Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: a systematic review.
Skin-picking is a type of self-injurious behavior involving the pulling, scratching, lancing, digging, or gouging of one's own body. It is associated with social impairment, and increased medical and mental health concerns. While there are several reports showing that skin-picking is common in individuals with developmental disabilities, knowledge about effective treatment approaches is sparse. We therefore reviewed studies involving the treatment of chronic skin-picking in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 16 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) functional assessment procedures and results, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 19 participants aged 6-42 years. Functional assessment procedures included direct observations, analog functional analyses, and functional assessment interviews. The most commonly identified function was automatic reinforcement. Treatment approaches included combinations of differential reinforcement, providing preferred items and activities stimuli (e.g., toys), wearing protective clothing (e.g., helmets or gloves), response interruption and redirection, punishment, and extinction. Improvements in behavior were reported in all of the reviewed studies. Suggestions for future intervention research are offered.
Lang
Russell
R
The Eli and Edythe L. Broad Center for Asperger Research, University of California at Santa Barbara, CA 93106-9490, USA. russlang@education.ucsb.edu
Didden
Robert
R
Machalicek
Wendy
W
Rispoli
Mandy
M
Sigafoos
Jeff
J
Lancioni
Giulio
G
Mulloy
Austin
A
Regester
April
A
Pierce
Nigel
N
Kang
Soyeon
S
D001321:Autistic Disorder / Q000150:complications / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002908:Chronic Disease; D002658:Developmental Disabilities / Q000150:complications* / Q000628:therapy*; D006801:Humans; D011218:Prader-Willi Syndrome / Q000150:complications / Q000628:therapy; D012652:Self Mutilation / Q000209:etiology* / Q000628:therapy*; D012867:Skin / Q000293:injuries*