Computer-assisted measurement of wound size associated with self-injurious behavior.

One adult who hurt himself lived on a hospital ward. Staff could not watch him every second.

The team took a photo of each wound. They opened the picture in free ImageJ software. The program counted pixels inside the wound.

They also counted how often the man hit himself each day. Then they compared the two measures.

Pixel counts and staff counts moved together. When hits went up, wound size went up. When hits went down, wound size shrank.

The computer gave the same answer three times in a row. A cheap camera plus free software worked as well as eyes on the skin.

Rojahn et al. (2012) looked at fifty years of self-injury studies. They said we must measure the behavior and the wounds. Griffith et al. (2012) gives the exact tool they asked for.

Adams et al. (2021) used a phone camera and OpenPose to score motor imitation. Both papers show the same trick: one camera plus free code equals solid data.

Mukherjee et al. (2021) took hair to check stress from severe self-hitting. Photos show outside damage; hair shows inside stress. Use both and you see the full picture.

You can start Monday. Snap a photo of any wound. Open ImageJ, trace the edge, read the pixel count. Do it daily. You now have a number line that tells you if the behavior plan is working, even when you can’t see the hit happen. No cost, no extra staff, just your phone.