Review incidental teaching, milieu teaching, pivotal response treatment, video modeling, and peer-mediated instruction

Review incidental teaching, milieu teaching, pivotal response treatment, video modeling, and peer-mediated instruction. How can these intervention models be used to teach social skills? Provide an example for each


Response to student Disscussion Question: (JK) According to the Barton & Harn text, incidental teaching, milieu teaching, and pivotal response treatment are naturalistic teaching methods that promote an increase in social skills acquisition. They are “…derived primarily from behavioral-based methods and have the following common elements: (a) the approach is child-led or child-initiated, as opposed to instructor-led; (b) the focus is on the child’s interest; (c) instruction is embedded or interspersed in the naturally occurring environment; and (d) natural reinforcers are delivered that relate to the child’s communicative act” (as cited in Barton & Harn, 2012).Video modeling is more about modeling and imitating demonstrations of behaviors, and peer-mediated instruction (once taught to typically developed peers) takes the prompting and maintaining of social interactions slightly from the teacher’s hands and places it on a peer who then socially interacts with ASD students in natural settings to increase generalizing and positive interactions (Barton & Harn, 2012).


Incidental teaching: At snack time, teacher arranges the environment to practice greeting peers, requesting items (the snack) and exchanging materials with appropriate prompts.

Milieu teaching: Student points to book on shelf- teacher models with making eye contact, looking quizzical, waiting and then prompting “would you like to read a book?”

Pivotal response treatment: Teacher uses a pop-up book of high interest to teach the question-asking skill of “what happened/what’s happening?” when tabs are pulled for the pop-up pictures.

Video modeling: ASD student watches a 1stperson perspective video of a young person going up to another young person on the playground, asking them to play on the swings with them and subsequently continuing that social interaction.

Peer-mediated instruction: Planned activity- making Mother’s Day cards. Teacher has explained to trained peer that they will be helping ASD student to make Mother’s Day cards and will be focusing on taking turns with materials, asking for assistance when needed and reciprocating conversation. Teacher monitors and offers feedback and prompting to peer and ASD student as needed for facilitation.


Barton, E. E., & Harn, B. (2012). Educating young children with autism spectrum disorders. Thousand Oaks, Calif: Corwin.

Evidence-Based Practices for Communication Skill
Acquisition Chapter 9
Matt Tincani and Jessica Zawacki Temple University Chapter Objectives:
• Understand the basic forms of communication.
• Identify how Augmentative and Alternative Communication (AAC) promotes
communication in children with autism.
• Describe research supporting the Picture Exchange Com-munication System
(PECS), Voice Output Communication Aides (VOCAs), and sign language for
children with autism.
• Identify strategies for embedding communication programming throughout the
• Understand how to incorporate parents into communication skill instruction
. • Describe two comprehensive treatment models for teaching communication and
language skills to children with autism, the Early Start Denver Model and the
Young Autism Project.
Educating Young Children With Autism Spectrum Disorders Language
impairments are a core skill deficit of persons with autism (American Psychiatric
Association, 2000; Lord & Spence, 2006).
Although estimates vary, reports suggest that up to 50% of adults with autism have
no functional communication (Wetherby & Prizant, 2005). Effective intervention is
critical in preventing early language delays from becoming lifelong
communication deficits. A variety of specific strategies have emerged to teach
communication and language to children on the autism spectrum (e.g., Koegel &
Koegel, 2006; Mirenda, 2003; Petscher, Rey, & Bailey, 2009; Schlosser & Wendt,
2008). Most of these strategies incorporate the principles and techniques of applied
behavior analysis (Cooper et al., 2007).
This chapter provides an overview of three specific strategies, augmentative and
alternative communication programming, pivotal response treatment (PRT), and
functional communication training, to teach communication skills. The chapter
concludes with a description of two comprehensive treatment models to teach
communication, the Early Start Denver Model and the Young Autism Project.
