Behavioral interventions for children biting their nails paper

Overview of intervention

            Habitual nail biting is a disorder prevalent in children and often persists into adulthood. The nail biting behavior can not cause impairment but if frequently done it can become a nuisance and if not controlled it can cause health problems like skin infections or damage to the tissues. There are several things that can be done to eliminate or reduce a behavior interfering with normal life. There are ethical concerns that arise as a result of using these approaches and techniques such as punishment and extinction. The ethical concern have made the researchers in human behavior come up with appropriate procedures for addressing the problematic behaviors in a humane and ethical manner. These ethical approaches emphasize on the use of reinforcements (awards, gifts, presents, money, coupons, and many others) to increase the occurrence of the desired behaviors. The methods also encourage the use of eliminations and extinction to reduce or eliminate the unwanted behaviors.

            Behavioral modification of presently known as applied behavior analysis (ABA) is the systematic application of interventions basing on the principles learned in theory to influence the behavior to a meaningful degree. These interventions can be applied to a child who constantly bites his or her teach to correct the disorder. To correct the nail biting behavior in children, this study is going to use differential reinforcement approach. Differential reinforcement approach is the most commonly used principle in ABA. The differential reinforcement approach allows the use of reinforcements for behaviors when the said behaviors occur in some occasions but the reinforcements are not used when the behaviors do not occur on other different occasions from the previous ones. The approach uses discrimination in achieving the end result for a given task. Discrimination allows the person to behave one way in a given situation and in another way in another situation. There are four procedures that use reinforcements to treat and address the undesired behaviors. They include differential reinforcement of other behavior (DRO), differential reinforcement of low rates of responding (DRL), differential reinforcement of incompatible behavior (DRI), and differential reinforcement of alternative behavior (DRA). The above methods have the goal of reinforcing the targeted behaviors that are easily adaptable than the intrusive behavior. The following is a discussion of above differential reinforcement approaches

Differential reinforcement of other behavior (DRO)

            DRO is a procedure that allows the use of reinforcements when the target behavior by the therapist is not displayed for a given period of time. The method only allows the therapist to use reinforcements when there is zero occurrence of the targeted conduct. DRO is the simplest approach that can be used to treat the problem of nail biting in children because the therapist only reinforce when the child bites the nails. It aims at reinforcing the absence of the misbehavior. The therapist is always on the look for of nail biting and come in with the corrective mechanism, otherwise no action is taken.

Differential reinforcement of incompatible behaviors (DRI)

            The approach allows reinforcing behaviors that are physically incompatible with the behaviors which the teacher does not desire. It allows use of reinforcements for behaviors which when they occur makes it physically impossible to perform the undesired behavior. Examples of inappropriate vs. incompatible behaviors.  Hand-in-mouth while sitting at the table vs. using fork and knife. Shouting loudly in class vs. quietly raising hand to speak. Removing clothes vs. keeping clothes on. Hitting peers vs. sharing/giving items they want. Talking about bizarre things vs. talking about current events. Keeping eyes on the teacher vs. looking out the window. Fighting with peers vs. walking away from peers .Picking nose vs. using a handkerchief to blow nose.

Differential reinforcement alternate behaviors (DRA)

            The approach is similar to DRI because they both reinforce the appearance of an alternative behavior chosen for reduction of the unwanted behavior. DRA approach allows the use of reinforcement for the alternative desirable behavior. The procedure involves developing the behaviors which are options to responding in an inappropriate way. The difference between DRA and DRI is that DRA does not necessary chose an alternative behavior that is incompatible with the undesired behavior. The use of DRI/DRA permits you to exert the greatest amount of control over the undesired target behavior without intervening directly on the undesired behavior. This control occurs because the appropriate and inappropriate behavior cannot occur at the same time, since they are physically and/or functionally incompatible. Thus, a DRI is really a combination of a DRO and a DRA and represents a very powerful procedure for teaching new skills.

Differential reinforcement of lower rates of behavior (DRL)

            The procedure develops a criteria for displaying the unwanted behavior allowing the occurrence of the unwanted behavior but under a specified rate. The method is used to slowly lower the occurrence of the undesired behavior. A reinforcement is allowed when the number of occurrences of the unwanted behavior is lower than the prescribed limit. The principle for using this approach is based on the belief that the behavior itself is not a problem but the frequency with which the behavior occurs is the problem. The child receives a reinforcement if he or she does not exceed the set limit.

An example can be used for this case. If the children bite their nails ten time in an hours, DRL procedure can be used as follows. The teacher can state that the reinforcement can be given to the children if they are able to bite their nails 5 times in an hour. If the mark is cored by the child the teacher can then reduce it to 3 times in every hour. Then twice in every hour until the desired number of times is attained. In this method of DRL it can be seen that the unwanted behavior is eliminated slowly as the child gains control of the new behavior. There are no efforts by the teacher to eliminate the nail biting immediately but focus is on reducing the number of times. The gradual reduction is desirable, since many children with nail biting exhibit high rates of behaviors that have occurred for a long period of time and are well ingrained into the child’s behavioral repertoire. By allowing the behavior change to occur at a low rate, the student gradually learns that alternative behaviors are reinforced by the absence of particular undesired behaviors. Moreover, as in the nail biting situation, it is not desirable to totally eliminate the behavior.

