A Meta-Analysis of Single-Case Studies on Functional Communication Training

Abstract

Functional Communication Training (FCT) is an intervention that involves teaching a communicative response to decrease the occurrence of challenging behavior in individuals with disabilities. FCT is a two step intervention in which the interventionist first determines the function, or purpose, of the challenging behavior and then teaches a communicative response that will provide the same function as the challenging behavior. This meta-analysis addressed the following questions: (a) Is FCT more effective with a complete or brief functional analysis? (b) Is FCT differentially more effective for one communication mode versus another (unaided augmentative and alternative communication, aided augmentative and alternative communication, or verbal)? (c) Is FCT more effective when implemented in natural or contrived contexts? (d) Is FCT more effective for different functions of challenging behavior (attention, tangible, escape and multiple)? (e) How effective is FCT with individuals with challenging behavior, across different age ranges? (f) How effective is FCT with individuals with challenging behavior, across different disability categories?

A thorough search was performed to find all articles related to FCT. The articles were then reviewed to ensure that they met the inclusion criteria. Data were extracted from the graphs within each study and then analyzed using Robust Improvement Rate Difference (IRD). Forest plots were also created to aid in visual analysis to determine statistical significance and consistency of the results. A variable was determined to moderate the effectiveness of FCT if there was a statistically significant difference between the levels within each variable.

Thirty nine studies were included in this meta-analysis. Over-all FCT has a Robust IRD score of .86 (confidence intervals = .85 - .87). Based on the findings of this meta-analysis FCT is most effective with brief functional analysis and verbal communication. FCT was equally effective in natural and contrived settings. FCT appears to be most effective when an individual's behavior serves as attention seeking or an attempt to gain access to a tangible item. FCT appears to be more effective with school age individuals rather than adults. Finally, FCT may be more effective with individuals with autism spectrum disorder than intellectual disabilities or other disabilities.