Facilitated Communication and its Critics

Facilitated Communication Training and its Critics

Chris Borthwick

Facilitated communication training (FCT) is a strategy for teaching individuals with severe communication impairments to use communication aids with their hands. In FCT a communication partner (facilitator) helps the communication aid user overcome neuro-motor problems and develop functional movement patterns. The immediate aim in FCT is to allow the aid user to make choices and to communicate in a way that has been impossible previously. Practice using a communication aid such as a picture board, speech synthesiser, or keyboard in a functional manner is encouraged, to increase the user's physical skills and self-confidence and reduce dependency. As the student's skills and confidence increase the amount of facilitation is reduced. The ultimate goal is for students to be able to use the communication aid(s) of their choice independently.

Facilitated communication training is a teaching strategy of particular relevance to individuals with severe communication impairments (SCI) who do not have severe physical impairments but nonetheless have had difficulty acquiring handwriting and manual signing skills. Many such individuals are diagnosed as intellectually impaired and/or autistic. Through FCT numbers of such individuals have achieved functional communication, often revealing unexpected understanding and academic potential.

FCT has been the subject of considerable controversy, much of it posted on the Web. There are two centres offering FC services ; DEAL Communication Centre and the Syracuse Institute on Communication and Inclusion. Their sites give a good account of the technique and provide references and links to the published evidence supporting its efficacy. Elsewhere on the Net there are also attacks on FCT by hostile critics. These criticisms are discussed and answered in Flying High on Paper Wings and In the Front Line, by Rosemary Crossley, and An Inappropriate Challenge to Professional Belief Systems, by Chris Borthwick. A fascinating case study of a successful intervention, the objections of the critics, and Rosemary Crossley's response to the critics can be found in Remediation of Communication Problems Through Facilitated Communication Training: A case study.

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