A Mega-Review of Functional Communication Training for Students with Disabilities in Educational Settings

Objectives: For individuals with challenging behavior, antecedent interventions such as modifying the motivation for the behavior have shown to be effective. In this study, we examined the effects of giving the participants the opportunity to continuously request tangible items (e.g. toys and activities) prior to instruction to determine if allowing them to satiate on the item would serve as an effective intervention to reduce challenging behavior maintained by access to the items.Method: Functional analyses identified that access to tangible items maintained the challenging behavior of four children with autism spectrum disorder. The children were then trained using Functional Communication Training (FCT) to request the items. Prior to 15 mins academic and/or functional skill instructional sessions, participants were exposed to either an FCT session and allowed to request the tangible items or did not receive an FCT session. The no FCT condition consisted of the child’s typically scheduled activities, without access to the preferred items maintaining challenging behavior for at least one hour prior to instruction. Following the FCT or no FCT conditions, we measured challenging behavior and academic engagement during 15-mins sessions of one-on-one instruction.Results: When instruction was preceded with FCT as a satiation intervention, we observed lower levels of challenging behavior and higher levels of academic engagement compared to no FCT conditions for two of four participants.Conclusion: Overall, the results of this study appear to support the use of FCT as a viable satiation procedure to reduce challenging behavior in instructional settings.

The purpose of this review was to quantitatively synthesize studies on functional communication training (FCT) for young children exhibiting challenging behavior when FCT was delivered in early care and education settings. Twenty studies published in peer-reviewed journals between 1992 and 2016 that met established inclusion criteria were reviewed and coded on variables associated with child-level, interventionlevel, and study-level characteristics. The What Works Clearinghouse (WWC) standards for evaluating single-case design research were then applied to each study. Study effects were calculated using the percentage of non-overlapping data and Tau-U. Results indicated that FCT interventions had strong effects for reducing challenging behavior. Findings suggest additional studies with more children and methodological rigor are needed before FCT can be characterized as an evidence-based practice for the treatment of challenging behavior of young children with disabilities in early care and education settings based on the WWC's evidence-based criteria. Limitations of the present synthesis and implications for future research are discussed.

Objective: To assess the functions of challenging behaviour in four children with Angelman syndrome (AS) and to study the effects of functional communication training (FCT) with precursor-based prompting. This study builds on and extends the study of Allen et al.Method: Experimental functional analysis assessed behavioural functions. FCT was implemented within an ABAB design and effect sizes were calculated. Burst analyses depict tendencies in (precursor) behaviours surrounding target behaviours.Results: Results show challenging behaviour to be aimed at receiving attention, tangibles or escape. Burst analysis designated physical and eye contact and reaching for tangibles as precursors. Effects of FCT ranged from small to large.Conclusion: Behavioural functions for challenging behaviour were found and FCT was effective in reducing its frequency, when precursors were used as the onset of prompting. Functional equivalence between challenging and communicative behaviour was found. Implementing treatment for challenging behaviour based on precursors is advised.

Parent education programs have become an effective mode of treatment delivery for teaching families effective behavioral strategies to manage challenging behavior in young children with autism. Functional assessment and functional communication training (FCT) are empirically validated procedures that have recently been introduced into parent education programming to help resolve challenging behaviors. The success of these procedures, however, is contingent on family members' ability to integrate them into the specific contexts in which challenging behaviors occur. Consequently, the application of these procedures in home settings necessitates consideration of the family context in the assessment and treatment planning process. A study is presented that investigated the use of information on family context (i.e., caregiving demands, family support, patterns of social interaction) to direct the assessment and intervention planning process. More specifically, information on family context was used to individualize behavioral support plans designed to support family use of functional communication training within important family routines. Through parent-investigator collaboration we individualized the manner in which functional communication training procedures were taught and implemented so they were contextually relevant. Utilizing a multiple baseline design, the challenging behaviors and functional communication of three children with autism were monitored across baseline, intervention (i.e., FCT, and contextulized FCT), and follow-up phases. Multiple routines for each participant were selected and monitored across all phases to evaluate changes in the dependent measures within training and generalization routines. A self-report questionnaire was administered intermittently to parents to determine if consideration of family context improved the "goodness of fit" of the functional communication training treatment packages across FCT and contextualized FCT intervention phases. Results from the study indicate that consideration of family context in the assessment and intervention planning process does not jeopardize and may contribute to the stability and durability of reductions in challenging behavior achieved with functional assessment and functional communication training procedures.

