A Meta-Analysis of Functional Communication Training for Young Children with ASD and Challenging Behavior in Natural Settings.
FCT gives big, quick behavior drops for young kids with autism, especially at school.
01Research in Context
What this study did
Blair et al. (2025) pooled 34 single-case experiments. All tested Functional Communication Training with young children who have autism.
Every study took place in a natural setting: home, preschool, or grade-K classroom. The team looked at two outcomes: how much problem behavior dropped and how much kids used new communication responses.
What they found
The meta-analysis showed large drops in challenging behavior across the 34 studies. Replacement communication rose by a moderate-to-large margin.
Effects were strongest when FCT happened at school. Home-based FCT still worked, just not as big.
How this fits with other research
Young (2020) ran a similar meta-analysis on nine Korean studies. That paper found communication gains but no clear drop in problem behavior. Blair’s larger, world-wide sample explains the clash: culture, setting, and more data flip the verdict.
Neely et al. (2018) warned that most FCT papers skip generalization and maintenance checks. Blair’s pool agrees; the positive averages do not erase Leslie’s point—plan follow-up probes even if initial gains look great.
Torelli et al. (2024) tried FCT without extinction in public school classrooms. Only one of two students lost problem behavior, showing that the strong school average Blair reports may hinge on using the full FCT package, not the toned-down version.
Why it matters
You can feel confident starting FCT with preschool or kindergarten clients who have ASD and hit, scream, or bolt. Run it at school if possible; the evidence pile is tallest there. Still, schedule monthly maintenance probes—Blair’s numbers are rosy, but Leslie’s review reminds us most studies stop collecting data too soon.
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02At a glance
03Original abstract
This meta-analysis synthesized 34 published single-case design studies on functional communication training (FCT) for young children with autism spectrum disorder (ASD). A systematic search of electronic databases and reference lists identified studies published between 1996 and 2021 involving 79 children with ASD aged 2 to 8. Quality evaluation using What Works Clearinghouse standards revealed that only 29.4% of studies met standards with or without reservations, primarily due to insufficient data points per phase. Most studies were conducted in home or school settings with therapists/researchers as primary implementers, followed by parents or caregivers. Low reporting rates were found for preference assessment, treatment fidelity, social validity, and maintenance and generalization effects. Overall, FCT demonstrated large effects for reducing challenging behavior (Tau-BC = 0.97) and moderate-to-large effects for increasing replacement behavior (Tau-BC = 0.78). Moderator analyses revealed significantly larger effect sizes in school versus home settings (p < 0.05). These findings further support FCT as an evidence-based practice for young children with ASD, although methodological rigor must be improved. Future research should systematically evaluate maintenance and generalization effects, develop effective parent training and support strategies, and report intervention dosage parameters to strengthen the evidence base and guide clinical implementation.
Behavioral Sciences, 2025 · doi:10.3390/bs15121688