Facilitated Communication Training, Appendix 2
13. APPENDICES
13.2. COMMON HAND FUNCTION PROBLEMS
1. Poor eye-hand co-ordination:
The student makes selections impulsively, without looking, or without allowing enough time between movements to scan the display and locate the target.
2. Low muscle tone:
The student's arm and hand are "floppy" or "heavy". There is difficulty raising the arm against gravity and muscles fatigue quickly.
3. High muscle tone:
The student's arm feels tense, and their movements are often too forceful, either over-reaching the target or pushing the aid away.
4. Index finger isolation and extension problems:
The student has difficulty in extending a first finger while holding back the other fingers. Users with this problem either point with all fingers extended or use the middle finger (which is the longest). Either method makes accurate selection difficult.
5. Perseveration:
The student makes a selection and continues hitting either that selection or adjacent selections inappropriately.
6. Using both hands for a task only requiring one:
If a student points to two items simultaneously it is hard to be sure which item (if either) was actually desired.
7. Tremor:
Tremor can either be a continuous tremor or an intention tremor, where the hand is stable while at rest but trembles when the person tries to do something (such as point).
8. Radial/ulnar muscle instability:
The muscles of forearm, wrist and hand exert unequal pull on the hand or fingers. Sometimes the index finger swerves to one side as the student goes to point, leading to unwanted selections. The most common problem is for the aid user’s index finger to move across in front of the other fingers. Often the hand also drops down from the wrist thus making the tip of the index finger invisible to its owner, who is then pointing blind.
9. Initiation problems:
The student does not spontaneously reach out to the communication display.
10. Impulsivity:
The student moves too fast to produce considered responses — starts pointing at the answer before you’ve finished the question, or points quickly all over the board so that you don’t know which item was meant.
11. Proximal Instability:
The person’s whole arm moves from side to side. Often an overarm pointing action, rather than the more controlled underarm action, is used.
12. Reduced Proprioception:
The aid user has a reduced sense of body and arm position, affecting the accuracy of responses.
13. Lack of confidence:
While not itself a physical problem nervousness certainly affects physical performance.
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Breaking the Silence
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