Why won’t they take their medication and what can I do?

You have just worked really hard, invested a lot of time and money into getting your child assessed. You finally have a diagnosis and a treatment plan, and one part of the treatment plan includes medication. Of course, as a parent, you have feelings about giving your child medication. It is, after all, putting a chemical in your child’s body. But, you work through those feelings, and you are now ready to start the treatment. Suddenly, you face yet another obstacle. Your child or teenager stands before you, refusing to take the medication. What to do?

The first step we need to take is to understand why they are resisting the idea. Understanding the underlying reasons for their refusal can help us address this issue effectively. Research in the field of pediatric healthcare sheds light on some common factors contributing to children's reluctance.

One key aspect is the fear of the unknown. Children's developing brains process new experiences with heightened sensitivity, leading to aversions and apprehensions towards unfamiliar tastes or textures. Additionally, negative associations with previous medical encounters might influence their perception of medication.

Moreover, children seek autonomy and control over their actions. When faced with medication, the lack of choice can lead to resistance. Giving them some control, like allowing them to choose flavors or forms, can significantly increase compliance.

Understanding these factors allows us to approach the situation with empathy and patience. By explaining the purpose and benefits of medication in a positive and age-appropriate manner, we can foster trust and open communication with our children. Mixing medication with soft food and employing reward systems can further encourage compliance.

Caring for a child's health encompasses not just physical well-being but also understanding the intricate workings of their developing brain. Neuroscience research reveals that a child's refusal to take medication is often a reflection of their natural instinct for self-preservation. Their growing brains process new experiences and stimuli with heightened sensitivity, leading to aversions and fear of the unknown. By empathetically acknowledging their hesitancy, we can foster an environment of trust and open communication, encouraging them to embrace their medication as an essential step towards nurturing their brain and overall health.

Research suggests that the best way to help children take medication involves a combination of strategies that address their unique needs and concerns. Here are some evidence-based approaches:

1. Positive Communication: Engage in open and honest conversations with your child about their medication. Explain the purpose of the medication and its benefits in age-appropriate language. Encourage them to ask questions and express their feelings.

2. Involve Children in Decision-Making: Giving children some control and autonomy over their medication can improve compliance. Allow them to choose the flavour or form of the medication when possible, and involve them in creating a medication routine.

3. Use Pill Swallowing Techniques: For children who have difficulty swallowing pills, consider breaking tablets into smaller pieces or using liquid formulations. Always consult with healthcare professionals to ensure safety and efficacy.

4. Combine Medication with Food: Mixing medication with soft food, like yogurt or applesauce, can make it more palatable for children, especially if they have taste aversions.

5. Implement a Reward System: A reward system, such as a sticker chart or earning points for each successful dose, can motivate children to take their medication consistently. After reaching a set goal, reward them with a predetermined incentive.

6. Maintain a Consistent Schedule: Create a medication routine that aligns with your child's daily activities. Consistency can help children remember when it's time to take their medication.

7. Explain Possible Side Effects: Prepare children for any potential side effects they might experience. Honest and transparent communication can ease their anxiety and help them understand the temporary nature of side effects.

8. Use Medical Play: Encourage medical play, where children can practice administering medication to a doll or stuffed animal. This play helps them become more comfortable with the process.

9. Ensure a Positive Atmosphere: Keep medication time positive and stress-free. Avoid expressing frustration or negativity, as this may increase their resistance.

10. While it’s not a first choice; when all else fails, we sometimes do need to use a system of consequences. As a clinician, I value creating experiences for children and teenagers that reflect real life. I believe we owe that to our children as otherwise they step into real life and become terribly shocked when consequences arrive at their feet.

In adult life there are consequences if you do not do what society expects of you. You can not for example just go as fast as you want in your car. You do need to find a way to earn an income, if you are fit for work. The list goes on, right? So sometimes, when children are resistant to medication, it is okay to say , “You have a choice. Would you like to not take your medication and not have your device, or would you like to take your medication and still have access to your device today?”

11. Seek Professional Support: If a child's refusal to take medication persists, seek guidance from healthcare professionals, such as pediatricians, child psychologists, or child life specialists. They can provide personalised strategies and support as each child will have their own unique set of circumstances, and sometimes it does take a professional to help you understand why and support you and your child/teen as you implement strategies.

By combining these evidence-based approaches, parents can create a supportive and encouraging environment to help children take their medication with greater ease and compliance.