Candy or Medicine: Can Children Tell the Difference?

Monday, October 17, 2011: 1:45 PM
Commonwealth Ballroom (Westin Waterfront)
Casey L. Gittelman1, Eleanor Bishop1, Michael Gittelman, MD2 and Terri Byczkowski2, (1)Ayer Elementary School, Cincinnati, OH, (2)Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Purpose: To determine if adult teachers could distinguish between candy and medicines more frequently than kindergarten youth and to elicit if there are characteristics of medicines that make them more difficult to separate from candy.

Methods: A convenience sample of 30 kindergarten students was chosen from one suburban elementary school for inclusion. If a student met exclusion criteria (eg. a child with special needs designated by the teacher), another student was randomly chosen to take their place. 30 teachers from the same institution were randomly chosen to participate as the comparison group. A medicine cabinet with 20 candy-medicine look-alikes supplied by the Cincinnati Drug and Poison Center was used. A survey was developed for students and teachers that included information about their background (such as age, gender, storage of medicine in home, daily medicine usage) and a chart that listed the subject’s responses when asked which item from the candy-medicine look-alike groups was candy. Teachers provided investigators with information about each students reading ability. Mean percent correct of determining which item is candy out of the 20 items by students was compared to adults. To see a difference of 20%, a sample of 30 subjects in each group was needed to give a power of 90%.

Results: 30 teachers (25 female, 5 males) and 30 students (16 female, 14 male) were surveyed. 17 teachers took medicine daily compared to only 4 students. Mean percent correct by teachers was 77.6% (range 50%-95%) vs 70.5% (range 20%-85%) by students (p-value = 0.05 ).  For students who could not read, designated by the teacher (n=22), percent correct was 67% (range 20%-85%) compared to those who could read (n=8) 79.3% (70% vs 85%). Medicine-candy combinations most commonly mistaken were: Coricidin/M&M 43%), Mylanta/Sweetart (53%), Sine-off/Reece’s Pieces (50%), and Tums/Sweetart (53%). Characteristics of combinations most frequently mistaken: circular objects, similar in color and shine, no distinguishable markings. When asked about safe storage of medicines to both groups, 47 (78%) did not store medicines locked and out of reach, 6 (10%) did, and 7 (12%) were unsure.

Conclusion: Teachers and kindergarten students have difficulty distinguishing medicine from candy. Children who are unable to read may have more difficulty identifying candy from medicine compared to their peers who are able to read. Medicines that are circular, shiny, and have no identifiable markings are often more likely mistaken for candy. Most teachers and students do not store their medicines appropriately in their home. Interventions to educate families about safe storage of medicines and manufacturing medicines to have distinguishable appearances may help to reduce unintentional ingestions to youth.