WHAT IS COMMUNICATION? Before we discuss strategies to teach
communication, it is important to understand how all children, including those with
autism, communicate. Communication, or verbal behavior, is “behavior reinforced
through the mediation of other persons” (Skinner, 1957, p. 2). For example, when a
child says to his mother, “Crackers, please,” and receives crackers, this is
communication, because the response, asking for crackers, is reinforced through
the action of someone else. In contrast, if the child walks to the cabinet and takes
out crackers without asking, this is not communica-tion because reinforcement is
not provided through another person. Importantly, the child’s communicative
response need not be vocal. Gestures, sign language, or augmentative responses
(discussed later) are communication if reinforcement is mediated through other
persons. Because children with autism often have speech delays, a central focus of
educational programming is to teach basic communication skills. Programs focus
on several core areas including requests, expressive labeling, conversation, and
receptive responses. As illustrated in the previous exam-ple, requests (or mands)
are perhaps the most important form of functional communication for young
children with autism (Tincani, Bondy, & Crozier, 2011). Requests enable the child
to have his or her most basic needs met, such as when asking for preferred items
and activities, requesting a break, or rejecting unwanted items. In contrast,
expressive labeling responses (or tacts) are controlled by stimuli that precede
them—typically an object or some aspect of the environment—and are socially
reinforced. For instance, expres-sive labeling occurs when a child sees a fire truck,
says “truck,” and receives social reinforcement (e.g., “Yes, that’s a truck.”).
Conversational responses, FOR TH Evidence-Based Practices for Communication
Skill Acquisitionor intraverbals, are evoked by someone else’s verbal behavior,
such as when a teacher says, “How are you today?” and the child says, “Pretty
good.” Conversational responses are also maintained by social reinforcement.
Receptive language is also a critical aspect of communication. Receptive language
happens when a child engages in nonverbal behavior in response to another
person’s verbal behavior: for instance, when a father says, “Come here,” and the
child walks over to him, or a teacher says, “Time to work,” and the child sits at his
or her desk. To function independently, children must fluently engage in
requesting, expressive labeling, conversation, and receptive responses across
home, school, and community environments. As we will see, each of the specific
communication strategies discussed next seeks to establish functional
communication across settings.
Augmentative and Alternative Communication (AAC) programming describes
strategies to teach communication to persons with limited speech abilities in a
modality other than speech. Broadly, AAC systems can be categorized into two
types, aided, which require a device, and unaided, which do not require a device;
however, there are many variations within these categories (Mirenda & Iacono,
2009). We will focus on three specific strategies for children with autism that have
been extensively described in the literature: the Picture Exchange Communication
System (PECS; Frost & Bondy, 2002), Voice Output Communication Aides
(VOCAs; Rispoli, Franco, van der Meer, Lang, & Camargo, 2010), and sign
language (Goldstein, 2002).
comprehensive program for teaching functional commu-nication to students with
autism and other developmental disabilities. Developed by Andy Bondy and Lori
Frost at the Delaware Autism Program (Bondy & Frost, 1994), PECS was initially
designed to promote communication in young children with autism; however, it
has success-fully been used with older children and adolescents (Tincani & Devis,
2010). PECS is perhaps the most popular aided AAC strategy for children with
autism (e.g., Stahmer, Collings, & Palinkas, 2005). PECS begins with a formal
assessment of the child’s preferences and is comprised of six phases (see Table
9.1; Frost & Bondy, 2002). In Phase I, the student is taught “how to communicate”
by exchanging a picture symbol to request a preferred item or activity.
In Phase II, the sstudent learns persistence and independence by travelling a
distance to the communication partner and the communication book.
In Phase III, the student is taught to discriminate among an array of picture
symbols, while Phase IV shows the student how to use a sentence structure when
requesting (i.e., “I want . . . .”). Finally, in Phases V and VI, the student learns to
respond to others’ questions (i.e., “What do you want?”) and to comment on the
environment (e.g., “I see . . . .”). Skinner’s (1957) analy-sis of verbal behavior
provides a conceptual basis for the PECS phases (Bondy, Tincani, & Frost, 2004).
