Facilitated communication, often referred to as supported typing, is a specialized form of alternative communication designed to assist individuals with severe autism or those who are unable to express their thoughts and feelings vocally. Since its inception in the 1970s, facilitated communication has played a pivotal role in providing a voice to those who otherwise might remain unheard. This comprehensive exploration delves deeper into the world of facilitated communication, shedding light on its origins, how it operates, the pros and cons associated with it, and whether it truly works.
The Origins of Facilitated Communication
Facilitated communication traces its origins back to the 1970s when it was first developed in Australia and Denmark. Originally, this form of communication was devised to aid individuals with cerebral palsy, seeking to bridge the gap between their thoughts and external expression. Notably, Australia became the pioneering country in utilizing facilitated communication as a therapeutic approach for individuals with autism.
How Facilitated Communication Operates
Facilitated communication relies on a facilitator who provides emotional and physical support while also assessing factors like posture and eye contact. The role of the facilitator is generally limited to offering minimal assistance, often through gentle guidance or touch, especially when guiding the individual’s hand during communication. In cases where more substantial support is needed, the facilitator may physically aid in guiding the patient’s hand or arm to utilize communication tools like keyboards, smartphones, or specialized devices.
A Glimpse into the Process
To illustrate the process, consider a typical facilitated communication scenario. A facilitator guides a disabled individual as they type words on a keyboard or letter board. Typically, the facilitator assists the individual in forming a closed fist, with the index finger (most commonly used for spelling) extended. The facilitator then supports the patient’s arm, elbow, or hand, guiding it toward the keyboard. Throughout this process, the facilitator provides encouragement while the patient continues to spell out their thoughts.
The Pros and Cons of Facilitated Communication
Facilitated communication offers several potential advantages, including enabling non-verbal individuals to express themselves, write complete and intelligible sentences, communicate with peers, and answer questions about their desires. Additionally, it can aid in the development of motor skills.
However, the practice is not without its disadvantages. One of the most significant drawbacks is the lack of substantial evidence supporting its efficacy in improving independent communication skills. Some individuals who have developed independent communication skills may be hindered from progressing further, as evidence suggests that facilitators may unconsciously write messages on behalf of their patients. This practice risks violating the autonomy, self-expression, consent, and privacy of disabled individuals.
Does Facilitated Communication Work?
The effectiveness of facilitated communication remains a topic of debate within the scientific community. While there have been instances where individuals, such as Sue Rubin, seemingly learned to communicate through facilitated communication, skepticism surrounds the extent of facilitator influence in many cases. It is worth noting that major health organizations, educational institutions, and autism advocacy groups do not endorse facilitated communication as a viable therapy. The American Association of Intellectual and Developmental Disabilities (AAIDD) is among the organizations that do not support its use.
Observations made by experts during facilitated communication demonstrations have raised concerns, as some disabled individuals seemingly avoid looking at the keyboard while communicating, further fueling doubts about the true source of the messages.
Controlled Studies
Controlled studies are essential in evaluating facilitated communication. These studies are conducted by experts who observe both the patient and the facilitator. They analyze what is being written and assess the level of control the patient has when typing compared to the facilitator. The prevailing evidence indicates that in most cases, undue influence by the facilitator exists.
Other Considerations
For the benefit of patients and their families, it is crucial that practitioners involved in facilitated communication avoid using this method in their practices. Ignoring the potential harm of facilitated communication could lead to professional liability. Professionals who do choose to employ this method should inform their patients, family members, and guardians of the evidence-based facts:
- Facilitated communication appears to be invalid compared to other forms of communication.
- Messages created during facilitated communication are often fabricated by the facilitator and provide no genuine insight into the patient’s thoughts.
- The American Speech-Language-Hearing Association does not endorse facilitated communication as a therapy.
Despite the lack of professional endorsement, facilitated communication remains a prevalent practice in some areas. Various factors contribute to its persistence, including individuals who modify scientific data to align with their beliefs, excuses made for cases where facilitated communication does not work, invested time and effort in researching and implementing this method, and herd mentality within certain communities.
In conclusion, facilitated communication, a method of alternative communication, stands at the intersection of a complex and contentious debate within the fields of special education and disability services. It is a technique that, on one hand, holds potential benefits in providing a voice to individuals who may struggle with traditional communication methods. However, it is plagued by a lack of substantial, empirically supported evidence substantiating its efficacy and claims of authenticity. Moreover, it raises valid concerns regarding the potential influence of facilitators on the communication process, as it is often difficult to ascertain whether the communication truly originates from the disabled individual or if it is primarily directed by the facilitator.
As the scientific community continues to scrutinize and question the validity of facilitated communication, practitioners in the realm of special education and disability services must exercise a high degree of caution and responsibility when considering its use. It is of utmost importance to remain informed about the evolving research and consensus within the field. Throughout this ongoing discourse, the paramount objectives should always revolve around safeguarding the well-being and autonomy of disabled individuals. Ensuring their voices are heard, respected, and genuinely representative of their thoughts and desires remains the ultimate goal, while simultaneously acknowledging and addressing the complexities and uncertainties surrounding facilitated communication.