Component analysis of functional communication training across three topographies of severe behavior problems

A component analysis of functional communication training across three topographies of severe behavior problems.
Authors: David P. Wacker, Mark W. Steege, John Northup, Gary Sasso, Wendy Berg, Thomas Reimers, Linda Cooper, Kama Cigrand, and Lisa Donn from the University of Iowa.

The study evaluates separate treatment components of functional communication training (FCT) for three severely handicapped individuals with different types of aberrant behavior: self-injury, stereotypy, and aggression.
Prior to training, a functional analysis was conducted to ascertain maintaining conditions for inappropriate behaviors.
- Example: For self-injury maintained by negative reinforcement, extinction (withholding reinforcement) for the target behavior might be one starting strategy.
Prior studies (e.g., Iwata et al. 1990; Carr, 1988) emphasized the importance of having a functional match between the intervention and target behavior.

FCT is noted for rapidly reducing problem behavior, as shown in studies by Carr and Durand (1985) which highlighted different functions of disruptive behavior (e.g., aggression, destruction).
Key points on the effectiveness of FCT:
- Active participant engagement versus passive reinforcement receiving.
- Control over delivery of reinforcement might be as important as reinforcement schedules.
- The efficiency of the alternative response (both consistency of reinforcement and delay in its delivery) may impact treatment success.

The primary aim is to systematically evaluate FCT through component analyses focusing on:
1. The necessity of intervention components for inappropriate behavior after initial training.
2. The communication response's control over the reinforcement schedule.
3. Efficiency of response across different conditions.
The study assesses FCT with a varied behavioral base (self-injury, stereotypy, aggression) to observe the findings' generality.

Participants:
- Bobby: 7-year-old nonverbal boy with autism, diagnosed with severe to profound mental retardation.
- Barb: 30-year-old woman with untreated phenylketonuria; also nonverbal and functioning low cognitively.
- Jim: 9-year-old boy engaging in aggressive behaviors, also diagnosed with severe to profound mental retardation.
All subjects are inpatients residing in a unit for children and adults with developmental disabilities, participating in behavioral evaluations.

Target behaviors were specifically operationalized for each participant:
- Bobby: Hand biting defined as placing teeth on fingers and closing jaws.
- Barb: Body rocking, defined as repetitive rocking with a 45-degree bend at the waist.
- Jim: Aggression defined as any contact between his hand/teeth and another person's body.
Alternative communicative responses included minimal motor responses that approximated communication (e.g., Bobby brushing his chin, Barb pressing a microswitch, Jim using signs).

FCT relied on materials corresponding to each participant's preferences established through prior functional analyses (e.g., a yellow bowl for Bobby).
Tools included microswitches for Barb to activate a recorded message stating, “I'm tired of rocking; somebody give me something to do.”

Behavior recorded through a 6-second partial interval recording system with interrater reliability computed using agreement methods.
Specific reliability rates were calculated for each participant across different stages using precise methodologies to ensure thorough tracking of behaviors and treatments.

Conducted in two phases:
- Phase 1: Functional analysis to identify maintaining conditions for behaviors, utilizing designs appropriate to each participant's conditions (Bobby and Jim used alternating treatments; Barb underwent a reversal design).
- Phase 2: Component analysis within a different reversal design, incorporating treatment packages, removal of contingencies, and return to treatment packages with both FCT and extinction procedures involved.

Functional analysis conditions included escape, tangible, alone, and social attention, to evaluate the maintaining functions of target behaviors individually.
Treatment sessions included direct communication training, reinforcement schedules, and behavioral prompts adjusted through varying conditions.

Assessment results indicated that hand biting was primarily maintained by positive reinforcement, leading to planned treatment collaborations achieving reduced behaviors.
FCT resulted in sustained increases in appropriate communicative behaviors with significant decreases in inappropriate behaviors.

Similarly, body rocking behavior was effectively reduced with substantial increases in alternative behaviors post-treatment yet decreased during the DRO conditions, mirroring Bobby’s trends.

The results paralleled those of Bobby and Barb, as aggressive behaviors were effectively reduced while signs for communication notably increased under treatment conditions.

The study validated the significance of combining functional analysis with FCT to effectively treat aberrant behaviors across different participants with varying needs.
Controlled reinforcement schedules highlighted the necessity of both manipulation of communication and behavioral consequences.
Concluded that effective training must involve both immediate reinforcement of appropriate behaviors and structured contingencies for inappropriate behaviors.
The unique distinction of FCT as a self-control procedure further emphasizes the participant's active role in their treatment process.

Both experimental and naturalistic settings yielded consistent results, reaffirming the positive impact that properly structured FCT paired with functional analysis can exert on diverse aberrant behaviors in severely handicapped individuals.

Carr, E. (1988). Functional equivalence as a mechanism of response generalization. In R. Homer, R. Koegel, & G. Dunlap, Generalization and maintenance: Life-style changes in applied settings (pp. 221-241). Paul H. Brookes.
Carr, E., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111-126.
Iwata, B., Dorsey, M., Slifer, K., Bauman, K., & Richman, G. (1982). Toward a functional analysis of self-injury. Analysis and Intervention in Developmental Disabilities, 3, 1-20.

(Compliance with acknowledgment noted for funding sources and editorial contributions provided throughout the text.)