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Clinical Pediatrics
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Teaching Children with Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Disorder (AD) How to Swallow Pills

Melissa H. Beck, PhD

Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, MD

Marilyn Cataldo, MA

Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, MD

Keith J. Slifer, PhD

Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, MD

Valerie Pulbrook, MA

Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, MD

Jaswinder K. Guhman, MD

University of Arizona, Division of Child and Adolescent Psychiatry, Tucson, Arizona

One barrier to medication adherence in pediatric populations is difficulty swallowing pills. Some children may not have prerequisite skills for pill swallowing, while others may have developed conditioned anxiety from repeated negative experiences. Eight children with attention deficit hyperactivity disorder or autistic disorder participated in behavioral training to increase cooperation with pill swallowing. A pill-swallowing protocol was utilized during practice sessions with placebo "pills" of increasing size to implement systematic desensitization. Seven of the 8 children swallowed medication with a therapist. Six of the 8 children maintained treatment gains over time. Interventions used to succeed with these children are presented along with methods to reduce conditioned behavioral distress.

Clinical Pediatrics, Vol. 44, No. 6, 515-526 (2005)
DOI: 10.1177/000992280504400608
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Home page
 Clinical Case StudiesHome page
D. Reitman and C. Passeri
Use of Stimulus Fading and Functional Assessment to Treat Pill Refusal With an 8-Year-Old Boy Diagnosed With ADHD
Clinical Case Studies, June 1, 2008; 7(3): 224 - 237.
[Abstract] [PDF]