This comparison draws in part from “Through Our Eyes Panel - Shifting the Paradigm: Extinction and Minimizing Harm” by Nyetta Abernathy, M.Ed, BCBA, LBA (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →One of the most consequential decisions a behavior analyst makes is not just what intervention to use, but how to approach the clinical question in the first place. For through our eyes panel - shifting the paradigm: extinction and minimizing harm, the difference between an evidence-based, individualized approach and a traditional, protocol-driven one can significantly impact outcomes.
This guide lays out the key factors side by side to support your clinical decision-making.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Primary Goal | Extinction: Eliminate the target behavior by removing its reinforcement | Harm reduction: Minimize the risk and severity of negative consequences associated with the behavior |
| Approach to Behavior Function | Extinction: Removes reinforcement for the current behavior; relies on replacement behaviors to meet the need | Harm reduction: Acknowledges the behavior's function and works to meet that need through safer channels while tolerating the behavior during transition |
| Known Side Effects | Extinction: Extinction bursts, induced aggression, emotional distress, spontaneous recovery, potential trust damage | Harm reduction: Slower behavior change, possible perception of permissiveness by others, requires ongoing environmental management |
| Individual's Experience | Extinction: May be experienced as rejection, abandonment, or loss of coping mechanism, particularly when communication or self-regulation behaviors are targeted | Harm reduction: Generally experienced as supportive and respectful; preserves the individual's sense of agency and existing coping strategies |
| Implementation Feasibility | Extinction: Requires consistent implementation across all settings and all individuals; inconsistency can produce intermittent reinforcement | Harm reduction: More forgiving of implementation variability; does not require perfect consistency to produce meaningful outcomes |
| Alignment with Autistic Self-Advocate Perspectives | Extinction: Frequently cited by autistic advocates as a source of trauma and distrust, particularly when applied to communication or self-regulation behaviors | Harm reduction: Generally endorsed by self-advocates as a more respectful and person-centered approach to addressing challenging behavior |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching through our eyes panel - shifting the paradigm: extinction and minimizing harm in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Through Our Eyes Panel - Shifting the Paradigm: Extinction and Minimizing Harm — Nyetta Abernathy · 2 BACB Ethics CEUs · $30
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
279 research articles with practitioner takeaways
256 research articles with practitioner takeaways
223 research articles with practitioner takeaways
2 BACB Ethics CEUs · $30 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.