Renewal during functional communication training
Plan for renewal—add a home probe and parent booster before you send FCT out of the clinic.
01Research in Context
What this study did
Saini and team taught four children with intellectual disability to ask for a break instead of hitting or throwing. The teaching happened in a clinic room with therapists.
After the kids used the new words in clinic, staff sent them home with parents. No extra coaching was given at home.
What they found
In clinic, destructive behavior dropped fast once the kids learned to ask for a break.
At home, three of the four children went right back to hitting and throwing. The problem returned even though they still knew the words.
How this fits with other research
Cameron et al. (1996) saw great results when two boys with autism used FCT in both places. They taught two separate mands and kept parent coaching short. Their success looks like a contradiction, but the key difference is extra home practice.
Winett et al. (1991) ran into the same clinic-to-home drop-off with social skills. They fixed it by adding a family meeting in the living room. Saini’s team did not add that step, so renewal is not surprising.
Sanberg et al. (2018) had parents wipe out sleep problems at home with no relapse. Their sleep plan included nightly parent feedback calls. Again, the missing home booster explains why FCT relapsed here.
Why it matters
Expect renewal every time you move FCT from clinic to home. Build in at least one home probe session before discharge and give parents a quick booster. A 15-minute role-play in the kitchen can save you from starting over later.
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02At a glance
03Original abstract
Functional communication training (FCT) is one of the most commonly prescribed interventions for the treatment of severe destructive behavior exhibited by individuals with intellectual disabilities. Although highly effective, FCT has been shown to fail in some cases when treatment is introduced into the child's typical environment. Basic and translational research on renewal provides a model for studying the relapse of destructive behavior following successful response to treatment in clinic settings using FCT. In the present study, we evaluated whether relapse of destructive behavior could be attributed to the discriminative control of the home context, which was historically correlated with reinforcement for destructive behavior. We implemented baseline contingencies in the home setting with caregivers acting as interventionists (i.e., Context A). We then implemented FCT in a treatment clinic with trained therapists (i.e., Context B). Finally, we introduced FCT in the home setting with caregivers implementing the treatment procedures (i.e., return to Context A). For three of four participants we observed the relapse of destructive behavior consistent with operant renewal. We discuss the implications of these findings with respect to strategies designed to promote generalization of FCT across settings during the treatment of severe destructive behavior.
Journal of Applied Behavior Analysis, 2018 · doi:10.1002/jaba.471