Behavioral Extinction as a Treatment for Sleep Problems in Children on the Autism Spectrum

• Adams, L. A., & Rickert, V. I. (1989). Reducing bedtime tantrums: Comparison between positive routines and graduated extinction. Pediatrics, 84(5), 756–761.

  Article  PubMed  Google Scholar 

• Ahrens, E. N., Lerman, D. C., Kodak, T., Worsdell, A. S., & Keegan, C. (2011). Further evaluation of response interruption and redirection as treatment for stereotypy. Journal of Applied Behavior Analysis, 44, 95–108.

  Article  PubMed  PubMed Central  Google Scholar 

• Allen, K. D., Kuhn, B. R., DeHaai, K. A., & Wallace, D. P. (2013). Evaluation of a behavioral treatment package to reduce sleep problems in children with Angelman Syndrome. Research in developmental disabilities, 34(1), 676–686.

  Google Scholar 

• Blampied, N., & France, K. G. (1993). A behavioral model of infant sleep disturbance. Journal of Applied Behavior Analysis, 26(4), 477–492.

  Article  PubMed  PubMed Central  Google Scholar 

• Carnett, A., Hansen, S., McLay, L., Neely, L., & Lang, R. (2019). Quantitative-analysis of behavioural interventions to treat sleep problems in children with autism. Developmental Neurorehabilitation, 23(5), 271–284.

  Article  PubMed  Google Scholar 

• Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis (3rd ed.). Pearson.

  Book  Google Scholar 

• Didden, R., Curfs, L. M. G., Sikkema, S. P. E., & de Moor, J. (1998). Functional assessment and treatment of sleeping problems with developmentally disabled children: Six case studies. Journal of Behavior Therapy and Experimental Psychiatry, 29, 85–97.

  Article  PubMed  Google Scholar 

• Didden, R., Curfs, L. M. G., van Driel, S., & de Moor, J. M. H. (2002). Sleep problems in children and young adults with developmental disabilities: Home-based functional assessment and treatment. Journal of Behaviour Therapy and Experimental Psychiatry, 33, 49–58.

  Article  Google Scholar 

• Durand, V. M., Gernert-Dott, P., & Mapstone, E. (1996). Treatment of sleep disorders in children with developmental disabilities. Research and Practice for Persons with Severe Disabilities, 21, 114–122.

  Google Scholar 

• Durand, V. N., & Mindell, J. A. (1990). Behavioral treatment of multiple childhood sleep disorders: Effects on child and family. Behavior Modification, 14(1), 37–49.

  Article  PubMed  Google Scholar 

• Ferber, R. (1985). Solve your child’s sleep problems. Simon & Schuster.

  Google Scholar 

• France, K. G. (1992). Behavior characteristics and security in in sleep-disturbed infants treated with extinction. Journal of Pediatric Psychology, 17, 467–475.

  Article  PubMed  Google Scholar 

• France, K. G. (2011). Extinction with parental presence. In Behavioral treatments for sleep disorders (pp. 275–283). Academic Press.

  Chapter  Google Scholar 

• France, K. G., & Blampied, N. M. (2005). Modifications of systematic ignoring in the management of infant sleep disturbance: Efficacy and infant distress. Child and Family Behavior Therapy, 27(1), 1–16.

  Article  Google Scholar 

• France, K. G., Blampied, N. M., & Wilkinson, P. (1991). Treatment of infant sleep disturbance by trimeprazine in combination with extinction. Developmental and Behavioral Pediatrics, 12, 308–314.

  Article  Google Scholar 

• France, K. G., Henderson, J. M., & Hudson, S. M. (1996). Fact, act, and tact: A three-stage approach to treating the sleep problems of infants and young children. Child and Adolescent Psychiatric Clinics, 5(3), 581–600.

  Article  Google Scholar 

• France, K. G., & Hudson, S. M. (1990). Behavior management of infant sleep disturbance. Journal of Applied Behavior Analysis, 23, 91–98.

  Article  PubMed  PubMed Central  Google Scholar 

• France, K. G., & Hudson, S. M. (1993). Management of infant sleep disturbance: A review. Clinical Psychology Review, 13(7), 635–647.

