Functional communication training using assistive devices: recruiting natural communities of reinforcement

The Role of Assistive Technology in Enabling Older Adults to Achieve Independent Living: Past and Future

In this viewpoint, we present evidence of a marked increase in the use of assistive technology (AT) by older adults over the last 25 years. We also explain the way in which this use has expanded not only as an increase in terms of the total number of users but also by going beyond the typical scopes of use from its inception in 1999 to reach new categories of users. We outline our opinions on some of the key driving forces behind this expansion, such as population demographic changes, technological advances, and the promotion of AT as a means to enable older adults to achieve independent living. As well as our review of the evolution of AT over the past 25 years, we also discuss the future of AT research as a field and the need for harmonization of terminology in AT research. Finally, we outline how our experience in North Norfolk (notably the United Kingdom's most old age-dependent district) suggests that cocreation may be the key to not only successful research trials in the field of AT but also to the successful sustained adoption of AT beyond its original scope of use.

Mand Modality Preference Assessments among High- and Low-Tech Options for Individuals with Intellectual and Developmental Disabilities: A Systematic Review

The extant literature demonstrates that individuals with intellectual and developmental disabilities (IDD) exhibit preferences among communication modalities when multiple modalities are available and produce reinforcement on identical reinforcement schedules. High- and low-tech communication options, such as voice output devices and picture cards, are commonly recommended for individuals with limited vocal communication skills. In this study, we conducted a systematic literature review of research studies that implemented mand modality preference assessments (MMPAs) that included both a high- and low-tech communication option with individuals with IDD. We identified 27 studies meeting our inclusion criteria and summarized the participant demographics, MMPA design and procedural variations, and MMPA outcomes. The results suggested that high-tech communication options were generally more preferred over low-tech options. However, there was a high degree of variability in how the studies were conducted and conclusions were reached. We discuss some of the current research gaps and the implications for clinical practice.

The effect of responsiveness to speech-generating device input on spoken language in children with autism spectrum disorder who are minimally verbal†

The use of speech-generating devices (SGD) in early interventions for children with autism spectrum disorder (ASD) can improve communication and spoken language outcomes. The purpose of this study was to describe children's responsiveness to SGD input modeled by a social partner during adult-child play interactions over a 24-week intervention trial and explore the effect of that responsiveness on spoken language growth. This secondary analysis consisted of 31 children with less than 20 functional words at study entry who received a blended behavioral intervention (JASPER + EMT) as part of a randomized controlled trial. Significant improvements were seen in rate of responsiveness to both adult SGD models and adult natural speech models; only rate of responsiveness to SGD models at entry was a significant predictor of frequency of commenting and was a more robust predictor of number of different words post-intervention. Lastly, at entry, children with more joint attention and language responded to SGD models at significantly higher rates. Attention and responsiveness to SGD output may be important mechanisms of language growth and children who have more joint attention skills may particularly benefit from use of an SGD.

Sustaining behavior reduction by transitioning the topography of the functional communication response

When a functional communication response (FCR) can be reliably occasioned, destructive behavior tends to be lower. However, the form of FCR may affect the durability of functional communication training, as missing FCR materials may promote resurgence. Experiment 1 demonstrated that resurgence of target responding was lower when a vocal FCR remained available but was placed on extinction compared to when a card-based FCR was unavailable. Experiment 2 replicated the finding that initiating treatment with a card FCR produced less target responding than when initiating treatment with a vocal FCR. We then evaluated a set of procedures for transitioning the card FCR to the previously unlearned vocal FCR. These findings suggest benefits of training different types of FCRs at different stages of treatment and provide a preliminary set of procedures for transitioning between FCR topographies while occasioning minimal target responding.

A comparison of single-case evaluation tools applied to functional communication training with augmentative and alternative communication supports for students with developmental disabilities

BACKGROUND

Students with developmental disabilities frequently present with both limited vocal speech and challenging behavior. Functional communication training (FCT) with augmentative and alternative communication (AAC) supports, is a commonly recommended intervention to reduce challenging behavior for these students, while also increasing appropriate communication.

