Retrospective Review and Descriptive Analysis of Behavior Therapy Strategies to Teach Pill Swallowing to Children and Youth With and Without Developmental Disabilities

Principal Investigator: Keith Slifer

Difficulty with pill swallowing is a commonly encountered barrier to medical regimen adherence faced by children and adolescents. Factors impacting a child’s ability to swallow pills include oral motor skills deficits, conditioned anxiety, behavioral distress and lack of instruction following. Parents often make alterations to assist with pill swallowing (i.e., requesting liquid format, crushing the pills); however, these strategies may not be feasible or may be contraindicated. Behavioral methods have been effective for teaching pill swallowing to typically developing children and adolescents, and those with ADHD, Autism or other developmental disabilities. Although there is evidence supporting structured behavioral pill swallowing protocols, it is often necessary to individualize parts of the treatment to address each child’s strengths and weaknesses.

Behavioral pill swallowing strategies are frequently utilized in the Pediatric Psychology Consultation Program at the Kennedy Krieger Institute to treat pill swallowing and medication adherence difficulties in youth. This project will present de-identified clinical outcome data on a series of 10 clinical cases treated in recent years in the Pediatric Psychology Consultation Program at the Kennedy Krieger Institute. We wish to obtain approval to utilize these clinical data to allow for professional conference presentation and journal publication of our clinical outcome data. Each case was pursued to assist the individual child with swallowing pills. These cases were not pursued to attempt to acquire generalizable knowledge, but for the individual benefit of the patients involved. Results indicated that behavioral training in conjunction with ongoing assessment and conceptualization of the idiosyncratic nature of barriers to pill swallowing were successful in teaching children to swallow pills. These data therefore lend support to the use of behavioral interventions in the pediatric medical setting to teach pill swallowing and enhance medication compliance in youth.