The Costs of Controlled Crying

5 Feb

‘Controlled Crying’ is a method, which is advised by most Health Visitors, to get a baby to sleep through the night. It involves leaving the baby to cry in their cot for a certain amount of time, before going to comfort them, without touching them, and then leaving again. This continues until the baby has cried their self to sleep, and throughout the night until they sleeps through. Needless to say this causes a lot of distress to both the baby and parents. It is a very controversial topic. Some mothers and health advisors swear by it, whilst others argue that it is a quick fix to help a tired mum, who is unaware of the Psychological consequences this could potentially cause their child.

Controlled Crying is essentially a form of Learned Helplessness, and whilst it works to stop a child from crying, it teaches the child not to cry when they are distressed (The Australian Association for Infant Mental Health, 2002). Learned helplessness, in turn, is linked to depression (Seligman, 1967), which surprisingly affects 1 in 40 babies (Shatkin, 2006). Leaving a baby to cry also prevents him or her from forming proper attachments (AAIMHI, 2002) leading to various psychological and behavioral problems (Evergreen Psychotherapy Center, 2004). Research also shows that children who were left to cry as babies are 10 times more likely to have ADHD (Wolke, 2002). There is now recent research suggests that controlled crying not only harms the baby Psychologically, but also affects their brain development. Babies who have been left to cry have been found to have higher Cortisol levels, which if extreme, could cause a reduction in the number of synapses and the death of neurons (Schore, 2001).

Other studies have reported that Sleep Training causes no detrimental effects to Infants (France, 1992). A good night routine is in fact healthy for children, and research suggests that children who have one do better in school (The Princes Trust, 2012). A parent who has had sufficient sleep will also be able to care for their baby better through the day. Where as, a lack of sleep may make parents tired and grumpy, leading to marital tension and possibly divorce. Therefore, for some families, Controlled Crying may be the best option for the baby to have a happy childhood. It is also not clear whether some of the research linked to Controlled Crying actually reflects on the sleep training in particular, or to excessive crying due to other reasons. If so, the correlation between ADHD and Controlled Crying, for example, would not be valid. It could be that a baby born with ADHD, would cry more than a usual baby. There is not much valid research done on the effects of Controlled Crying due to ethics, and the fact the studies need to be longitudinal.

The question remains as to whether it is ethical to leave a baby, who is clearly in distress to cry by them selves. Separation anxiety often affects babies, causing them to want to be with their mothers. It would not be right to leave a hyperactive adult in a cage to teach them to sit still, so what really is the difference? Although research is not reliable at the moment, it is not worth the risk to the wellbeing of the baby.

“Many parents argue that they tried “Ferberizing” their baby and enjoyed great success with the technique. Indeed, the infant may stop crying and learn to go to sleep on his own, but this is a short-term pay off for parents. The baby has not suddenly discovered quiet content. He simply is exhausted from his futile efforts to be nurtured. Fifteen years later, the same parents shrug their shoulders and wonder why their kids are shutting them out.”  (Coburn, 1998)

A Couple of interesting links are:

http://www.askdrsears.com/topics/fussy-baby/science-says-excessive-crying-could-be-harmful

http://www.earlychildhoodaustralia.org.au/Controled%20Crying.pdf (really good leaflet)

References

 Australian Association for Infant Mental Health. (2002). Controlled Crying: AAIMHI Position Paper. Retrieved from http://www.earlychildhoodaustralia.org.au/Controled%20Crying.pdf

Coburn, J. (1998) In Commons, M. L. (1998). Emotional Learning in Infants: A Cross-Cultural Examination. Retrieved from http://www.dareassociation.org/Papers/AAAS%20Interviews.pdf

Commons, M. L. (1998). Emotional Learning in Infants: A Cross-Cultural Examination. Retrieved from http://www.dareassociation.org/Papers/AAAS%20Interviews.pdf

France, K. G. (1992). Behavior Characteristics and Security in Sleep-Disturbed Infants Treated with Extinction. Journal of Pediatric Psychology, 17(4), 467-475.

