Forty-two respondents (of whom 69.0% were identified as autistic) indicated how important it is to consider the child's emotional and psychological needs when choosing procedures. For example, one autistic adult wrote: “I think it helps to identify why the child is behaving negatively. First, respondents consistently reported that the child was the most important stakeholder in determining goals, learning contexts and procedures; that is, the child's perspectives are most important when making educational decisions.
Respondents from various stakeholder groups reported that child perspectives should be the highest priority in all aspects of educational decision-making, including setting goals, creating learning contexts, and choosing procedures. When considering these recommendations, respondents consistently reported that decisions will vary depending on the child's unique context and characteristics.
Improving Social Validity and Decreasing Restrictiveness of Established Behavioral Interventions for Preschoolers in Classroom Settings
During typical schedule rarefaction, neither functional communication nor challenging behavior results in access to functional-based reinforcement before the completion of the task direction or waiting interval ( Hagopian et al., 2011 ). Effective non-extinction FCT has been implemented for increasing functional communication and decreasing anti-aggressive and challenging behavior for young children. Dilution of the no-extinction schedule has been implemented effectively for increasing tolerance of delays and maintaining low levels of pre-cursor and challenging behavior for young children.
Is embedded schedule thinning without escape extinction effective in increasing delay tolerance and maintaining low levels of antecedent and challenging behavior for young children. We used the FAST and open-ended FAI to operationally define each participant's challenging behavior(s) and any precursor behaviors that reliably occurred before challenging behaviors. We also used the FAST and open-ended FAI to determine the reinforcer that maintains challenging behavior.
However, if the participant engaged in challenging behavior that depended on the physical stimulus within a session, the implementer planned to use an alternative prompt for the remainder of the session. FAST showed that pre-cursor and challenging behavior were likely to be evoked by escape from non-preferred activities to preferred items and activities, and this hypothesis was. FAST showed that pre-cursor and challenging behavior is likely to be evoked by escape from non-preferred activities to preferred items/activities.
FAST suggested that precursor and challenge behavior were likely elicited by escape from non-preferred activities to preferred objects/activities and adult attention, and this hypothesis was substantiated by open-ended FAI.
Trial-Based Functional Analysis (TBFA; Baseline)
Within the semi-structured interview, we collaborated with the teacher to select a controlling prompt for the participant. For example, if the teacher reports that the participant consistently followed a dot, we would select a gestural prompt. If the participant engaged in challenge behavior conditioned by the physical stimulus for three consecutive sessions, we planned to use an alternative request in all remaining sessions.
Subsequent classroom observations revealed that Benji engaged in challenging behavior in group contexts to avoid small and large group activities. If the hypothetical reinforcer involved escape from the inappropriate task or activity, the performer gave the task instructions, waited 5 s, gave the prompt, waited 5 s, and repeated this sequence if necessary. If the child engaged in pre-pointer or challenging behavior, the experimenter immediately returned the hypothetical reinforcer and removed all task instructions.
If the participant exhibited a behavior that was not assessed (e.g., automatically pressing the chin), the implementer ignored that behavior unless it was potentially dangerous or harmful. In these cases, the implementer intended to pay minimal attention to blocking or monitoring the typical parental response, to ensure the safety of the participant. Each neutral segment typically lasted 1 minute, but could be longer if the participant engaged in precursor or challenging behaviors carried over from the test segment.
These data indicate a clear functional link between the removal of the hypothesized reinforcer and the occurrence of precursor and challenging behavior.
Embedded Functional Communication Training (FCT) Experimental Design
At the beginning of the test segment, the implementer removed the reinforcer (for tactile and attention-maintained behavior) and/or provided a task direction (for escape-maintained behavior). After a certain waiting interval, the implementer gave a control request (eg, gestural, physical) to engage in the FCR. If the participant engaged in the FCR, the implementer provided access to the reinforcer to initiate the next control segment.
If the participant was not engaged in the FCR, the implementer (a) waited 5 s, (b) provided a more intrusive stimulus (if applicable) and waited 5 s, (c) demonstrated the FCR (e.g., tap the break icon and saying “I want a break” out loud), and (d) provided access to the reinforcer. If the participant engaged in the FCR at any point in this sequence, the implementer provided immediate access to the reinforcer. Depending on precursor behavior, the implementer (a) who engaged with a verbal (e.g., “Tell me on your device!”) and gestural prompt (e.g., point to icon), (b) continued to engage at the gestural incentive for a 5 s wait interval, (c) demonstrated the FCR, and (d) provided access to the reinforcer.
