1 FUNCTIONAL COMMUNICATION TRAINING TO PROMOTE POSITIVE BEHAVIOR INFORMATION FOR FAMILIES Center for Effective Collaboration and Practice Are These Scenarios Familiar? While you are talking on the telephone, your daughter begins to pull your pant leg. You turn around to prompt her to stop as you continue talking. With your back turned, your daughter presses the disconnect button. When you turn around, she says, Will you play with me? You respond, Fine. You walk by your son s bedroom and see toys all over the floor. You prompt your son to put the toys he is not playing with in his toy box. On hearing the prompt to clean his room, your son throws some toys against the wall and repeatedly screams NO and you walk away. When you announce your pending departure from an activity with your granddaughter, she falls to the floor and quickly removes your shoelaces to prevent you from leaving. You respond by saying, I can only stay for five more minutes. We express our wants, needs, and desires through our behavior. This holds true no matter what the behavior looks like. Some individuals with disabilities, especially those with behavioral problems, may use both appropriate and inappropriate behaviors instead of conventional oral communication. What Prompts Individuals Who Have Behavioral Problems to Communicate Inappropriately? Several possible explanations exist for why individuals with behavioral problems may use inappropriate behaviors instead of using appropriate communication to express their wants, needs, or desires. First, the individuals may have expressive language or speech and language difficulties. They may have a small or limited repertoire of words from which to pull during interactions with others. They may also have difficulty putting those words into a coherent message that matches the interaction and their communicative intent. Second, these individual may use their inappropriate behavior in place of oral or gestural communication because it is more efficient. For some individuals, less time and energy are needed to display an inappropriate behavior than to compose a message. For example, a child who wants an immediate reaction or decision in a given situation may have learned that using inappropriate behavior is the best way to achieve that goal. If a combination of speech and language difficulties and efficiency issues are present, then the individuals may also use behavior in place of communication. Third, the individuals may have learned that it can be more effective to use inappropriate behavior than oral or gestural communication. For some individuals, using inappropriate behavior may produce the desired outcome more consistently compared with formulating a coherent oral or gestural message. Efficacy is a prime motivator for why we choose one form of communication over another. Often, children with behavioral problems select the most expedient path, which may not be the most appropriate one. Fourth, individuals may use inappropriate behaviors during specific situations to manipulate the situation. For example, if prompted to bathe, an individual may tantrum to avoid taking a bath or a shower or may engage in a discussion about all the reasons why he or she should not take a bath or a shower tonight but will take one tomorrow. It is likely that these individuals have a long history of receiving some type of reinforcement for their inappropriate behavior instead of their use of oral or gestural communication. This reinforcement can take many forms (e.g., verbal: stop that ; nonverbal: facial expression), be provided during a variety of situations (e.g., at home, in the community, at a relative s house), and be given by various persons (e.g., mother, father, sister, brother, friend). These four possible explanations of why children with behavioral problems may use inappropriate behavior instead of appropriate forms of communication strongly suggest that inappropriate behaviors serve a purpose. BEHAVIOR SERVES A PURPOSE Two main purposes of inappropriate behavior for those with behavioral problems have been identified in the research literature. The first purpose of such behavior is to avoid a specific situation, person, task, or event. In the examples above, one child was avoiding picking up his toys. The second purpose of behavior is to gain attention from or to access specific persons, items, or situations, as well as to
2 evoke a reaction. In the examples above, one child gained her mother s attention by hanging up the phone; another child removed her grandfather s shoelaces to continue an interaction. FUNCTIONAL COMMUNICATION TRAINING One method to promote the use of communication regardless of whether the inappropriate behavior is to avoid or to access persons, situations, or tasks is to implement functional communication training (FCT). FCT teaches individuals to use communica-tion to manipulate their environment through appropriate behavior (communication) instead of through inappropriate behaviors. FCT is based on a teaching model: first teach an appropriate behavior, then model the behavior, and finally reinforce the use of the appropriate behavior. In fact, FCT will change not only the behavior of the individuals who are using inappropriate behaviors to manipulate the environment but also the behaviors of the people with whom the individuals are interacting. FCT has been extensively researched in home, school, and community environments with positive results for children and adults with behavioral problems (Jolivette & colleagues), mental retardation, and autism (Carr & colleagues; Durand & colleagues). These studies demonstrated that when individuals were taught various ways to appropriately communicate their wants, needs, and desires and were reinforced for doing so, inappropriate behaviors decreased or were eliminated. The scope of the inappropriate behaviors measured in these studies is vast and includes opposition/noncompliance, off-task behavior, aggression, destruction of property, tantrums, and self-injurious behavior. Many individuals with behavioral problems engage in these behaviors at home and in the school and community. HOW TO IMPLEMENT FUNCTIONAL COMMUNICATION TRAINING INTERVENTIONS AT HOME FCT is an adaptable intervention that can be used just as effectively in the home as in the school environment. It does not require implementers (e.g., mother and father, sister and brother) to have specialized training, but it does require forethought and consistency. Again, FCT is based on the premise of teaching instead of punishing the individual who is engaging in inappropriate behaviors. At the same time, FCT is an intervention that can be tailored to meet the individual s needs as well as the broader needs of the family. The research literature outlines multiple steps to follow when considering implementing FCT with children with behavioral problems. 1. Identify the inappropriate behavior that is interfering with your child s interactions within the family. As a family, you will need to decide which inappropriate behavior to target if your son or daughter displays more than one inappropriate behavior. It will be helpful for the family to list all inappropriate behaviors, then rank them by the number of times the child displays the behavior. After ranking these behaviors, the family will decide whether there is a behavior that frequently occurs that if changed, could decrease or eliminate other inappropriate behaviors. For example, a child is disruptive to her siblings at the dinner table when she leaves her chair. In this case, the family may want to target having her remain in her chair because further inappropriate behaviors do not occur when she remains seated. In this case, the family may teach the child to request a brief break from sitting at the table (e.g., May I get up to? ) or may teach her to share information about her day (e.g., Today, I or I have something to say ). 2. Answer this question: Why does this inappropriate behavior occur? Once an inappropriate behavior has been targeted, the family will want to speculate why this behavior occurs so many times a day or week and during specific situations. By discussing this behavior in detail, you will address the function being served by your child s inappropriate behavior. That is, is your son or daughter being allowed to avoid situations or to gain attention by behaving inappropriately? Once the family has identified the function of the inappropriate behavior, you are ready to begin thinking about and identifying appropriate communication behaviors related specifically to the function. 3. Decide what you would like your child to do in place of the inappropriate behavior. This step is often referred to as the identification of a replacement behavior a behavior that will take the place of the targeted inappropriate behavior. It is imperative that family members
3 agree on why the inappropriate behavior is occurring (the function) prior to brainstorming more appropriate forms of communicative behavior. Without this agreement, the family is likely to choose a replacement behavior that is not linked to the function. When the function of the inappropriate behavior is not taken into account in the FCT intervention, the intervention will not be as effective as one that is linked to the function and it may actually provoke the inappropriate behavior. With agreement, family members can come up with communicative words, phrases, sentences, and gestures that they would prefer the child to display and that are typical for the family. That is, the intent of the FCT is to teach your child a more appropriate form to communicate his or her wants, needs, and desires, not to teach forms of communication not typically used or recognized by the family. At the same time, it is equally important that the replacement behavior be developmentally appropriate and match the needs of the child. Prior to starting the FCT, the family should double check that the replacement behavior actually matches the speculated function of the child s inappropriate behavior. For example, if a child uses his or her inappropriate behavior to avoid tasks, then appropriate FCT replacement behaviors may include such phrases as I need a break, Can I stop for a minute? or Can I do this other thing for a while? If a child is using inappropriate behavior to gain family member s attention, then appropriate FCT replacement behaviors may include such phrases as Can you help me? Will you come here for a minute? or Can we talk? 4. Decide when you want your child to use the appropriate communication. After you decide on the replacement communication behavior you want your son or daughter to use, you need to decide when you want your child to use it. For a child with behavioral problems who displays problem behavior across the day, the family will want to identify a specific time to start the FCT. Family members will want to consider variables that may affect their consistent use of the FCT, such as the amount of energy they have during certain times of the day, ; the times of the day when the family is under stress, such as bedtime; and the times that family members are unable to support one another during the intervention, such as when the mother is at work. Once those variables have been discussed, select a time that your family can consistently and systematically use the FCT with the child. 5. Teach your child how to communicate appropriately by using examples and nonexamples. During FCT, you will need to teach your child how to use the replacement behavior. This teaching may entail modeling and playing roles, with you and the child taking turns displaying the new behavior. This step is critical: If the family does not teach the child how to use the replacement behavior, the child will not use it and will continue to display the inappropriate behavior. Teach the child the replacement behavior during the time identified in step 4 with the family members who are going to participate. The family should also anticipate some resistance during this step because you are asking the child to display something new or unknown. Be patient. Provide multiple examples of how and when to display the replacement behavior, give the child multiple opportunities to practice the replacement behaviors, and encourage the child to ask questions about this new behavior. 6. Reinforce your child s use of the appropriate communication while ignoring the inappropriate behavior. Begin using FCT at scheduled times with the same family members. You should be ready to reinforce your child each time he or she uses the replacement behavior. Family members should decide how they will reinforce the display of the appropriate replacement behavior before they use FCT. Reinforcement can take many forms and should not be an undue burden on the family. Examples of ways to reinforce a child during FCT are (a) verbal praise ( Great job telling me what you want ); (b) physical praise (pat on the back, a hug, a smile), (c) preferred activities (computer time, extra 5 minutes of play time prior to bed, select a video to rent); and (d) preferred food (vegetable to serve for dinner, a special lunch snack, a type of ice cream). As your child continues to use the replacement behavior more frequently than the inappropriate behavior, you can begin to encourage him or her
4 to use the replacement behaviors during other family times. THE APPROPRIATE TIME TO IMPLEMENT FUNCTIONAL COMMUNICATION TRAINING Families need to consider their motivation for selecting FCT to use with their daughter or son who is displaying inappropriate behaviors instead of using communication skills to achieve the same purpose. Obviously, families are concerned with any inappropriate behaviors displayed by their child; however, the behaviors displayed by children with behavioral problems can cause stress on the entire family unit. Using FCT will require a concerted group effort by the family because the child may initially resist the replacement behaviors because they are less efficient and effective. It is appropriate to consider using FCT if the family wants to (a) take the time to teach an alternative communication skill, (b) teach a skill that is matched to the function of the child s inappropriate behavior, (c) consistently reinforce the child s use of the new skill, and (d) increase the communicative repertoire of their child. POINTS TO REMEMBER WHEN USING FUNCTIONAL COMMUNICATION TRAINING AT HOME Families should keep in mind not only the premise of FCT but also how the home environment can build on and strengthen already existing skills and abilities that their child possesses. 1. FCT can provide the opportunity to strengthen interventions and behaviors being implemented with their child in school and build school-tohome partner-ships. If the school is already using a form of FCT, use the same or similar interventions at home. The school and the family can work together in various ways. For example, the parents can ask the child s teacher for a copy of the intervention plan with the specific intervention steps. In addition, the family can visit the school to observe the child s teacher using FCT in various contexts. For instance, the family may observe the teacher using FCT during (a) a demand situation (e.g., an academic task, such as completing a math worksheet), (b) an unstructured activity (e.g., free time, such as selecting an item to play with), and (c) nonclassroom periods (e.g., physical education class, such as playing on a team). As part of these observations, the family can ask for training by the teacher on the specific steps outlined in the FCT and ask questions about using FCT in the home setting. Family members can ask the school to help them create materials needed to facilitate their child s use of appropriate forms of communication. Such materials may include a list of acceptable verbal phrases (e.g., I need some help with, I need a break, I would like to ); picture prompts depicting meaning (e.g., snapshots, magazine pictures, or computer images of people, places, tasks, and situations specific the child s life with the text word provided underneath); and gestural guides (e.g., sign language words or phrases, action pictures with the text word provided underneath). By using methods and materials similar to those used in the school-based FCT, the family has a stronger beginning point for implementation in the home. 2. FCT promotes effective, efficient, and appropriate forms of communication through a variety of ways that are linked to the abilities of the child and the goals of the family and the school goals. It is essential that the form of the communication being taught, modeled, and reinforced is both developmentally appropriate and individualized to the child. This form may not be the form that family members use. For example, if a child has an expressive language disorder, it may be more appropriate for the child to orally say a short, key word or phrase (e.g., help ) instead of a complete sentence (e.g., I need some help ) as do mom, dad, and brother. Once the child has successfully used the short, key phrase or word instead of inappropriate behavior, then more complex phrases can be added to the FCT. In addition, it may not be appropriate for some children with behavioral problems to use oral communication as their form of replacement behavior. Instead, they may use a combination of gestures and picture prompts (e.g., a sign stop and point to picture of a stop sign) to communicate a want, need, or desire. As part of the reinforcement for using the appropriate behavior, the family may restate the child s communicative intent with a verbal statement (e.g., Ok, you can take a break since you put three toys away ). As the child uses the appropriate form of communication with more frequency and the inappropriate behavior decreases, the family will want to model and
5 reinforce more complex communication attempts. 3. FCT is a flexible intervention that can stand alone or can be interwoven with other academic and social behavioral interventions. In either case, FCT will be beneficial to most children with behavioral problems because of the complex and consistent nature of their inappropriate behaviors. It is common for teachers and families to simultaneously target multiple inappropriate behaviors for intervention. FINAL THOUGHTS Using FCT with children with behavioral problems can result in lifestyle changes for the child as more appropriate forms of communication are used within the family. With more frequent displays of appropriate behaviors, the more likely it is that children with behavioral problems will experience success at home, in the community, and at school during social and work interactions. Prepared by Kristine Jolivette, Ph.D. Christine A. Christle, M.Ed. Kimberly L. Webster University of Kentucky References Carr, E., & Durand, V. (1985). Reducing behavior problems through functional commu-nication training. Journal of Applied Behavior Analysis, 18, Carr, E., Levin, L., McConnachie, G., Carlson, J., Kemp, D., & Smith, C. (1994). Communication-based interventions for problem behavior: A user s guide for providing positive change. Baltimore: Brookes Publishing. Durand, V.M., & Carr, E.G. (1991). Functional communication training to reduce challenging behavior: Maintenance and applications in new settings. Journal of Applied Behavior Analysis, 24, Jolivette, K., Stichter, J., Fishback, K., Sasso, G., & Miller, C. (2001). Commu-nication training using three functional variables for a student with emotional and behavioral disorders. Manuscript submitted for publication.