The Importance of Teaching Functional Communication

A Teaching Aside

This post is a culmination of this year’s experiences working in classrooms with escalated students. Regardless the school team’s preconceptions of the behavior, I have had the same solution. EVERY. SINGLE. TIME. And it works!

Teach the student how to ask for [whatever they need].

Really, Teach them to Ask?

Yes. I teach them to ask. In some cases it is to ask for help. For others it is asking for space. For some it is asking to use the restroom. Asking for assurance. Asking for ear plugs. Asking for a fidget. Asking for time to stim. Asking for a break. Asking for escape. Asking for freedom by saying, “No Thank You”. Asking. Ask.

The more difficult task has been teaching teachers to respond appropriately. The only way this works is if the adults around the student respect the communication and reinforce to the student that their words are important.

The Plan

Two separate autistic students at two schools will be my examples, and I will call them Chip and Dale. They are both perpetually in trouble for extreme behavior. In this case it ranged from tantrums to eloping to chucking things at people (kind of like Chip and Dale messing with Donald Duck as seen in the cartoon below – one of my personal favorites).

In all cases, extreme behaviors happened after the student was given a task demand, no matter how small. Even as small a demand as opening a book or not talking over the teacher. A side comment, you can learn so much from the video…if the teacher escalates and gets made, the students will just continue to escalate and in the end the students always win! Always. Whole behavior management can be summed up watching Chip and Dale. Back to the real discussion…

I saw this as an opportunity to teach the school teams a functional communication training protocol (I talked a bit about this in my IISCA post here). This is a procedure associated with ABA, but I do not approach it the same way most ABA practitioners do – I just cannot escape the procedure’s name and recent history.

In short, I teach the student to ask, rather than use behavior, to get their needs met. I do this by reinforcing communication to show the student their communication is valued by adults around them.

I have a protocol that I have written up that I apply with varying degrees of modification to virtually all students I encounter as a first pass intervention. I know it is never a great idea to use a canned procedure, but in this case teachers tend to forget to teach and reward effective communication, so I err on the side of empowering students before I move on to more restrictive interventions.

Note: In all cases there was NEVER any punishing stimulus applied or pleasant stimulus removed for refusing to request a break, only a 30 second period prior to me repeating prompting the student to take a break. I chose 30 seconds simply because it is a practical amount of time between attempts, there is no scientific basis, just a practical one. This is where I deviate from traditional ABA-flavored protocols as they add in punishment contingencies to ensure high levels of expected responses. Go watch the Chip and Dale movie to reinforce why punishments will only backfire…

My simplified  general protocol is simplified below (it is changed to cater to the needs to each individual student based on an observational functional assessment):

  1. The student is started with what I call an ad libitum access to breaks upon request. This means they can have wall to wall access to breaks if they want them. They only need ask. And at this phase I provide as many prompts to the student to take breaks as possible.
  2. Once the student masters asking for breaks whenever they want, we move them to a more contingent break (e.g., Student does some kind of work or compliance with teacher requests for X minutes and then they can ask for a break).
  3. …and so on until the student is able to function in a typical classroom setting with minimal to no behaviors.

Yes, this seems simple. That is because it is. Painfully so. That is why it works. I don’t over complicate things. I make the kid feel valued and listened to, then I let them solve their own problem. I invariably start with 100% reinforcement for communication and slowly reduce the reinforcement level until the student is able to tolerate delay (e.g., work for 2 minutes before you ask for a break) and perhaps not having 100% of the breaks they request (though I never go below giving them 70% of the breaks they ask for. Not because it is ineffective, but because I would rather err on the side of having the student trust me and know most of the time they will get what they ask for).

In Practice

So, what does this look like. Both Chip and Dale received identical plans, so I will cover them together. Both of them were using extreme behaviors to get out of work that they were easily able to complete. They were just sick of schoolwork. They were chucking pointy things at teachers, running out of classrooms, screaming, swearing, and generally using violence and destruction.

