DESCRIPTION OF THE STRATEGY

Children and adults with developmental disorders often engage in behaviors that are
extremely disruptive and occasionally dangerous to themselves and others. Aggression, selfinjurious behavior, and other disruptive behaviors pose a serious threat to efforts to help these
individuals lead more independent lives. Traditional behavioral approaches to treatment
typically include a wide range of punishing consequences, including time-out from positive
reinforcement, contingent restraint, overcorrection, and, in extreme cases, contingent electric
shock. Although many of these interventions demonstrate effectiveness in the initial reduction
of challenging behaviors, sustained and clinically relevant improvements are elusive.
Over the past several decades, researchers have studied the functions or reasons why these
behaviors occur among persons with developmental disabilities. Several functions seem
important, including attention from others, escape from demands, access to desired tangibles,
and sensory stimulation. With our growing knowledge of the functions of these behaviors has
come interventions that rely on this understanding for their design. The most heavily
researched of these function-based approaches was developed in the mid-1980s and has been
referred to as functional communication training (FCT). FCT specifically uses communication
to reduce challenging behavior. This strategy includes assessing the variables maintaining the
behavior to be reduced and providing the same consequences for a different behavior. It is
assumed that if individuals can gain access to desired consequences more effectively with the
new response, they will use this new response and will reduce their use of the undesirable
response. Applying this logic to challenging behavior, one is able to teach individuals more
acceptable behaviors that serve the same function as their problem behavior. So, for example,
we could teach students to ask for attention in a classroom by saying, Am I doing good
work? This would allow them to gain teacher attention in this appropriate way rather than in
an inappropriate way such as through slapping their face.
The mechanism behind the success of FCT is assumed to rely on functional equivalence. In
other words, behaviors maintained by a particular reinforcer (e.g., escape from work) are
replaced by other behaviors if these new behaviors serve the same function and are more
efficient at gaining the desired reinforcers. Using communication as the replacement behavior
provides an added benefit because of its ability to recruit natural communities of the desired
reinforcers. One effect of this view of behavior problems is that it suggests that these
behaviors are not just responses that need to be reduced or eliminated. This perspective
reminds us that attempting to eliminate these behaviors through some reductive technique
would leave these individuals with no way of accessing their desired reinforcers and there
fore you could anticipate that other maladaptive behaviors would take their place (also called
symptom substitution or response covariation).
To assess the function of a problem behavior, the antecedents and consequences of that
behavior are identified. Once the purpose of a targeted behavior is understood, individuals can
be taught to request the variables previously obtained by the challenging behavior. There are a
number of functional assessment strategies that are useful for determining the function of
behavior, including ABC charts, functional analyses, and a variety of rating scales. Most
clinicians begin with informal observations and interviews of significant others but continue
the process using multiple forms of assessment, including rating scales such as the Motivation
Assessment Scale (MAS) and structured observations in the individuals' environment.
Information from these functional behavioral assessments are used to design plans for
reducing the behavior problems.

A functional analysismanipulating aspects of the environment to assess behavior change

is frequently cited as the best method of determining the function of a behavior problem.
However, there are also a number of issues to consider prior to conducting this type of
assessment. One issue is accessibility to manipulation. There are certain influences that you
cannot or would not manipulate or change in order to perform a functional analysis. Factors
such as some illnesses, disrupted family life, and chromosomal aberrations can certainly affect
behavior problems, but they cannot or should not be turned on and off in order to assess their
influence.
Another concern involves the ethics of conducting a functional analysis. There are other
influences that you could manipulate, but you may not want to change if they will result in an
increase in challenging behavior. In many instances, deliberately increasing a severe behavior
problem in order to assess it (e.g., by reinforcing challenging behavior) can be questioned on
ethical grounds. In these cases, assessment that does not involve manipulation (and
subsequent increases in challenging behavior) would be recommended.
The type of response to encourage from the individual needs to be determined. If the
individual already has some facility in one mode of communication (e.g., verbal, signing),
then that mode should be considered for FCT. Usually, if an individual has been unsuccessful
in learning to communicate effectively after extensive verbal language training, then the
communication modality to be used should either be signing or symbolic. If the person has
also been unsuccessful with sign language training (e.g., has not learned to sign or uses sloppy
and incomprehensible signs), it is typically recommended that some type of symbolic
communication training be used, at least initially. Symbolic communication training can
involve the use of picture books, tokens with messages written on them, or other assistive
devices (e.g., vocal output devices). This form of communication training has the advantage
of being relatively easy to teach and is universally recognizable.
The environment is arranged to create opportunities for communication (e.g., putting an
obstacle in the way of a person trying to open a door and prompting him or her to ask for
assistance). This use of incidental teachingarranging the environment to establish situations
that elicit interest and that are used as teaching opportunitiesis an important part of
successful communication training. Using the person's interest in some interaction, whether it
be a desire to stop working on a difficult task or to elicit the attention of an adult, is a very
powerful tool in teaching generalized communication. As soon as possible, training trials are
interspersed throughout the individual's day where appropriate. Generalization and
maintenance of intervention effects may be facilitated by using the criterion environment (i.e.,
where you want the person to communicate) as the training environment. With the typical
model of teaching skills in a separate setting (e.g., in the speech therapist's office), once the
response is learned, you need to encourage the performance of that behavior in settings where
you want it to occur (e.g., in the cafeteria). By beginning training in the natural or criterion
setting, extensive programming for generalization is not necessary because it will be
occurring where you want it to occur. In addition, obstacles to maintenance can be
immediately identified when teaching in the criterion environment (e.g., are the consequences
being provided in that setting going to maintain the new response?).
Teaching individuals to communicate as a replacement for their challenging behavior requires
a range of sophisticated language training techniques. A multi-phase prompting and promptfading procedure is used to teach the new communicative response. Prompts are introduced as
necessary, then faded as quickly as possible. Some learners negatively resist attempts to

