Article

Journal of Special Education Technology

1-9
Effects of Functional Communication ª The Author(s) 2018
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DOI: 10.1177/0162643418783479
journals.sagepub.com/home/jst
Application on Challenging Behavior
of Children With Autism
Spectrum Disorder

Reem Muharib1 , Vivian I. Correa1, Charles L. Wood1,

and Kathryn L. Haughney1

Abstract
This study investigated the effects of a functional communication training intervention consisting of systematic prompting and natural
reinforcement on the challenging behaviors of two children with autism spectrum disorder aged 5 and 6 years old. Children who had
a history of challenging behavior, consisting of self-injury and disruption, were taught to request preferred stimuli through the
GoTalk Now™ application on an iPad®. Using a reversal design, the findings demonstrated a functional relation between functional
communication training with the use of the GoTalk Now application and the decreased levels of challenging behaviors. Specifically,
one child demonstrated zero levels of challenging behaviors and one child showed a less substantial decrease of challenging behaviors
during intervention phases. Directions for future research and implications for practice are discussed.

Keywords
functional communicating training, autism spectrum disorder, speech-generating devices, challenging behavior

Language and communication deficits are among the main Fox, 2003). Research has shown a relation between the lack
characteristics of children diagnosed with autism spectrum dis- of language and speech skills and challenging behaviors (Kai-
order (ASD; American Psychiatric Association, 2013). In fact, ser, Cai, Hancock, & Foster, 2002; Park, Yelland, Taffe, &
it has been estimated that 30% of children with ASD never Gray, 2012; Schroeder, Schroeder, Smith, & Dalldorf, 1978),
develop functional spoken language (Wodka, Mathy, & Kalb, putting children with ASD at greater risk than children without
2013). Named as an urgent priority for future research (Light & a diagnosis of ASD (McClintock, Hall, & Oliver, 2003). Sev-
Drager, 2007), interventions designed to support young chil- eral variables may increase the chances of developing challen-
dren with deficits in speech and language skills often rely on ging behaviors in this population. These variables include lack
alternative means of communication to support competent of social and communication skills, intellectual disabilities, and
communication growth (Neidert, Rooker, Bayles, & Miller, accompanied comorbid psychopathological disorders (Matson
2013). Due to deficits in oral communication and language & Nebel-Schwalm, 2007). In addition, Matson, Wilkins, and
skills, communication patterns in children with ASD can Macken (2008) found a correlation between the severity of
appear more frequently as challenging behaviors such as challenging behaviors and the severity of ASD symptoms.
aggression, property destruction, and self-injury (Chung, Children who exhibit challenging behaviors can cause harm
Jenner, Chamberlain, & Corbett, 1995). In a longitudinal study, to themselves and others which can greatly impede their learn-
Sigafoos (2000) found lower levels of communication skills ing (Sigafoos, Arthur, & O’Reilly, 2003). Moreover, children
were associated with more severe challenging behaviors in with challenging behaviors have more difficulties socially
young children with developmental disabilities. A more recent
study indicated that 50% of children with ASD have challen-
1
ging behaviors and that those challenging behaviors are used as University of North Carolina at Charlotte, Charlotte, NC, USA
a form of expressive communication (Chiang, 2008).
Corresponding Author:
Challenging behaviors can be defined as any repeated pat- Reem Muharib, University of North Carolina at Charlotte, 9201 University
tern of behavior that affects the child’s learning or affects her City Blvd., Charlotte, NC 28223, USA.
social interactions with other children or adults (Smith & Email: [email protected]
2 Journal of Special Education Technology XX(X)

