Children with Autism
The Impact of Functional Communication Training and Extinction on Challenging Behaviors in Children with Autism
Activity Description For this assignment,
Develop an initial literature review draft. The literature review draft should be based on at least 10-12 peer-reviewed original sources within the past 5 years. Do not include book sources, secondary summary sources, or sources older than 5 years, unless the source is a peer-reviewed original seminal study essential for the foundational synthesis of the related research. The literature review draft should provide an objective discussion presenting a synthesis of the related concepts from the previous research findings, any identified contradictory concepts, and underlying related conceptual/theoretical framework(s) supported by APA formatted reference citations. Download and follow the Literature Review Supports file when developing the literature review draft. Length: 8-10 pages (include an additional page(s) containing APA formatted references) Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards. Be sure to adhere to Northcentral University’s
The articles used should be peer reviewed and or scientific and not older than 5 years. There should be an introduction and a conclusion.
The Impact of Functional Communication Training and Extinction on Challenging Behaviors in Children with Autism
Autism refers to a spectrum condition of brain development that affects the way people interact with others and perceive the world. Autism is basically characterized by difficulties in learning, temperament, difficulties in motor coordination, and difficulties in social interaction. Children with autism may also have other health issues like gastrointestinal disturbances and sleep disorders which make it more difficult for them to live independently. Children with autism may experience delays in language development and tend to repeat words spoken by others instead of formulating their own. It is very difficult for children with autism to participate effectively in everyday social, family, school and work life (Graff & Hall, 2012).
Graff and Hall (2012) argue that it is extremely important to intervene and introduce therapies that focus on addressing these particular challenges and increasing communicative competence of children with autism. Functional Communication Training is a very common behavioral intervention therapy whose main focus is to replace negative self-injurious behaviors with much more meaningful verbal or functional communication serving the same purpose as the challenging behavior. The individual is taught positive communication which is an alternative to the negative self-destructive behavior. Extinction refers to an Applied Behavior Analysis procedure of discontinuing reinforcement for a previously reinforced problematic behavior which decreases the frequency of those behaviors.
Impact of early intervention therapies
Randomized clinical control trials conducted on over ten participants have proved the benefits of early intervention therapies in reducing and eliminating symptoms in children with autism thereby enabling them to function without any special support. Single case studies and experimental designs have shown the positive effects of Functional Communication Training in reducing the verbal aggression, physical aggression, property destruction, self-injurious behaviors (SIB) and tantrums. Functional behavior assessment gathers information on the antecedents, behaviors and the preceding consequences of the behaviors on the person. Once these have been identified, the functions of the behaviors can then be speculated. Behavior functions include internal stimulations, tangible rewards and escape of situations. Behavioral interventions are then formulated based on the common functions of behavior (Durand & Moskowitz, 2015).
Functional communication training applies reinforcement-based strategies (positive and negative) to encourage desirable communication and reduce the frequency of self-injurious behaviors. The persons with autism are taught more appropriate and functionally equivalent communication forms such as sign language, speech or picture cards which they can use to get attention and communicate their needs. These communication responses reliably replace the self-injurious behaviors and they serve the same function as the problematic behaviors. Functional communication training promotes generalizations across settings and people in order to ensure the self-injurious behaviors are completely replaced with appropriate communication phrases (Durand & Moskowitz, 2015).
Single case experimental studies conducted on selected participants with autism have proved the effectiveness of extinction in improving the communication and social skills of the children. Extinction has been used successfully in children with autism to address challenging behaviors. The procedure can take different forms depending on what is causing the behavior. Extinction decreases the frequency of occurrence of problematic behavior because of lack of reinforcement. Generally, there is no positive reinforcement that will strengthen the behavior. The child with autism will then realize that the problematic behavior (for example outbursts and tantrums) no longer work and will, therefore, find more appropriate means of communicating to get reinforcement (Hupp, Symons & Wolff, 2012).
