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Functional Communication Training
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Functional Communication Training
Student Name
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Functional Communication Training
Abstract
Introduction
Human beings thrive in social settings. Behavioral problems due to biological, genetic, and environmental difficulties typically reduce the ability of such individuals to function appropriately and interact with others (Shpall, 2020). Empirical research paved the way for developing evidence-based interventions that help individuals lead socially acceptable lives.
Developed by Carr and Durand (1985), Functional Communication Training (FCT) is an empirical behavioral intervention program used to treat maladaptive behaviors displayed by individuals with Autism Spectrum Disorder and other developmental challenges (Battaglia, 2017). According to Shpall (2020), FCT is an effective behavioral reinforcement procedure. Carr and Durand (1985) express that FCT involves reinforcing a functional communication response or desired behavior to replace the challenging or maladaptive behaviors. Shpall (2020) asserts that FCT’s implementation requires evoking maladaptive behaviors through the systemic introduction of a function communication response (FCR). Assertively, FCT works by replacing the challenging behavior with a socially accepted or valid communication skill.
The continued success of FCT interventions correlates to subsequent research on the original idealization by Carr and Durand (1985). According to Shpall (2020), FCT is successful in rapidly decreasing maladaptive behaviors and increasing the appropriate communication approaches for individuals. However, Shpall (2020) and Carr and Durand (1992) argue that implementing the intervention is challenging in the long term as individuals experience difficulties maintaining and adopting the learned functional communication. Shpall (2020) highlights that consistent and immediate reinforcement and monitoring helps diminish the reemergence of maladaptive behaviors. The author argues that delays in reinforcement poses a threat to the intervention as it jeopardizes fidelity, leading to the resurgence of the challenging behaviors. According to Battaglia (2017), effective intervention programs for maladaptive behaviors must have a comprehensive behavior plan. Battaglia (2017) further argues that preventative, resurgence, and reactive strategies should be included with teaching new skills for optimal performance of FCT.
FCT is an intervention strategy that allows practitioners to address the underlying function behind maladaptive behavior. The practitioners develop a framework to replace the inappropriate response with appropriate communication skills coherent with the function of the maladaptive behavior (Battaglia, 2017). According to Ness (2017), FCT’s practicality as a positive behavior intervention program helps individuals communicate in socially acceptable ways. Garcia (2018) highlights FCT as a useful tool when combined with other behavioral interventions. FCT provides a framework to identify the behavior’s functions, hence replacing it with a socially appropriate form of communication (Worcester and McLaughlin, 2013).
The Acquisition of Maladaptive Behaviors
The development of maladaptive behaviors in the current era primarily reiterates the psychological theories of socially acceptable behaviors (Varava, 2016). Consequently, the theory declares that an individual’s actions are more prone to the influence of their environment, more so the descriptive norms. According to Worcester and McLaughlin (2013), the treatment of maladaptive behaviors among individuals with behavioral disorder requires a functional analysis to determine the behavior’s function in communication. Similarly, Varava (2016) indicates that maladaptive behaviors derive from different motivational and reinforcing factors that encourage the individual to continue with the specific behavior.
FCT is an effective framework for intervening communication deficiencies. Deficiencies in functional communication are characteristics of autism spectrum disorder (APA, 2013). Subsequently, individuals may lack effectual speech, argumentative, and alternative communication, therefore relying on maladaptive behaviors for communication (APA, 2013; Worcester & McLaughlin, 2013). Besides, functional communication deficits result in non-symbolic and prelinguistic approaches of communication such as pointing or reaching for objects, informal gestures, body movements, vocalizations, gazing, and facial expressions. Individuals are predisposed to engaging in problem behaviors, including self-injury, tantrums, and aggression for their form of communication (Keen, Sigafoos & Woodyatt, 2001). Whereas, individuals without these deficits rely on similar prelinguistic forms, they form a more symbolic communication (Battaglia, 2017). FCT allows individuals to gradually shift from prelinguistic to symbolic forms of communication. (Battaglia, 2017).
