Association for Behavior Analysis International

While airborne respiratory aerosols are currently thought to be the main transmission pathway for the SARS-CoV-2, fomite-mediated transmission remains an important risk during the current pandemic. Fomites are inanimate object surfaces where viral particles can remain viable for hours or days. Community-based epidemiological studies cannot readily establish the relative contribution to infection risk of several transmission pathways when they operate simultaneously and most transmission models have focused on human-to-human transmission of the SARS-CoV-2. However, recent studies indicate that transmission due to contact with contaminated surfaces may play an important role, particularly in the early stages of an outbreak and in closed environments such as child daycare services, schools, nursing homes, and offices. Hand contact with contaminated surfaces poses a risk of infection when subsequently engaging in hand-to-face contact with the mouth, nasopharynx, or eyes. Therefore, face-touching is a risk behavior of significant public health interest. In the current series of studies we will explore various treatment approaches to reducing face touching in both typically developed adults and children with autism spectrum disorder. We will also present various strategies for detecting and recording face touching including automated systems. The studies will be discussed by Dr. Ray G. Miltenberger, a world-renowned expert in the assessment and treatment of habitual behaviors.

Students, practitioners and applied researchers.

Face touching is a prevalent behavior for individuals of all ages. However, frequent face touching has potential negative side effects such as the transmission of viruses, bacterial infections, and skin infections. The present investigation extended previous research by evaluating a reinforcement-based intervention package on the reduction of face touching for children with autism spectrum disorder who tolerated wearing face coverings (i.e., face masks, face shields). The treatment package included an unsignaled, momentary differential reinforcement of other behavior procedure with prompts. Results indicated that rates of face touching decreased from baseline levels for children during 5-min treatment sessions. Furthermore, low levels of face touching were observed during follow-up sessions that were longer in duration (i.e., 15 min) across participants. Minor procedural modifications across participants will be described. Overall, results support the utility of behavioral interventions on the reduction of potentially unsafe behaviors related to medical routines for children with autism.

Fomite-mediated self-infection via face-touching is a potentially important and understudied transmission pathway for COVID-19. In the current study we evaluated the effect of a computer-mediated vibrotactile cues (presented through experimental bracelets located on one or both hands of the subject) on the frequency of face-touching among eight healthy adults living in the community. We conducted a treatment evaluation totaling over 25,000 minutes of observation. The treatment was evaluated through a multiple treatment design and a hierarchical linear model indicated that all participants engaged in significant levels of face-touching prior to the intervention. On average, the one-bracelet intervention did not produce significantly lower levels of face-touching, whereas the two-bracelet intervention did result in significantly lower levels. The effect increased over repeated presentations of the two-bracelet intervention with the second implementation producing 31 fewer face-touching events, on average, relative to baseline levels. The intervention effect was robust to potential face touching disruptors including wearing a mask, speech, moving around, or being outdoors. Dependent on the dynamics of fomite-mediated self-infection via face-touching, treatment effects could be of public health significance. The implications for research and practice are discussed.