In treatment, diametrically opposed courses of action are often pursued. Following the medical analogy, the symptom is not directly attacked because alleviation of the symptom, although possible, does not treat the underlying cause and other symptoms will appear. In contrast, the behavioral therapist views the symptom as learned behavior which can be altered by the systematic application of appropriate procedures derived from learning theory. In the case of Tom, both the psychiatrist and the pediatrician were consistent in their application of the medical model. Tom's nontalking, the symptom, was an indirect expression of an underlying cause and treatment of the symptom did not assume first priority. Tom was maintained in a situation for almost complete years where he experienced a minimal amount of reinforcement in relation to the potential reinforcement present. His kindergarten teacher, who was very conscientious, thought of herself as a failure and experienced a great deal of frustration.