In the late 1990’s, a child psychologist and researcher in the midwest was struggling to balance being both a clinician and the mother of a young boy. As a child psychologist who guided countless parents of struggling children, she felt pressure to have it all figured out in her own role as a mother. But there was one problem she just could not seem to solve. Every night her young son would get ready for bed without issue. He would brush his teeth, change into his pajamas, and get in his own bed with little resistance. She would proceed to tuck him in, kiss his little forehead, and maybe have a little bedside chitchat with him before leaving. Bedtime was a breeze. If you’re feeling envious as you read this, just wait. Like clockwork, after a couple of minutes of leaving her son’s room, she hears the squeaking sound of the bedroom door slowly creeping open. Her son, poking his head out, asks “can I have a glass of water?” Not wanting to deprive her child of water, she obliges and then puts her son back into bed again. A few minutes later, her son is out of bed again, this time asking for one final goodnight hug. “How can I pass up giving my child one more hug?” She wonders. So she caves and plants a big fat hug on her son before sending him to bed again. A few minutes later, of course, he is out of his room again, this time asking his mother to read him one more chapter of the new Captain Underpants book. This cycle sometimes went on for hours, and occurred almost every night. Oftentimes it would be midnight before her son finally fell asleep.
After weeks of this, the psychologist and mother was exhausted. She begged her son to stay in bed, but her pleas seemed to fall on deaf ears. Her son would even express profound guilt when he would come out of his room, as if he couldn’t help himself. One night, after her son had come out of his room for the fourth time, she hands him a spare piece of paper lying around. Spitballing off the cuff she explains, “Here! Take this. This is now your ‘bedtime pass.’ Anytime you want to come out of your room you may do so, and I will attend to whatever you need, but you must give me your bedtime pass.” Her son took the bedtime pass, went back to his room and then, to his mother’s shock, he fell asleep and never came out again. Each night thereafter, she would provide her son with one tangible ‘bedtime pass.’ She was amazed that every night, sans the occasional exception, her son would never use the bedtime pass.
The psychologist took this idea to her research lab. She was curious if her impulsive idea that seemed to work magic in her home could help other parents in similar situations. Through multiple research trials, results consistently found that the vast majority of children who were given a bedtime pass did not use it and more importantly, showed no latency in sleep onset.
Unpacking the Bedtime Pass
So what’s behind the bedtime pass and why does it seem to work so well? The bedtime pass is an intervention primarily used for a phenomenon referred to as “nighttime curtain calls.” This is when a child repeatedly comes out of their room at night in an effort to delay bedtime. The child, however, is less concerned with avoiding bedtime as they are with avoiding separating from their parents. Even children with no history of anxiety can experience trace amounts of separation anxiety at nighttime when they have to retire to their own room, away from the parent(s). For some children, the anxiety can be overwhelming and keeps a child wide awake, hence why they often repeatedly come out of their room seeking their parents. When given a bedtime pass, the child now has access to their parents in the palm of their hands, metaphorically speaking. Researchers hypothesize that having this bedtime pass provides the child with a soothing sense of control and predictability, alleviating the anxiety just enough to make sleep onset easier.
How it Works
In my own practice, I use this intervention for parents of children ages 3-10. I advise the parent(s) to give their child 1-3 bedtime passes each night (higher for children with more severe anxiety). For younger children, I often will help them make a tangible bedtime pass that incorporates their own interests (e.g., a slip of paper with drawings of Harry Potter characters). Regardless of what it looks like, the bedtime pass should be something tangible. Each night, the child will receive the bedtime pass and is reminded that anytime they need something from their parents, they must turn in their bedtime pass. When a child does use a bedtime pass, I advise parents to attend to their request, but to make interactions quick and minimal. Finally, if a child does not use their bedtime pass they can exchange their unused pass for a small prize the following morning. This helps motivate a child to get used to the uncomfortable feelings of nighttime separation so it gets easier over time.
