| At a glance: Functional Communication Training (FCT) |
Type of therapy
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Therapy-based
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The claim
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Improves communication and reduces difficult behaviour
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Suitable for
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Nonverbal children with ASD who show difficult behaviour
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Research rating
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Time
Estimate of the total time for family in hours per week and duration. |
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Cost
Estimate of cost to family per session/item or week. |
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About this intervention
What is it?
Functional Communication Training (FCT) is a therapy that focuses on replacing difficult behaviour with more appropriate communication that serves the same purpose. For example, some children might have tantrums when they want a toy. In FCT, these children would be taught how to ask for the toy in a more appropriate way.
Who is it for?
FCT is designed for children with autism who show difficult behaviour.
What is it used for?
FCT is used to identify the purpose of a difficult behaviour, and teach an easier, more appropriate way of communicating the same thing (such as speech, sign language, gestures or pictures).
Where does it come from?
The first research in the area of functional communication was conducted in the 1980s in the US. FCT grew out of more traditional behavioural interventions. People receiving these older-style interventions tended to go back to behaving in difficult ways after the intervention. FCT was designed to achieve more long-term changes in behaviour.
What is the idea behind it?
FCT is based on learning theory and the principles of Applied Behaviour Analysis (ABA). The idea behind FCT is that all behaviour, including difficult behaviour, might be a form of communication. FCT therefore aims to identify the purpose of a person’s behaviour, and teach the person an easier, more appropriate way of communicating the same thing.
An important principle of FCT is that you must teach a child another way to communicate before eliminating a difficult behaviour, so the child doesn’t need the old behaviour anymore. Also, without either the old behaviour or a new one, the child has no way to communicate at all.
What does it involve?
The first step is a detailed functional assessment of the difficult behaviour.
The next step is starting intervention. This involves:
- deciding on a more appropriate way for the child to communicate
- systematically teaching the child the new communication skill
- reinforcing the child’s behaviour whenever the child uses the new skill
- ignoring the difficult behaviour whenever it recurs
- prompting or reminding the child to use the new skill when appropriate.
This approach can take a long time (perhaps weeks or months). It can be quite intensive to do, especially in the early stages.
Cost considerations
You will need to pay a professional to conduct the assessment, plan the intervention and train you in how to conduct FCT at home. The cost will vary according to the type and experience of the professional you use.
This therapy might be covered for up to 20 sessions by Medicare. Whether the cost is covered will depend on the professional you consult. Read more about new Medicare items for diagnosis and early intervention under the federal government’s Helping Children with Autism package.
Some private healthcare funds might also cover a portion of the consultation fee. This can be claimed immediately if the professional you consult has HICAPS.
Does it work?
This therapy is supported by quality research as an effective approach. FCT is considered to be effective in reducing difficult behaviours over both the short and long terms. In some cases, however, it might be difficult to identify appropriate skills and replacement behaviours.
Who practises this method?
Psychologists, speech pathologists and some teachers might have experience or training in this therapy. They can also train parents to implement FCT at home.
Parent education, training, support and involvement
Parents are heavily involved in this approach. They are trained by the therapist to implement the intervention at home. They are then required to engage their child in 10–30 minute training sessions everyday. They must also reinforce the replacement behaviour whenever it occurs throughout the day.
Where can I find a practitioner?
You can ask your GP to refer you to a psychologist, but this is not essential. To self-refer, you can go to your psychologist registration board.
Also, the Australian Psychology Society (APS) is the national organisation for psychologists. It provides a service to help people find a psychologist. Note: membership of the APS in not compulsory, and not all psychologists are listed on the APS database.
You can also ask your GP for a referral to a speech pathologist, or visit the Speech Pathology Australia website.
Not all psychologists and speech pathologists will be experienced in working with FCT. You will need to find out about the experience of the professionals you choose to work with.
