Wednesday June 23, 2010 Functional Communication Training (FCT)

1. Wednesday June 23, 2010 Functional Communication Training (FCT)

2. START/NPDC Summer Institute June 2010 Functional Communication Training (FCT) Mary Garrigus & Maureen Ziegler Mary Thomas & Beth Economou

3. Promoting Functional and Social Communication in Children and Adolescents with ASD: Evidence-Based Practices

4. Evidence-Based Practices: Functional Communication Overview Review the communicative characteristics of learners with ASD Identify EBPs that target communication Describe the implementation of EBPs with individual students: PECS Naturalistic strategies Functional communication Speech generating devices Explain NPDC, START & Hartland steps of Functional Communication Overview

5. Expressive Communicative Characteristicsof Learners with ASD • May not develop speech, or develop an alternative method of communication such as pointing or gesturing • Have speech, then lose it • Speak on very narrowly focused topics • Difficulty in talking about abstract concepts • Lack or impairment in conversational skills • Repeat words or phrases instead of using normal language (echolalia) Sicile-Kira, 2004

6. Expressive Communicative Characteristics of Learners with ASD “…some forms of delayed echolalia were produced with evidence of communicative intent, while others were not.” Prizant and Rydell, 1984

7. Receptive Communicative Characteristics of Learners with ASD • Do not appear to understand simple requests • Difficulties with receptive vocabulary tied to difficulties with joint attention (Schreibman, 2005) If Mom points to the ball and says, “Ball,” the child needs to be able to move attention from Mom to the ball and understand that the word she is saying is related to the object in front of him.

8. Pragmatic Communicative Characteristics of Learners with ASD • Difficulty with the back-and-forth of conversation; reciprocity • Differences in eye contact, facial expression, body language • May not pick up on nonverbal cues • Unusual prosody and/or tone • Very concrete language; little “tact”

9. EBPs that Target Communication • Computer Aided Instruction • Differential Reinforcement • Discrete Trial Training • Functional Communication Training • Imitation and Modeling • Joint Action Routines • Picture Exchange Communication System • Pivotal Response Training • Self-Management

10. EBPs that Target Communication (continued) • Peer Mediated Intervention and Instruction • Video Modeling • Speech Generating Devices • Music Therapy • Social Narratives • Naturalistic Strategies

11. IEP Implementation Goal One Goal: Sam will improve expressive communication skills across the school day. Related Objective: Sam will request a desired item during snack and/or free choice time three times per day for two consecutive weeks.

12. How do we decide which EBP to use? Ask: What is our objective targeting? • Expressive Language Ask: What are our options?

13. How do we decide which EBP to use?

14. How do we decide which EBP to use? Next, make a decision based on: • Your professional expertise • The learner’s learning style • The learner’s temperament • The learner’s interests and motivators • Supports already in place • History of what has and hasn’t worked

15. How do we decide which EBP to use? Let’s say we know this… • Sam is in an inclusive elementary setting. • Sam is already using pictures for a visual schedule at school. • One of Sam’s classmates uses PECS, and Sam is interested in the pictures. • Sam does not like talking to most people and he is difficult to understand.

16. How do we decide which EBP to use? So, let’s say we decide to try… PECS Picture Exchange Communication System What does this look like for Sam?

17. PECS – Pre-Program StepAssess Reinforcers **Note: This is a great, formalized practice to determine what motivates learners and can be used outside of the PECS protocol. • Determines what activities and/or objects are truly motivational for a learner. • Will need to be updated periodically – for some kiddos, quite frequently! • Can be especially beneficial for this students who “aren’t motivated by anything!”

18. PECS – Pre-Program Step Assess Reinforcers Think outside the (cereal) box!

19. How do we decide which EBP to use? Let’s say we know this… • Sam is a fifth grader. • Sam is already involved in a “lunch bunch” that includes typically developing peers as well as other students with special needs. • The typically developing peers, Ryan and Nate, are interested in learning how to help Sam and his buddies.

20. How do we decide which EBP to use?

21. How do we decide which EBP to use? So, let’s say we decide to try… Naturalistic Language Training What does this look like for Sam?

22. Naturalistic Language Training Meeting the students where they already are! • Recess • Lunch • Home • Play Practice • Grocery Store • Job Sites

23. Naturalistic Language Training Step 1: Gather baseline data Sam’s teacher uses video to record lunch bunch. She observes that Sam frequently reaches toward Nate and Ryan’s lunches, vocalizes, and that the peer usually hands over the desired item, like a chip.

24. Naturalistic Language Training Pre/post data collection Training: parents, peers, teachers Video modeling Reflective practice/case-based discussion Self assessment (teachers, parents)

25. Naturalistic Language Training Step 2: Identify language strategies that can be embedded into routines. Sam’s teacher decides that peers can map language onto Sam’s nonverbal requests.

