Assessment and Treatment of a Foot Fetish Exhibited by an Adolescent With Autism
A quick functional analysis plus either a rule with reprimand or fun alternative activities can drive foot-fetish ISB in autistic teens to near-zero.
01Research in Context
What this study did
Hodges and team worked with an autistic teen who stared at and touched people’s bare feet.
They first ran a short functional analysis to see what triggered the behavior.
Then they tested two fixes: a clear rule plus a quiet reprimand, and a box of fun foot-free activities.
What they found
Bare feet alone made the behavior spike.
Both the rule-reprimand combo and the fun-activity box dropped the behavior to almost zero.
The teen kept the gains when staff slowly faded the prompts.
How this fits with other research
Early et al. (2012) used exposure therapy for a similar foot-focused teen and also saw low rates, but they never tested why the behavior happened.
Sasson et al. (2018) reviewed 23 studies and warned no single response-blocking tactic is evidence-based until you run a functional assessment—exactly what Hodges did.
Slocum et al. (2024) and Fabbretti et al. (1997) show the same pattern: run a quick functional analysis, then build a simple differential-reinforcement plan; big drops follow.
Why it matters
If you support an autistic adolescent who touches or stares at feet, start with a 10-minute functional analysis.
Once you know bare feet are the cue, give a short rule (“Keep hands up”) and a calm “no” if it happens, or hand a favorite game the moment shoes are in view.
Both choices are low-effort, classroom-friendly, and can wipe out the behavior in days.
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Join Free →Test bare feet versus covered feet for 5-minute sessions, then pick either a brief rule plus calm “no” or a favorite foot-free activity and use it the next time shoes come off.
02At a glance
03Original abstract
We conducted a functional analysis to identify the specific features of feet responsible for evoking inappropriate sexual behavior (ISB) by an adolescent male with autism. Results showed that bare female and male feet evoked ISB. We then evaluated a treatment consisting of a rule describing appropriate and inappropriate behavior in the presence of bare feet and a verbal reprimand contingent on ISB; the combination of these was effective. Finally, as an additional treatment option, we evaluated an environmental enrichment procedure, which also reduced ISB to low levels.
Behavior Analysis in Practice, 2020 · doi:10.1007/s40617-020-00468-1