Functional communication training with and without extinction and punishment.

Nangle et al. (1993) compared three ways to run functional communication training. They worked with people with intellectual disability who lived in a hospital unit.

One group got FCT only. Another got FCT plus extinction. The third got FCT plus punishment. The team watched which package cut destructive behavior the most.

FCT plus punishment gave the biggest and most steady drops in destructive behavior. FCT alone helped some people, but not everyone.

Results were mixed. Some clients did fine with just FCT. Others needed the extra layer of punishment to see real change.

Connell et al. (2004) ran a similar test with a child who had TBI. They also saw that FCT plus extinction worked better than FCT alone. This backs up the 1993 finding that plain FCT is often not enough.

Cruz-Montecinos et al. (2024) looked at 19 school studies and found almost none gave enough detail for teachers to copy. So while W et al. showed punishment can boost FCT, the 2024 review warns that most write-ups still lack the steps staff need to copy the work.

Prigge et al. (2013) moved the whole process into preschool classrooms. They used FAs and brief time-out instead of punishment and still cut problem behavior. This extends the 1993 idea: once you know the function, you can pick the right add-on, even without punishment.

If you run FCT and the target behavior barely budges, do not abandon the plan. Add extinction first. If that is not enough, consider mild punishment like brief response cost or token fine. Track daily. One client may need only FCT. The next may need the full package. Always write the exact steps so aides can copy you.