Differential Reinforcement of Other Behaviour for the Reduction of Severe Nail Biting

Onychophagia as a clinical symptom: A pilot study of physicians and literature review

Although onychophagia is a medical condition and is associated with poorer health, there are no guidelines for assessment or treatment. The purpose of this study was to investigate the clinical aspects of nail biting from doctors' points of view, to estimate the prevalence of onychophagia among physicians, and to review the literature on and treatment methods for onychophagia. Twenty-four percent of doctors reported nail-biting periods during their lifetimes, and 2% of them remained active nail biters. A total of 64.4% of doctors see nail biting in their practices, and 60.6% never or only on request ask patients about nail biting and examine their nails. Family doctors and pediatricians ask their patients about nail biting most often. Attitudes and opinions on the treatment of nail biting are undefined and vary. Doctors reported usually treating nail-biting patients by referring them to another specialist or offering special nail polish. There is a need to improve physicians' knowledge of nail-biting treatment methods, but a lack of studies evaluating the clinical aspects of onychophagia and its relation to mental health and emotion dysregulation. Further research is needed. Clinical attitudes toward nail biting could be more precise in training and medical practice.

Differential Reinforcement of Other Behaviors to Treat Challenging Behaviors Among Children With Autism: A Systematic and Quality Review

This review summarizes the literature regarding differential reinforcement of other behaviors (DRO) to treat challenging behavior among children with autism spectrum disorder (ASD) and determines the quality of studies among the current literature according to the 2014 Council for Exceptional Children (CEC): Standards for Evidence-Based Practices in Special Education. Studies that focused on the use of DRO in the treatment of challenging behavior for individuals with ASD were included for systematic analysis. Forty-five studies were identified for inclusion in this review and were evaluated using the eight quality indicators described by the CEC. To the authors’ knowledge, this is the only systematic review of the literature that evaluates DRO as an intervention for individuals diagnosed with ASD. Principle findings, practical recommendations, and areas of future research are discussed.