A Systematic Review of Tangible Reinforcers During Functional Communication Training

We conducted a systematic review of the functional communication training literature to synthesize the types of high‐ and low‐tech stimuli included in functional communication training and their associated levels of social validity. Our search was restricted to studies published in 2010 or later, marking the introduction of the Apple iPad. We identified 116 studies comprising 250 participant‐level FCT applications. We summarized participant characteristics, the types of high‐ and low‐tech stimuli incorporated into treatment procedures, assessments used to identify stimuli, the extent to which social validity was evaluated for applications with high‐ and low‐tech stimuli, and social validity outcomes. Findings suggest that tablet devices were the most common high‐tech stimuli, whereas edibles were the most common low‐tech stimuli, and that applications involving these types of stimuli were associated with moderate to high levels of social validity. We discuss these findings with respect to considerations surrounding the incorporation of high‐tech stimuli in the assessment and treatment of challenging behavior.