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Skillz with Pillz: The Mechanics of Medicating Your Child

Along with inheriting my disorganized brain, my child also got my horrendous lack of coordination.  That means we both spend a lot of time doing wonderfully graceful things like biting our tongues and choking on our own saliva.  Taking pills is difficult enough for many people but for children who have trouble coordinating their mouth parts, it’s even more of a challenge.

We’ve always used liquid or dissolvable medications to make taking them a little less stressful but when he was prescribed medication for his ADHD, we found that it only came in pill form.  This sent us on an adventure in discovering how to get medication into a child.

Methods we found to not work:

Just taking the pill.  This results in a puddle of water on the bathroom floor with a pill in the middle of it and a child gasping for air.

Yelling at the child to TAKE THE PILL!  Generally still ends with a wet floor and a ruined pill but with the added consequence of two angry people.

Crying in a heap on the floor while explaining to the child that the pills cost $3 apiece.  This one just makes the kid look at you like you’ve finally lost it.

Bribery.  The outcome here is much the same as the “just taking the pill strategy” but with a child gasping for air and crying because he isn’t going to get what he would have gotten if he had been able to take the pill.

Hiding the pill in a piece of food.  They just eat around it.  Apparently, they can smell it or something.  Wait, that might have been the cat.  Never mind.

Pills3

In all seriousness, the issue many kids have with taking pills is not that they don’t want to take them; it’s a physical issue that makes the child unable to take them.  No amount of begging, pleading, promising or explaining is going to change that. When we have a physical task that we need to accomplish but our bodies just aren’t going along with the request, we need to tackle the problem in baby steps.  We need to teach our bodies.  We need to condition them to move in ways they are not used to moving.

So how does one condition a body to swallow a pill?  For us, the answer began with candy corn.  Yep, candy corn.  We started the medication in November and I still had some candy corn left from Halloween which alone is a small miracle considering how quickly candy disappears at my house.  It was still soft enough that I could mold it easily with my hands.  I had my son sit in the bathtub (I was tired of wiping the floor) and I sat on the edge of the tub.  Explaining each step to him before trying it, I gave him a glass of water and told him to take a sip.  Done; no problem.  Then I had him take a sip and tip his head back but not swallow for about 2 seconds.  Success.  Next, we did the same thing but this time, when he had his head tipped back, I took a tiny piece of candy corn, rolled it into a ball and popped it in his mouth before he was allowed to swallow.  Amazingly, it went down!  It was a definite confidence boost but he didn’t feel he would be able to swallow anything larger so we agreed to take a break.

When we went back to it, we quickly made it through all of our initial steps and the larger piece went down just fine, too. Then the big test: swallowing a piece that was the same size as the pill.  To both of our surprise, he was able to do it with no problem at all so we agreed it would be a good time to try with the pill and just like that, the medication was in my child.  No crying, no clean-up, no wasted $3.00 pills.  Boom.

Pills2

For about two weeks, we went through the practice steps each morning, working up to taking the pill.  We had a few days that were more difficult than others when we had to go back and start from the beginning but we got the pill in every single day.  After about a week, we took it up a notch, starting around step 3.  A week later, he was able to take the pill on the first shot almost every time.  There are some days that he still asks for practice and I have to go scrambling for a TicTac or something (we used smashed bits of bread one day, in desperation) but for the most part, we have been able to condition his body to swallow a pill without it being a source of stress for either of us.

Yes, it takes some time.  Yes, it’s giving your kid extra candy.  Yes, the school nurse will look at you like you are insane the first time you forget to medicate at home and show up at the school with a pill and a bag of candy corn but in the end, the goal is to get your child the medication they need and in our case, it was worth all of that and more.

What do you think?  Is this a method you would try?  Have you found any other great ways to get your kids to swallow pills?

 

 

Pill mix image courtesy of Ramberg Media Images at www.rambergmedia.com

White pills in canister image courtesy of Destinys Agent at http://www.flickr.com/photos/destinysagent/

Ayer’s Cathartic Pills image courtesy of Miami University Libraries

 

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Cara

Cara

My name is Cara. I'm an ADHD mom with an ADHD kid, a husband, several cats and a messy house. I write about ADHD and mental health issues, skeptical parenting and education. I also like to hula hoop.

