Brief report: A "storybook" ending to children's bedtime problems - The use of a rewarding social story to reduce bedtime resistance and frequent night waking

Objective To evaluate the efficacy and acceptability of a social story with tangible rewards to reduce children's disruptive bedtime behavior and frequent night waking. Method Four children (ages 2 to 7), with clinically significant disruptive bedtime behavior, received the intervention, which consisted of a social story (The Sleep Fairy) that sets forth (a) parental expectations for appropriate bedtime behavior and (b) rewards for meeting those expectations. Results Parent sleep diaries indicated that children had a 78% average decrease in frequency of disruptive bedtime behaviors from baseline to intervention, with another 7% decrease at 3-month follow-up. Night wakings, a problem for 2 children during baseline, were not a problem during intervention and follow-up. Parents reported improved daytime behavior for 3 of the 4 children. Parents gave the intervention high acceptability ratings and maintained a high level of treatment fidelity. Conclusions Use of a social story helped parents implement a multicomponent intervention using a familiar bedtime routine, thereby increasing the likelihood that implementation and effects occurred. The book format makes this intervention widely available to parents and professionals, with minimal costs and inconvenience.