My student Molly is nonvocal. Whenever I assign independent worksheets, Molly will often refuse to work by ripping up the assignment, throwing her pencil, or putting her head down. There are also times when the students are working and I have to take a phone call or am helping another student, and she screams. I am not sure why she does this, but I am concerned she is not completing assignments and disturbing her peers. She seems to show these behaviors only during academic times or when I am busy and cannot immediately respond to her. What is the best way to respond in these situations? My district recently hired a Board Certified Behavior Analyst who mentioned something about a procedure called Functional Communication Training.
Answered by
Lesley Shawler, PhD, BCBA and David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment
It can be difficult to know how best to respond when a student, such as Molly, becomes disruptive or engages in potentially harmful behavior. It is important to remember that her behavior serves a functional response, and, in all likelihood, is effective for her in achieving a desired outcome (escape from demands or access your attention). If these behaviors are successful in meeting her needs, they will continue to occur in similar situations until they are no longer successful. Fortunately, this also means that these behaviors are modifiable, and you can teach new, replacement behaviors, particularly those that are communicative in nature and serve the same function (i.e., purpose) as the challenging behavior.
Based on the details that you shared, we wanted to shine a spotlight on functional communication training (FCT). FCT is an evidenced-based intervention that teaches an appropriate replacement behavior that should replace the interfering behavior (Carr & Durand, 1985). FCT has been supported through decades of research to decrease problem behavior and increase functional behaviors (e.g., Tiger, Hanley, & Bruzek, 2008; Hagopian, Boelter, Jarmolowicz, 2011). An important component of FCT is the removal of reinforcement for the inappropriate behavior (i.e., extinction). Essentially, the child should learn that the old methods (i.e., the unwanted behavior) are ineffective, and that in order to achieve his/her desired outcome, he or she must engage in a new response (i.e., the communicative alternative). For example, if Molly has learned that refusing to work and/or destroying her materials will end or delay the difficult task, we need to teach her that this behavior does not lead to that outcome, and instead teach her a more acceptable way to achieve the very same goal (ending a task). This could be a response such as requesting a different task, or asking for a break. Similarly, if she screams to gain attention, a replacement behavior such as raising her hand, or tapping her desk, could be taught. The most important take-away is the new communication skill must serve the same function as the unwanted behavior.
Given that, it is very important to clarify what the underlying motivation is for the behaviors in question. The process should begin with a functional behavior assessment (FBA) in which the function of the problem behavior is assessed (a board certified behavior analyst can assist you with this effort). This can start with an open-ended interviews with those who are familiar with or have knowledge of the student in question. Some questions may include, “does the behavior typically occur when work is given and students are working independently? Is the typical reaction that the teacher reminds the student to get back on task?” Assessment could also be conducted through direct observations of the student in which teachers can determine what may commonly precede (antecedents) and follow problem behavior (consequences). These data are documented in an A-B-C (antecedent-behavior-consequence) format which involve recording events that preceded and followed the behavior. By observing repeated occurrences of the problem behavior, the purpose of Molly’s behavior may become clear (i.e., she wants attention from the teacher, she does not want to complete the work) This information can then be used to formulate hypotheses about why the behavior is occurring. These types of direct methods are the most important, and should be relied upon over indirect methods. In some cases, a behavior analyst may need to directly manipulate certain variables that are thought to maintain the problem behavior, in an experimental functional analysis (LaRue, 2009).
Taken together, the results from the FBA will provide information pertaining to the function of the behavior(s). The possible functions include: escape from non-preferred/aversive situations, demands, or people (social negative reinforcement), attention from others (positive or negative forms) or access to preferred items/activities (social positive reinforcement) and sensory stimulation often in the form of repetitive or stereotypic behaviors (automatic reinforcement). Once identified, the behavior analyst and teacher should work together to identify appropriate functional communication skills. In Molly’s case, one would likely hypothesize that throwing and ripping up material and putting her head down are maintained by escape or avoidance from demands and screaming may be maintained by attention from the teacher. As such, teaching an appropriate method to ask for a new task, a break, attention, or other similar concepts may be best.
Selecting a replacement behavior is of utmost importance and various factors should be considered. Not only should the response match the purported function, but the new response should initially be easy to teach, not too effortful for the student, highly likely to be noticed by others, and consistently and immediately reinforced. If the replacement behavior is too difficult, the student may rely on their previous history of behavior, which to this point has been effective. This explanation supports the necessity of choosing a relatively simple response. Replacement behaviors can also come in various forms, whether for vocal or non-vocal students. For students like Molly, as she is nonvocal, you would need to teach her a nonvocal response. You also want to consider her current skill set and select and target a response that is feasible for her. Bear in mind that teaching new skills, especially those replacing behaviors that have received considerable reinforcement previously, will require the teacher to deliberately focus on the student as the process may take time. If she has a communication system in place (e.g., PECS, iPad application), you could teach a response that is within that system so she could ask for a break or attention. If she does not have a system in place, a simple card touch response may be appropriate. This response will serve as her communication method, and each time she touches the card, she will be immediately given a break, and/or provided with attention. This type of response will not be disruptive to those around her, but does require the teacher to attend to her more intensively, in order to immediately reinforce the newly taught response.
Once the function is determined, and a replacement behavior is selected, it is time to teach! The best method to teach the response is through a set of steps that provides Molly with repeated practice in asking for what she wants and showing her that problem behavior is ineffective (i.e., behavior skills training; Sarokoff & Sturmey, 2004) or prompt fading. This could be done with a brief explanation, modeling the card exchange using most to least prompting, and then role-playing. Continue to practice this while gradually fading out prompts over time until she is exchanging the card with less and then no prompts. Continue practicing until Molly can reliably demonstrate the card exchange without prompting. Following teaching this response, multiple opportunities to practice in more natural settings should occur. Try to create opportunities that appear natural but allow you to observe her engaging in the response. For example, when a worksheet is provided, as soon as she touches the card, immediately offer her a break. If she is doing another activity, act like you are attending to another student, then following the card touch, provide immediate attention to her. Should she engage in other responses in order to gain a break or attention, these behaviors should not provide her with those respective outcomes. Continue to encourage her to complete her assignment, even providing additional copies if she needs them. Allow her extra time to finish assignments even if it means missing out on a preferred activity she may enjoy. Similarly, do not provide attention following disruptive behaviors. Once she learns that these behaviors are no longer effective, she will start to engage in those behaviors that have recently been reinforced. However, often times we warn that when using extinction (i.e., removing reinforcement for behavior), the behavior often gets worse before it gets better. If this occurs, do not panic. Consistency and patience are key, as are the strategies being used to teach the alternative. Over time, with repeated practice, she will learn how to obtain the desired outcomes and problem behaviors will begin to reduce.
Eventually, once Molly becomes more consistent with the card touch, the complexity and effort level can also be increased. Molly may have to hold the card up, or walk over to the teacher and hand them the card before reinforcement is provided. It is also important to plan for generalization and maintenance of this response by slowly and systematically increasing the delay to which the response is reinforced and to eventually teach the child that his/her request for a break will not always be reinforced. Try modifications such as using the card in different settings, with different adults, and different responses. It is also important to plan for generalization and maintenance of this response by slowly and systematically increasing the delay to which the response is reinforced and to eventually teach the child that his/her request for a break will not always be reinforced. However, consistency and independence of the card touch response initially should occur prior to any changes in expectations. Ideally generalization will occur, however, if not, try practicing again either in a novel setting, with a new person, or with other modifications to the original context. These changes may be more likely to promote generalization (Stokes & Baer, 1977). Remember to maintain a vigorous schedule of catching Molly using her skills to ensure that the hard work that has been done will continue to be rewarded. If carefully implemented, these types of modifications may promote enduring success in the natural environment.
It is always appropriate to make individual adjustments and changes as related to your specific situation.
Good luck!
References
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problem through functional communication
training. Journal of Applied Behavior Analysis, 18, 111-126.
Hagopian, L. P., Boelter, E. W., & Jarmolowicz, D. P. (2011). Reinforcement schedule thinning following functional communication training: Review and recommendations. Behavior Analysis in Practice, 4(1), 4-16.
LaRue, R. (2009). Clinical Corner: What is meant by functional analysis? When should this be done and who should do it? Science in Autism Treatment, 6(2), 16-17.
Sarokoff, R. A., & Sturmey, P. (2004). The effects of behavioral skills training on staff implementation of discrete-trial teaching. Journal of Applied Behavior Analysis, 37(4), 535-538.
Stokes, T. F. & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10(2), 349-367.
Tiger, J. H., Hanley, G. P., & Bruzek, J. (2008). Functional communication training: A review and practical guide. Behavior Analysis in Practice, 1(1), 16-23.
Citation for this article:
Shawler, L., & Celiberti, D. (2019). Clinical corner: What is functional communication training? Science in Autism Treatment, 16(12).
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