Autism Spectrum Disorders (ASD) are characterized by communication impairments which may manifest in challenging behavior. Functional Communication Training may help your autistic child communicate wants and needs more effectively, decreasing the need for expression through such challenging behaviors.
Communication goes way beyond verbal and nonverbal interaction; even though this is what often comes to mind first when we think about the word communication. Much (some say all) of our everyday behavior is also a form of communication.
It’s easy to imagine a situation where you are trying to get to the other side of an aisle in a supermarket, but someone is blocking the aisle with their shopping cart. You say: “Excuse me,” but they are talking loudly on their phone, and they don’t even acknowledge you.
You’re in a rush and you need something from that specific aisle so you roll your eyes (communicating exasperation) and you politely tap them on their shoulder (communicating a need to get their attention) and you indicate with gestures (communicating respect for their phone conversation) that you’d like to pass.
For austistic children, especially nonvocal children, communicating needs and wants may be a daily struggle. When frustration builds up, this may be expressed through difficult behaviors as they lack the skills to communicate emotions, wants, and needs appropriately.
Imagine, in the above scenario, that the shopper brushed off your attempt to get their attention—you wouldn’t be the first shopper to forcefully remove the shopping cart and perhaps indulge in showing displeasure with a particular gesture. Communicating with behavior is a natural reaction when we feel like we are not being heard.
An explorative study (Jansen et al., 2020) evaluated the relative contribution of language and intentional communication to parent-rated levels of problematic behavior in children with language challenges. The authors’ conclusions indicated that such a relation may be influenced by maturation and children’s capacity to communicate intentionally.
Children need the ability to communicate intentionally to be in control of their environments. Being able to communicate their needs, frustration with a situation, or any other information will ensure they don’t need to engage in challenging behavior to get their message across. FCT is an effective treatment to improve functional and intentional communication.
What is Functional Communication Training (FCT)?
FCT was introduced by Carr and Durand in 1985 as a treatment for problematic behavior in children with developmental disabilities. In this study the authors hypothesized that certain behavioral problems in children may be seen as nonverbal communication.
Therefore, problematic behavior and verbal communicative acts could be equivalent in function. With experiments the authors proved that by strengthening communication, problem behavior could be lessened.
Functional communication includes the most basic of communication, a manner to express (spontaneously and independently) needs and wants and socialize. Although such communication may not be complex, its function cannot be overstated. One can imagine that difficulty in this area may lead to frustration, especially in children who have limited tools of expression at their disposal.
A child who struggles to communicate basic needs (for example a nonverbal or nonvocal child) will benefit from a treatment like FCT to address this skill deficit. If a child has difficulty with functional communication, they may find an alternative way to communicate their wants and needs—problematic behavior may register as the only way to get the attention of those who can fulfil such needs.
FCT is a Differential Reinforcement methodology that aims to teach and establish replacement behaviours for problematic ones. The replacement behavior should serve the same purpose, or achieve the same goals—just in a more appropriate way.
Autism spectrum disorders: challenging behaviors and lack of functional communication skills
A study titled Communication Development and Aberrant Behavior in Children with Developmental Disabilities (Sigafoos, 2000) suggests that deficits in communication development may lead to the emergence of problematic behavior in young children with developmental disabilities (including children with autism).
Neurotypical society often views children on the spectrum as difficult because of challenging behaviors. If one takes research like the above into consideration, such behavior may just be their way to communicate. Communication challenges are a key symptom of ASD, a child who struggles to express their needs may feel the only way to get what they want is to revert to behavior that proved successful in the past.
Difficulties with transitions are the cause of much distress in children with autism (Sevin et al., 2015). Due to communication deficits an autistic child may not be able to communicate the distress experienced when a parent wants him or her to move on to another activity. The child may bang their head to avoid the transit and accompanying distress.
If, in this scenario, the parent relents—for instance allowing the child more time with their special interest rather than taking a bath—the child may feel their behavior expressed their distress effectively and they’ll resort to such behavior in future. In the child’s mind they communicated, and they were heard!
