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A habit cough is a cough that occasionally develops in children after a cold or other airway irritant.
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Indications
Habit cough is characterized by a harsh tinny type sound, and becomes persistent for weeks to months. The cough's hallmarks are severe frequency, often a cough every 2-3 seconds, and the lack of other symptoms such as fever. The diagnosis is made when the child falls asleep and the cough stops completely. Any other pathologic cough will not totally stop at night. The child can have trouble falling asleep but once asleep will not cough.
Treatment
The treatment does not involve medicines. Cough medicines, even opioid ones are ineffective as are inhalers or steroids. The child will often begin to miss school and other activities due to the cough. Most of the time these children are not psychologically abnormal, but the cough can be a source of secondary gain.
Successful treatments have involved self-hypnosis, speech therapy, and a brief course of suggestion therapy outlined in the Annals of Allergy, Volume 67, December 1991, pp.579-83 (Lokshin, MD, et.al.) With suggestion therapy, the patient was given a distractor (lidocaine nebulizer) while being told by a physician (authority figure) that he/she can control the cough with this exercise, and that the cough is just vicious cycle where the initial irritant that caused the cough is gone but the urge to cough continues the irritation.
Then starting with 3 seconds the child is asked to hold the cough for that amount of time. After success the amount of time the child is asked to hold his breath is increased to 5 seconds, 10 seconds, etc. up to 60 seconds. When the child gets to 60 seconds usually the desire to cough is gone and the child congratulated on controlling the cough. Follow-up sessions can be done at home with the parent using chloroseptic spray as the distractor. In the study in the Annals of Allergy, some children who coughed for months were stopped in one session. If short therapy does not work refer the child to a psychologist.
See also
References
- "Outcome of Habit Cough in Children Treated with a Brief Session of Suggestion Therapy," Boris Lokshin, MD:Scott Lindgren, PhD; Miles Wineberger, MD; and Jean Koviach; Annals of Allergy, Volume 67, December 1991, pp. 579-83.
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- Irwin, RS, Glomb, WB, Chang, AB (2006). "Habit Cough, Tic Cough, and Psychogenic Cough in Adult and Pediatric Populations.". Chest 129 (1 Suppl): 174S–179S. doi:. PMID 16428707.[1]
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- This page was last modified on 20 June 2008, at 18:45.
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