Functional Communication Training & autism

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.

Functional Communication Training is often used in combination with other behavioural therapies.

Functional Communication Training is a major part of a Positive Behaviour Support approach.

Who is Functional Communication Training for?

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

What is Functional Communication Training used for?

Functional Communication Training is used to:

identify the purpose of a challenging behaviour
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, so they might hit others or scream to express themselves. In Functional Communication Training, 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 come from?

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

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

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

There are several key ideas behind Functional Communication Training:

All behaviour, including challenging behaviour, is a form of communication.
Challenging behaviour is how children express themselves to get something they need or want.
It’s important to help children learn new ways to communicate before trying to change challenging behaviour.
If children can communicate in new ways, they don’t need the challenging behaviour anymore.

Functional Communication Training 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.

What does Functional Communication Training 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 what they want or need
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 help autistic children?

High-quality research shows that when Functional Communication Training 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 Functional Communication Training isn’t used as part of an overall behavioural therapy, research suggests that it might help with changing children’s behaviour.

Research suggests that Functional Communication Training can work better for children than adults.

Which professionals offer Functional Communication Training?

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

Where can you find a Functional Communication Training therapist?

You can find therapists who offer Functional Communication Training by going to:

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

If you’re interested in Functional Communication Training, 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.

How are parents involved in Functional Communication Training?

If your child is taking part in a therapy or program that uses Functional Communication Training, you’re heavily involved. The therapist will train you to do Functional Communication Training 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.

You might need to work with your child’s other health professionals, support workers or teachers so that they can help with reinforcing the replacement behaviour too.

How much does Functional Communication Training cost?

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

The costs of visits to these professionals might be covered by Medicare. Whether the cost is covered depends on the therapist 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 Functional Communication Training in your child’s NDIS plan. 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.