Addressing Challenging Behavior | Organization for Autism Research

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OAR’s Board of Directors authorized funding for this study in October 2017. Virginia Walker, Ph.D., BCBA-D, an assistant professor who transferred to the University of North Carolina at Charlotte mid-year, is now conducting her OAR-funded study. Dr. Walker’s study brings the total number of applied studies funded in 2017 to seven.

Many students with autism exhibit challenging behavior, which can lead to negative academic, vocational, and social outcomes. Breakdowns in communication are a primary reason for challenging behavior among students with autism. It’s not hard to understand: if a student cannot effectively communicate their needs or wants, they learn to accomplish those goals through the use of challenging behavior. When looked at that way, challenging behavior serves a purpose.

Augmentative and alternative communication (AAC) can help students with autism communicate their needs in a more healthy and effective manner, and improve their overall social, academic, and communication skills as well. The American Speech-Language-Hearing Association describes AAC as using “a variety of techniques and tools, including picture communication boards, line drawings, speech-generating devices (SGDs), tangible objects, manual signs, gestures, and finger spelling, to help the individual express thoughts, wants and needs, feelings, and ideas.” However, even with AAC, challenges in communication still exist and can still lead to challenging behavior as students try to communicate their wants and needs.

Study Goal

The purpose of this study, “Training Paraprofessionals to Implement FCT with Students with Autism Who Use AAC,” is to evaluate the effectiveness of training paraprofessionals on how to implement functional communication training (FCT) to address challenging behavior in students who use AAC.

Functional communication training, or FCT, is an evidence-based practice for students with autism that is delivered through on-the-job coaching. It can be an effective behavioral intervention to teach socially acceptable replacement behaviors for less adaptive ones.

Study Format

The study is divided into two phases:

  • Intervention phase 1: Dr. Walker will deliver training to four paraprofessionals through workshops and coaching sessions. Those four paraprofessionals will deliver FCT to four students with autism who use AAC. Students who participate in the study will have been identified as engaging in persistent challenging behavior that causes harm to themselves or others, interferes with learning, and/or socially isolates them.
  • Intervention phase 2: Walker will train and supervise four special education teachers as they provide workshops and coaching sessions to the paraprofessionals they supervise. Those paraprofessionals will in turn deliver FCT to four students.

While Dr. Walker noted that FCT interventions for the study will be developed based on the needs and histories of each individual student, she did supply some information about how FCT interventions work generally. In the first step of FCT, practitioners identify the communicative function of challenging behavior, using a variety of methods including interviews, surveys, observations, and functional analysis. In the second step of FCT, practitioners choose a response that can replace the challenging behavior. For students with complex communication needs, the response will often involve AAC. In the third step of FCT, students are taught the replacement response, with reinforcement given for using that response rather than challenging behavior.

Evaluation

Dr. Walker will evaluate the effects of the workshops and coaching sessions on paraprofessional implementation of FCT by using a checklist of FCT strategies throughout the study, such as during the baseline and intervention sessions, live observation, and video recording. She will also evaluate audio recordings of the special education teachers conducting the workshop and coaching sessions during the second phase of the study.

In addition, the paraprofessionals and special education teachers will complete an online social validity questionnaire to evaluate the effectiveness and feasibility of the workshop and coaching sessions as well as how well the FCT worked.

Practical Relevance

The outcomes of this study could help students with autism who use AAC to have a more meaningful and equitable school experience, with a reduction in the challenging behavior that limits meaningful instruction, social opportunities, and access to inclusive settings with peers without disabilities.

Because the study offers intervention training to paraprofessionals, it may address the need to equip paraprofessionals with the knowledge and skills necessary to implement effective behavioral interventions. Additionally, it can provide information to schools and school systems about how to design effective and cost-efficient paraprofessional training practices.


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