People with DD need motivation to wash their hands

By Christopher Walmsley
Western Michigan University

Although hand washing with soap and water is known to substantially reduce the risk of infections, many people do not wash their hands regularly. Further, only a few studies have reported on attempts to promote hand washing in people with developmental disabilities (DD).

What did you do in your research?
We first taught students with DD all of the steps to accurately wash their hands, including rinsing hands with water, getting plenty of soap on the hands, washing hands for at least 15 seconds, and sufficiently rinsing the soap off. After participants knew how to wash their hands, to increase motivation, we put in place a lottery system, where they had a chance to win tickets that could be turned in for preferred food items, and later on we added a feedback component to let them know how they could improve to earn more chances to win. Throughout the study, we assessed the extent to which they washed their hands by putting a lotion on their hands before lunch that glowed under a black light, and measured any differences following lunch.

What did you find out?
We found that merely teaching how to correctly hand wash failed to sufficiently increase the target behavior before lunch in all but one student. When the lottery system was added, we observed improvements in hand washing. More specifically, students washed their hands both more frequently and accurately. Once feedback was added, hand washing further improved to superior levels (e.g., both sides of the hands were washed, as well spots in between fingers). When the feedback and the lottery system stopped, we continued to measure hand washing, and saw that many of the students' hand washing practices persisted.

What are the take-home messages?
This study showed that educational efforts alone did not effectively increase hand washing in students with DD, and that only after making it a friendly game where they could earn lottery tickets did hand washing improve. Thus, interventions that target hand washing should create fun consequences for engaging in hand washing to effectively motivate students on the importance of hand hygiene.

To learn more about these findings contact Alan Poling.

Full Journal Article
Walmsley, C., Mahoney, A., Durgin, A., and Poling, A. (2013). Fostering hand washing before lunch by students attending a special needs your adult program. Research in Developmental Disabilities, 33(1), 95-101.