Functional Communication Response Research Articles

Functional Communication Training Including Discrimination and Tolerance to Denial for Elementary Age Students With Autism

Functional communication training (FCT) provides an efficient means for reducing a variety of challenging behaviors while increasing social communication. After establishing a functional communication response (FCR), interventionists may need to design a program to thin the schedule of reinforcement to provide more durable effects and maintenance in the natural environment. Hanley et al. provided one means for thinning schedules that involved the systematic introduction of extinction (or denial trials) following a process of delaying reinforcement. This study evaluates a classroom application of this thinning process with three elementary age students who engaged in a variety of aggression, self-injury, disruption, and crying. The results indicate positive effects of the FCT program with systematic introduction of denial trials once the participants demonstrated proficiency with the FCR. In addition, data for two participants show prolonged effects post-intervention. Results are discussed in terms of extending Hanley et al. and how these procedures can be used within typical school-based settings.

Using Pyramidal Training to Address Challenging Behavior in an Early Childhood Education Classroom

Challenging behavior exhibited by students in a school setting is one of the most significant obstructions to student learning. These behaviors often warrant specialized interventions delivered by educators in the presence of typically developing peers; however, the availability of personnel to prepare educators to implement said interventions is limited. One viable solution may be to leverage a pyramidal training model in which training is provided in tiers, allowing for more individuals to be trained within a shorter period. In the current study, one researcher utilized pyramidal training to prepare four educators to implement functional communication training without extinction to decrease aggression toward peers for one student in an inclusionary early childhood education setting. With written instruction only (similar to what a teacher might receive as part of a behavior intervention plan), all educators implemented the intervention with low fidelity (M = 15% steps completed correctly). Post-intervention, all educators were able to implement the intervention with the trainer at or above 80% fidelity, and skills improved to 100% fidelity during in situ training with the student. For the student, aggression was completely decreased to zero levels, and functional communication responses increased. Moreover, all results were maintained after the holiday break without additional training. Implications for research and practice will be discussed.

Evaluation of a break‐to‐choice chained‐schedule intervention for multiply maintained problem behavior

AbstractInterventions for multiply maintained problem behavior often involve developing separate treatment conditions to address each function. Although isolating treatment conditions lead to positive outcomes, developing individual treatments for each identified function may be time‐consuming. Alternatively, synthesizing treatment procedures may allow for more efficient treatment effects. We extended previous research by evaluating functional communication training (FCT) and chained schedules of reinforcement to treat multiply maintained problem behavior in children diagnosed with autism spectrum disorder. First, we conducted a functional analysis that concluded problem behavior was multiply maintained. Next, we taught functional communication responses (FCRs) and implemented a chained schedule of reinforcement. During the initial link, FCRs for a break resulted in the presentation of a choice menu with the other putative reinforcers in the terminal link. The relevant reinforcer was delivered contingent on the emission of subsequent FCRs. Finally, we systematically schedule thinned to caregiver‐informed terminal schedules for each participant. The results of our study demonstrated that FCT, in combination with a sequential compound schedule of reinforcement, effectively decreased multiply maintained problem behavior and increased appropriate alternative responses (FCRs and compliance) even at terminal schedules of reinforcement.

A Practitioner's Guide for Selecting Functional Communication Responses.

Functional communication training (FCT) is an effective and widely used procedure to reduce problem behaviors. The purpose of FCT is to replace a problem behavior with a socially appropriate and communicative behavior - the functional communication response (FCR), which produces the same reinforcer as the problem behavior. Recent reviews of FCT have focused on providing overall recommendations for how the procedure should be implemented. A relatively small body of literature has been devoted to the selection of the FCR. The purpose of this article is to propose a set of considerations for practitioners in selecting FCRs.

Parent-Implemented Behavior Interventions via Telehealth for Older Children and Adolescents.

Children and adolescents with intellectual and developmental disabilities (IDD) are more likely to engage in challenging and interfering behavior than their typically developing peers, which has been linked to many negative outcomes. The most effective interventions to address challenging and interfering behavior incorporate function-based assessments, which are used to develop individualized behavior interventions. Functional communication training (FCT) is an evidence-based practice to decrease challenging and interfering behavior that can be taught to parents using behavioral parent training (BPT); however, there are limited skilled professionals who can develop interventions and train parents. Telehealth can enable greater access to these professionals. This study used withdrawal designs to determine whether high parent treatment fidelity resulted in decreased challenging and interfering behavior and increased appropriate replacement behavior. Three participants (8–17 years) were included in the study, and their parents served as interventionists during mealtime, toothbrushing, and room cleaning. Data were analyzed using visual analysis. Each parent achieved high treatment fidelity with one session of BPT and bug-in-ear coaching. All participants had a decrease in challenging and interfering behavior and an increase in functional communication responses (FCRs) upon the introduction of the intervention with reliable reversals. All parents reported high social validity. Results and implications for practice and future research are discussed.

