Functional Communication Training for Problem Behavior

Recruiting at 1 trial location

Overseen By John M Falligant, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Auburn University

Disqualifiers: IDD, SPB, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 16 weeks

10 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to assist children and teens with challenging behaviors, such as tantrums or crying, by teaching them improved communication and frustration management through Functional Communication Training. Researchers seek to determine if these skills persist when children are in new environments or with unfamiliar people. Participants will learn to request attention or wait for rewards instead of acting out. The trial seeks individuals aged 6 to 17 with intellectual or developmental disabilities whose challenging behaviors stem from a need for attention or access to favorite items. As an unphased trial, this study provides a unique opportunity for participants to contribute to valuable research that could enhance communication strategies for many children.

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 prior data suggests that these techniques are safe for children and adolescents?

Previous studies have shown that Functional Communication Training (FCT) is a safe and effective method for assisting individuals with challenging behaviors. Research indicates that FCT is a well-accepted approach, often used to help children, especially those with autism, enhance their communication skills. The goal is to replace problematic behaviors, like tantrums, with more appropriate actions, such as asking for attention.

Importantly, FCT is widely used and supported by evidence as a safe approach. No reports have specifically linked negative effects to FCT, making it a reliable option for those involved in behavior-change programs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Functional Communication Training (FCT) for managing problem behaviors because it focuses on teaching individuals to communicate their needs effectively, which can significantly reduce challenging behaviors. Unlike traditional approaches that might involve medication or simple behavior modification, FCT uses a tailored, multi-faceted strategy that includes teaching appropriate communication responses and using specific stimuli to signal reinforcement changes. This approach not only addresses the root cause of the behavior but also promotes skill generalization and maintenance across different environments, making it a holistic and potentially more effective solution for individuals with behavioral challenges.

What evidence suggests that these trial's treatments could be effective for improving communication skills in children with challenging behaviors?

Studies have shown that Functional Communication Training (FCT), included in the Enhanced Teaching Arm of this trial, effectively reduces severe behavior problems. It teaches individuals to replace difficult behaviors with improved communication methods. Research indicates that FCT not only reduces problem behaviors but also enhances communication skills, even with new people or in new environments. Further evidence suggests that FCT remains effective over time, aiding children and teenagers in adapting to various situations. Overall, FCT is recognized as a reliable method for improving behavior and communication in those with challenging behaviors. ^{1 2 6 7 8}

Who Is on the Research Team?

John Falligant, PhD

Principal Investigator

Auburn University

Are You a Good Fit for This Trial?

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.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

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

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.

How Is the Trial Designed?

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.

Who Is Running the Clinical Trial?

Auburn University

Lead Sponsor

Trials

81

Recruited

14,600+

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

Collaborator

Trials

93

Recruited

25,200+

Published Research Related to This Trial

Functional communication training effectively reduced severe aggressive and self-injurious behaviors in two adult men with mental retardation, demonstrating its efficacy after years of less successful interventions.

The training not only led to behavior reduction but also generalized across different staff, environments, and tasks, highlighting its adaptability and potential as a safer alternative to aversive interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing severe aggressive and self-injurious behaviors with functional communication training. Bird, F., Dores, PA., Moniz, D., et al.[2011]

Functional communication training was effective in reducing problem behaviors in primary teaching settings for three children with autism, highlighting its efficacy as a higher effort intervention.

The study suggests that for lasting behavior change, lower effort interventions need to be combined with intensive functional communication training, especially when applied across different settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Generalized reduction of problem behavior of young children with autism: building trans-situational interventions. Schindler, HR., Horner, RH.[2006]

Functional communication training can be beneficial for treating severe behavior problems in individuals with communication deficits, but it may not be effective enough on its own for all patients.

Combining functional communication training with punishment strategies led to the most significant and consistent reductions in destructive behaviors among the four clients studied.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional communication training with and without extinction and punishment. Fisher, W., Piazza, C., Cataldo, M., et al.[2018]

Functional communication training (FCT) was effective in reducing both targeted destructive behaviors and non-targeted disruptive behaviors in preschool-aged children with developmental disabilities, as shown in a study involving 10 participants.

