Functional Assessment and Behavioral Treatment of Skin Picking in a Teenage Girl With Prader-Willi Syndrome

Skin picking is common in individuals with Prader-Willi Syndrome (PWS) but few treatment studies exist. This study reports the successful functional behavioral assessment (FBA) and treatment of skin picking in a 16-year-old female with PWS. A treatment package based on FBA results consisted of differential reinforcement for alternative and incompatible behavior, self-evaluation of progress, and reinforcement for weekly progress and participation in treatment. Pictures of wounds resulting from skin picking were taken during treatment. A total of 30 pictures were randomly selected and shown in a random order to 16 individuals unfamiliar with the study. The individuals then rated severity of the wounds displayed in the pictures. Pearson’s χ2 was used to assess changes in the ratings of severity during the course of treatment, and significant results indicate improvement over the course of intervention, χ 2(1) = 246.6, p < .001. This study adds to the very small literature on treatment of skin picking in people with PWS