Sir, sucking of the thumb, digits or dummies is common childhood behaviour, which has an adaptive value for children up to the fourth year of life. A chronic prolonged habit may cause deleterious effects on dentofacial structures. A wide range of methods have been used for helping children quit their habit. They are generally categorised as operant procedures and sensory attention procedures. The operant procedures include contingency reinforcement and reframing. The sensory attenuation methods tend to interrupt the sensory feedback experience with the sucking habits either by appliance therapy or response prevention.

We would like to share our experience of using a concept of psychotherapy called reverse psychology, or symptom prescription, in treating children with a thumb sucking habit.

Symptom prescription is a technique whereby you address the symptoms that someone brings to therapy by encouraging them in some way to engage in those symptoms.1 It helps in solving the problem by prescribing the very behaviour which has been viewed as the problematic one.2 It is generally believed that appliance therapy might not be really effective unless the child really wants to quit the habit, as they can always create newer ways to continue the habit. Dunlop beta hypothesis, a technique used in treatment of thumb sucking, is probably based on this concept. Each child is made to sit in front of a mirror and asked to suck his thumb, observing himself as he indulges in the habit. If he can be forced to concentrate on the performance of the act at the time he practises it, he can learn to stop performing the act. Children were asked to repeat the same in their home for an hour every day for one week and to report for re-assessment. Forced purposeful repetition of a habit eventually associates it with unpleasant reactions and the habit is abandoned. We believe that children aged five and above, with adequate cognition, could be helped to quit their bad habits and reinforce good oral habits, if this technique can be used the right way.