Understanding the effects of prompting immediately after problem behavior occurs during functional communication training.

When reported, the methods for prompting functional communication responses (FCRs) following problem behavior during functional communication training (FCT) vary. Some researchers have prompted the FCR immediately following problem behavior but doing so may inadvertently strengthen problem behavior as the first link in an undesirable response chain. This study investigated the effects of prompting FCRs following problem behavior during FCT with 4 children who exhibited severe problem behavior. Problem behavior remained low and FCR rates were near optimal when prompts were delivered immediately following problem behavior for 2 participants. Delaying prompts following problem behavior was instrumental for FCR acquisition for 1 participant but led to escalation of problem behavior for a 2nd participant. The conditions under which immediate prompts following problem behavior may improve or worsen FCT are discussed.

Efficiency and preference for alternative activities during schedule thinning with functional communication training.

Functional communication training is an effective treatment for decreasing socially reinforced destructive behavior (Carr & Durand,1985). Clinicians frequently use multiple schedules to thin the reinforcement schedule (Hanley et al.,2001). Individuals are often taught to wait for functional reinforcers without alternative programmed stimuli. However, concurrently available items and activities are often accessible in the natural environment. In this study, we taught 4 participants a functional communication response to access functional reinforcers. We implemented a multiple schedule during schedule thinning, comparing a control condition (nothing available during SΔ intervals) to separate conditions with items/activities (moderately preferred tangible items, attention, demands) noncontingently available during SΔ intervals. After reaching the terminal schedule in one condition, therapists assessed participant preference across SΔ conditions. For all participants, the terminal schedule was reached with alternative items and activities, and participant preference corresponded with the most efficient schedule thinning condition. Therapists also indicated preference for alternative items/activities.

LOCCATE: A tool to identify the diagnostic spectrum profile of motor function and functional communication responses for the individual with a prolonged disorder of consciousness

ABSTRACT Standardized neurobehavioural assessment tools (SNBATs) form a key aspect of diagnostic assessment for individuals with prolonged disorders of consciousness (PDOCs). Each SNBAT has different psychometric properties, operational definitions of behaviours, scoring systems and methods of administration. Selection and implementation of SNBATs varies within and between healthcare settings. Defining diagnostic and prognostic parameters requires collating multiple SNBAT results over time, which is problematic if several assessors and professions are involved. The Levels of Consciousness Calibration of Assessment Tools Evaluations (LOCCATE) is the first tool designed to calibrate the results of any recognized PDOC SNBAT. It also categorizes the diagnostic spectrum profile of both motor and communication responses into eight criteria of behaviours. Each criterion has up to three levels of reproducibility, ultimately producing a LOCCATE calibration score ranging from 1 to 27. A case study is presented to illustrate changes in LOCCATE scores over time, while an audit explores the tool’s clinical utility. With current directives placing less emphasis on a PDOC diagnosis, there is now a greater need for a calibration tool such as LOCCATE to identify exactly what the individual can do and create an accurate trajectory as an evidence base to support clinical and best-interest decision-making.

Sustaining behavior reduction by transitioning the topography of the functional communication response.

When a functional communication response (FCR) can be reliably occasioned, destructive behavior tends to be lower. However, the form of FCR may affect the durability of functional communication training, as missing FCR materials may promote resurgence. Experiment 1 demonstrated that resurgence of target responding was lower when a vocal FCR remained available but was placed on extinction compared to when a card-based FCR was unavailable. Experiment 2 replicated the finding that initiating treatment with a card FCR produced less target responding than when initiating treatment with a vocal FCR. We then evaluated a set of procedures for transitioning the card FCR to the previously unlearned vocal FCR. These findings suggest benefits of training different types of FCRs at different stages of treatment and provide a preliminary set of procedures for transitioning between FCR topographies while occasioning minimal target responding.

Evaluating skills correlated with discriminated responding in multiple schedule arrangements.

