Pill-Swallowing Training in Pediatric Psychology Practice: Applied Intervention to Promote Adherence to Oral Medication

Objective: Many pediatric treatment regimens require oral medications, rendering the ability to swallow pills is an essential skill for adherence and an important target for pediatric psychology intervention. This article sought to (a) review existing evidence for pill-swallowing interventions in pediatrics, (b) describe a pill-swallowing training intervention currently employed in a large, pediatric tertiary care hospital and utilized in diverse patients with a wide range of medical conditions, (c) report data from pill-swallowing intervention records from 2011 to 2020 to depict intervention outcomes in inpatient and outpatient settings, and (d) offer strategies for commonly encountered challenges. Methods: A topical review of the literature was conducted utilizing search terms “pill-swallowing training” and “pediatrics,” with filters applied for peer-reviewed articles published between 2000 and 2022. Articles were selected with relevance to pill-swallowing protocols. Description of a pill-swallowing protocol utilizing shaping and modeling techniques is then presented, followed by outcome data gleaned through retrospective chart review. Variables related to implementation of this protocol in a tertiary care hospital with various medical conditions were examined. Illustrative case examples of pill-swallowing training with diverse patients in real-world pediatric psychology practice are also provided. Results: The study found 88% (n = 246) of patients were able to learn to swallow a placebo pill. Further, 73% (n = 179) of patients were able to learn to swallow a clinically useful placebo size. Conclusions: Pill-swallowing training is effective in teaching the majority of pediatric patients to swallow capsules in a short period of time.