The Basic Approach: Shaping

Is It Candy or Medicine?

Here is a poster to share with your child. Click on the image to view it on your screen.

Shaping is the basic method generally used to teach children how to swallow pills. It is a behavior modification term. Through "shaping", you teach a child how to do a difficult task by breaking the task down into the simplest task and then increasing the difficulty as the child has success. When teaching a child how to swallow pills, one generally starts with very small candy ‘pills’ and then moves to progressively larger ones as the child masters the technique.

With children, the best non-medication substances to use for practice are cake decorations and candies. Purchase a series of increasingly larger sized cake decorations (such as tiny round candy balls called “mixed decors” and sprinkles) and candies (such as mini-M&M's, Nerds, or Tic-Tacs). [Click here to view the Candy Chart for Shaping.] Although some suggest you only use the white decorations since they most look like medication, medication comes in many colors and it is equally reasonable to use colored candies and cake decorations.

The Basic Steps in Teaching a Child to Swallow a Pill:

Sessions should last no more than 10-15 minutes, and possibly shorter -- depending on your child's tolerance level.

Subsequent sessions should start with the last size with which your child was successful before progressing to the next size. Your child may be able to progress through all the sizes in one session; however, it may take anywhere up to 5 or 6 more sessions before the skill is mastered.

When your child can reliably swallow the Tic-Tacs or mini-M&Ms, you can ask him to try swallowing an actual pill such as a children's vitamin. By the way, experts advise not to refer to these fake ‘pills’ as candy during practice, since swallowing real candy rarely triggers anxiety and the child may not transfer the skill to real medication if he believes he is practicing on candy. In addition, most people typically chew candy and medicine should usually NOT be chewed. In the sidebar on the right is a poster, Is It Candy or Medicine?, that you can share with your child that shows the similarities between medications and many well-known brands of candy. It is important to emphasize to your child that although the medicine may look like candy, they are very different.

Remember, kids require the opportunity to practice in order to maintain this new skill.

Some children will enjoy tracking their progress through the different sized pills. Click here for a sample chart that you and your child may find helpful.

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