# Stimulus Control Refinements of Functional Communication Training in ID

> **NIH NIH R01** · RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL · 2020 · $484,473

## Abstract

Project Summary
Severe destructive behavior represents a comorbid condition of developmental disability for which risk
increases with intellectual disability severity, communication deficits, and co-occurring autism spectrum
disorder.24,78 Destructive behavior, such as self-injurious behavior and aggression, causes harm to the child
and others and increases the risk for institutionalization, social isolation, physical restraint, medication over-
use, service denial, and abuse.79 Clinicians have used functional analyses to identify the variables that
reinforce or motivate destructive behavior and to develop effective, function-based treatments.4 Functional
communication training (FCT) is an empirically supported, function-based treatment that decreases destructive
behavior. The clinician teaches the child to use the functional communication response (FCR) to request the
reinforcer for destructive behavior, and destructive behavior is on extinction during FCT.6,39 For example, if
functional-analysis results showed that attention reinforced destructive behavior, the clinician would provide
attention when the child used the FCR (“Play with me, please.”) and would not provide attention for destructive
behavior. One limitation of FCT is that relapse, an increase in destructive behavior after initially effective
treatment, often occurs when we transfer treatment to new therapists, caregivers, or settings or when change
agents implement it incorrectly.8,39,80,81 Behavior analysts describe relapse as (a)
renewal when the treatment
context changes (e.g., transfer treatment from clinic to home),12 (b) resurgence when the FCR does not
produce reinforcement,82 and superresurgence when renewal and resurgence co-occur and cause higher
levels of relapse than that produced by either alone,14 and (c) reinstatement when the caregiver mistakenly
provides reinforcement
at unplanned times.83 Our research from Period 1 of this project, based on behavioral
momentum theory, suggested that signaling when the FCR will and will not produce reinforcement during our
multiple-schedule FCT (mult FCT) procedure: (a) prevented extinction bursts, (b) facilitated reinforcement-
schedule thinning, and (c) prevented or mitigated relapse when caregivers did not deliver planned
reinforcement for the FCR.9 In addition, our related preliminary research showed that mult FCT often:
(a) rapidly reduced destructive behavior, (b) facilitated treatment transfer across contexts without
evoking renewal, and (c) reduced the need for a punishment component. We will conduct a randomized clinical
trial to compare the effectiveness of mult FCT to traditional FCT, which does not signal reinforcement
availability and unavailability, for mitigating renewal, superresurgence, and reinstatement. We also will test
whether mult FCT + stimulus fading, in which we conduct each context change in gradual steps, will further
reduce treatment relapse. This novel project has the potential to change the way research...

## Key facts

- **NIH application ID:** 10016377
- **Project number:** 5R01HD079113-08
- **Recipient organization:** RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
- **Principal Investigator:** WAYNE WILLIAM FISHER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $484,473
- **Award type:** 5
- **Project period:** 2014-07-11 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10016377

## Citation

> US National Institutes of Health, RePORTER application 10016377, Stimulus Control Refinements of Functional Communication Training in ID (5R01HD079113-08). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10016377. Licensed CC0.

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