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

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}

Research Team

John Falligant, PhD

Principal Investigator

Auburn University

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.

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
• 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.

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.

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+

Findings from Research

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 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]

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 (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 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 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]

References

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

Functional communication training with and without extinction and punishment. [2018]

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

The effects of competing reinforcement schedules on the acquisition of functional communication. [2018]

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

Reducing severe aggressive and self-injurious behaviors with functional communication training. [2011]

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

Functional communication training: a review and practical guide. [2021]

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

Functional communication training: From efficacy to effectiveness. [2021]

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

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior. [2021]

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]

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

Generalized reduction of problem behavior of young children with autism: building trans-situational interventions. [2006]