Previous research related to functional communication training has demonstrated its effectiveness across various communication modalities. Additionally, at least one study has demonstrated that, while the intervention can be effective across various communication modalities, individual participants demonstrate a preference among available communication modalities (indicated by response allocation under a concurrent schedules arrangement). The current study evaluated preference among concurrently available communication modalities for 18 individuals with developmental disabilities, including autism spectrum disorder and intellectual disability. Results of the study indicated that each of the individuals demonstrated a preference between communicative response modalities, though preference was not always immediately ascertained. The results are discussed within the context of implications for design and implementation of functional communication training.

Functional communication training (FCT) involves the reinforcement of an appropriate communicative response as an alternative to challenging behavior. The intervention has been identified as an evidence-based practice across multiple populations. Despite its extensive research support, FCT may be impractical in some educational settings because it often requires educators to reinforce alternative responses at high rates. In this discussion article, we describe three procedures (delay to reinforcement, chained schedules of reinforcement, and multiple schedules of reinforcement) that can be used following FCT in educational settings to teach students who exhibit challenging behaviors to tolerate waiting for a reinforcer.

ABSTRACTFunctional communication training is an effective and well‐established intervention for socially maintained challenging behavior. Previous research determined that preference for functional communication responses (FCRs) influences treatment durability. This study extends previous research by evaluating the use of a sequential extinction procedure to establish a hierarchy of preference for FCR modalities within a treatment context. We taught participants different FCR modalities to access the same reinforcer maintaining challenging behavior and assessed modality preference via a concurrent operant mand modality preference assessment measuring FCR modality response allocation and challenging behavior. We then sequentially placed preferred modalities on extinction to establish a preference hierarchy and evaluate persistence of communication and challenging behavior during treatment challenges. Preference hierarchies were established for all participants within the context of treatment (functional communication training). Additionally, some challenging behavior was observed when preferred modalities were placed on extinction; however, effects were temporary and did not always persist across sequential extinction phases. These findings provide preliminary evidence to support teaching multiple communication modalities may lead to a more durable treatment. Implications for clinical practice and future research are discussed.

The purpose of this meta-analysis was to summarize single-case intervention studies in which Functional Communication Training (FCT) involving augmentative and alternative communication (AAC) was implemented in school settings. Overall, the findings suggest that FCT involving AAC was effective in reducing challenging behaviour and promoting aided or unaided AAC use among participants with disability. FCT was more effective for the participants who engaged in less severe forms of challenging behaviour prior to intervention. Additionally, FCT was more effective when informed by a descriptive functional behaviour assessment and delivered within inclusive school settings. Implications for practice and directions for future research related to FCT for students who use AAC are addressed.

Effectiveness of functional analysis (FA) and functional communication training (FCT) on challenging behavior was assessed in three children with Angelman syndrome (AS). Analogue FA conditions were used to assess the behavioral function of the challenging behavior. FA and FCT protocols were administered in the children’s classroom and were performed by their teachers. Replacement behavior was prompted upon the onset of precursor behavior. One or more function(s) of their challenging behavior were identified and challenging behavior appeared to be escape or tangibly motivated. Making physical contact with the teacher was found to be a precursor of challenging behavior in one child. In all children, challenging behavior decreased as a function of FCT. Functional equivalence of both challenging and replacement behavior was evinced. Clinical and research implications are discussed.

Ample research indicates that functional communication training (FCT) is an effective intervention to reduce challenging behavior. The purpose of this study was to evaluate the effect of demand fading on escape-maintained challenging behavior, mands, and task completion for 2 children with autism spectrum disorder. The study utilized an embedded reversal and alternating-treatments design to evaluate the efficacy of the intervention and compare the efficacy of the demand fading and dense schedule conditions. During FCT, participants were taught 2 mand topographies, one of which was associated with demand fading. FCT with and without demand fading resulted in decreases in challenging behavior for both participants. FCT with demand fading resulted in higher task completion for both participants. The effect of demand fading on the rate of mands varied by participant. Results provide further support for the use of FCT. The importance of intervention fading in the treatment of challenging behavior is discussed.