Research supporting PECS. PECS is among the most well researched AAC
strategies, with a growing body of single-subject and group design stud-ies
(Flippin, Reszka, & Watson, 2010; Hart & Banda, 2010; Sulzer-Azaroff, Hoffman,
Horton, Bondy, & Frost, 2009; Tincani & Devis, 2010). Overall, PECS has been
shown to be an effective system for teaching children to request a basic vocabulary
of preferred items as taught in Phases I to IV. Bondy and Frost (1994) reported that
the system successfully promoted speech for over 50% of young children who
were taught PECS for more than 1 year; however, subsequent research has shown
that speech acquisition is Table 9.1 Phases and Objectives of the Picture Exchange
Communication System PhasesObjectivesPhase I—How to CommunicateStudent
learns to exchange a picture symbol for a highly preferred item.Phase II—Distance
and PersistenceStudent learns to remove a picture symbol from a communication
board, get the trainer’s attention, and exchange the picture symbol at a
distance.Phase III—Picture DiscriminationStudent learns to request the appropriate
picture symbol from an array.Phase IV—Sentence StructureStudent learns to
request items using a multiword sentence strip (i.e., “I want _______ ”).Phase V—
Responding to “What Do You Want?”Student learns to exchange a picture sym-bol
in response to the question, “What do you want?”Phase VI—CommentingStudent
learns to answer the following questions: “What do you see?” “What do you
have?” “What do you hear?” and “What is it?” Source: Frost & Bondy, 2002. FOR
TH Evidence-Based Practices for Communication Skill Acquisitionvariable, with
some users acquiring speech and others not acquiring speech (e.g., Flippin et al.,
2010). Furthermore, few studies have examined the effectiveness of PECS in
establishing more complex verbal behavior beyond making requests, including
expressively labeling (tacting) items (e.g., “I see a ball”) or engaging in
conversations, and virtually no studies have system-atically evaluated Phases V
and VI (Tincani & Devis, 2010). How to and for which core skills? PECS is a
thoroughly manualized AAC system, which means that all the steps for conducting
training are specifi cally defi ned; the second edition of PECS: The Picture
Exchange Communication System Training Manual (Frost & Bondy, 2002)
provides step-by-step descriptions of various prompting, prompt fading,
reinforcement, shaping, and error correction strategies. Those who wish to
implement PECS are strongly encouraged to follow the manual’s highly prescribed
teaching procedures. PECS is effective for teaching users to request pre-ferred
items and activities. Although speech is viewed as a desirable out-come of the
system, implementers are discouraged from requiring speech of users unless they
speak functionally and independently of PECS. Embedding communication across
the day with PECS. As with all AAC strategies, it is critical to embed many
opportunities for communica-tion with PECS across the day. Implementers should
use naturalistic or incidental teaching techniques (e.g., Cowan & Allen, 2007) to
promote communication by providing contingent access to highly preferred items
throughout the learner’s environments or by “sabotaging” activities by requiring
the learner to emit a communicative response in order to com-plete an activity. For
instance, when a child reaches for something he or she wants, such as a favorite
toy, the parent could briefl y delay providing the toy until the child exchanges a
picture symbol to request it. Sabotaging involves identifying opportunities to
communicate within daily activities and then systematically altering activities to
promote communication. For example, while getting dressed to go outside a
teacher might put the child’s hat on his or her head and look for the child to protest
or request the hat. Also, if a child enjoys completing puzzles, his or her teacher
could hide a puzzle piece under the puzzle and then prompt the child to request
help to fi nd the piece by exchanging a picture symbol. Importantly, par-ents are
actively encouraged to participate in PECS as trainers and com-municative
partners in order for skills to generalize from school to home and community
While PECS is one of the most popular “low tech” AAC strategies avail-able, a
variety of “high tech” alternatives exists, as well. VOCAs (also called speech
generating devices or SGDs) are an aided AAC strategy in which the user activates
a switch on an electronic device to produce a spoken mes-sage (Rispoli et al.,
2010). VOCAs vary considerably in their technological sophistication and use,
ranging from simple devices comprised of four or fewer buttons (e.g., Olive, Lang,
& Davis, 2008; Schepis, Reid, Behrman, & Sutton, 1998) to sophisticated
computers with touch screens that enable the user to generate messages from an
array of vocabulary (e.g., Choi, O’Reilly, Sigafoos, & Lancioni, 2010). Unlike
PECS, VOCAs were not primarily designed for persons on the autism spectrum;
rather, anyone who lacks the ability to speak can use a VOCA to communicate.
British physicist Stephen Hawking is probably the most famous VOCA user.