26. Naturalistic Language Training Step 3: Provide training and support to familiar people so that strategies can be used in daily routines. Sam’s teacher teaches Ryan and Nate signs for desired foods. She shows them how they can map language onto the activity for Sam, using simple phrases and lots of repetition.

27. Naturalistic Language Training Step 3: Provide training and support to familiar people so that strategies can be used in daily routines. Sam’s teacher, Nate, and Ryan role-play lunch bunch, practicing how the boys will respond when Sam reaches for desired items.

28. Naturalistic Language Training Step 4: Implement strategies within routines. Nate and Ryan use the strategies during lunch bunch. Sam’s teacher occasionally video records lunch bunch so that she can gather data and discuss how it’s going with Nate, Ryan, and the rest of Sam’s team.

29. Naturalistic Language Training – Next Steps Having peers available for choice making during some free-choice opportunities Increasing the vocabulary used during lunch bunch Increasing the number of peers trained to respond to Sam

30. IEP Implementation Goal Two Goal: Rosita will expression frustration with words, signs, or pictures rather than physical aggression. Related objective: When Rosita experiences frustration with difficult or challenging academic tasks, she will use words to request a break or assistance.

31. How do we decide which EBP to use? Middleand High School:

32. How do we decide which EBP to use? Next, make a decision based on: • Your professional expertise • The learner’s learning style • The learner’s temperament • The learner’s interests and motivators • Supports already in place • History of what has and hasn’t worked

33. How do we decide which EBP to use? Let’s say we know this… • Through the FBA process, the team determined that Rosita was using aggression when she became frustrated with her academic workload. • Rosita does have oral language, but tends to not talk very much. • Rosita is captivated by print and is a voracious reader.

34. How do we decide which EBP to use? So, let’s say we decide to try… Functional Communication Training What does this look like for Rosita?

35. Functional Communication Training Step 1: Identify behaviors and triggers for these behaviors, and the function/purpose of these behaviors Rosita becomes frustrated and self-injurious while working on math facts and while writing on assigned topics. Why?? Rosita is sent out of the classroom when she becomes self injurious.

36. Functional Communication Training Step 2: Provide a communicative response to the trigger which replaces the undesired behavior Rosita’s SLP creates a laminated sentence strip: “I need a break.” Strip is velcroed to Rosita’s desk.

37. Functional Communication Training Step 3: Support the student in using communicative response in the context of naturally occurring opportunities SLP observes Rosita’s behavior during math and sees signs of frustration. She cues Rosita to hand a sentence strip to the teacher. An SEA does the same during writing sessions. Rosita leaves the room for a break.

38. Functional Communication Training “But all she does is request breaks!” • What is the big goal?? • Honor the communication. • Limit the number of break strips • Facilitate Rosita’s breaks • Make them useful • Eventually shorten them

39. Functional Communication Training Step 4: Fade cues We get to the point where either the SLP or the classroom teacher can make eye contact with Rosita as she becomes heightened, and Rosita brings the sentence strip to the teacher.

40. Functional Communication Training:Next Steps Use sentence strips in other environments. Identify communicative responses to other inappropriate behaviors, and creating novel sentence strips.

41. IEP Implementation Goal Three Goal: Andre will use assertiveness skills in interactions with peers across school and community settings. Related objective: Andre will independently initiate interactions with peers during a structured group activity at least one time during a thirty minute time period, in four out of five opportunities.

42. How do we decide which EBP to use? Ask: What is our objective targeting? • Expressive Language/Initiation Ask: What are our options?

43. How do we decide which EBP to use? Middleand High School:

44. How do we decide which EBP to use? Next, make a decision based on: • Your professional expertise • The learner’s learning style • The learner’s temperament • The learner’s interests and motivators • Supports already in place • History of what has and hasn’t worked

45. How do we decide which EBP to use? Let’s say we know this… • Andre already has a GoTalk 9+ that he uses to make requests at home and in the community, but it is not used for anything other than these purposes. • Andre is part of a group that goes on community outings one each week.

46. How do we decide which EBP to use? So, let’s say we decide to try… Speech Generating Devices What does this look like for Andre?

47. Speech Generating Devices Important Question: What does a meaningful outcome look like? One person’s interpretation of success with a device can be another person’s evidence of failure.

48. Speech Generating Devices Step 1: Identify environments Andre likes to go bowling!

49. Speech Generating Devices Step 2: Identify vocabulary

50. Speech Generating Devices Step 3: Set up communicative opportunities • Andre’s SLP arranges for his community outings group to go bowling for three weeks in a row, so that Andre has opportunities to practice with his new board. Step 4: Allow learner to check out the device • Andre is allowed to fiddle with the board in the van on the way to the alley.