I pulled them aside (note, these students were at 2 schools 17 miles and we chatted 3 months apart, so these were definitely separate conversations) and had a conversation about what they wanted to accomplish by acting out (I always tell them that the extreme behaviors they are using is “acting like a punk”, I find colloquialisms and subtle silliness help in times of stress). Chip and Dale both told me that they were, “done with work” or that the teachers were “unfair”, “mean”, or “don’t listen” to them.

I said, “okay, thanks for telling me”. I never have a discussion or ask follow ups at this point, I just want to get them talking.  I validate their feelings and emotions, but then I explicitly outline the deal. I  give them a data sheet that is designed to collect the data required to assess the fidelity of the behavior plan and tell them how to fill it out for themselves. I level with them so they know exactly what the plan is. I figure kids hate not knowing what is going on, so I inform them.

In both cases, I told each of the students that all they had to do was either ask for a break verbally, in writing, or else touch a break card and they would immediately get a 5-minute break. I explain to them that the 5 minute break is simply just a break from doing work and that they cannot go disrupt the rest of the students. I let them know they can take a break as often as they like.

Student 1

Chip was able to realize I was serious, and learned the contingencies to get access to breaks in under 2 days. The first day he did not believe me and tried to test the waters, a lot. Regardless his behavior, I gave him a break every time he asked for it, but kept school work demands on when he tried to use behavior instead to escape. In other words, rather than backing off and reducing my demands I would hold my ground and keep pressure on if they tried to misbehavior instead of asking for a break. Even if Chip was misbehaving at the time that he asked for a break, I gave it to him and told him I was giving him a break because he asked, not because he was being a punk. At the end of the day we talked about the day; focusing on what he learned and what I learned from the day.

On Day 2 he just asked for breaks any time I got near him. And I granted them. ALL. OF. THEM. Every single one. The school team was not happy because I was giving him what he wanted (“But you are just giving into him”, “He is manipulating you”, and so on…). I told them to have faith in the plan. What they were missing was the most important data: HE LEARNED. HE WAS COMPLIANT. HE WAS ASKING FOR BREAKS. No one got hurt. No pencils or number cubes were flying around the classroom. Chip was socially engaging with adults and peers. No fighting. No yelling. No swearing. No tantrums.

After a week I started to slowly (I cannot over emphasize the slowly) added work expectations (i.e., student must work for 2 minutes) before the student could ask for a break. Here’s the important part, I gave the student a timer, so they knew exactly how long they had to work . It again took 2 days to truly believe me, but Chip went with it. We had 2 days of gently butting heads, but the skirmishes were at most minor. Another week down and virtually no behavior problems outside the first 15-ish minutes of each day.

The next week it was a random 5 to 15 minute work period before a break. I also started to drop the break from 5 minutes to 2 minutes. The student adopted this immediately – after making a deal that I leave the timer in plain sight so Chip knew I wasn’t cheating. I set it and left it on the other side of the room and never approached it. Chip got it. I backed off and left the plan to the team and headed out.


Now, I have not mentioned how Chip was doing academically. That was intentional because this is the part I love most about functional communication training. Increased work completion is entirely a beneficial side effect of functional communication.

The first week he went from literally ZERO ( 0 ) work completion before I got there to 25% work completion when breaks were available. The team was still expressing frustration with me for gleefully granting him 75% escape, but in my not-so-humble-opinion, increasing from 0 to 25% work completion is a staggeringly large improvement. During week 2 it went up to 55-60% completion. During the final week I was there, Chip was at 85% work completion, which is pretty much the goal for a general education classroom. Aggressions were down to virtually nil, with only typical grade school playground rough housing gone too far comprising the reports of aggression. Chip also stopped picking fights with teachers to get out of work. Chip just started asking for breaks when feeling overwhelmed.

Worked like a charm.

