Treating aerophagia with contingent physical guidance.

Allen et al. (2001) worked with one person who kept swallowing air. The behavior is called aerophagia. It can cause pain and bloating.

Every time the client swallowed air, the therapist gave a quick physical prompt. The prompt gently blocked the swallow. Later they added a wristwatch. The watch became a new cue to keep the behavior low.

Physical guidance cut the air-swallowing to almost zero. When the team faded the touch prompt, the behavior stayed low. The wristwatch alone kept the client on track.

Steege et al. (1989) did the wristwatch trick first. They used watch beeps to remind wheelchair users to do pressure-relief push-ups. D et al. copied the idea but swapped the behavior: instead of adding a healthy act, they blocked a harmful one.

Romanowicz et al. (2025) pushed the idea further. They sent real-time smartwatch prompts to parents during telehealth. Parents answered in under four seconds and used PCIT skills before tantrums grew. Same wearable cue, new job—parent coaching instead of self-management.

Martens et al. (1989) also used prompt fading. They taught deaf-blind students to pack items using only tactile cues. Both studies show you can pull the prompt away and still keep the gain, as long as you transfer control to a new stimulus.

You can copy the wristwatch transfer with any discrete cue. Pick a behavior you want to kill, like finger-biting or shirt-chewing. Pair a quick physical block with a small wearable item. Fade the block but leave the item on. The cue keeps the suppression alive long after you stop touching the client.