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Posted by DRR on May 30, 2000 at 21:45:33:

In Reply to: Victoria's Drills posted by Jaqui on May 30, 2000 at 17:20:45:

Don't have a copy of Victoria's Drills but the sites below look interesting ....

May or may not work for your autistic kids ....

(Note: This is for cancer patients taking prednisone)

Excerpt from site...

How to Teach Your Kid to Swallow Pills

This subject brings a little levity into the cancer parents' lives. At least it does when it's not your kid you are trying to teach. I'll start off with a couple long stories:

I decided to try teaching pill swallowing to my son (he had just turned 5 a few weeks earlier) during our initial hospitalization--after 5 days of forcing down the prednisone, I decided WE couldn't live like that for 3 years. The floor nurse told me the older kids usually took their prednisone in gel caps, as even the coating on prednisone tablets leaves a nasty aftertaste--we ordered up from the pharmacy a bunch of size 03 gel caps. They also manufacture 2 sizes smaller--I might have gotten smaller ones if they'd have been in stock but the O3s ended up working fine. Now he can take 00 and even bigger (pretty gigantic)--this is pretty impressive from a kid without the oral motor coordination to spit out toothpaste after brushing his teeth.

At first, I didn't tell him we were working on pill swallowing--I just bought a few kinds of candy he liked and also got some of those powder "Pixie Stix" which they happened to have in the hospital gift shop. After a bit of general candy play, I told him I had a game to play with him--he had to close his eyes, I would put a tiny touch of the Pixie Stix powder on his tongue, and he would try to guess what flavor it was without looking at the color. That was the end of lesson one--leave him having fun.

Several hours later, we played the candy game again. This time, after a while, I told him I had a way to trick him--I had filled a few of the gel caps in advance with his favorite Pixie Stix flavor. When he had his eyes closed, I gently dropped the pill on his tongue and told him to guess--when he couldn't taste it or anything, we talked about what a funny joke it was. I was careful not to suggest he might want to swallow it or that it was a pill or anything and he usually spit it out or occasionally opened it and poured it in his mouth. We did this a few more times, and end of lesson two for a while. Lesson 3 was similar, but at the end of this lesson, I told him to trick me with any color/flavor pixie stix gel cap he wanted (I had filled a few in advance). When he dropped one in my mouth, I very cheerfully swallowed it with a big drink of water and talked about how good it was and guessed all kinds of goofy flavors since I couldn't taste it. I bet him a dollar that he couldn't do that, too. After some gentle coaxing, he gave it a shot. He gagged a bit the first couple of times, but luckily the nurse came in about then and helped me challenge/encourage him to swallow a couple. (Again, we hadn't yet mentioned that this might be done with something other than candy). We made a huge deal of this, and had other nurses come in and view and applaud, etc.

Later that evening, the nurse dispensing meds suggested that since he hated the prednisone tablets smushed in juice so very very much, that she could put it in gel caps like the candy and he could swallow it without tasting it, just like the candy. It took a bit of coaxing, but he eventually agreed to try one if I would buy him a new Hot Wheels car. The rest is history . . . he found that even though he occasionally gagged, this was much much better than trying to take the prednisone other ways.

After a couple of months, we were able to gradually increase the gel cap size so that he didn't have to take so many pills every night. In the last month or so, I've been sneaking in the Bactrim, methotrexate, and the 6-TG without gel caps and he does fine. I still always put the prednisone in the gel cap, just in case.

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