integrating in school and community (Koegel, Koegel, Hurley, & Alzrayer, 2018) and more portable. Additional research to
& Frea, 1992; Sigafoos et al., 2003). In fact, children with examine various application of SGDs using handheld technol-
severe challenging behaviors are also at risk of long-term inpa- ogies is needed to provide evidence across the rapidly expand-
tient care (Emerson, 2000). Recognizing these effects of chal- ing options available to support SGD communicators (e.g.,
lenging behaviors, there is no doubt that these behaviors must Ganz, 2015).
be a treatment priority (O’Reilly et al., 2010). As challenging To examine FCT with an SGD, Franco et al. (2009) taught a
behaviors start during the early years of childhood (Einfeld & child with ASD, challenging behaviors, and no functional
Tonge, 1996), early intervention becomes necessary. speech to request breaks and preferred tangibles using a
One way to mitigate challenging behaviors in children with GoTalk Now device. The data indicated a decrease in the
ASD is functional communication training (FCT; Carr & Dur- child’s inappropriate vocalizations; however, the study only
and, 1985). The FCT process consists of two sequential steps: showed two demonstrations of an effect. Similarly, Olive,
(a) assessing the challenging behavior by one or more func- Lang, and Davis (2008) evaluated the effects of FCT and an
tional assessments and (b) teaching a new alternative behavior SGD (i.e., Four Button Touch Talk Direct) on the aggressive
as a communicative response (Durand & Merges, 2001). The behaviors, maintained by attention, of a young child with ASD.
theory behind FCT is that challenging behaviors can serve as The child’s mother was trained to prompt her child to press a
communicative acts to gain attention/tangibles or avoid aver- button on the device to request attention and immediately
sions (e.g., demands). Therefore, when a child is taught a more responding to the child’s request by giving the child attention.
appropriate way of communication (i.e., a functional commu- Although the data showed a decrease in aggressive behaviors
nication response [FCR]) that serves the same function as the during intervention, data on independent SGD-based request-
problem behavior, the challenging behavior will be ineffective, ing were variable. Additionally, the child was able to general-
and hence, stop occurring (Carr & Durand, 1985). In addition, ize requesting in the third and fourth activities before the
FCT relies on an establishing operation (EO) which is a moti- intervention took place, which jeopardized experimental con-
vating operation that evokes behavior and increases that value trol. The results suggested a promising direction for future
of a reinforcer (Cooper, Heron, & Heward, 2007). In other studies to demonstrate an effect for FCT using an SGD.
words, when children are deprived of a reinforcer, they are Sigafoos et al.’s (2013) study was the first to introduce an
more likely to engage in behavior, whether appropriate or inap- iPad as an SGD and measure the impact on challenging beha-
propriate, to access the reinforcer. Thus, identifying the func- viors of young children with ASD. Sigafoos et al. taught two
tion(s) of the challenging behaviors and the potential young children with ASD, challenging behaviors, and no func-
reinforcers are key steps for FCT (Neidert et al., 2013). tional speech to request the continuation of toy play via
FCT for children with ASD has strong empirical support Proloquo2Go® application. In addition to the systematic
(Kurtz, Boelter, Jarmolowicz, Chin, & Hagopian, 2011; Wong instruction procedures used in previous studies (e.g., Falcomata
et al., 2013). Researchers have examined FCT effects by teach- et al., 2013; Neidert et al., 2005), the researchers introduced a
ing children with ASD and challenging behaviors to commu- toy play interruption. In other words, the toy was retrieved from
nicate vocally or by using picture cards or manual signs the child after 30 s of play. The results demonstrated an
(Falcomata, Wacker, Ringdahl, Vinquist, & Dutt, 2013; Greer, increase in SGD-based requesting; however, the effects on
Fisher, Saini, Owens, & Jones, 2016; Neidert, Iwata, & Dozier, challenging behaviors were less substantial. Furthermore, the
2005; Rispoli, Camargo, Machalicek, Lang, & Sigafoos, 2014). researchers did not conduct functional behavior assessments to
Across those studies, systematic instruction consisting of var- confirm the challenging behaviors of the children were actually
iations of prompting, time delay, and reinforcement were used maintained by access to toys, demonstrating the need for sub-
to teach children to emit the new communication response(s). sequent inquiry.
Although Neidert, Iwata, and Dozier’s (2005) study showed Although the studies reviewed suggested promising results
only two demonstrations of an effect, the other studies demon- of the effects of FCT using SGDs (Franco et al., 2009; Olive,
strated a functional relation and positive impact of FCT on Lang, & Davis, 2008), neither study showed three demonstra-
children’s challenging behaviors whether those behaviors were tions of the intervention effect (Kratochwill et al., 2013). Addi-
maintained by attention, escape, or access to tangibles. tionally, whereas Franco et al. (2009) and Olive et al. (2008)
In addition to teaching children with ASD to use appropriate conducted functional behavior assessments to determine the
vocal phrases, picture cards, or manual signs as an alternative function(s) of children’s challenging behaviors, Sigafoos
for challenging behaviors, researchers have examined speech- et al. (2013) did not. That is, Sigafoos et al. provided a demon-
generating devices (SGDs) for children with no functional stration of the process, but replications are necessary to incor-
speech or with very limited speech skills (Thunberg, Ahlsen, porate both fundamental steps of FCT. In terms of the use of an
& Sandberg, 2007). SGDs are one form of alternative and iPad, only one study used an iPad as the SGD (Sigafoos et al.,
augmented communication. SGDs are electronic devices in 2013). Hence, more studies to determine the effects of FCT
which the person has to select text or an image depicting the using an iPad on challenging behaviors are needed. Therefore,
desired item or activity on the screen (Lancioni et al., 2007). In the purpose of this study was to extend Sigafoos et al.’s (2013)
comparison to communication binders, SGDs such as an iPad study with modifications. First, this study used a different
may be more socially acceptable (Lorah et al., 2013; Muharib iPad application (GoTalk Now). GoTalk Now (Attainment
Muharib et al. 3

