The Use of Suggestion and Behavioral Methods in the Treatment of Aerophagia

Abstract

Aerophagia is a stereotypic air swallowing that is rarely observed among non retarded children and adults. A possible explanation for aerophagia lies in the concept of automatic reinforcement. Repeated air swallowing produces outcomes that, if perceived as pleasant or relieving, could serve as reinforcing stimuli. A number of behavioral approaches have been used to reduce or eliminate this symptom. Partial positive results have been reported using response satiation, overcorrecting, DRO, response cost and contingent visual screening. Two cases of treating aerophagia in children are presented. In the first, treatment combined suggestions, covert desensitization and positive reinforcement of non aerophagic behavior. Four meetings resulted in complete elimination of the symptom. In the second case, the child was taught a response that was incompatible with air swallowing. Differential reinforcements were used for the “correct” versus the aerophagic response. Daily practice of 2-4 hours resulted in meaningful reduction of the aerophagic response. Treatment is continuing meanwhile, using the same procedure.