Effectiveness of Functional Communication Training With and Without Extinction and Punishment: A Summary of 21 Inpatient Cases

Abstract

Functional communication training (FCT) is a frequently used treatment for reducing problem behavior exhibited by individuals with developmental disabilities. Once the operant function of problem behavior is identified by a functional analysis, the client is taught to emit an appropriate communicative response to obtain the reinforcer that is responsible for behavioral maintenance. Studies on FCT have typically used small numbers of participants, have reported primarily on clients for whom FCT was successful, and have varied with respect to their use of other treatment components. The main purposes of the present study were to evaluate the efficacy of FCT for treating severe problem behavior in a relatively large sample of individuals with mental retardation (N = 21) and to determine the contribution of extinction and punishment components to FCT treatment packages. FCT with extinction was effective in reducing problem behavior for the majority of clients and resulted in at least a 90% reduction in problem behavior in nearly half the applications. However, when demand or delay-to-reinforcement fading was added to FCT with extinction, treatment efficacy was reduced in about one half of the applications. FCT with punishment (both with and without fading) resulted in at least a 90% reduction in problem behavior for every case in which it was applied.

Reinforcement Schedule Thinning Following Functional Communication Training: Review and Recommendations

“…Hagopian et al (1998) describe typical implementation of a delay schedule. Participants were treated with FCT while on an inpatient hospital unit for the assessment and treatment of severe problem behavior.…”

“…FCT has been demonstrated to be a highly effective treatment for individuals with intellectual disabilities, ranging from mild to profound, who engage in severe problem behaviors such as self-injury and aggression (e.g., Bailey, McComas, Benavides, & Lovascz, 2002;Carr & Durand, 1985;Fisher et al, 1993;Hagopian, Fisher, Sullivan, Acquisto, & LeBlanc, 1998;Kurtz, et al, 2003;Shirley, Iwata, Kahng, Mazaleski, & Lerman, 1997;Wacker et al, 1990). We searched and reviewed the published literature from 1985 to 2009 1 and identified 76 studies employing FCT as a treatment for 235 individuals with intellectual disabilities of varying ages (i.e., 2-34 years old) displaying a wide range of problem behavior (e.g., aggression, disruption, SIB, inappropriate sexual behavior).…”

“…We searched and reviewed the published literature from 1985 to 2009 1 and identified 76 studies employing FCT as a treatment for 235 individuals with intellectual disabilities of varying ages (i.e., 2-34 years old) displaying a wide range of problem behavior (e.g., aggression, disruption, SIB, inappropriate sexual behavior). In the vast majority (79%) of these studies, FCT was used concurrently with extinction for problem behavior, suggesting that extinction is a critical component of FCT for the treatment of severe problem behavior (Fisher, Thompson, Hagopian, Bowman, & Krug, 2000;Hagopian et al, 1998 across all settings, may be neither feasible nor effective in the long run. In response, clinicians sometimes attempt to alter the schedule of reinforcement for the communication response.…”

A Preliminary Analysis of the Effects of Coaching Feedback on Teacher Implementation Fidelity of First Step to Success

“…Therefore, we agree wholeheartedly that students need less aversive contingencies and more positive ones. However, it is impossible to ignore the empirical evidence demonstrating that punishment procedures can sometimes enhance the effectiveness of other procedures, especially if problem behaviors are severe (e.g., Hagopian, Fisher, Sullivan, Acquisto, & LeBlanc, 1998). Given that it is unlikely that schools will (or should) abandon punishment altogether, it would be helpful to provide some guidelines for situations that might warrant punishment, as well as specific guidelines for its ethical use.…”

Using Video to Bridge the Gap Between Problem Behavior and a Delayed Time-out Procedure

“…effective than programs that include reinforcement alone (Charlop-Christy & Haymes, 1996;Durand, 1982;Foxx & Azrin, 1972, Hagopian, Fisher, Sullivan, Acquisto, & LeBlanc, 1998. Individuals with developmental disabilities have a right to the most effective behavioral treatments available (Van Houten et al, 1988), however, so punishment procedures should be applied when clinically indicated.…”