Sensory profiles and a teacher-mediated classroom intervention for preschool skin-picking behaviours

Preschool skin-picking is an understudied behaviour that can disrupt self-regulation and participation. Its proposed links to atypical sensory processing highlight the need for classroom-based, sensory-informed support.

To compare sensory profiles of preschoolers with skin-picking versus typically developing (TD) peers, pilot a brief teacher-mediated, classroom-embedded sensory programme (feasibility, fidelity, preliminary effectiveness), and explore teacher/parent acceptability in Saudi preschools.

In a sequential explanatory mixed-methods study, 52 Saudi preschool children (3-6 years) were recruited from six classrooms in Saudi Arabia (45 with skin-picking; 7 typically developing). Measures included the Sensory Profile 2, Preschool Skin-Picking Severity Scale (PSP-SS), and structured observations. A subgroup of 15 children received a 4-week teacher-mediated sensory programme.

Children with skin-picking exhibited higher levels of Sensory Seeking and Sensory Sensitivity than TD peers. Within the intervention subgroup, the programme resulted in a large reduction in PSP-SS scores (η²p = .64), with marked decreases during transitions (78 %) and sedentary activities (65 %). Severity correlated with Sensory Seeking (r = .52, 95 % CI [.26-.71]) and Sensory Sensitivity (r = .41, 95 % CI [.12-.64]). Qualitative findings indicated limited prior awareness of the behaviour and strong acceptance of the structured sensory routines.

Atypical sensory processing-particularly elevated sensory seeking-appears central to preschool skin-picking. A brief, teacher-mediated, classroom-embedded sensory programme showed preliminary feasibility, acceptability, and effectiveness; these findings support integrating sensory-informed screening and routine-based classroom supports during high-risk contexts (e.g., transitions and seated tasks), with referral pathways for non-responders.