The Effectiveness of Functional Communication Training
FCT is one of the most researched intervention models for modifying undesirable behaviors (Wong et al., 2014). For instance, Keen et al. (2001) established in their experiment that FCT is effective in replacing challenging and unwanted behaviors with appropriate forms of communication. The authors argue that the framework entails a functional assessment to evaluate the underlying function of the target behavior. Thereafter, a functionally and socially acceptable form of communication is identified as the target for intervention. Keen et al. (2001) evaluated FCTs effectiveness by identifying communicative functions for children identifying conventional and symbolic communicative approaches for intervention. Similarly, Austin and Tiger (2015) argued that continued maintenance of the immediate reinforcements is ineffective. Consequently, Austin and Tiger (2015) emphasize that providing alternative reinforcements during FCT’s reinforcement delays cause a reduce in the likelihood of the prevalence of problem behaviors. Research by Keen et al. (2001) and Austin and Tiger (2015) convey that the effectiveness of FCT depends on consistently monitoring the progress of the problematic target behaviors and integrating differential reinforcement procedures to improve intervention outcomes.
The underlying theory behind FCT’s effectiveness holds that maladaptive behaviors and verbal communication are different forms of communication, but they have identical functions (Carr & Durand, 1985). An individual’s maladaptive behavior is an undesired form of communication, and FCT allows differential reinforcement for essential communication by minimizing maladaptive behaviors (Carr & Durand, 1985). Keen et al. (2001) express that FCT should include training, consulting, and feedback. The authors applied this framework in an intervention of four participants and established that the approach helped replace prelinguistic behaviors among children with more symbolic communication. Durand and Carr (1992) assert that FCT intervention's continued effectiveness requires intervention in different stimulus conditions. The researchers also argue that the continued prevalence of challenging behaviors among students re-emerges due to the environmental incongruities in diverse community settings where their communication attempts are not well interpreted (Durand & Carr, 1992).
The Application of Function Communication Training
The studies by Durand and Carr (1992; 1985) reveal that FCTs effectiveness depends on the application methodology to ensure successful outcomes. Caldwell (2018) and Garcia (2018) explored the impact of socio-cultural environments in improving intervention outcomes across individuals from diverse backgrounds. Caldwell (2018) focused on applying FCT and extinction in reducing attention-maintained behaviors, while Garcia (2018) focused on the cultural adaptation aspects of FCT. Both Caldwell (2018) and Garcia (2018) exhibit significant coherence to the contributions by Durand and Carr (1992) by observing the external factors that influence and potentially reduce the efficacy of functional communication training. Specifically, Caldwell (2018) primarily focused on Spanish speaking families while Garcia (2018) mainly focused on involving parents throughout the intervention process to ensure the acquired functional communication responses were reinforced through consistent monitoring by parents. The research by Caldwell (2018) aimed to address the practical challenges for families requiring access to behavioral assessments and interventions such as FCT. Still, language disparities made it difficult for professionals to improve the patients' outcomes due to ineffective communication.
Behavioral problems and appropriate behaviors are inherently tied to the patients' existing
environment and cultural values (Garcia, 2018). Parents as the primary caregivers must collaborate with professionals to ensure their children's development problems and the replacement befits the required societal norms. Garcia (2018) actively engaged parents to develop a culture-based response evaluation that helped identify the (FCR) that adhered to the family and cultural values. Garcia (2018) also trained the parents on how to implement FCT using FCR practices. The study by Garcia (2018) reduced the threats highlighted by Durand and Carr (1992) by engaging parents to ensure consistent monitoring and reinforcements of the desired functional communication behaviors. Caldwell (2018) also recognized the cost implications of translators for behavioral teams interacting with families with different languages. Caldwell (2018) utilized technological frameworks, including Google Translate and other online materials, to prepare the descriptions in the Spanish language on the daily activities to be bale to communicate with the parents. The approach ensured communication with the parents who provided informed consent and collaborated with behavioral analysts for better outcomes from the implemented FCT approaches (Caldwell, 2018).