13 Comments

  1. December 31, 2013 at 10:42 pm —

    If possible I would break it up or grind it into a small amount of food or drink. But I believe that is not possible for all types of medications.

  2. Aaron
    January 1, 2014 at 8:15 am —

    I found that not giving my child drugs that people snort for fun is a better way to go. While the school would like to believe he has ADHD I find that the diagnosis is often completely wrong and that we are over medicating our children. I have been a teacher for 12 years and have seen many kids who have been incorrectly diagnosed. Any kid who doesn’t behave exactly as the school thinks he or she should is automatically diagnosed with ADHD. I my son’s case, he was, and still is, a straight A student. He has minor behavioral issues. I am not deluded into thinking that my child is an angel. I’m well aware of who he is and how well he does or does not behave. But just because a kid is difficult at times or occasionally has trouble focusing doesn’t mean that they require drugs. I’ve seen scores of children medicated over the years and I can honestly say that I only think two or three were diagnosed properly. This was my field of research in graduate school and everything pointed to over diagnosis. The drugs have not been tested long term in children and I cannot imagine that giving methamphetamine to a nine year old is a good thing. We are told that there is something wrong with their brain chemistry and the medication corrects it but I think that that’s garbage. A glass of wine or a joint will “correct” my brain chemistry as well but that doesn’t mean I want to be high all day (we are also told that the medication doesn’t have do that to people who are sick but that’s complete bunk). I was diagnosed with ADD many years ago but my parents told me that they refused medication for similar reasons. I’m glad they did. I wasn’t the best kid either but not all kids are great. Most are immature. But you know what happened? I grew up. And I did it without medication. My son’s principal brags that 50 kids in the school are medicated and they’re all better for it. That’s 15% of the school. I refuse to accept (and I’m not in denial) that 15% of the school needed to be medicated. Perhaps he needs to be a better administrator and teachers, myself included, need proper education in dealing with behavior issues instead of medicating our nation’s children. It’s not the answer to invented diseases which include “symptoms” like “doesn’t wait his or her turn in line.”

  3. Dave
    January 1, 2014 at 11:44 am —

    Great idea. We used mini m&ms.

  4. De
    January 1, 2014 at 12:13 pm —

    I didn’t learn to swallow pills with water until I was about 16. It wasn’t a physical problem, I could swallow them fine if I didn’t know I was swallowing them (like when they were put into my yoghurt and then I just ate that).

    What really helped me was the tip to -*not* tilt the head backwards like they always do in movies etc. Tilting it forward makes the pills easier to swallow, at least for me.

  5. January 1, 2014 at 2:56 pm —

    J.G., that’s a good idea as well though this particular medication is extended release and requires swallowing whole.

    De, I’m glad you found a tactic that worked for you. Interesting that tilting it forward would be helpful. I wonder if maybe it opens the throat differently allowing the pill to go down easier for some?

    Aaron, the post was about how to help children take medication; not about ADHD itself so you’re a bit off topic. Even so, I’d like to address some of your points. The fact that some people abuse ADHD medications does not make them any less appropriate for their approved uses. In fact, people with un-medicated ADHD are at a higher risk of drug abuse as adults than those who are appropriately medicated according to many sources including NIMH and the AACAP. Additionally, some ADHD medications, my son’s included (Strattera), are not amphetamine-based.
    Most of what you’ve provided is anecdotal evidence and opinion and while I am happy that everything worked out great for you, your information is outdated and runs contrary to medical science.
    While ADHD may have behavioral manifestations for a lot of people, that is not true for all. My son never acts out at school. He has no difficulty waiting his turn. He loves his teacher and he loves learning and doesn’t have any major issues with his peers. What he *does* have are a complete inability to focus, an inability to organize himself and his work, an inability to think clearly, an inability to process information that comes in larger packages and difficulty with working memory. It was not anyone at the school who suggested he might have ADHD; they only told me he was not finishing assignments and having other difficulties. We tried many non-medical interventions without success. I had him assessed by his pediatrician and by a private psychologist and they diagnosed him independently.
    I do not believe that ADHD is over-diagnosed; I think it is a widely prevalent issue. I will agree that some kids may be inappropriately diagnosed but when a child is struggling with ADHD-like symptoms, it makes sense to assign the most likely diagnosis. If medications are ineffective, the child should be reassessed and may receive a different diagnosis. Some of that 15% you mention might be dealing with unrecognized depression or anxiety or a different learning disability. On the other hand there are many people who struggle and are labeled as “behavior problems” who never get the help they need because of people with out-dated ideas or anti-medication biases who think they should just be able to get with the program or blame the issue on the parents or the schools instead of understanding that the issue may well be neurological.