Student 2

For Dale, it was a slower learning curve but a similar pattern. Day 1 was hard. Dale DID NOT want to ask for breaks or even touch a break card. Mainly because Dale did not want to comply with my instructions. His attitude at school pretty much is summed up by Bobby Knight in the GIF below.

I am patient, so I waited him out. When Dale fought back, I simply ignored the behavior and waited 30 seconds to offer the break opportunity again. From raw annoyance at having to constantly use increasingly escalated behaviors to not comply and me not falling for it, Dale relented. (The GIF below is what I look like when students are attention seeking using behavior)

We got a nice learning curve across the day from complete belligerence, to having to be given hand over hand help to touch a break card, to a verbal reminder, to independent requests when Dale felt I was going to ask them to do something. And unexpected/aggressive behaviors dropped to virtually zero in direct proportion to increasing functional communication.

The next day started tough with a 30-minute long defiance bout of not wanting to touch the card. Then 100% breaks independently requested. The rest of the week followed the same pattern.

Monday of the next week was tough as Dale was having none of my – as he loudly called it – “Work for 5 minutes before breaks bullshit”. Again, half of the day was tough, but after that it was easy the rest of the week.

Week 3 was cake. Dale learned communicating with words or a card was easier than fighting. And it got him what he wanted. A Break. Also, bonus, it got me to walk to the other side of the room and log onto my computer; thus not paying attention to what Dale was doing. I think getting me off their case was the greatest reward for them. And frankly, it let me get some work done.


Again, aggression was only high the first 30 minutes of each day before Dale got into the groove of asking for breaks, then incidences fell to virtually zero. Work completion went from 0 to 75% by the end of week 3. Interestingly, as early as during week 1, Dale got bored with repetitive breaks and started requesting work, which he was given. He often then promptly asked for a break from this work when he got sick of it, which was granted. And so on. A delightful virtuous cycle.

Communication. He got it. He used it. He understood.

What am I actually teaching them?

Yes, students that I am training for functional communication get out of work for a time. A lot of work. They escape from a TON of work. I am willing to patiently grant escape for the better part of a month.

But honestly, most of these students are either on task reduction anyway or else they have the system completely gamed and working in their favor, and are thus not completing any assignments anyway. So I bide my time until they start working. They always come around eventually.

What I hope to be teaching them during this time they are not focused on academics is that communicating their intents and desires to others in a way that is easy to understand gets their needs met. Plain and simple. Ask and you shall receive. In fact, during the first phase of any good functional communication protocol, ANYTHING appropriate the student asks for, they get. 100% of the time. No questions. No haggling. No delays. I think this is the part of the training that often gets under appreciated. Most of this post is talking about how I, the teacher, got a student to communicate, but in reality it is about showing the student that they can trust adults to listen when they talk.

I REWARD ALL COMMUNICATION for that first week. Otherwise there are problems. Moving forward, I would use explicit instruction to teach the student what the next phase is going to look like: Work for reward.

Most importantly, I teach the student to use a form of communication that requires little effort but is socially appropriate. They can type, write, talk, touch, sign, or even do an interpretive dance for all I care – I will reward them. They learn to move beyond unexpected, dangerous, or otherwise maladaptive behaviors to get their needs met. They grow up a bit. I show them the easy way to get their needs met. Once they learn, they readily continue using communication rather than extreme behaviors. It is easier. And kids are lazy. No need to waste energy trashing a room if all they have to is touch a break card.

And so on…


Note: I will gladly provide digital copies all my FCT materials, all you have to do is shoot me an email. I will giddily send you everything I have. We can also chat by phone, text, or email as needed to help implementation fidelity if you find any hiccups along the way.


If you have an ABA/BCBA background, I recommend Greg Hanley’s website for protocols and specific methods for building in delay tolerance during initial FCT. Mine are not ABA sanctioned and I have tweaked the reward contingencies from the accepted norms.