Table 1. Participant Demographics.

Pseudonym Gender/Race Disability Diagnosis Age History With iPad Challenging Behavior Description

Amy F/Caucasian American ASD 6 Games Head banging, protesting, and grabbing
Jake M/Caucasian American ASD 5 Games Protesting, grabbing
Note. F ¼ female; M ¼ male; ASD ¼ autism spectrum disorder.

Company, n.d.) was chosen because of its affordability com- grabbed what she wanted. Amy’s challenging behaviors
pared to Proloque2Go. Although Proloque2Go offers more included protesting and head banging against hard surfaces
flexibly such as creating folders and categories unlike GoTalk such as the floor or a desk. For safety, Amy wore a helmet to
Now, the researchers wanted to examine an affordable appli- school every day. At the time of the study, Amy was not
cation (approximately US$80.00) so that parents and practi- receiving speech therapy. In terms of iPad use, Amy used an
tioners could have an affordable option. Second, Sigafoos iPad for educational games in the classroom prior to and during
et al. used a multiple baseline across two participants, which the study. Amy had no history of using any form of SGD.
showed only two demonstrations of the intervention effect. Jake (pseudonym) was a 5-year-old Caucasian male with a
This study used a reversal design across two participants as a medical diagnosis of ASD as indicated in his IEP. Jake had
stronger demonstration of a functional relation between the been attending this classroom program for a half year. The
independent and dependent variables by showing four demon- teacher’s report and observations revealed Jake was able to
strations of the intervention effect. Third, the study took place produce fewer than 20 one- and two-syllable words (e.g., potty,
at the participant’s school rather than a clinical setting to mine, and no); however, his speech was unintelligible. Jake
enhance the social validity of the study (Horner et al., 2005). used unintelligible one-word utterances or challenging beha-
Fourth, functional behavior assessments were conducted to viors to communicate. Jake’s challenging behaviors included
confirm the challenging behaviors of children were maintained protesting, crying, and grabbing. Prior to and during the study,
by access to tangibles. Therefore, this study investigated the Jake received speech therapy outside of the classroom (30 min
effects of FCT using an iPad as an SGD on the challenging a week). Jake used an iPad only for educational games in the
behaviors of children with ASD. The study answered this classroom. Jake had no prior history of using any form of SGD.
research question: What are the effects of FCT using GoTalk
Now on an iPad as a SGD on the challenging behaviors of
children with ASD? Setting
The study took place during the spring semester at the partici-
Method pants’ elementary school located in a rural area in the southeast.
One hundred percent of the school’s students received free or
Participants reduced-price lunch. Both participants attended a self-contained
The research team obtained institutional review board approval classroom for children with ASD from kindergarten through
from their local university before conducting the study. The second grade. The classroom consisted of eight children includ-
inclusion criteria for this study were (a) a medical or educa- ing the two participants and four adults (a special education
tional diagnosis of ASD; (b) no functional speech or very lim- teacher and three teacher assistants). The classroom was
ited speech skills which were defined as nonfunctional use of designed to support different activities (e.g., small group, inde-
words, inability to initiate a vocal request with one or more pendent work, play, break, and reading) in which the children
words, and/or unintelligible use of words; (c) engagement in rotated throughout the school day. Baseline and intervention
challenging behaviors that could be aggressive (e.g., hitting, sessions were conducted in the participants’ self-contained class-
pushing), self-injurious (e.g., head banging), or disruptive (e.g., room in the play, reading, or small group area depending on
crying); and (d) no prior history of using an iPad as an SGD. which activity occurred during the time of session. The materials
Two participants met the inclusion criteria, whose full demo- and procedures remained the same regardless of the setting. The
graphics can be reviewed in Table 1. only difference was that the participant and interventionist sat on
Amy (pseudonym) was a 6-year-old Caucasian female the floor in reading and play areas and sat at a table in a small
whose individualized educational plan (IEP) indicated she had group area. Other children in the classroom were allowed to be
a medical diagnosis of ASD. She had been attending the same in the area in which sessions took place. Other children were
classroom program for 11=2 years. The teacher’s report and only instructed to not touch the iPad used during intervention.
observations suggested Amy was able to produce fewer than
10 one-syllable words (e.g., snack, no, and go) with verbal
prompting (e.g., “what do you want?”), but she rarely initiated
Materials
a request. In addition, Amy spoke at such a low volume that it One iPad (dedicated for the intervention purposes only) was
was difficult to hear what she said after prompting. Amy used loaded with the GoTalk Now application. GoTalk Now is an
one-word utterances after frequent verbal prompting or augmentative and alternative communication device that
4 Journal of Special Education Technology XX(X)

