When challenging behavior poses minimal risk to the individual or the implementer, extinction generally can be implemented without taking additional steps to ensure safety. As risk increases, care needs to be taken to ensure safety should extinction result in increases in the frequency of the target behavior and/or occurrence of other undesired behaviors. If safety cannot be maintained, then extinction should not be used. When the function of the behavior is attention, it may be difficult for some individuals to withhold attention when the behavior occurs, in which case extinction is not recommended. If the function of the behavior is gaining access to certain activities or items, then extinction should not be considered unless it is feasible to withhold those items.

For responses maintained by escape or avoidance, interventions should include antecedent strategies to reduce the aversiveness of the context or situation. Examples include adjusting the difficulty of a task or the amount of time a task occurs for. If a response is maintained by access to items or activities, then extinction is feasible only if access can reasonably be restricted should the problem behavior occur. In all cases, it is important that the person has one or more alternative ways of obtaining access to desired items or activities (e.g., FCT), and that those behaviors are reinforced (pay off).

When a response seems to be maintained by sensory or automatic reinforcement, extinction is more difficult and often not feasible. Sometimes devices or equipment can be used to reduce effects of the behavior, and if this results in reduction in responding, this could be extinction. For example, someone who bites their fingertips might wear gloves to reduce the sensation of biting. In general, extinction is not effective for such behavior.

Another important consideration is negative emotional arousal. Because extinction involves ensuring that a response is no longer reinforced, undergoing extinction can be difficult for a person for whom it is being implemented. A person experiencing extinction may experience significant emotional distress. Therefore, it is important that anyone considering the use of extinction understand that such distress is likely to occur and be certain that all stakeholders agree that using extinction to reduce challenging behavior is necessary and is able to justify its use in the face of significant distress.