  Article  Google Scholar 

• Freeman, K. A. (2006). Treating bedtime resistance with the bedtime pass: A systematic replication and component analysis with 3-year-olds. Journal of Applied Behavior Analysis, 39(4), 423–428.

  Article  PubMed  PubMed Central  Google Scholar 

• Friman, P. C., Hoff, K. E., Schnoes, C., Freeman, K. A., Woods, D. W., & Blum, N. (1999). The bedtime pass: An approach to bedtime crying and leaving the room. Archives of Pediatrics & Adolescent Medicine, 153(10), 1027–1029.

  Article  Google Scholar 

• Gray, C. A., & Garand, J. D. (1993). Social stories: Improving responses of students with autism with accurate social information. Focus on Autistic Behavior, 8(1), 1–10.

  Article  Google Scholar 

• Heussler, H., Patrick, C., Price, A., Waters, K., Davey, M., & Hiscock, H. (2013). Pharmacological and non-pharmacological management of sleep disturbance in children: An Australian Paediatric Research Network survey. Sleep Medicine, 14(2), 189–194.

  Article  PubMed  Google Scholar 

• Hewitt, K. (1985). Behavioural approaches to sleeplessness in children with severe learning difficulties. British Journal of Learning Disabilities, 13(3), 112–114.

  Google Scholar 

• Howlin, P. (1984). A brief report on the elimination of long term sleeping problems in a 6-yr-old autistic boy. Behavioural Psychotherapy, 12(3), 257–260.

  Article  Google Scholar 

• Iwata, B. A., Pace, G. M., Cowdery, G. E., & Miltenberger, R. G. (1994). What makes extinction work: An analysis of procedural form and function. Journal of Applied Behavior Analysis, 27(1), 131–144.

  Article  PubMed  PubMed Central  Google Scholar 

• Jin, C. S., Hanley, G. P., & Beaulieu, L. (2013). An individualized and comprehensive approach to treating sleep problems in young children. Journal of Applied Behavior Analysis, 46(1), 161–180.

  Article  PubMed  Google Scholar 

• Johnston, J. M., & Sherman, R. A. (2017). Applying the least restrictive alternative principle to treatment decisions: A legal and behavioral analysis. The Behavior Analyst, 16, 103–115.

  Article  Google Scholar 

• Kazdin, A. E. (2013). Behavior modification in applied settings (7th ed.). Waveland Press.

  Google Scholar 

• Kodak, T., & Piazza, C. C. (2008). Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders. Child and Adolescent Psychiatric Clinics, 17, 887–905.

  Article  Google Scholar 

• Kuhn, B. (2011). The excuse-me drill: A behavioral protocol to promote independent sleep initiation skills and reduce bedtime problems in young children. In Behavioral Treatments for Sleep Disorders (pp. 299–309). Academic Press.

  Google Scholar 

• Lattal, K. A., St. Peter, C., & Escobar, R. (2013). Operant extinction: Elimination and generation of behavior. In G. J. Madden, W. V. Dube, T. D. Hackenberg, G. P. Hanley, & K. A. Lattal (Eds.), APA handbook of behavior analysis, Vol. 2. Translating principles into practice (pp. 77–107). American Psychological Association.

  Chapter  Google Scholar 

• Lattal, K. M., & Lattal, K. A. (2012). Facets of Pavlovian and operant extinction. Behavioural Processes, 90(1), 1–8.

  Article  PubMed  PubMed Central  Google Scholar 

• Lawton, C., Blampied, N. M., & France, K. G. (1995). Help them make it through the night: Behavioral treatment of infant sleep disturbance. Children Australia, 20, 31–34.

  Article  Google Scholar 

• Lawton, C., France, K., & Blampied, N. (1991). Treatment of infant sleep disturbance by graduated extinction. Child and Family Behavior Therapy, 13(1), 39–56.

  Article  Google Scholar 

• Lerman, D., Iwata, B., & Wallace, M. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 32(1), 1–8.

  Article  PubMed  PubMed Central  Google Scholar 

• Lerman, D. C., & Iwata, B. A. (1995). Prevalence of the extinction burst and its attenuation during treatment. Journal of Applied Behavior Analysis, 28(1), 93–94.