Gunnar, M. R., Brodersen, L.,Nachmias, M., Buss, K., & Rigatuso, J. (1996). Stress reactivity and attachment security. Developmental Psychobiology, 29(3), 191-204. DOI: 10.1002/(SICI)1098-2302(199604)29:3<191::AID-DEV1>3.0.CO;2-M

Orlans, M., & Levy, T. (2004). Evergreen Psychotherapy Center; Attachment Treatment & Training Institute. Suite, America: Comfort Technical Assistance, LLC. Retrieved from http://www.attachmentexperts.com/

Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2), 201-269. DOI: 10.1002/1097-0355(200101/04)22:1<201::AID-IMHJ8>3.0.CO;2-9

The Princes Trust. (2012). Retrieved from http://www.princes-trust.org.uk/

Wolke, D. (2002). Persistent Infant Crying and Hyperactivity Problems in Middle Childhood. Pediatrics, 109, 1054-1060.

Advertisements

7 Responses to “The Costs of Controlled Crying”

  1. bpmjb February 8, 2012 at 12:24 pm #

    Wolfson, Lacks and Futterman (1992) investigated the effects of parent training on infant sleep patterns, parental sleep and perceived parental competence, using couples from child birth classes. Couples were randomly assigned to a 4-session training group or a control group. Couples in the training group were educated in behavioural strategies aimed at promoting healthy self-sufficient sleep patterns in the infant, whereas the control group received an equal amount of personal contact but were not educated in the behavioural strategies. Results indicated that infants in the training group demonstrated significantly better sleep patterns aged 6-9 weeks compared to infants in the control groups. Furthermore couples in the training group reported responding less to infant signalling, heightening their sense of parental competence. Conversely control group couples reported an increase in stress over the duration of the investigation. This research signals the benefits of providing post natal support and training for both parents, particularly in relation to stress management surrounding unsettled infants with dysfunctional sleep patterns. Furthermore it supports the idea that you have stated, that sleep training can be both beneficial for the parent and infant.

    References
    Wolfson, A., Lacks, P., & Futternan, A. (1992). Effects of parental training on infant sleeping patterns, parental stress and perceived parental competence. Journal of Consulting and Clinical Psychology, 60, 41-45.

    • jessicabibby February 8, 2012 at 4:16 pm #

      “Furthermore couples in the training group reported responding less to infant signalling.” This could be debated to be both a positive and negative effect. Infants signal for a reason, whether it be because they are hungry, need a nappy change, or just want a hug. Responding less to their signals means, in a way, depriving them of something they need. At the age of 6-9 weeks, babies will not have learnt to manipulate parents to get what they want yet, so them crying will be for something which they need. A study by Bell and Salter Ainsworth (1972) showed that maternal responsiveness to infant signalling actually decreased the amount the baby cried in the long run. Bell and Salter Ainsworth (1972) claimed that a baby crying is their way of communicating with their mothers, so responding to them helped them to develop ways of communication without crying. Which in the long run is better for both the parent and the baby.

      References
      Bell, S. M., & Salter Ainsworth, M. D. (1972). Infant Crying and Maternal Responsiveness. Child Development, 43(4), 1171-1190. Retrieved from http://www.jstor.org/pss/1127506

  2. bpmjb February 8, 2012 at 10:06 pm #

    It is not always the case that when newborn infants signal through crying it is because they want something and therefore the parent should automatically respond. James-Roberts, Conroy and Wilsher (2002) investigated the link between maternal care and persistent infant crying in early months. They found infants aged 6 weeks who were categorised as persistent criers had mothers who spent the most time interacting and physically stimulating them. They used these findings to suggest that persistent infant crying in the early months can occur in spite of a high degree of maternal care. Therefore by not responding to infant signalling it is not necessarily the case that you are depriving the infant. In relation to the research conducted by Wolfson, Lacks and Futterman (1992) couples in the training group in the investigation may have recognised as a result of their training, that it is not always the case that when their infant cried they may be distressed or needed something, particularly if the couples felt they had effectively implemented the behavioural strategies they had learned. Although I absolutely agree with you that crying is a medium through which infants can communicate, particularly in the early years, and furthermore parents should be receptive to this. I do however think that not all infant crying is signalling distress or need.