Empirical research (Caldwell, 2018; Garcia, 2018) reveals that structural modifications of functional communication training (Durand & Carr, 1992) increase the intervention's predictive validity in modifying maladaptive behaviors. The incorporation of societal factors during the intervention, as evidenced by Garcia (2018) and Caldwell (2018), reiterates the social influence of behaviors emphasized by Mapple (2015) and Varava (2016). Moreover, Caldwell (2018) used a single case study and used technology to facilitate collaboration with caregivers. The study results indicate that the modifications helped reduce the behavioral problems in the participant (Caldwell, 2018). The research by Worcester and McLaughlin (2013) asserted that effective treatments for children with maladaptive behaviors required the integration of different socio-cultural and environmental considerations to prevent the loss of such behaviors. Caldwell (2018) was uncertain of the social validity of the study, while Keen, Sigafos, and Woodyatt (2001) primarily focused on the application of the functional communication model (Garr & Durland, 1985) without notable modifications. However, Garcia's (2018) incorporation of primary caregivers during intervention provides a framework for behavioral analysts to work with parents despite language barriers to develop intervention models that address the social norms and requirements of functional communication.
McConachie and Diggle (2007) found that children on the Autism Spectrum have challenging behaviors towards their family members on a frequent basis. Therefore, it is essential to incorporate parental involvement to enhance the possibility of generalization across individuals. Increasing parental involvement also increases the individual’s range of learning throughout different settings. Involving parents in the programing to enhance the child’s development can benefit in several ways: parents-child interaction pattern, family functioning, parental knowledge, the child’s developmental progress, and attitude and stress levels.
Research Question
The purpose of this project is to extend the research on examining whether FCT is effective in modifying acquired problem behaviors, such as tantrums, aggression, and/or self-injury, specifically in the participant’s home and whether the functional communicative response will generalize with family members outside of scheduled sessions. Generalization skills will be monitored by professionals working alongside parents to ensure the proper tools and techniques will be maintained outside of scheduled sessions. Following the identified literature on professional and parental inclusion with the use of functional assessments, interventions, differential reinforcement and parent training, the current study will utilize single-case research design to evaluate the use of FCT to decrease disruptive or unwanted behaviors and replace those with acceptable communication skills.
Methods
Participants and Settings
The participants for this study were two children who have been diagnosed with autism spectrum disorder (ASD) that use challenging behaviors to communicate. The participants that qualified for this study exhibited the challenging behavior of tantrums, aggression to others and their environment.. The participant’s age range will fall between a two-year-old child and a fourteen-year-old young adult. Participants who receive applied behavior analysis (ABA) services primarily in their home will be recruited to participate. There will be no changes to the participant’s in-home setting. The ABA sessions will be located in an area with limited distractions. For example, a table in the dining room, living room, or bedroom. The materials necessary for this study consist of reinforcement that will be identified by a stimulus preference assessment, functional behavioral assessment, and written and video scenarios paired with social praise.
Measurement and Design
A multiple baseline design was used in this study to identify the magnitude of problematic behaviors across participants. The frequency of each target problem behavior will be calculated throughout the entire ABA session and for parental data the number of occurrences will be calculated continually outside of ABA sessions. The specific behaviors that will be targeted include tantrums, aggression, and/or self-injury.
A tantrum is a combination of crying, screaming, laying on the ground, and/or flopping limbs for longer than 5 seconds. Aggression to others is an instance where any part of the participant’s body or any object obtains physical contact with another person. Aggression to the environment disrupting items or objects in the immediate environment (e.g., forcefully slamming doors/items against surfaces, kicking items not meant to be kicked, or throwing items not meant to be thrown).
Procedures
ABA sessions will be conducted five days out of a week with the range of three to five hours per session. The procedural order will begin with observation for baseline data, a preference assessment to identify motivational operants, a behavioral assessment to identify the function of the target behavior, parent training, and communication training.
