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 (Crossley and MacDonald 1980).

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 publicised 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." (Crossley and Remington-Gurley 1992)

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 over recent years built up a useful body of research against FC. Howlin (1997), 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 the originated by clients.

Bebko, Perry and Bryson (1996) 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 that the phenomenon fails to materialise once facilitator effects have been controlled.

Mostert (2001) in his review of studies into FC since 1995 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.