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It is not a substitute for a medical exam and direct advice from your physician.

When your child refuses to go to bed

This situation occurs when the child refuses to go to bed or stay in his bedroom. He can come out of the bedroom because he no longer sleeps in a crib. Such children often fall asleep while watching TV with the parent or lying in the parents' bed. In a milder form, the child stays in the bedroom but prolongs the bedtime interaction with ongoing questions, unreasonable requests, protests, crying, or temper tantrums. Children who behave in these ways are often tired in the morning and have to be awakened.

These are manipulative behaviors, not fears. Your child has found a good way to postpone bedtime and receive all kinds of extra entertainment. He is stalling and taking advantage of your good nature. The child who occasionally comes to the parents' bed when he is frightened or not feeling well should be supported at these times. Manipulative children, however, try to share the parents' bed all night every night or sneak into their parents' bed in the middle of the night and attempt to spend the rest of the night there.

Establish and enforce a rule that your child can't leave the bedroom at night. Once you have finished the bedtime ritual and placed your child in his bedroom for the night, don't allow him to come out. Do not stay in the room until he lies down or falls asleep. He needs to learn to put himself to sleep at bedtime in his own bed. Establish a set bedtime and stick to it. Make it clear that your child is not allowed to leave the bedroom between 8 p.m. and 7 a.m. (or whatever times you decide on). Obviously, this change won't be accomplished without some crying or even screaming for a few nights, so pick a weekend to do this when you're rested and can afford to wage the battle.

If your child has been sleeping with you, tell him, "Starting tonight, we sleep in separate beds. You have your room, we have our room. You have your bed, we have our bed. You are too old to sleep with us anymore."

Ignore verbal requests. Do not respond to ongoing questions or demands from the bedroom, and do not engage in any conversation with your child. All requests should have been dealt with during the bedtime ritual (usually 15 to 30 minutes long). Before you give your last hug and leave your child's bedroom, ask, "Do you need anything else?" Then don't return or talk with your child, unless you think he is sick. There are some exceptions: If your child says he needs to use the toilet, tell him to take care of it himself. If your child says his covers have fallen off and he is cold, promise him you will cover him up after he goes to sleep. You will usually find him well covered.

If the child screams, close the bedroom door. Tell him that you will open it again when he stops screaming. If he pounds on the door, open it after one or two minutes and suggest that he go back to bed. If he does, you can leave the door open. If he doesn't, close the door again. For continued screaming and pounding on the door, reopen it approximately every 15 minutes, telling your child that when he quiets down, the door can stay open. Never spend more than 30 seconds reassuring him.

Close the bedroom door if the child comes out. If your child comes out of the bedroom, return him immediately to his bed. During this process, avoid any lectures and skip the hug and kiss. Establish good eye contact and remind him again that he cannot leave his bedroom during the night. Warn him that if he comes out again, you will have to close the door. If he comes out, close the door. Tell him you can open the door after he's in his bed. Every ten to 15 minutes, open the door just enough to ask your child if he's in his bed now.

Barricade or lock the bedroom door if the child comes out repeatedly. If your child is very determined and continues to come out of the bedroom, consider putting a barricade in front of his door. A helpful device is a half-door that is kept locked throughout the night. A heavy dresser, single or double gate, or plywood plank may also serve this purpose. Then if your child screams at night, you can go to him without taking him out of his bedroom and say, "Everyone is sleeping, I'll see you in the morning." If your child attempts to climb over the barricade, a full door may need to be kept closed until morning with a hook, piece of rope, or chain lock. While you may consider this step extreme, it can be critical for protecting children under 5 years old who wander through the house at night without understanding the dangers (such as fire, hot water, knives, and going outside).

Return the child to his room if he comes into your bed at night. For middle-of-the-night attempts to crawl into your bed, sternly order your child back to his own bed. If he doesn't move, escort him back immediately without any physical contact or pleasant conversation. If you are asleep when your child crawls into your bed, return him as soon as you discover his presence. If he attempts to come out again, temporarily close his door. If you are a deep sleeper, consider using some signaling device that will awaken you if your child enters your bedroom (such as a chair placed against your door or a loud bell attached to your doorknob). Some parents simply lock their bedroom door. Remind your child that it is not polite to interrupt other people's sleep. Tell him that if he awakens at night and can't go back to sleep, he can read or play quietly in his room, but he is not to bother his parents.

One new successful trick is to give the child a 'Get Out of Bed Once Pass'.To make a good-looking card, print out this page, cut out the ticket, laminate it, and present it to your child with great ceremony.  This card can be used by your child for one brief trip out of the bedroom each night, but it must be surrendered to the parent when used, after which, the child must remain in their room for the rest of the night.

Help the child's roommate. If bedtime screaming wakes up a roommate, have the roommate sleep in a separate room until his sibling's nighttime behavior improves. Tell the child with the sleep problem that his roommate cannot return until he stays in his room quietly for three consecutive nights. If you have a small home, have the sibling sleep in your room temporarily; this will provide an added incentive for the other child to improve.

Praise appropriate sleeping behavior. Praise your child in the morning if he stayed in his bedroom all night. Tell him that people are happier when they get a good night's sleep. GOOD LUCK!

Rev. 10/2005 BEDTIMEREFUSAL.htm