FCT for Aggression

Study Notes on Providing Alternative Reinforcers to Facilitate Tolerance to Delayed Reinforcement Following Functional Communication Training

Authors and Affiliation

  • Jillian E. Austin and Jeffrey H. Tiger

  • University of Wisconsin–Milwaukee

Abstract and Background

  • Functional Communication Training (FCT): Early stages involve providing immediate, continuous reinforcement for a communicative response (FCR) that is functionally equivalent to a targeted problem behavior.

    • This method is effective initially but impractical for long-term consistency, leading to issues when delays between the FCR and reinforcement are introduced.

    • Enhanced problem behavior reemergence occurs when delays are implemented without supports, as indicated in studies (e.g., Fischer et al., 2000; Hagopian et al., 1998).

  • Delay Fading: A strategy to teach tolerance for delayed reinforcement after FCT by gradually introducing delays following the FCR.

    • Prior studies showed mixed results, with some indicating that delays can lead to increased problem behavior.

    • Research (Hagopian et al., 2005) suggested providing alternative reinforcers during delays might improve outcomes by competing with the problem behavior for attention.

Purpose of the Current Study

  • Objective: To evaluate the effectiveness of providing alternative reinforcers during delays across a sample of a 13-year-old boy with an intellectual disability to facilitate tolerance for delayed reinforcement.

  • Keywords: alternative reinforcers, delay fading, delay tolerance, functional communication training.

Method

Participant and Setting

  • Participant: Cameron, a 13-year-old boy diagnosed with an intellectual disability due to agenesis of the corpus callosum and conduct disorder.

  • Communication Level: Near-age appropriate; capable of asking and answering questions in complete sentences.

  • Location: Sessions were conducted in Cameron’s bedroom at his family home.

Measurement and Interobserver Agreement

  • Aggression Measurement: Included behaviors such as hitting, kicking, scratching, throwing objects, pinching, hair pulling, and grabbing, alongside recording two vocal FCRs (“excuse me” and “May I please play Xbox?”).

  • Data Collection Method: Employed a laptop for real-time scoring.

    • Interobserver agreement was assessed during 45% of sessions, achieving a mean agreement score of 96% (range: 73% to 100%) for aggression, and also 96% (range: 85% to 100%) for FCRs.

Procedures

  1. Functional Analysis: Conducted to determine the sources of positive reinforcement sustaining Cameron's aggression based on variables such as toy-play, attention, tangible items, escape, and ignore conditions (Iwata et al., 1982/1994).

    • Identified maintaining sources of reinforcement for aggression as attention and tangible items.

  2. Treatment Design: Used a combination of reversal and concurrent multiple baseline designs to evaluate treatment effects across different contexts.

  3. Baseline Condition: During baseline, the therapist withheld reinforcement except after instances of aggression, providing access to attention or Xbox as reinforcement for aggressive behavior.

  4. Noncontingent Reinforcement (NCR): In this phase, Cameron received continuous access to the identified reinforcer (attention or Xbox), demonstrating clear competition with aggressive outbursts.

  5. Functional Communication Training (FCT): Targeted vocal FCRs were used to obtain reinforcers in two contexts:

    • For attention sessions: "When you want my attention, say, 'excuse me'."

    • For tangible sessions: "When you want to play Xbox, say 'May I please play the Xbox?'."

    • Any unrequested FCRs was disregarded.

  6. Terminal-Delay Probe: Before implementing measures for delay fading, Cameron's tolerance for delayed reinforcement was assessed in conditions mirroring FCT but included a 5-min delay post-FCR, without any consequences during the delay.

  7. Delay Fading: Gradually introduced shorter delays:

    • Started at 30 seconds and increased by 10 seconds after two sessions with low aggression rates (below 0.5 responses per minute).

    • If aggression exceeded 1 response per minute for four consecutive sessions, the delay decreased by 20 seconds.

  8. Delay Fading with Alternative Reinforcers: In this variant, the FCR initiated a protocol where Cameron would receive access to Xbox during the delay period. This condition followed the same criteria for adjusting delay timelines as earlier.

  9. Final Terminal Delay with Alternative Reinforcers: Involved replicating the terminal delay probe with alternative reinforcers available.

Results and Discussion

  • Results indicated variations in aggression and FCRs across different conditions:

    • Elevated aggression levels during baseline in both attention and tangible contexts.

    • NCR effectively eliminated aggression, confirming the hypothesized function of identified reinforcers.

    • During FCT, a consistent reduction in aggression was observed alongside increased FCRs.

  • The introduction of delay fading initially maintained low aggression levels, but problems were noted when delays exceeded 120 seconds without additional reinforcers.

  • However, the presence of alternative reinforcers improved outcomes:

    • Cameron met the 5-min delay criterion with stable FCRs and minimal aggression (nearly zero occurrences across about 30 sessions).

  • Generalization: Assessments revealed no transfer of delay tolerance across different contexts without alternative reinforcers.

  • Contrastingly, the introduction of alternative stimuli during delays not only maintained engagement in FCRs but also permitted delayed reinforcement without the previous escalation of problem behaviors.

Implications and Future Research

  • Further research should explore ways to implement alternative reinforcers effectively in scenarios predetermined for fading conditions.

  • Teaching caregivers to manage and deliver alternative reinforcers is pivotal, ensuring treatment fidelity and improved client independence.

  • Consideration should be given to the client’s capacity to request alternative reinforcers during delays, potentially enhancing self-management skills and reducing reliance on caregivers.

References

  • Fisher, W. W., et al. (1998). Establishing discriminative control of responding using functional and alternative reinforcers during functional communication training.

  • Fisher, W. W., et al. (2000). Facilitating tolerance of delayed reinforcement during functional communication training.

  • Hagopian, L. P., et al. (2005). Schedule thinning following communication training.

  • Iwata, B. A., et al. (1994). Toward a functional analysis of self-injury.

  • Piazza, C. C., et al. (1996). Using a choice assessment to predict reinforcer effectiveness.

  • Tiger, J. H., et al. (2008). Functional communication training: A review and practical guide.

Study Notes on Providing Alternative Reinforcers to Facilitate Tolerance to Delayed Reinforcement Following Functional Communication Training

Jillian E. Austin and Jeffrey H. Tiger from the University of Wisconsin–Milwaukee authored this study focusing on Functional Communication Training (FCT). In the early stages of FCT, immediate and continuous reinforcement is provided for a communicative response (FCR) that substitutes for a targeted problem behavior. While this method is initially effective, it becomes impractical for long-term use, leading to challenges when delays between the FCR and reinforcement are introduced. Enhanced problem behavior may reemerge when delays are implemented without appropriate supports, as evidenced by studies (e.g., Fischer et al., 2000; Hagopian et al., 1998).

Delay Fading, a strategy aimed at fostering tolerance to delayed reinforcement after FCT, involves gradually introducing delays following the FCR. Previous studies have yielded mixed results; some indicated an increase in problem behavior due to delays. Research by Hagopian et al. (2005) proposed that giving alternative reinforcers during these delays could enhance outcomes by competing with problem behavior for attention.

The objective of the current study is to evaluate the effectiveness of providing alternative reinforcers during delays for a 13-year-old boy named Cameron, who has an intellectual disability, enabling better tolerance for delayed reinforcement. Key terms relevant to this study include alternative reinforcers, delay fading, delay tolerance, and functional communication training.

The study's participant, Cameron, has an intellectual disability due to agenesis of the corpus callosum and conducts disorder. His communication skills are near-age appropriate, able to ask and answer questions in full sentences. The sessions occurred in Cameron’s bedroom at his family home. Aggressive behaviors, such as hitting and kicking, alongside vocal FCRs (“excuse me” and “May I please play Xbox?”), were measured throughout the study using a laptop for real-time data scoring. Interobserver agreement, assessed during 45% of sessions, demonstrated a mean agreement score of 96% for both aggression and FCRs.

The methodology involved a functional analysis to identify positive reinforcement sources for Cameron’s aggression across different conditions, determining attention and tangible items as key sources. A combination of reversal and concurrent multiple baseline designs was employed for treatment evaluation. The baseline condition involved withholding reinforcers except after instances of aggression, providing reinforcement for aggressive behavior. In the Noncontingent Reinforcement (NCR) phase, Cameron had continuous access to the reinforcer (attention or Xbox), demonstrating its competition against aggressive outbursts. FCT utilized specific vocal FCRs for obtaining reinforcers in two contexts, with unrequested FCRs being disregarded.

Cameron’s tolerance for delayed reinforcement was assessed under conditions resembling FCT but incorporated a 5-minute delay following the FCR, without consequences during this delay. Delay fading commenced with 30-second delays, systematically increasing by 10 seconds after two sessions of low aggression rates (below 0.5 responses per minute), while aggression levels exceeding 1 response per minute for four consecutive sessions necessitated reducing the delay by 20 seconds. In a variation of delay fading, Cameron received access to Xbox during the delays, adhering to the prior conditions for adjusting delay timelines. The final terminal delay replicate tested the conditions with alternative reinforcers accessible.

Results indicated fluctuations in aggression and FCRs across conditions, with heightened aggression during baseline scenarios in both attention and tangible contexts. NCR effectively mitigated aggression, verifying the hypothesized functions. During FCT, a consistent aggression reduction was accompanied by increased FCRs. Delay fading initially maintained low aggression levels, but issues arose when delays surpassed 120 seconds without alternative reinforcers. However, alternative reinforcers enhanced outcomes—Cameron met the 5-minute delay criterion with stable FCRs and minimal aggression throughout approximately 30 sessions. Generalization assessments indicated no transfer of delay tolerance across contexts without alternative reinforcers. Conversely, introducing alternative stimuli during delays facilitated continued FCR engagement while allowing for delayed reinforcement without escalating problem behaviors.

The study suggests further research into effectively implementing alternative reinforcers under fading conditions, emphasizing the role of caregivers in managing and delivering these reinforcers. It highlights the importance of teaching clients to request alternative reinforcers during delays, potentially enhancing self-management skills while decreasing dependence on caregivers.