What is Functional Communication Training (FCT)?

Functional Communication Training (FCT) is a therapy for autistic children. It aims to help children replace challenging behaviour that negatively affects them or other people with new ways of communicating.

The therapy might focus on verbal communication, or it might include signing, pictures or speech generating devices.

FCT is often used in combination with other behavioural therapies.

FCT is a major part of Positive Behaviour Support.

Who is Functional Communication Training (FCT) for?

Functional Communication Training (FCT) is designed for autistic children who behave in challenging ways.

What is Functional Communication Training (FCT) used for?

Functional Communication Training (FCT) is used to identify the purpose of a challenging behaviour and help children learn new ways of communicating that involve similar or less effort.

For example, a child might be distressed when they want a toy but can’t ask for it. In FCT, the child would learn how to ask for the toy differently – for example, using speech, Key Word Sign, gestures or pictures.

Where does Functional Communication Training (FCT) come from?

The first research on functional communication was conducted in the 1980s in the United States.

Functional Communication Training (FCT) grew out of more traditional behavioural therapies. People getting these traditional therapies tended to go back to old ways of behaving after their therapy. FCT was designed to achieve longer-term changes in behaviour.

What is the idea behind Functional Communication Training (FCT) for autistic children?

Functional Communication Training (FCT) is based on learning theory and the principles of Applied Behaviour Analysis (ABA). Learning theory suggests that how people behave in a situation depends on their previous experiences of similar situations.

The idea behind FCT is that all behaviour, including challenging behaviour, is a form of communication. An important principle of FCT is that you must help children learn new ways to communicate before trying to change challenging behaviour. If children can communicate in new ways, they don’t need challenging behaviour anymore.

What does Functional Communication Training (FCT) involve?

The first step is a detailed functional assessment of a child’s challenging behaviour.

The next step is starting the therapy. This involves:

• deciding on a new 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 challenging behaviour whenever it happens
• prompting or reminding the child to use the new skill when appropriate.

This therapy can take a long time, perhaps weeks or months. It can be quite intensive to do, especially in the early stages.

Does Functional Communication Training (FCT) help autistic children?

High-quality research shows that when Functional Communication Training (FCT) is used as part of an overall behavioural therapy, it reduces challenging behaviour in both the short and long term. Research shows that it also helps autistic children develop new and more effective communication skills to replace the behaviour.

Even when FCT isn’t used as part of an overall behavioural therapy, research suggests that it might help with changing children’s behaviour.

Research suggests that FCT can work better for children than adults.

Who practises Functional Communication Training (FCT)?

Some psychologists and speech pathologists are experienced in working with Functional Communication Training (FCT). You need to ask about the experience of the professionals you choose to work with.

Where can you find a practitioner?

You can find practitioners of Functional Communication Training (FCT) by going to:

• Australian Psychological society – Find a psychologist
• Speech Pathology Australia – Find a speech pathologist.

Some disability organisations also have behaviour specialists who might be able to help with Functional Communication Training (FCT).

If you’re interested in FCT, it’s a good idea to talk about it with your GP or one of the other professionals working with your child. You could also talk with your NDIA planner, early childhood partner or local area coordinator, if you have one.

Parent education, training, support and involvement

If your child is taking part in a therapy or program that uses Functional Communication Training (FCT), you’re heavily involved. The FCT therapist trains you to do FCT with your child at home, and you do training sessions of 10-30 minutes each day with your child. You also have to reinforce the replacement behaviour throughout the day.

Cost considerations

You need to pay a professional to conduct the assessment, plan the therapy and train you in doing Functional Communication Training (FCT) at home. The cost varies depending on the type and experience of the professional you use.

The costs of visits to these professionals might be covered by Medicare. Whether the cost is covered depends on the professional providing the consultation and the number of consultations. Some private health care funds might also cover a portion of the consultation fee. You can claim this immediately if the professional you consult has HICAPS.

You might be able to include the cost of using FCT in children’s NDIS plans. You can contact the NDIS to find out.

Therapies and supports for autistic children range from behavioural therapies and developmental approaches to medicines and alternative therapies. When you understand the main types of therapies and supports for autistic children, it’ll be easier to work out the approach that will best suit your child.