Behavior Intervention Plan
Alexia Cardona
Mercedes Hernandez Cardoso
Anya Marques
Identification of
Problem
Target Behavior: Nail Biting
Operational Definition: Defined as any instance in which
an individual places the fingers into the mouth and uses
the teeth to bite, peel, and manipulate the tips of the
fingernails and surrounding cuticle skin. Specific nail-
biting gestures include biting nails down extremely short
past the nail beds, aggressively tearing cuticle skin with
the teeth, and spitting out the removed nail/skin debris.
The behavior prevents nail growth beyond stubs and
causes tissue damage as indicated by sensitivity, redness,
swelling, and occasional bleeding around nail beds on
hands. Episodes of nail biting are scored as a single
response unless at least 60 seconds have elapsed since the
last nail-biting behavior.
Rationale for Intervention: Treatment for
nail biting is being considered due to its
significant impact on physical health,
emotional well-being, and social
functioning. Nail biting can cause damage
to the nails and surrounding skin,
increasing the risk of infections and dental
issues, while also serving as a maladaptive
coping mechanism for stress and anxiety.
This behavior often results in feelings of
embarrassment, affecting confidence in
social and professional settings.
Ethical Considerations
● When conducting the assessment for nail biting behavior, we will ensure informed
consent is obtained from participants, clearly explaining the assessment’s purpose
and methods.
● We will prioritize confidentiality by securely storing data and limiting access to
authorized individuals.
● We will minimize harm by being sensitive to the emotional impact of the assessment
process and avoiding any methods that could distress the participant.
● Cultural sensitivity will be important, ensuring that the assessment is respectful and
appropriate for the participant’s background.
● We will maintain the integrity of the data by ensuring accurate and unbiased
collection and reporting of results.
Research Summary 1
The first article selected was “Self-Administered Behavior Modification to Reduce Nail
Biting: Incorporating Simple Technology to Ensure Treatment Integrity” by Craig (2010). The
study was conducted to address the issue of chronic nail-biting behavior, which is a common
behavior that can persist into adulthood and cause health complications. project.
The study involves a single participant, a male, 21-year-old student, who had engaged in
chronic nail-biting. The independent variable was the Differential Reinforcement of Other behavior
(DRO) intervention, which rewarded the participant with tokens for nail-biting non-occurrence
intervals. The dependent variable was the frequency of nail-biting incidents measured through self-
recording. The study used a single-subject reversal design (ABAB), allowing for the observation of
behavior changes across baseline and intervention phases.
The results showed a significant decrease in nail-biting frequency during the DRO phases,
demonstrating a clear functional relationship between the intervention, behavior change, and the
reduction of nail-biting.
Research Summary 2
The second article selected was “The Incidence of Nail Biting Among School Children” by Birch
(1955). The research investigates the prevalence of nail-biting among school-aged children. The study’s
central goal was to examine how prevalent this habit is and whether it is linked to stress or anxiety.
The study involves participants aged 8-11, primarily drawn from British schools. Although the
study focused more on boys, data was also collected for girls. In this study, there was no experimental
intervention or manipulation of variables, as the research focused purely on observation of naturally
occurring behaviors in the classroom. The dependent variable in the study was the frequency and
severity of nail-biting. The behavior was documented by the teachers.
The results revealed that a significant portion of the children engaged in nail-biting behavior,
particularly among boys, with over 60% in certain groups. The behavior was less frequent among girls,
though still present. The findings suggested a possible link between nail -biting and psychological stress or
anxiety, though this was not directly tested.
Research Summary 3
The third article selected was “Nail Biting Behaviour and Its Treatment Through Applied Behaviour Analysis:
A Case” by Bhutto (2013). The research addresses the issue of chronic nail biting (onychophagia) in a 14-year-old girl,
emphasizing its frequency during stressful situations and the negative impact on her social life and self-esteem.
The study involves a single participant, a 14-year-old girl from Karachi, Pakistan. The study aimed to
determine whether these ABA methods could significantly decrease her nail biting, which had become a source of
concern for her and her parents. 1. The independent variable consisted of DRI strategies, which included rewarding
the participant for reducing nail biting and implementing consequences for failing to do so. 1. The dependent
variable measured was the frequency of nail biting incidents, documented during various phases of the study: pre-
intervention, intervention, post-intervention, and follow-ups.
Results indicated a remarkable reduction in nail biting frequency, with a 50% decrease during the
intervention phase compared to the pre-intervention period. Although post-intervention levels showed a slight
increase, they remained significantly lower than the baseline, suggesting a positive and lasting change.