If the child engaged in the FCR prompt at any point during this sequence, the performer immediately returned the reinforcer. Depending on the challenging behavior or another instance of precursor behavior, the performer demonstrated the FCR and provided access to the reinforcer. If the participant engaged in the pre-cursor or challenging behavior more than three times in two consecutive sessions, the performer resumed the initial waiting interval of 0 s for the FCR.
During these sessions, the implementer pulled out a new toy at least once every 3 min, to create at least 10 possible search opportunities per session.
Embedded Delay Tolerance Experimental Design
Once on the green carpet, the implementer set a timer on her phone for the specified waiting interval, and showed it to Addie if she indicated interest in the timer (eg, reaching for the phone). If Addie was engaged in the FCR during the waiting interval, the implementer reminded her, "You can ask for a break when the timer beeps." If Addie started to move to the edge of the mat, the implementer would show her the timer and remind her how much time was left. For the first four sessions, no timer was used, and the implementer provided access to the toy bucket each time Caleb requested.
For the fifth and subsequent sessions, the implementer set a timer for the specified waiting interval at the beginning of the session. If Caleb engaged in an FCR for the toys during the waiting interval, the implementer reminded him, "You can ask for more toys when the timer runs out." If he asked several times within 30 seconds, the enforcer would silence the timer. If Caleb engaged in an FCR for more toys after the waiting interval, the implementer provided access to the toy bucket, said “You can pick one thing from the bucket,” and reset the timer.
If Caleb engaged in leading or challenging behavior at any point during the session, the implementer acknowledged his feelings (eg, “You seem to be feeling frustrated”). The implementer also interrupted the timer so that he could not access the toy bucket while he was off the bed. For the first session, no timer was set, and the implementer provided an additional 2-3 minutes of attention each time he requested.
For the second and subsequent sessions, the implementer set a timer when she removed her attention, reminding him, "You can ask me to play again when the timer beeps." If Caleb engaged in an FCR for attention during the waiting interval, the implementer reminded him, "You can ask me to play when the timer beeps." If he asked more than once in 30 s, the implementer silently gestured to the timer.
Generalization Experimental Design
The purpose of this session was to determine an appropriate initial interval for thinning the schedule. For Addie, pre-cursor and challenge behaviors remained low during schedule dilution (0–3 instances), relatively consistent with data from the FCT condition. For Caleb, pre-cursor and challenging behavior was extremely high and unstable during the initial dilution of the schedule (52, 20, and 68 cases/hour).
The FCR for pauses was also extremely high and unstable during the initial plan thinning (12, 28 and 20 cases/hour), and also decreased to near zero levels throughout both modified intervention phases (0 – 2.4 cases/hour). During schedule thinning for toys, FCR for toys showed some variability and typically fell close to criterion levels. During planning thinning for attention, FCR for attention was variable and high in the first five sessions (times/hour) and decreased to stable, lower rates for the last three sessions and 10.8 times/hour (10.8 times/hour, respectively).
Results indicated that FCT with these modifications was consistently effective in increasing functional communication and reducing pre-cursor and challenging behaviors among participants. We did not conduct a schedule thinning generalization session with Benji because we were unable to identify schedule thinning changes that resulted in increased delay tolerance. We recommend that researchers continue to investigate FCTs and design dilution adaptations in endogenous contexts with endogenous practitioners to make studies as useful as possible for the intended end users of these interventions.
Results from the FCT and thinning phases of the schedule indicate that for some children changes can be made to improve social validity without sacrificing efficacy. In this study, several changes were made to the traditional FCT and plan thinning to improve social acceptability and reduce restrictiveness. To improve the social validity of FCT and plan dilution in the classroom, we recommend that clinicians try these modifications, collect data on their efficacy, and make adjustments as necessary.
Note: CB = Challenging Behavior; FCR = functional communication response; PCB = precursor behavior; TBFA = trial-based functional analysis. Note: CB = Challenging Behavior; FCR = functional communication response; PCB = precursor behavior; TBFA = trial-based functional analysis; * = generalization to a new environment (classroom); ** = generalization to new practitioner (lead teacher); *** = added panel of silent volume tokens; for Caleb, PCB+CB exceeded the peak values of the graph for sessions 1 and 3 (n = 52, 68).
