child and have some contingency plan for when the child screams. A basic outline of one possible management policy is given below:

  • the parent settles the child briefly, without letting the child fall asleep, and leaves the room. The parent leaves the room and tells the child that s/he will return in 5 minutes. The door is left ajar.
  • the parent only returns before the end of the 5 minute period if the child gets out of bed. If this occurs then s/he returns and tells the child that the door will be shut if the behaviour is repeated.
  • the parent returns after the 5 minute interval and settles the child and leaves the room before the child has gone to sleep.
  • the procedure is repeated at intervals that increase by 5 minutes ie 10 minutes, 15 minutes etc. This procedure is repeated until the parent returns and finds the child asleep.
  • after the first night the time intervals are increased by 5 minutes each night, ie for the second night, 10 minutes to the first settle, then 15, then 20.

This form of management often results in the child settling well by the end of the week.


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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