At this point, it is incumbent upon me to say that I do not explicitly endorse Hanley’s or any other FCT protocols that allow for the application unpleasant stimulus (positive punishment), or else removing reinforcing stimuli during failed FCT attempts as a negative punishment. I consider these punishments unethical and abusive to the child. Regardless the ethics, it is just bad practice that makes FCT MUCH less powerful and breeds distrust from the student toward the teacher.

Moving Beyond ABA: How to do a Functional Analysis…

#Ooh Ooh Ooh! They Finally Did It!

“In all my years of doing Functional Analysis and treating problem behavior, I have never once, not once, been thanked by a parent for effecting a long-lasting, socially relevant change. None of them have been able to tell me I long-term changed their children’s lives for the better” – Greg Hanley, BCBA-D, Ph.D.

I recently went to a conference about critical issues impacting children and adolescents. I was hopefully optimistic that because the conference was in Utah there would not be too strong a focus on Applied Behavioral Analysis (ABA) as a primary treatment measure for autism.

Alas, I was slightly disappointed when I saw the presenter information and noticed Greg Hanley, Ph.D., BCBA-D was the keynote speaker and teaching all the sessions I was interested in. Anyone following this blog knows I do not put much stock in ABA as a science, which means I have a particular disdain for a rather large proportion of the methods used in ABA and have not shied away from being vocal about it. However, in speaking with my colleagues in the district office that are working toward their BCBA, I found out Dr. Hanley has a “unique and somewhat controversial approach” to functional analyses and the treatment of problematic and dangerous behaviors in autism, and that they were interested to see the “other side” of the debate among BCBA regarding treatment methods.

As a scientist and teacher, I do try to keep an open mind and I try very hard to give everyone the benefit of the doubt, so I took a deep breath, left my prejudice at the door (mostly), and focused on the science of what was being presented. All that being said, I am ecstatic I attended the conference as well as the fact I attended all of Dr. Hanley’s presentations. I enjoyed the presentations immensely and I left hopeful that the methods being used in ABA-based therapy are starting to evolve and treatments are becoming more humane – or at least some precedent is being laid down to justify such a movement.

I will refer the reader to the following links to get information about Dr. Hanley’s works I am speaking about. The first is his website outlining his methods. Under the presentations tab if you look at November 2-5, 2016 there are the powerpoints and handouts from the conference I attended. Relevant papers can be downloaded Here and Here (please contact me if you cannot get these or any articles I link to in this post, I have them and am very happy to share the science).


What is a “standard” Functional Analysis?

Before I dive further in, I do not mean to infer that all functional analyses are standardized tests. They aren’t. I use the term “standard” functional analysis in the same way Dr. Hanley does in his manuscripts. This means any functional analysis that isolates attention, escape, or tangibles as motivators will be referred as a “standard” functional analysis.

Rather than try to give an explanation of a functional analysis, I will give a pseudo-textbook definition and then explain quickly what it means. I leave deeper conversations regarding functional analyses, their validity, and methodology to others.

From Wikipedia:

A functional analysis is the most direct form of functional behavior assessment, in which specific antecedents and consequences are systematically manipulated to test their separate effects on the behavior of interest. Each manipulation of the antecedent and consequence in a particular situation is referred to a condition. In a functional analysis, conditions are typically alternated between quite rapidly independent of responding to test the different functions of behavior. When data paths are elevated above the control condition (described below) it can be said that there is a functional relation between that condition and the behavior of interest. Below, common examples of experimental conditions are described. A standard functional analysis normally has four conditions (three test conditions and one control):

Attention

In this condition, the experimenter gives the individual moderately preferred items and instructs them to go play. After that initial instruction, the experimenter pretends to act busy and ignores all bids for attention from the individual. If the individual engages in the behavior of interest, the experimenter provides the individual with attention (commonly in the form of a reprimand). Behaviors that occur more frequently in this condition can be said to be attention maintained.

