An analysis and treatment of chronic thumb sucking and chronic hair pulling

Abstract

Thumb sucking often occurs with other habit disorders such as hair pulling. There have been several suggested relationships between thumb sucking and hair pulling, including that thumb sucking is an establishing operation for hair pulling. In the current study a 12-year-old girl with Cri du Chat Syndrome engaged in chronic bi-lateral thumb sucking and chronic hair pulling. Classroom data suggested that thumb sucking and hair pulling occurred simultaneously, thus the purpose of the study was three-fold, 1) Identify the function of thumb sucking, 2) Identify the relationship between thumb sucking and hair pulling, and 3) Assess the direct effects of protective equipment (i.e., ThumbGuards®) on thumb sucking and indirect effects on hair pulling. Functional analysis results showed that the duration of thumb sucking was highest in low stimulation conditions suggesting an automatic function. Results of the relationship analysis suggested that thumb sucking functioned as an establishing operation for hair pulling. During the treatment analysis, implementation of the ThumbGuards® decreased thumb sucking to low levels and eliminated untreated hair pulling. Interobserver agreement was assessed on 30 percent of all sessions and averaged above 80 percent on all measures.