Ellie  A Case study

Ellie was 2 years 6months old. She was the older of two children. She had always slept without waking her parents, until the arrival of her baby brother. Although her parents had done some work to prepare her for the new arrival she was suddenly not at all keen to accept bed time. She had a good pre bed routine but now dad had to settle her if mum was feeding or caring for her baby brother. She did not like this at all, and the protests she set up were proving challenging. First she would try to delay bed time by wanting to wait until mum could take her to bed. Then, if mum was able to do this, she would expect mum to remain with her until she was asleep. She was not afraid of her room before, and had never had any difficulty in completing her pre bed routine and settling to sleep within a few minutes. Her brother was about 4 months old when I was asked if I could help mum improve this situation.

Although to begin with Ellie was doing her best to delay bed time, she was sleeping through the night, and initially her parents had thought this was her way of protesting at less time one to one with mum. They had gone along with things until the bed time delay had gone from half an hour to two to three hour,s before she would finally give in to sleep. At about this stage she was also waking through the night and demanding mum resettle her. Ellie could determinedly remain awake and chatty for two to three hours before she would allow her exhausted mum to return to her own room.

We talked about the changes Ellie was dealing with and how she had coped with each part of these changes. Previously dad had often been late home and had not had much to do with a pre bed routine. Dad was keen that she accept that he settle her and was a little concerned that she would not co-operate with him. We discussed his ideas of how to settle her and how much time this should take. We talked about the games she liked to play with dad and the differences between mum and dad's views of a good pre bed routine. We looked at practical aspects of Ellie's becoming more independent and how best to support that alongside her sleep patterns.

From sleep diaries it became clear that she was waking when her brother was being settled for the night, when he was fed through the night, and occasionally when Ellie needed to go to the toilet. We then had a long discussion about what we thought Ellie was feeling and thinking and how best to help her to accept her role as big sister.

Mum and dad were given strategies to use to help Ellie make appropriate decisions and feel involved in the process. It took a few weeks before Ellie started to protest less about bed time and to allow the settling process to be shortened.

As children grow and develop their own independence they become aware that they have few to no choices in life. The only control they have is over what they put in their mouths. This can result in picky eating for some. Giving a child some control of their day to day life can reap big rewards for parents as it also improves the child's view of fairness. Children can be given choices, usually between no more than two things. 

The choices offered should both be acceptable to the parents.

"Do you want to put on your socks or your pants first? " for example.  If the child is allowed to make choices through the day and the time comes when there is no choice, X has to be done, the parents can say "OK, you made a lot of choices today, now it's my turn. You have to ....." The child may protest but will see this as a fair action and usually will accept it.  A choice between more than two possibilities can be confusing at this age but having made a choice and having to live with the consequences of that decision is part and parcel of becoming an independent person.

Within a few weeks Ellie was much more settled and slept through the night without disturbing her parents. She accepted her pre bed routine with mum or dad and the household was happier and better rested.