Baseline &
Intervention
Graph
Summary of Behavior Assessment
The functional assessment of nail biting used frequency data collection, ABC (Antecedent-Behavior-
Consequence) analysis, and the Motivational Assessment Scale II (MAS-II). Over four days, frequency
data established baseline occurrences, averaging 5.75, 5, and 6.5 instances per session. ABC data revealed
triggers like stress and inactivity, with consequences such as temporary relief or sensory stimulation. The
MAS-II indicated the behavior serves two primary functions: escape from stress or aversive tasks and
automatic reinforcement through sensory stimulation. Participant observations confirmed the high
frequency of nail biting in response to specific triggers, highlighting its impact on daily functioning and
guiding intervention planning.
Summary of Treatment Package
Antecedent Interventions:
● Non-contingent Reinforcement (NCR): Provide preferred items (e.g., stress balls, fidget toys) at fixed intervals to reduce
nail-biting motivation.
● Task Modification: Break lengthy or difficult tasks into manageable parts, reduce durations, or add breaks to minimize
aversion.
● Environmental Manipulation: Use sensory items, eliminate triggers, and encourage hand engagement to prevent nail-biting.
● High-Probability Request Sequence: Precede challenging tasks with simple actions to increase compliance and reduce nail-
biting.
Consequence Strategies:
● Positive Reinforcement: Encourage alternative behaviors (e.g., using a fidget toy) with immediate praise or access to
preferred activities.
● Reinforcement Schedule: Start with continuous reinforcement (e.g., for 10-minute intervals without nail-biting) and
transition to intermittent reinforcement as progress is made.
● Token Economy: Implement a system where tokens earned for refraining from nail-biting can be exchanged for rewards.
Replacement Behaviors:
Promote stress-relief techniques (e.g., deep breathing, stress balls), fidget activities, trimmed nails, and deterrents like bitter-tasting
nail polish. Encourage mindfulness or hand-focused hobbies like drawing or knitting to redirect behavior.
This comprehensive plan emphasizes preventing triggers, reinforcing alternative behaviors, and fostering self-efficacy while reducing
nail-biting.
Analysis of Baseline and Treatment Data
Baseline Data:
During baseline observation, nail-biting incidents ranged between 3 to 8 per session, with averages of 5.75, 5, and 6.5. The data
showed moderate but consistent occurrences of the behavior, suggesting regularity without extreme frequencies.
Treatment Data and Trends:
The intervention aims to reduce nail-biting incidents from 15 to 3 or fewer per day over four weeks. Success would be reflected by a
decreasing trend in nail-biting incidents and reduced variability over time. Continued variability or lack of progress would signal the
need for intervention adjustments.
Results and Barriers:
The intervention’s effectiveness will be measured by sustained reductions in nail-biting frequency. Barriers include inconsistent
reinforcement, fluctuating stress levels, and environmental factors like work or school pressures that may impact outcomes.
Adjustments to Intervention:
Potential changes could include increasing reinforcement frequency, enhancing the token economy, tailoring task modifications, or
incorporating alternative strategies like habit reversal training.
Conclusion:
The intervention’s success hinges on a clear reduction in nail-biting incidents and maintenance of these changes over time. Regular
monitoring and data analysis will guide necessary adjustments to ensure optimal results.
References
Birch, L. B. (1955). The incidence of nail biting among school children . British Journal of Educational Psychology,
25(2), 123-128. https://doi.org/10.1111/j.2044-8279.1955.tb01345.x
Bhutto, Z. H., & Ali, M. S. Q. (2013). Nail Biting Behavior And Its Treatment Through Applied Behavior Analysis: A Case
STudy. Pakistan Journal of Clinical Psychology, 12(1). https://pjcpku.com/index.php/pjcp/article/view/86
Craig, A. R. (2010). Self-administered behavior modification to reduce nail biting: Incorporating
simple technology to ensure treatment integrity. Behavior Analysis in Practice, 3(2), 38–
41. https://doi.org/10.1007/bf03391763
- Slide 1: Behavior Intervention Plan
- Slide 2: Identification of Problem
- Slide 3
- Slide 4: Ethical Considerations
- Slide 5: Research Summary 1
- Slide 6: Research Summary 2
- Slide 7: Research Summary 3
- Slide 8: Baseline & Intervention Graph
- Slide 9: Summary of Behavior Assessment
- Slide 10: Summary of Treatment Package
- Slide 11: Analysis of Baseline and Treatment Data
- Slide 12: References