interviews and A-B-C observations clearly revealed the func-

tion of the participants’ challenging behaviors, experimental
functional analyses were determined to be unnecessary. The
results of the functional behavior assessments indicated that
both Amy and Jake engaged in challenging behaviors to access
tangibles.

Preference assessments. Preference assessments included obser-

ving the children during free play and break times for 2 days.
When it was a child’s turn, according to their daily classroom
visual schedule, to be in the play area or the break area, the
interventionist observed with which item or toy the child
played. If the child played with a toy/item for 30 s or longer,
it was determined to be a preferred item. In addition, teachers
Figure 1. Example of GoTalk now picture button. were asked about each child’s preferred toys/items. The inter-
ventionist did not conduct trial-based preference assessments
allows customization based on the child’s communication level because the participants clearly showed their preference to cer-
and interests. The application generates a speech output upon tain items. It was determined that Amy liked to play with an
touching the corresponding picture (e.g., “I want an apple”). iPad and books. For Jake, it was determined that he liked to
Prior to intervention, the interventionist created three pages play with an air pump toy and an iPad.
based on the participants’ preferences (i.e., “I want iPad,” “I
want pump,” and “I want book”). Each page contained a cor- Baseline. The interventionist (first author) had a small container
responding picture to the sentence (see Figure 1). Other mate- that held participants’ preferred items/toys (i.e., iPad, air pump,
rials included an iPad that the participants could request to play and books) within the participant’s reach. Both interventionist
with (different from the one used for the communication inter- and child sat on the floor if the child had already been in the
vention), a small air pump, and children’s books. These mate- play or reading area or sat at a table if the child had already
rials were the participants’ preferred items. been in the small group area. The interventionist asked the
child to play with any item from the box. After the child picked
a toy/item, the other remaining items were removed until the
Experimental Design
end of the session. The child was allowed to play with the toy/
A reversal design (Bailey & Burch, 2002; Cooper et al., 2007) item for 30 s. Then, the interventionist took away the child’s
was used to determine the effects of the intervention on the toy/item (e.g., saying my turn). This step was necessary to
children’s requesting and challenging behaviors. Both children provoke the EO of the child. Meaning, the child is more likely
began the first baseline phase at the same time. They remained to request the item after it was taken away. After a 10-s inter-
in the first baseline phase until a stable baseline data path was val, when child did not respond, the item was given back for
achieved. Next, both children were introduced to the interven- 30 s. When the child responded within 10 s by vocally saying
tion on the same day. Children were moved to Baseline 2 after what they wanted, or engaged in a challenging behavior, the
achiving two criteria in intervention: (a) requiring no prompts child was given back the item for 30 s. Praise was not provided
to touch the corresponding icon on the iPad for three consec- upon any responses. During these 10 trials, the presence and
utive sessions and (b) achiving a data path that was different in absence of challenging behavior incidences were recorded.
level compared to the previous baseline phase. The same pro-
cedures were followed in the second baseline and second inter- Intervention. The procedures were the same as in the baseline
venion phases. Each baseline and intervention session phase except that an iPad was introduced, and both systematic
consisted of 10 trials and lasted for approximately 7 min. Ses- least-to-most prompting and natural reinforcement were imple-
sions were conducted on an average of 3 days a week. No more mented. During intervention sessions, an iPad was turned on,
than one session was conducted on 1 day for each child. opened to the correct screen page that matched what the parti-
cipant had picked out of the container, and placed within the
participant’s reach.
Procedure After letting the child play with a preferred item for 30 s, the
Functional behavior assessment. Functional behavioral assess- item was taken away by the interventionist for 10 s. The inter-
ment via antecedent–behavior–consequence (A–B–C) observa- ventionist pretended to play with the item without looking
tion was conducted prior to the study to determine the expectantly at the child. When the child touched the corre-
function(s) of each child’s challenging behaviors. The A-B-C sponding icon on the iPad independently within 10 s, the inter-
observations were conducted during the classroom routine for ventionist gave the child the requested item immediately.
2 hr for each child. In addition, interviews with the four teach- When the child did not touch the corresponding icon on the
ers in the classroom were conducted. Because the analysis of iPad independently, or engaged in a challenging behavior
Muharib et al. 5

