Controlled comforting or checking method
Controlled Comforting or the Checking Method (for older children) is a strategy for dealing with persistent settling and waking problems in children. It involves briefly comforting, settling and then leaving your child for short time periods so your child learns to go to sleep on their own. The purpose of this is to reassure your child you are still there and to reassure yourself that your child is OK. This can be particularly helpful for children who are anxious about going to sleep.
About the method
The idea with the controlled comforting/checking method is to give your child the opportunity to learn to go to sleep by themselves. If your child gets upset when you leave their bedroom, wait a short time before you go back to them, gradually increase the time you spend outside the bedroom before going to check on them. In this way, they are also learning that you are not far away and will return.
Before you start
Parents dealing with sleep and settling problems can become very tired and stressed, particularly if they’re losing sleep themselves. Controlled comforting is sometimes tried by parents who feel overwhelmed, or whose wellbeing is suffering. Before you start, make sure your child is getting lots of attention, time and affection during the day.
Step by step
- First establish a consistent and positive bedtime routine (see Good Sleep Habits)
- Decide on waiting times between checks that are best for you and your child. For some children, frequent checking is good – say 2, then 4, 6, 8, then 10 minutes. For others, less check- ing is best – say 5, then 10, 15, 20, then 25 minutes.
- When it is time, settle your child in bed, say “goodnight” and leave the room before your child is asleep. Promise to come back and check on him.
- Stay out of the bedroom and give your child a chance to settle by herself. Ignore grizzling.
- If your child starts to really cry, wait the first time interval you have decided (e.g. 2 minutes) before checking your child.
- After leaving the room, again give your child a chance to settle by herself.
- If she again starts to cry, wait for the second time interval (e.g. 4 minutes) before going to check her.
- Continue to check on your child as long as she is upset, gradually stretching the interval times.
Checking your child
The checks should be brief (1 minute) and boring!
1. Soothe your child by talking or patting them. Try to soothe your child without picking them up if you can.2. Do this for one minute, or until there quiet, depending on your preference.
3. Keep an eye on their nappy. If it’s dirty, change under low light and
with minimal fuss.
4. If your child tries to play with you, calmly tell them it is sleep time and say you will be back to check on them.
5. As soon as there quiet (or after one minute), but before your child is asleep, leave the room.
When your child wakes overnight: Follow the same routine.
Use this strategy for any daytime sleeps too: This will lead to less confusion for you and child. If your child wakes up from a day sleep after less than an hour, try to re-settle them for another 15-20 minutes, again using controlled comforting. If, after that time, your child hasn’t gone back to sleep, its fineto get them out of bed and try again later.
If your child comes out of the room: Take them straight back to their room, say “goodnight”, and leave. Ignore any requests for food, drink or talking. You may have to take your child back many times before they get the message
Some important tips
1. This method takes 3-14 days to work.
2. Turn baby monitors down or even off:Make sure you can still hear your child without a monitor.
3. Don’t wait outside your child bedroom:Go into another room and distract yourself – make a cup of tea or turn on the TV. Only go back to check on your child when the set time is up.
4. Talk to your partner first:Make sure that you both agree with what’s going on. Work out what role each of you will play – for example, helping with resettling or timing the intervals.
5. Consider taking turns each night.
6. Avoid important commitments:Clear your schedule for the first few days after you start controlled comforting. You need to be able to see it through without a major change to your child’s routine.
Rewards
For children over three it can be helpful to reward them in the morning for being able to stay in their own bed. See the Rewards handout for ideas.
Frequently asked questions
Putting a sleep behaviour strategy into practice doesn’t always go smoothly. Here are some common questions about the controlled comforting / checking method and practical tips for how to deal with them.
Concerns about your child
Is controlled comforting harmful? Despite concerns about potential harms to the child, no studies published in peer-reviewed journals have shown any psychological or physical harm from using controlled comforting.
What if my baby vomits? Some babies tend to vomit more often than others, and about one in five might vomit during controlled comforting. If this happens it can be upsetting for baby and you. Try to calmly clean up any vomit from the bed and put a fitted mattress protector over the sheet. It’s best to avoid making a big fuss, turning on lights, or completely changing the baby unless absolutely necessary – otherwise, some babies can learn to vomit each time they areput into the cot.
What if you’ve had enough? If you’re too tired, or feeling too distressed or upset, pick up your baby, calm them in any way you wish – for example, with a small drink or a cuddle – and try again next time.
What if my baby is unwell? If your baby is unwell, you should stop controlled comforting start again when they feel better. If they have a slight runny nose and cough but no fever, you can still use controlled comforting.
What if my baby is in pain? Many parents are concerned about teething causing pain. If you pick up your baby and he settles almost immediately, it’s very unlikely he was in pain – he just wanted to be picked up. You can give paracetamol (Panadol) if you’re concerned. Paracetamol takes about 20 minutes to work, so babies who settle after that might have been in pain. If you have persistent concerns about your baby being in pain, talk to your doctor.
Recent research has shown that babies who have undergone controlled comforting are more likely to sleep better in the short term, and are as well-adjusted as their peers in terms of behaviour and sleep in the long term. A recent study also found that parents who used these techniques with their babies reported fewer symptoms of depression in both the short and long term than parents who didn’t.
What if controlled comforting or checking method isn’t working?
There can be several reasons why a sleep program doesn’t appear to be working.
Are you using the strategy correctly? To check, re-read the steps described here. Is there anything you’re not doing, or could do differently? Perhaps check with a professional who understands the use of this strategy.
Are you returning to your child too soon? Are you following the time intervals? Are you using a clock? Have you got something you can do to help you cope during the intervals?
Are you going in when your baby is only grizzling, not crying? Many babies grizzle when drifting off to sleep and by going in you might be stopping your baby from falling asleep. Only return when your baby is crying.
Do you really want to carry through with this? Is the goal of uninterrupted sleep worth it for you and your child? If you’re convinced that learning to sleep independently through the night is in your child’s best interests, it’s easier to find the motivation to carry on through the few nights needed to help them adjust to the change. If not, consider using a different strategy such as Camping Out or having a break and trying again when your child is a bit older.
Are the time intervals right for your child? Some children calm down whena parent enters the room. Other children get more upset. If your child is getting more upset, lengthen the time intervals to 5, 10 and 15 minutes. This way your child has more time to go to sleep by themselves, and less time to get upset by your return. Is your support network actually supportive? Not everyone agrees with controlled comforting. Disapproving family or friends are one thing, but if your partner or other close support people aren’t in agreement, it will be difficult
to carry through with the strategy. It’s best if at least the people in your house hold can agree on a consistent approach
The extinction burst
After a few good nights or even weeks, your child may suddenly start doing the old behaviour, and more often or more strongly than before. This is known as an extinction burst, and while discouraging, it is temporary. If you can keep going with your strategy, the behaviours should stop after a few days.
When the controlled comforting / checking method seems too hard
1. Consider breaking it down into a series of steps. For example, you couldpat your child until they’re quiet and put them down/leave the room with them semi-asleep for a week. Then for the next week, put your child into their cot/bed fully awake
2. Try using the method only at the start of the night, when it’s likely to be more successful.
3. Ask your partner to manage the controlled comforting or checking method (if he or she agrees to).
4. Use camping out as an alternative (see the camping out strategy for how to do this). Download pdf
