What is facilitated communication?
Facilitated communication involves a facilitator physically prompting an autistic person to communicate.
The physical prompting usually happens in one of the following ways:
- The therapist supports the autistic person’s hand, wrist or arm while the person spells out words on a keyboard or letterboard. This is sometimes called ‘assisted typing’ or ‘supported typing’.
- The facilitator holds up an alphabet chart and encourages the autistic person to touch letters, either with their finger or a pencil. This approach is used in programs like the rapid prompting method, spellers method and spelling to communicate (S2C).
In both approaches, the autistic person doesn’t have full physical control, because the facilitator is controlling either the person’s hand or the alphabet board.
Who is facilitated communication for?
Facilitated communication is most often used with people who have little or no verbal speech, including autistic people.
What is facilitated communication used for?
Supporters claim that facilitated communication unlocks communication skills in autistic people who have little or no speech. But research strongly suggests that the communication mostly comes from the facilitators, rather than from the autistic people they’re supporting.
Where does facilitated communication come from?
Facilitated communication techniques were developed in Australia and Denmark in the 1970s. In Australia, the therapy was designed to help people with cerebral palsy communicate.
Australia was the first country where facilitated communication was used as a therapy for autism. It’s now also used in other countries including New Zealand, the United Kingdom, Canada and the United States. But government departments and professional organisations in these countries have said that facilitated communication is a discredited technique and shouldn’t be used.
What is the idea behind facilitated communication?
Supporters of facilitated communication suggest that autism is mostly a movement disorder.
Facilitated communication is based on the idea that autistic people want to communicate. Movement difficulties stop them from being able to speak or independently use tools like typewriters or storyboards to communicate. When their arms are supported, or when a facilitator holds letters in the air, they can use these tools.
What does facilitated communication involve?
Facilitated communication involves a facilitator physically prompting an autistic person to communicate, either by touching the autistic person in some way, or holding a device or letterboard in front of them.
How much support the facilitator offers depends on the person’s needs, but there’s always some prompting from the facilitator.
Does facilitated communication help autistic children?
The American Psychological Association, the American Academy of Pediatrics, Speech Pathology Australia, Speech-Language & Audiology Canada and many other organisations have recommended that facilitated communication not be used because of its potentially harmful effects and lack of proven success.
Concerns about facilitated communication
- There’s no evidence that facilitated communication leads to independent communication like typing. In fact, many autistic children continue to need some form of physical prompting for typing, even after years of facilitated communication.
- It has led to some people with independent communication skills becoming more passive communicators.
- There’s strong evidence that the facilitator writes the messages, often unconsciously, not the autistic person. This means facilitated communication is blocking the autistic person’s ability to communicate.
- Sometimes children seem to produce high-quality written material, but it has been written by their facilitators. This has led to children being put in mainstream schools, when the children need specialised school support.
- There have been several cases of people making allegations of sexual abuse using facilitated communication. When these cases were investigated, the facilitator was found to have written the allegations, which were also found to be untrue.
If autistic children type to communicate, it’s essential that they have full control over their own bodies and the keyboard or letterboard they’re using. If autistic children can’t type, they can use other augmentative and alternative communication (AAC) systems and speech-generating devices, including devices for people with movement difficulties.
Who offers facilitated communication?
Anyone can become a facilitator.
Where can you get professional advice about facilitated communication?
If you’re interested in facilitated communication, see your GP or one of the other professionals working with your child. They can talk with you about whether the therapy works and what its risks are.
How are parents involved in facilitated communication?
If you plan to be a facilitator, your involvement will be time intensive. Otherwise, there’s very little parental involvement.
How much does facilitated communication cost?
The cost depends on who the facilitator is and whether paid professionals are involved in setting up and teaching this system. For example, if the facilitator is a paid employee, the cost can be high. If you’re the facilitator, the cost might be quite low.
Therapies and supports for autistic children range from behavioural therapies and developmental approaches to medicines and alternative therapies. When you understand the main types of therapies and supports for autistic children, it’ll be easier to work out the approach that will best suit your child.