These reinforcement programs are now the foundations for addressing problematic behaviors for children with autism. According to Hupp, Symons & Wolf (2012) extinction occurs when a subsequent action following a behavior is systematically stopped until the frequency of the behavior reduces. For instance, a child with autism who is used to dropping his pencil on the floor to get the teachers attention will not continue dropping the pencil if the teacher continuously ignores the behavior and does not pick up the pencil for the child. Extinction procedure is very straightforward and does not require punishments or reinforcements.
Decreased Disruptive behaviors
The results of randomized control trials performed on more than ten participants prove that teaching children with autism communicative phrases greatly helped in reducing destructive behaviors. A good example is a child who displays self-injurious behaviors when given a difficult task. The child is taught how to say he does not understand how to do the task instead of throwing tantrums. In this regard, the phrase “I don’t understand” was very effective at reducing the self-injurious behavior since the adult provided assistance with the difficult job. Children who display excessive tantrums should, therefore, be taught appropriate communication phrases as early as possible to reduce the challenging behaviors. Over time, the children will learn that reinforcement will still be received through appropriate communication and not self-injurious behaviors (Carr, Fisher & Roane, 2016).
Improved communication skills
Group research designs show that children with autism who are not able to speak verbally can also be taught to use augmentative communication forms such as signing and touching instead of the destructive behaviors. If a certain destructive behavior is caused by positive reinforcement like wanting to access a preferred item, the individual can be taught to sign “please” instead of throwing tantrums. This promotes the use of appropriate communication phrases and decreases the challenging destructive behaviors of persons with autism. The challenging behavior is minimized as long as reinforcement is received. When positive communication did not result to reinforcement, self-injurious behaviors increased (Carr, Fisher & Roane, 2016).
According to Koegel, Ashbaugh & Bradshaw (2014), all the disruptive behaviors exhibited by children with autism have a communicative function. The self-injury, tantrums and general aggression are all secondary symptoms that come as a result of failure to address key primary symptoms. Functional communication training is mandatory in eliminating or reducing these symptoms. Adults with autism also experience anxiety and depression as a result of difficulties with socialization. Recent research indicates anxiety and depression may be minimized and even eliminated if the individuals are trained on using appropriate communication phrases. Failure to provide Functional Communication Training may lead to grave consequences for the children with autism because the core area (communication) will be a problem.
Improved emotional and social skills
Functional communication training and extinction help children with autism to develop emotional, behavioral, academic and social skills important for success in their education. Research studies show that there is a direct correlation between social competence and school success (Doubet & Ostrosky, 2014). Randomized control trials show the positive impact of Functional communication training and extinction in minimizing challenging behaviors caused by lack of social and emotional skills. These problematic behaviors such as property destruction, aggression towards peers and self-injury normally interfere with social interactions and learning. These therapies are very important in equipping children with autism all the skills they need to begin their school work.
Koegel, Ashbaugh & Bradshaw (2014) also argue that Functional Communication Training leads to financial savings for the families of children with autism in regards to the overall costs incurred. This intervention technique helps to address the key symptoms of autism which prevent the occurrence of the secondary symptoms. Untreated symptoms of autism usually develop and become more severe after a certain period of time requiring much more expensive and substantive treatment plans which greatly affects the financial position of the families. Functional Communication training helps to reduce these costs to the minimum as well as improving the quality of life for children with autism.
Reduced parental stress
These early intervention tools and techniques also help to minimize the coincidental stress for the parents of children with autism. Raising a child with autism is not easy since the parents have to make adjustments to their life. Various stresses may emerge over time bringing feelings of grief to the parents. The parents may experience shock, tremendous guilt, denial, sorrow and even rejection. Functional Communication Training and extinction helps the parents of children with autism not develop complicated health problems. The parents are empowered and they become much more confident when raising their children. This benefits both the children with autism and their parents (Graff & Hall, 2012).
The challenging behaviors displayed by children with autism negatively affect their self-esteem. Single case experimental designs conducted on school-aged children with autism between 9 and 22 years have proved that intervention therapies reduce the occurrence of destructive behaviors thereby leading to increased self-esteem of the children. The negative social stigma towards persons with autism generally decreases improving the quality of their lives. Functional communication training reduces the seriousness of these problematic behaviors and reduces negative attention from the public. The children will, therefore, cope better with life challenges and unexpected situations (Binns et al, 2015).
