Facilitated Communication: Its Role in Autism

Evaluating Facilitated Communication

The evaluation of facilitated communication (FC) in relation to autism is multifaceted, encompassing scientific opinions and various critiques.

Scientific Consensus on Facilitated Communication

The scientific community has been largely skeptical about facilitated communication and its effectiveness. According to the Association for Science in Autism Treatment, numerous studies have found that messages produced during facilitated communication may not originate from the individual with autism, but rather reflect the facilitator's input or thoughts. This raises significant concerns regarding the validity and accuracy of the communication claimed to be produced by users.

As noted by the American Speech-Language-Hearing Association, there is insufficient empirical evidence supporting the efficacy of facilitated communication as a reliable method for communication among individuals with autism. Many professionals argue that it does not facilitate authentic communication for the person receiving the support.

Criticisms of Facilitated Communication Methods

Critics of facilitated communication point out several key issues that undermine its credibility as a communication method:

In summary, parents seeking communication strategies for children diagnosed with autism should approach facilitated communication critically, aware of its limitations and the scientific consensus surrounding it. For alternative communication methods, consider exploring options like sign language, picture cards, or Augmentative and Alternative Communication (AAC), which are well-supported by research.

Understanding Facilitated Communication

Facilitated communication is a method developed to assist individuals diagnosed with autism who struggle with conventional forms of communication. This approach is particularly noteworthy for parents seeking alternative communication methods for their children.

Origins of Facilitated Communication

The concept of facilitated communication originated in Australia during the 1970s, with Rosemary Crossley recognized as the technique's creator. Initially developed to help individuals with cerebral palsy, it later gained traction as a communication aid for individuals with autism, particularly through its introduction in the United States by Douglas Biklen in the mid-1990s. Various countries, including New Zealand, the United Kingdom, Canada, and the United States, havesince incorporated this method, but it has also faced considerable scrutiny and rejection by government departments and professional organizations [2].

CountryYear IntroducedInitial FocusAustralia1970sIndividuals with cerebral palsyUnited StatesMid-1990sIndividuals with autism

Process of Facilitated Communication

Facilitated communication involves a facilitator who physically supports the individual with autism—often by guiding their hand, wrist, or arm—while they type on a keyboard or point to letters on an alphabet chart. This method is aimed at enabling non-verbal or minimally verbal individuals to express their thoughts and messages. It is sometimes referred to as "assisted typing," "supported typing," or the "rapid prompting method" [2].

The process is built on the belief that with appropriate support, individuals who face communication challenges can more effectively articulate their needs and ideas. This approach can be particularly beneficial for parents looking for ways to improve their child's communication abilities, reinforcing the importance of understanding facilitated communication and autism.

For further exploration of communication strategies, consider learning more about alternative communication methods like sign language and augmentative and alternative communication (AAC).

Controversies Surrounding Facilitated Communication

Facilitated Communication (FC) has stirred significant debate due to various controversies surrounding its application and efficacy. Parents navigating this topic need to understand these controversies, particularly concerning facilitator influence and the dichotomy between anecdotal evidence and scientific research.

Facilitator Influence in Communication

Critics of facilitated communication emphasize that facilitators may inadvertently influence or control the messages produced. This raises concerns about the authenticity and reliability of the communication, as the messages may not originate from the individual with disabilities but rather from the facilitator.

Evidence from a meta-analysis involving 343 subjects highlighted overwhelming indications of facilitator influence in FC, inferring that the method lacks validity and could potentially harm the psychological and social well-being of those involved. Controlled research studies employing message-passing and double-blind methodologies consistently demonstrated that it was the facilitators, rather than the individuals with disabilities, who controlled the messages produced during FC [5].

Anecdotal Evidence vs. Scientific Research

Despite anecdotal claims supporting facilitated communication as an effective tool for individuals with autism, the scientific community has largely discredited the technique. The American Speech-Language-Hearing Association (ASHA) has reinforced this position, asserting that there is no credible scientific evidence to validate facilitated communication's efficacy. While people may share personal success stories using FC, the lack of rigorous scientific backing raises important questions about its actual effectiveness.

Additionally, various institutions, including the International Society for Augmentative and Alternative Communication and the New Zealand Ministries of Health and Education, advise against using facilitators due to insufficient evidence supporting their effectiveness [7]. With ongoing discussions regarding facilitated communication and autism, it's vital for parents to critically assess the information available and consult with professionals regarding alternative, evidence-based communication methods.

Risks and Ethical Concerns

The use of facilitated communication for individuals with autism raises several important risks and ethical considerations. Understanding these factors can help parents make informed decisions about communication strategies for their children.

Risks Associated with Using Facilitated Communication

Facilitated communication (FC) presents several concerns, particularly regarding its effectiveness and impact on the communication skills of individuals with autism. Research shows that FC does not improve language skills and typically involves facilitators exerting control over the communication process. In many observed interactions, the facilitator guides what is being written or typed, leading to questions about the authenticity of the messages conveyed. Controlled studies consistently indicate that facilitators have significant influence over the outcomes of these sessions.