AIMS

Current research on this topic has not applied multiple evaluation tools, despite the recent suggestion to do so. Further, there are limited studies in the field of special education that have (a) applied multiple evaluation tools and (b) compared the results of the tools.

METHOD

In the current review, we applied three evaluation tools to intervention studies examining the use of FCT with AAC supports in school-based settings to determine the current level of scientific support for this intervention. We identified 38 studies, which contained 59 single-case designs (SCDs). Next, we compared the methodological rigor and/or quality, outcome scores, and Evidence-Based Practice (EBP) ratings provided by the three evaluation tools.

RESULTS AND CONCLUSION

Our results yielded inconsistent methodological rigor and/or quality, participant outcome measures, and EBP classifications between the evaluation tools. No two evaluation tools completely aligned. Limitations and future research are discussed.

Does teaching an omnibus mand preclude the development of specifying mands?

When problem behavior is controlled by a synthesized reinforcement contingency, a simple omnibus mand that yields access to all reinforcers simultaneously has been shown to effectively replace problem behavior. The question arises as to whether teaching an omnibus mand will preclude the acquisition of specifying mands for each of the combined reinforcers. In this study, after 3 students diagnosed with autism acquired an omnibus mand ("My way, please") that yielded all identified reinforcers simultaneously, specifying mands (e.g., "All done," "May I have my toys?" "Play with me") were taught to yield each individual reinforcer (e.g., escape, tangibles, attention). Problem behavior was immediately eliminated for all children, and the omnibus mand was acquired quickly. Teaching an omnibus mand did not preclude acquisition of specifying mands for any learner and instead allowed for the acquisition of specifying mands once problem behavior had been effectively reduced.

A review of investigations of operant renewal with human participants: Implications for theory and practice

Operant renewal is the recurrence of a previously eliminated target behavior as a function of changing stimulus contexts. Renewal as a model of treatment relapse in humans suggests that a change in stimulus conditions or context is sufficient to produce relapse of a previously eliminated maladaptive behavior. The extent to which general findings from operant renewal studies involving nonhuman animal subjects are supported by relapse studies involving human participants is unknown. We conducted a systematic review of studies demonstrating or mitigating operant renewal in human participants in peer-reviewed studies found in PsycINFO, ERIC, PubMed, and Scopus between 1980 and 2019. We identified 12 studies involving 61 participants and 93 cases of operant renewal. We coded descriptive data on participant and study characteristics and calculated summary statistics. Results indicated that the renewal effect was a robust phenomenon, supported by demonstrations in both clinical and human-laboratory studies, and across a variety of variables and experimental preparations. However, there were relatively few studies involving human participants that attempted to reduce or eliminate renewal of clinically meaningful behavior. We discuss variables relevant for studying renewal in socially meaningful contexts, practical limitations of observing the renewal effect in real-world settings, implications for theoretical models of renewal, and identify barriers to methodology unique to human participants. We provide directions for future research related to implementing and translating nonhuman animal studies of renewal to applied settings.

A systematic review of Functional Communication Training (FCT) interventions involving augmentative and alternative communication in school settings

The purpose of this meta-analysis was to summarize single-case intervention studies in which Functional Communication Training (FCT) involving augmentative and alternative communication (AAC) was implemented in school settings. Overall, the findings suggest that FCT involving AAC was effective in reducing challenging behaviour and promoting aided or unaided AAC use among participants with disability. FCT was more effective for the participants who engaged in less severe forms of challenging behaviour prior to intervention. Additionally, FCT was more effective when informed by a descriptive functional behaviour assessment and delivered within inclusive school settings. Implications for practice and directions for future research related to FCT for students who use AAC are addressed.

