Children with autism experience deficits across a wide variety of skill areas that include social communication. In addition, many children with autism also have comorbid diagnoses that include other types of communication challenges such as apraxia. As a result, these children tend to engage in higher rates of challenging behavior than their peers. This makes the use of Functional Communication Training (FCT) one of the most widely applicable interventions available in the field of Applied Behavior Analysis (ABA).
Due to deficits in effective communication, children with autism often rely on challenging behavior as a form of communication to get their needs met. An extensive body of research supports the use of Functional Communication Training (FCT) across a wide demographic of children, settings and behaviors. Here we look at 5 key facts from the research that you need to know before you get started.
In order to effectively implement FCT, you must understand each of the steps involved.
1. Functional Communication has both advantages and disadvantages
As with any intervention, professionals must carefully consider the advantages and disadvantages of functional communication training.
|Reduces problem behaviors||May result in the development of an undesired behavior chain if not implemented carefully (*see note below table)|
|Increases opportunities for reinforcement|
|Effective with any age and diagnosis|
|Can be taught to parents and teachers|
* When challenging behavior is followed by a prompt for a communicative response and subsequent reinforcement, the child may learn that she needs to engage in challenging behavior in order for her communication to result in reinforcement. To mitigate this concern, prompt the communicative response prior to the occurrence of the challenging behavior.
Here’s an example:
You work with Josie, a 3-year-old with autism, who tantrums when she sees the iPad. Meaning well, staff have taught Josie to say, “I want iPad.” When she begins to cry and throw herself on the floor, staff prompt her to say, “I want iPad.” They reinforce this request by giving her the iPad for 3 minutes. Staff report that her tantrums happen far more frequently now, and she asks for the iPad up to 6 times an hour. Whenever staff present a demand, she begins to tantrum then asks for the iPad. She spends all of her time either engaging in a tantrum or playing on the iPad.
2. Functional Communication Training can be used with children who don’t communicate vocally
Pat Mirenda (2003) reviewed existing research to evaluate the use of different types of augmentative and alternative communication (AAC) in teaching functional communication to children who don’t use speech functionally. Many children with autism lack sufficient vocal verbal ability to clearly communicate what they want. For many of these children, challenging behavior becomes a primary means of communication.
Children who don’t communicate with speech learn to get what they want through a variety of means, often including challenging behavior. Teaching these children to use AAC (sign language, PECS, or Speech Generating Device) to communicate these wants and needs leads to a reduction in undesirable behavior as they develop a more extensive repertoire of mands.
Children who use AAC to communicate can be taught to mand for those things they want as we would do with their vocal verbal peers. You can create programs for teaching children to use AAC to request desired items, activities or attention or to escape from those tasks they don’t want to participate in.
Even if your learner uses AAC, incorporate FCT in your programming if this would otherwise be an appropriate intervention.
3. FCT can reduce challenging behavior maintained by multiple variables
One of the keys to effective intervention in ABA is teaching functionally equivalent replacement behavior when trying to reduce or eliminate challenging behavior. Often functional communication serves as one of the best replacement behaviors, whether the behavior is maintained by access or escape.
Prior to implementing FCT, you must conduct a functional behavior assessment (FBA) or functional analysis (FA) to identify the function of the challenging behavior. If you’re not sure which is best for your specific situation, read the article: What is the Difference Between Functional Analysis and Functional Behavior Assessment? on Accessible ABA. Often, the assessment identifies multiple different variables that support the challenging behavior.
For example, aggression might be initially triggered by the demand to engage in a difficult task during a period of low attention with a consistent response of an adult nagging or negotiating compliance. In this situation, it’s likely that the aggression is maintained both by adult attention and escape from the task demand. When you use FCT to teach the child to first request the adult’s attention and then ask for a break, then you teach replacement for both of the identified functions of behavior.
Accurately identifying the function of the challenging behavior leads to successfully determining which communicative response best serves as a replacement behavior. Carr and Durand (1985) conducted a study that evaluated the effectiveness of FCT on behaviors that were controlled by access to adult attention and escape from difficult tasks. Teaching communicative responses that serve the same function (i.e. access or escape) often leads to meaningful decreases in challenging behavior.