Research supporting VOCAs. There have been a number of studies to evaluate the
effects of VOCAs on communicative skills of children with autism and other
developmental disabilities (Lancioni, O’Reilly, Cuvo, Singh, Sigafoos, & Didden,
2007; Rispoli et al., 2010). It is diffi cult to charac-terize the overall effectiveness
of VOCAs for children with autism because studies have used a variety of devices
and techniques. Much of the research has focused on VOCAs to teach basic
communication to students with autism and intellectual disabilities. For instance,
Olive et al. (2008) used a four-switch VOCA to conduct functional communication
training (FCT; discussed later) with a 4-year-old girl with autism, who was taught
to press a button to gain her mother’s attention. Decreases in challenging behavior
and increases in communication were observed with VOCA training. Less is
known about VOCAs as a comprehensive, primary communication system for
children with autism. Increasing prevalence of smart phones and other personal
technology devices capable of running speech-generating software creates the
potential for researchers to conduct broader evaluations. As mentioned earlier,
there are many VOCA systems available, rang-ing from one-button machines to
computers that generate speech from typewritten words. For example, Fatima uses
an AlphaSmart keyboard to communicate in five-plus-word sentences. She types
words and sentences into the computer and the computer generates a voice output.
Her parents taught her to use the AlphaSmart keyboard at age 4, because she used
no speech and mostly communicated through letters, but she seemed to be able to
understand most of what they said. Also, her parents noticed she spontaneously
made words with blocks and letters. She has started speaking in one- and two-word
phrases to communicate wants and needs. However, her expressive language skills
are above average with the use of the AlphaSmart. The AlphaSmart allows her to
participate in classroom activities, interact with peers, and have conversations
across adults in the school and in the community. She uses the AlphaSmart to
make choices during lunch in the school cafeteria, answer questions during small
and large group instruction, and get her needs met across the day. Perhaps most
importantly, the AlphaSmart allows Fatima to have developmentally appropriate
conversations with her peers across the day.
Evidence-Based Practices for Communication Skill
Acquisition Chapter 10
How to and for which core skills? Because many VOCAs are relatively easy to
use, requiring the user to press a single button for communication, they lend
themselves well to teaching basic functional communication skills. In one
example, Schepis and colleagues (1998) assessed the effects of a single-switch
VOCA and naturalistic teaching strategies on commu-nicative interactions of four
young children with autism. Children’s and staff’s communicative interactions
increased during play and snack activi-ties with the VOCA. Behavior shaping
techniques, including differential reinforcement, prompting and prompt fading, are
necessary for users to acquire independent use of their devices. As with any hightech device, cost and availability are signifi cant considerations (Tincani & Boutot,
2005). Devices should be maintained by an assistive technology specialist who can
train others in proper maintenance and use. Embedding communication across the
day with AAC. Similar to PECS and other AAC systems, it is important to conduct
a preference assess-ment to identify items and activities the student is likely to
request, and to arrange the natural environment so that these items are available
through use of the VOCA. A good fi t between the user and device is essential to
best outcomes. Implementation of the VOCA should proceed from a care-ful
assessment, including evaluation of the user’s receptive and expres-sive
communication skills, symbol comprehension, device preferences, and identifi
cation of functional vocabulary (Light, Roberts, Dimarco, & Greiner, 1998). Sign
Language VOCA and PECS are aided AAC systems that require the learner to
have a device for communication; however, children with autism can also be
taught sign language as a form of unaided functional communication. Individuals
with autism rarely learn American Sign Language; rather, vocabulary is identified
and children are taught to perform manual signs that represent spoken words
(Goldstein, 2002). Children often learn sign language in the context of total
communication, in which manual signs are paired with spoken words and the
learner is provided with reinforcement for speaking while signing (e.g., Carbone,
Sweeney-Kerwin, Attanasio, & Kasper, 2010). The goal of total communication is
to promote speech as well as sign use. An advantage of sign language compared to
PECS and VOCAs is that it does not require an apparatus for communication.
Therefore, the learner is able to communicate without the aid of special equipment.
