A review of Promoting Functional Communication within the Home

Bondy, A., Horton, C., & Frost, L. (2020). Promoting functional communication within the home. Behavior Analysis in Practice, 13(2), 321-328. https://doi.org/10.1007/s40617-020-00439-6

Reviewed by Kaitlyn Evoy, BA and David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment

Photographed by PNW Production (pexels.com)

As many of you will recall, the COVID-19 pandemic created an abrupt and enduring disruption to the educational programs of countless children with autism spectrum disorders (ASD). With little preparation, parents were placed in a primary instructional role. For any number of circumstances, such as outbreaks in their communities, parents were often required to assume or resume this role. We applaud Dr. Andy Bondy, Catherine Horton, MS, CCC-SLP, BCBA, and Lori Frost, MS, CCC-SLP for writing this comprehensive and useful article at a time when so many were struggling to create meaningful experiences for our learners and their families. To put the authors’ swift effort in perspective, their article was published online in May 2020 and was accessible in PDF form at no cost to the reader. The authors purposefully used language to promote understanding from all readers by removing unnecessary jargon, using an abundance of practical examples, and explaining complex concepts in accessible ways.

Bondy and colleagues highlight nine critical communication skills as a response to the COVID-19 crisis and the subsequent increased time children spent at home. The critical communication skills encompass both speaker and listener roles and were emphasized because of their relevance and necessity for everyday functioning. Helping children use these communication skills reliably and competently may lessen frustration and reduce or eliminate the need to engage in other ways to get those needs met (e.g., challenging behaviors).

The authors describe and elaborate upon each of the nine skill areas. The summaries include the rationale for prioritizing that skill, useful teaching strategies, commonly faced problems, and possible solutions. The article reviews the process for assessing current performance levels for the nine skill areas and offers tips to caregivers through this effort. For assessment of present levels, a checklist is provided with specific examples of phrases and/or subcategories. For example, the authors separated “request reinforcers” into edibles, toys, and activities. The skill of responding to directions is broken down into two distinct areas -visual and verbal directions. Authors elaborate on these two areas and provide examples for each (e.g., “come here,” “stop,” and “sit down” for verbal directions). Some of the tips include prioritizing teaching functional communication in the activities and routines where it is most needed, and using these nine core areas as a basis for overall instruction. In short, the authors emphasize targeting most immediate needs as a strategy to improve overall communication skills.

Nine Critical Communication Skills:

1. Request Reinforcers:

We wholeheartedly agree with the authors that the skill of requesting reinforcers is of paramount importance. The authors suggest that parents should start by discerning what is preferential for a child before working on requesting reinforcers. They also recommend re-creating situations as needed for additional learning opportunities, setting realistic goals, raising expectations carefully, and using different levels of motivating reinforcers in an intentional and strategic manner.

1. Request Help/Assistance:

The authors aptly note that this skill is one that all children and adults will need in their lives. They recommend increasing levels of task difficulty over time to promote mastery. First, they suggest starting with tasks that are easier to solve. When the child can ask for help in less challenging situations, parents are encouraged to increase the level of difficulty. The authors note that it is important to gauge frustration levels and be willing to decrease the demand when warranted. Similar to the Request Reinforcer skill area, the authors remind readers to proactively re-create situations to promote additional learning opportunities rather than address them amidst challenging behavior.

1. Requesting a Break:

Asking for a break when overwhelmed or tired is another critically important skill for all of us, and we appreciate the authors’ inclusion of this skill. When working on newer, challenging skills with a child, it is essential that they can ask for a break when needed. Acquiring this skill can decrease physically aggressive behavior, self-injurious behavior, and other problematic behaviors. The authors recommend that parents should work on this skill before frustrations reach crisis levels. Once you have an understanding (baseline) of tasks/work time your children can consistently do without needing a break, you can slowly increase the number of tasks and/or work time. Perhaps one of the most important points that the authors raise with respect to break requests is that parents should not rely on their hunches and provide a break in the absence of a direct request, but rather give children the tools to request a break themselves on their own terms. In addition to the suggestions offered by the authors, we would recommend considering a more elaborate response once a similar request has been established (“I need a break. I am tired.” or “Can we stop? My stomach hurts.”). Of course, this depends on the vocal-verbal ability of the child. For other children, a more elaborate response may be to state “Want break” rather than just “break.” The important takeaway is to provide abundant modeling and prompting and to refrain from upping the ante in too greedy a manner as this may increase frustration in the child.

1. Reject:

We agree that learning to reject appropriately is an essential skill and can be critical in decreasing maladaptive behaviors. Being able to reject, refuse, or withdraw assent or consent is another important skill that will be needed throughout one’s life. If children are not able to reject situations, activities, or items using functional communication, this can lead to frustration and they may engage in challenging behaviors to get their needs met. The most important thing to remember when teaching this skill is to always honor their rejection so that they learn they functional communication actually “works” (i.e., the new way of communicating gets their needs met). Furthermore, new skills such as this require abundant and consistent reinforcement. As with the teaching of other communication skills, caregivers can increase the difficulty by including situations, activities, or items that are more likely to be disliked or have a greater level of aversion.

1. Affirm/Accept:

As with rejection, affirmation is a communication skill needed for everyday life. The authors were right – answering “yes” is also an important communication skill. This point is especially true when situations arise that a caregiver can’t prepare for ahead of time. When teaching children to differentiate between “no” and “yes,” try teaching them separately before giving them both as options.

1. Responding to “Wait” or “No”:

Although this was particularly relevant during the pandemic given that many preferred activities were less available during times of social distancing, there are numerous situations where plans may be impacted (e.g., the weather is bad and the child cannot go outside or some other barrier to a preferred task or activity). We commend the authors for including this challenging yet inevitable skill in their article and for making the important distinction between learning to accept delayed versus denied gratification. Learning to wait is a challenging skill, particularly when the duration of time needed to wait is not clear. Although difficult, waiting and accepting an unwanted answer are important skills in situations that children will often encounter. This skill can be difficult for caregivers to increase complexity. The authors recommend predicting negative responses, coping with them, and being willing to reset the challenge. The authors also highlight three essential elements to consider – go read the article to learn more!

1. Following Directions:

In addition to the obvious benefits of being able to follow directions, there are also possible risks when children cannot follow directions, especially in safety situations. To promote skill acquisition, the authors recommend starting with tasks that are more desirable for the child (e.g., accessing a favored item) before tasks that only lead to social outcomes (e.g., labeling an item that may only culminate in praise but not access).

1. Following a Schedule:

Although the above skills involve the expression of communication, following a schedule is necessary and can be an essential tool for creating a predictable environment, as well as for learning to tolerate change. Visuals help children anticipate expectations and learn independence. The authors also discuss how schedules can vary in terms of the number of tasks/activities as well as descriptive factors. For example, scheduled items can be represented by physical objects, pictures, or words. Once children can follow a schedule, parents can introduce planned changes (the authors refer to this as a “surprise”) to increase tolerance of unexpected changes that may naturally occur.

1. Transitions:

We appreciate the decision to discuss transitions an essential functional communication skill. Transitioning between activities and coping with unexpected transitions can be particularly challenging for children with autism. Parents can prepare children for transitions, but not all changes can be predicted. Like many of the skills noted above, frequent practice is needed. The authors suggest that parents showcase upcoming reinforcers to promote successful transitions across activities. This recommendation may be a helpful strategy for many families particularly when the next activity is not inherently rewarding.

Final Thoughts

Parents and other caregivers need support, guidance, and accessible information in providing instruction to their children in the home environment. The COVID-19 crisis disrupted children’s lives, including therapies targeting functional communication. This comprehensive, useful, and easily accessible article breaks down the main areas of functional communication and provides actionable steps for caregivers to address each area. The insights and suggestions provided continue to bear tremendous relevance. Although beyond the scope of this brief article, we would also like to draw attention to a few other skills, such as initiating and responding to greetings, and expressing feelings, discomfort, fatigue, and sickness.

This very accessible article is valuable as a resource to other stakeholders besides the target audience of parents and caregivers. Teachers, therapists, and other educational staff can use these critical functional communication skills to assess current overall functioning and target areas for improvement.

Citation for this article:

Evoy, K., & Celiberti, D. (2022). Review of Promoting functional communication within the home. Science in Autism Treatment, 19(1).

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