Behavioral training for pill-swallowing difficulties in young children with autistic disorder.
BACKGROUND
Difficulty with swallowing pills is a common problem, leading to noncompliance with treatment recommendations. Many young children with autistic disorder (AD) who also show comorbid symptoms associated with attention deficit hyperactivity disorder (ADHD) have difficulty swallowing pills. This pilot study describes our experience in teaching pill-swallowing skills to 4 children with AD who also had comorbid symptoms associated with ADHD.


METHODS
Four children, aged 5-;6.5 years, were enrolled for pill-swallowing training, 3 of the children were Caucasian boys and 1 child was a Hispanic girl. All children met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnostic criteria for AD and ADHD-like symptoms. The children's verbal IQ ranged from 54-96, their nonverbal IQ ranged from 85-107, and the Preschool Language Scale-3 total language score ranged from 50-98.


RESULTS
At the end of the pilot study, 2 children (50%) successfully learned to swallow the study capsules, 1 child (25%) was able to swallow the study capsules with the behavior therapist but had difficulty with the caregiver, and 1 child (25%) made slow progress and was withdrawn by the caregiver in favor of proceeding with a crushable medication for clinical care.


CONCLUSIONS
Caregivers were appreciative of the opportunity for this short intervention. Behavioral training for pill swallowing may be indicated in some circumstances in young children with AD and/or other developmental disorders.
Ghuman
Jaswinder K
JK
Johns Hopkins University/Kennedy Krieger Institute, Baltimore, Maryland, USA. jkghuman@email.arizona.edu
Cataldo
Marilyn D
MD
Beck
Melissa H
MH
Slifer
Keith J
KJ
D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D001321:Autistic Disorder / Q000523:psychology*; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D003679:Deglutition; D005240:Feasibility Studies; D006801:Humans; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D013607:Tablets
D013607:Tablets