Research supporting sign language. Few studies on teaching sign language to
children with autism have been conducted and these have yielded mod-est support
for sign language as a communication technique (Schwartz & Nye, 2006). For
example, Yoder and Layton (1988) randomly assigned 60 children with autism to
four teaching conditions: speech alone, sign FOR THE 178Educating Young
Children With Autism Spectrum Disordersalone, simultaneous presentation of sign
and speech, and alternating presentation of sign and speech. Results showed little
difference between conditions with sign language and conditions without sign
language on spoken word use, suggesting that sign language training had marginal
effects on spoken communication. Other investigators have used single-subject
designs to evaluate total communication for children with autism and intellectual
disabilities, fi nding more favorable outcomes (e.g., Carbone et al., 2010; Carr,
Binkoff, Kologinsky, & Eddy, 1978; Clarke, Remington, & Light, 1988); however,
more research is needed to establish sign language as an evidence-based
communication intervention for students with autism. How to and for which core
skills? Like PECS and VOCAs, sign language instruction should begin with an
assessment of the child’s preferences (e.g., Tincani, 2004). This can be
accomplished by asking parents, caregiv-ers, or teachers what the child likes and
then presenting items to see if the child will reach for them, indicating motivation
to communicate. To enhance the child’s acquisition, signs taught can be iconic,
which means that they resemble the items they represent (e.g., the sign for “ball” is
both hands cupped in the shape of the ball). Motor imitation skills affect a child’s
ability to learn sign language (Seal & Bonvillian, 1997)— children who have poor
motor imitation abilities may acquire fewer signs or make frequent errors when
signing. Therefore, communicative partners should be consistent in prompting and
reinforcing the same signs across set-tings. Prompt delay techniques, which
involve delaying the delivery of an item until the child signs, can be used to
encourage speech with sign language (Carbone et al., 2010; see Chapters 7 & 8);
however, caregivers should not require the student to speak unless he or she can
communi-cate clearly without sign language. Embedding communication across
the day with sign language. As with other AAC strategies, students need frequent
opportunities to communi-cate across the day to learn sign language. Caregivers
should capitalize on naturalistic teaching strategies to encourage communication.
For example, if a variety of highly motivating items are available during play
activi-ties, parents can use prompt delay techniques to encourage requesting of
preferred items (e.g. “I want the truck”) or commenting on relevant items (e.g.,
parent: “What color is the truck?” child: “Blue”). PIVOTAL RESPONSE
TREATMENT It is often reported that children with autism display limited or no
social interaction among typical peers, family, or community members (Koegel,
Koegel, Harrower, & Carter, 1999). PRT changes the environment to increase skill
acquisition and decrease challenging behavior, giving indi-viduals the proficiency
to participate meaningfully in inclusive settings FOR THE Evidence-Based
Practices for Communication Skill Acquisition(Koegel, Koegel, Harrower, &
Carter, 1999). Like other communication techniques described in this chapter, PRT
is based on the principles of applied behavior analysis, which assume that an
individual’s impairments can be improved with environmental manipulations, such
as prompting, reinforcement, and extinction (Baker-Ericzen, Stahmer, & Burns,
2007). PRT increases motivation and enhances generalization using natural-istic or
“loose” training techniques in the learner’s natural environment (Schreibman,
Kaneko, & Koegel, 1991). Pivotal areas are defined as those that, when changed,
generally produce large collateral improvements in other skill areas (Koegel,
Koegel, Harrower, & Carter, 1999). For instance, a child who can independently
gain another person’s attention will be more successful in a variety of play, school,
and family activities. Individuals with autism often struggle with initiating and
responding to peers, which may severely limit social and verbal learning
opportunities (Koegel, Koegel, Shoshan, & McNerney, 1999). In PRT, the
individual is allowed to choose the stimuli and the nature of the teaching
interaction, while the teacher, caregiver, or peer reinforces his or her attempts to
respond. Research Supporting PRT Naturalistic interventions such as PRT have
been shown to be effective in producing positive changes in complex social
behaviors of individuals with autism (Baker-Ericzen et al., 2007; Pierce &
Schreibman, 1997; Schreibman et al., 1991). Increases in social initiation,
reciprocal communication, func-tional language, and play skills are seen as a result
of PRT (Koegel, Koegel, Harrower, & Carter, 1999; Pierce & Schreibman, 1997;
Stahmer, 1999). One important finding in the research suggests that PRT is not
