Graduated Extinction

Description of the Strategy

Extinction is a term used to describe how a reinforced behavior becomes less frequent if reinforcement for that behavior is withdrawn. Eventually, if the behavior is not reinforced over a period of time, the behavior will cease. Extinction procedures are typically applied by removing a reinforcer in its entirety following a behavior (e.g., removing all attention from a tantrumming child). Graduated extinction is an application of the extinction principle that removes a reinforcer for a behavior in an incremental fashion or reduces the magnitude of reinforcement incrementally.

Graduated extinction is most widely used as an intervention for childhood sleep problems (e.g., refusal to go to sleep, frequent nighttime wakings). Two common variations of graduated extinction have been applied. In the first approach, a parent waits for longer periods of time over successive trials before attending to the child. In the other approach, a parent may attend to the child immediately but decrease the total amount of time spent attending to the child over successive interactions.

For example, if a child exhibits crying or noncompliant behavior at bedtime that is reinforced and maintained by adult attention, a parent may choose to implement a graduated extinction procedure. In such an approach, the parent would refrain from checking on the child for 5 minutes. The parent would then check on the child after 5 minutes regardless of whether the child was exhibiting negative behavior. After the first visit, the parent would then wait 10 minutes before checking on the child a second time. Once again, the parent would check on the child regardless of whether the child was crying or not. A third visit would not occur until 15 minutes later. Further visits would continue on 15-minute intervals until the child falls asleep. On subsequent nights, the time parents wait before the initial check is gradually lengthened from 5 minutes to increasingly longer time periods. In addition, the time between visits is also lengthened gradually. All visits throughout the procedure are short, and the focus is on minimizing disruption to help the child fall asleep faster. The procedure may be enhanced by setting a regular bedtime and establishing a bedtime routine.

Research Basis

Graduated extinction for sleep problems has been investigated in single-subject multiple baseline studies as well as randomized, controlled, between-group studies. The majority of studies were conducted with infants or young children. Across studies, graduated extinction procedures were more effective than or equivalent to other behavioral interventions for sleep (e.g., extinction procedures). Compared to extinction, graduated extinction procedures result in better treatment compliance and less parental stress for nighttime wakings. As parents may be unwilling to completely ignore a child who appears to be in distress (e.g., wakes up in the middle of the night), parents may be more likely to comply with a graduated extinction procedure over an extinction procedure that requires complete ignoring. Because of this, some studies have found graduated extinction to be more palatable to parents than extinction, perhaps because the procedures permit the parent to “check” on the child periodically to ensure that the child is in no real distress.

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