Escape/Avoid

In this condition, the experimenter instructs the individual that it is time to work. After the initial instruction, the experimenter delivers a series of demands that the individual is typically required to complete (e.g. math problems, cleaning up, etc.). If the individual engages in the behavior of interest, the demand is removed and the child is allowed to take a break. Behaviors that occur more frequently in this condition can be said to be escape maintained.

Alone

Normally referred to as tangible condition. In this condition, the child is left alone with a variety of items to engage with. If the child engages in the behavior of interest, no programmed consequences are delivered. Behaviors that occur more frequently in this condition can be said to be automatically maintained.

Control (play)

In this condition, the child is allowed to engage with a variety of items during the session. No demands are placed on the child throughout the duration of the session. The experimenter provides attention to the individual throughout the session on any behavior that is not the target behavior. If the target behavior occurs, the experimenter removes attention until the behavior has subsided. This session is meant to act as a control condition, meaning that the environment is enriched for the purpose of the behavior not occurring. Said another way, by meeting environmental needs for all possible functions, the individual is not likely to engage in the behavior of interest. This condition is used as a comparison to the other conditions. Any condition that is elevated to a large degree form the control condition, shows a higher degree experimental control indicating the functional relationship between the specific environmental conditions and the behavior of interest.

In essence, a functional analysis is an experiment. The researcher, teacher, or behavioral analyst forms a hypothesis regarding the function of the behavior – or why the child engages in a certain behavior. They then place the child in a controlled environment and test their assumptions by repeatedly offering the child challenges by removing what they hypothesize the child wants and recording the responses. To preserve experimental replicability, the tangibles used in a standard analysis are held relatively constant across functional analyses, as are the escape and attention contingencies (where to escape and/or scripted attention).

The standard functional analysis can take hundreds of trials and takes a significant amount of time. If everything goes as predicted, the child will respond with a behavior when the experimenter removes the hypothesized contingency (attention, escape, or tangible), whereas removing the other contingencies will not result in similar flare-ups of behaviors. The standard functional analysis also interspersed free-play conditions they consider a control or no task condition. This differential effect is called “differentiation” and is the hallmark result of a behavioral analysis.

What is this new thing I am talking about (IISCA)?

What Dr. Hanley proposed in 2014 was a new way to perform a functional analysis. The quote I started this post with was what Dr. Hanley said as his motivation for changing how he does his functional analyses. He spent decades performing standard functional analyses and designing behavioral treatments based on the results of those analyses.

In his presentations, Dr. Hanley belabored a point I agree with entirely. He suggested it as a motivation for developing the IISCA and relying on open-ended rather than standardized interviews.

[F]rom a clinician perspective, it does not matter whether or not we can characterize the function of a behavior; just so long as we can identify the topography of the behavior and use our identified synthesized contingencies to turn the behavior on and off. If we can do that, then we can help the child or young adult. We get too bound up as BCBA and ABA therapists on characterizing the behavior that we forget that our goal is to help the child overcome problematic or dangerous behaviors. We get too bound up in positive and negative reinforcements and other definitions that we lose sight of our mission.

IISCA stands for Interview-Informed Synthesized Contingency Analysis. They chose to go with the clumsy acronym IISCA because it captures two procedural differences between this method and the traditional, “standard” functional analyses. The first is that the specific contingencies (and combinations thereof) assessed and materials used in the sessions are derived from the interviews, thus the analysis is interview informed rather than experimenter driven.

The first part of the IISCA is the open-ended interview (you can download the actual template here). This is important for two reasons: First, checklists like those commonly used by BCBA to interview parents tend to limit responses to multiple choices and thus can actually guide responses rather than allow parents or caretakers to report their experiences. And B, open-ended questionnaires take a lot less time to perform. Often, the checklist questionnaires take 60-90 minutes to perform, whereas the open-ended interviews take 30 minutes. Sometimes, parents even take the forms home, talk to their family, and return it at their leisure.