Functional communication training and extinction also empower children with autism and their families to successfully participate in community activities. Group research designs indicate that these therapies help in improving family and community relationships. The children are able to communicate and socialize with their peers normally. The early intervention support therapies minimize developmental delays improving the overall quality of life and well-being. Social interaction will reduce anxiety levels, frustration and the extremely aggressive behaviors of the children with autism. Socially appropriate behaviors are enhanced thereby increasing social skills of the children (Canagasabey et al, 2012)
It is evident from the randomized clinical trials and single-case experimental designs conducted that the symptoms of autism can be eliminated with these early intervention therapies. Functional communication training helps to typically put challenging and destructing behaviors on extinction. Even though the problematic behavior is expected to reemerge sometime during the process of reinforcement, appropriate stimulus controls can help to strengthen the communicative response. These therapeutic interventions help children with autism to function without the need for any special support and fit well in the society. The children are able to engage in normal leisure activities and even get employment later on in life. It is however very unlikely that the children will function normally without early intervention therapies (Durand & Moskowitz, 2015).
Limitations of methodologies applied
There are a few challenges encountered when randomized control trials are applied to behavior interventions for children with autism. The heterogeneity of children with autism makes it hard to determine the participants responding to a specified behavior intervention program and the degree of response. For instance, a verbal child with autism may respond better to an intervention therapy as compared to a non-verbal child with autism. Secondly, it is very difficult to have a non-intervention control group unlike in medication studies because all parents look for therapies to help their children. Group research designs also provide limited amounts of information about the participants.
However, it is important to address the challenges of the above intervention therapies. Resistance to change is likely to cause some difficulties in the implementation of the above therapies. The procedures may initially lead to an increase in the target problem such as the emergence of even more aggressive behaviors. There will be many extinction bursts during the process of reinforcement. Before giving up on long-practiced routines, the children with autism will make desperate attempts to try and demand what they were accustomed to. These are temporary increases in the problematic behaviors that occur when previous conditioned behavioral responses no longer attract reinforcement. This should be expected when the extinction therapy is being initiated.
Unlike Functional communication training, extinction procedures do not teach children with autism the most appropriate method for obtaining reinforcement. This method should, therefore, be coupled with other reinforcement based therapies to improve the effectiveness. The combination of different behavioral therapies also reduces the likelihood of extinction outbursts at the onset of the intervention programs (Hupp, Symons & Wolff, 2012).
There are also cost implications for conducting functional communication training. The parents of children with autism and the government (through Medicare) have to pay professionals for them to train the children. These costs vary depending on the experience and type of training professionals as well as the total number of sessions. Reinforcement of the replacement behavior can, therefore, be a costly venture for parents who are not financially stable. More experienced speech pathologists and psychologists charge higher rates which severely affect the family’s finances (Graff & Hall, 2012).
Due to the worldwide increase in the prevalence of children diagnosed with autism, it is important to identify autism symptoms early enough and come up with intervention strategies. These intervention programs are crucial to minimizing the poor outcomes previously experienced for children with autism. Before comprehensive intervention programs were available, the majority of children with autism ended up in undesirable living conditions mostly in mental institutions and locker wards of hospitals. However, there is hope for persons with autism because of the emergence of behavior management therapies and communication improvement methods. Many researchers now argue that autism is no longer a permanent disability and can be managed with appropriate intervention therapies.
Functional communication training can help children with autism improve their communication skills, self-esteem as well as emotional and social skills. Extinction procedures also help to minimize on the negative self-injuring behaviors and replacing these with more appropriate behaviors. These therapies help to reduce the stress levels of parents. The parents will also save on costs that will be incurred in case the initial symptoms are not addressed. These therapies also help to promote effective participation of the children with autism in the community since they feel more accepted by their peers.
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