What is Functional Communication Training (FCT)?
Functional Communication Training (FCT) is therapy for autistic children. It aims to replace difficult behaviour with more appropriate communication that achieves the same thing. 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 behaviour therapies.
FCT is also a major part of Positive Behaviour Support.
Who is Functional Communication Training (FCT) for?
Functional Communication Training (FCT) is designed for autistic children who show difficult behaviour.
What is Functional Communication Training (FCT) used for?
Functional Communication Training (FCT) is used to identify the purpose of a difficult behaviour and teach a more appropriate way of communicating that involves similar or less effort.
For example, a child might have a meltdown when they want a toy but can’t ask for it. In FCT, the child would be taught how to ask for the toy in a more appropriate way – for example, using speech, Key Word Sign, gestures or pictures.
Where does Functional Communication Training (FCT) come from?
The first research in the area of functional communication was conducted in the 1980s in the United States.
Functional Communication Training (FCT) grew out of more traditional behaviour therapies. People getting these traditional therapies tended to go back to behaving in difficult ways 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 difficult behaviour, is a form of communication. An important principle of FCT is that you must teach a child another way to communicate before trying to change a difficult behaviour, so the child doesn’t need the old behaviour anymore. Otherwise the child is left without either the old behaviour or a new one and has no way to communicate.
What does Functional Communication Training (FCT) involve?
The first step is a detailed functional assessment of a child’s difficult behaviour.
The next step is starting the therapy. 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 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.
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.
This therapy might be covered for up to 20 sessions by Medicare. Whether the cost is covered will depend on the professional you consult.
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.
Does Functional Communication Training (FCT) work?
High-quality research shows that when Functional Communication Training (FCT) is used as part of an overall behaviour therapy, it does reduce difficult behaviour in both the short and long term.
Even when FCT isn’t used as part of an overall behavioural therapy, research suggests that it still might work.
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 find out about the experience of the professionals you choose to work with.
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.
Where can you find a practitioner?
You can find practitioners by going to:
- Australian Psychological society – Find a psychologist
- Speech Pathology Australia – Find a speech pathologist.
If you’re interested in Functional Communication Training (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, NDIS early childhood partner or NDIS local area coordinator (LAC), if you have one.
There are many therapies and supports for autistic children. These range from behaviour therapies and developmental approaches to medications and alternative therapies. When you understand the main categories that these therapies and supports fall into, it’ll be easier to work out the approach that will best suit your child.