Combined Curricular Intervention with Brief Hands Down to Decrease Hand Mouthing and the Use of Arm Splints for a Young Boy with Profound Disabilities

Hand mouthing is highly prevalent in individuals with severe to profound developmental disabilities. Frequent hand mouthing may interfere with appropriate responding, have negative health impacts, and result in restrictive interventions, such as the application of arm splints, to prevent this challenging behavior. The continuous application of arm splints can have negative health outcomes and can interfere with daily activities. The purpose of this study was to replace arm splints with appropriate curricular activities in a 10-year-old boy with profound disabilities. An intervention package involving the provision of curricular activities and a brief hands down procedure was evaluated using a combined alternating treatments and reversal design across several hours of the school day to demonstrate the effectiveness of the intervention on the reduction of hand mouthing. The intervention was successfully implemented across several hours of the student's school day within his natural school environments. Limitations, implications, and directions for future research are discussed.