Taking medications can be a difficult task for children with autism. It is important to understand the specific needs of an autistic child in order to teach them how to take medications safely and effectively. With patience and understanding, parents and caregivers can help autistic children learn how to take medications without fear or anxiety. By breaking down the process into small steps, providing visual cues, and using positive reinforcement techniques, parents can help their autistic child learn how to take medications properly.
Children with autism often struggle to take medications due to sensory overload and difficulty in understanding instructions. This can be particularly challenging for parents and caregivers who are trying to ensure that their child takes the medication as prescribed. Taking medication is an important part of managing autism symptoms, so it is important to understand why some children may be avoiding taking medicine, and what can be done to help them.
Why may some children be avoiding taking medicine?
Autism and anxiety disorders
It can have a profound impact on the lives of autistic children, making it difficult for them to take medicine. This can be especially true for those who have an aversion to taking pills or injections.
It is important to understand why some autistic children may be avoiding taking medicine in order to provide the best possible care. By understanding the root cause of their anxiety, parents and medical professionals can work together to create a plan that helps reduce their fear and increase their willingness to take medication. With the right support, these children can learn coping strategies that will help them manage their anxiety and make taking medication easier.
Taking medication may also represent a change in routine—a common trigger of distress among children diagnosed with ASD.
Sensitivity to tastes and textures
Food selectivity may be linked to heightened sensitivity to tastes and smells. Children with autism may experience the world around them differently. A sound, sight, or taste that seems unremarkable to most people can trigger extreme reactions. In other words, liquid medicine that smells fine to you could smell disgusting to a child with autism.
Difficulty swallowing pills
Swallowing is a complex process requiring coordinated movements by the tongue, hard palate, and esophagus. Because children diagnosed with ASD are more likely to have sensory-motor and coordination difficulties, some simply aren’t able to activate the motor functions needed to swallow on command.
Fear of needles
Specific fears and phobias are some of the most frequent subtypes of disorders for ASD. Children with autism are prone to common childhood fears (like fear of needles), but uncommon fears may cause anxiety as well.
How to teach a child with autism to take medicine
If your child can follow instructions and is able to manage to swallow ‘chunky,’ textured foods (e.g., oatmeal or chunky applesauce) without gagging or choking and swallows mouthfuls of liquid without it spilling from her mouth or causing coughing/gagging, she should be ready to learn pill swallowing.
Around age 6 or 7, most children have the motor skills, attention span, and ability to follow instructions required to successfully swallow pills. For children with autism, these abilities may take longer to develop. You may want to ask a medical professional for an assessment of whether your child is ready or not. Once you’ve decided to teach your child to take pills, here are some techniques to use.
Shaping or gradual introduction
For pill swallowing, the process is simple. You start by giving the child water to practice swallowing on command. Then, you begin introducing small candy “pills” to swallow such as cake decorations. Increase the size of the “pills” until the child is a pill-swallowing expert.
For liquid medicine, you can start by introducing small amounts of a liquid your child is already familiar with like water or juice. Once up to the required dosage, mix in or switch to the prescribed medication.
Stimulus fading is a behavioral procedure that entails the gradual approach of the feared stimuli (e.g., an unfamiliar person) closer to the child, allowing time for habituation (or adjustment) to the stimulus prior to each move closer.
At first, clinicians simply presented the boy with an empty syringe. Then they required him to open his mouth with the empty syringe present. The next steps involved slowly decreasing the distance between the boy and the empty syringe until the syringe was less than an inch from his mouth. Next, the boy was required to ingest water at increasing volumes, and then, once that was completed, the boy was given a placebo liquid medication. The final step was for the clinician to leave the room while the boy’s mother took over the process.
The technique requires dedication but can be successful. By the end of the stimulus fading process, clinicians reported the boy “often smiled and requested the medicine during the last dozen or so sessions of treatment.
Experts report that maintaining a positive attitude can help children take medicine without fear or resistance. But positive reinforcement in the form of rewards can also help.
Positive reinforcement can be combined with other techniques. In the case of the stimulus fading treatment above, positive reinforcement was a key aspect of the program. When the boy successfully completed a step, the clinician gave him one or two pieces of candy or 30 seconds of access to a toy.
Modeling is showing a child that the action you want them to take is easy and harmless. When a child sees a parent successfully complete the action of pill swallowing or taking liquid medicine from a syringe, they may feel less anxiety about doing it themselves.
Modeling can be a more successful technique for children with autism who may struggle to understand spoken instructions. Seeing a person perform a task, and then being given the chance to imitate the task, maybe a more effective way to learn. Keep pill-like objects or placebos on hand to model proper medicine-taking behavior for your child with autism.
Special steps with liquid medication
In addition to using the steps above to introduce liquid medication to a child with autism, you may also be able to introduce additives to make the medication taste better.
Ask your pharmacist if it’s okay to mix the liquid medication with water, juice, or another liquid that will hide the medication’s taste. Your pharmacist will be able to make sure certain drinks or foods don’t interact with the medication. You should also only use a small amount of additional liquid because you need to be sure that the child is ingesting enough of the medication.
If your child refuses liquid medication, you can ask a medical professional if the same medication is available in a chewable tablet form.
Ideally, the techniques above will allow your child to become a pill-swallowing expert.