Let’s Get Talking: Functional Communication Training
Nola George, RBT, Lead RBT
Ineca Elliot, RBT, Lead RBT
Kanesha Johnson, RBT, Lead RBT
Lisa Pavlik, MA, BCBA, LBA, Clinical Manager
Functional Communication Training (FCT) is a form of treatment that is used to help a child communicate their wants and needs. Intensive training may be used to address verbal and nonverbal deficits in social communication (Hollo & Burt, 2018). It is also helpful in addressing functionally equivalent alternatives to maladaptive behaviors (e.g., teaching the child to ask for a cookie, instead of tantruming). This may be in the form of Picture Exchange Communication System (PECS), Augmentative Alternative Communication (AAC) Device, Sign Language, and/or Vocal Language.
SOME BENEFITS OF FCT:
-Reducing maladaptive behaviors (e.g., tantrums)
-Gaining access to their wants and needs
-Telling others what they don’t like (e.g., a child might say, ”I do NOT like broccoli, but I like carrots!”)
-Promoting independence (e.g., a child may request for their shoes, so they can go outside and play)
-Comprehending language and communication
-Increasing verbal communication
Accessing more opportunities to invite others in their world (e.g., a child may learn how to invite a peer to play with their favorite toy)
-Increasing appropriate ways to express those big emotions (e.g., a child may tell you that they are mad and need a break)
-Caregivers are not guessing what their child wants and needs. Their child is telling them!
-Consistency may lead to faster progress
-Accessing reinforcement (ooh! I asked for a piece of candy, now I can have candy. Neat!).
-Generalizes to various caregivers, situations, places, etc.
-Overall, a child learns to utilize appropriate replacement behaviors that serve the same purpose as challenging behaviors.
(Dunlap & Duna 2004).
WHAT THIS MAY LOOK LIKE:
A child engages in challenging behaviors in the form of screaming and aggression in order to obtain access to a preferred item. In this example, the child wants to obtain access to a snack in the kitchen. When implementing FCT, you teach the child to communicate their wants to obtain the preferred item. Depending on the form of FCT, this consists of using vocal or sign language, using PECS of snacks, or selecting snack/eat on an AAC device. The child’s communication is increased in order to decrease the occurrence of screaming and aggression, resulting in the child using functional communication initially to obtain a snack in the future.
TYPES OF FCT:
Functional communication training can be taught using Picture Exchange Communication System (PECS), Augmentative Alternative Communication (AAC) Device, Sign Language, and Vocal Language. In this section, we will review the different types of learning communication and the technological tools that assist with learning and engaging in functional communication.
Picture Exchange Communication System (PECS): This type of communication system allows the user to give picture cards to others in order to communicate their wants and needs.
Augmentative Alternative Communication (AAC) Device: supplements or replaces vocal language through the use of low or high tech devices. This may look like an iPad with pictures on it. The user will press the pictures and a voice will communicate that want or need.
Sign Language: The user will use gestures with their body (e.g., hands and face) to communicate.
Vocal Language: The user will use vocal speech with their voice to communicate.
THE PROCESS OF TEACHING FCT AND WHY IT MATTERS:
Whether it’s the picture exchange system or sign language that has been chosen as an alternative way of communicating for your child, all of the FCT technologies require the same steps for mastery. The first step is to find out WHY( other known as the function) your child is engaging in the problem behavior. The function of the problem behavior may be fueled by wanting to get out of a demand. For example, a child may throw his bowl of cereal on the floor because he no longer wants it or he may start to scream when he is told to tie his shoes. The function of behavior may also be due to wanting something. A child who wants your phone may start to pinch himself as he looks at the device while whining. Flopping to the floor may be due to him wanting your attention. Of course, one can not be certain of the “why” behind such behavior until a proper assessment has been made. In a study conducted by Durand & Moskowitz, results showed that maladaptive behaviors decreased substantially when the FCT appropriately matched the function of the behavior in the 4 children that were part of the study (Durand & Moskowitz, 2015).
Once the Board Certified Behavior Analyst has conducted a Functional Analysis( FA) or Functional Behavior Analysis( FBA) on the problem behavior and the function(s) of the behavior(s) have been identified, FCT can start. If PECS has been selected, it is important that all of the necessary pictures are added to his communication binder. “All done” “Break” and/or “I need help” should always be added for they should be used to replace those maladaptive behaviors that function as escape. Using the examples that were mentioned earlier, a child who throws their bowl of cereal on to the floor, can be taught to give the “All done” icon. A child who screams when told to tie his shoes may be taught using sound approximations that will lead him to say “help, please.” Just as your child has learned that engaging in maladaptive behaviors will get them what they want, they can learn that communicating functionally will get them the same outcome. Do you know the common denominator between maladaptive behaviors and socially acceptable behaviors?
