ABA for Skin Picking & Dermatillomania in Autism

Skin picking — picking at scabs, cuticles, bug bites, or dry skin until they bleed — is one of those behaviors that parents notice long before they know what to do about it. It is very common in autism, and ABA has effective strategies for reducing it.

Why skin picking is so persistent

Skin picking is usually what ABA calls a automatically reinforced behavior — meaning the act itself provides the reinforcement, typically sensory input (the tactile sensation of picking or the visual result) or relief from anxiety or dysregulation. Because the reinforcer is internal and happens every single time, it is harder to address than behaviors reinforced by social attention. It is also associated with anxiety and can become a ritualistic or compulsive pattern. A BCBA will determine whether the picking is primarily sensory, anxiety-driven, or both, since treatment looks different for each. Related: sensory processing.

ABA strategies for skin picking

Because automatic behaviors are maintained by sensory input, treatment focuses on competing stimulation: giving the hands something that provides a similar or more satisfying sensory experience (fidget tools, textured objects, putty) as an alternative. Response blocking and environmental modifications (covering common picking sites) reduce access during high-risk times. Anxiety reduction and emotional regulation skills are often part of the plan as well. ABA does not shame or punish picking — it works with the child’s sensory needs, not against them.

Frequently asked questions

This page is general educational information, not medical advice. Every child is different — a BCBA can assess your child’s specific needs. Autumn ABA serves families in all 21 NJ counties; see where we provide ABA therapy.

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