Baseline
The participants will be observed for a total of five consecutive ABA sessions and five consecutive days outside of ABA sessions. During ABA sessions the behavioral technician will use the provided company iPad to collect frequency data of the target challenging behaviors. Parents will be provided with a chart to write down the frequency of challenging behaviors the participant engages in outside of ABA sessions for 5 consecutive days.
Preference Assessment
The experimenter will conduct a paired stimulus preference assessment with the participant in order to identify highly preferred items that will motivate current responses during the intervention phase. The items for this assessment will be identified by parent and participant report. A number of tangible items will be identified and presented to the participant in pairs. This process will allow implementor to identify the high, medium, and low preferred items (Fisher et al, 1992).
Behavioral Assessment
During the baseline phase, each target behavior (e.g., tantrums, noncompliance, and aggression) will be observed to identify the function. When the target behavior is exhibited by the participant the behavioral technician will use an A-B-C structured assessment in order to identify what happens before and after the behavior occurs. The A is the antecedent or what occurs before the behavior, and C is the consequence or what happens after the behavior. Parents of the participants will be provided with a chart to implement the behavioral assessment outside of ABA sessions (Gresham et al, 2001).
Parent Training
Throughout this study parent involvement is essential for the participant to generalize appropriate communication training. The parents will spend time with the Board-Certified Behavior Analyst (BCBA) and the behavioral technician to learn how to place the target behavior on extinction. The parents will learn how to conduct a behavioral assessment for each target behavior. Additionally, parents will learn how to approach each target behavior once the function is identified. For instance, if a problem behavior is being maintained by attention then attention will be removed or if a problem behavior is being maintained in order to access a tangible then access will be blocked until an appropriate response is given.
Intervention
During the intervention phase all target behaviors will be placed on extinction. There will be multiple approaches to the target problematic behavior depending on the function. If the behavior is being maintained by attention, then the behavior will no longer be followed by attention until an appropriate response is given. If the behavior is being maintained by access to escape then the participant will no longer be able to escape without an appropriate response. If the behavior is being maintained by access to tangibles, then the participant will not be allowed access until an appropriate mand is given. If the behavior is being maintained by sensory stimulation the participant will have a response block implemented to decrease the occurrences. During ABA sessions the participants will be given a number of written and video scenarios in order to familiarize correct responses. The participants will be read or shown a realistic scenario and then asked a “what would you do?” question. When a correct response is given the participants will receive a highly preferred tangible paired with social praise. When an incorrect response is given the participants will be prompted to emit a correct response.
Interobserver Agreement
Treatment Fidelity
The primary observer in this study during scheduled ABA sessions will be the behavior technician while the BCBA will be the secondary observer. Outside of ABA scheduled sessions the parents will be the primary observer. The behavior technician, BCBA, and parents will all have continuous access to the operationally defined problem and appropriate behaviors. They will also obtain detailed copies of the proper strategies to place the problem behaviors on extinction and how to reinforce the appropriate behaviors. The parents will obtain A-B-C charts and a detailed description on how to use them outside of scheduled sessions. The behavior technician will collect problem behavior data during scheduled ABA sessions and once a week for two hours the BCBA will adhere to the same process. The behavior technician’s data will be compared to the BCBA’s data in order to identify reliability across observers. In a two parent home each parent will collect problem behavior data separately, which will be compared to identify reliability across observers.
Social Validity
Results
Understanding the underlying differences in noncompliance, aggression to others as well as aggression to the environment. It is understood that different factors are likely to influence an individual ability to respond to different situations. Thus, this research focuses on whether there is a difference in professional and parent data and how they influence noncompliance, aggression to others and aggression to the environment. Thus, it is essential to understand these relationships to be better placed in making conclusions. An independent sample t-test is the most appropriate statistical test since the analysis aims to compare two groups based on the three levels. The two groups include professional data and parent data. The figure below compares the maladaptive behaviors amongst the two groups to visually express a downward trend.
An independent sample t-test was conducted to investigate whether there was a statistically significant difference between professional and parent data. The findings showed no statistically significant relationship between professional and parent data based on non-compliance levels, t (28) = -1.997, p = 0.056).
