Functional Communication Response Research Articles

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.

Shaping complex functional communication responses.

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed.

Incorporating Interview-Informed Functional Analyses into Practice.

We replicated and extended the effects of an assessment and treatment model employed by Hanley et al. (Journal of Applied Behavior Analysis, 47, 16-36, 2014) with one participant receiving home-based services. Following a functional analysis, we taught the participant multiple functional communication responses (FCRs) and to tolerate delays and denials to requested items. The participant learned the FCRs and the delay to reinforcers was increased to 34min. Results generalized across stimuli, people, settings, and time. Social validity results supported that the behaviors were important, the treatment was acceptable, and the effects were significant.

Further evaluation of latency measures in the assessment and treatment of severe self‐injurious behavior

Recent research has demonstrated the utility of latency measures during the functional analysis of problem behavior; however, few studies have evaluated the utility of latency measures during subsequent treatment analyses. The current study seeks to extend the literature on the use of latency measures during the treatment of severe self‐injurious behavior (SIB). Following a latency‐based functional analysis, a treatment analysis was conducted using a hybrid procedure in which baseline sessions were terminated following the first instance of SIB, and test sessions ended after a fixed length of time. Latency to SIB was compared across conditions, whereas latency and rate measures for both SIB and functional communication responses were compared for the functional communication training condition. Results suggest that latency measures may be too sensitive during treatment analyses and that it is beneficial to use a hybrid procedure that allows for both latency and rate comparisons.

Treatment of Self-Injurious Behavior in Adults with Intellectual and Developmental Disabilities: A Systematic Review

The current review summarized 54 peer-reviewed articles concerning the assessment treatment of self-injurious behavior (SIB) in adults with intellectual and developmental disabilities. Results indicated that functional analysis was most commonly used to identify the operant function of SIB. Noncontingent reinforcement, differential reinforcement, functional communication training and response blocking were found to be the most frequently implemented interventions across studies. The methodological quality of each study was evaluated using the Council for Exceptional Children quality indicator standards. None of the included studies met all indicators to be considered methodologically sound. Directions for future research and implications for practice are discussed.

A preliminary investigation on improving functional communication training by mitigating resurgence of destructive behavior.

Despite the effectiveness and widespread use of functional communication training (FCT), resurgence of destructive behavior can occur if the functional communication response (FCR) contacts a challenge, such as lapses in treatment integrity. We evaluated a method to mitigate resurgence by conducting FCT using a multiple schedule of reinforcement prior to extinction. After functional analyses of 2 boys' destructive behavior and treatment with FCT (Study 1), we compared levels of resurgence during an extinction challenge either after a typical FCT sequence or after exposure to schedule thinning in the context of a multiple-schedule arrangement (Study 2). Results for both participants suggested that schedule thinning using discriminative stimuli in a multiple schedule mitigated the resurgence of destructive behavior.

Evaluation of multiple schedules with naturally occurring and therapist-arranged discriminative stimuli following functional communication training.

Many studies have shown that (a) functional communication training (FCT) is effective for reducing problem behavior, and (b) multiple schedules can facilitate reinforcer schedule thinning during FCT. Most studies tha have used multiple schedules with FCT have included therapist-arranged stimuli (e.g., colored cards) as the discriminative stimuli (S(D) s), but recently, researchers have evaluated similar multiple-schedule training procedures with naturally occurring S(D) s (e.g., overt therapist behavior). The purposes of the current study were to compare the effects of arranged and naturally occurring S(D) s directly during (a) acquisition of discriminated functional communication responses (FCRs) and (b) generalization of discriminated FCRs when we introduced the multiple schedules in novel contexts in which the naturally occurring stimuli were either relatively easy or difficult to discriminate. Results showed that (a) 2 of 3 participants acquired discriminated responding of the FCR more rapidly with arranged than with naturally occurring stimuli, (b) 2 of 3 participants showed resurgence of problem behavior , and (c) 2 of 3 participants showed greater generalization of discriminated responding to novel contexts with arranged stimuli than with naturally occurring stimuli. We discuss these results relative to the conditions under which naturally occurring and arranged S(D) s may promote rapid and generalized treatment gains.

Response restriction produces discriminated responding consisting of high rates of communicative responses when reinforcement is available and low/no communicative responding when reinforcement is unavailable while maintaining low rates of destructive behavior in four young children

This review provides a summary and appraisal commentary on the treatment review by Fisher, W.W., Greer, B.D., Querim, A.C., & DeRosa, N. (2014). Decreasing excessive functional communication responses while treating destructive behavior using response restriction. Research in Developmental Disabilities, 35, 2614–2623.Source of funding and disclosure of interest: No source of funding reported, and no conflicts of interest reported by the original authors of this research report.

Decreasing excessive functional communication responses while treating destructive behavior using response restriction.

Functional communication training (FCT) is an established treatment for destructive behavior that missucceeds in about 37% of cases when the reinforcement schedule for the functional communication response (FCR) is thinned using multiples schedules (mult FCT; Hagopian, Boelter, & Jarmolowicz, 2011). In this investigation, we evaluated the use of response restriction FCT (RR FCT) in a cohort of patients with poorly differentiated responding of the FCR during mult FCT. Results showed that (a) RR FCT maintained high rates of correct FCRs during the reinforcement component of RR FCT without increasing destructive behavior; (b) children displayed highly discriminated FCRs when an FCR card and a control card were simultaneously available during the reinforcement component of RR FCT; and (c) near-zero rates of destructive behavior were observed during the last five sessions of the terminal reinforcement schedule. Results are discussed relative to differences between mult FCT and RR FCT and successive and simultaneous discriminations.

A COMPONENT ANALYSIS OF SCHEDULE THINNING DURING FUNCTIONAL COMMUNICATION TRAINING

One limitation of functional communication training (FCT) is that individuals may request reinforcement via the functional communication response (FCR) at exceedingly high rates. Multiple schedules with alternating periods of reinforcement and extinction of the FCR combined with gradually lengthening the extinction-component interval can effectively address this limitation. However, the extent to which each of these components contributes to the effectiveness of the overall approach remains uncertain. In the current investigation, we evaluated the first component by comparing rates of the FCR and problem behavior under mixed and multiple schedules and evaluated the second component by rapidly switching from dense mixed and multiple schedules to lean multiple schedules without gradually thinning the density of reinforcement. Results indicated that multiple schedules decreased the overall rate of reinforcement for the FCR and maintained the strength of the FCR and low rates of problem behavior without gradually thinning the reinforcement schedule.