Sometimes children have to take a medication that needs to be swallowed. Some
medications can be crushed or sprinkled but when medication has an extended
release, it must be swallowed to allow time for it to progress through the
digestive system before dissolving. The problem is when the child does not know how
to swallow pills. This becomes more difficult, if on top of that, it engages in serious challenging behavior
when mother asks the child to do something he does not want to do, and this child happens also to have
autism which complicates the entire process.
There is a wonderful pill swallowing technique that has been developed based on
research, which can be easily accomplished in a total of 8-10 hours
spread over the course of several days.
Stimulus Fading
First, you purchase a variety of stimuli that you could use to teach
swallowing. You can start with something as small as a mustard seed. Use
items like tapioca pearls, quinoa pellets, and similar. Purchase items in
varying size take care to include items up to the size of a navy bean or
flageolet. You may also purchase blank pills in various sizes starting at size 4
going up to a size 0.
Note: some folks might suggest that you use small candies or cake decorating
items. We advise against this, because those items taste good and could possibly
encourage chewing. Remember, we want children to swallow the stimuli WITHOUT
chewing.
Then arrange the stimuli in order from smallest to largest. FYI, a
flageolet is about the same size as a size 5 capsule. A size 0 capsule is quite
large (but they do come larger! 00 and 000). When the child demonstrates that he
can swallow a tiny object, we gradually increase the size of the stimuli.
After a few session, he will be able to swallow a size 1 capsule.
Modeling
The next step is to model pill swallowing for your child. Initially, we
recommend that you model it every time you take your medication. Then, when you
are ready to teach your child, tell him/her to “watch me” then over-exaggerate
the action and promptly say, “your turn”.
Reinforcement
The final step is to reinforce the child for attempting and for successfully
swallowing. Reinforcement can be as simple as verbal praise but it can also
include brief access to a favorite movie, song, or iPad game.
Check out this link
for additional information including videos. A professor utilizes a head turn
that you can teach if you want.
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