The second part that I will emphasize for the IISCA, and why I like it as a method, is that it accepts that reality is complicated. What I mean is that I have never met a child misbehaving for something as simple as “attention” or “escape”. I have never seen a student try to get out of doing work and being contented with fleeing from work to a corner of the room to do nothing. I also have never seen students seek any attention I am willing to give. They want a certain type of attention. Ditto for a tangible. Only rarely do children respond to any tangible-they prefer certain ones over others.

The IISCA method emphasizes the use of so-called “synthesized contingencies”. By “synthesized contingency”, Dr. Hanley (and I) is referring to the phenomenon that children tend to escape from tasks to play with toys while seeking attention from a preferred adult (i.e.,  escape to attention + tangible). Some children escape to predictability (i.e., they flee from unpredictability or transition to force the typical schedule). Others are rewarded by what is called “mand compliance”, or having adults comply with verbal demands. This is clearly a form of attention seeking, but it is qualitatively different enough that it needs its own category. Interestingly, in his presentations Dr. Hanlkey makes a point I agree with entirely:

The IISCA procedure also emphasizes using the specific reinforcers that the child responds maximally to. Oftentimes, they use whatever stimuli the parents bring with the child. The assumption is that there is a reason why the family brought those items: that reason is that those items sooth and calm the child.

Also, the IISCA emphasizes focusing on what are called precursor behaviors to the major problem behaviors. In other words, if a child always growls or yells prior to physically aggressing, then the experimenter or analysis terminates trials when the child growls or yells, rather than waiting until they engage in physical aggression.

Of interest is that the average IISCA takes approximately 30 minutes for the open-ended interview and then 30 minutes for the functional analysis. There are three 5-minute control sessions wherein the child is given access to reinforcers (even if that is adult attention, iPad, etc) regardless their behaviors. There are then three 5-minute sessions wherein the child is given demands and separated from the reinforcers. Once the child shows precursor behaviors the reinforcement is returned and the data are taken. Since the IISCA is only evaluating the synthesized contingency, there are only 2 conditions (control, experiment) and if there is differentiation, the IISCA is finished quickly (in one report Dr. Hanley suggests an IISCA can be performed in 5 minutes).

Another cool part with the IISCA, it has been shown to be easy enough a protocol that parents and teachers can replicate the findings of the experimenters, with only minimal training and assistance through Skype (manuscript here).

Is the IISCA really better?

Yes. Much better. In pretty much every way you can imagine.

I say this because the treatment informed by the IISCA is functional communication training (FCT). This means training the child to use communication to get reinforcement rather than using misbehavior to fulfill needs. Based on the literature, using the information obtained from the IISCA results in faster, more efficient, and longer lasting FCT than using information obtained through a standard functional analysis.  Below is a figure from a Master’s thesis showing that treatment based on standard functional assessments are much less reliable than those informed by an IISCA.

Basically, what this shows is that the kids are much more willing to use FCT to get their needs met if they are offered the entire reward (i.e., the synthesized contingency) rather than isolated attention, escape, or access to a tangible. They can even be taught to tolerate being told, “No” and tolerate rather long delays before receiving rewards because the reward is so salient when it is finally presented.

Conclusion

Overall, I am excited to see this new direction in the ABA community and I hope it will be implemented in the larger ABA community. For my part, I have already used the IISCA method twice this month and it works. It is basically the method I was using before to “figure out what is making this kid tick” as I put it, but it is nice to finally have a formalized method to follow so I do not have to keep justifying my methods that always appear at odds with what other people are doing. I can vouch for the rapidity of the method and the validity of the data. The kids also seem to have much more fun during this type of functional analysis compared to the standard functional analysis.

In my opinion, although Dr. Hanley’s ideas are new and novel, we can and should begin to use them in schools to help our kiddos overcome behavioral challenges to access their education. This will improve these students’ quality of life greatly, and in the end that is all we are after.