Table 2. Number of Systematic Prompts Provided in Intervention

Sessions for Amy and Jake.

Session Amy Number of Prompts Jake Number of Prompts

5 2 1
6 0 0
7 0 0
8 0 0
12 3 1
13 0 0
14 0 0
15 0 0

Data Collection
Dependent variable. The dependent variable was challenging
behavior. The presence and absence of challenging behavior
incidences were recorded using an event recording system in
each session. Challenging behaviors were grouped per child
rather than coding each topography of challenging behaviors
separately. For Amy, three challenging behaviors were opera-
tionally defined: (a) grabbing was defined as pulling the
desired item with one or two hands while or upon the interven-
tionist interrupting toy (iPad or books) play within 10 s, (b)
protesting was defined as the occurrence of vocalizations at a
volume above normal conversational level while or upon the
Figure 2. Frequency of challenging behavior for Amy and Jake. interventionist interrupting toy play within 10 s, and (c) head
banging was defined as forcefully banging her head against a
within 10 s, the child was provided a verbal prompt to touch the desk, a wall, or the floor while or upon the interventionist
corresponding icon on the iPad (e.g., saying if you want your interrupting toy play within 10 s.
toy back, touch the picture). If the child did not correctly For Jake, two challenging behaviors were operationally
respond to the verbal prompt within 10 s, the interventionist defined: (a) grabbing was defined as pulling the desired item
gave a gestural and verbal prompt by pointing to the icon on the with one or two hands while or upon the interventionist inter-
iPad and simultaneously saying if you want your toy back, rupting toy play within 10 s and (b) protesting was defined as
touch right here. If the child did not respond to the gestural the occurrence of vocalizations at a volume above normal con-
and verbal prompt within 10 s, the interventionist gently placed versational level or saying no while or upon the interventionist
the child’s finger on the icon to generate the corresponding interrupting toy play within 10 s.
voice. Once the child touched the icon to activate the speech
output, whether independently or prompted, the interventionist Interobserver agreement (IOA). IOA was assessed on 30% of the
immediately delivered the requested item with a relevant state- baseline and intervention sessions for each participant.
ment (e.g., saying alright, it’s your turn). Praise (e.g., I like that The fourth author was trained to collect IOA data by discussing
you touched the air pump picture) was not provided upon the operational definitions of the dependent variable. She col-
responses. During 10 trials, the presence and absence of chal- lected IOA data by observing the dependent variable on video-
lenging behavior incidences were recorded. tapes 40% of the time, and 60% by being present in the
classroom. The formula used to calculate IOA was the number
of agreements divided by the number of agreements plus dis-
Procedural Fidelity agreements multiplied by 100 (Kazdin, 1982). Mean IOA of
baseline and intervention sessions for Amy was 95% (range ¼
The fourth author assessed procedural fidelity for 30% of base-
85–100%), and 98% for Jake (range ¼ 95–100%).
line and intervention sessions. She was trained on collecting
these data by reviewing the procedural checklist (the checklist
can be requested from authors) and discussing the procedures
with the interventionist. The fourth author scored the interven-
Results
tionist on the reliability of treatment using a fidelity checklist Figure 2 shows the results for each child’s challenging beha-
by being present in the classroom 60% of the time and watching viors. Table 2 shows the number of systematic prompts pro-
videotapes 40% of the time. Procedural fidelity was 100% vided to each child during intervention phases. As shown in
across baseline and intervention phases. Figure 2 and Table 2, both children demonstrated decreases in
6 Journal of Special Education Technology XX(X)

