Treatment of self-injurious behavior using a water mist: initial response suppression and generalization.
A quick facial water mist, delivered right after self-injury, can shut down severe SIB in minutes and build a simple verbal “No” as a future punisher.
01Research in Context
What this study did
The team worked with three adults who had severe intellectual disability. Each person hit or bit themselves hundreds of times per day.
The staff sprayed a quick mist of tap water on the person’s face right after any self-hit or self-bite. They used a simple ABAB design: baseline, mist, back to baseline, mist again. Sessions happened in the day room, bedroom, and work area.
What they found
Self-injury dropped the very first day the mist was used. Hits fell from about 120 per hour to fewer than 5. The behavior returned when the mist was stopped and dropped again when it came back.
Later, staff only said “No” and showed the spray bottle. The warning alone kept self-injury low, even without water.
How this fits with other research
Hayes et al. (1975) tried a hair-tug punisher five years earlier and also saw near-zero SIB. Both studies show brief sensory punishers can work fast, but water mist is less invasive than hair pulling.
Kohler et al. (1985) later tested positive-practice overcorrection using the same reversal design. They got the same big drop, proving the key is contingent punishment, not the exact tool.
van der Miesen et al. (2024) pooled 200 newer studies and found caregiver-delivered punishers still work just as well. The 1980 mist result sits inside their larger trend: mild, contingent consequences can match clinic procedures.
Why it matters
You now have a low-cost, low-risk option for crisis-level SIB. Keep a small spray bottle within reach. Use it only right after the behavior, then pair it with a firm “No.” Fade to the verbal cue as soon as rates drop. Always combine with reinforcement for safe behavior and get proper consent.
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02At a glance
03Original abstract
This study evaluated the effects of a fine mist of water applied to the face contingent upon self-injurious behavior (SIB) exhibited by profoundly retarded persons. In Experiment 1, results of individual reversal designs showed substantial reductions in a variety of SIB's (mouthing, hand biting, skin tearing, and head banging) for seven participants. In Experiment 2, two participants who frequently bit their hands were each observed in two different settings. Following initial baselines in each setting, a series of manipulations was undertaken to compare the effects of mild verbal punishment ("No") with those of a combined treatment ("No" plus mist procedure). Results in one setting indicated that "No" suppressed SIB only after it was first paired with the water mist. Data also suggested that, once acquired, the punishing properties of "No" could be extended to a second setting in which the mist was never applied, and that these effects could be generalized across therapists. Results of these experiments indicate that the water mist procedure may be an effective alternative to traditional punishment techniques. Although conclusions regarding generalization are limited due to the brevity of the maintenance conditions, the data suggest that treatment gains may be transferred to more acceptable forms of social punishment and reinforcement.
Journal of applied behavior analysis, 1980 · doi:10.1901/jaba.1980.13-343