  6. Michelle
    January 1, 2014 at 5:16 pm —

    My youngest likes to use strawberry jelly. And you rock, Cara. Very creative solution and method for teaching your son to take a pill.

  7. Jules
    January 1, 2014 at 9:03 pm —

    This was a wonderful article Cara. My husband’s mom taught him to take medication by using M&Ms. Kids aren’t born knowing how to take medication and they have to be taught, just like anything else. Good for you for finding a way to make it work! You rock!! I had to take meds as a kid (allergy) and don’t remember how I learned, but do remember it being a bit traumatizing.
    I agree with you on medication and ADHD as well. As a teacher, I do see kids that are misdiagnosed, but those normally corrected quickly. I would like to see teachers trained in behavior issues but it’s clear that’s not going to happen anytime soon. Great post and great response!

  8. Jim
    January 1, 2014 at 9:56 pm —

    Good article Cara! At the risk of sidetracking the conversation, I have to add my personal experience, all the while acknowledging that true plural of anecdote is not “data.”

    I’ve also raised several children with ADD/ADHD, and strongly support your views on medication when necessary. Aaron does a fine job knocking down a couple of straw men, but seems to have missed (or actively dodged) the point. ADD children aren’t doped up to make them behave – they are generally already well-behaved, compliant, intelligent, and eager to please. They want to focus and organize, but just can’t. As it was described to me, the part of the brain involved in executive function is just a bit behind in its development, so their thought processes can go essentially unguided after a short period of concentration. The stimulant (that’s right – we’re actually stimulating these kids!) amps up the executive functions, allowing the child to better collect and focus their thoughts.

    As for the story of the principle “bragging” that 15% of the students are medicated, this might include allergy medications, insulin for diabetics, eye and ear-drops, etc… Remember – students aren’t allowed to take so much as a Tums without following proper procedures.

  9. Nadine
    January 2, 2014 at 11:08 am —

    We did something similar to help my 9 year old learn to swallow Strattera (which cannot be opened up.) This set of videos and reporting forms from the Alberta Children’s Hospital shows the system that we used. http://research4kids.ucalgary.ca/pillswallowing

    Being able to swallow pills may seem like it is very useful but not completely necessary for children with ADHD it can makes a tremendous difference in the quality of life for young children with other illnesses. Many liquid version of medicines need to be refrigerated which really limits the amount of time a family can be away from home.

  10. January 2, 2014 at 6:00 pm —

    Another fine article, Cara, and glad you sorted a way round the problem. Great to share solutions like this to help others who might face similar difficulties… 🙂

  11. Carpe Librarium
    January 4, 2014 at 6:33 pm —

    The biggest problem I had as a kid was the gross, chemical taste in my mouth left by a partially dissolved tablet after a failed attempt to swallow.
    Using M&Ms or something similar sounds like a great way to get the technique down, as false starts are less icky.

  12. […] I know I’m not alone in this. My wife tells stories about the difficulty her father had in teaching her how to drive a stick shift; of course, it was easy for him after all those years, so how could it not be easy for her? They had the same problem when he had no idea how to help her swallow a pill. […]

  13. April 8, 2014 at 11:09 am —

    […] I know I’m not alone in this. My wife tells stories about the difficulty her father had in teaching her how to drive a stick shift; of course, it was easy for him after all those years, so how could it not be easy for her? They had the same problem when he had no idea how to help her swallow a pill. […]

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