Functional Communication Training for Problem Behavior
Palo Alto (17 mi)Age: < 18
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Auburn University
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.
What safety data exists for Functional Communication Training?The research indicates that Functional Communication Training (FCT) is generally effective in reducing problem behaviors in individuals with developmental disabilities. It is considered an evidence-based practice and has been shown to reduce severe aggressive and self-injurious behaviors, as well as non-targeted disruptive behaviors. However, FCT alone may not always be sufficient, and combining it with other interventions like punishment can produce more significant reductions in destructive behavior. The studies suggest that FCT is a promising and safe intervention, but its effectiveness can vary depending on the individual and the context.12467
Is Functional Communication Training a promising treatment for problem behavior?Yes, Functional Communication Training is a promising treatment for problem behavior. It helps reduce severe aggressive and self-injurious behaviors by teaching alternative ways to communicate. It has been effective in various settings and is considered an evidence-based practice for individuals with developmental disabilities.12357
What data supports the idea that Functional Communication Training for Problem Behavior is an effective treatment?The available research shows that Functional Communication Training (FCT) is effective in reducing severe aggressive and self-injurious behaviors, especially when other treatments have failed. For example, one study found that FCT helped reduce these behaviors in two adult men after years of less successful treatments. Another study highlighted that FCT alone might not always be enough, but when combined with other strategies like punishment, it led to the largest reductions in problem behavior. Overall, FCT is recognized as a promising treatment, but its effectiveness can vary depending on the situation and additional strategies used.12358
Do I need to stop taking my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications.
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
We will include individuals between the ages of 6 to 17 with IDD who have at least one topography of SPB that is maintained by social positive (e.g., attention, access to preferred items) reinforcement. The age range is driven by the need to maximize the number of participants; there is no evidence to suggest that age is a relevant variable regarding relapse of SPB
Treatment Details
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.
1Treatment groups
Experimental Treatment
Group I: Enhanced Teaching ArmExperimental Treatment5 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 nearbySelect from list below to view details:
Auburn UniversityAuburn, AL
Kennedy Krieger InstituteBaltimore, MD
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Who is running the clinical trial?
Auburn UniversityLead Sponsor
Hugo W. Moser Research Institute at Kennedy Krieger, Inc.Collaborator
References
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.
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.
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.
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.
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.
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.
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.
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.