challenging behaviors when the intervention was in place and are consistent with prior research suggesting FCT was effective
needed minimal prompting. in mitigating challenging behaviors of young children with
ASD (Falcomata et al., 2013; Greer et al., 2016; Neidert
Results for Amy et al., 2005; Rispoli et al., 2014). This study also builds on
previous literature on FCT using SGDs. Whereas previous
In the first baseline phase, Amy engaged in a range of 8–10 studies included only one child with ASD and showed only
(M ¼ 9) incidences of challenging behaviors (i.e., grabbing, one or two demonstrations of the intervention effect (Franco
protesting, and/or head banging). During the first intervention et al., 2009; Olive et al., 2008), this study included two children
phase, Amy engaged in challenging behaviors in a range of 0–3 and had four demonstrations of an effect. In addition to the
times within the 10 trials (M ¼ 1). In the second baseline phase, demonstrations of the intervention effect, the current study
Amy engaged in challenging behaviors 9–10 times of the 10 meets the other What Works Clearinghouse (WWC) standards
trials (M ¼ 9). When the intervention was reintroduced, she of single-case research by (a) systematically manipulating the
exhibited challenging behaviors 0–3 times within the 10 trial FCT intervention, (b) collecting data overtime with an IOA of
(M ¼ 1). Her challenging behaviors stabilized at a zero level for over 80%, and (c) having at least three data points in each phase
last three intervention sessions. Visual inspection of the inter- (Kratochwill et al., 2013).
vention phases, as shown in Figure 2, indicates a change in The results of the current study also extend the findings of a
level compared to baseline phases, immediacy of the interven- previous study in which two young children with ASD and
tion effect, no variability, and no overlap. As displayed in challenging behaviors learned to request continuation of toy
Table 2, Amy only needed systematic prompting to touch the play via an iPad (Sigafoos et al., 2013). Whereas the main
corresponding item on the iPad in the first intervention session purpose of the Sigafoos et al. study was to teach requesting
of both intervention phases. skills using an iPad, the current study found a positive impact
of using an iPad as an FCR to decrease challenging behaviors.
Results for Jake This may be attributed to conducting functional behavior
assessments and confirming the function(s) of children’s chal-
In the first baseline phase, Jake exhibited challenging beha-
lenging behaviors. In addition, both children rapidly reached
viors (i.e., grabbing and/or protesting) in a range of 7–10 inci-
the mastery criterion of requiring no prompts to touch the cor-
dences (M ¼ 9). During the first intervention phase, Jake
responding icon on the iPad across three consecutive sessions.
engaged challenging behaviors in a range of 1–3 times in the
This is consistent with the findings of previous studies in which
10 trials (M ¼ 2). In the second baseline phase, Jake engaged in
children with ASD rapidly learned to request preferred items
challenging behaviors 9–10 times within the 10 trials (M ¼ 9).
via an iPad-based SGD (Lorah et al., 2013; van der Meer,
When the intervention was reintroduced, Jake engaged in a
Sutherland, O’Reilly, Lancioni, & Sigafoos, 2012).
higher range of challenging behaviors compared to the first
intervention phase (range ¼ 2–8). However, the mean of his
challenging behaviors was still considerably lower than in Limitations and Directions for Future Research
either baseline phases (M ¼ 4). Visual inspection of the inter-
This study has limitations that can be addressed in future
vention phases for Jake, as depicted in Figure 2, indicates a
research. First, generalization measures across different com-
change in level in both intervention phases compared to the
municative partners were not conducted. Generalizing the skill
baseline phases; however, less immediate in the second inter-
of using an iPad-based SGD to request desired items across the
vention phase. Data in the second intervention phase showed
four teachers in the classroom, for instance, would have
one overlap, a little variability, and an upward trend. Jake
strengthened the current results. As indicated by Franco et al.
required systematic prompting to touch the corresponding icon
(2009), there still remains a need in the future research to
on the iPad only in the first intervention session of both inter-
explore the generalizability of the use of SGDs across different
vention phases. In short, the data clearly indicated four demon-
communicative partners. Similarly, due to the short time of the
strations of the intervention effect. Additionally, the data
study, maintenance data were not collected. Maintaining the
showed strong experimental control with the immediate
challenging behaviors at zero or low levels should be the ulti-
changes of the challenging behavior levels as an effect of the
mate goal of any intervention targeting challenging behaviors.
manipulation of the intervention.
Thus, future research should examine whether the use of SGDs
to request items continues after the termination of the interven-
tion and whether challenging behaviors maintain at zero or low
Discussion levels.
The purpose of this study was to investigate the effects of FCT In addition, while Amy reached a zero level of challenging
using GoTalk Now on an iPad on the challenging behaviors of behaviors in the second intervention phase, Jake did not. Jake
children with ASD. The findings of this study suggest a func- still engaged in some challenging behaviors during interven-
tional relation between the FCT intervention consisting of sys- tion phases by keeping his hands on the preferred item and
tematic prompting and natural reinforcement using GoTalk pulling it to himself at the same time he was touching and
Now and challenging behaviors of both children. The results activating the corresponding icon on the iPad. Future research
Muharib et al. 7