only effective in increasing language skills, but it can be implemented in natural
social envi-ronments with typical peers as trainers (Pierce & Schreibman, 1995,
1997). PRT is also designed as a parent-training tool to be used in the natural environment and thus promotes generalization across both environments and trainers
(Koegel, Koegel, Harrower, & Carter, 1999; Stahmer, 1999). How to and for
Which Core Skills? Core pivotal skills include increasing motivation to initiate and
respond in complex social, linguistic, and academic interactions. Peripheral
features of autism have been documented to improve, including self-help, expressive language, pragmatic language, and in academic areas. The model uses databased applied behavior analysis procedures that are positive, self-reinforcing, and
family centered (Koegel, Koegel, Harrower, & Carter, 1999). PRT is also often
used to increase play skills in children with autism, which may be important for
community and classroom integration and improvement of interaction and
language skills (Stahmer, 1999). It is imperative that naturalistic training
techniques used in PRT are conducted in loosely controlled contexts, with multiple
exemplars, and target individ-ual’s preferences in the teaching interaction (Pierce
& Schreibman, 1995). FOR THE 180Educating Young Children With Autism
Spectrum DisordersFor example, a child who is learning to say numbers could
practice them in school (e.g., during circle time, the child says the number of balls
on the floor), at home (e.g., at dinner, the child counts the pieces of chicken on his
plate), or in the community (e.g., at the store, the child counts the number of
quarters to purchase a piece of candy). Often during training, the peer or instructor
will use a manual in which the PRT strategies are represented both pictorially and
in written form. For example, seeking peer attention is a pivotal communicative
behavior because gaining joint attention of a peer increases play and reciprocal language opportunities. To teach a child with autism to seek joint attention, the peer
would first ensure the target child is attending. The peer would also ensure that
choices are given among highly preferred items or activi-ties to maintain
motivation. These items would then be varied frequently based on individual
preference. The peer would then model appropriate social behavior including
various verbal statements and complex play actions. Any attempt made by the
target individual to engage or function-ally play would be reinforced and
conversation would be encouraged by withholding desired objects until a verbal
response related to the object is emitted. The peer would also make attempts to
extend the conversation by asking follow-up questions and engaging in narrative
play. Turn tak-ing and complex social behaviors are targeted whenever possible,
such as using descriptive labels while making choices (e.g., “I want the blue
truck”; Pierce & Schreibman, 1997). Embedding Communication Across the Day
With PRT PRT is designed to be a technique for parents to use in the home environment that can easily be incorporated into their daily routines. The inter-vention
results in higher levels of positive parental affect, as opposed to interventions that
require parents to designate specific periods of time to teach (Stahmer, 1999).
Teaching initiations and other pivotal responses are likely to reduce parental stress
by transferring responsibility to the child. Most parents find that these steps are
relatively easy to implement and enjoy being able to interact and play with their
children (Koegel, Koegel, Shoshan, & McNerney, 1999). FUNCTIONAL
COMMUNICATION TRAINING Individuals with autism often engage in
challenging behaviors that likely serve a specific social function. Reinforcement of
problem behav-ior falls into two broad classes: escape/avoidance and attention
(Carr & Durand, 1985). It is assumed that if individuals can gain access to desired
consequences at a higher rate with a new functional response, they will increase
their use of this new response and thus reduce their use of the undesired response
(Durand & Carr, 1992). An intervention strategy that FOR THE Evidence-Based
Practices for Communication Skill Acquisitionuses communication as a
functionally alternative response to aberrant behavior is called Functional
Communication Training (FCT; Carr & Durand, 1985). FCT generally includes
two major components. Initially, a functional assessment is conducted to identify
consequences maintaining the prob-lem behavior. After the consequence(s) have
been identified, the child is taught to perform an alternative functional response
(e.g., signing, exchanging a picture symbol, activating a VOCA switch) that results
in the same consequence(s) (Fisher, Piazza, Cataldo, Harrell, Jefferson, & Conner,
1993). The rationale behind this approach is that students will be less likely to
engage in challenging behaviors if they can gain access to reinforcement by
exhibiting the alternative functional response (Shirley, Iwata, Kaung, Mazaleski, &
Lerman, 1997). Research Supporting FCT Research on FCT has consistently
shown success in promoting func-tional communication as a replacement for
