ABA Fundamentals

An analysis of the reinforcing properties of hand mouthing.

Goh et al. (1995) · Journal of applied behavior analysis 1995
★ The Verdict

Hand mouthing is fueled by finger feel, not mouth feel—give tactile hand toys instead of chewables.

✓ Read this if BCBAs treating automatic hand mouthing in school or clinic settings.
✗ Skip if Clinicians working only with vocal or body-top stereotypy.

01Research in Context

01

What this study did

The team ran three small experiments with kids who kept putting hands in mouth. They wanted to know why the behavior felt good.

First they let the kids mouth their hand while blocking other feelings. Next they gave a chewy tube so the mouth got busy but hands were free. Last they gave a soft cloth to rub the fingers while the mouth stayed empty.

Each test lasted a few minutes and they counted how often the hand went back to the mouth.

02

What they found

Every child mouthed their hand most when the hand itself was the only thing available. When the kids chewed on a tube, hand mouthing stayed high. When they could rub a cloth, hand mouthing dropped a lot.

The result was the same for every participant: the feeling on the fingers, not the mouth, kept the behavior alive.

03

How this fits with other research

Migan‐Gandonou et al. (2020) later used the same test-then-treat idea on rumination. They also found an oral behavior kept going for its own feeling and cut it with a quick tooth-brush consequence.

Goldman et al. (1979) looked similar on the surface: they used Listerine to stop rumination. Their fix worked, but they never asked what feeling started the behavior. Einfeld et al. (1995) show the earlier team skipped the key first step—find the real reinforcer before you pick the consequence.

Ellement et al. (2021) used EMG wires to spot silent teeth grinding. Like L et al., they let the data tell them why the body kept doing the motion. Both papers push the field toward measuring first, guessing later.

04

Why it matters

Stop handing out chewables the minute you see hand mouthing. Run a quick 5-minute test: give a soft cloth, a chewy tube, and a baseline. If the cloth wins, you know the fingers need busy work, not the jaw. Swap in tactile fidgets, not food, and you will likely see the behavior fade without extra calories or tooth damage.

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Test one client: offer a soft cloth in one condition and a chewy tube in another for 3 minutes each—pick the item that cuts mouthing most and place it on the desk.

02At a glance

Intervention
functional analysis
Design
single case other
Sample size
21
Finding
positive

03Original abstract

Hand mouthing often has been described as a stereotypic response that is maintained by nonsocial (automatic) reinforcement; however, data supporting this conclusion can be found in relatively few studies. This series of studies presents an experimental analysis of conditions associated with the maintenance of hand mouthing. In Experiment 1, a functional analysis was conducted for 12 individuals who engaged in chronic hand mouthing, to determine whether the behavior is usually maintained independent of social contingencies. Results obtained for 10 subjects were consistent with an automatic reinforcement hypothesis; the remaining 2 subjects' hand mouthing was maintained by social-positive reinforcement. Based on these results, Experiment 2 was designed to identify the specific reinforcing properties of hand mouthing. Each of 4 subjects was provided with a toy that substituted for hand mouthing, and preference for a specific topography of toy manipulation (hand-toy contact or mouth-toy contact) was measured. Results indicated that hand stimulation was the predominant reinforcer for all subjects. Experiment 3 provided an extension of Experiment 2 in that the same responses were measured across a variety of toys presented to each of 5 subjects. Results again indicated that hand stimulation was the predominant reinforcer for all subjects. Implications of these results are discussed with relevance to treatment.

Journal of applied behavior analysis, 1995 · doi:10.1901/jaba.1995.28-269