Beyond the B.A.S.I.C.S. Blog
Nail Biting Interventions
October 3, 2011
– 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.
– 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.
– “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