Functional Communication Training for Problem Behavior

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen by John Falligant, PhD

Age: < 18

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Auburn University

Disqualifiers: IDD, SPB, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The goal of this study is to improve how we teach self-control and communication skills to children and adolescents with challenging behaviors. Researchers aim to find ways to make behavior-change treatments more effective and long-lasting, even when the environment or reinforcement schedules change. The main questions this study will answer are: Can innovative techniques help children maintain learned skills, such as asking for attention or waiting for rewards, when faced with new people, places, or situations? How do cognitive and behavioral factors, like memory, timing, and decision-making, affect the success of treatments? Participants in this study will: Complete assessments to identify preferred activities and understand the causes of challenging behaviors. Learn communication skills to replace challenging behaviors, such as tantrums or crying, with more appropriate actions like asking for attention. Participate in activities designed to understand their individual responses to different types of rewards and delays.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Caregiver Fading, Extinction-Correlated Stimuli, Functional Communication Training, Multiple-Context Generalization Training, Structured-Probe Schedule Thinning?

Research shows that Functional Communication Training (FCT) is effective in reducing severe behavior problems by teaching alternative communication methods. Studies indicate that FCT can lead to significant reductions in aggressive and self-injurious behaviors, especially when combined with other strategies like extinction or punishment. ^{1 2 3 4 5}

Is Functional Communication Training generally safe for humans?

Functional Communication Training (FCT) has been used safely in various studies to reduce severe behavior problems in individuals with developmental disabilities. It is considered an evidence-based practice and has been shown to decrease both targeted destructive behaviors and non-targeted disruptive behaviors without reported safety concerns. ^{1 3 6 7 8}

How is Functional Communication Training different from other treatments for problem behavior?

Functional Communication Training (FCT) is unique because it focuses on understanding the reasons behind problem behaviors and teaches alternative, positive ways to communicate those needs. Unlike other treatments that might use punishment or ignore the behavior, FCT aims to replace the problem behavior with a more appropriate communication method, making it a more positive and constructive approach. ^{1 2 3 4 7}

Eligibility Criteria

This trial is for children and adolescents aged 6 to 17 with intellectual and developmental disabilities (IDD) who exhibit severe problem behavior (SPB) maintained by social positive reinforcement, like seeking attention or wanting preferred items.

Inclusion Criteria

I am aged 6-17 with IDD and show behaviors seeking attention or items.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in assessments and training sessions to identify and target challenging behaviors, replace them with functional communication skills, and evaluate behavior change robustness under varying conditions.

16 weeks

Regular sessions (frequency not specified)

Follow-up

Participants are monitored for the maintenance and generalization of newly acquired skills across various contexts and with different individuals.

4 weeks

Treatment Details

Interventions

• Caregiver Fading (Behavioural Intervention)
• Extinction-Correlated Stimuli (Behavioural Intervention)
• Functional Communication Training (Behavioural Intervention)
• Multiple-Context Generalization Training (Behavioural Intervention)
• Structured-Probe Schedule Thinning (Behavioural Intervention)

Trial Overview The study tests methods such as Functional Communication Training and other techniques aimed at improving self-control and communication in participants. It seeks to ensure these skills remain effective across different environments and situations.

Participant Groups

Group I: Enhanced Teaching Arm Experimental Treatment 5 Interventions

Participants in this arm will receive a behavioral intervention designed to reduce challenging behaviors and improve skill acquisition. The intervention includes functional communication training (FCT) to teach appropriate communication responses, the use of extinction-correlated stimuli to signal changes in reinforcement conditions, terminal probe schedule thinning to systematically reduce the frequency of reinforcement, competing stimuli to minimize engagement in challenging behaviors during reinforcement delays, and caregiver fading to promote skill generalization and maintenance across naturalistic environments. These strategies will be tailored to individual needs and administered within structured sessions.

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Auburn University Auburn, AL

Kennedy Krieger Institute Baltimore, MD

Who Is Running the Clinical Trial?

Auburn University Lead Sponsor

Hugo W. Moser Research Institute at Kennedy Krieger, Inc. Collaborator

References

1. United States pubmed.ncbi.nlm.nih.gov

Functional communication training with and without extinction and punishment. [2018] Functional communication training has been reported to be a promising treatment for severe behavior problems. In this study, functional communication training alone and combined with extinction and/or punishment was evaluated for 4 clients with severe retardation, behavior problems, and communication deficits. The participants were inpatients on a hospital unit for treatment of severe behavior disorders. They received individualized interventions based on functional assessment that included reinforcement of a communication response with the same function as their destructive behavior. Results showed that for some patients, functional communication training was not sufficient to produce clinically significant reductions in destructive behavior, and the combination of training plus punishment produced the largest and most consistent reductions.

