Improving functional communication
By Dan Allard
Many children struggle with basic communication skills that most of us take for granted. With a strong body of evidence to support its benefits, functional communication training has become a trusted intervention for speech and language therapists across the globe.
The Communication Trust says that over one million children in the UK have some form of long-term and persistent speech, language and communication difficulty – that's the equivalent of two to three children in every classroom.
The ability to communicate wants and needs comes naturally to most children. However, those suffering from autism and other disabilities can struggle to express even the most basic thoughts and desires. That can result in challenging behaviour, ranging from tantrums and disobedience to aggression, destructive acts and self-harm. According to the Communication Trust, two thirds of 7-14 year olds with serious behaviour problems have language impairment.
What is functional communication training?
A highly effective tool for those in speech and language therapy, functional communication training aims to replace challenging behaviour with meaningful communication that's socially acceptable. Used alone or in conjunction with other behavioural therapies, it gives the child alternative ways to express their thoughts and feelings, taking away much of the frustration they feel because of their inability to communicate.
How does it work?
The first step is for the speech and language therapist to find an appropriate means of communication for the child. The majority of us naturally use a combination of spoken words, gestures and body language. A child with significant speech and language disability may struggle with articulating their feelings, but they may be able to use other forms of communication, such as gestures, sign language or pictures.
The idea is to give the child some form of communication that's easy for them to use and for parents, carers, health professionals and other adults to understand. It's about having a basic communication framework on which to build meaningful progress in speech development.
Once the speech and language therapist has found a form of communication the child is comfortable with, and has taught them to use it, they can gradually associate the child's responses with language by suggesting and reinforcing relevant words. The child can then be encouraged to use those words in addition to or instead of the gestures or other forms of communication they've been using.
The effectiveness of functional communication training – what's the evidence?
Functional communication training is widely used by practitioners in a variety of healthcare roles, including psychologists and speech and language therapists. Research into its effectiveness goes back over thirty years to a study carried out by autism treatment pioneers Edward Carr and Dr V M Durand. In 2018, a systematic review of literature by researchers at Baylor and Purdue Universities in the USA found that functional communication training is an evidence-based practice which consistently results in the reduction of challenging behaviour in children with disabilities.
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