In a recent study, CARD researchers Averil Schiff, Dr. Jonathan Tarbox, Taira Lanagan, and Peter Farag found behavioral intervention to increase compliance with liquid medications in a child with autism spectrum disorder (ASD). Children with ASD often have trouble taking medications in both pill and liquid form. For this reason, CARD researchers set out to evaluate the effectiveness of behavioral intervention in improving compliance with liquid medications in a child with ASD.
The participant was Lukas (fake name), a 3-year-old male with ASD. Like many children with ASD, Lukas refused to take liquid medications. This concerned his mother since Lukas frequently experienced ear infections that required the administration of antibiotics. To increase Lukas’ compliance with liquid medications, behavioral intervention procedures involving positive reinforcement and stimulus fading were implemented.
During the treatment phase, liquid medication administration was broken down into many steps, which were gradually introduced as Lukas’ compliance improved. For correct responses, Lukas was provided positive reinforcement in the form of candy or toys. Furthermore, to improve Lukas’ tolerance to liquid medication, stimulus fading was used to:
- Increase the amount of time the empty syringe was visible.
- Increase the amount of time Lukas was required to open his mouth.
- Decrease the distance between Lukas and the syringe.
- Increase the amount of water Lukas was required to take from the syringe.
- Increase the ratio between placebo medication and water in the syringe.
- Introduce dosages of real liquid medication.
- Introduce Lukas’ mother as the medication provider while reducing the presence of clinicians.
Lukas displayed 0% correct responding during baseline sessions, however, once treatment was initiated, Lukas’ correct responding increased to 100%. Furthermore, at the end of treatment, Lukas’ mother was able to successfully administer liquid medication without a clinician present.
These results suggest that behavioral intervention may be effective in improving compliance with liquid medications in children with ASD. These findings are significant since refusal to take medication is a serious problem faced by many families.
Schiff, A., Tarbox, J., Lanagan, T., & Farag, P. (2011). Establishing compliance with liquid medication administration in a child with autism. Journal of Applied Behavior Analysis, 44, 381-385. doi: 10.1901/jaba.2011.44-381