Of course parents would not want their child to communicate emotion or needs in such a negative and harmful way. Severe behavior problems could result if a child feels their only way to communicate wants (or emotion) is through extreme behavior.
FCT may be a successful strategy (used within a comprehensive Applied Behavior Analysis or ABA program) to find positive replacement behaviors for problematic ones like head banging mentioned above. Other problematic or difficult behavior that can be addressed by FCT include elopement (wandering off), aggressive, and self-injurious behavior. A review (Mancil, 2006) of FCT in children with autism found the treatment consistently reduces challenging or problematic behavior and it also increased communication.
How does FCT change challenging behavior?
FCT usually involves a three step process (Mancil & Boman, 2010):
- Completion of a functional behavior assessment to identify the function of the child’s problematic or difficult behavior. The child may use tantrums to get out of an activity that causes distress, or the difficult behavior may be geared towards getting attention. It can also be a way to demand access to something the child wants
- The next step involves identifying a communication response, therefore, determining a more desirable way of communication to replace the challenging behavior. This does not have to mean verbal communication, other forms of communication like sign language is appropropriate as a replacement for the difficult behavior. The child may use any readily available (appropriate) method to communicate, this could include gestures, nonverbal communication, or pictures. In the above example the child had a tantrum because an activity caused distress; the child could be taught to point to a picture that indicates: “I need help.” Instead of a tantrum the child is communicating that he/she finds the activity overwhelming and help is needed to complete it successfully
- In the last step a FCT treatment plan is devised which may include ignoring difficult behavior and rewarding, reinforcing or acknowledging the positive replacement behaviors (or appropriate communication) identified in step two. In future, attempts by the child to communicate through the past problematic behavior will need to be ignored—the child should realize that communicating in the appropriate way will get attention, reinforcement and/or rewards.
Is it the right treatment for my child?
A behavioral psychologist trained in ABA, or a speech and language pathologist could provide guidance to parents about the appropriateness of FCT. Some experts caution that parents expect results too quickly, it may take a while for FCT to replace challenging behaviors with positive communication acts.
It may be worth investing the time when research indicates that FCT is an empirically supported practice for children with autism. This means it meets evidence-based practice criteria, and it has demonstrated effectiveness instilling positive behavior and communication skills in autistic adolescents and children.
When we notice difficult behavior in a child, our natural instinct is to try and get rid of the behavior. The behavior, however, may only be a manifestation of the real problem—in this case a lack of functional communication skills to express basic wants and needs. By providing a positive way to communicate (gestures, pictures, nonverbal communication or sign language) the child will no longer need the difficult behavior to express him or herself.
References:
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of applied behavior analysis, 18(2), 111–126. https://doi.org/10.1901/jaba.1985.18-111
Jansen, R., Maljaars, J., Verhappen, A., Zink, I., Steyaert, J., & Noens, I. (2020). Problem behavior in young children referred with language difficulties: Relations to language and intentional communication. Autism & Developmental Language Impairments.https://doi.org/10.1177/2396941519900076
Mancil, Richmond & Boman, M.. (2010). Functional Communication Training in the Classroom: A Guide for Success. Preventing School Failure. 54. 238-246. 10.1080/10459881003745195.
Mancil, Richmond. (2006). Functional communication training: A review of the literature related to children with autism. Education and Training in Developmental Disabilities. 41. 213-224.
Sevin, J.A., Rieske, R.D. & Matson, J.L. (2015). A Review of Behavioral Strategies and Support Considerations for Assisting Persons with Difficulties Transitioning from Activity to Activity. Rev J Autism Dev Disord 2, 329–342. https://doi.org/10.1007/s40489-015-0056-7
Sigafoos, Jeff. (2000). Communication Development and Aberrant Behavior in Children with Developmental Disabilities. Education and Training in Mental Retardation and Developmental Disabilities. 35.
