Reinforcement schedule thinning following functional communication training: A systematic review

Abstract

Functional communication training (FCT) is a highly effective intervention to reduce challenging behavior. However, continuous reinforcement of the functional communicative response typically used during FCT cannot be maintained in natural settings. Reinforcement schedule thinning addresses this drawback. In order to better inform practice and future research, we conducted a systematic review of all peer-reviewed studies published between the years 1985 and 2022 that implemented schedule thinning following FCT. We identified 82 articles with 296 participants and 401 applications of schedule thinning. We summarized each application according to characteristics of the participant, FCT, and schedule thinning procedure. We identified nine unique schedule thinning procedures. The four most prevalent were multiple schedules, chained schedules, delay-to-reinforcement, and response restriction with a correlation between the function of challenging behavior and the selected schedule thinning approach. Notably, there was great procedural variability across each procedure. Very few studies were conducted in natural settings or involved natural change agents in selecting the terminal schedule of reinforcement or as schedule thinning implementers. Although there is ample evidence supporting the efficacy of schedule thinning after FCT, more research is needed to determine the most effective procedures necessary to ensure that the benefits of FCT can be maintained via schedule thinning in natural settings.