Facilitated communication
| Alternative medicine | |
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Facilitated communication shown in a 1993 PBS documentary, in which a disabled person's right hand is helped to move (or simply pulled) by a facilitator across a board showing the alphabet. The image shows a principal criticism of FC: that often the person is not looking at the board, so they cannot really be signing out a message.
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| Claims | Disabled people may be able to communicate by pointing at letters or with a keyboard if physically held and assisted by an expert facilitator. |
| Related fields | Alternative medicine |
| Year proposed | Late 20th century |
| Original proponents | Rosemary Crossley |
| Subsequent proponents | Douglas Biklen |
Facilitated communication (FC), or supported typing, is a discredited technique used by some caregivers and educators in an attempt to assist people with severe educational and communication disabilities. The technique involves providing an alphabet board, or keyboard. The facilitator holds or gently touches the disabled person's arm or hand during this process and attempts to help them move their hand and amplify their gestures. In addition to providing physical support needed for typing or pointing, the facilitator provides verbal prompts and moral support. In addition to human touch assistance, the facilitator's belief in their communication partner's ability to communicate seems to be a key component of the technique.
There is widespread agreement within the scientific community and multiple disability advocacy organizations that facilitators, not the person with the communication disability, are the source of all or most messages obtained through FC, by guiding the arm of the patient towards answers they expect to see or that form intelligible language. Alternatively, the facilitator may hold the alphabet board and move it to the disabled person's finger. Studies asking about things the facilitator cannot know (for example showing the patient but not the facilitator an object) have confirmed this, showing that a facilitator is generally unable to ‘help’ the patient sign out the answer to a question where they do not know what the answer should be. Numerous cases have been reported by investigators in which disabled persons were claimed by facilitators to be engaged in signing a coherent message while their (the disabled person's) eyes were closed, or they were looking away from or showing no particular interest in the letter board. Some facilitators have countered that FC cannot be clearly disproven by this method, since a testing environment might feel confrontational and alienating to the subject.
Because the scientific consensus is that FC is a pseudoscience which causes great risk and emotional distress to people with communication disabilities, their families, and their caregivers, in 2015 Sweden banned the use of FC in special needs schools.
Facilitated communication is promoted as a means to assist people with severe communication disabilities in pointing to letters on an alphabet board, keyboard or other device so that they can communicate independently. It also appears in the literature as "supported typing", "progressive kinesthetic feedback", and "written output communication enhancement". It is somewhat related to the "rapid prompting method" (RPM), also known as "informative pointing". which has no evidence of efficacy.
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