Implementing Aided Augmentative Communication Systems With Persons Having Complex Communicative Needs

Augmentative and alternative communication (AAC) systems can support communication skills for people with significant developmental disabilities who experience complex communication needs (CCNs). There is a need to tailor best practices in AAC assessment and intervention to create individualized communication systems with this population. In this article, we outline the important components of AAC systems that can be implemented in authentic settings. However, given the limited evidence on AAC interventions specific to people with CCNs, we also identify some priority areas for future inquiry. Among these involve strategies to enhance decision making regarding (a) matching communication mode(s) to learner skills and contextual demands, (b) identifying communicative opportunities and obligations, (c) individualizing aided communication display features, (d) selection of vocabulary specificity, and (e) considering dosage parameters needed to acquire and maintain a communicative repertoire. In addition, we briefly discuss the use of telehealth to enhance intervention capability.

Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies

PURPOSE

This article presents a systematic review that aimed to synthesize single-subject-design studies that have examined naturalistic interventions for teaching the expressive use of speech-generating devices (SGDs) to children with complex communication needs. Specifically, this review describes what intervention strategies are most commonly applied in studies with positive effects and minimal methodological flaws and examines the populations and outcomes for which these strategies have been effective.

METHOD

A systematic approach was used to qualitatively code variables of interest to this review. Results were summarized via both visual analysis and effect size methods, and a certainty of evidence methodology was adopted to describe the quality of the evidence.

RESULTS

Thirty-two unique studies met inclusion criteria, with 19 having consistent positive results and meeting minimum requirements for certainty of evidence. Although studies used a variety of titles to describe intervention packages (e.g., milieu teaching, interaction strategies), certain strategies were common across studies. These included (a) creating and capturing communication opportunities via methods such as time delay and questioning; (b) providing feedback via methods such as reinforcement of requests, praise, or expansions; (c) prompting (verbal, physical, gestural); (d) modeling; and (e) training communication partners.

CONCLUSIONS

Findings regarding these intervention components help to provide practical guidelines for naturalistic SGD intervention. Limitations of the current body of research (e.g., need to include more home-based studies and more intermediate to advanced SGDs, need to critically analyze the most critical intervention components) provide suggestions for future research.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.6615332.

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review

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.

Effects of response preference on resistance to change

Treatments based on differential reinforcement of alternative behavior, such as functional communication training, are widely used. Research regarding the maintenance of related treatment effects is limited. Nevin and Wacker (2013) provided a conceptual framework, rooted in behavioral momentum theory, for the study of treatment maintenance that addressed two components: (a) reemergence of problem behavior, and (b) continued expression of appropriate behavior. In the few studies on this topic, focus has been on variables impacting the reemergence of problem behavior, with fewer studies evaluating the persistence of appropriate behavior. Given the findings from applied research related to functional communication training, variables related to response topography, such as response preference, may impact this aspect of maintenance. In the current study, the impact of response preference on persistence was evaluated in the context of functional communication training for individuals who did not exhibit problem behavior (Experiment 1) and for individuals with a history of reinforcement for problem behavior (Experiment 2). High-preferred mands were more persistent than low-preferred mands. These findings suggest that response related variables, such as response preference, impact response persistence and further suggest that response related variables should be considered when developing interventions such as functional communication training.

Communication Intervention for Young Children with Severe Neurodevelopmental Disabilities Via Telehealth

Young children with neurodevelopmental disorders such as autism spectrum disorders (ASD) and Rett syndrome often experience severe communication impairments. This study examined the efficacy of parent-implemented communication assessment and intervention with remote coaching via telehealth on the acquisition of early communication skills of three young children with ASD (2) and Rett syndrome (1). Efficacy of the intervention was evaluated using single-case experimental designs. First, functional assessment was used to identify idiosyncratic/potentially communicative responses and contexts for each child. Next, parents implemented functional communication training (FCT). All of the children acquired the targeted communication responses. The findings support the efficacy of telehealth as a service delivery model to coach parents on intervention strategies for their children's early communication skills.

