What is facilitated communication?
Facilitated communication involves a facilitator physically supporting the hand, wrist or arm of an autistic person while the person spells out words on a keyboard or similar device. It’s sometimes called ‘assisted typing’ or ‘supported typing’.
Who is facilitated communication for?
Facilitated communication is sometimes used with people who have little or no 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.
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, which shouldn’t be used.
What is the idea behind facilitated communication?
Supporters of facilitated communication suggest that autism is mostly a movement disorder. They think that autism isn’t characterised by social and communication challenges.
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, they can use these tools.
Also, some supporters of facilitated communication say that autistic people need emotional support. They say that facilitated communication provides this kind of support too.
What does facilitated communication involve?
Facilitated communication involves a facilitator physically guiding the hand, wrist or arm of an autistic person while the person types on a keyboard. The facilitator offers physical assistance and emotional encouragement. How much support the facilitator offers depends on the person’s needs.
Does facilitated communication help autistic children?
The American Psychological Association, the American Academy of Pediatrics, Speech Pathology Australia, Speech-Language & Audiology Canada and other organisations have recommended that facilitated communication not be used because of its potentially harmful effects and lack of proven success.
There are many concerns about facilitated communication:
- There’s no evidence that it leads to independent communication like typing. In fact, many autistic children continue to need some form of physical support for typing.
- 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 person with the communication difficulty.
- Sometimes children seem to produce high-quality written material, but it has actually been written by their facilitators. This has led to 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 facilitators have influenced the way the allegations are stated.
This intervention has potential risks, including making children more passive and less likely to initiate interaction. There are other augmentative and alternative communication (AAC) systems and speech-generating devices to help children who don’t use speech, including devices to help children who have minimal movement.
Who practises this method?
Anyone can become a facilitator.
Where can you find a practitioner?
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 the risks and benefits of this therapy.
You could also talk about this therapy with your NDIA planner, early childhood partner or local area coordinator (LAC), if you have one.
Parent education, training, support and involvement
If you plan to be a facilitator, your involvement will be time intensive. Otherwise, there’s very little parental involvement.
Cost considerations
The cost depends on who the facilitator is. 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 behaviour 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.