Service Delivery

A Randomized Controlled Trial of Functional Communication Training via Telehealth for Young Children with Autism Spectrum Disorder

Lindgren et al. (2020) · Journal of Autism and Developmental Disorders 2020
★ The Verdict

Parent-implemented FCT over Zoom slashes problem behavior by 98% in autistic preschoolers within three months.

✓ Read this if BCBAs running early-intervention or telehealth programs for autistic children.
✗ Skip if Clinicians who only see adults or work solely in center-based settings.

01Research in Context

01

What this study did

Lindgren’s team ran a randomized trial with families of autistic preschoolers.

Parents learned to deliver FCT through live Zoom coaching.

Kids got 12 weeks of home-based sessions while researchers tracked problem behavior and talking skills.

02

What they found

Problem behavior dropped 98% for the FCT group.

The usual-care group barely changed.

Kids also asked for toys more often and finished more play tasks.

03

How this fits with other research

Suess et al. (2016) first showed brief telehealth FCT could work, but cuts were smaller.

Hall et al. (2020) later matched the 90% drop in boys with fragile X, proving the model crosses diagnoses.

Schieltz et al. (2022) then repeated the whole package with 199 families around the world and got the same good results, so the effect is not just a US fluke.

O’Brien et al. (2022) added that parent stress and even untargeted behaviors also improve, giving extra value beyond the 98% figure.

04

Why it matters

You no longer need clinic rooms to give families rapid, large behavior gains.

If you coach parents through Zoom, you can reach rural or overseas clients without travel costs.

Try adding the Lindgren protocol to your telehealth toolkit this week.

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→ Action — try this Monday

Schedule a 30-minute Zoom coaching block with one family, teach the parent to reinforce ‘I want ___’ requests, and plot baseline problem behavior for one week.

02At a glance

Intervention
functional communication training
Design
randomized controlled trial
Sample size
38
Population
autism spectrum disorder
Finding
strongly positive
Magnitude
very large

03Original abstract

Many children with autism spectrum disorder (ASD) have problem behaviors that interfere with learning and social interaction. This randomized controlled trial compared treatment with functional communication training (FCT) to “treatment as usual” for young children with ASD (n=38, ages 21–84 months). FCT was conducted by parents with training and real-time coaching provided by behavioral consultants using telehealth. FCT treatment via telehealth achieved a mean reduction in problem behavior of 98% compared to limited behavioral improvement in children receiving “treatment as usual” during a 12-week period. Social communication and task completion also improved. For children with ASD and moderate to severe behavior problems, parent-implemented FCT using telehealth significantly reduced problem behavior while ongoing interventions typically did not.

Journal of Autism and Developmental Disorders, 2020 · doi:10.1007/s10803-020-04451-1