The use of Social Stories to help bedtime resistance in a sample of young school-aged children

Abstract

Childhood sleep problems are highly prevalent and the importance of adequate sleep quantity and quality in child development has been well documented. The most common area of difficulty associated with young school-age children is bedtime resistance, where the child typically refuses to go to bed or attempts to delay bedtime with repeated requests. Current behavioural approaches used to address such difficulties typically involve the use of extinction techniques, which aim to minimise parental attention after bedtime. Research has shown that these techniques have led to a reduction in problem behaviours, but the emotional difficulties that parents face during the initial phase of the intervention have led to the exploration of alternative techniques.

This review explored the potential use of a Social Story™ intervention (a short personalised story designed to teach a child how to manage their own behaviour during a specific situation) to help children with their bedtime problems. Current literature has shown that Social Story™ interventions have a good level of treatment acceptability,
with supporting evidence provided for their use with both typically developing children and those with an Autistic Spectrum Disorder (ASD). Only 2 studies however have
investigated the use of Social Stories™ within the specific area of children’s bedtime problems (Burke, Kuhn & Peterson, 2004; Moore, 2004).

The empirical paper reports a study that investigated the use of a Social Story™ intervention with a community sample of 6 children who found it difficult to settle at
bedtime. Results replicated previous findings, demonstrating a reduction in the frequency of disruptive bedtime behaviours for all 6 children associated with the
introduction of the Social Story™. Treatment effects, however, were not maintained on all measures at the 6-month follow-up and results from an objective measure of sleep behaviours (actigraphy) produced mixed findings.

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