Pill Swallowing Made Easy


Many children have difficulty in swallowing pills. They may be unable

to perform the necessary reflex, they may be feeling too sick, or they

may have unpleasant associations with pills and illness. Many desperate

parents have coaxed, wheedled, cajoled and bribed their children to

take their pills. They’ve mashed pills in apple sauce or bananas, diluted

them in soda, and tried other creative ways to disguise them. But sometimes

pill-taking becomes a battleground and compromises the child’s health.

Parents, however, can help children learn to swallow pills automatically.

The secret lies in patience and in a system that teaches the skill by

using gradual steps with candy “pills” of different sizes.

Multi-colored round candy balls

called mixed decors found in the cake-decorating section of a supermarket;


Be sure your child is capable of an automatic swallowing reflex.

To assess this, make sure that the child is able to swallow small

amounts of water without difficulty. Have the child take a mouthful

of water (not so much that his cheeks are full) and attempt to swallow

it without having any dribble out.

If there are no problems with swallowing water, have the child swallow

one of the multi-colored round candy ball “pills.” Some children may

not need to start with the smallest size. The child should begin with

the appropriate size candy “pill” that he can comfortably swallow.

Starting with a bigger size enables the child to move up more quickly

without wasting water swallowing nothing. Tell the child to place

one ball as far back on her tongue as possible, take a drink of water

from a cup (not a fountain) and swallow the “pill.” The child can

have as many practice trials as she needs. Most children find swallowing

these balls surprisingly easy, so the first attempt is almost always

a positive one. Praise the child for both effort and success.

After five consecutive successful attempts, the child may move on

to the next size candy “pill.” The candy pill levels are:

the multi-colored mixed decors

color shots

small silver decors


larger silver decors

1/2 of a cinnamon or fruit décor

whole cinnamon or fruit décor, and


Practice trials should be given at each level.

If the child is unable to swallow a candy “pill” five times in a

row, continue

the procedure using the same size candy pill (even if the child has

swallowed the candy four times in a row and then failed on the fifth

try). Sessions generally last 10 to 15 minutes. However, it’s not

advisable to prolong the sessions so that the procedure becomes aversive

to the child. Consider the following factors:

If the child moves to another size candy pill and is not successful,

return to the previous size pill before ending the session, so that

the session ends with success.

In subsequent sessions always begin with the first size candy pill

used at the first session. If the child swallows it easily on the

first attempt, progress directly to the next size, and so on. If the

child is unable to swallow the pill, move to the size below that.

Give practice trials, using a criteria of 5 successes before trying

the size that the child was unable to swallow again. Some children

move through all the sizes easily in one session. Others may have

more trouble and move up slowly over 2 to 6 sessions.

Progress from the candy pills to actual medication. It is rare that

a child progresses through the shaping program through the tic-tac

level and then has difficulty in swallowing the medication.

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