Introduction: Challenging behaviours are frequently observed in children diagnosed with Autism Spectrum Disorder (ASD), potentially hindering their daily functioning. As the prevalence of autism continues to rise, the array of challenging behaviours, including repetitive patterns, stereotypes, and self-harm, emphasizes the importance of developing effective interventions in occupational therapy. These interventions aim to manage these challenging behaviours and enhance the overall wellbeing and functionality of these children. Aim: To compare the effectiveness of Functional Communication Training (FCT), Sensory Integration Therapy (SIT), and Behavioural Interventions (BI) on challenging behaviours in children with ASD. Materials and Methods: An experimental study with prepost test design was conducted in the Paediatric Unit of the Department of Occupational Therapy, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India. The duration of the study was nine months, from September 2020 to May 2021. A total of six (N=6) children selected through convenience sampling. The SIT took place at the paediatric unit of the occupational therapy department at SRM Medical College Hospital & Research Centre, Kattankulathur, Chennai, Tamil Nadu, India. Due to Coronavirus Disaese-2019 (COVID-19) restrictions, FCT and BI were conducted simultaneously at the participants’ homes. Outcomes were measured using Functional Behavioural Assessment (FBA) and the Repetitive Behaviour Scale-Revised (RBS-R). Within-group analysis involved utilising the Wilcoxon signed-rank test, while between-group analysis entailed the application of the Kruskal-Wallis and one way Analysis of Variance (ANOVA) test. Results: The mean age of the study participants was 7.83±1.83 years. A significant reduction in challenging behaviours was seen in all six children in the three intervention groups when outcomes were measured using FBA (p<0.05). Among these interventions, BI proved to be the most effective in reducing the frequency of challenging behaviours in children with ASD, as evidenced by a mean post-test score of RBS-R (19.50±12.02 for BI, compared to 20±1.41 for SI and 23±11.31 for FCT, p=0.047). Conclusion: The results of the study indicated that all three interventions - SIT, FCT, and BI successfully decreased the occurrence of challenging behaviours in children with ASD.

We evaluated the effects of lag schedules of reinforcement during functional communication training (FCT) on the varied use of mands and challenging behavior by two individuals diagnosed with autism. Specifically, we compared the effects of Lag 0 and Lag 1 schedules of reinforcement during FCT. The results showed that each participant exhibited increases in varied mand responding during FCT with the Lag 1 schedule of reinforcement relative to Lag 0; challenging behavior remained low during both FCT lag conditions relative to baseline. Results are discussed in terms of treatment implications relating to FCT and the potential prevention and/or mitigation of clinical relapse during challenges to treatment.

Functional communication training (FCT) is a commonly used, often recommended intervention that involves teaching a functionally equivalent communicative response to replace challenging behavior. The purpose of this literature review was to evaluate the strength of the evidence for the use of FCT. A systematic review of the literature resulted in the identification of 215 single-case-design articles that evaluated the efficacy of FCT to reduce challenging behavior for individuals diagnosed with a disability. FCT resulted in a decrease in challenging behavior for 135 participants. The reviewers rated FCT as an evidence-based practice for individuals with autism, intellectual disability, other health impairments, and multiple disabilities based on What Works Clearinghouse standards. Overall, the extant literature indicates FCT consistently results in the reduction of challenging behavior in children with disabilities. Implications for practice and directions for future research are discussed.

Functional communication training (FCT) is highly effective in reducing challenging behavior and increasing appropriate communication in children with developmental disabilities. However, the challenging behavior may re-occur following successful treatment with functional communication training when the functional communication response contacts extinction. Therefore, it is imperative to evaluate the variables that reduce resurgence of challenging behavior following successful treatment. For the current review, the systematic search yielded 14 articles from the current literature that evaluated resurgence following functional communication training. The effect of demand fading, the language of instruction, the presence of stimuli associated with the intervention, previous exposures to extinction, schedule of reinforcement during baseline, and reinforcing multiple mands were evaluated in the present literature review. Overall, relatively few applied studies with human participants have evaluated variables that affect resurgence. It is imperative that future research utilizes systematic manipulation to identify variables that reduce the resurgence of challenging behavior. Implications for practice and directions for future research are discussed.

More is known about how to reduce challenging behavior with functional communication training (FCT) than how to mitigate its resurgence during or following a course of treatment. Research suggests reinforcing mand variability during FCT may mitigate the resurgence of challenging behavior, but validated procedures for reinforcing mand variability are limited and poorly understood. Lag schedules can reinforce variability in verbal behavior such as manding in individuals with autism, but studies have been largely limited to nonvocal mand modalities. Therefore, in the current study, we further evaluated the effects of FCT with lag schedules on vocal mand variability and challenging behavior in children with autism. The results suggest lag schedules alone or in combination with response prompt-fading strategies during FCT can increase mand variability and expand mand response classes but may fail to produce clinically significant reductions in challenging behavior.