    James-Roberts, S., Conroy, S., & Wilsher, K. (2002). Links between maternal care and persistent infant crying in early months. Child: Care, Health and Development, 24, 356-356.
    Wolfson, A., Lacks, P., & Futternan, A. (1992). Effects of parental training on infant sleeping patterns, parental stress and perceived parental competence. Journal of Consulting and Clinical Psychology, 60, 41-45.

    • jessicabibby February 8, 2012 at 11:15 pm #

      But then according to Bell and Salter Ainsworth (1972) the ‘persistent criers’ that you mentioned in James-Roberts, Conroy and Wilsher’s research (2002) would be the quickest babies to learn ways, other than crying, to communicate. This, in the long run, may be more beneficial to mother and child? I agree with your comment that not all infant crying is signalling distress and need. But the age at which the child is old enough to have learnt to cry for other things apart from distress and need is difficult to state. Brazelton (1962) stated that a certain amount of crying is necessary. Sleep training, to teach a baby not to cry, could therefore be preventing the baby from developing his or her emotions.

  3. jessicabibby February 8, 2012 at 11:20 pm #

    References

    Bell, S. M., & Salter Ainsworth, M. D. (1972). Infant Crying and Maternal Responsiveness. Child Development, 43(4), 1171-1190. Retrieved from http://www.jstor.org/pss/1127506

    James-Roberts, S., Conroy, S., & Wilsher, K. (2002). Links between maternal care and persistent infant crying in early months. Child: Care, Health and Development, 24, 356-356.

    Brazelton, T. B. (1962). Crying in Infancy. Official Journal of The American Academy of Pediatrics, 29(4), 579-588.

  4. riggerb February 9, 2012 at 11:01 pm #

    I find your blog very interesting and it is something that I have research myself in the past.

    I agree with what you have suggested and I find it difficult to believe that leaving a child to cry themselves to sleep is the best or the most productive way or forming a routine.

    As adults we know ourselves that when you are upset crying yourself to sleep is not nice. We all need a good cry from time to time and as a babies when crying is your only form of communication if is often the only way to get your parents to respond. So then to be left to cry could become even more distressing.
    This link backs up what you have said in that it can be more damaging for the baby to be left to cry:
    http://www.guardian.co.uk/society/2010/apr/21/leaving-baby-to-cry-brain-development-damage

    A well know tv programme called ‘super nanny’ approaches this by using the ‘Sleep separation technique’ and altho this may not be valid research it seems to have worked for hundreds of parents aswell as children.
    http://www.supernanny.co.uk/TV-Show/Clips/Clips/Sleep-Separation-Technique.aspx

    To sum it up the parent stays in the room whilst the child falls to sleep, and each night moving further away from where the child sleeps so eventually the child learns to ‘self sooth’.

    If the research into leaving a child to cry has the possibility of developmental problems or ADHD then i would not think that it was worth it. Babies like cuddles 🙂

  5. bngpsych February 10, 2012 at 4:54 pm #

    To fiberize your child, you are ultimately training them to sleep by themselves. Dr. Richard Ferber, director of centre for paediatric sleep, Boston Children’s hospital, argues for the fiberizing technique. He argues that a best way for a baby and everyone in the family to be happy is for everyone to have a good night sleep. He also states that babies are well adapted to sleeping in many different places, so once they have learned to sleep by themselves, they will be well adapted to sleeping in other places without problems (Coukell, 2006).

    However, Bob Sears, paediatrician and co-author of the book; The baby sleep book, argues that allowing a baby to cry themselves to sleep can cause neurobiological and psychological damage. Sears claims that a child that is left to cry themselves to sleep will turn into a quiet child. Dr. Laura Markham, who is trained in attachment psychology argues against Dr. Ferber’s techniques, stating that the Ferber technique is barbaric and can cause babies to emotionally reject their parents. Dr. Markham mentions a British research team who claim to have found and repeated an experiment which shows that babies who have repeatedly cried without reassurance from their parents have slower and less optimally developed brains (Markham, unknown).

    References:

    Coukell, A. (2006, May 30). Dr. Ferber revisits his ‘crying baby’ theory. NPR Books. Retrieved from http://www.npr.org/templates/story/story.php?storyId=5439359

    Markham, L. (Unknown). The case against Ferber sleep training. Pregnancy.org. Retrieved from http://www.pregnancy.org/article/case-against-ferber-sleep-training?page=1

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: