Functional Communication Training: A Review and Practical Guide

Jeffrey H. Tiger, Louisiana State University, Gregory P. Hanley, Western New England College
and Jennifer Bruzek, Vanderbilt University

ABSTRACT
Functional communication training (FCT) is one of the most common and effective interventions for severe
behavior problems. Since the initial description of FCT by Carr and Durand (1985), various aspects of the FCT
treatment process have been evaluated, and from this research, best practices have emerged. This manuscript
provides a review of these practices as they arise during the development of effective FCT interventions.
Descriptors: Behavior disorders, differential reinforcement of alternative behavior, functional communication
training, function-based treatment

F
unctional communication training FCT interventions progress through if they were published in an English-
(FCT) is a differential reinforcement three stages. A functional analysis is language scholarly journal, described use
(DR) procedure in which an conducted to identify the environmental of a pretreatment functional assessment
individual is taught an alternative response events that serve as reinforcers for problem in any form (i.e., indirect, descriptive, or
that results in the same class of reinforcement behavior and the conditions that evoke functional analysis), and included FCT as an
identified as maintaining problem behavior. problem behavior (i.e., the relevant intervention for problem behavior. A total
Problem behavior is typically placed on “establishing operations” that increase the of 91 articles, published in 19 journals, and
extinction (i.e., reinforcement no longer value of the reinforcer; Michael, 1982). A consisting of 204 individual participants3
follows problem behavior). Functional socially-acceptable communicative response were included. A list of all 91 FCT articles
communication training differs from other is strengthened by reassigning the reinforcer can be found on www.abainternational.
function-based DR procedures in that the found to maintain problem behavior to org/BAinPractice.asp.
alternative response is a recognizable form that communicative response.2 Finally, the .

of communication (e.g., a vocalization, FCT treatment is extended across settings For Whom Have FCT Interventions
manual sign). and caregivers. Been Developed?
Carr and Durand (1985) introduced Although this process can be briefly The 204 participants in this review
FCT as treatment for the problem summarized, there are procedural variations ranged from young children to adults,
behavior of 4 children with developmental at each stage that are likely to affect the nearly all of whom were diagnosed with
disabilities. A vocal response that resulted outcomes associated with FCT. The purpose a developmental disability or mental
in teacher attention (“Am I doing good of this paper is to identify the variations retardation (195 of the 204 cases). Eighty-
work?”) was taught to the children for whom described in published research for each one individuals were diagnosed with
attention was thought to be maintaining stage of treatment, to critically evaluate the autism. Those individuals not diagnosed
their problem behavior. A different vocal effectiveness of different FCT variations, with a developmental disability or mental
response (“I don’t understand”) that and to generate guidelines for best practice retardation were diagnosed with traumatic
resulted in teacher assistance was taught to on the basis of this research. Ideally, this brain injury (3 cases), attention deficit
the children for whom escape from difficult manuscript will serve as a practical guide disorder or attention-deficit hyperactivity
tasks was thought to be maintaining their to individuals who implement FCT for disorder (3 cases), and speech or language
problem behavior. These procedures individuals with behavior disorders. delays (3 cases). Although FCT has the
resulted in acquisition of these vocal Studies on FCT were identified greatest level of empirical support for
responses and substantial reductions in the through a search of Psychinfo and use with individuals with developmental
problem behavior of all 4 children. In the 20 ERIC using the keywords “functional disabilities, there is limited evidence that
plus years since the publication of Carr and communication training” or “functional FCT may be relevant for other persons who
Durand (1985), FCT has emerged as the equivalence training” from 1985 through display problem behavior.
most published function-based treatment 2006. The reference section of each article
for problem behavior.1 was examined to identify additional FCT 3
Four additional FCT studies that consisted of
1
A search of PsychInfo in which the key articles. Finally, each article was reviewed to relatively large groups of participants were excluded to
terms functional communication training (FCT), determine if it met inclusionary criteria for avoid the possibility of overlap with other published
differential reinforcement of other behavior (DRO), the present review. Studies were included papers. The reader is referred to Hagopian, Fisher,
and noncontingent reinforcement (NCR) were Sullivan, Acquisto, and LeBlanc (1998) for FCT
linked to functional assessment, functional analysis, summary data relevant to an inpatient sample, to
2
and behavioral assessment yielded 66 FCT papers, The communicative response may be Kurtz et al. (2003) for an outpatient sample of young
31 NCR papers, and 11 DRO papers. These results, conceptualized as a mand in that it is evoked in the children, and to Wacker et al. (2005) and Wacker
although preliminary, support the assertion that presence of a relevant establishing operation and et al. (1998) for samples of young children with
FCT is the most popular function-based treatment maintained by a characteristic consequence developmental disabilities served in their homes.
for problem behavior.

16 FCT REVIEW
 .
conducting a functional analysis of severe to discriminate between multiple pictorial
Which Forms and Functions of problem behavior prior to implementing or textual stimuli. On the other hand,
Problem Behavior Have Been FCT (see Iwata & Dozier in this issue more precise motor control is required for
Addressed with FCT? of BAP for guidelines on conducting effective manual signing relative to picture
Participants most often engaged in functional analyses). exchanges. Thus, selection-based responses
aggression, self-injury, or motor and vocal may be easier to shape or prompt, facilitating
How Do You Select a Communicative
disruptions; however, FCT evaluations quicker acquisition of the communicative
Response Topography?
have also included bizarre vocalizations response. Nevertheless, the extent to
(Mace & Lalli, 1991), stereotypy (Wacker A variety of response topographies which the relative effort of selection-based
et al., 1990), inappropriate sexual behavior have been targeted in FCT, including vocal and topography-based communicating
(Fyffe, Kahng, Fittro, & Russell, 2004), responses, picture exchanges, sign language, systems impact the effectiveness of FCT
self-restraint (Vollmer & Vorndran, gestures, and activation of voice or text interventions has not yet been determined.
1998) and inappropriate communicative output devices. Findings suggest several There is also evidence that the use of
behaviors (Frea & Hughes, 1997). Problem factors should be considered when selecting simple and low-effort responses should be
behaviors were maintained by attention a communicative response topography. restricted to the initial stage of treatment.
(32% of cases); materials (29% of cases); This includes the effort required to engage While teaching young children with
access to other events, such as restraint or in the response, the likelihood that others language and developmental delays,
wheel chair movement (3% of cases); escape will recognize and respond appropriately to Hernandez, Hanley, Ingvarsson, and Tiger
from demands (43% of cases); and escape the response, and the consumer’s current (2007) showed that reinforcement of
from other aversive events, such as loud behavioral repertoire. relatively high-effort responses (requests
noises and social interaction (4% of cases).4 Consider response effort. Horner and embedded within a frame such as, “May
Thus, FCT is an appropriate treatment for Day (1991) first showed that when a I have the __[car]__, please”) were more
a variety of problem behaviors maintained communicative response required more likely to induce generalization (e.g., “May
by social (positive or negative) sources of effort than problem behavior (e.g., manually I have the book, please”) than low-effort
reinforcement. signing a full sentence), the response failed responses (characterized by single specific
to occur at levels higher than that of words such as “Car”).
Guidelines for Developing problem behavior. By contrast, when the Consider the social recognition of the
FCT Interventions communicative response required less effort response. Response topographies that a novel
(e.g., signing a single word), it occurred to conversation partner will likely reinforce
How Do You Identify the Reinforcer for the the exclusion of problem behavior. Thus, should be selected (Durand & Carr,
Communicative Response? the communicative response should be less 1992). Logically, adults unfamiliar with
The first step in implementing FCT effortful than problem behavior, at least in an individual’s behavioral programming
is to conduct a functional assessment of the initial stages of treatment. While this will be unlikely to respond appropriately
the client’s problem behavior. Functional recommendation seems straightforward, to arbitrary gestures such as a hand claps
assessments identify the environmental the complexity or effort of acquiring a and only slightly more likely to respond
event(s) maintaining problem behavior, communicative response is often not fully appropriately to manual sign language.
thus allowing for the maintaining event to appreciated. Novel adults are most likely to respond
be withheld following problem behavior Preliminary language research suggests to communication that unambiguously
and reassigned to follow a recognizable that individuals with developmental identifies the reinforcer.
communicative behavior. The majority of disabilities are more adept at acquiring One investigation provided strong
studies (71 of 91 published articles) used topography-based responding relative to support for selecting recognizable response
the functional analysis model in which selection-based responding (Sundberg topographies. Durand (1999) taught 5
potential controlling variables for problem & Sundberg, 1990; Wraikat, Sundberg, individuals with disabilities to recruit
behavior were manipulated (see Hanley et & Michael, 1991). In topography-based reinforcement through voice-output
al., 2003, for a review). Without the accurate systems, such as sign language, the form devices as alternatives to destructive
identification of maintaining reinforcers, the of the response differentiates one verbal behavior. Following this training, the
event(s) assigned to follow a communicative response from another (i.e., the sign devices were introduced in community
response may be functionally unrelated to for “play” is different from the sign for settings (e.g., an individual with problem
problem behavior. Such interventions may “break”). In selection-based systems, such behavior maintained by access to food was
be less likely to decrease problem behavior as picture exchanges, the form of each trained to use a voice output device to
and/or strengthen a socially acceptable response is identical (e.g., handing someone request food, and then took the device to
alternative. Therefore, we recommend a picture card) and are differentiated by the a mall food court). This study showed that
stimulus selected. Selection-based systems these responses occurred under untrained
4
Individuals presenting with multiply may present challenges to individuals with conditions for all 5 participants and that
controlled problem behavior resulted in the sum of
disabilities because these systems require untrained adults responded appropriately
these percentages to be greater than 100%.
individuals to scan an array of stimuli and to the communicative responses.

FCT REVIEW 17
 Consider the likely speed of response of stimulus control and generalization. The and personal or public property can be
acquisition. Response forms that can be ultimate success of FCT is determined by minimized by eliminating other individuals
quickly acquired as replacements for the extent to which communication occurs from the training environment (e.g.,
problem behavior should be selected. in the presence of all relevant caregivers other students), using special protective
Vocal responses are the ideal alternative for in all relevant settings. That does not equipment (e.g., padded rooms and
socially maintained problem behavior due necessarily mean that all relevant caregivers tables), and removing fragile or dangerous
to the possibility of recruiting reinforcement should simultaneously implement FCT in items (e.g., lamps, televisions, and tables).
from novel persons or from people at a all relevant settings. There are important Initiating treatment in a protected settings
distance. However, motor responses may starting conditions to ensure acquisition of is strongly recommended for individuals
be preferable for individuals who engage the communicative response. Eventually, whose problem behavior poses undue
in little or no vocal behavior, as extensive the teaching conditions are modified to danger to themselves or others.
training would be necessary to develop promote generalization and maintenance That is not to say that conducting
recognizable vocal responses. Motor of treatment effects. training only in a controlled setting
responses probably should be considered Consider the initial teaching conditions. will be sufficient. Conducting FCT in
as initial FCT responses even when vocal Functional communication training has a single training environment will not
verbal repertoires are intact because vocal been conducted by experts in highly consistently result in clinically acceptable
responses are more difficult prompt. controlled settings (e.g., clinicians in levels of generalization to other settings
Efforts can be dedicated to increasing the hospitals or clinics; Hagopian et al., 1998; or individuals (Wacker et al., 2005).
developmentally appropriate nature of the Kurtz et al., 2003) and by parents or teachers When a controlled training environment
response once the communicative behavior in community settings (e.g., Northup et al., is used, additional strategies typically will
has replaced problem behavior. 1994; Wacker et al., 2005). The amount be necessary to promote generalization of
Alternative vocal or motor responses of time required to train a caregiver to behavior changes to other environments.
may already exist in the repertoires of implement FCT is worth considering Consider strategies for promoting
consumers but not occur under the when deciding who should implement generalization. We highly recommend three
conditions evoking problem behavior. FCT initially. Functional communication of the generalization techniques described
Clinicians may strengthen these responses training requires the precise manipulation by Stokes and Baer (1977), along with
through FCT. For example, an individual of establishing operations, timing of caregiver training, to promote the generality
may sometimes manually sign “all done” or prompts, and delivery of consequences for of responding. One technique is to
engage in self-injury in difficult situations. communicative and problem behavior while eventually incorporate multiple trainers or
Therefore, the manual sign “all done” ensuring the safety of the implementer and training settings (i.e., the multiple exemplar
may be strengthened as a communicative consumer. Caregivers may require extensive approach). Durand and Carr (1991) had
response by terminating tasks only training to implement FCT, during which three trained implementers conduct the
following the “all done” sign. The training time problem behavior may continue initial FCT training, and then observed
of a pre-existing response is likely to result to occur. Trained practitioners often generalization of the communicative
in more rapid acquisition than introducing implement the early stages of FCT (which response to the classroom for 3 participants.
a novel response alternative (Winborn, are commonly the most challenging) and In this regard, generalization to the teacher
Wacker, Richman, Asmus, & Geier, 2002). then introduce caregivers into the training was enhanced by training the response in
However, reinforcement of a pre-existing environments following successful out- the presence of multiple trainers.
response may result in an increase in comes (when communication is occurring A second technique that has not been
problem behavior in some cases (see Derby, to the exclusion of problem behavior). clearly articulated in the FCT literature
Fisher, Piazza, Wilke, & Johnson, 1998). By contrast, some researchers have is to include like stimuli into the training
In summary, communicative responses adopted the approach of initiating FCT environment or, said another way, to
that are recognizable and can be acquired exclusively in natural environments (e.g., make the training environment similar
quickly (i.e., low effort) should be selected training job coaches at a job site; Kemp to the natural environment. For instance,
during the initiation of FCT. More complex & Carr, 1995). This approach has the common items found in classrooms can
response forms should be considered after advantage of developing communicative be introduced in training settings (e.g.,
initial responses are acquired and problem responding under target conditions (i.e., particular curricular materials) to facilitate
behavior is satisfactorily reduced. issues of generalization are minimized), the transition back to classrooms. A third
. but suffers two potential limitations. First, technique is often referred to as sequential
Who Should Implement FCT, and Where
problem behavior or other behaviors that modification, or sequentially conducting
Should They Implement It?
are incompatible with the communicative training in each relevant context.
When the reinforcer and communi- response may continue to be reinforced in When minimal generalization of the
cative response have been identified, the the natural environment. These competing communicative response occurs in other
teaching setting and the individual who will sources of reinforcement are more easily settings, training should be sequentially
teach the communicative response should be removed or minimized in controlled settings. introduced in each setting to produce
selected. Both decisions are essentially issues Second, risk to the client, other individuals, generalized reductions in problem behavior.

18 FCT REVIEW
Although more challenging in terms of routines or could repeatedly prompt an errorless backward-chaining procedure. A
time and effort, this technique is clearly individual to engage in self-care tasks during therapist physically prompted the consumer
necessary when other attempts to promote contrived training sessions. Conducting to engage in the target communicative
generalization have failed. training during naturally occurring response immediately upon removal of
There is little doubt that caregivers can routines will promote generalization to the reinforcer (i.e., when the relevant
be successfully trained to implement FCT. these conditions. However, this “natural establishing operation was in place). Upon
Several studies have evaluated the effects of establishing operation only” approach successive trials, the physical prompt was
FCT implemented by school teachers and in isolation is likely to result in relatively gradually faded by removing the intensity of
staff members with minimal involvement slower acquisition of the target response due the prompt until the individual responded
from trained clinicians (e.g. Durand to fewer learning opportunities and may independently. Carr and Durand (1985)
& Kishi, 1987; Northup et al., 1994). be dangerous for severe problem behavior. described a similar approach to prompt
However, there is a lack of consensus on how Contriving teachable opportunities can vocal responses by initially providing the
best to train these individuals. Common accelerate learning by arranging for multiple vocal prompt, “Say, ‘Please’,” and gradually
staff-training procedures (e.g., the use of opportunities to prompt and reinforce the reducing the volume of the prompt (i.e.,
modeling, scripts, role play, videotapes, and communicative response, both of which progressively whispering the prompt). The
feedback) have been anecdotally reported can be repeatedly arranged to occur under aim of most-to-least prompting strategies is
throughout the literature but have not been presumably safer conditions. However, this also to transfer control from the teacher’s
the focus of a formal evaluation. “contrived establishing operation only” prompting to the evocative event, but this
In sum, we recommend that FCT be approach in isolation may require additional occurs through the gradual elimination of
initiated by a well-trained practitioner training to promote generalization to more the prompt as opposed to the time-delay
in a setting that minimizes competing typical conditions (Moes & Frea, 2002). inherent in the least-to-most procedure
sources of reinforcement and maximizes Consider prompting and prompt fading used by Shirley et al. (1997).
the safety of the therapist, consumer, and tactics to promote communicative responding. Although there have not been any
personal property. Strategies to promote Several prompting and prompt fading comparative analyses of these prompting
generalization to important settings and techniques have been described in the techniques in the context of FCT, there
caregivers should be incorporated, and FCT literature. In a general sense, these are some distinct advantages to each that
generalization should be assessed to ensure prompting techniques can be described as may be considered. The least-to-most
its occurrence. Direct training in these least-to-most and most-to-least prompting procedure permits problem behavior to
important environments may be necessary sequences. One version of the least-to- occur during the initial stages of training,
in some cases. Caregivers should be trained most prompting technique was described creating brief experiences with extinction
to implement FCT; however, the ideal by Shirley, Iwata, Kahng, Mazaleski, which may be helpful in decreasing future
way to arrange this training has yet to be and Lerman (1997), who began each problem behavior occurrences. However,
described. teaching trial by setting up the relevant undesirable response chains involving the
establishing operation (e.g., removing problem behavior and the communicative
How Should You Teach the
access to a preferred item) and providing response may develop if bouts of problem
Communicative Response?
an opportunity for the communicative behavior consistently precede a prompted
There are two considerations for response to occur (e.g., waiting for 5 s). and reinforced communicative response.
teaching the communicative response. First, This 5-s delay was then followed by a There is much less opportunity for
will teaching trials be arranged through verbal or physical prompt (i.e., physically undesirable response chaining to occur with
contrived situations or will therapists wait guiding the participant’s hands to complete the most-to-least procedure (e.g., Fisher et
for naturally arising opportunities? Second, the target sign), after which reinforcement al., 1993) which ensures the emission of
how will the communicative response be was delivered in the form of brief access to the communicative response as soon as the
prompted, and how will this prompting be the preferred item. The physical prompt evocative event is experienced. However,
faded? The following section will address then was further delayed to eliminate the extinction of problem behavior may be
each consideration individually. participant’s dependence upon prompting rarely experienced so problems may emerge
Consider using contrived versus natural (i.e., the response eventually occurred when even after successful communication
establishing operations. The distinction the target item was removed). The aim of training.
between contrived and natural establishing this procedure is to transfer control from the
How Should You Select the Consequences for
operations depends upon whether a trainer teacher’s prompting to the evocative event
Problem Behavior?
waits for the maintaining reinforcer to (e.g., a toy or attention being removed)
become valuable or specifically sets up via progressively increasing delays in time When implementing FCT, three generic
conditions that will increase the value of between the presentation of the evocative classes of consequences can be arranged
the reinforcer. For instance, a trainer could event and the prompt. for problem behavior: reinforcement,
embed FCT trials during morning self-care A version of the most-to-least extinction, and punishment.
routines for individuals whose problem prompting technique was described by Consider continued reinforcement of
behavior is maintained by escape from these Fisher et al. (1993) in what was termed an problem behavior. Problem behavior may

FCT REVIEW 19
need to be reinforced during FCT when enhanced the efficacy of FCT with in training to an intermittent or delayed
there is little control over the reinforcer extinction. Although the therapeutic use schedule under natural conditions, the
(e.g., peer attention in a classroom), or of punishment raises ethical issues, research response is likely to undergo extinction,
when withholding the reinforcer may be indicates that punishment contingencies setting the stage for the reemergence of
dangerous (e.g., a large adult who engages are often effective and sometimes necessary problem behavior (e.g., Fisher et al., 1993;
in severe aggression or self-injury). The for sustained reductions of severe problem Hanley, Iwata, & Thompson, 2001).
effectiveness of this treatment approach behavior. For example, in Hagopian et al., Therefore, procedures have been developed
relies upon the communicative response after FCT with extinction was ineffective to systematically thin CRF schedules to
competing with problem behavior. A in reducing problem behavior in 14 of 25 more manageable schedules that maintain
limited number of reported cases have reported applications, the addition of a treatment gains. The following sections
shown FCT to be effective in the absence of punishment contingency (e.g., room time- describe these reinforcement-thinning.
extinction, and suggest that longer duration out, brief manual restraint) resulted in Consider introducing a time delay
of reinforcement (Peck et al., 1996; Peterson a 90% reduction in all 14 cases. Thus, it between the communicative response and
et al., 2005), more immediate or higher should be expected that punishment may reinforcement. One reinforcement thinning
quality of reinforcement (Horner & Day, be needed for successful treatment in some technique involves introducing a time
1991), and a higher rate of reinforcement cases. The aversive aspects of situations delay between the communicative response
(Kelley, Lerman, & Van Camp et al., 2002; involving punishment can be minimized and delivery of the reinforcer. Following
Worsdell et al., 2000) should be assigned by continuing to deliver reinforcement FCT for 1 participant, Fisher, Thompson,
to the communicative response if problem for the communicative response, clearly Hagopian, Bowman, and Krug (2000)
behavior will continue to be reinforced. identifying the behaviors that result in the introduced a 1-s delay to reinforcement for
Consider extinction for problem behavior. punisher, and delivering the punisher on the communicative response and gradually
FCT without extinction will frequently a reliable schedule (Hanley et al., 2005; extended this delay up to 30 s. This
fail to result in sufficient reductions in Lerman & Vorndran, 2002). approach is the most frequently reported
problem behavior (Fisher et al., 1993; Based on the available evidence, we reinforcement-thinning procedure (see, for
Hagopian et al., 1998; Shirley et al., 1997; recommend arranging extinction for instance, Hagopian et al., 1998); however,
Wacker et al., 1990; Worsdell et al., 2000). problem behavior during initiation of FCT. its effectiveness is compromised with
Perhaps the most definitive study on the For cases in which extinction cannot be lengthier delays between the response and
relative importance of arranging extinction implemented or is ineffective, parameters its reinforcer. The contingency between the
for problem behavior was reported by of reinforcement should be adjusted to communicative response and reinforcement
Hagopian et al. (1998) in a summary of 27 favor the communicative response and is weakened as the time between the
applications of FCT implemented on an punishment should be arranged for problem communicative response and the
inpatient unit specializing in the treatment behavior. Selection of punishers should be reinforcement delivery increases, making
of severe behavior disorders. FCT without based on a direct assessment that indicates the resumption of problem behavior likely
extinction was applied as a treatment in 11 their likely effectiveness. (Fisher et al., 2000; Hanley et al., 2001).
of these applications and was not effective This contingency weakening effect of delay
How should Reinforcement be Thinned for
in reducing problem behavior below 90% may be minimized, but not eliminated, by
Communicative Responding?
of baseline levels in a single case. FCT with including a salient cue during the delay that
extinction was implemented during 25 A continuous reinforcement (CRF) reinforcement is forthcoming (see Vollmer,
applications and resulted in at least 90% schedule has been used during the Borrero, Lalli, & Daniel, 1999, for an
or greater reductions in problem behavior initial teaching of the communicative example).
in 11 cases. Based on these results and response (i.e., each response resulted Lalli, Casey, and Kates (1995)
those of additional studies, we recommend in reinforcement) in all FCT studies; described an alternative delay procedure
implementing extinction for problem therefore, we strongly recommend that the that maintained the temporal contiguity
behavior as the starting point for FCT communicative response be reinforced on a between the communication response
when possible. CRF schedule initially. However, caregivers and the reinforcer. Lalli et al. first taught
Consider punishment of problem often have multiple responsibilities (e.g., their participant to vocally request a break
behavior. Although FCT with extinction cooking, caring for other children) that from a 16-step task by delivering the break
has proven effective for a variety of behavior preclude them from reinforcing each following each request. Subsequently,
disorders, several rigorous component instance of communicative behavior. That the participant was required to complete
evaluations have shown that this treatment is, reinforcement for the communicative more and more steps of the task before a
may not be effective for all individuals response is likely to be delivered request would be honored. In this regard,
(e.g., Fisher et al., 1993; Hagopian et al., intermittently, after considerable delays, or the reinforcer was delayed for responses
1998; Hanley, Piazza, Fisher, & Maglieri, both under natural conditions. When the that occurred before the task requirements
2005; Wacker et al., 1990). These same schedule for communicative responding were fulfilled, but the break immediately
studies showed that adding a punishing is abruptly shifted from a CRF schedule followed any requests that occurred as soon
consequence for problem behavior as the work requirement was completed.

20 FCT REVIEW
 Consider establishing stimulus control of effectively avoid important activities (e.g., Derby, K., Fisher, W. W., Piazza, C. C.,
the communicative response. After showing personal hygiene or academic activities). Wilke, A. E., & Johnson, W. (1998). The
that delayed reinforcement resulted in Teaching consumers to tolerate periods effects of noncontingent and contingent
extinction of the communicative response without reinforcement and to complete attention for self-injury, manding, and
and resumption of problem behavior, initially aversive activities should follow collateral responses. Behavior Modification,
Hanley et al. (2001) described a procedure initial FCT by thinning the reinforcement 22, 474-484.
that involved teaching the individual to schedule. It is likely that the practical Durand,V. (1999). Functional communication
identify when reinforcement would not be exigencies that make FCT challenging training using assistive devices: Recruiting
available for the communication response. to implement with integrity would be natural communities of reinforcement.
The experimenters alternated between best addressed by incorporating multiple Journal of Applied Behavior Analysis, 32,
periods of reinforcement and extinction thinning tactics into FCT programs. 247-267.
for communicative responses, and each Arranging appropriate stimulus controls Durand, V., & Carr, E. G. (1991). Functional
period was correlated with a distinct (i.e., signaled delays to reinforcement and communication training to reduce
discriminative stimulus (a red card viewable signaled periods of extinction) and making challenging behavior: Maintenance and
during reinforcement periods, and a white alternative reinforcers available during delay application in new settings. Journal of
card viewable during extinction periods). or extinction periods are most likely to Applied Behavior Analysis, 24, 251-264.
This stimulus control procedure was maintain the strength of the communicative Durand, V., & Carr, E. G. (1992). An analysis
highly effective when reinforcement for the response over time (Fisher, Thompson, of maintenance following functional
communicative response was only available Hagopian, Bowman, & Krug, 2000). In communication training. Journal of
for 20% of the time. This procedure has the case of escape-maintained problem Applied Behavior Analysis, 25, 777-794.
the advantage of maintaining a strong behavior, we recommend the approach Durand, V., & Kishi, G. (1987). Reducing
contingency between the newly acquired described by Lalli et al. (1995) due to the severe behavior problems among persons
communicative response and the reinforcer potential contingency weakening effects of with dual sensory impairments: An
while still allowing caregivers a “break” the delay procedure. evaluation of a technical assistance model.
during extinction periods. Journal of the Association for Persons with
Be aware of the reemergence of problem Summary Severe Handicaps, 12, 2-10.
behavior. Problem behavior should be The past 20 plus years of research have Fisher, W. W., Kuhn, D. E., & Thompson,
expected to occur during the reinforcement provided an empirical basis for making R. H. (1998). Establishing discriminative
thinning process, regardless of the strategy decisions during the implementation of control of responding using functional and
used. Continued exposure to extinction FCT as a treatment for severe problem alternative reinforcers during functional
may be sufficient to reduce problem behavior. The important histories of those communication training. Journal of
behavior; however, additional treatment served and the contexts in which behavior Applied Behavior Analysis, 31, 543-560.
components may be necessary. One option analysts serve them will dictate some Fisher, W. W., Piazza, C. C., Cataldo, M.
is to provide preferred items during delay aspects of the FCT treatment process, but F., Harrell, R., Jefferson, G., & Conner,
intervals or extinction periods to compete we have offered evidence-based guidelines R. (1993). Functional communication
with the occurrence of problem behavior. for making decisions at each stage of the training with and without extinction and
For instance, Fisher, Kuhn, and Thompson FCT process. These are summarized in punishment. Journal of Applied Behavior
(1998) taught a participant to request Table 1. It is our hope that these guidelines Analysis, 26, 23-36.
preferred materials during periods in will allow for more effective function-based Fisher, W. W., Thompson, R. H., Hagopian,
which the functional reinforcer (attention) interventions to be applied by behavior L. P., Bowman, L. G., & Krug, A.
was unavailable. Another option, to be analysts charged with improving the (2000). Facilitating tolerance of delayed
considered if preferred stimuli do not conditions for persons who engage in severe reinforcement during functional
effectively compete with the reinforcer for problem behavior and their caregivers. In communication training. Behavior
problem behavior, is to include punishment addition, these guidelines may be useful Modification, 24, 3-29.
of problem behavior during the extinction for proactive implementation of functional Frea, W. D., & Hughes, C. (1997). Functional
periods. communication training with persons at analysis and treatment of social-
In conclusion, teaching consumers to risk for developing severe problem behavior communicative behaviors of adolescents
appropriately escape from an aversive task (see Hanley, Heal, Tiger, & Ingvarsson, with developmental disabilities. Journal of
and to request materials or attention are 2007, and Keen, Sigafoos, & Woodyatt, Applied Behavior Analysis, 30, 701-704.
appropriate early steps in the treatment 2001, for examples). Fyffe, C. E., Kahng, S. W., Fittro, E., &
process; however terminating treatment Russell, D. (2004). Functional analysis
at this phase will result in extremely References and treatment of inappropriate sexual
unsatisfied caregivers. Although parents Carr, E. G., & Durand, V. (1985). Reducing behavior. Journal of Applied Behavior
may be happy that their children are no behavior problems through functional Analysis, 37, 401-404.
longer engaging in problem behavior, communication training. Journal of Hagopian, L. P., Fisher, W. W., Sullivan, M.
they will not be satisfied if their children Applied Behavior Analysis, 18, 111-126. T., Acquisto, J., & LeBlanc, L. A. (1998).

FCT REVIEW 21
 Effectiveness of functional communication Table 1: Best Practice Guidelines for Conducting FCT
training with and without extinction and
punishment: A summary of 21 inpatient
cases. Journal of Applied Behavior Analysis,
31, 211-235.
When beginning FCT
Hanley, G. P., Heal, N. A., Tiger, J. H., & 1) Conduct a functional analysis to identify the reinforcer maintaining
Ingvarsson, E. I. (2007). Evaluation of a problem behavior.
classwide teaching program for developing 2) Select a communicative response that is recognizable and can be acquired
preschool life skills. Journal of Applied quickly.
Behavior Analysis, 40, 277-300. 3) Identify a trained individual to initiate FCT in a safe, controlled
Hanley, G. P., Iwata, B. A., & McCord, B. environment.
E. (2003). Functional analysis of problem 4) Arrange multiple opportunities to prompt and reinforce the communication
behavior: A review. Journal of Applied response to promote rapid acquisition.
Behavior Analysis, 36, 147-185. 5) Teach the communicative response using most-to-least or least-to-most
Hanley, G. P., Iwata, B. A., & Thompson, prompting procedures, and reinforce every instance of the response.
R. H. (2001). Reinforcement schedule 6) Withhold reinforcement for problem behavior and, when necessary,
thinning following treatment with arrange punishers for problem behavior.
functional communication training.
Journal of Applied Behavior Analysis, 34,
Once problem behaviors are reduced in controlled situations
17-38.
Hanley, G. P., Piazza, C. C., Fisher, W. 1) Thin the schedule of reinforcement for the communication response by
W., & Maglieri, K. A. (2005). On either delaying reinforcer delivery or teaching the client to recognize
the effectiveness of and preference for situations or times when reinforcement is not available for the response.
punishment and extinction components 2) Implement strategies to promote generalization by incorporating multiple
of function-based interventions. Journal trainers or settings into the training, including stimuli from the generaliza-
of Applied Behavior Analysis, 38, 51-65. tion settings, and conducting training in all relevant contexts.
Hernandez, E., Hanley, G. P., Ingvarsson, E. 3) Teach caregivers to respond to communicative and problem behavior.
I., & Tiger, J. H. (2007). A preliminary 4) Arrange learning situations in the natural environment.
evaluation of the emergence of novel 5) Increase the complexity of the communicative response over time.
mand forms. Journal of Applied Behavior
Analysis, 40, 137-156.
Horner, R. H., & Day, H. (1991). The effects
of response efficiency on functionally young children: A summary of 30 cases. early intervention for children with autism
equivalent competing behaviors. Journal Journal of Applied Behavior Analysis, 36, and their families. Journal of Autism and
of Applied Behavior Analysis, 24, 719- 205-219. Developmental Disorders, 32, 519-533.
732. Lalli, J. S., Casey, S., & Kates, K. (1995). Northup, J., Wacker, D. P., Berg, W. K.,
Keen, D., Sigafoos, J., & Woodyatt, G. Reducing escape behavior and increasing Kelly, L., Sasso, G. M., & DeRaad, A.
(2001). Replacing prelinguistic behaviors task completion with functional (1994). The treatment of severe behavior
with functional communication. Journal communication training, extinction, problems in schools using a technical
of Autism and Developmental Disorders, and response chaining. Journal of Applied assistance model. Journal of Applied
31, 385-398. Behavior Analysis, 28, 261-268. Behavior Analysis, 27, 33-47.
Kelley, M. E., Lerman, D. C., & Van Camp, Lerman, D. C., & Vorndran, C. M. (2002). Peck, S. M., Wacker, D. P., Berg, W. K.,
C. M. (2002). The effects of competing On the status of knowledge for using Cooper, L. J., Brown, K. D., Richman, D.,
reinforcement schedules on the acquisition punishment: Implications for treating et al. (1996). Choice-making treatment of
of functional communication. Journal of behavior disorders. Journal of Applied young children’s severe behavior problems.
Applied Behavior Analysis, 35, 59-63. Behavior Analysis, 35, 431-464. Journal of Applied Behavior Analysis, 29,
Kemp, D. C., & Carr, E. G. (1995). Reduction Mace, F. C., & Lalli, J. S. (1991). Linking 263-290.
of severe problem behavior in community descriptive and experimental analyses in Peterson, S. M., Caniglia, C., Royster, A.
employment using an hypothesis-driven the treatment of bizarre speech. Journal of J., Macfarlane, E., Plowman, K., Baird,
multicomponent intervention approach. Applied Behavior Analysis, 24, 553-562. S. J., et al. (2005). Blending functional
Journal of the Association for Persons with Michael, J. (1982). Distinguishing between communication training and choice
Severe Handicaps, 20, 229-247. discriminative and motivational functions making to improve task engagement and
Kurtz, P. F., Chin, M. D., Huete, J. M., Tarbox, of stimuli. Journal of the Experimental decrease problem behaviour. Educational
R. S. F., O’Connor, J. T., Paclawskyj, T. Analysis of Behavior, 37, 149-155. Psychology, 25, 257-274.
R., et al. (2003). Functional analysis and Moes, D. R., & Frea, W. D. (2002). Shirley, M. J., Iwata, B., Kahng, S. W.,
treatment of self-injurious behavior in Contextualized behavioral support in Mazaleski, J. L., & Lerman, D. C. (1997).

22 FCT REVIEW
 Does functional communication training Wacker, D. P., Berg, W. K., Harding, J. W., Analysis, 35, 295-298.
compete with ongoing contingencies Barretto, A., Rankin, B., & Ganzer, J. Worsdell, A. S., Iwata, B. A., Hanley, G. P.,
of reinforcement? An analysis during (2005). Treatment effectiveness, stimulus Thompson, R. H., & Kahng, S. (2000).
response acquisition and maintenance. generalization, and acceptability to parents Effects of continuous and intermittent
Journal of Applied Behavior Analysis, 30, of functional communication training. reinforcement for problem behavior
93-104. Educational Psychology, 25, 233-256. during functional communication
Stokes, T. F., & Baer, D. M. (1977). An Wacker, D. P., Berg, W. K., Harding, J. W., training. Journal of Applied Behavior
implicit technology of generalization. Derby, K. M., Asmus, J. M., & Healy, Analysis, 33, 167-179.
Journal of Applied Behavior Analysis, 10, A. (1998). Evaluation and long-term Wraikat, R., Sundberg, C. T., & Michael,
349-367. treatment of aberrant behavior displayed J. (1991). Topography-based and
Sundberg, C. T., & Sundberg, M. L. (1990). by young children with disabilities. selection-based verbal behavior: A further
Comparing topography-based verbal Developmental and Behavioral Pediatrics, comparison. The Analysis of Verbal
behavior with stimulus selection-based 19, 260-266.* Behavior, 9, 1-17.
verbal behavior. The Analysis of Verbal Wacker, D. P., Steege, M. W., Northup, J.,
Behavior, 8, 31-41. Sasso, G. M., Berg, W., Reimers, T., Authors Note
Vollmer, T. R., Borrero, J. C., Lalli, J. S., & et al. (1990). A component analysis of Portions of this manuscript were
Daniel, D. (1999). Evaluating self-control functional communication training across completed in partial fulfillment of the
and impulsivity in children with severe three topographies of severe behavior University of Kansas requirements for
behavior disorders. Journal of Applied problems. Journal of Applied Behavior the doctoral degree of the first author.
Behavior Analysis, 32, 451-466. Analysis, 23, 417-429. Address correspondence to Jeffrey H. Tiger,
Vollmer, T. R., & Vorndran, C. M. (1998). Winborn, L., Wacker, D. P., Richman, D. Department of Psychology, 218 Audubon
Assessment of self-injurious behavior M., Asmus, J., & Geier, D. (2002). Hall, Louisiana State University, Baton
maintained by access to self-restraint Assessment of mand selection for Rouge, LA 70803 (email: [email protected]).
materials. Journal of Applied Behavior functional communication training
Analysis, 31, 647-650. packages. Journal of Applied Behavior

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