Information Avenue Archives

Facilitated Communication

In a previous issue of Special Child, we published a horror story written by one of our readers regarding facilitated communication (FC). As a result, some of our readers expressed an interest in learning more about FC, while others felt as though that particular story was an isolated incident and did not truly represent the benefits of FC. Therefore, we are providing the facts, and explain the controversy surrounding facilitated communication.

Facilitated communication is a technique that allows non-verbal individuals to communicate by having them point to letters (if they can read) or pictures (if they cannot read), with the assistance of a "facilitator." The pictures or letters can be on a computer, letter board, or word processing program, and the facilitator can be a properly trained teacher, parent, or caregiver. The role of the facilitator is to provide physical support (isolating the index finger, stabilizing the arm or wrist, etc.), without guiding the person to a selection, and to provide mental support, which includes encouragement but not direction. FC has been used for individuals who have severe disabilities including mental retardation, autism, Down syndrome, cerebral palsy and other developmental disabilities.

The whole concept behind FC is that many individuals are not mentally impaired, as they appear to be, but have a neuromotor impairment instead, which prevents them from initiating and controlling vocal expression. This neuromotor impairment also affects the ability to effectively motor the hand and arm. Therefore, with the use of a communication device and a facilitator to provide physical support, individuals who were once unable to communicate are now spelling words, writing sentences, and are able to answer questions.

As you may know, there has been a lot of controversy regarding the use of FC. Those advocating the use of this method claim that those individuals who had no means of communicating are given the ability to do so with FC, as long as it is provided in the proper environment. Those opposing the method believe that it’s not the disabled individual who is communicating, but is instead, the facilitator.

As parents, we want to do everything possible to give our children the opportunity to reach their full potential. This means that many of us are willing to try an assortment of therapies, alternative approaches, and different types of assistive technology devices. But when deciding whether FC is appropriate for your child, there are several things to consider.

 

According to the Advocates

• Controlled studies, observational studies, and autobiographical accounts have proven that FC is a method that works.

• FC may be very rewarding for the parent. When a child successfully communicates via FC, it can feel as though the parent has given birth to a new child; a child who can communicate with the parent and share his or her feelings and desires.

• FC may be very rewarding for the child. A child who is locked in a body that doesn’t function properly can now communicate with the world and be considered an intelligent human being, rather than a mentally impaired individual.

• FC may improve the relationship between you and your child. With your child able to communicate, you can share ideas and opinions, and plan things together.

• FC may provide opportunities for your child that would have ordinarily been overlooked, such as mainstreaming a child into a regular education class.

• FC is considered a training program so that the child can one day communicate independently, without the aid of a facilitator.

• FC is accepted by The Association for Persons with Severe Handicaps (TASH) due to the fact that access to alternative means of expression is an individual right.

 

According to the Opposition

• Use of FC has led to false allegations of abuse (including sexual abuse), which has led family members and caregivers to psychological distress, alienation, and financial hardship. As a result of these allegations, children have been wrongly taken from their parents and placed in foster homes.

• The Office of Mental Retardation and Developmental Disabilities conducted an experiment to test for facilitator influence. After nine months of testing, it was found that there was overwhelming evidence of unconscious facilitator influence, which proved that it was not the disabled individual communicating, but the facilitator instead.

• The American Association of Pediatrics and the American Academy of Child & Adolescent Psychiatry have stated that "studies have repeatedly demonstrated that FC is not a scientifically valid technique for individuals with autism or mental retardation."

• The American Association on Mental Retardation (AAMR) states that "a substantial number of objective clinical evaluations and well-controlled studies indicate that facilitated communication has not been shown to result in valid messages from the person being facilitated.

• The American Psychiatric Association states that "facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy."

 

At this point, you may be wondering who to trust: the parents and professionals who claim through hands-on experience that FC is an effective method, or the various national organizations who have resolved that FC is not a scientifically valid method. Whatever you decide, keep in mind that both sides do agree on two very important issues: facilitator influence can definitely take place and false allegations of sexual abuse have been known to occur.

For more information on Facilitated Communication, refer to the web sites listed below.

• Facilitated Communication Institute http://soeweb.syr.edu/thefci
• Green, Gina, Skeptic vol. 2, no. 3, 1994, pp. 68-76 http://www.skeptic.com/02.3.green-fc.html
• Autism Society of America http://www.autism-society.org/packages/facilitated_communication.html#intro
• New York State Commission on Quality of Care for the Mentally Disabled http://www.cqc.state.ny.us/fchot.htm

 

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