BAAM Special Feature

What is "Facilitated Communication"?

by

James T. Todd
(Eastern Michigan University)

Facilitated Communication (FC), is a set of methods by which pointing-, typing-, or writing- based communication is simulated in a non-verbal person by a facilitator who provides physical, gestural, verbal, or other cues to the subject for the communications. FC is also known as "Supported Typing," and advocates sometimes hide its use entirely by simply saying the subject "communicates by typing." The "Rapid Prompting Method" is a type of FC.

What does FC look like in everyday use? Mostly it looks like hand-holding, but can take many forms.

In the typical instance of FC, the facilitator holds the hand, wrist, or arm of the subject, guiding it to letters on a printed letter board or other typing device. In some cases, the cues are provided at the elbow, upper arm, shoulder, or back--or by holding on to the subject's clothing or even using a stick. Non-physical guidance is also possible when the facilitator provides gestural or verbal cues to a subject for letter selections, rather than guiding by touch. In some instances, the facilitator may hold the letter board instead of the subject, or guide the subject's hand while also holding the letter board. Holding the letter board is the standard practice in the Rapid Prompting version of FC. Facilitated handwriting is also possible.

What does FC training look like? It can be nearly anything.

FC training ranges from no formal instruction at all to organized workshops spanning days. For many, FC is simply attempted after reading about it or viewing it, and practiced until it seems to work (or does not). In some cases, it is formally modeled by a practitioner, then attempted by the prospective facilitator. FC training workshops usually consist of background information on FC theory and philosophy, testimonials and demonstrations, modeling of technique, simulated practice, and sometimes practice involving people who cannot speak. More formal, graduated training practice may be done by facilitators involving "set work"-- practice with basic tasks -- but this is relatively rare. Training for the Rapid Prompting version of FC is much more formalized than training for traditional FC. It involves graduated, trials-based practice in guiding the subject to select from an increasingly large number of options until letter-by-letter communication is simulated.

Are formal psychological or language assessments used in FC? No.

According to its advocates, FC is supposed to be used only with people who cannot effectively communicate in other ways. However, there is little evidence that FC advocates make any formal assessments of actual communicative competence or attempt to first guide subjects to the use of evidence-based augmentative or alternative communication methods. In fact, because the use of FC is based on the premise that standard language and cognitive assessments cannot detect "hidden communicative competence," standardized testing may be actively avoided or its findings dismissed.

How does FC protect against or test for facilitator control of the output? It does not. It objects to authorship testing.

Even though FC advocates admit that facilitator control is possible and sometimes occurs, they nevertheless strongly object to objective testing for facilitator control. Objective testing is described as "confrontational," "insulting" to the subject, and damaging to the confidence required for FC to function.

Rather than formal assessments that would clearly identify the author of the output, FC advocates instead suggest making inferences about authorship based on casual inspection of facilitated output. Even this rarely seems to be done. There is little, if any, acknowledgment that objective testing would protect subjects from facilitator control.

How do FC advocates deal with sensitive information, such as sex-abuse allegations? They recommend a test that usually cannot identify the author of the output.

According to FC advocates, only the discovery of "sensitive" information, such as sexual abuse allegations, warrants an objective test. In such instances, FC advocates recommend the "naive facilitator test." (See Facilitated Communication Training Standard). That is, they suggest bringing in a facilitator who is unaware of the details of the allegations, and re-interviewing the subject. If something similar to the original allegations is typed, the allegations are said to be confirmed. If something different is typed, there should be doubts about the original allegations.

The problems with this method are many and serious.

• Only when the original and new statement correspond very closely, and the naive facilitator could not have guessed (or does not know) the details, does the naive facilitator test indicate anything. Even then, it only points to the subject as author. It says nothing about the truthfulness of the statements.
• If the statements are different, then we do not know the author. Assuming for a moment that FC might work, (1) the first facilitator could have authored the output, (2) the second facilitator could have authored the output, (3) both facilitators could have authored different outputs, or (4) some or all the output is genuine, but the subject is changing the story. Any of these possibilities allows a prosecution to dismiss anything it wants, and accept anything it wants.
• Because abuse allegations are one of the few situations that would trigger a naive facilitator test, the naive facilitator, just by being asked, knows that abuse allegations are probably involved.
• It is not likely that an abuse investigation will be conducted like a science experiment, with careful safeguards against biasing the new facilitator with relevant information. Leading questions and the transfer of critical information are common during the interrogation of witnesses.
• New information typed by the naive facilitator may used to implicate others in the alledged activities or be taken as

 

 

 

 

So, RPM does not use objective tests to determine whether facilitator or subject is the author of the output.

Exactly.

Who invented RPM? FC is attributed to Rosemary Crossley, who was working in a center for people with disabilities in Australia. In 1980, Crossley FC was brought to the United States

Is there scientific research supporting RPM? No.

There is no body of scientific evidence supporting the claims that FC can produce reliable and sophisticated expressive communication in people who are otherwise incapable of it.

Is FC potentially dangerous? Yes. It has directly harmed many people.

FC not only diverts time and resources from effective interventions, it also carries with it the potential for false allegations of abuse.

Notes

¹For instance, a teacher who always looks at the correct answer asks for the child to point to a specific object, and the child simply selects the one the teacher is looking at.

References and Sources

Friðriksson, F. Þ. (Director) (2009). Sólskinsdrengurinn [Documentary movie; aka: "The sunshine boy;" Rereleased as A Mother's courage: Talking back to autism]. Frontier Filmworks in Association with Klikk Productions: Reykjav'k: Iceland.

Iversen, P. (2006). Strange son: Two Mothers, Two Sons, and the Quest to Unlock the Hidden World of Autism. New York: Riverhead Books.

Iversen, P. (2007). The informative pointing method. Unpublished manuscript. Retrieved August 8, 2011 from http://www.strangeson.com/files/Informative_Pointing_Method.pdf.

Lang, R. Tostanoski, A.H., Travers, J., & Todd, J.T. (2014). The only study investigating the rapid prompting method has serious methodological flaws but data suggest the most likely outcome is prompt dependency. Evidence-Based Communication Assessment and Intervention, 8(1), 40-48.

Mostert, M. P. (2001). Facilitated communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders, 31(3), 287-313.

Mostert, M.P. (2010). Facilitated communication and its legitimacy: 21st century developments. Exceptionality, 18(1), 31-41.

Mukhopadhyay, S. (2008). Understanding autism through rapid prompting method. Denver, CO: Outskirts Press.

Tostanoski, A., Lang, R., Raulston, T., Carnetti, A., Davis, T. (2014). Voices from the past: Comparing the rapid prompting method and facilitated communication. Developmental Neurorehabilitation, 17(4), 219-223.

Wombles, K. (2010). Why Rapid Prompting Method Doesn’t Pass the Evidence-Based Test. Retrieved October 7, 2014 from http://kwomblescountering.blogspot.com/2010/04/why-rapid-prompting-method-doesnt-pass.html