Stimuli previously associated with reinforcement mitigate resurgence

Resurgence refers to the recurrence of an extinguished target behavior following subsequent suspension of alternative reinforcement. Delivery of reinforcers during extinction of alternative behavior has been shown to mitigate resurgence. The present experiment aimed to determine whether delivering stimuli associated with reinforcers during resurgence testing similarly mitigates resurgence. Three groups of rats pressed target levers for food according to variable-interval 15-s schedules during Phase 1. In Phase 2, lever pressing was extinguished, and an alternative nose-poke response produced alternative reinforcement according to a variable-interval 15-s schedule. Food reinforcement was always associated with illumination of the food aperture and an audible click from the pellet dispenser during Phases 1 and 2. Phase 3 treatments differed between groups. For one group, nose poking continued to produce food and food-correlated stimuli. Both of these consequences were suspended for a second group. Finally, nose poking produced food-correlated stimuli but not food for a third group. Target-lever pressing resurged in the group that received no consequences and in the group that received only food-correlated stimuli for nose poking. Resurgence, however, was smaller for the group that received food-correlated stimuli than for the group that received no consequences for nose poking. Target-lever pressing did not increase between phases in the group that continued to receive food and associated stimuli. Thus, delivery of stimuli associated with food reinforcement after suspension of food reduced but did not eliminate resurgence of extinguished lever pressing. These findings contribute to potential methodologies for preventing relapse of extinguished problem behavior in clinical settings.

Conducting Functional Communication Training in Home Settings: A Case Study and Recommendations for Practitioners

We coached a parent to conduct functional analysis and functional communication training (FCT) procedures in her home to reduce the destructive behavior displayed by her 2-year-old son. Descriptive assessment information and functional analysis results suggested that destructive behavior was maintained by escape from demands. After conducting a series of baseline probes, the parent implemented an FCT program to teach her son to comply with designated task requests and to mand for a break to play. Results showed that destructive behavior decreased and manding and independent task completion increased during FCT. Positive intervention outcomes were maintained for 1 year. Results are discussed with respect to developing an FCT program that is both efficient and acceptable for parents to implement in their homes.

Comparing Single Case Design Overlap-Based Effect Size Metrics From Studies Examining Speech Generating Device Interventions

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with intellectual and developmental disabilities (IDD) with moderate to profound levels of impairment. The effect size metrics included percent of data points exceeding the median (PEM), percent of nonoverlapping data (PND), improvement rate difference (IRD), percent of all nonoverlapping data (PAND), Phi, nonoverlap of all pairs (NAP), and Tau(novlap). Results showed that among the seven effect size metrics, PAND, Phi, IRD, and PND were more effective in quantifying intervention effects for the data sample (N = 285 phase or condition contrasts). Results are discussed with respect to issues concerning extracting and calculating effect sizes, visual analysis, and SCD intervention research in IDD.

The role of augmentative and alternative communication for children with autism: current status and future trends

BACKGROUND

Augmentative and alternative communication (AAC) interventions are used for children with autism, often as stand-alone communication interventions for those who are minimally verbal. Our aim was to synthesize the evidence for AAC interventions for children (up to 21 years), and then consider the role of AAC within established, comprehensive, evidence-based autism interventions targeting learning across multiple developmental domains.

DESIGN

We completed a systematic search of three databases (OVID Medline, PsycINFO, ERIC) as well as forward citation and hand searches to identify systematic reviews of AAC intervention efficacy research including children with autism, published between 2000 and March 2016 in peer-reviewed journals. Data pertaining to the quality indicators of included studies, effect sizes for intervention outcomes, and evidence for effectiveness were extracted for descriptive analysis.

RESULTS

The search yielded 17 systematic reviews. Most provided indicators of research quality for included studies, of which only relatively few provided conclusive results. Communication targets tended to be focused on teaching children to make requests. Still, effect size measures for included studies indicated that AAC was effective to highly effective.

CONCLUSION

There is growing evidence for the potential benefits of AAC for children with autism, but there is a need for more well-designed studies and broader, targeted outcomes. Furthermore, a lack of evidence for the role of AAC within comprehensive intervention programs may account for a tendency by autism researchers and practitioners to neglect this intervention. Attempts to compare evidence for AAC with other interventions for children with autism, including those in which the use of AAC is delayed or excluded in pursuit of speech-only communication, must take into account the needs of children with the most significant learning needs. These children pose the greatest challenges to achieving large and consistent intervention effects, yet stand to gain the most from AAC interventions.