The study found that all participants' behaviors were maintained by negative reinforcement, and during FCT, both types of behaviors occurred at lower levels compared to baseline conditions, indicating the efficacy of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior. Schieltz, KM., Wacker, DP., Harding, JW., et al.[2021]

Functional communication training (FCT) is an effective evidence-based practice for addressing problem behaviors in individuals with developmental disabilities, as shown in a systematic review of 37 studies.

However, only six of these studies demonstrated successful maintenance and generalization of behavioral changes, indicating that additional strategies may be needed beyond the natural contingencies of FCT to sustain these improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review. Neely, L., Garcia, E., Bankston, B., et al.[2018]

Functional communication training (FCT) is recognized as a highly effective intervention for addressing severe behavior problems, based on extensive research since its introduction in 1985.

The review highlights the emergence of best practices in the FCT treatment process, which can enhance the development and implementation of effective interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional communication training: a review and practical guide. Tiger, JH., Hanley, GP., Bruzek, J.[2021]

Functional communication training (FCT) is effective in significantly reducing problem behaviors in both children and adults, demonstrating its efficacy as a treatment.

However, there are limitations in its effectiveness in real-world settings, indicating a need for future research to focus on practical applications and overall life improvements for individuals using FCT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional communication training: From efficacy to effectiveness. Ghaemmaghami, M., Hanley, GP., Jessel, J.[2021]

Functional communication training (FCT) was evaluated for its effectiveness in reducing problem behavior in three participants, with two showing significant improvement.

FCT was most effective when combined with strategies like extinction or response blocking, suggesting that these methods enhance the training's efficacy in managing problem behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of competing reinforcement schedules on the acquisition of functional communication. Kelley, ME., Lerman, DC., Van Camp, CM.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2846575/

Functional Communication Training: A Review and ... Abstract. Functional communication training (FCT) is one of the most common and effective interventions for severe behavior problems.

2. mastermindbehavior.com mastermindbehavior.com/post/how-functional-communication-training-reduces-problem-behaviors

How Functional Communication Training Reduces ... This article explores how FCT works, its integration with Applied Behavior Analysis (ABA) therapy, and the research supporting its effectiveness ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC1279571/

Functional communication training to reduce challenging ... We evaluated the initial effectiveness, maintenance, and transferability of the results of functional communication training as an intervention for the ...

4. link.springer.com link.springer.com/article/10.1007/s10864-025-09598-4

A Mega-Review of Functional Communication Training for ... (2023) found that implementing FCT in educational settings led to decreased challenging behaviors and enhanced communication outcomes.

5. linksaba.com linksaba.com/functional-communication-training-fct-explained/

Functional Communication Training (FCT) Explained Successful FCT implementation follows a systematic, multi-phase approach that ensures comprehensive assessment, targeted intervention, and sustainable outcomes.

6. afirm.fpg.unc.edu afirm.fpg.unc.edu/wp-content/uploads/Functional-Communication-Training-Brief-Packet-Griffin-AFIRM-Team-Updated-2025-1.pdf

Functional Communication Training Brief Packet - AFIRM 6.3 Systematically use data from a variety of sources to identify the purpose or function served by problem behavior to plan, implement, and evaluate behavioral ...

7. goldenstepsaba.com goldenstepsaba.com/resources/what-is-functional-communication-training-in-aba

Functional Communication Training in ABA FCT is a therapy approach commonly used in Applied Behavior Analysis (ABA) to help individuals, particularly children with autism, develop meaningful ways to ...

8. asatonline.org asatonline.org/research-treatment/clinical-corner/functional-communication-training/

What is Functional Communication Training? FCT is an evidenced-based intervention that teaches an appropriate replacement behavior that could replace the interfering behavior (Carr & Durand, 1985). FCT ...