problem behavior such as severe aggression, self-injurious behavior, and violent
tantrums, which significantly restrict the lives of the individuals with autism and
intel-lectual disabilities (e.g., Durand & Carr, 1991; Shirley et al., 1997). FCT has
been successful in reducing undesired behaviors that are maintained by attention,
tangibles, escape, and sensory input (Carr & Durand, 1985; Durand & Carr, 1992;
Wacker et al., 1990). By strengthening an alternative response that results in
reinforcement, the child is placed in active con-trol over his or her own
reinforcement rather than a passive recipient of reinforcement from an instructor
(Carr & Durand, 1985; Durand & Carr, 1991). When used in conjunction with
extinction procedures, FCT provides a significant decrease in aberrant behavior
and an increase in functional communication (Hagopian, Fisher, Sullivan, Aquisto,
& LeBlanc, 1998; Shirley et al., 1997). FCT has been shown to promote
maintenance of func-tional communication over time and generalization of
communication across environments and trainers, including parents, because FCT
gives the individuals the tools they need to communicate across environments and
tasks and with other individuals (e.g., Derby et al., 1997; Durand & Carr, 1991,
1992). How to and for Which Core Skills? The first step in conducting FCT is to
identify the problem behav-ior, through a combination of parent and teacher
interviews and direct observation. Prior to the implementation of FCT, a functional
behavioral assessment (FBA) is conducted to determine the function(s) of the
problem behavior (Wacker et al., 1990). Based on the individual abilities of each
par-ticipant, a replacement form of communication is chosen that has a lesser
response effort and serves the same function as the problem behavior. For FOR
THE 182Educating Young Children With Autism Spectrum Disordersexample, if a
child engages in self-injurious hitting to obtain assistance from a parent, then he or
she could be taught to place a picture symbol in the parent’s hand to request
assistance as a functional alternative. Critically, the response taught should be one
that others are likely to rec-ognize and reinforce (Durand & Merges, 2001). For
example, if the replace-ment behavior involves using a VOCA in a noisy
classroom, it might be beneficial to teach the student to approach somebody so that
the message is clearly understood. The replacement behavior, asking for help, is
then systematically reinforced while the problem behavior, self-hitting, is not
reinforced. Importantly, FCT is effective in teaching appropriate attention seeking,
access to tangibles, escape from work, or sensory input. The steps for conducting
FCT are illustrated in Figure 9.1. For example, FCT was used to teach DJ to
communicate wants and needs across the day. DJ used one-word utterances that
were about 50% intelligible. When he turned 3, he started exhibiting increased
tantrums than often lasted more than 10 minutes. These were disruptive to the family and a major concern for the childcare staff. The tantrums had escalated such
that the staff had discussed excluding DJ from many classroom activities and were
considering removing him from the childcare program. However, DJ’s
developmental specialist suggested they try FCT training. They conducted a
functional assessment and determined the function of DJ’s tantrums were to obtain
preferred toys, activities, and adult atten-tion. The developmental specialist worked
with DJ’s parents and the staff to teach him signs for “more,” “help,” “computer,”
and “train.” These represented his favorite items and allowed him to appropriately
ask for adult attention and preferred items. The staff prompted him to use these
signs throughout the day, and DJ was only provided adult attention or preferred
toys when he appropriately requested them (see Chapters 7 and 8 for prompting
and reinforcement strategies and Chapter 11 for positive behavior support
strategies). Embedding Communication Across the Day With FCT Derby et al.
(1997) presented a comprehensive model for conducting FCT in home settings and
provided data to support successful, longer-term implementation of FCT. They
sought to extend the literature on FCT by following students for at least 6 months
with regularly scheduled follow-up visits and probes for maintenance of learned
communicative responses. Participants were four children enrolled in a long-term,
in-home, early intervention project. The problem behaviors exhibited by the
participants were assessed through an FBA and were more likely to occur when
parents provided attention and/or escape from a nonpre-ferred activity in response
to them. Thus, during FCT, participants were exposed to intervention packages in
which they were taught alternative, more appropriate ways to request attention
and/or escape, while parents ignored inappropriate behaviors. The study showed
long-term reduction FOR THE Evidence-Based Practices for Communication Skill
AcquisitionVignette: JamieJamie is a 3-year-old girl who has recently been
diagnosed with autism. She attends an inclusi