Improving adherence to medication regimens for children with asthma and its effect on clinical outcome.

Two elementary-age kids with asthma kept forgetting their inhalers.

The team paired a five-minute lesson with a simple token board.

Every on-time puff earned a sticker; full cards traded for small toys.

They flipped the plan on and off four times to be sure it worked.

Sticker boards made both kids take every dose.

One child also breathed better on the lung test.

When tokens stopped, doses dropped; when tokens returned, doses rose again.

Rojahn et al. (1987) got the same pattern with an 11-year-old girl doing chest therapy.

Both studies used ABAB reversals and saw big jumps in daily health steps.

Petursdottir et al. (2019) push the idea further.

They added a function check and then faded the tokens while gains stayed high.

That gives you a road map for keeping inhaler habits after the stickers end.

You can run this in one clinic visit.

Teach the family why puffs matter, hand over a token board, and review weekly.

No fancy gear, no meds changed—just behavior.

Try it with any child who leaves the inhaler in the backpack.