Treatment of sleep problems in young children: A case series report of a cognitive–behavioral play intervention.

Abstract

Sleep problems and bedtime resistance are common in young children. Treatment is critical because sleep problems typically persist, and insufficient sleep is related to worse outcomes. Current behavioral treatments do not work directly with the child to reduce anxiety and distress at bedtime. Cognitive–behavioral play therapy is a treatment approach designed to teach coping skills to young children by combining cognitive–behavioral therapy with pretend play, a developmentally appropriate intervention mode. The current case series examined the effectiveness of adding a brief cognitive–behavioral play intervention (CBPI) to parent behavior management for young children with sleep difficulties. Four children (4–6 years of age) received 3 20- to 30-min individual sessions during which the child played out stories with an advanced graduate student therapist (first author, K. F.) about a child coping with sleep problems. Each child’s parent also received a 30-min sleep information session. Three parents returned questionnaires posttreatment. As expected, all 3 parents reported improvements in their child’s sleep habits, sleep anxiety, and general fears. All 3 parents also reported a high level of satisfaction with the treatment. These preliminary results suggest that the CBPI may be effective for decreasing anxiety and child distress when added to behavioral treatment, thus increasing the breadth of treatment approaches available for young children with sleep problems. These results are promising, although a randomized study is needed to further refine the intervention and establish the efficacy of a CBPI for treatment of sleep problems in young children.

Prospective relations of preschoolers’ prosocial and aggressive affect themes in pretend play with prosocial and aggressive behaviors across contexts

“…Thus, these findings highlight the importance of examining (and supporting) both cognitive and affective features of children’s pretend play. Indeed, although the majority of play‐based intervention efforts have focused on cognitive play features, such as the frequency of pretend play and quality of imagination (Fehr, Russ, & Ievers‐Landis, 2016; Thibodeau, Gilpin, Brown, & Meyer, 2016; Tucker, Schieffer, Wills, Hull, & Murphy, 2017), this study suggests that affective play processes can and should be harnessed to promote children’s adaptive functioning (Fehr & Russ, 2016; Hoffmann & Russ, 2016; Moore & Russ, 2008). For example, ongoing work may clarify when aggressive affect themes in young children’s pretend play become a risk indicator that warrants supportive efforts to help children differentiate playful, safe expressions of aggressive impulses from potentially problematic aggressive behaviors in the social world.…”

The Interventions for Sleep Disorders in Children with Attention Deficit and Hyperactivity Disorder: A Narrative Review

“…Each parent received a sleep information session lasting 30 min. Results indicate that CBPI is potentially effective for reducing anxiety and difficulty with sleep problems [33].…”

“…Play therapy is included as one method of behavioral therapy under the name of cognitivebehavioral play therapy (CBPT). CBPT is an approach designed to teach coping skills to children by combining cognitive behavioral therapy with pretend play [33]. This program is good for use in school-age children who have had ADHD for <6 years, do not have siblings diagnosed with ADHD, and have sleep disorders.…”

Multi-Organ Dysfunction in Cerebral Palsy

“…This includes measures such as a consistent bedtime routine, a dark and quiet bedroom, limiting technology use before bed and independence in falling asleep ( 25 , 123 ). Other therapy options for managing sleep disorders in children with neurodisability include behavioral strategies such as play-based therapy ( 124 ) and medications such as melatonin.…”