2. United States pubmed.ncbi.nlm.nih.gov

The effects of competing reinforcement schedules on the acquisition of functional communication. [2018] The initial efficacy of functional communication training (FCT) was evaluated when problem behavior continued to produce intermittent reinforcement. Results for 2 of 3 participants showed that FCT was most effective when problem behavior was also exposed to extinction, response blocking, or both.

3. United States pubmed.ncbi.nlm.nih.gov

Reducing severe aggressive and self-injurious behaviors with functional communication training. [2011] Functional communication training is a behavioral intervention that incorporates a comprehensive assessment of the communicative functions of maladaptive behavior with procedures to teach alternative and incompatible responses. In two studies severe aggressive and self-injurious behaviors exhibited by two adult men with mental retardation were reduced through the implementation of functional communication training. In both studies, these reductions came after years of less successful nonaversive and aversive interventions and generalized across staff, new environments, and increasing task demands. The role of this training as a refinement of the traditional differential reinforcement of other behavior and as an alternative to the use of aversive interventions was discussed.

4. Switzerland pubmed.ncbi.nlm.nih.gov

Functional communication training: a review and practical guide. [2021] Functional communication training (FCT) is one of the most common and effective interventions for severe behavior problems. Since the initial description of FCT by Carr and Durand (1985), various aspects of the FCT treatment process have been evaluated, and from this research, best practices have emerged. This manuscript provides a review of these practices as they arise during the development of effective FCT interventions.

5. United States pubmed.ncbi.nlm.nih.gov

Functional communication training: From efficacy to effectiveness. [2021] Functional communication training (FCT; Carr & Durand, 1985) is a common function-based treatment in which an alternative form of communication is taught to reduce problem behavior. FCT has been shown to result in substantial reductions of a variety of topographically and functionally different types of problem behavior in children and adults (efficacy). The extent to which these reductions maintain in relevant contexts and result in meaningful changes in the lives of those impacted (effectiveness) is the focus of this paper. This review evaluates the degree to which FCT has been established as an evidence-based practice in psychology (EBPP) according to the definition set out by the American Psychological Association's 2005 Presidential Task Force on Evidence-Based Practice. Our review finds overwhelming evidence in support of FCT as an efficacious treatment but highlights significant limitations in support of its effectiveness. In order to also be recognized as an EBPP, future research on FCT will need to focus more closely on issues related to home, school, and community application, feasibility, consumer satisfaction, and more general and global changes for the individual.

6. United States pubmed.ncbi.nlm.nih.gov

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior. [2021] The purpose of this study was to evaluate the effects of functional communication training (FCT) on the occurrence of non-targeted disruptive behavior. The 10 participants were preschool-aged children with developmental disabilities who engaged in both destructive (property destruction, aggression, self-injury) and disruptive (hand flapping, spinning in circles, shrill laughter, screaming, crying) behaviors. Only destructive behavior was targeted for the functional analyses and FCT, but data were also collected on disruptive behaviors. All procedures were conducted in the participants' homes by their mothers with investigator coaching. Phase 1 consisted of conducting a functional analysis within a multielement design. Phase 2 consisted of conducting FCT with demand fading and repeated extinction baselines within a reversal design. Single-case data are provided for 3 participants, and summary data are provided for all 10 participants. Results of phase 1 showed that all participants' destructive and disruptive behavior was maintained, at least in part, by negative reinforcement. Results of phase 2 showed that both destructive behavior and non-targeted disruptive behavior occurred at lower levels during FCT when compared to the functional analysis demand condition and baseline conditions, suggesting that FCT was effective in decreasing both target destructive behavior and non-targeted disruptive behaviors.

7. United States pubmed.ncbi.nlm.nih.gov

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review. [2018] Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT.

8. United States pubmed.ncbi.nlm.nih.gov

Generalized reduction of problem behavior of young children with autism: building trans-situational interventions. [2006] The effects of functional communication training on the generalized reduction of problem behavior with three 4- to 5-year-old children with autism and problem behavior were evaluated. Participants were assessed in primary teaching settings and in three secondary, generalization settings. Through baseline analysis, lower effort interventions in the secondary settings were documented as ineffective when implemented alone. Higher effort interventions incorporating functional communication training were documented within a multiple baseline design to reduce problem behavior in the primary setting, but not in secondary settings until the lower effort interventions were re-introduced. Results demonstrate the need for trans-situational interventions based on a common functional assessment hypothesis across settings and including intensive interventions that enhance the effects of lower intensity interventions.