The Ferber Method: Gain Sleep Now but Lose Sleep Later

The Ferber Method:  Gain Sleep Now but Lose Sleep Later

A. Moss and M. Martin

http://www.movieweb.com/tv/TEIlwMIJofRTMP/ferberize

In this clip from a season one episode of Modern Family, Mitchell decides to “Ferberize” daughter Lily against his partner Cameron’s will.  Mitchell succinctly describes the Ferber Method as a “method for getting the baby to sleep through the night by, yes, basically letting her cry herself to sleep,” but this particular and popular facet of the “cry it out” approach is slightly more complicated.  Dr. Richard Ferber’s 1985 book Solve Your Child’s Sleep Problems advocates an incremental approach to training children to go to sleep on their own in which parents increase the amount of time they wait to respond to their children’s cries from bed each night.  There is some evidence from Reid, Walter, and O’Leary (1999) supporting Ferber’s essential claim that children trained in his method sleep more soundly and regularly.  These researchers found that children in an incremental sleep training group slept through the night without waking significantly more often than children in a control group during a six week period.  Additionally, it seems reasonable to assume that a child’s ability to sleep through the night would lead to better rested and less stressed parents more able to provide engaging stimulation for their child when he or she was awake.

However, our analysis indicates that sleep training a child using the Ferber Method or any similar sleep training program incurs both immediate and delayed costs that ultimately outweigh such benefits.  According to Middlemiss, Granger, Goldberg, and Nathans (2012), infants experienced immediate cortisol elevation when placed on a sleep training schedule.  These authors reported physiological asynchrony between mothers and infants on the third day of a training program.  Mothers experienced significantly decreased salivary cortisol, but infants continued to exhibit significantly increased levels of this stress hormone despite the disappearance of their previous outward suffering.  Granger et al. raised the possibility that the stress associated with sleep training would modify the hypothalamic-pituitary-adrenal axis, the physiological system that manages stress, in genetically vulnerable infants in this group who would consequently continue to show elevated stress responses and have difficulty regulating stress in the future.  We advocate parents not rely on sleep training methods like the Ferber Method given infants’ physiological distress and this potential long-term impact of sleep training as well as the likelihood that the benefits of training programs are only temporary.  The regularity of infant sleep relates to the rhythmicity dimension of infant temperament (Siegler, DeLoache, & Eisenberg, 2011).  Siegler et al. note that this dimension is neither especially important in predicting future behavior nor particularly stable.  We argue this instability indicates that parents using the Ferber Method cannot at all be sure that the stress their infants experience as a result will lead to a greater good of consistent future sleeping. Conversely, it is likely parents whose infants are irregular sleepers can hope for more regular sleeping in the future and thus do not need to use the Ferber Method to prompt it in infants’ early lives.

It is during the early life, particularly the first two years, that infants form attachment relationships with their primary caregivers, usually the parents.  Attachment relationships involve a close emotional bond that provides infants with a sense of security as well as with an internal working model of attachment.  The internal working model includes an infant’s representation of the self, the caregivers, and how relationships in general work and shapes the infant’s expectations of and behaviors in relationships in the future (Siegler et al., 2011).  Mary Ainsworth’s attachment classification system places infants who form positive internal working models in the secure attachment category.  These infants, usually classified before twenty-four months based on Ainsworth’s Strange Situation test of attachment quality, are able to explore new environments because of the security their caregivers provide them.  They also expect high-quality responses to their behavior from their caregivers and positive interactions in their other relationships because of their beneficial interactions with caregivers. In contrast, insecurely attached infants have more negative internal working models and attachment to their caregivers and may either cling to caregivers who cannot easily comfort them or show no special distress when separated from their caregivers.

Ainsworth and colleagues concluded that sensitivity on the part of caregivers, which centers on responsiveness to infants’ signals like laughing and crying, is the most important predictor of secure attachment (Siegler et al., 2011). Thus, the first two years, when attachment relationships are formed and when parents often turn to sleep training programs like the Ferber Method, are a critical time for parents to show responsiveness to their crying infants and offer comfort.  Unfortunately, the Ferber Method and other training schedules of its kind that instruct parents to avoid responding to their infants’ cues of distress deliberately encourage a lack of parental sensitivity.  The insecure attachment that we assert can follow is not merely a theoretical issue, as insecure attachment in infancy predicts a host of later undesirable outcomes.  Jacobsen’s and Hofmann’s (1997) longitudinal study suggested that insecure attachment classification significantly predicted lower attention in school, higher insecurity about the self, and lower GPA at age fifteen.  Furthermore, Dallaire’s and Weinraub’s (2007) work demonstrated that insecurely attached fifteen-month-olds were more likely to experience anxiety symptoms at 4.5 years than their securely attached peers who had weathered equivalent stressors. Finally, DeMulder, Denham, Schmidt, and Mitchell (2000) found that insecurely attached preschool boys and girls exhibited significantly more anger and aggression outside the home.  Parents may gain sleep in the short-term after Ferberizing their infants, but they can expect to lose sleep as their children age and engage in these negative behaviors associated with lack of parental sensitivity.

 

References

Dallaire, D. H., & Weinraub, M. (2007). Infant-mother attachment security and children’s anxiety and aggression at first grade. Journal of Applied Developmental Psychology, 28(5-6), 477-492. Retrieved from http://www.sciencedirect.com/science/article/pii/S0193397307000706

DeMulder, E. K., Denham, S., Schmidt, M., & Mitchell, J. (2000). Q-sort assessment of attachment security during the preschool years: Links from home to school. Developmental Psychology, 36(2), 274-282. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10749084

Ferber, R. (1985). Solve your child’s sleep problems. New York: Simon & Schuster, Inc.

Jacobsen, T., & Hofmann, V. (1997). Children’s attachment representations: Longitudinal relations to school behavior and academic competency in middle childhood and adolescence. Developmental Psychology, 33(4), 703-710. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9232385

Middlemiss, W., Granger, D. A., Goldberg, W. A., & Nathans, L. (2012). Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early Human Development, 88, 227-232. Retrieved from http://www.cnn.com/2013/01/24/health/child-sleep-debate-enayati/

Modern Family S01E11:Up all night [Video file]. (n.d.) Retrieved from http://movieweb.com/tv/TEIIwMIJofRTMP/ferberize

Reid, M. J., Walter, A. L., & O’Leary, S. G. (1999). Treatment of young children’s bedtime refusal and nighttime wakings: A comparison of ‘standard’ and graduated ignoring procedures. Journal of Abnormal Child Psychology, 27(1), 5-16. Retrieved from http://link.springer.com/article/10.1023%2FA%3A1022606206076

Siegler, R., DeLoache, J., & Eisenberg, N. (2011). How children develop (Third ed.). New York: Worth.

 

 

 

 

 

 

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