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Facilitated Communication

What is it?

Facilitated Communication (FC) was devised by an Australian, Rosemary Crossley, thirty years ago. Rosemary Crossley worked in an institution for people with severe disabilities. She asked a patient who had cerebral palsy to come and live with her and tried to find an alternative to speech in order to communicate with her. She wrote a book entitled "Annie's Coming Out", which is based on their experience. According to Rosemary Crossley, the difficulty that some disabled individuals have with language is not cognitive but due to the fact that they have a problem expressing themselves; as a result their intellectual skills tend to be underestimated but once they are able to communicate they often reveal unexpected understanding and academic skills. She believes that when individuals' communication skills improve they tend to become more confident and independent. She founded the DEAL Communication Centre in 1986. The charity based in Victoria, Australia, assesses individuals needs and tries to find some means of communication for people who have little or no speech; it also provides training for parents or carers.

How does it work?

The aim of FC is to help individuals with limited or no speech find other ways of communicating using Alternative and Augmentative Communication strategies (AAC). The technique involves gesture and body language such as pointing, eye gaze, touching or sound. A "facilitator" helps a child or adult by giving them physical support, for example holding their hand, wrist, forearm or finger while they point to objects, signs or letters or even type or write. Each session is individualised. After assessing the client, the "facilitator" chooses a specific type of communication or technique which is appropriate to the needs of the client:

- Graphics: pictures, drawings, abstract symbols, text
- Voice
- Sign language
- Gestures
- Speech
- Vocalisations
- Concrete objects touched or pointed to.

Various tools and devices may be used such as: alphabet or picture boards, mouth or headsticks, switches, keyboards or typewriters and synthesisers. Emotional support, for instance giving encouragement, also plays an important role in FC.

Conditions that may respond to FC

Autism
Brain damage
Cerebral palsy
Developmental delay
Down's syndrome
Speech impairment

What results can be expected?

FC is very controversial, Douglas Biklen, from the Facilitated Communication Institute at the Syracuse University in America, claims that "Facilitated Communication is not a cure for autism or other developmental disabilities...but a means of communicating". Opponents to the technique argue that the "facilitator" can influence or manipulate the users as they attempt to point or type and therefore do the communicating. Recent scientific studies have not been conclusive:

- Mostert MP. Facilitated communication since 1995: a review of published studies
J Autism Dev Disord 2001 Jun;31(3):287-313.

This review critiques and discounts the claims of two studies purporting to offer empirical evidence of FC efficacy using control procedures.

- Gorman BJ. Facilitated communication: rejected in science, accepted in court-a case study and analysis of the use of FC evidence under Frye and Daubert. Behav Sci Law 1999;17(4):517-541

For more research papers visit the following websites:
- http://soeweb.syr.edu/thefci/fcjrnl.htm (Syracuse Institute)
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=&DB=PubMed
- http://crow.open.ac.uk/education-and-languages/research/groups/chdlrg/cdmhsn/projects.htm: Facilitated communication in Autism Andrew Grayson is completing the third year of a project on facilitated communication with adults with communication disabilities, involving the fine-grained analysis of video records.

Resources

Organisations

DEAL Communication Centre Inc.
538 Dandenong Road
Caulfield Victoria 3162
Australia
Tel: (0061) 3 9509 6324
http://www.deal.org.au

Facilitated Communication Institute
Syracuse University
370 Huntington Hall
Syracuse
New York
NY 13244-2340
USA
Tel: (001) 315 443 9657
http://soeweb.syr.edu/thefci

The National Autistic Society (NAS)
393 City Road.
London EC1V 1NG
Tel: 020 7833 2299
http://www.nas.org.uk/

The Light and Sound Therapy Centre
90 Queen Elizabeth's Walk
London N16 5UQ
Tel: 020 8880 1269
http://www.ldb.co.uk/autism.htm

YAACK (Augmentative and Alternative Communication Connecting Young Kids)
http://www.pediatricservices.com/prof/prof-30.htm

Books

These are some of the references that have been passed to us; the list is not
exhaustive. We have not necessarily read the books and cannot say how easy it
will be to get them.

- Crossley R. & Mc Donald A. (1980) Annie's coming out. Penguin Books
- Crossley R. (1994) Facilitated communication training. New York: Teachers College Press.
- Crossley R. (1997) Speechless: Facilitated communication for people without voices. New York: Dutton: 309 pp.
- Biklen D. (1993) Communication unbound. New York Teachers College Press.
- Biklen D., Saha N., Kliewer C. (1995) How teachers confirm the authorship of facilitated communication: A portfolio approach. Journal of the Association for Persons with Severe Handicaps, 20 (1) 45-46.

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