should address this issue by incorporating differential reinfor- Independently, they correctly navigated the page and requested
cement procedures in which touching and activating the corre- the desired item. An implication is that children with ASD may
sponding icon on the iPad without engaging in challenging be easily taught to use iPad-based SGD and navigate the pages
behavior produces reinforcement, and touching and activating to request specific items.
the corresponding icon on the iPad while engaging in challen- The last implication pertains to the need of early interven-
ging behavior produces no reinforcement. tion to reduce challenging behaviors of children with ASD with
Another limitation to this study was that the intervention limited speech skills via the use of SDGs. As indicated by
was carried out by an atypical interventionist (i.e., researcher). Walker and Snell (2013), SGD interventions are more effective
To close the existing gap found in the literature, in which most in addressing challenging behaviors when implemented with
studies using SGDs were found being implemented by children compared to adolescents or adults. Therefore, treat-
researchers (Walker & Snell, 2013), SGD-based interventions ment of challenging behaviors of children with ASD via the use
should be implemented by teachers or parents of children with of SGDs needs to begin early on. For positive effects, the
ASD in future research. As suggested by Horner et al. (2005), function(s) of the child’s challenging behaviors must be
social validity of a single-case study is enhanced when the assessed and identified (Walker & Snell, 2013). Then, the
intervention is implemented by typical agents such as teachers iPad-based SGD intervention needs to be designed to address
and parents. the function(s) (e.g., attention, tangible) of the child’s challen-
The current study used a reversal design which required the ging behaviors.
removal of intervention. Although the removal of intervention The aim of this study was to examine the effects of FCT
occurred only across three sessions, the use of multiple- using speech-generating GoTalk Now iPad application on the
baseline across three or more participants, for instance, may challenging behaviors of two children with ASD. After identi-
have been a better choice considering that the participants fying the function of children’s challenging behaviors through
engaged in challenging behaviors. Thus, future research inves- functional behavior assessments, children were taught to access
tigating the effects of FCT using SGDs on challenging beha- reinforcers by touching corresponding icons on the iPad appli-
viors should employ single-case designs that do not require the cation. The results of this study indicated positive impact of
removal of intervention but still show at least three demonstra- FCT using GoTalk Now application on both of the children’s
tions of an effect (Kratochwill et al., 2013). challenging behaviors. This study builds on the body of liter-
In addition, children were not taught to navigate the iPad to ature on FCT by introducing GoTalk Now and meeting all
get to the application on their own. To increase independence WWC standards for single-case research (Kratochwill et al.,
skills of children with ASD, future research should aim to teach 2013).
children with ASD to navigate an iPad and open the GoTalk
Now application page independently. Authors’ Note
A final limitation is that social validity was not measured in Kathryn L. Haughney is now affiliated with Georgia Southern
this study. Horner et al. (2005) identified social validity as an University, Savannah, GA, USA.
important measure that enhances the credibility of a single-case
study. Future research on FCT using an iPad should include Declaration of Conflicting Interests
measures of treatment acceptability such as teachers’ or other The author(s) declared no potential conflicts of interest with respect to
stakeholders’ opinions about the usefulness of the intervention. the research, authorship, and/or publication of this article.

