|Assessment and Treatment of Face Touching During the COVID-19 Pandemic
|Monday, May 30, 2022
|9:00 AM–10:50 AM
|Meeting Level 1; Room 103
|Area: CBM/AUT; Domain: Applied Research
|Chair: Javier Virues Ortega (Universidad Autónoma de Madrid)
|Discussant: Raymond Miltenberger (University of South Florida)
|CE Instructor: Javier Virues Ortega, Ph.D.
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.
|Instruction Level: Intermediate
|Keyword(s): COVID-19, face touching, habit reversal, video analysis
Students, practitioners and applied researchers.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Understand the behavioral processes involved in face touching and its importance as a health risk behavior; (2) Understand various methodological approaches to monitor face touching in typically developed adults and people with autism spectrum disorder; (3) Understand various approaches to reducing face touching including awareness training, habit reversal, and differential reinforcement of other behavior.
Decreasing Face Touching for Children With Autism Spectrum Disorder
|MARY HALBUR (University of Nebraska Medical Center's Munroe-Meyer Institute), Tiffany Kodak (Marquette University), Marisa E. McKee (Marquette University), Jessi Reidy (Marquette University), Elizabeth J. Preas (UNMC ), Regina A. Carroll (University of Nebraska Medical Center Munroe-Meyer Institute)
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.
|A Habit Reversal Intervention for Face Touching
|EMMA AUTEN (University of North Carolina Wilmington), Carole M. Van Camp (University of North Carolina Wilmington)
|Abstract: The Centers for Disease Control and Prevention (CDC) reports that touching one’s own face with unwashed hands can transmit infections, and previous literature has reported the average rate of face touching for neurotypical adults to be 17.8-23 times per hour (Kwok et al., 2015; Morita et al., 2011). Habit reversal is a multicomponent intervention developed by Azrin and Nunn (1973) that has been successful for a variety of behaviors including hair pulling, nail biting, speech disfluencies, and motor or vocal tics (Azrin & Nunn, 1973; Nunn & Azrin, 1976; Pawlik and Perrin, 2019; Rapp et al., 1998; Twohig & Woods, 2001). The purpose of the current study was to apply a simplified habit reversal intervention to face touching behavior evaluated in a multiple baseline design. Participants were students at a university, and they were blind to the purpose of the study during baseline. Simplified habit reversal consisted of a sequential application of awareness training and competing response training. For some participants, debriefing on the purpose of the study reduced face touching. For other participants, at least one component of habit reversal (i.e., awareness training or competing response training) was necessary to significantly reduce face touching.
|Automated Detection of Face Touching as an Aid to Face Touching Reduction Studies
|AIDA TARIFA RODRIGUEZ (ABA España, Universidad Autónoma de Madrid), Peter A. Krause (University of California, Santa Cruz
California State University, Channel Islands
), Javier Virues Ortega (Universidad Autónoma de Madrid), Agustin Gonzalo Perez-Bustamante Pereira (Hospital Universitario Ramón y Cajal)
|Abstract: In the current study we evaluated an automated face-touching detection system. Face touching was detected automatically for the two participants wearing head-mounted camera. Five hours of naturalistic footage was obtained from each participant. A custom Python script divided each video recording into 10 s segments and each of these segments was then processed by the OpenFace 2.0 face-tracking software. OpenFace detects the most prominent face within a digital video, compares it to a normalized facial model using 128 key parameters, and estimates the three-dimensional position of each parameter frame by frame. We identified modal parameter displacement patterns that were suggestive of face-touching events by using parallel behavioral observation data. We integrated the parameter displacement patterns into a face-touching detection algorithm. We then conducted signal detection analyses to evaluate the precision of the detection algorithm when applied to novel samples of video both within and across individuals. We will discuss the potential of using this system in applied research
Reducing Face-Touching through Motion Sensing and Vibrotactile Cueing During the COVID-19 Pandemic: Treatment Effects and Disruptor Descriptive Analysis
|JAVIER VIRUES ORTEGA (Universidad Autónoma de Madrid), Agustin Gonzalo Perez-Bustamante Pereira (Hospital Universitario Ramón y Cajal), Neil Timothy Martin (Behavior Analyst Certification Board), Mariola Moeyaert (University at Albany, SUNY), Peter A. Krause (University of California, Santa Cruz
California State University, Channel Islands
), Aida Tarifa Rodriguez (ABA España, Universidad Autónoma de Madrid), Carolina Trujilo-Sánchez (Universidad Autónoma de Madrid), Maithri Sivaraman (Ghent University, Belgium)
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.