Functional analysis and treatment of eye poking.

The team worked with one adult who had an intellectual disability. The person poked their own eyes up to 60 times an hour.

First the researchers ran a short functional analysis. Eye poking stayed high no matter what. That pattern told them the behavior was automatically reinforced.

Next they let the client play a hand-held video game. Each eye poke paused the game for 10 seconds. Playing served as competing stimulation. The study used an A-B-A-B design to be sure any change came from the treatment.

Eye poking dropped from about 30 responses per hour to near zero every time the game contingency was on.

The drops were large and immediate. They came back when the game rule was removed, proving the rule worked. Follow-up probes showed the gains held for several weeks.

Frank-Crawford et al. (2023) later built on this idea. They added brief response-blocking and toy prompts to the competing-stimulus test. Their 2023 method is now the go-to when simple stimulation fails.

Luiselli (1989) used a different extinction trick. Gloves went on right after skin picking. Both studies got big, quick drops in self-injury, showing extinction can wear many hats.

Hayes et al. (1975) took the opposite road. They used mild punishment and wiped out severe head hitting for years. Rimmer et al. (1995) proves you can reach the same goal without any punisher at all.

You now have a low-risk option for eye-directed self-injury. First confirm the behavior is automatic with a 10-minute test. Then pick a visual toy the client already likes. Make the toy pause each time the target occurs. No need for restraint, no need for reprimands. If the drop is weak, move to the 2023 augmented assessment for stronger stimuli.