Functional communication training: From efficacy to effectiveness.

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.

On the Standardization of the Functional Analysis.

The functional analysis procedures described in the seminal Iwata et al. (1982/1994) study are prominent in the applied behavior analytic literature, having been replicated hundreds of times over the past 30 years (Beavers, Iwata, & Lerman, 2013; Hanley, McCord, Iwata, 2003). However, the extent to which particular components of this functional analysis model have become more or less prominent over time is not clear from these literature reviews. We therefore conducted a review of the functional analysis literature between the years of 1965 and 2016 to determine the trends in the usage of particular components over time and to determine if the published literature reflects a standardization of the manner in which functional analyses of problem behavior are conducted. Furthermore, we discuss whether or not this standardization of a functional analysis model is currently necessary.

Toward accurate inferences of response class membership.

In their review of synthesis within the functional analysis (FA) literature, Slaton and Hanley (2018) reported that most synthesized contingency analyses have included multiple topographies of problem behavior in the reinforcement contingency class. This leaves the question of whether one, some, or all forms of problem behavior are sensitive to the synthesized reinforcement contingencies in published analyses. To address this ambiguity, all topographies of problem behavior that were reported by caregivers to co-occur with the most concerning problem behavior were analyzed for 10 participants. We implemented extinction across one or more forms of problem behavior to determine whether all forms reported to co-occur were sensitive to the same synthesized reinforcement contingency. For nine of 10 participants, the most concerning topographies were sensitive to the same synthesized reinforcement contingencies as the less concerning topographies (results were inconclusive for one). Implications for inferring response class membership from single analyses are discussed.

Shaping complex functional communication responses.

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed.

Contingencies promote delay tolerance.

The effectiveness of functional communication training as treatment for problem behavior depends on the extent to which treatment can be extended to typical environments that include unavoidable and unpredictable reinforcement delays. Time-based progressive delay (TBPD) often results in the loss of acquired communication responses and the resurgence of problem behavior, whereas contingency-based progressive delay (CBPD) appears to be effective for increasing tolerance for delayed reinforcement. No direct comparison of TBPD and CBPD has, however, been conducted. We used single-subject designs to compare the relative efficacy of TBPD and CBPD. Four individuals who engaged in problem behavior (e.g., aggression, vocal and motor disruptions, self-injury) participated. Results were consistent across all participants, and showed lower rates of problem behavior and collateral responses during CBPD than during TBPD. The generality of CBPD treatment effects, including optimal rates of communication and compliance with demands, was demonstrated across a small but heterogeneous group of participants, reinforcement contingencies, and contexts.

Interview-informed synthesized contingency analyses: Thirty replications and reanalysis.

The speed with which a functional analysis (FA) provides a convincing demonstration of the variables that influence problem behavior may be termed efficiency. Multiple FA formats have been developed to improve analytic efficiency while the core components of the Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) procedures are maintained. We attempted to illustrate an alternative efficient process for conducting FAs of problem behavior that relied on modifying those core components. In Study 1, we describe 30 applications of the interview-informed synthesized contingency analysis (Hanley, Jin, Vanselow, & Hanratty, 2014), which required an average of 25 min of analysis. The first sessions of these analyses were reanalyzed in Study 2 to determine if contingencies that controlled problem behavior could be identified in only 3 to 5 min. This was the case in 80% of analyses.

A translational evaluation of transitions.

Transitions with nonhuman animals are typically framed as inescapable changes in signaled reinforcement schedules that result in a pause in responding unique to switches from rich to lean schedules. Pausing is considered to be a function of the aversive qualities of the contrasting reinforcement schedules. Transitions are typically framed in applied research as physical changes in location that evoke problem behavior maintained by the escape of an aversive event or resumption of a preferred event. We attempted to extend the basic framing of transitions to behaviors and contexts of social significance and evaluate a novel treatment for the problem of dawdling by 3 boys who had been diagnosed with autism spectrum disorder during rich-to-lean transitions. Dawdling during physical transitions was most readily observed when transitioning to lean contexts in Experiment 1. We then shortened transition duration in Experiment 2 by programming unsignaled and probabilistic rich reinforcement in the upcoming context.