Effective behavioral treatment of self-biting by a child with Lesch-Nyhan syndrome

Behavior modification consisting of differential reinforcement of incompatible behavior and "punishment' was used for short periods at an early intervention center and was effective in eliminating self-biting of the arms, forearms and backs of the hands by a two-year-old with Lesch-Nyhan syndrome. No side-effects of the "punishment' component were observed. The effectiveness of the treatment was generalized to 3 1/2-hour sessions with his teacher at the early intervention center, and to the child's home. At six-month follow-up the teacher and parents indicated the continued absence of biting of the arms, forearms and back of the hands. The same treatment was applied to biting the fingers and the palms of the hands, without success.