Beyond the B.A.S.I.C.S. Blog

Nail Biting Interventions

October 3, 2011


FOR PARENTS:

–        Check for yeast problems in your child – children who are overwhelmed with yeast tend to bite and gnaw on themselves (and other things).

–        Proactively offer your child a manicure set and praise him/her for using it appropriately.

–        Proactively offer hand lotion to keep hands soft and less likely to develop broken nails or hang nails.

–        Apply a jingly bracelet or strong smelling perfume to your child’s hands to make him/her aware of hand movements.

–        Talk to your doctor about trying a B-vitamin supplement (inositol) – it helps to decrease anxiety and obsessive behaviors, and is water soluble.

–        Talk to your doctor about trying an SSRI (antidepressant) – they have shown up to 65% improvement in obsessive behaviors including nail biting.

–        Promote self-monitoring: praise your child when he/she notices nail biting and stops on his/her own.

–        Offer sensory input throughout the day (not just when you see your child biting): hand squeezes, nail bed squeezes, fist clenching, etc.

FOR THERAPISTS:

–        Rule out any medical causes first (yeast infection, problems with teeth, gums, or mouth, etc).

–        Teach competing responses at one and three minute intervals.

–        Differentially reinforce nail growth.

–        Implement a sensory diet.

–        Implement a response cost.

–        Create a social story explaining the potential dangers.

–        Teach appropriate nail grooming techniques.

–        Teach fine motor skills (bead work, knitting, typing).

–        Teach a socially appropriate replacement behavior (chewing gum, a toothpick, disposable “wisp” toothbrush, etc).

–        Teach self-regulation techniques.

 

SOURCES:

–        “Onychophagia: Compulsive Nail Biting,” M. Williams, PhD, BrainPhysics.com.

–        Augmenting simplified habit reversal in the treatment of oral-digital habits exhibited by individuals with mental retardation,  Long, ES, Miltenberger, RG, Ellingson, SA, and Ott, SM, 1999: JABA 32, 353-365.

–        Evaluating the duration of the competing response in habit reversal: a parametric analysis, Twohig, MP and Woods, DW, 2001: JABA 34, 517-20.

 

Melissa L. Ruiz, BCaBA

BASICS ABA Therapy, LLC

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