Training acceptance of bad-tasting medications
(published to the PCEM list)

Target elephant in position allowing delivery of medication paste or liquid via blunt syringe to the mouth

Allow elephant to see, feel, smell, hear and possibly touch (on its own) medication syringe

Assemble a variety of good tasting items to fill syringe with during training

• Using good tasting items, teach the medication process, including:
• Targeting for a duration of up to a minute
• Maintaining firm target contact while syringe is brought to lips and put in position
• Maintaining firm target contact while various liquids are delivered -
• At this point, start isolating and naming concept of swallowing liquid or paste
• Preferentially bridge for swallowing, and for the elephant moving into better position to be able to capture all liquid,
• Negate when any substance escapes,
• Make it a challenge - try to make some liquid escape
• Name "swallow" - identify as the desired endpoint
• Name "dribbling" (or maybe "spitting") - identify as an undesired endpoint
• Name various substances. Identify which the elephant prefers and name these "tasty" or some such descriptor

When elephant is proficient at the above, assemble some harmless but neutral and not-so-good tasting substances to train with, such as:

• Water
• Carbonated water
• Tonic water
• (Mild) hot sauce
• Coffee, various flavors and strengths
• Dissolved supplements

Introduce each substance and name, and pay the elephant for maintaining criteria:

• Maintaining firm target contact
• Allowing introduction of substance
• Swallowing introduced substance

If the elephant starts to withdraw from contact, withdraw yourself - further, and initiate a time out (for a few seconds- you can just look down if the elephant stops but does not withdraw from the target). Act as mirror of the elephant, approaching as the elephant approaches the target, withdrawing as the elephant does. Do not change the fluid, do not apologize for the substance.. Name the substance. Intermediate bridge for staying on target, accepting the substance and terminal bridge for swallowing the substance. Wait the elephant out, if necessary, till you get compliance. This can be done in short sessions outside normal training time, so that any necessity to time out does not dash the rest of your training goals.

As the elephant accepts the neutral and mildly distasteful substances, bridge and praise for swallowing and keeping all introduced substance.
Compare the tastes of the preferred to the non-preferred substances. Introduce the descriptors "bland" and "crummy" or some such identifiers. Randomly present, with naming, the substances, but the less desirable the taste, the greater the reward

Working with the vets, assemble some foul-tasting substances to use for training. These might be actual medications that might need to eventually be used, although probably in small doses for training purposes.
Introduce each new substance, naming it, and requiring the elephant maintain firm target contact, acceptance and swallow of substance

If the elephant reacts to the taste, apply a fourth descriptor, such as "foul", decrease the increment, and bridge and praise generously for the elephant agreeing to take the substance despite its taste. The first tiny acceptance of an actual aversive taste could warrant a treat
jackpot and the end of the session. It could also warrant a preferred substance, delivered just as the foul tasting stuff was, to keep the apparatus a positive, or at least a neutral stimulus. It could also warrant a taste chaser, such as a mint, a tic tac, or peanut butter, to help the elephant get rid of the undesired taste. The various substances used to mask medications might all serve to dispel the taste of the unmasked medication, after it is consciously accepted by the elephant.

Do not try to cover the taste of the substances during training. Instead, label them with specific names and "category of taste" names (tasty, bland, crummy, foul) and show that the worse the taste is, the greater the reinforcer. Be inexorable about not dropping the process, even if the elephant times you out frequently when the foul tasting stuff is first introduced.

Once the elephant will agree to take "foul" substances, for maintenance, substances can be randomly presented, a la blunt medication syringe, and "foul" tasting things can be followed by favored substances and by things to dispel the flavors.

Harvest at end of training plan:

• Competency and compliance in getting substance from syringe
• Identification of limits of behavior (dribbling and spitting not allowed)
• Identification of "swallow" and assignment of a cue
• Vocabulary expansion to include various taste identifications, and the concepts "tasty", "bland", "crummy" and "foul"
• Conscious appreciation of a sliding pay scale, depending on relative taste of substance

Further applications:

• Relative desirability of substances can be charted and might give insight for preference and expansion of reinforcers
• The above process might contribute to the training of other care procedures, such as tooth examination and brushing (with toothpaste?), and
• Medication of the head area with ointments or other liquids or pastes, acceptance of aversive smells from topical medications

Plan by Kayce Cover contributions by Inge Teblick, Julie Alexander

Copyright 2002 Kayce Cover