Functional Communication Training: The Strength of Evidence Across Disabilities

2018 ◽  
Vol 85 (1) ◽  
pp. 86-103 ◽  
Author(s):  
Stephanie Gerow ◽  
Tonya Davis ◽  
Supriya Radhakrishnan ◽  
Emily Gregori ◽  
Gabby Rivera

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.

2020 ◽  
pp. 109830072095799
Author(s):  
Virginia L. Walker ◽  
Megan E. Carpenter ◽  
Amy Clausen ◽  
Katherine Ealer ◽  
Kristin J. Lyon

The purpose of this study was to examine the effects of special educators’ delivery of training that included an initial training session and follow-up coaching on paraprofessional implementation of an evidence-based practice for students with autism spectrum disorder (ASD). Three special educators each trained a paraprofessional in their classroom to implement functional communication training (FCT) to address the challenging behavior of a student with ASD. The training procedures incorporated the following aspects of behavioral skills training: instruction, modeling, rehearsal, and feedback. Training from special educators resulted in high levels of paraprofessional FCT implementation that maintained over time for two paraprofessionals. Special educators and paraprofessionals found the training to be practical and effective. We present implications for practice and future research directions for paraprofessional training models focused on challenging behavior interventions.


2017 ◽  
Vol 42 (3) ◽  
pp. 335-363 ◽  
Author(s):  
Stephanie Gerow ◽  
Shanna Hagan-Burke ◽  
Mandy Rispoli ◽  
Emily Gregori ◽  
Rose Mason ◽  
...  

Supporting parents in reducing challenging behavior of children with autism spectrum disorder (ASD) requires the identification of effective, feasible, and sustainable interventions. Functional communication training (FCT) is one of the most well-established interventions in the behavioral literature and is used increasingly by parents. However, there is a need for additional evaluation of the literature related to parent-implemented FCT. In the present review, we identified 26 peer-reviewed studies on parent-implemented FCT. We conducted systematic descriptive and social validity analyses to summarize the extant literature. Across studies, parent-implemented FCT was effective in reducing child challenging behavior, and in some cases, intervention outcomes maintained and generalized to novel settings and implementers. However, few studies reported fidelity data on parent implementation of FCT, and data regarding sustained use of FCT by parents were limited. Results of the social validity analysis indicate that while FCT is often implemented by natural change agents in typical settings, parent training is often provided by professionals not typically accessible to parents. These findings suggest that future research is warranted in the areas of parent training and long-term sustainability of parent-implemented FCT.


2021 ◽  
Vol 126 (2) ◽  
pp. 114-141
Author(s):  
Nicole Neil ◽  
Ashley Amicarelli ◽  
Brianna M. Anderson ◽  
Kailee Liesemer

Abstract This systematic review evaluates single-case research design studies investigating applied behavior analytic (ABA) interventions for people with Down syndrome (DS). One hundred twenty-five studies examining the efficacy of ABA interventions on increasing skills and/or decreasing challenging behaviors met inclusion criteria. The What Works Clearinghouse standards and Risk of Bias in N-of-1 Trials scale were used to analyze methodological characteristics, and Tau-U effect sizes were calculated. Results suggest the use of ABA-based interventions are promising for behavior change in people with DS. Thirty-six high-quality studies were identified and demonstrated a medium overall effect. A range of outcomes was targeted, primarily involving communication and challenging behavior. These outcomes will guide future research on ABA interventions and DS.


Autism ◽  
2021 ◽  
pp. 136236132110655
Author(s):  
Reem Muharib ◽  
Art Dowdy ◽  
Adithyan Rajaraman ◽  
Joshua Jessel

Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising on efficacy. In this synthesis, we meta-analyzed the literature using log response ratio effect sizes to investigate (a) combined and across type effectiveness of contingency-based delays and (b) moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for autistic individuals (log response ratio = −2.17; 95% CI = (−2.76, −1.58)) and most effective when the contingency incorporated positive reinforcement (log response ratio = −2.30; 95% CI = (−2.83, −1.78)). In addition, delay procedures that included differential reinforcement of alternative behavior were overall more effective (log response ratio = −2.13; 95% CI = (−2.72, −1.55)) than those that involved differential reinforcement of other behavior (log response ratio = −1.24; 95% CI = (−3.84, 1.37)). Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for autistic individuals. Lay abstract Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.


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