Functional Communication Training (FCT) in Autism

Autism spectrum disorder (ASD) is a range of conditions that features deficits in social skills, speech, and nonverbal communication. Many people with autism also have unique strengths. 

Autism spectrum disorder is a spectrum with a wide range of challenges and strengths for people with autism. Studies have found that various genetic and environmental factors are responsible for autism spectrum disorder. 

Besides showing repetitive behaviors, children with autism have a lot of communication challenges. They express themselves through challenging behaviors, or sometimes they may experience communication breakdowns due to their inability to express themselves. It results in frustration for the child, parents, and people around.

Autism doesn’t have permanent treatment. There are several types of therapies for autism that assist people with autism spectrum disorder (ASD) and alleviate symptoms. Therapy should start at the earliest, when you find the child has ASD, without delaying the diagnosis. Health professionals individualize different approaches as ASD affects each person differently.

There are three branches of the science of behavior analysis that are involved in autism, they are:

1. Behaviorism
2. Experimental Analysis of behavior (EAB)
3. Applied behavior analysis (ABA)

Applied behavior analysis (ABA) is the most commonly used therapy in autism. Backed by scientific studies, ABA improves communication and enhances good behavior. It uses different types of interventions and positive reinforcement techniques, rewards, and consequences.

Functional Communication Training (FCT)

Difficulties in communication and social interaction are a big challenge in children with autism. Children develop frustration and anger that eventually lead to anxiety and depression. 

Functional communication training is an effective therapy to replace interfering behaviors like disruptive, repetitive, and subtle communication in people with ASD.  FCT has its foundation in the applied behavior analysis (ABA) approach.

FCT has its foundation in the applied behavior analysis (ABA) approach. Functional Communication Training (FCT) helps identify the purpose of interfering behavior and assists people with ASD learn a new way of communication.  

For implementing, functional communication training, the practitioner undertakes the following steps:

• Find out and assess the interfering behavior
• Decides the appropriate alternate communication for the child
• Teaches the new communication skills
• Reinforces/strengthens the behavior whenever the child uses the desired communication
• To prompt the child to practice the preferred form of communication
• Disregard or ignore the challenging behavior whenever it happens

We will study the different steps that the teacher/practitioner completes to implement functional communication training (FCT).

1. Identifying the Interfering Behavior 

In the first step, the practitioners:

• Identify inappropriate behavior serving as a communicative function.  
• Find a subtle communication and replace that with a more conventional communication form.

Practitioners like speech or language pathologists identify an interfering behavior. These interfering behaviors may be a repetitive, disruptive, self-injurious, and subtle form of communication. These behaviors continue to occur as they are reinforced unknowingly.

2. Complete a Functional Behavioral Assessment (FBA) 

After identifying the interfering behavior, the practitioner applies systematic strategies to find the underlying function of a behavior. Functional behavioral assessment helps to plan an effective intervention.

FBA describes the interfering behavior and identifies consequent events controlling the behavior. 

• To complete a high-quality FBA, the practitioners use:
  • Indirect assessment method through interviews, record review, and questionnaires
  • Direct assessment- By creating a hypothesis about the function of the interfering behavior, to find reasons for reinforcing the behavior.

An FBA gives the practitioners a clear understanding of why the person with ASD engages in the interfering behavior. 

• For the identification of the function of the interfering behavior, FBA include:
• To gain attention 
• To escape from a situation 
• To get access to something
• To acquire sensory stimuli (e.g., flapping hands during language arts). 

Data also provide information critical for planning effective interventions like:     

• Antecedents- the cause of behavior
• Consequences-what happens after the behavior, helping the reoccurrence 
• Environments- where the interfering behavior occurs  
• People involved-when the interfering behavior occurs  
• The intensity and the frequency- of the interfering behavior.

3. To Identifying a Replacement Behavior for the Interfering Behavior 

After determining the underlying function of a behavior, the practitioners identify a replacement behavior. 

The replacement behavior serves the same function as the interfering behavior. It acts like a substitute.  With the help of the replacement behavior, the person with ASD gets what he wants easily as compared to the interfering behavior. The person with ASD gets reinforcer/incentive to use the replacement behavior if he doesn’t use it.

• The practitioners select an appropriate form of communication e.g., verbalizations, gestures, pictures, singing, or a speech generating device.
• Then the practitioner select and efficient replacement behavior.  It should be simple and easy to acquire and get the reinforcement easily.
• Identify an acceptable and appropriate replacement behavior.

4. Design and Implement Data Collection Procedures

In Step 4, the practitioners design functional, meaningful, and helpful data collection procedures. The data help to monitor the progress of the person with ASD and determine the effectiveness of the FCT. It also assists in identifying ways to modify interventions if the person uses interfering behavior more often than the replacement behavior.

You can collect data before implementing functional communication training or during the FBA process. Data helps monitor the effectiveness of functional communication training, and it focuses on:

• Antecedents  
• Prompts- Needed to produce the replacement behavior
• To decide the frequency of the replacement behaviors
• To find the frequency of the target interfering behaviors, and
• To observe the consequences of the behavior

Data collection also allows the practitioners to determine if the replacement behavior is decreasing the occurrence of the interfering behavior. It also helps to monitor the level of prompting needed to use the replacement behavior. The data also guides the practitioners if aspects of FCT need any adjustment for an effective outcome.

