Strategies Which Address Purposeful Spitting

Both purposeful spitting and difficulty managing saliva (drooling) are behaviors  that may be seen in some students with disabilities. It is important to distinguish the two as one may be related to low muscle tone or other physical issues. For example, a child may be a mouth breather due to larger adenoids or tonsils or have oral motor weakness due to other physical problems which may make it difficult to close his lips and manage his saliva. Purposeful spitting on the other hand, is behavioral in that the student is using the spitting to communicate a need or solve a problem in a maladaptive way.

If your student is purposefully spitting on others, it may be an indication of a learned maladaptive behavior or a method the student is using to communicate a need.

• Collect data to help identify what your student is trying to communicate when they choose to spit by using an ABC chart.
• Teach your student appropriate communication skills to replace the spitting behavior. Visual supports and behavior stories can be very helpful in teaching alternative behaviors and communication methods to your student with special needs.
• Use a rewards system so your student is rewarded each time he/she uses a replacement behavior rather than spitting. Acknowledge when the student is practicing appropriate alternative behaviors every time they occur.
• Implement your plan with your students for 4 weeks. If the strategies suggested are not helping, it may be necessary to seek more help and/or get a more in-depth behavioral assessment.

 

When a child cannot manage saliva in his mouth, there is likely a physical or medical reason for this and should be addressed by the appropriate professional which may include:  Pediatrician, Ear Nose & Throat Specialist, Speech Pathologist or Occupational Therapist.

 

For the issue of keeping saliva in his mouth, please seek feedback from the student’s speech pathologist who can conduct an oral motor evaluation, an occupational therapist and/or a  referral to a medical professional may be warranted.  In some cases, a student may benefit from a visual cue to close his mouth and swallow more often or need some type of bandana or towel to have available to wipe his mouth.  It is important to rule out any medical issues prior to trying a new technique.

 

For the purpose of this answer, we will address purposeful spitting. When a child purposely spits on others, it is a learned maladaptive behavior and can be addressed by teaching an appropriate replacement behavior, positive reinforcement of the new behavior and if necessary, imposing  consequences for the spitting behavior (e.g. loss of privilege, time out or cleaning an area spit on).

• Child's Age: 6-10
• Planning Effort: Moderate
• Difficulty Level: Moderate

Child should understand simple directions, be able to distinguish between right and wrong or “green” or “red” choices and have the skills to complete the replacement behavior/s you will teach.

 

Child should understand that earning tokens for positive behavior can lead to gaining a preferred item/activity if a token system is to be used.

1. Collect data to determine the possible function of spitting. For example, is it to gain attention or avoid certain activities?  A simple ABC Chart(see Resources) can easily be marked after each occurrence of spitting to determine in which instances spitting is more likely to occur and what is maintaining the behavior.   For example if the student spits when he has to give up a preferred item, you may want to teach him to say,  “I want it longer.” or “2 more minutes please” as an alternative behavior or to give up the item in response to a visual timer as the preferred behavior.  Follow use of appropriate behavior with  positive reinforcement (tangible/verbal).

2. Teach the student the appropriate social/communication skills that he is lacking so that he does not resort to spitting.  For example, you may teach: turn-taking, asking to play, asking for a break, saying no, or waiting.

3. Use Behavior Stories or other visuals (see Resources below) to teach alternatives to spitting and the consequences for both spitting and the use of newly learned skills such as “asking for a break”.

4. A tangible reward system, such as a reinforcement tower (see Resources below) or token system is a great way to reward appropriate behavior (in this case, using an alternative to spitting).

5. If the behavior continues with no change after 4 weeks of intervention, a more thorough functional behavioral assessment may be warranted.