An independent-samples t-test was conducted to determine whether there was a statistically significant difference between professional and parent data based on aggression to others. The analysis findings showed a significant difference between professional and parent data, t(28) = -2.222, p = 0.035. The findings show that parent data was significantly higher than professional data on aggression to others.
An independent-samples t-test was conducted to determine whether there was a statistically significant difference between professional and parent data based on aggression to the environment. The analysis findings showed a significant difference between professional and parent data, t(28) = -2.120, p = 0.043. The findings show that parent data was significantly higher than professional data on aggression to the environment.
The findings from the analysis showed that there was no difference in professional data and parent data on noncompliance. However, there was a statistically significant difference in professional and parent data based on both levels of aggression to environment and aggression. It was found that parent data was higher in both aspects.
Discussion
The utilization of functional communication training has been proven to have a major influence on the lives of individuals faced with maladaptive behaviors. Behavioral challenges are diverse, especially in children. The brain controls the body's functionality as well as the coordination of human activities. Thus, these symptoms do not reference physical well-being, which social and environmental changes could have explained. Therefore, this study investigated the use of a critical intervention, functional communication training, to assess its effectiveness in controlling behavior challenges.
The findings from the study have shown that Functional Communication Training is efficient in limiting the frequency of maladaptive behaviors among individuals. The analysis found that before integrating the intervention, the average frequency of maladaptive among participants was 5. However, after incorporating the Functional Communication Training, there was a significant reduction in the first week and a higher subsequent reduction in the second week of training based on information captured by the parents of the participants. These findings are consistent with Caldwell (2018), who integrated technological frameworks in investigating the efficacy of Functional Communication Training in controlling maladaptive behavior. The results from their study found a significant change in adverse behavioral challenges reported by subjects in the study.
The use of parents to obtain the frequency of the challenges in behavior is well informed, considering that parents can learn to understand the needs of their children and can efficiently identify any changes. With the knowledge of identifying functions of behavior a trained parent can effectively implement functional communication which allows generalization across individuals. Garcia (2018) stressed that parental engagement is essential in the success of Functional Communication Training implementation. Thus, engaging parents to ensure consistent monitoring and reinforcements of the desired functional communication behaviors.
A longer implementation of FCT is associated with increased positive outcomes. The needs and well-being of participants are effectively engaged, which offers a clear and more interactive emphasis on the needed outcomes. Ghaemmaghami et al. (2020) stated that improving the communication approach among children with maladaptive behaviors allows a proper understanding of new behavior, which is vital in making informed decisions. Further, longer communication training on major functional concepts will enable participants to understand the basic approaches that control challenging behavior.
In another study conducted by Roby (2016) assessing the efficacy of functional communication training in children with autism spectrum disorder, it was revealed that FCT is essential in increasing appropriate communication skills and reducing unwanted problem behaviors among individuals. The study investigated school-going children where the FCT was investigated in the classroom with the help of teachers. The teachers of the students acknowledged that the participants had demonstrated a reduction in problem behavior. There was also a rise in effective manding responses as a result of these behaviors. Furthermore, both teachers agreed that after the intervention, they spent less time dealing with problem habits.
Similarly, another study conducted by Kim (2012) revealed that the current FCT technique successfully taught communicative, self-initiated toileting activities to certain students with intellectual disabilities in a school environment. The results of the FCT intervention without punishment seemed to take longer than those of the FCT intervention with punishment. Thus, controlling challenging behavior presents a key focus in allowing these children with diagnosed behavioral disorders to improve their communication and interaction with others.
Conclusion
The findings from the analysis have shown that functional communication training has been efficient in reducing challenging behavior among children diagnosed with autism spectrum disorder (ASD). Longer use of functional communication training was associated with higher positive outcomes. There were much reduced maladaptive behaviors at week two compared to challenges that were noted at week one. Thus, functional communication training should be effectively embraced in controlling maladaptive behavior to improve their functionality through the control of challenging behavior.
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Functional Communication Training
References
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