Mainstream health organizations, such as the American Psychological Association and the American Academy of Pediatrics, advise against using facilitated communication techniques. They emphasize the risks of making children more passive and less likely to initiate their own communication. Moreover, evidence suggests that there are other augmentative and alternative communication (AAC) systems that can be more effective at assisting children with communication challenges.

Ethical Considerations in Using Facilitated Communication

The ethical implications of facilitated communication are significant. The main concern is that using FC may lead to misrepresentation of an individual's thoughts and feelings. If a facilitator unintentionally controls the language or ideas that are expressed, it raises questions about consent and the integrity of the communication. Parents and caregivers must consider whether they are genuinely facilitating the child’s communication or inadvertently imposing their own messages.

Various professional bodies discourage the use of methods associated with facilitated communication, such as the Rapid Prompting Method (RPM), which is closely linked to facilitated communication and lacks scientific evidence of effectiveness. Critics believe that promoting techniques with little or no proof of success can detract from more established therapies and interventions that could benefit individuals with autism.

Parents should be aware of the risks associated with facilitated communication and consider alternative communication methods that are backed by research. These include strategies like sign language and picture cards or more scientifically-supported augmentative and alternative communication systems. Making informed choices about communication strategies can ensure that children with autism receive the support they need to effectively express themselves.

Alternative Communication Methods

For parents of children diagnosed with autism, exploring alternative communication methods becomes essential, especially in light of the controversies surrounding facilitated communication. There are several effective options available, including sign language and picture cards, as well as Augmentative and Alternative Communication (AAC) devices.

Sign Language and Picture Cards

Sign language stands out as a highly beneficial form of communication for nonverbal autistic children. Studies by the National Institutes of Health highlight sign language as one of the most advantageous forms of AAC, significantly assisting in communication skills. In fact, learning and using sign language can provide children with a clear means of expressing their needs and feelings.

Picture cards also serve as a practical solution for many children with autism. These visual aids can simplify communication by allowing children to point to pictures representing their thoughts or desires. Both methods empower children with the ability to express themselves effectively.

Communication MethodAdvantagesSign LanguageDirect communication; promotes independencePicture CardsVisual representation; easy to use; reduces frustration

Many parents find success by combining both methods to enhance communication capabilities. For more insights on related techniques, check our article on how did applied behavior analysis (aba) start?.

Augmentative and Alternative Communication (AAC)

AAC encompasses a broad range of communication tools and strategies, designed specifically to support individuals with speech and language impairments. This can include everything from low-tech solutions like communication boards and symbols to high-tech devices that generate speech.

Parenting resources indicate a variety of AAC devices that accommodate different communication needs. These devices can be tailored to a child's specific preferences, making it easier for them to communicate. Regular use of AAC can lead to improved interactions and a greater sense of autonomy.

AAC Device TypeDescriptionLow-Tech (e.g., communication boards)Simple, cost-effective options for communicationHigh-Tech (e.g., speech-generating devices)Advanced technology that produces spoken language

Integrating AAC methods can significantly enhance the quality of life for children with autism, providing them with essential communication skills. For additional communication resources and ideas, explore more on chelation for autism spectrum disorder (asd) and cognitive remediation therapy.

Professional Recommendations

Stance of Mainstream Health Organizations

Mainstream health organizations generally express a position of caution regarding facilitated communication in autism. The American Speech-Language-Hearing Association clearly states that, while the intentions behind facilitated communication may be noble, there is insufficient scientific evidence to support its effectiveness. Moreover, the American Psychological Association emphasizes that facilitated communication lacks empirical validation, and its outcomes may not reliably reflect the communicative intentions of individuals with autism.

Other organizations, such as Speech Pathology Australia and Speech-Language & Audiology Canada, share similar concerns, advocating for evidence-based practices that prioritize validated communication methods. Parents are encouraged to explore therapies supported by substantial research and proven effectiveness.

Impact on Communication and Interaction

The impact of facilitated communication on the quality of communication and interaction for individuals with autism has been a subject of debate. For some families, facilitated communication seems to open up new avenues for expression, making it an appealing option. However, the lack of endorsement from professional organizations raises significant concerns.

Here’s a table summarizing the perspectives of various organizations on facilitated communication:

OrganizationStance on Facilitated CommunicationAmerican Speech-Language-Hearing AssociationInsufficient evidence supports effectivenessAmerican Psychological AssociationLacks empirical validation; caution advisedSpeech Pathology AustraliaAdvocates for evidence-based practicesSpeech-Language & Audiology CanadaRecommends validated communication methodologies

For parents, it remains crucial to consider other communication methods, such as cognitive remediation therapy or augmentative and alternative communication (AAC). These alternatives are better supported by research and may offer more reliable avenues for fostering effective communication and interaction for their children.

References

[2]:

[3]:

[4]:

[5]:

[6]:

[7]:

[8]: