Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review.
Most FCT studies look good on day one but give little proof the skill lasts—so probe after the fade.
01Research in Context
What this study did
Neely et al. (2018) read every FCT paper they could find. They kept 37 studies that worked with people with autism, Down syndrome, or other delays. They then scored each paper for how well it checked whether the new communication skills lasted or spread to new places, people, or times. Only six papers passed every quality check.
What they found
Most FCT studies stop measuring once the child learns the new request. Few teams return weeks later to see if the skill still works. Fewer still test if the child uses the skill with a new teacher or in a new room. The review warns that we do not really know if FCT sticks.
How this fits with other research
Martin et al. (1997) tracked four kids for up to 27 months after home-based FCT. All kept their gains. That single success story is inside the 2018 review, but it is an exception.
Blair et al. (2025) pooled 34 newer single-case studies. They found big drops in problem behavior and large gains in communication. Their upbeat numbers seem to clash with the 2018 warning. The gap is method: Blair counted immediate effects, while Leslie asked, 'What happens later?'
Tsami et al. (2020) give a middle view. Only one of five children held steady when FCT moved from mixed to single conditions. The other four needed extra teaching. This fits the 2018 call for more follow-up probes.
Why it matters
Before you call an FCT program a win, schedule at least two post-checks. Probe the mand with a new staff member and in a new room. If the skill drops, run a quick booster. One extra week of data can save months of retraining later.
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02At a glance
03Original abstract
BACKGROUND: Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT. METHOD: A systematic review identified 37 studies that met the pre-set inclusion criteria. Those studies were summarized in terms of: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) maintenance and generalization teaching strategy, and (e) latency to maintenance probes. All studies employed single-case research designs and were evaluated using the What Works Clearinghouse pilot single-case research standards (Kratochwill et al., 2013) as adapted by Maggin, Briesch, and Chafouleas (2013). Maintenance and generalization data were evaluated using a researcher-developed rubric based on the WWC standards. RESULTS AND DISCUSSION: Results indicate that 30 studies met standards or met standards with reservations while only six studies also met all of the maintenance and generalization standards. Of the six studies, five did not implement any additional strategies beyond the contacting natural contingencies that is inherent in the FCT intervention. Implications for future research and practice are discussed.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.02.002