What is facilitated communication?

Facilitated communication is a technique that 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 was originally designed in Australia in the 1970s. 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 that 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 it’s not a disorder characterised by social and communication difficulties.

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 be helped to use these tools.

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 level of need.

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 a parent or volunteer is the facilitator, the cost might be quite low.

Does facilitated communication work?

The American Psychological Association (APA), 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.
• There’s strong evidence that the facilitator writes the messages, often unconsciously, not the person with the communication difficulty.
• 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 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.

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.

Where can you find a practitioner?

If you’re interested in facilitated communication, you should talk about this therapy with your GP or one of the other professionals working with your child. You could also talk about it with your NDIA planner, NDIS early childhood early intervention (ECEI) coordinator or NDIS local area coordinator (LAC), if you have one.