Fostering hand washing before lunch by students attending a special needs young adult program

A multiple baseline across groups design was used to investigate the effects of a treatment package on hand washing before lunch by five students with disabilities who attended a young adult educational program. To evaluate hand washing, a lotion called Glo Germ was applied to participants' hands. Glo Germ is visible under a black light, which allowed the quality of hand washing to be assessed by comparing the amount visible before and after hand washing using a 3-point scale. Following a baseline period in which hand washing was assessed, participants were exposed to a hand washing training procedure, which improved one participant's hand washing. Next, a lottery system was imposed in which the number of lottery tickets earned each day depended on the quality of hand washing, specifically, on the rating assigned (0, 1, or 2). This condition was associated with improved hand washing by the other four participants. Finally, a condition adding feedback to the lottery system resulted in further improvements in the quality of hand washing for all participants. Follow up data indicated modest maintenance of hand washing after lunch. These results suggest that treatment packages similar to that used in the present study merit further investigation and that Glo Germ is of value in ascertaining the quality of hand washing. (C) 2012 Elsevier Ltd. All rights reserved.