ABSTRACT
Ethically , behavior analysts are required to use the least aversive and restrictive procedures capable of managing behaviors of concern. This article introduces and discusses a multi-element paradigm for devising support plans that include ecological, positive programming, and focused-support proactive strategies for reducing the frequency of problem behavior occurrence. It also includes reactive strategies, i.e., separate independent variables. In this paradigm, reactive strategies are aimed solely at getting rapid, safe control over the incident, thereby reducing measured and quantified episodic severity. Behavior analysts who publish in mainstream behavioral journals do not always make it explicit how they, in fact, successfully employed non-aversive reactive procedures to achieve rapid/safe control over the severity of a behavioral incident. Three examples of published studies in the behavioral literature which successfully, though only implicitly, used non-aversive reactive strategies (NARS) to reduce the severity of the behaviors of concern are described. The multi-element paradigm discussed in the present article is illustrated by the support plans that address the challenging behavior of three children in a pre-school setting, using both proactive and reactive strategies. Reactive strategies were used for the purpose of reducing episodic severity (ES) and proactive strategies were aimed at reducing the frequency of occurrence. Following a comprehensive functional analysis and assessment (CFA) and the implementation of a multi-element behavior support (MEBS) plan, results show successful outcomes without the need for any aversive or restrictive procedures. When addressing severe behaviors of concern, in addition to reducing behavioral occurrence, safety should also be improved by reducing ES as a measured outcome and as a function of the reactive strategies employed, including in many cases, the use of strategic capitulation, i.e., providing the identified reinforcer for the target behavior.
ABSTRACT
Until the 1970s, smallpox was feared worldwide for the significant morbidity and mortality it caused. Although naturally occurring disease has been eliminated, the virus itself has not been destroyed, and it is assumed that some of the variola stored in the former Soviet Union has been removed. The majority of the world's population is susceptible to smallpox because vaccination ended in 1972 in the United States and in the rest of the world in 1982. A major epidemic could result if there was an intentional release of smallpox. Variola is both durable and highly infective, 2 features that make it an attractive bioweapon. Because of this threat, physicians should be familiar with the clinical features of smallpox and the appropriate isolation and medical response procedures. Although there is a vaccine that can provide pre- and postexposure protection, the vaccination itself is not without risks. There is no effective therapy for smallpox and studies of new treatments are underway.
