Behavioral management of oral medication administration difficulties among children: a review of literature with case illustrations.

Nonacceptance of prescribed oral medications among young children hinders medical treatment. The literature pertaining to teaching children how to swallow pills or capsules is reviewed. In addition, a multiple case study demonstrating the efficacy of a brief, easy-to-implement procedure designed to promote capsule acceptance is presented. In this study, two four-year-old children diagnosed to have chronic illnesses participated. In Case 1, use of verbal instruction, modeling, shaping, and contingent reinforcement resulted in the rapid acquisition of capsule swallowing skills. In Case 2, these training procedures, in combination with physical guidance contingent upon noncompliance, successfully produced repeated acceptance of medication by a child who had refused to swallow capsules. In both cases, compliance has been maintained for at least six months.