Functional Communication Training

Shanti Kurada, M.Sc., MBA

Imagine for a minute that you have been persuaded to attend a rock concert by your friends. But once you are there, you find the sound level to be unbearably loud. Although your friends seem to be having a great time, you can’t stand to stay a moment longer. You try to leave but you are blocked by crowds. You say, “Excuse me”, but no one seems to understand you. They continue blocking you while they keep enjoying the concert. They look at you but ignore you. What are you likely to do? Chances are, you might yell at them. Something similar happens when an individual with autism tries to communicate his discomfort or fear or agitation and the people around him fail to respond because they do not understand his message or signal. The fear/anxiety/agitation builds up to a point where the individual has an outburst. Functional Communication Training gives him a way to communicate his needs and have them met immediately and avoid the outburst. It is therefore one of the most important things to teach, especially when verbal abilities are limited.

Functional Communication Training (FCT) is used to help individuals with autism avoid challenging behaviors by learning to communicate their needs and wants. Challenging behaviors can include disruptive behavior such as shouting or throwing objects, hitting and other forms of aggression, elopement, and self-injury. Individuals with autism may engage in such behaviors because they feel frustrated or upset after repeated failed attempts to have their needs and wants met.

FCT is based on the principles of Applied Behavioral Analysis. All of behavior is communication and serves a function or purpose. Once the function of the behavior (what outcome is desired) is understood, the individual can be taught to engage in an alternate (acceptable) behavior that serves the same function (produces the same outcome).

For example, a neurotypical toddler may throw a tantrum (challenging behavior) and get a drink of juice. Or, the toddler can be taught to request juice by pointing to it or saying a word approximation such as “ju” or signing for a drink (alternate, acceptable behaviors). In FCT, the challenging behavior is replaced with the alternate behavior which serves the same function (produces the same outcome of getting juice).

Steps involved in implementing FCT

- Observe the challenging behavior – where, when, with whom, how often, what’s the consequence – to understand the function of the behavior

For example, a boy screams and kicks the child next to him in the middle of story time. This happens very often during the story time activity. His aide takes him for a walk. He calms down. Here, the screaming and kicking are the challenging behaviors. The function of these behaviors is escape. That is, the boy finds story time aversive and wants to escape from this uncomfortable experience. He may have tried to communicate this in some way (by looking around or stimming with his fingers) but the people around him did not get the message. So, he screams and kicks in frustration. Surprisingly, it brings him what he needs – a break from a distressing situation. This then becomes his reliable mode of communication – kicking and screaming – to convey the need for a break.

- Teach the replacement behavior.

o Teach the boy to communicate that he needs a break in an acceptable way. This can be done by using a break card (he is taught to hand over the card to the aide) or by pushing the ‘I need a break please’ button on his device, or by using the sign for break. In the beginning, this teaching may involve using hand over hand to physically prompt him to use his break card or push the button or make the sign – at the first sign of frustration or anxiety or distress. Watch for these signals carefully and prompt immediately when they appear. As soon as he hands over the card or pushes the button or makes the sign, say “Great job asking for a break!” and give him the break (either a walk or play with favorite toy in a separate area). The replacement behavior must be easier than his challenging behavior to get him his desired outcome – so support him to make him successful with the replacement behavior. Prompting can be gradually faded as he becomes more independent with communicating appropriately to get this need met.

- Address the distressing situation.

o Once his challenging behavior has been replaced with an acceptable form of communication, it is important to understand why he is having difficulty with story time and what supports he needs so he can participate in it. First look at antecedent-based strategies.

§ Should the environment be modified in any way? Is the rug comfortable or does it feel scratchy? How is the lighting in this part of the room?

§ A visual schedule might help him predict and prepare for the circle time activity.

§ One on one practice with reading books can be done with the aide at school and parent at home. During this time, he should be given a choice of books and asked to turn the pages to increase his engagement.

§ Also, books could be chosen to cater to his specific interests or sensory needs (touch and feel books).

o Another way is to use consequence-based approaches to build tolerance. Set small duration sitting goals and provide reinforcers when these goals are met. For instance, 3 minutes of sitting earns him his favorite toy. The goal of 3 minutes can be gradually increased until he can sit through the entire circle time.

The important thing to remember is that the individual with autism has the right to be comfortable, have his needs and wants met, and must be taught the skills needed to communicate and learn. Without these skills, the individual’s environment becomes very limited and varied experiences such as group participation, outings, and making social connections become difficult. Functional communication training teaches alternate, acceptable behaviors that not only help the individual meet his needs but also help gain him access to various environments that facilitate engagement, connection, and learning.