When a behavior continues to occur one would say that reinforcement of that behavior has occurred. Whatever is given ( or taken away) right when a behavior occurs is the reinforcer that strengthens and increases the chances the behavior will appear in the future (Cooper et al., 2020). Removing the task of your child having to tie their shoe contingent on them screaming is reinforcing their screaming behavior. Giving your child the phone every time he/she whines and/or engages in pinching behavior is reinforcing their pinching and/or whining behavior. Whenever he/she wants the phone, they learn that pinching and whining will result in getting the phone. Behavior is highly dependent on the consequences that occur preceding it. FCT is continuously reinforcing the selected mode of communication. Whenever your child gives you the Icon for “ipad” you give your child the ipad. Whenever your child signs “break” during virtual learning, you allow them to leave the area for a couple of minutes. Whenever they say “paah” for “play” you play with your child. Reinforcing the replacement behavior must occur every time and immediately. The ABA technician will teach your child the proper way to communicate systematically. Both during discrete trial teaching and Natural environment teaching.
During discrete trial teaching the technician will contrive the environment where opportunities to use the selected mode of communication will occur often and frequently. For example, during table time, the PECS card that says “break” may be introduced. Depending on your child’s prompt level, the technician may use gesture prompting to have your child give them the icon. Demands will be taken away and a break will be given. This will occur multiple times throughout the day. The effort level will be low and the reinforcement will be delivered quickly. When it comes to teaching FCT in the natural environment, the same rules will apply. Instead of having to contrive the environment all of the time, FCT will be taught using your child’s motivation. For example, if your child wants the IPAD, they would be told using a vocal prompt “Ipad” in order to receive it. Again the effort level will be low. So if they are not able to say “Ipad” but can say “uh” then that response will be accepted. Of course, saying the full word will be shaped throughout training and is the ultimate goal. No matter what your child's motivation might be, we will take that opportunity to teach. For example, during meal times, when they are likely to be hungry, your child might be taught to select “hungry” on a voice output device where food will be delivered immediately. It can even be customized to include your child’s favorite food, snacks, and drinks.
So what happens when your child engages in those maladaptive behaviors? It will be ignored and they will be prompted to use the replacement behavior. Extinction burst is likely to occur in the initial stages of FCT. Extinction burst is when the maladaptive behavior increases in intensity and/or rate due to not
receiving the reinforcer that was once granted ( Cooper, 2020).
This is normal and requires patience and endurance from the caregivers and technician. This then brings me to the final part of FCT which involves generalization. It is important that all members who are part of your child’s life know what to do when your child makes any request using the selected mode of communication and what to do when they engage in those interfering behaviors. Training will be provided to caregivers, teachers and even your child’s peers/siblings. This will open the opportunity for your child to practice communicating in various settings such as school, the mall, playground, etc.
Functional Communication training has proven to be effective in reducing maladaptive behaviors as well as increasing the use of functional communication such as speech, PECS and augmentative alternative communication. The key to remember is reinforce those appropriate behaviors in all instances and put those maladaptive behaviors on extinction. With consistency and patience amongst everyone, your child will learn and value the use of functional communication.
IMPORTANT THINGS TO NOTE:
Find a strong reinforcer when you start to teach.
Reinforcer: Something that is given or taken away immediately after a behavior was emitted that increases the chances of that behavior occurring in the future
Reinforcement: The action one does to strengthen a behavior
Extinction and extinction bursts may occur when teaching your child FCT. If your child is going through an extinction burst, then ask your ABA provider for help.
Extinction: Reinforcement of a behavior is discontinued, resulting in the behavior to decrease in the future (Cooper et al., 2020).
Extinction Burst: The behavior suddenly increases. Typically occurs when an extinction procedure has been implemented (Cooper et al., 2020).
Consistency is key! All caregivers, teachers, etc. should learn how to teach FCT. This assists in more positive outcomes with language and communication.
Several types of FCT exist and are determined by a child's skill level. Types include verbal language, Picture Exchange Communication System (PECS), Augmentative Alternative Communication Device (AAC), and Sign Language.
Things to consider when choosing sign language as an alternative way to communicate is your child’s fine motor and imitation skills as well as everyone in your child’s life being able to understand the meaning behind each sign.
Determining which mode of communication will be used is determined by the learner’s needs, which can be assessed by various healthcare professionals working with the learner (e.g., speech and language pathologist, behavior analyst, occupational therapist, etc.).
Talk to your BCBA to find which method of FCT might work best for your child.
For more information please contact us as firstname.lastname@example.org
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