Adams L A, Rickert V I
Arkansas Children's Hospital, Little Rock.
Pediatrics. 1989 Nov;84(5):756-61.
A total of 36 toddlers and preschool children exhibiting bedtime tantrum activity were randomly assigned to one of three groups: positive routines, graduated extinction, or control. Positive routines involved changing the child's bedtime to coincide with when he naturally fell asleep, as well as parent and child engaging in a series of four to seven enjoyable activities before the child being placed in bed. During the treatment period, bedtimes were systematically scheduled earlier such that the child went to bed at the time parents had originally used. Graduated extinction consisted of the parent putting the child to bed and ignoring the tantrum activity for increasingly longer amounts of time throughout the treatment. Children in these two treatment groups had tantrums less frequently and for shorter periods than control subjects during 6 weeks of treatment and during two follow-up observations 3 and 6 weeks after treatment. Although both treatments were more effective than waiting for the child to outgrow this problem, parents of the positive routine group reported significantly improved marital satisfaction, suggesting additional benefits of this treatment strategy.
共有36名表现出睡前发脾气行为的幼儿和学龄前儿童被随机分为三组之一：积极程序组、渐进消退组或对照组。积极程序包括将孩子的就寝时间调整到与他自然入睡的时间一致，以及父母和孩子在孩子上床睡觉前进行一系列四到七项有趣的活动。在治疗期间，就寝时间被系统地提前安排，以便孩子在父母最初使用的时间上床睡觉。渐进消退包括父母让孩子上床睡觉，并在整个治疗过程中越来越长地忽略发脾气行为。在6周的治疗期间以及治疗后3周和6周的两次随访观察中，这两个治疗组的孩子发脾气的频率更低，持续时间更短。尽管两种治疗方法都比等待孩子长大后自行解决这个问题更有效，但积极程序组的父母报告说婚姻满意度有了显著提高，这表明这种治疗策略还有其他好处。
