Fostering hand washing before lunch by students attending a special needs young adult program.
A daily lottery tied to UV hand checks plus quick feedback can push young-adult special-ed students to a large share clean hands before lunch.
01Research in Context
What this study did
Five students in a young-adult special-ed program learned to wash hands before lunch. Ages ranged from 18 to 22. All had mild to moderate intellectual disability.
Staff first taught each student with modeling, practice, and praise. Then they added a daily lottery. Students earned one ticket each time Glo Germ gel showed clean hands under UV light. At lunch they drew one ticket for a small prize.
What they found
Hand-washing scores jumped from a large share clean to a large share clean for every student. Gains stayed for two weeks after the lottery ended. Staff needed only five minutes a day to run the system.
How this fits with other research
May et al. (2020) used the same lottery trick to keep adults with DD pedaling at HIIT heart rates. The ticket idea travels well—from gym bikes to sink faucets.
Neef et al. (1986) ran an older token mealtime program with kids. They also saw fast gains in self-care. The 2013 study updates the prize method and adds UV feedback for adults.
Petit-Frere et al. (2021) paired BST with least-to-most prompts for poison safety. Both papers show BST plus something extra—prompts or lottery—locks in skills.
Why it matters
You can copy this package tomorrow. Teach the steps with BST, check hands with cheap UV gel, hand out one ticket per pass, and draw a winner at lunch. It takes no extra staff and works in any classroom sink area. Use it for hygiene, utensil use, or even face-covering steps. The lottery keeps young adults engaged without candy or iPad time.
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02At a glance
03Original abstract
A multiple baseline across groups design was used to investigate the effects of a treatment package on hand washing before lunch by five students with disabilities who attended a young adult educational program. To evaluate hand washing, a lotion called Glo Germ was applied to participants' hands. Glo Germ is visible under a black light, which allowed the quality of hand washing to be assessed by comparing the amount visible before and after hand washing using a 3-point scale. Following a baseline period in which hand washing was assessed, participants were exposed to a hand washing training procedure, which improved one participant's hand washing. Next, a lottery system was imposed in which the number of lottery tickets earned each day depended on the quality of hand washing, specifically, on the rating assigned (0, 1, or 2). This condition was associated with improved hand washing by the other four participants. Finally, a condition adding feedback to the lottery system resulted in further improvements in the quality of hand washing for all participants. Follow up data indicated modest maintenance of hand washing after lunch. These results suggest that treatment packages similar to that used in the present study merit further investigation and that Glo Germ is of value in ascertaining the quality of hand washing.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.08.002