  Article  PubMed  PubMed Central  Google Scholar 

• Lerman, D. C., & Iwata, B. A. (1996). Developing a technology for the use of operant extinction in clinical settings: An examination of basic and applied research. Journal of Applied Behavior Analysis, 29(3), 345–382.

  Article  PubMed  PubMed Central  Google Scholar 

• Matthey, S., & Crncec, R. (2012). Comparison of two strategies to improve infant sleep problems, and associated impacts on maternal experience, mood and infant emotional health: A single case replication design study. Early Human Development, 88(6), 437–442.

  Article  PubMed  Google Scholar 

• McLay, L., France, K., Blampied, N., Danna, K., & Hunter, J. (2017). Using functional behavioral assessment to develop a multicomponent treatment for sleep problems in a 3-year-old boy with autism. Clinical Case Studies, 16(3), 254–270.

  Article  Google Scholar 

• McLay, L., France, K., Blampied, N., van Deurs, J., Hunter, J., Knight, J., & Lang, R. (2021). Function-based behavioral interventions for sleep problems in children and adolescents with autism: Summary of 41 clinical cases. Journal of Autism and Developmental Disorders, 1–15.

  Google Scholar 

• McLay, L. K., France, K. G., Knight, J., Blampied, N. M., & Hastie, B. (2019). The effectiveness of function-based interventions to treat sleep problems, including unwanted co-sleeping, in children with autism. Behavioral Interventions, 34(1), 30–51.

  Google Scholar 

• McLay, L., Sarah, G., Hansen, A., Carnett, K. G., France, N M., Blampied (2020) Attributions causal beliefs and help-seeking behavior of parents of children with autism spectrum disorder and sleep problems. Autism 24(7), 1829–1840.

  Google Scholar 

• Miltenberger, R. G., & Crosland, K. A. (2014). Parenting. In F. K. McSweeney & E. S. Murphy (Eds.), The Wiley-Blackwell handbook of operant and classical conditioning (pp. 509–531). Wiley.

  Chapter  Google Scholar 

• Mindell, J. A. (1999). Empirically supported treatments in pediatric psychology: Bedtime refusal and night wakings in young children. Journal of Pediatric Psychology, 24(6), 465–481.

  Article  PubMed  Google Scholar 

• Mindell, J. A., Kuhn, R., Lewin, D. S., Meltzer, L. J., & Sadeh, A. (2006). Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep, 29(10), 1263–1276.

  PubMed  Google Scholar 

• Meltzer, L. J., & Mindell, J. A. (2011). Graduated extinction: Behavioral treatment for bedtime problems and night wakings in young children. In Behavioral Treatments for Sleep Disorders (pp. 265–273). Academic Press.

  Google Scholar 

• Moore, B. A., Friman, P. C., Fruzzetti, A. E., & MacAleese, K. (2007). Brief report: Evaluating the bedtime pass program for child resistance to bedtime—A randomized, controlled trial. Journal of Pediatric Psychology, 32(3), 283–287.

  Article  PubMed  Google Scholar 

• Moore, P. S. (2004). The use of social stories in a psychology service for children with learning disabilities: A case study of a sleep problem. British Journal of Learning Disabilities, 32, 133–138.

  Article  Google Scholar 

• O’Reilly, M., Lancioni, G., & Sigafoos, J. (2004). Using paired-choice assessment to identify variables maintaining sleep problems in a child with severe disabilities. Journal of Applied Behavior Analysis, 37(2), 209–212.

  Article  PubMed  PubMed Central  Google Scholar 

• Owens, J. L., France, K. G., & Wiggs, L. (1999). Behavioural and cognitive- behavioural interventions for sleep disorders in infants and children: A review. Sleep Medicine Reviews, 3(4), 281–302.

  Article  PubMed  Google Scholar 

• Piazza, C. C., & Fisher, W. W. (1991). A faded bedtime with response cost protocol for treatment of multiple sleep problems in children. Journal of Applied Behavior Analysis, 24, 129–140.

  Article  PubMed  PubMed Central  Google Scholar 

• Price, A. M. H., Wake, M., Ukoumunne, O. C., & Hiscock, H. (2012). Five-year follow-up of harms and benefits of behavioral infant sleep intervention: Randomized trial. Pediatrics, 130(4), 643–651.

