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Functional Communication Training for Toddlers At-Risk for Autism with Early Problem Behavior

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Abstract

Objective

Problem behavior typically emerges in early childhood as part of human development. Current approaches to intervention wait to see if child maturation will naturally lead to reduction of behavior. However, for children at-risk for autism, there is may be a need to provide intervention during this early phase to prevent escalation of problem behavior and promote functional communication. Functional communication training (FCT) is an evidence-based intervention that consists of identifying the function of problem behavior, and teaching a functional communication response (FCR) that serves the same function as the problem behavior. In this study, researchers evaluated the use of FCT to teach toddlers at risk for autism to appropriately request for caregiver attention instead of engaging in early problem behavior (EPB) when the caregiver withdrew their attention.

Methods

Four children participated in this study. Researchers used a non-concurrent multiple baseline design to evaluate the effects of FCT on participant FCR and EBP. Sessions occurred twice a week for up to 15 weeks.

Results

EPB decreased for all participants from 100% of trials in baseline to 0% of trials in intervention. The use of functional communication increased in all participants from 0% of trials in baseline to 100% of trials in intervention. Two of the four participants maintained their treatment gains during the reversal phase.

Conclusions

This study replicates previous FCT research by extending the evidence-based practice to very young children (under 3 years old) who meet criteria to be identified as at-risk for autism.

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Funding

Please note that this work was supported in whole or part by a grant from the Texas Higher Education Coordinating Board (THECB) Award #20477 and Award #22943 (PI Neely). The opinions and conclusions expressed in this document are those of the author(s) and do not necessarily represent the opinions or policy of the THECB.

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Authors and Affiliations

  1. Department of Educational Psychology, University of Texas at San Antonio, 501 West Cesar E. Chavez, TX, San Antonio, USA

    Leslie Neely, Katherine Cantrell & Sierra Stegemann

  2. Child and Adolescent Policy and Research Institute, University of Texas at San Antonio, San Antonio, TX, USA

    Leslie Neely & Katherine Cantrell

  3. Department of Educational Psychology, Victoria University of Wellington, Wellington, New Zealand

    Amarie Carnett

  4. Autism Treatment Center, San Antonio, TX, USA

    Sierra Stegemann

  5. Children’s Hospital of San Antonio and Baylor College of Medicine, San Antonio, TX, USA

    Melissa Svoboda

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  1. Leslie Neely
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Contributions

LN designed the study methodology, oversaw the implementation of the study, and led the writing of the manuscript. AC designed the study methodology, oversaw implementation of the study, and contributed to writing the discussion section of the manuscript. KC led data collection and analysis and contributed to writing the results of the manuscript. SS led data collection and analysis and contributed to writing the introduction of the manuscript. MS led the screening of participants and identification for inclusion in the study and made edits and revisions to the manuscript.

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Correspondence to Leslie Neely.

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Neely, L., Carnett, A., Cantrell, K. et al. Functional Communication Training for Toddlers At-Risk for Autism with Early Problem Behavior. Adv Neurodev Disord 6, 537–548 (2022). https://doi.org/10.1007/s41252-022-00306-1

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