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Am J Dis Child. 1991;145(11):1227. doi:10.1001/archpedi.1991.02160110017010.
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In Reply.—I appreciate Szonyi's comments on her method of treating thumb-sucking, which certainly seems successful. Missing, of course, are supportive data, but she is not offering her comments as a scientific report. Should she need empirically derived support for her method, she need go no further than the nearest behavioral journal focused on analysis, modification, or therapy. Her method sounds similar to "time-out," a procedure involving contingent removal from reinforcing conditions. Time-out has been used effectively for a variety of child behavior problems and its use is often discussed in behavioral journals.

The primary advantage of the method I described is its privacy. Use of Szonyi's method makes a child's thumb-sucking and its treatment public. Given the potential risk that chronic thumb-sucking poses to selfesteem, a health care provider should weigh carefully the potential costs and benefits of such public intervention.

Finally, Szonyi's letter is something of a non sequitur because


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