Bye-Bye Pacifier: 6 Steps to Help Your Child or Client with Autism Stop Using a Pacifier!

Mary Barbera Autism ABA Pacifier

By Mary Barbera, PhD, RN, BCBA-D (Autism Mom, BCBA-D & Best-Selling Author)

Is your child or client with autism addicted to a pacifier?

Many children, especially those with behavioral issues frequently use pacifiers well past infancy. Their parents struggle with what to do about it so to keep them quiet and happy, they usually give in and “plug the child up” with a pacifier.

Older children can also be addicted in the same way to a bottle. Both bottles and pacifiers are both really bad for toddlers and older children because they hamper talking, increase problem behaviors for items, and can be detrimental to normal teeth development (both baby and adult teeth).

These steps should help with weaning your child from a pacifier or bottle if you are not willing or able to go the “cold turkey” route.

  • Assess (rate of use, times of day when your child most needs it and when you most need it–ie nighttime, car rides, church, etc.)
  • Make a plan with boundaries to wean based on your assessment (I will only feed via a bottle 4 times/day, she will only have a pacifier at nap/nighttime in the car and at church, I will only give one bottle at night when I’m at home sitting in a certain rocking chair).
  • If your child likes/has more than one bottle/pacifier, hide or dispose of all others (so they can’t stash them or accidentally find one during non-pacifier times). If you want to keep one pacifier in bedroom and one in the glove compartment of the car, that is fine….you just need to have one or two and maintain control of them.
  • If you are going to wean to just using the pacifier at nap/nighttime for instance, create a “Binky Box” to be stored on the high shelf in the closet that the child puts it in the morning or naptime after waking. Don’t take the pacifier and hide it or make it disappear. Instead, have the child put it in the “Binky Box” or “Paci Box.”
  • Give a strongly preferred edible or toy for giving up the pacifier and putting it into the box.
  • For bottles give the least preferred drink in the bottle and the most preferred drink in a cup. Also pair cup with highly reinforcing videos during non-bottle times.

While your child or client probably will not understand your complex plan, even infants will respond to reinforcement and other behavioral procedures.

If your child is ever crying while trying to access these items, do not give it to them.

Also if they are crying or having problem behaviors while accessing any reinforcement (including blankets, pacifier or bottles) take the item away for at least a few seconds to show her/him that crying will not work!

At the very minimum, children should not have access to pacifiers, blankets, or bottles on demand at any time of the day or night. They need you to help them with boundaries!

Assessing, planning and taking action may be emotionally taxing to you and your child so it’s OK to pick a less stressful time to implement all of this such as after the holidays, when the other siblings go back to school, after a vacation is over, etc.  The important thing to remember is that with these 6 steps you can tackle the pacifier problem and help your child.