4. Functional Communication Training can be implemented by parents and teachers
Mancil and Boman (2010) looked at generalizing functional communication that was initially taught in a clinical setting to a more natural setting such as the home or school. The authors identified 10 support components that improved the maintenance and generality of functional communication training:
- Data collection procedures
- Seizing the environment
- Planning for generalization
- Following data
Although all of these 10 components belong in most ABA treatment packages, it’s helpful to specifically relate them to FCT when considering having professionals or parents outside the field implement the intervention. Training must include all of these components for successful implementation.
Due to the relative simplicity and effectiveness of FCT, parents and teachers often find this intervention highly acceptable and willingly implement it. With minimal training, parents and teachers often implement the intervention with high fidelity.
5. FCT can be included in a comprehensive treatment package to reduce high intensity behavior
In the article: Autism and Social Skills: Complete Guide we discuss the use of a Hard Times Board to teach functional communication as a replacement for challenging behavior. In the example below, the social story includes a functional way for the child to use language to escape from an aversive stimuli (a loud noise). The social story identifies the triggers, things the child can’t do and then what the child can say to get away from the noise.
Gerhardt, Weiss, and Delmonlino (2004) used a treatment package that included functional communication training and noncontingent reinforcement (NCR) to reduce severe aggression from an 18 year old man with autism. NCR is the delivery of the identified reinforcer for a challenging behavior independent of a specific response. Here’s an example:
You conduct an FBA to determine the variables maintaining your client’s aggression. Based on data analysis, you hypothesize that the behavior is maintained by access to a tangible, specifically the iPad. You determine that NCR is the best intervention to reduce this behavior and establish an initial reinforcement interval of 10 minutes based on baseline data. You train parents to provide your client with the iPad every 10 minutes, regardless of what your client is doing during that interval.
During NCR, there is no requirement that the child perform any specific response or behavior to earn reinforcement. NCR can be an effective intervention when included as part of a complete treatment package that teaches an adaptive alternative behavior. FCT teaches the child how to request that item (or attention or escape, etc.) and NCR reduces the motivating operations (MO) for that reinforcer. Used together, FCT and NCR form a powerful treatment package for high intensity behavior.
6. Functional Communication Training can be taught using 4 steps
Teaching functional communication requires careful planning and an understanding of what the child wants. Whenever a child struggles to communicate effectively, develop a plan to help him get his needs met through functional communication.
Functional Communication Training-Step 1
The first step to implementing functional communication training is to define the challenging behavior and complete a functional behavior assessment (FBA) to determine why the behavior is occurring. This is essential in effectively implementing this strategy. To learn more about creating behavioral definitions and determining function, read our posts: Operational Definitions: Clearly Define the Behavior and Functions of Behavior in ABA: Complete Guide.
Functional Communication Training-Step 2
The second step involves identifying an appropriate form of communication that results in the learner getting what he or she wants based on the outcome of the FBA. You must consider what type of communication will work best for the learner. Can the learner use verbal language, PECS, or sign language?
Functional Communication Training-Step 3
During Step 3, you teach the communication that you identified in the previous step by creating situations where the challenging behavior is likely to occur, then prompting the appropriate communication, before the behavior occurs. If the learner uses the communication, or even attempts the communication, as it was prompted, immediately reinforce this by giving the learner access to the item or activity that was requested. If the learner engages in challenging behavior, do not allow access to the item or activity. This behavior should be ignored, if possible.
Functional Communication Training-Step 4
In Step 4, you create opportunities for the learner to practice the communication across settings and situations. You must continue to prompt the communication as needed to ensure the learner accesses what he or she wants at each opportunity. Fading prompts must be done systematically to ensure the learner continues to use the response while promoting independent responding.
There are a couple of important things to keep in mind. Initially, every attempt at communicating by the learner should be reinforced by granting access to what was requested. This can be impractical at times but is crucial for success. Once the learner has mastered the communicative response, it would be appropriate to occasionally deny access to what was requested when the request is impractical or unavailable. Additionally, it is important to ensure that the challenging behavior does not result in the learner gaining access to what he or she wants. If the learner continues to access what he wants through the challenging behavior, it is unlikely he or she will use the communication you are trying to teach.
