Two-Session Group Parent Training for Bedtime Noncompliance in Head Start Preschoolers

ABSTRACT

Bedtime struggles are some of the most common childhood behavior problems. These disruptions are associated with children's daytime misbehavior, impaired social functioning, poorer school performance, and even an increased risk of child abuse. These problems also have a number of negative consequences for members of the child's family. Of the evidence-based treatments for bedtime noncompliance in young children, graduated extinction is the most widely used by clinicians. A number of studies have demonstrated its efficacy. The present study is the first to examine the efficacy of graduated extinction with children from ethnic minority or low socioeconomic backgrounds. Additionally, this is one of the first studies to examine the effects of graduated extinction when it is delivered in a group format. In an interrupted time-series design, five parents of children enrolled at a Head Start preschool site participated in one of two groups that received instruction on the use of graduated extinction. According to visual inspection as well as single case and multilevel statistical analyses, parents reported that at posttest their children experienced large reductions in both bedtime and daytime behavior problems. Parents also reported that their own levels of depression and stress declined during this period. At two-month follow-up, gains in the children's bedtime behavior were maintained. Parents also reported high levels of satisfaction with the intervention. These results suggest that graduated extinction for bedtime noncompliance is effective for a wide range of parents and can be successfully administered in a group setting.

KEYWORDS:

• Parent training
• bedtime noncompliance
• preschool