Summary of application of interventions in Different populations and settings

            The success of the differential reinforcement approaches depends on how effective they are applied. The success depends on how often the reinforcement for the child is given. In the case of treating the nail biting behavior, the reinforcement can only be given is the child does not bite his or her nails within the prescribed procedure. The following is a summary of the application procedure that can be applied in different populations and settings and treat the nail biting problem.

            First, data relating to the number of times the children bite their nails should be collected. It forms the baseline data which is kept to keep the track record as well as to tell the number of times differential reinforcement procedures should be scheduled. The selection of an effective time interval is very important and it can only be set effectively is all the necessary data is collected. Setting the time interval arbitrary can affect the attainment of the expected result. During baseline, the time between the children biting the nails is recorded and an interval should be selected to establish when to give the reinforcement when the children do not bite their nails.

            For example, the teacher can collect baseline information on the children biting their nails for five days.  Let us say the finding of the baseline data indicate that the child bites his nails at an interval of four times in a hour. The teacher then records the time of day when the children bite their nails and determine the average. Basing on the findings, the teacher can then set the differential reinforcement schedule.

In the above example, it may be determined ahead of time that any aggressive behaviors will result in the interval being extended without reinforcement. So, if the target behavior is “not biting nails” and during the interval the child bites her nails, she would not receive reinforcement during that interval. The problem is that the child may not receive sufficient reinforcement during the interval to allow discrimination to occur as to when and under what condition she will receive reinforcement. Thus, the DRO procedure may lose its effect.

            Second, the procedure for increasing the differential reinforcement interval should be established. The best way to go about it is by starting by a smaller interval so that the children can get more reinforcements for not biting their nails. The interval should be set at one half of the baseline data collected on nail biting. Basing on the above baseline findings, the teacher can give reinforcements for not biting nails not more than twice in a hour. As the treatment proceeds the interval can gradually be increased basing on the data collected. If after two weeks the teacher determines that the child is able to only bite his nails twice in a hour without reinforcement, the interval can further be squeezed to once in a hour. The interval can continue to be squeezed as long as the teacher wants until there is zero appearance of nail biting. The increase in the length of the interval basing in the baseline data on nail biting indicates the level of success.

Third, specifically for DRI and DRA is the selection of the incompatible of alternative behavior. The teacher should select a behavior the children have which competes with nail biting that are physically incompatible. If selecting the behavior is a challenge, the teacher can narrow down to behaviors that are in the children’s response repertoire. The behavior must be a difficult one for the children that nail biting. For nail biting the teacher can choose an alternative behavior such as using a spoon during meal hours.

On selecting the alternative behavior, the teacher needs to reinforce it with greater frequency so that the children can easily use spoons when eating as opposed to fingers.  Analyze the environment to determine whether the undesired behavior serves some communicative function in the environment and select an alternative behavior that is functionally equivalent to the undesired behavior.

How can the success of intervention be measured?

            The success of the behavioral intervention for children biting their nails can be measure simply by observing the rate of nail biting. The success of the intervention methods can be determined in the early stages of the treatment by observing the progresses in interval length. An increase in the length of interval before a reinforcement is increased can indicate progress in mitigating the misbehavior. It is due to the fact that the adjustment of the interval length before reinforcing is based on the data collected that show how the child is performing. So, if the target behavior is “not biting nails” and during the interval the child bites her nails, she would not receive reinforcement during that interval. The problem is that the child may not receive sufficient reinforcement during the interval to allow discrimination to occur as to when and under what condition she will receive reinforcement. A reduction in occurrences of nail biting can mean success of the intervention method.

            Another way to measure the success of the intervention mechanisms is by setting time frames. Being able to meet goals of the intervention within the stipulated time is a clear indication of success. Nail biting is a problem that is mostly experienced during the young age so the mechanisms should be able to meet the goal before the child gets into adulthood. Giving the approach an indefinite time can lead to in appropriate conclusions about the effectiveness of the procedures.  

            On the interventions that focus on learning new behaviors such as DRI and DRA their success can be measured by determining the success in learning the new behavior. The behavior exhibited by the child after the session is over is enough evidence for the success of the intervention. The flexibilities that the interventions offer to the learner in acquiring the desired behavior can also be other factors to show how successful the interventions are in meeting the desired goals.

Overview of implication of such treatments or interventions

            The use DRO has the following implications. The use of DRO is very easy to use in any setting by the teacher of the new behavior. It allows the teacher to easily monitor the progress of nail biting and come up with the effective methods of intervening. The method also, allows the teacher to directly work with the child and help stop nail biting. It focusing on directly tackling the problem by reinforcing the wanted behavior. However, DRO has the following negative implications. It only focus on eliminating the unwanted behavior and it does not teach any appropriate behavior. Also, when using DRO the teacher might end up reinforcing negative behavior because a reinforcement is only given in the absence of a specifically unwanted behavior. The methods leaves the teacher open to awarding any behavior provided it is different from the unwanted behavior.

The use of DRI and DRA has the following implications. The methods focus on an approach that can be used to manage inappropriate and undesired behavior. They identify the mechanisms that can be used by the teachers of appropriate can use in handling the unwanted behavior. Therefore, at the end of the session it leaves the learner informed on how to tackle the unwanted behavior. Second, the methods encourage positive reinforcements that develop appropriate behaviors and other skills. It gives the learner an idea of what they are supposed to do and not only what they need to avoid doing. Also, DRA and DRI have been used in many behavioral problem situations such as self-injury, disruptive behaviors, off-task behaviors, and many others showing how effective they are.

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