  Article  PubMed  Google Scholar 

• Rapp, J. T., & Lanovaz, M. J. (2016). Stereotypy. In Handbook of evidence-based practices in intellectual and developmental disabilities (pp. 751–779). Springer.

  Chapter  Google Scholar 

• Richdale, A., & Wiggs, L. (2005). Behavioral approaches to the treatment of sleep problems in children with developmental disorders: What is the state of the art? International Journal of Behavioral and Consultation Therapy, 1(3), 165–189.

  Article  Google Scholar 

• Rolider, A., & Van Houten, R. (1984). Training parents to use extinction to eliminate nighttime crying by gradually increasing the criteria for ignoring crying. Education and Treatment of Children, 119–124.

  Google Scholar 

• Sadeh, A. (1994). Assessment of intervention for infant night waking: Parental reports and activity-based home monitoring. Journal of Consulting and Clinical Psychology, 62(1), 63.

  Article  PubMed  Google Scholar 

• Singh, K., & Zimmerman, A. W. (2015). Sleep in autism spectrum disorder and attention deficit hyperactivity disorder. Seminars in Pediatric Neurology, 22, 113–125.

  Article  PubMed  Google Scholar 

• Skinner, B. F. (1938). The behavior of organisms. Appleton-Century.

  Google Scholar 

• Skinner, B. F. (1953). Some contributions of an experimental analysis of behavior to psychology as a whole. American Psychologist, 8(2), 69.

  Article  Google Scholar 

• Souders, M. C., Zavodny, S., Eriksen, W., Sinko, R., Connell, J., Kerns, C., … Pinto-Martin, J. (2017). Sleep in children with autism spectrum disorder. Current Psychiatry Reports, 19(6), 34.

  Article  PubMed  PubMed Central  Google Scholar 

• Thackeray, E. J., & Richdale, A. L. (2002). The behavioural treatment of sleep difficulties in children with an intellectual disability. Behavioral Interventions, 17, 211–231.

  Article  Google Scholar 

• Turner, K. S., & Johnson, C. R. (2013). Behavioral interventions to address sleep disturbances in children with autism spectrum disorders: A review. Topics in Early Childhood Special Education, 33(3), 144–152.

  Article  Google Scholar 

• Vollmer, T. R., & Athens, E. (2011). Developing function-based extinction procedures for problem behavior. In Handbook of applied behavior analysis (pp. 317–334).

  Google Scholar 

• Vurbic, D., & Bouton, M. E. (2014). A contemporary behavioral perspective on extinction. In F. K. McSweeney & E. S. Murphy (Eds.), The Wiley-Blackwell handbook of operant and classical conditioning (pp. 53–76). Wiley.

  Chapter  Google Scholar 

• Weiskop, S., Matthews, J., & Richdale, A. (2001). Treatment of sleep problems in a 5-year-old boy with autism using behavioural principles. Autism, 5(2), 209–221.

  Article  PubMed  Google Scholar 

• Weiskop, S., Richdale, A., & Matthews, J. (2005). Behavioural treatment to reduce sleep problems in children with autism or fragile X syndrome. Developmental Medicine & Child Neurology, 47, 94–104.

  Article  Google Scholar 

• Wiggs, L., & France, K. (2000). Behavioural treatments for sleep problems in children and adolescents with physical illness, psychological problems or intellectual disabilities. Sleep Medicine Reviews, 4(3), 299–314.

  Article  PubMed  Google Scholar 

• Williams, C. D. (1959). The elimination of tantrum behavior by extinction procedures. The Journal of Abnormal and Social Psychology, 59(2), 269.

  Article  PubMed  Google Scholar 

• Winterbauer, N. E., Lucke, S., & Bouton, M. E. (2013). Some factors modulating the strength of resurgence after extinction of an instrumental behavior. Learning and Motivation, 44(1), 60–71.

  Article  PubMed  PubMed Central  Google Scholar 

• Wolf, M., Risley, T., & Mees, H. (1963). Application of operant conditioning procedures to the behaviour problems of an autistic child. Behaviour Research and Therapy, 1(2–4), 305–312.

  Article  Google Scholar 

Download references