A novel approach to assessment in the treatment of childhood trichotillomania.

The present study describes the successful treatment of a 9-year-old girl with trichotillomania. Intervention involved praising attractive hair and ignoring hair loss, education in hair hygiene, response prevention for night-time hair pulling, and a variable schedule of monetary rewards for criterion hair growth. Progress was assessed by counting hairs in random scalp areas and measuring bald areas. Hair growth increased from three hairs per area sampled at baseline to such dense hair growth that individual hairs could not be counted and no bald spots were noted. Results maintained at 2, 6 and 10 months follow-up.