Facilitated Communication

Facilitated Communication (FC) began in Australia in the 1970s. Rosemary Crossley, an aide at an institution for people with severe multiple disabilities, encouraged a young woman who had cerebral palsy to communicate by acting as her facilitator.

The facilitator normally supports the child's hand, wrist or arm while that person uses a communicator to spell out words, phrases or sentences.

Crossley went on to establish the DEAL Communication Centre in Melbourne in 1986 which aimed to "assist people with no speech or with dysfunctional speech to find alternative means of communication". Much of the philosophy of the DEAL Centre was based upon the premise that the language skills (as opposed to speech skills) of people with autism and other communication disorders were generally less impaired than previous research had indicated. Interest in FC quickly spread to other countries.

There have been highly publicized claims for FC's effectiveness; "Many are now communicating ... and producing language of such complexity as to challenge commonly held beliefs about the language of people diagnosed as autistic or significantly intellectually impaired."

Alongside the enthusiasm there has been significant criticism of the approach. However, there has been some reluctance by advocates of FC to put it forward for independent evaluation on the basis that such evaluation would be artificial and interfere with the relationship of trust between facilitator and client.

Experimenters have built up a useful body of research against FC. Patricia Howlin, in her review of 45 controlled trials of FC involving over 350 subjects, found confirmation of independent communication in only 6% of subjects. In more than 90% of cases the responses were found to be influenced unwittingly by the facilitators rather than originated by clients.

In 19996, other reseaerchers found some evidence of independent communication in nine of 20 subjects. However, among students who were capable of responding independently, their responses were worse under facilitated conditions than they were without a facilitator.

Meanwhile in the United States, in an unprecedented move, five major national professional bodies adopted a formal position of opposing the acceptance of FC as a valid mode of enhancing expression for people with disabilities. These bodies include The American Association on Mental Retardation, the American Academy of Child & Adolescent Psychiatry and The American Speech-Language-Hearing Association.

The research review on educational interventions commissioned by the US Department for Education and Employment (Jordan, Jones and Murray 1998) concluded that it would be hard to justify further research on FC. While a large number of anecdotal and ethnographic case study reports detail the technique's supposed benefits, an even greater number of controlled scientific studies show the phenomenon fails to materialize once facilitator effects have been controlled.

Mark Mostert, in his review of studies into FC from 1995 to 2001, confirms that their conclusions support those of earlier studies which stated that claims were largely unsubstantiated and that its use as an intervention for people with communication impairments should not be recommended.