teach important skills (e.g., individual screams and kicks), others positively resist (e.g.,
individual laughs and giggles instead of working), and still others passively resist (e.g.,
individual does not look at materials, makes no response). When an individual kicks, screams,
and rips up work materials whenever they are presented, or passively ignores efforts to get
them to attend to a task, teaching becomes a major challenge and learning becomes highly
unlikely.
One procedure used for these types of problems is to teach the individual to request assistance
(e.g., Help me) or a brief break from work. Often the problem behaviors appear to be
attempts to avoid or escape from unpleasant situations. It makes sense, then, that if the
individual is taught to appropriately request assistance and receives it, then the task will seem
easier and problem behaviors should be reduced. Similarly, if an individual has been working
for some time on a task and is allowed to ask for a break and receives it, then this individual's
problem behavior should also be reduced.
Reducing the individual's reliance on prompts begins by fading back on the most intrusive
assistance being used. In the case of teaching a student to point to a picture book to make a
request, one goes from a full physical prompt to partial prompts (e.g., just touching his or her
hand), to gestural prompts (e.g., motioning to prompt his or her hands), to finally, only the
verbal prompt What do you want? Throughout the individual's training, delayed prompting
is used extensively. After several trials, clinicians intersperse a trial with a delayed prompt
(i.e., we waited approximately 5 seconds) to see if the individual would respond without the
next level of prompt. For example, if a student had been responding to just a touch of his or
her hand to point to a picture, one would make a gesture as if the student was about to be
prompted, and then wait 5 seconds.
It is recommended that one not wait until responding is extremely stable to move on to the
next level of prompting. One should attempt to move to the next step if the individual is
successful at a step for three to five consecutive responses. This is done in order to prevent the
person from becoming prompt dependent (i.e., too reliant on prompts to respond). Training
progresses quickly over several weeks to the point where the individual can communicate
with no external prompting. As is typical in training, behavior improves most dramatically as
soon as the individual begins to make requests without prompts. Once successful, intervention
continues by introducing new communicative forms (e.g., requests for food, music, work),
reintroducing work demands, expanding the settings in which communication is encouraged
to include the whole day, and introducing new staff into the training program.
Recommendations are often made concerning environmental and curricula changes. For
example, it can be useful to consider curricular changes for a student who is attempting to
escape from academic tasks. However, it is wise to approach these types of changes with
considerable caution. The fear is that we will create such an artificial environment that the
student may not be able to adapt to new challenges or new environments. The goal of FCT is
to teach the student a form of coping skill to be able to appropriately respond to new and
unexpected situations (e.g., a new teacher, more difficult work). Therefore, environmental
modifications should be viewed as a form of short-term prevention strategy rather than the
main programmatic intervention.

RESEARCH BASIS

Empirical support for the success of functional communication training to reducing

challenging behavior is growing. Numerous studies are now available demonstrating the
effectiveness of this approach with a wide range of behaviors and individuals. Researchers are
beginning to explore the boundaries of this intervention approach through the study of
maintenance, the role of response efficiency, as well as a variety of other important
parameters.
With growing evidence of the value of this intervention approach in reducing a variety of
problem behaviors, it is important to evaluate how FCT compares with other interventions.
One study, for example, compared the effectiveness of FCT with noncontingent reinforcement
(NCR) on the multiple behavior problems of two children. This research established that both
interventions initially reduced problem behaviors, but that the participants demonstrated a
preference for FCT.
An important aspect of FCTits usefulness outside of specially designed settingshas also
been investigated. Several studies have found that not only can individuals be taught to
communicate to reduce their behavior problems, but their requests can be adapted (at times
using alternative communication systems) so that they are effective outside of school and with
untrained community members. The research to date suggests that we can teach people with
behavior problems ways of communicating that will be understood even by people who do
not have training in the area of communication difficulties or intellectual disabilities.

