By Raising Children Network
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At a glance: Facilitated communication
Type of therapy
The claim
Improves communication skills in people with ASD.
Suitable for
People with ASD who have little or no speech
Research rating
Find out more about this rating system in our FAQs.
Research shows this approach is ineffective or can be harmful.
Warning This intervention has potential risks, including making the child more passive and less likely to initiate intervention.
Estimate of the total time for family in hours per week and duration.
0-10 Variable
Estimate of cost to family per session/item or week.
$0-30 Variable
Visit the Autism Service Pathfinder to browse Service Providers information.

About this intervention

What is it?
Facilitated communication is a technique that involves a person (the facilitator) physically supporting the hand, wrist or arm of someone with autism while the person spells out words on a keyboard or similar device.

Who is it for?
Facilitated communication is used with people who have little or no speech, including people with autism.

What is it used for?
Supporters claim that facilitated communication unlocks communication skills in people with autism who have little or no speech.

Where does it come from?
The method was originally designed in Australia in the 1970s. It was designed to help people with cerebral palsy communicate. Australia was the first country in which facilitated communication was used as a therapy for autism. The therapy was then transferred to practice in other countries including New Zealand, the UK, Canada and the US.

What is the idea behind it?
Supporters of this approach suggest that autism is mostly a movement disorder – they think it’s not so much a disorder characterised by social and communication difficulties.

The theory says that people with autism want to communicate. Movement difficulties stop them from being able to speak or independently use tools (such as typewriters or storyboards) to communicate. When their arms are supported, they can be helped to use these tools.

What does it involve?
The approach involves a facilitator physically guiding the hand, wrist or arm of a person with autism while the person types on a keyboard. The facilitator’s role is to offer physical assistance and emotional encouragement. The level of support the facilitator offers will depend on the person’s level of need.

Cost considerations
The cost will vary depending on who is used as the facilitator. For example, if the facilitator is a paid employee, the cost can be high. If a parent or volunteer is the facilitator, the cost might be quite low.

Does it work?
More high-quality research is needed to determine the effectiveness of this therapy. However, the American Psychological Association (APA) and the American Academy of Pediatrics have recommended that facilitated communication not be used because of its potential harmful effects and lack of proven success.

The specific concerns associated with facilitated communication are that:

  • There is no evidence that it leads to independent communication (the content of what is typed is significantly influenced by the facilitator).
  • It has led to some people with independent communication skills becoming more passive communicators.
  • Sometimes children produce high-quality written material, but this material has actually come from the facilitator. This has led to the children being put in mainstream schools, accompanied by their facilitators. But the children would often benefit more from specialised schooling.
  • There have been several cases involving allegations of sexual abuse. In these cases, people have talked about their abuse using facilitated communication. But when such allegations are made, the person or people accused of the abuse can question the truthfulness of the allegations. This is because it might not be clear how much the facilitator has influenced the way the allegations are stated.

Who practises this method?
Anyone can become a facilitator. You can find out more about facilitated communication therapy in Australia from the Anne McDonald Centre.

Parent education, training, support and involvement
If parents are facilitators, their involvement will be time intensive. Otherwise, parental involvement is minimal.

Where can I find a practitioner?
Contact the autism association in your state and ask them to recommend a service or practitioner.

  • Last updated or reviewed 11-07-2011