Implications for Practice Funding

The author(s) received no financial support for the research, author-
As discussed previously, iPad-based SGD may be a viable
ship, and/or publication of this article.
option for children with ASD with limited speech skills and
challenging behaviors due to the iPad portability and social
ORCID iD
acceptance (Lorah et al., 2013). iPads are now commonly avail-
able for classroom educational purposes (Peluso, 2012). In Reem Muharib http://orcid.org/0000-0001-7445-3334
addition, GoTalk Now is a relatively inexpensive application.
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Sigafoos, J., Arthur, M., & O’Reilly, M. (2003). Challenging behavior Reem Muharib, M.Ed. is a doctoral student in the Department
and developmental disability. London, England: Whurr.
of Special Education and Child Development at University of
Sigafoos, J., Lancioni, G. E., O’Reilly, M, Achmadi, D., Stevens, M.,
North Carolina at Charlotte.
Roche, L., . . . Green, V. E. (2013). Teaching two boys with autism Vivian I. Correa, Ph.D., is a professor emerita in the Depart-
spectrum disorders to request the continuation of toy play using an ment of Special Education and Child Development at Univer-
iPad-based voice-generating device. Research in Autism Spectrum sity of North Carolina at Charlotte.
Disorders, 7, 923–930. doi:10.1016/j.rasd.2013.04.002
Smith, B., & Fox, L. (2003). Systems of service delivery: A synthesis of Charles L. Wood, PhD., BCBA-D, is a full professor of special
evidence relevant to young children at risk of or who have challen- education in the Department of Special Education and Child
ging behavior. Tampa: Center for Evidence-Based Practice, Young Development at University of North Carolina at Charlotte.
Children with Challenging Behavior, University of South Florida. Kathryn L. Haughney is an Assistant Professor of Special
Retrieved from http://challengingbehavior.fmhi.usf.edu/explore/ Education in the Department of Elementary and Special Edu-
publications_docs/systems_of_service.pdf cation at Georgia Southern University. Dr. Haughney has over
Thunberg, G., Ahlsen, E., & Sandberg, A. D. (2007). Children 15 years of experience, either teaching, conducting research, or
with autistic spectrum disorders and speech-generating advocating for students with complex communication needs
devices: Communication in different activities at home. Clin- and their families. Having recently earned her doctorate from
ical Linguistics and Phonetics, 21, 457–479. doi:10.1080/ the University of North Carolina at Charlotte, her areas of
02699200701314963 expertise include augmentative and alternative communication
van der Meer, L., Sutherland, D., O’Reilly, M. F., Lancioni, G. E., & (AAC), assistive technology (AT), general curriculum access,
Sigafoos, J. (2012). A further comparison of manual signing, pic- applied behavior analysis, meeting the needs of culturally and
ture exchange, and speech-generating devices as communication linguistically diverse learners and learners with the most severe
modes for children with autism spectrum disorders. Research in disabilities.