Using multiple schedules during functional communication training to promote rapid transfer of treatment effects

Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects across settings and therapists. With 2 children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings.

An examination of the effectiveness of video modelling intervention using a speech-generating device in preschool children at risk for autism

OBJECTIVE

To investigate whether preschool children at risk for autism would learn to request a preferred object using a speech-generating device (SGD) following a video modelling (VM) intervention and generalize requesting behaviours to preferred objects across stimuli and communication partners.

METHOD

A single-subject multiple baseline design across participants (n = 3) was used to assess the effects of VM intervention on requesting behaviour. Intervention consisted of having each participant view a VM of two adults demonstrating the requesting of a preferred object using the SGD. Additionally, a least-to-most-prompting technique was employed to facilitate the production of a correct response.

RESULTS

All three participants demonstrated the ability to request preferred objects following the intervention and were able to generalize the newly acquired requesting behaviour across stimuli and people.

CONCLUSIONS

Study findings indicate that a VM treatment package is effective in facilitating communication in children with little or no functional speech.

Psychological therapies for people with intellectual disabilities: comments on a matrix of evidence for interventions in challenging behaviour

BACKGROUND

Psychological therapies with a proven efficacy in the general population are being adapted for use with people who have intellectual disabilities in community settings.

METHODS

A systematic review of peer-reviewed literature published between 1980 and 2010 was carried out, to identify the evidence base for effective psychological interventions in challenging behaviour. Relevant databases were searched using applied key terms. Evidence was graded, according to the quality of the research. A best-evidence Matrix was produced to improve guidance for service providers and practitioners in the range, volume and quality of psychological interventions.

RESULTS

There is a limited amount of efficacy research that meets the most stringent standards of empirical evidence.

CONCLUSIONS

It is important to broaden the evidence base and consider the context of psychological interventions, alongside the values underpinning care and treatment.

Effects of augmentative and alternative communication on challenging behavior: a meta-analysis

The purposes of this review were to (a) use meta-analytic procedures to examine the effectiveness of single-case AAC intervention research on challenging behaviors exhibited by individuals with disabilities, (b) identify study characteristics that moderate intervention effects, and (c) evaluate the quality of research. The authors provided inferential and descriptive analyses of 54 studies representing 111 participants and estimated effect sizes using the Nonoverlap of All Pairs (NAP) method. Overall, AAC interventions were found to be equally effective across a broad spectrum of participants and interventions. AAC interventions were more effective with younger children than with adults. Interventions in which functional behavior assessments (FBA) were used had significantly larger effect sizes than those that did not use FBAs. Further, functional communication training interventions resulted in larger effect sizes than Picture Exchange Communication System interventions. Descriptive analysis revealed that (a) interventions often occurred in atypical environments (e.g., therapy room, experimental room) and with atypical interventionists (e.g., therapists, researchers), and (b) numerous studies did not exhibit quality characteristics of single-case research.

Functional communication training: a review and practical guide

Functional communication training (FCT) is one of the most common and effective interventions for severe behavior problems. Since the initial description of FCT by Carr and Durand (1985), various aspects of the FCT treatment process have been evaluated, and from this research, best practices have emerged. This manuscript provides a review of these practices as they arise during the development of effective FCT interventions.

An analysis of autism as a contingency-shaped disorder of verbal behavior

This paper analyzes autism as a contingency-shaped disorder of verbal behavior. Contingencies of reinforcement in effect during the first to third year of a child's life may operate to establish and maintain those behaviors that later result in a diagnosis of autism. While neurobiological variables may, in some cases, predispose some children to be more or less responsive to environmental variables than others, our analysis suggests that reliance on neurobiological variables as causal factors in autism is unnecessary. We present six paradigms that may play critical etiologic roles in the development of behaviors labeled as autistic. Recognizing these contingencies and their resulting behaviors during the first two years of a child's life may contribute substantially to earlier identification, more effective treatment and, quite possibly, to the development of Applied Behavior Analysis programs for the prevention of autism that could be implemented immediately. Conceptualizing autism as a contingency-shaped disorder of verbal behavior may provide a new and potentially more effective paradigm for behavioral research and treatment in autism.

