Use of escape and reward in the management of young children during dental treatment.

The team worked with five preschool kids who screamed, hit, or tried to leave the dentist chair.

Before the real drill, each child got a three-minute practice round. They earned stickers and praise for lying still. They also learned they could ask for a five-second break by raising a hand.

The dentists used a multiple-baseline design. They started the program at different times for each child to be sure the change came from the practice, not just growing up.

Disruptive behavior dropped from about 90% of the visit to under 15%. Heart-rate and sweating also went down.

The gains lasted for the whole study and moved to the real drill without extra training.

Bryson et al. (2024) later used the same escape idea, but for dressing skills in older clients with developmental delays. Both papers show that letting the person "take five" cuts problem behavior across very different tasks.

Bickel et al. (1984) used padded helmets instead of escape and saw a similar big drop in self-injury. The two studies together tell us that simple, non-punishing fixes—gear or brief breaks—can give large, fast relief.

Junaid et al. (2021) also used a multiple-baseline design, yet they targeted college students’ step counts with self-management. The shared design strengthens our trust in single-case methods, even when the age and goal change.

You can copy the three-minute recipe tomorrow. Run a short practice, deliver stickers and praise, and promise a quick break signal. It works for dentist visits and any clinic task that scares kids. The same escape rule also applies to dressing, helmet use, or any procedure where the child wants out. Build in an easy exit and you usually get more cooperation and less crying.