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Abstract
The aim of the present study was to examine the effects of the differential reinforcement of other behavior procedure with reinforcement and punishment in reducing nail-biting behavior of an autistic student. A changing criterion design was used in a home setting with a total of five treatment phases in addition to the baseline. The results of this study support the use of differential reinforcement of other behavior as an effective treatment for habitual nail biting in an autistic subject.

Keywords: nail-biting, autism, DRO, differential reinforcement of other behavior

Nail biting is a prevalent habit in children and adolescents that often persists into adulthood (Christmann & Sommer, 1976). Even though it usually does not cause a lot of damage, sometimes, in more severe cases, it can lead to health problems such as minor tissue damage and skin infections (Libretto, 2000). Nail biting habit is usually triggered by stress or anxiety, extreme boredom (Libretto, 2000). In addition to stress, boredom, and anxiety, psychological factors have been identified as prompters of nail biting are oral-gratification, obsessive-compulsive disorder, poor self-image, lack of self-esteem and attention seeking (Libretto, 2000).

Habitual nail-biting, similar to other problematic habitual behaviors, is often treated with behavior-modification techniques, such as self-managed behavior-modification program, aversive therapy, habit-reversal training, overcorrection or differential reinforcement of other behavior (Libretto, 2000; Christensen & Sanders, 1987).

Differential reinforcement of other behavior (DRO) is a treatment protocol frequently used for reduction of undesired behavior (Jessel, Borrero & Becraft, 2015). It is typically applied in concert with other programs, for example, positive and negative reinforcement, token economy and response cost (Jessel, Borrero & Becraft, 2015). DRO is considered an omission procedure because a reinforcer is presented only when no target response occurs in a specified period of time (Catania, 2013). In situations when target behavior does occur, a reinforcer is either canceled or delayed (Jessel, Borrero & Becraft, 2015). DRO is often used in applied settings, as differential reinforcement of alternative behavior in cases with positive contingency (DRA), noncontingent reinforcement with no contingency (NCR) or differential reinforcement of other behavior with negative contingency (DRO) (Jessel, Borrero & Becraft, 2015). Reinforcement is defined as any stimuli that increase a probability of a certain response while punishment is defined as adding aversive stimuli to decrease the probability of a certain behavior (Jessel, Borrero & Becraft, 2015). Positive contingencies strengthen responding because the probability of reinforcer is increased with response happens, while negative contingencies weaken responding because the probability of reinforcer is increased with the absence of response relative to its occurrence (Jessel, Borrero & Becraft, 2015). For that reason, DRA is commonly used to strengthen appropriate responses, i.e. behavior, and DRO is used to weaken excess inappropriate behavior, e.g. problem behavior (Jessel, Borrero & Becraft, 2015).

In a recent study by Craig (2010) self-monitoring and self-managed differential reinforcement procedure were used for the treatment of problematic habitual nail biting behavior in a home setting. The author of the study was the subject of the study and with help of an

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