Reinforcement schedule thinning following functional communication training: review and recommendations

This paper extends the Tiger, Hanley, and Bruzek (2008) review of functional communication training (FCT) by reviewing the published literature on reinforcement schedule thinning following FCT. As noted by Tiger et al. and others, schedule thinning may be necessary when the newly acquired communication response occurs excessively, to the extent that reinforcing it consistently is not practical in the natural environment. We provide a review of this literature including a discussion of each of the more commonly used schedule arrangements used for this purpose, outcomes obtained, a description of methods for progressing toward the terminal schedule, and a description of supplemental treatment components aimed at maintaining low levels of problem behavior during schedule thinning. Recommendations for schedule thinning are then provided. Finally, conceptual issues related to the reemergence of problem behavior during schedule thinning and areas for future research are discussed.

Picture Exchange Communication (PECS) Training for Young Children: Does Training Transfer at School and to Home?

The limited communicative abilities of young children with autism and developmental disabilities may be enhanced by augmentative communication systems such as the Picture Exchange Communication System (PECS). Both children and adults can learn to use PECS, but research is inconsistent in establishing the degree to which PECS training transfers reliably from the training setting to other settings, for example, regular classrooms, and home. Three 5–6 year-old children, diagnosed as autistic and/or developmentally disabled, were given 1:1 PECS training at school, structured to enhance generalisation and transfer. Concurrent observations were made in their regular classroom and at home to probe the extent of generalisation. All three acquired the ability to request a preferred object or activity by exchanging a picture symbol with a communicative partner. In tests of transfer and generalisation, a multiple-baseline across subjects design showed no use of PECS symbols either in the classroom or at home prior to training, with spontaneous initiations of picture exchange (transfer) occurring to a slight to moderate degree in the classroom and to a slight degree at home. Even with PECS training structured to enhance transfer, functionally significant degrees of generalisation of training may be difficult to achieve, and cannot be assumed to occur.

An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities

This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults.

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior

The purpose of this study was to evaluate the effects of functional communication training (FCT) on the occurrence of non-targeted disruptive behavior. The 10 participants were preschool-aged children with developmental disabilities who engaged in both destructive (property destruction, aggression, self-injury) and disruptive (hand flapping, spinning in circles, shrill laughter, screaming, crying) behaviors. Only destructive behavior was targeted for the functional analyses and FCT, but data were also collected on disruptive behaviors. All procedures were conducted in the participants' homes by their mothers with investigator coaching. Phase 1 consisted of conducting a functional analysis within a multielement design. Phase 2 consisted of conducting FCT with demand fading and repeated extinction baselines within a reversal design. Single-case data are provided for 3 participants, and summary data are provided for all 10 participants. Results of phase 1 showed that all participants' destructive and disruptive behavior was maintained, at least in part, by negative reinforcement. Results of phase 2 showed that both destructive behavior and non-targeted disruptive behavior occurred at lower levels during FCT when compared to the functional analysis demand condition and baseline conditions, suggesting that FCT was effective in decreasing both target destructive behavior and non-targeted disruptive behaviors.

The use of speech generating devices in communication interventions for individuals with developmental disabilities: a review of the literature

OBJECTIVE

This review synthesizes communication interventions that involved the use of speech generating devices (SGD) for individuals with developmental disabilities.

METHODS

Systematic searches of electronic databases, journals and reference lists identified 35 studies meeting the inclusion criteria. These studies were evaluated in terms of (a) participants, (b) SGD function, (c) SGD characteristics, (d) intervention procedures, (e) intervention results and (f) certainty of evidence.

RESULTS

Across these studies, intervention was provided to a total of 86 participants aged 1-42 years. Communication skills targeted included requesting, social or conversational skills, labelling items and receptive language. Intervention approaches were categorized as using Discrete Trial Training, Milieu teaching or a combined instructional approach. Positive outcomes were reported in 86% of the studies with 54% of studies categorized as providing conclusive evidence.

