Simplified habit reversal plus adjunct contingencies in the treatment of thumb sucking and hair pulling in a young child

The authors examined the effectiveness of a simplified habit reversal treat ment (SHR) consisting of awareness training, competing response training, a nd social support procedures for a 6-year-old girl who exhibited thumb suck ing and covarying hair pulling. Initially, the implementation of SHR plus b ooster sessions for thumb sucking produced minimal reductions in thumb suck ing and hair pulling. However, additional treatment phases involving differ ential reinforcement and response cost resulted in near zero levels of the behavior when implemented with thumb sucking and then hair pulling. Thereaf ter, hair pulling was treated with the same procedure, resulting in levels of behavior. Covariation of thumb sucking and hair pulling, limitations of SHR, and directions for future research involving the use of external conti ngencies are discussed.