Behavioral treatment of spitting in a child with autism spectrum disorder: Functional analysis, intervention evaluation, and maintenance assessment

One elementary boy with autism kept spitting in class. The team first ran a functional analysis. Spitting stayed high in every condition, so they ruled it was automatically reinforced.

They then tried an A-B-A-B reversal. In B phases the boy earned candy for keeping his lips closed and got a brief, non-exclusionary time-out after every spit.

Spitting dropped to zero during the first B phase and returned when the intervention was withdrawn. When the plan came back, spitting stayed at zero.

Three months later the gain held. Teachers kept the plan running with no extra training.

Rooker et al. (2022) also wiped out automatically maintained behavior—self-injury—by flooding the moment with food reinforcement. Both studies show you don’t need matched sensory stimuli; dense competing reinforcement is enough.

Halbur et al. (2022) cut face-touching with differential reinforcement plus prompts, the same DR logic Hartz used for spitting. The pair confirms DR works for repetitive, body-focused behaviors across topographies.

Shalev et al. (2018) reduced liquid expulsion too, but during feeding treatment, not behavior reduction. Same mouth behavior, different purpose—highlighting the need to check context before choosing your procedure.

If a client’s spitting is automatic, you can skip sensory extinction. Pair any strong reinforcer with lip-closure or swallowing and add a brief, in-place time-out after the spit. Run a quick reversal to show control, then keep the plan in the classroom. Teachers can manage it alone and the change sticks.