We Still Have a Lot to Learn.

Use of contingent electric skin shock in the treatment of severe problem behavior has been criticized on the grounds that (a) it is not necessary because function-based procedures using positive reinforcement are just as effective; (b) it violates contemporary ethical standards; and (c) it lacks social validity. There are good reasons to challenge these claims. The meaning of "severe problem behavior" is imprecise and we should be cautious in our claims about how to treat it. It is not clear that reinforcement-only procedures are sufficient because they are commonly paired with psychotropic medication, and there is evidence that some instances of severe behavior may be refractory to reinforcement-only procedures. Ethical standards, as expressed by the Behavior Analysis Certification Board and the Association for Behavior Analysis International, do not prohibit punishment procedures. Social validity is a complex concept that can be understood and measured in multiple, potentially conflicting ways. Because we still have a lot to learn about these matters, we should be more skeptical of sweeping claims such as the three enumerated above.