RELEVANT TARGET POPULATIONS AND

EXCEPTIONS
A variety of individuals with developmental disorders such as autistic disorder and mental
retardation have been assisted with this approach. In addition, new research is exploring its
use with children and adolescents with behavior disorders who do not also have
developmental delays. Research on FCT has focused on severe challenging behaviors such as
aggression and self-injurious behavior, stereotyped behavior, and a variety of communication
disorders. Intervention has been conducted in group homes, schools, and vocational settings.

COMPLICATIONS
Several factors can limit the effectiveness of FCT as an intervention. For example, because of
its reliance on communication, those individuals who are in environments that are relatively
unresponsive to their needs and requests will often be frustrated in their attempts to gain
access to preferred reinforcers. Therefore, major environmental modifications are sometimes
required prior to any attempt to implement FCT. Researchers have documented that the new
more appropriate communicative response must be easier to use than the challenging behavior
for replacement to occur (response efficiency). Individuals will continue to be disruptive if the
requirements for communication are too difficult (e.g., required to speak in a full sentence
versus a brief phrase). Similarly, if the new communicative response is seen as unacceptable
in community settings, then others will not respond appropriately, and the desired
consequences will not be obtained. Finally, if the trained response is not easily recognizable
by significant others in the environment, then these other people will not respond, and
challenging behavior will not be reduced. Efforts must be made to ensure that the
communicative response is clear and unambiguous.

CASE ILLUSTRATION
Michael was a 7-year-old boy with diagnoses of autistic disorder and moderate mental
retardation. He lived at home with his mother and 12-year-old brother and attended the
neighborhood school. Michael could communicate basic requests (e.g., for food, bathroom)
using a picture communication system but used it only with adults. Multiple times throughout
the school day he would become upset and engage in a variety of disruptive behaviors. These
behaviors included self-injury (e.g., face slapping and hand biting), aggression (e.g., pushing
others away, grabbing clothing), and tantrums (e.g., screaming, running out of the classroom).
A variety of functional assessments were conducted, including observations in the classroom
and a rating scale (Motivation Assessment Scale) completed by the teacher and teacher's aide.
These assessments pointed to escape from academic demands as playing an important role in
the maintenance of these behaviors. For example, if Michael was requested to complete a new
task, he would become disruptive. A common consequence used at school was a time-out,
where he was removed from the situation and placed in the corner of the room. This strategy
seemed only to increase the frequency of his disruption.
FCT for Michael involved teaching him to respond to academic demands by requesting
assistance. The rationale was for him to learn that rather than try to escape from new or
difficult situations, he should request help. By requesting assistance and receiving it, this
should make new and/or difficult tasks less aversive. Intervention began by sitting him at his
desk and placing a task in front of him. Before he became disruptive, he was prompted to
point to a new picture placed on his desk (two open hands held out, with the words Help me
written underneath). Prompting occurs prior to any disruptive behavior so that the signal
(discriminative stimulus) for the student's communication is eventually the difficult task and
not an adult responding to the disruption. Once he pointed to the picture, the teacher would
provide extra promptsin essence, making the task easier. Over time, the prompts to point to
the picture were faded until he pointed to the picture only when the task was placed on the
desk. When he could request assistance without prompts, the picture was placed in his
communication book, which was then made available to him on his desk.
Within a few days, Michael would spontaneously point to the picture for help when a new
task was placed in front of him, and this generalized to outside the specific training setting.
Simultaneously, Michael's disruptive behavior was significantly reduced. Whereas before he
was disruptive at least 5 to 10 times per day, now this was reduced to once or twice per week.
At first he asked for help using his picture during most tasks, even ones that were not new or
difficult. Yet, after several weeks, the number of requests was reduced and his teachers were
able to increase the number of new tasks they presented to him since he was rarely disruptive.
V. Mark Durand
Further Reading

Entry Citation:

Durand, V. Mark. "Function Communication Training." Encyclopedia of Behavior

Modification and Cognitive Behavior Therapy. 2007. SAGE Publications. 15 Apr. 2008.
<http://sage-ereference.com/cbt/Article_n2057.html>.