One potential solution for excessively high-rate functional communication responses (FCR) is to establish stimulus control of the FCR through a multiple schedule. However, several studies have demonstrated difficulty with establishing discriminated responding across multiple schedule components. The primary aim of the current study was to evaluate how participants' skills related to color discrimination may be related to the emergence of discriminated responding in a multiple schedule with colors as the schedule-correlated stimuli. Three secondary aims of the current study were to evaluate: a) varied multiple schedule arrangements, b) if topographically dissimilar stimuli facilitated the emergence of discriminated responding, and c) if employing different colored stimuli across multiple schedule arrangements reduced the likelihood that discriminated responding emerged simultaneously across varied arrangements. Nine participants' ability to match, select, tact, and respond intraverbally to colors was assessed, and 1 of 2 evaluations of multiple schedule arrangements were conducted. Results indicated that participants' ability to select and tact colors was strongly correlated with the efficacy of standard multiple schedule arrangements. Additionally, multiple schedule arrangements employing topographically dissimilar stimuli were observed to be equally as effective as standard arrangements and the inclusion of different colored stimuli across arrangements did not reduce the likelihood that discriminated responding emerged simultaneously across all conditions, when it was observed to emerge at all.

DRA contingencies promote improved tolerance to delayed reinforcement during FCT compared to DRO and fixed-time schedules.

Following Functional Communication Training (FCT), clinicians often gradually expose newly taught communicative responses to delayed reinforcement contingencies to prepare clients for the normative environment in which requests are frequently reinforced after a delay. The introduction of delays may result in the resurgence and maintenance of problem behavior and the weakening of the newly trained communicative response. The current study compared delay tolerance with three individuals diagnosed with intellectual and developmental disabilities when reinforcement for the functional communication response (FCR) was delivered following (a) the passage of time, (b) the omission of problem behavior, or (c) the occurrence of an alternative behavior. We measured delay tolerance in terms of minimizing problem behavior and maintaining efficient FCRs. Outcomes support requiring alternative responding during delays to attain optimal treatment results.

Resurgence following differential reinforcement of alternative behavior implemented with and without extinction.

In the clinic, differential reinforcement of alternative behavior (DRA) often involves programming extinction for destructive behavior while reinforcing an alternative form of communication (e.g., a functional communication response); however, implementing extinction can be unsafe or impractical under some circumstances. Quantitative theories of resurgence (i.e., Behavioral Momentum Theory and Resurgence as Choice) predict differences in the efficacy of treatments that do and do not involve extinction of target responding when reinforcement conditions maintaining alternative responding worsen. We tested these predictions by examining resurgence following two DRA conditions in which we equated rates of reinforcement. In DRA without extinction, target and alternative behavior produced reinforcement. In DRA with extinction plus noncontingent reinforcement, only alternative behavior produced reinforcement. We conducted this study in a reverse-translation sequence, first with participants who engaged in destructive behavior (Experiment 1) and then in a laboratory setting with rats (Experiment 2). Across both experiments, we observed proportionally lower levels of target responding during and following the DRA condition that arranged extinction for the target response. However, levels of resurgence were similar following both arrangements.

Mitigating resurgence of destructive behavior using the discriminative stimuli of a multiple schedule.

Results of several recent translational studies have suggested that correlating contextual or discriminative stimuli with the delivery and withholding of reinforcement for the functional communication response (FCR) may mitigate resurgence of destructive behavior, but few, if any, have isolated the effects of those stimuli. In the present study, we first trained the FCR, brought it under stimulus control of a multiple schedule, and thinned its reinforcement schedule in one stimulus context. Next, we conducted resurgence evaluations (i.e., baseline, functional communication training [FCT], extinction challenge) in two novel contexts to test the effects of the discriminative stimuli on resurgence. We programmed one context to include the (a) SD during the FCT phase to signal the availability of reinforcement for the FCR and (b) SΔ during a subsequent extinction challenge to signal the unavailability of reinforcement for the FCR. The other context did not include the SD during the FCT phase, nor the SΔ during the extinction challenge. We expected to see greater persistence of the FCR in the context that included the SD during FCT and less persistence of the FCR and less resurgence of destructive behavior in the context that included the SΔ during the extinction challenge. Obtained results confirmed this latter prediction, but we observed no reliable difference when the SD was present or absent during the FCT phase. Our results have relevance for practitioners in that they provide further empirical support for the use of discriminative stimuli when treating destructive behavior.

Evaluation of an Omnibus Mand in the Treatment of Multiply Controlled Destructive Behavior.

Functional communication training is a commonly used and effective treatment for socially reinforced destructive behavior. However, when a functional analysis suggests that destructive behavior is multiply controlled (e.g., by attention, tangibles, and escape), teaching and evaluating separate functional communication responses (FCRs) can be time-consuming or only partially effective when failing to address multiple establishing operations that may occur simultaneously. We evaluated the use of an omnibus FCR or mand that produced access to attention, tangibles, and escape within each functional-analysis test condition for two boys with autism spectrum disorder who displayed multiply controlled destructive behavior. The omnibus-FCR treatment produced low rates of destructive behavior and high percentages of independent FCRs within each condition for both children, suggesting that such a treatment option may reduce destructive behavior and teach communication skills quickly prior to introducing other treatment components, such as teaching individual FCRs to address each unique function of destructive behavior.