CONCLUSION

This literature base is considered promising due to the large number of conclusive studies and the replication of intervention approaches.

Communication interventions involving speech-generating devices for children with autism: a review of the literature

OBJECTIVE

The current review synthesizes communication intervention studies that involved the use of speech-generating devices (SGD) for children with autism.

METHODS

Twenty-three studies were identified that met the inclusion criteria following systematic searches of electronic databases, journals and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) mode of communication, (d) communication skill(s) taught to the participant, (e) intervention procedures, (f) outcomes, (g) follow-up and generalization, (h) reliability and treatment integrity and (i) design and certainty of evidence.

RESULTS

Intervention, most commonly targeting requesting skills, was provided to a total of 51 children aged 3-16 years. Intervention strategies followed two main approaches: operant/behavioural techniques and naturalistic teaching procedures. Positive outcomes were reported for 86% of the studies and 78% of the studies were categorized as providing conclusive evidence.

CONCLUSION

The literature base suggests that SGDs are viable communication options for children with autism. However, several areas warrant future research.

Do children prefer contingencies? An evaluation of the efficacy of and preference for contingent versus noncontingent social reinforcement during play

Discovering whether children prefer reinforcement via a contingency or independent of their behavior is important considering the ubiquity of these programmed schedules of reinforcement. The current study evaluated the efficacy of and preference for social interaction within differential reinforcement of alternative behavior (DRA) and noncontingent reinforcement (NCR) schedules with typically developing children. Results showed that 7 of the 8 children preferred the DRA schedule; 1 child was indifferent. We also demonstrated a high degree of procedural fidelity, which suggested that preference is influenced by the presence of a contingency under which reinforcement can be obtained. These findings are discussed in terms of (a) the selection of reinforcement schedules in practice, (b) variables that influence children's preferences for contexts, and (c) the selection of experimental control procedures when evaluating the effects of reinforcement.

An Evaluation of Manding Across Functions Prior to Functional Communication Training

The purpose of this study was to evaluate whether destructive behavior and manding were maintained by the same social reinforcers. A summary of 10 participants that met criteria for differentiated functional analysis and mand analysis results were included in this study. All participants were preschool-aged children with developmental disabilities who engaged in destructive behavior. All procedures were conducted in the participants' homes by their parent with investigator coaching. Functional analyses (attention, escape, and tangible test conditions) of destructive behavior and manding were conducted within multielement designs and showed social functions. The functional analysis of destructive behavior and functional analysis of mands identified the same reinforcers for only 2 of the 10 participants. The analysis of mands identified a reinforcer that was not identified by the analysis of destructive behavior for 5 participants (over-identification), did not identify a reinforcer that was identified by the analysis of destructive behavior for 2 participants (under-identification), and identified mixed reinforcers (combination of over-identification and under-identification) for 1 participant. Results suggest that the analysis of destructive behavior and the analysis of mands identified different reinforcers and are not interchangeable.

A demonstration of individual preference for novel mands during functional communication training

Preference for mand topography was evaluated for 2 individuals with developmental disabilities who exhibited problem behavior. The results of a functional analysis showed that each participant's problem behavior was maintained by social reinforcement. Participants were taught two novel mand topographies for the same functional reinforcer, and each proved to be effective in reducing problem behavior. Finally, preference for mand topography was assessed within a concurrent-schedules design. Results indicated that functional communication training was an effective treatment, regardless of the mand used, and that each participant demonstrated a preference for one mand topography relative to the other.

A review of empirical support for differential reinforcement of alternative behavior

Differential reinforcement of alternative behavior (DRA) is one of the most common behavior analytic interventions used to decrease unwanted behavior. We reviewed the DRA literature from the past 30 years to identify the aspects that are thoroughly researched and those that would benefit from further emphasis. We found and coded 116 empirical studies that used DRA, later grouping them into categories that met APA Division 12 Task Force criteria. We found that DRA has been successful at reducing behaviors on a continuum from relatively minor problems like prelinguistic communication to life-threatening failure to thrive. DRA with and without extinction is well established for treating destructive behavior of those with developmental disabilities, and to combat food refusal.