Today a mother wrote the following to the ES email list.
[My son] was making great gains on the ginkgo. However he won’t take it any more. He can taste in anything I try and is now refusing to eat some of his favourite foods even when they have no ginkgo in them… ((He really was doing well. It is now almost 2 weeks since the last dose and I can see him sinking away from me again. It is breaking my heart. I was getting you to my new, interactive, boy ((I have tried all the brilliant suggestions from this list: in yoghurt, in applesauce, trying to get him to swallow tablets…. you name it.I don’t know what to do or where to turn. … Sorry to be asking the same questions over and over, but I do want my little boy back. [snipped, link added]
One parent suggested crushing the pill, adding a bit of water, and squirting it into the back of his mouth. That may be a good short term solution. Another parent suggested dividing this into little steps with lots of positive reinforcement when he does the practice steps.
Here are some other ideas for going forward. First, your son needs to trust you. Please don’t put nasty hidden things in his favorite foods. This has come up from parents again and again; because far too often it backfires. If I were you, I would leave all his food alone, and determine never to put vitamins, gingko, medicine in it again. If something like applesauce is used to mix supplements in, then do it in a way that he learns that this is medicine coming and not a normal bowl of applesauce. Maybe you always use the same blue saucer to mix it in. Or you always give it away from the table. Or you always give it before the actual meal starts. But however you do it, your child needs to know whether or not the spoonful coming at him will be the nasty stuff or not. Mommy needs to be predictable and trustworthy on this; then he can trust you on his regular food.
Second, before you try to administer something to him, decide whether or not this is optional. It must be you (the mom) and not the child who decides whether or not he takes certain foods/supplements/medicines. If it is optional, then fine. In our house it is optional whether or not the kids eat cauliflower. We offer it to them, and if they decide against it, it was their decision to make.
However if some food, or supplement or medicine is important and not optional, then don’t let the child win. You are the mom. Based on your love for your child, and your wisdom, you have decided that he must swallow this spoonful of yuk. If your tone of voice is pleading, or whining, or worried, or frantic, then a smart child will know that this is a confrontation that he can win. You must use your deep stern voice, the voice that means business. Make the obedience short and quick, only one swallow if you can manage it. You must not waver on your insistence on this spoonful (or syringeful) of stuff
If you already have a history of the child winning these confrontations, then you have some work to do to regain your authority. So, make the next time different. Use a different location. Use a different serving utensil. Use a different medium to mix the stuff in. Or, bring dad into the picture. And only choose as big a battle as you are sure you can win.
I don’t usually go into psychology, but sometimes it it helpful, so let me digress here a bit and mention some Skinnerian psychology. If you want to untrain a habit in your child, you need to understand the dangers of intermittent reinforcement. The Internet is full of info on intermittent reinforcement, but here is one link:
The interesting thing that Skinner discovered about intermittent reinforcement and maybe one of Skinner’s most important discoveries was that behavior that is reinforced intermittently is much more difficult to extinguish than behavior that is reinforced continuously. “This is why many of our student’s undesirable behaviors are so difficult to stop. We might be able to resist a child’s nagging most of the time, but if we yield every once in a while, the child will persist with it.” (Crain, 187) [emphasis added]
If you only sometimes reinforce your son’s refusal to take his supplements by letting him succeed, then it will be even harder to get him to stop his behavior of refusing. You must succeed every time, because every time you don’t will make it even harder the next time. If you decide to train him to swallow what is on your spoon, then you are making your job much more difficult if you once or twice relent and let him skip the supplements this time. Psychologists predict that with intermittent reinforcement, the negative behavior will get worse and more intense, and not get better.
Now, let’s look at long term supplement taking. It is just worth the effort to teach our kids to swallow pills.
Here are some suggested steps to teach a child to swallow pills.
- Get the Oralflo Pill Swallowing Cup Watch that picture sequence on their home page. Doesn’t that make it look easy?
- Begin to teach him to drink from this cup without any pills in it. Just put in his favorite juice.
- While he learns to drink from the cup, introduce some pill-sized candy to him, not to take as a pill, but just to become comfortable with. Let him have these occasionally so that he knows that they taste good.
- Now, try a piece of the candy in the oralflo cup. If he swallows it down, great. If he is able to trap it in his mouth, then there is no harm done. Just keep practicing until he can swallow the candy with a swig of his juice.
- Only after he is able to reliably swallow a small candy should you risk a nasty pill. He should have repeated successes at swallowing candy before he risks the trauma of some nasty pill dissolving in his mouth.
The Oralflo cup is optional. I taught all my kids to swallow pills without it. But, it sure looks like it makes like easier.
In the short term, change your tactics and make sure that you only reinforce behavior from your son that you want to keep. Divide it into smaller steps. Practice behavior that he can succeed at and that you can reinforce. I think it is worth the time here to do this right. The short term benefit of occasional ginkgo is not worth the long term ability of your son to thwart your good intentions for his health.
In the long term, teach that boy to swallow pills.
Filed under: diet, feeding, Health, home life, nutrition | Tagged: changing minds foundation, Down Syndrome, gingko | 1 Comment »