Using Schedule-Correlated Stimuli During Functional Communication Training to Promote the Rapid Transfer of Treatment Effects.

Prior research has shown that bringing functional communication responses under the discriminative control of schedule-correlated stimuli facilitates rapid reinforcement schedule thinning and the transfer of functional communication training (FCT) treatment effects to other therapists and settings. In Experiment 1, we extended this body of research by rapidly transferring FCT treatment effects to a caregiver, despite the caregiver's unique and lengthy history of reinforcement of the child's destructive behavior. In Experiment 2, we evaluated the degree to which FCT treatment effects transferred to another participant's caregivers when the caregivers implemented FCT with and without schedule-correlated stimuli. Rapid transfer of FCT treatment effects occurred only when caregivers used the schedule-correlated stimuli. We discuss the use of schedule-correlated stimuli within FCT procedures as a method of programming for generalization when extending treatment to caregivers.

Thinning Schedules of Reinforcement Following Functional Communication Training for Children with Intellectual and Developmental Disabilities: A Meta-analytic Review.

Functional communication training (FCT) is an evidence-based practice used to mitigate challenging behavior by increasing functional communication skills. To increase the practicality and feasibility of FCT in natural settings, thinning schedules of reinforcement are typically programmed following FCT. In this review, we meta-analyzed 28 studies that incorporated a thinning schedule procedure following FCT for 51 children with intellectual and developmental disabilities ages 8 and younger. Using Tau-U, the results demonstrated overall moderate effect sizes for both challenging behavior and functional communication responses. Additionally, moderator analyses pertaining to participant characteristics, interventions, and study quality were conducted. Thinning procedures were most effective for children who had stronger communication repertoire. Implications for future research and practice are discussed.

Impact of language on behavior treatment outcomes.

Resurgence of problem behavior following effective functional communication training (FCT) can occur if the functional communication response contacts extinction. For children from dual-language households, extinction may unintentionally occur due to language variations among communication partners. In the current study, the experimenters evaluated the effect of language on FCT outcomes. Participants were 3 children with autism who engaged in problem behavior and whose parents reported Spanish as the primary home language. The experimenters conducted FCT in the English language followed by probes in the Spanish language. Results suggest that functional communication responses (FCRs) learned in the first language (English) may lead to resurgence of problem behavior when English FCRs do not contact reinforcement in the untaught language (e.g., Spanish). Two of the participants required additional teaching in the secondary language (Spanish), while the third participant eventually emitted Spanish FCRs in the Spanish condition without explicit teaching.

The Link Between Problem Behavior and Communication Impairment in Persons with Developmental Disabilities

Functional communication training (FCT) is rooted in the theory that if people with developmental disabilities (DD) have a socially appropriate way (i.e., communication) to get their needs or wants met, they will no longer need to resort to problem behavior. This review will examine the history of the link between problem behavior and communication impairment in individuals with DD as well as recent advances in research on FCT and directions for future research. Teaching people with DD a functional communication response (FCR) leads to a decrease in problem behaviors, provided that the FCR is at least as efficient as the problem behavior. Recent findings suggest ways to mitigate the resurgence of problem behavior as well as the importance of teaching an FCR that is acceptable to caretakers and addressing cognitive obstacles that may interfere with caretakers’ ability to carry out FCT. Through programming for maintenance and generalization of the FCR as well as addressing the needs of caretakers when teaching them to implement and sustain FCT, we can improve outcomes for individuals with DD.

Resurgence of Challenging Behavior Following Functional Communication Training for Children with Disabilities: a Literature Review

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.

Assessing the generality and durability of interview-informed functional analyses and treatment.

Due to the limited research demonstrating socially valid outcomes of function-based treatments in ecologically relevant environments (Santiago, Hanley, Moore, & Jin, 2016), we replicated and extended the effects of the interview-informed functional analysis and skill-based treatment procedure described by Hanley, Jin, Vanselow, and Hanratty (2014) with two children diagnosed with autism in a home setting. The assessment and treatment was implemented by a home-based service provider and treatment was extended to the participants' parents. Following the interview-informed functional analyses, we taught the participants functional communication responses and to engage in less-preferred activities when functional communication outcomes were delayed. We observed large reductions in problem behavior following the introduction of the function-based treatment. The effects extended to novel settings, stimuli, and caregivers and the results maintained at 6-week follow-ups.