ABSTRACT: Controversy continues to rage over the application of punishment of aversive procedures in treatment and habilitation. A lack of clear definition of terms may be contributing to confusion in the debate. Tracing the history of the term punishment shows that its retention as a description of a behavioral process is due primarily to happenstance. The unfortunate choice of a word long associated with cruel and inhumane treatment has led to considerable confounding of the technical and traditional usages in public debate. The alternative term, aversive, is of more recent origin, yet it also suffers from inconsistent usage and some degree of negative association. Important questions concerning the appropriateness of behavior reduction procedures are made more difficult to answer when those procedures are designated by names laden with surplus meaning. Attempts by professional associations to address the behavior reduction dilemma offer opportunities for implementing more precise, less pejorative terms. Toward that end a conceptual framework is presented that could guide the choice If an alternative terminology for behavior reduction.
The application of punishment in human service programs continues to be controversial. Concern over the application (or misapplication) of unpleasant or noxious stimuli has led to the suggestion that punishment and aversive procedures should be abandoned in favor of less aversive alternatives (Donnellan, Negri-Shoultz, Fassbendes, & LaVigna, 1988; Evans & Meyer, 1985; Guess, 1988). At least one major professional organization has renounced the use of "intrusive procedures" (The Association for Persons with Severe Handicaps, 1981). Withholding treatment on the basis of presumed aversiveness raises ethical issues in its own right, however, because severe behavior disorders, left untreated, may cause pain or harm to the untreated individual, or to others in that individual's environment (Schopp, 1984). This concern is especially salient when the treatment that is withheld has been shown to be more effective in remediating the disorder than nonaversive alternatives (Baer, 1970; Neel, 1978; Van Houten, 1983). This conflict between two valid, yet conflicting, ethical claims makes the topic one that defies easy resolution.
Ethical concerns may be only part of the problem. In the case of punishment or aversive stimulation, it could be argued that at least some of the controversy and confusion has been generated by the terms themselves. The prevailing terminology used to designate behavior reductive procedures may be profoundly tainted by associations with colloquial usage and inhumane practice. Arguments for and against the use of punishment suggest that both the effectiveness and the noxiousness of behavior reductive procedures are crucial in deciding whether and when to use those procedures (Harris & Ersner-Hershfield, 1978; Martin, 1975). Yet it could be argued that current terminology hinders research in either domain by confounding what are essentially two conceptually distinct issues.
The present review does not argue the appropriateness or inappropriateness of behavior reduction procedures. Strong cases have been made, both for the effectiveness of, and the ethical problems associated with, punishment. Rather, it is argued that the most widely used terms in this area, punishment and aversive, are rooted in misconception and continue to promote misunderstanding and confusion. By confounding the domains of effectiveness and ethics, the current terms may in fact hinder systematic research and may cloud public discussion concerning the appropriate use of behavior reductive procedures.
CONCEPT OF PUNISHMENT
The definition of punishment most widely adhered to in the current literature was proposed by Azrin and Holz (1966). They defined punishment as follows:
Our minimal definition will be a consequence
of behavior that reduces the future probability
of that behavior. …