FCT may need alteration if the person with ASD:

• Continue to use the interfering behavior instead of picking the replacement behavior,
• Require prompts to use the replacement behavior
• Find difficult to use the replacement behavior

Checkout our Blog –  Autism and Social Skills Development

5. Manipulate the Environment to Trigger the Interfering Behavior

The practitioners change the materials or activities to elicit the interfering behavior in the person with ASD. It provides opportunities for the person to practice replacement behaviors instead of interfering behaviors.

The practitioners teach and help practice the replacement behavior in the environments where the interfering behavior occurs. They provide opportunities for the learner to practice replacement behavior repeatedly. 

6. Plan Opportunities to Practice Replacement Behaviors

Planning opportunities for generalization is a critical component of functional communication training. It helps the autistic to practice replacement behaviors with multiple people and in different situations.

Including multiple people is a critical factor in the generalization of replacement behaviors. It helps the autistic person become habitual in interacting with different people.

Secondly, the practitioner also plans and teaches the replacement behaviors in multiple environments. The new setting may be a school, home, job site, or care facility. The environment and home programs encourage choice-making and make the FCT program successful. It helps in the generalization of skills.

The Teachers or the practitioners train communicative partners like parents, and peers, to respond to the use of the replacement behavior by autistic. The communicative partners should provide reinforcement quickly and consistently.

The practitioners also teach varied vocabulary for daily functions appropriate for the learner’s developmental level. They make sure that the words chosen for teaching are reinforcing for autistic.

7. Prompt Learners to Use Replacement Behavior

To help a person with ASD use replacement behavior, the practitioners use prompting procedures when appropriate. The prompts vary depending on the abilities of the learning autistic.

The practitioner begins with a prompt that ensures errorless learning of the replacement behavior. The prompt should guarantee the use of the replacement behavior. All the prompting procedures focus on providing errorless teaching and learning. To achieve this, the practitioner may use a higher level of prompting. It ensures that the learner produces the replacement behavior instead of interfering behavior.

The level of correct prompting level will depend on the learner. Some autistics can use the replacement behavior with subtle prompts.

8. Not to Reinforce the Interfering Behavior

When autistic learners use subtle communicative acts and dangerous behaviors, the practitioners alter their reactions. They do not reinforce the interfering behavior to decrease its effectiveness.

If the learner with ASD engages in dangerous behaviors dangerous to themselves or others, the practitioners intervene to protect all people involved.

The practitioners make the interfering behavior less efficient for subtle communicative acts than the replacement behavior. He prompts the autistic learner to use the replacement behavior by providing reinforcement.  

The delay in reinforcement makes the subtle communicative act less efficient than the replacement behavior.

9. Providing Reinforcement  

Providing reinforcement quickly and regularly in response to the replacement behavior is critical. If the autistic person does not get the reinforcer immediately, the interfering behavior will not decrease. The learner will not use the replacement behavior.

10. Fading the Use of Prompts

The next step involves fading the use of prompts. The practitioners decline the use of prompts to make the person with ASD learning FCT become more independent in using replacement behaviors. The therapist fades the prompts slowly using data and time delay.

Prompts are given early in the training process. Later, they are faded and replaced with less intrusive prompts. Time delay helps to identify the type of prompts the person with ASD on FCT requires. On introducing a less interrupting prompt, the practitioner waits long enough for the response. But, when he gives more intrusive prompts, he intervenes if it appears that the learner with ASD will produce interfering behavior instead. The time varies from learner to learner. 

11. To Increase the Time Between the Replacement Behavior and Reinforcement

The practitioners slowly increase the interval between the replacement behavior and reinforcement. It is not ideal to always provide reinforcement upon request. 

The practitioners and the team members determine a reasonable interval time between production of the replacement behavior and reinforcement. Thereafter, they slowly increase the time interval for delivery of reinforcement.

Moreover, the practitioner later increases the distance between the person with ASD on FCT and communicative partners. The aim is to let learners seek out communicative partners before using the replacement behavior. The communicative partners and the learner may stay in the same room or a hall but at a distance.

12. To Monitoring the Progress  

The practitioner of the FCT collects all the data related to the learner’s use of the replacement behavior. The data helps to measure progress and decide what prompting and reinforcement procedures the learner with ASD needs.

The data also helps to note how the learner uses the replacement behavior in different settings. It also guides the type and intensity of prompts the learner with ASD needs to use the replacement behavior correctly. Moreover, practitioners also use the data to determine if the independent use of skills generalizes in all situations, environments, and with all communicative partners.

 Conclusion 

The inability to communicate needs and desires often results in inappropriate behavior among children with ASD due to frustration and anxiety. FCT is an effective behavioral intervention that gives children with ASD the ability to communicate in alternative ways. It helps alleviate much of the frustration that arises due to the inability to communicate.

Functional communication training (FCT) helps to provide the child with ASD with a different way to communicate to eliminate negative behaviors. FCT is a scientifically proven solution for replacing interfering behaviors and teaching new communication skills. Although FCT doesn’t produce results overnight when practiced correctly, it provides encouraging results.