7. Children can learn to identify “signals” for when reinforcement is available
One concern with functional communication training is the relatively high rates of reinforcement requested by children. Initially, when using FCT, interventionists must reinforce each request made by the child to reinforce the communicative response. This can lead to rates of reinforcement that are impractical in the natural environment (i.e. home or school). To address this concern, Kuhn, Chirighin, and Zelenka (2010) taught 2 children to discriminate between times when adults engaged in busy and non busy activities. The children’s communicative responses were reinforced during the non busy activities and they were taught to wait during the busy activities.
This study opens the door to other means of signaling to the children the need to wait for a period of time before reinforcement is available again. The authors in the study used natural cues to signal availability of reinforcement , although similar studies have also looked at more contrived stimuli (i.e. signal cards). Although consistent reinforcement is critical to the success of FCT, for the intervention to be practical in the natural environment, teaching delay to reinforcement is a critical step in the process.
Parents, teachers or direct care staff can signal when reinforcement is available through a variety of means such as a bracelet, card or activity. Although it takes a little time and effort to teach this delay to reinforcement, it’s well worth it in the long run.
Functional Communication Training in Action
Let’s take a look at this example:
Mike works with a 6-year-old student named Sam who has autism and limited verbal skills in a general education classroom. Sam’s class is working on simple addition skills. Sam is able to count and write numbers. He has begun to scream and bang the table each time Mike gives him a worksheet to practice addition. Mike believes that FCT would be an appropriate way to help Sam. He begins Step 1 and works with the BCBA in the school to conduct an FBA to determine why Sam has started doing this. The results of the FBA indicate that Sam is trying to gain attention in the form of help from Mike.
During Step 2, Mike and the BCBA decide that Sam needs to learn to ask for help. They decide that PECS is appropriate for Sam, as he is already proficient with making several requests. Sam will give a picture symbol for help to Mike.
Mike moves on to Step 3 of FCT. He teaches Sam to request help by creating multiple situations where Sam is unable to complete his work independently. Mike places the picture symbol for help on the front of Sam’s communication book, within easy reach. During the first trial, Mike gives Sam a worksheet with one difficult math problem on it and immediately prompts Sam to exchange the picture symbol. Mike responds by saying, “You want help,” and assists Sam in completing the problem on the worksheet.
Mike continues with Step 4. He repeats the process through a variety of different worksheets and activities that require help from Mike. Mike gradually fades prompts used to assist Sam in asking for help using a time delay. During one trial, Sam begins screaming and banging the table. Mike turns away from Sam. He does not provide any help. Once Sam is quiet, Mike turns back to Sam who is then able to request help using the picture. Mike shortens the time delay during the next several trials to reduce the likelihood Sam would engage in these behaviors. After many days, Sam is able to independently use the picture to ask Mike for help. Mike made sure that Sam only got help when he used the picture to ask.
References and Further Reading
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of applied behavior analysis, 18(2), 111-126.
Gerhardt, P. F., Weiss, M. J., & Delmolino, L. (2004). Treatment of severe aggression in an adolescent with autism: Non-contingent Reinforcement and Functional Communication Training. The Behavior Analyst Today, 4(4), 386.
Kuhn, D. E., Chirighin, A. E., & Zelenka, K. (2010). Discriminated functional communication: A procedural extension of functional communication training. Journal of Applied Behavior Analysis, 43(2), 249-264.
Kurtz, P. F., Boelter, E. W., Jarmolowicz, D. P., Chin, M. D., & Hagopian, L. P. (2011). An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Research in Developmental Disabilities, 32(6), 2935-2942.
Mancil, G. R. (2006). Functional communication training: A review of the literature related to children with autism. Education and Training in Developmental Disabilities, 41(3), 213.
Mancil, G. R., & Boman, M. (2010). Functional communication training in the classroom: A guide for success. Preventing School Failure: Alternative Education for Children and Youth, 54(4), 238-246.
Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism. Language, speech, and hearing services in schools.
Volkert, V. M., Lerman, D. C., Call, N. A., & Trosclair‐Lasserre, N. (2009). An evaluation of resurgence during treatment with functional communication training. Journal of Applied Behavior Analysis, 42(1), 145-160.