Research

Graduated extinction vs extinction: what the research compares

What studies say about graduated extinction (the Ferber method) versus extinction (cry it out): how well each works, and which parents find easier to follow.

The Ferber team September 26, 2026 6 min read

Here is what usually happens, with a research note citing Price et al., Pediatrics, 2012.

If you have read anything about sleep training, you have met the two clinical terms that sit underneath most of it. Extinction is the research word for cry it out. Graduated extinction is the family the Ferber method belongs to. The question many parents end up asking is whether the check-ins make any difference.

Here is the short answer. Both approaches have research support, and a trial that compared them directly found they improved sleep about equally. Where they differed was in the parents: for night wakings, mothers using the graduated approach reported sticking to the plan more consistently and feeling less stressed by it. So the check-ins may help parents keep going as much as they help the baby.

What the two terms mean

Extinction (also called unmodified extinction, standard ignoring or cry it out). After the bedtime routine, you put your baby in the crib awake and leave. You do not go back until a set time in the morning, apart from checking for safety or illness. The idea, from behavioral psychology, is that crying which no longer brings a parent to settle the baby gradually fades.

Graduated extinction (also called graduated ignoring, checking in, controlled crying or controlled comforting). You put your baby down awake and leave, then return for brief check-ins if they cry. The waits between check-ins grow longer through the night and across nights. The Ferber method is the best-known version; its classic chart runs from 3, 5 and 10 minutes on Night 1 to 20, 25 and 30 minutes on Night 7. The chart article has every night.

Both rest on the same principle. Neither has you rock, feed or hold your baby to sleep. The glossary has short definitions of these terms and their aliases.

What the big reviews say about each

The most cited review is a 2006 paper by a task force of the American Academy of Sleep Medicine. It covered 52 treatment studies. Across all of them, 94% reported that behavioral treatments worked, and over 80% of children treated showed clinically significant improvement that lasted 3 to 6 months (Mindell et al., 2006).

On the two methods specifically, the review found strong support for unmodified extinction (along with preventive parent education), based on controlled group studies. It found support for graduated extinction, as well as for bedtime fading with positive routines and scheduled awakenings.

That wording grades the strength of the evidence behind each approach, using formal criteria for evidence-based treatment. It is a statement about how much proof existed in 2006, and the summary does not report one method beating the other.

A 2014 meta-analysis pooled 16 controlled trials of behavioral approaches in children and found moderate-level evidence that they help young children fall asleep faster, wake less often and for shorter stretches, and sleep more efficiently (Meltzer and Mindell, 2014).

Graduated extinction vs extinction head to head

The clearest direct comparison is a 1999 trial in the United States. Young children with sleep problems were assigned to standard ignoring (extinction), graduated ignoring (graduated extinction) or a wait-list control group (Reid, Walter and O’Leary, 1999).

What it found:

Both worked. Both brief treatments did better than the wait-list group and produced comparable improvements in bedtime and night-time sleep problems.
Bedtime was similar. At bedtime, the two groups did not differ in how well mothers stuck to the plan or in their stress.
Night wakings favored the graduated approach for parents. For night wakings, mothers in the graduated ignoring group reported higher rates of following the plan and less treatment-related stress.
Side effects were positive. Only positive side effects were observed. Mothers using standard ignoring reported less stress in parenting than the wait-list group, and mothers using graduated ignoring reported improved relationships with their children.
The gains held over a 2-month follow-up.

The researchers also found that mothers’ own characteristics predicted how well standard ignoring worked. In that study, results with extinction depended more on the parent doing it.

This was a single study of young children, not specifically infants, with a short follow-up, so it cannot settle the question alone. It does fit what many parents report: going in at planned times can make the night easier to get through, especially at 3 a.m.

Trials of graduated extinction on its own

Graduated extinction has also been tested against control groups in babies.

In an Australian trial of 156 mothers of babies aged 6 to 12 months with severe sleep problems, a graduated approach called controlled crying resolved more sleep problems at two months than written information alone (53 of 76 vs 36 of 76). By four months, the groups were similar. Mothers’ depression scores fell further in the intervention group, and for mothers with higher scores, that difference was still there at four months (Hiscock and Wake, 2002).

In a 2016 randomized trial of 43 babies aged 6 to 16 months, graduated extinction produced large decreases in how long babies took to fall asleep, in the number of night wakings and in time awake during the night, compared with a sleep-education control group. Infant cortisol, a stress hormone, showed small-to-moderate declines, and at a 12-month follow-up there were no significant differences in emotional or behavioral problems or attachment (Gradisar et al., 2016). Our article on stress hormone studies looks at that cortisol finding in more detail.

What this means if you are choosing

The research does not crown a winner on sleep outcomes. Both approaches tend to work for many families, and both share the same core: a baby put down awake, with parents who respond in the same way every time.

The practical differences come down to you:

Can you hold the line without going in? Extinction is simple to describe and hard to do. If a parent goes in after a long stretch of crying, a baby can learn that crying longer brings a parent, which can make the next night harder.

Would checking in help you stay consistent? The 1999 trial suggests that, for night wakings especially, a graduated plan can make consistency easier for parents. Many families find that seeing their baby is safe is what lets them keep going.

How does your baby react to visits? Some babies settle after a check-in. Others get more upset each time a parent appears and leaves. If yours is the second kind, fewer visits may be kinder.

Expect a rough patch with either. Crying often gets worse for a night or two before it improves, which is known as an extinction burst. For a broader comparison that includes gentler approaches, see our methods page.

A next step for tonight

Talk with your partner, or with yourself if you are doing this alone, about one question: if your baby is still crying at 2 a.m., would it help you to go in briefly at planned times? If the answer is yes, graduated extinction is probably the better fit for your family.

If you choose the Ferber method, the Ferber app runs each wait, alerts you at check-in time, and restarts from the night’s first interval after a waking, so you do not have to track the clock yourself.

Common questions

What is the difference between extinction and graduated extinction?

With extinction, often called cry it out, parents put the baby down awake and do not return until morning except for safety or illness. With graduated extinction, which includes the Ferber method, parents return for brief check-ins at set intervals that get longer over time.

Which works better, extinction or graduated extinction?

Both have research support. A 2006 American Academy of Sleep Medicine review found strong support for unmodified extinction and support for graduated extinction. A 1999 trial comparing the two found comparable improvements in bedtime and night-time sleep problems, with gains maintained at a 2-month follow-up.

Is graduated extinction easier for parents?

In one comparison trial, yes, for night wakings. Mothers using graduated ignoring reported following the plan more consistently at night and less treatment-related stress than mothers using standard ignoring. At bedtime, the two groups did not differ.

Is the Ferber method a form of extinction?

Yes. Researchers class the Ferber method as graduated extinction, sometimes called graduated ignoring, checking in or controlled crying. It uses the same principle as extinction, with planned parent visits added.

Sources

Written by The Ferber team. Educational information, not medical advice. If you are worried about your child’s health, feeding or growth, talk to your pediatrician.

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