Facilitated Communication

Facilitated Communication (FC), also known as supported typing, is a controversial technique that was developed in the 1970s to help individuals with severe disabilities, particularly those with autism or cerebral palsy, communicate. FC involves a facilitator physically assisting a person with disabilities by supporting their hand or arm as they point to letters on a board or type on a keyboard. While FC initially garnered widespread attention and optimism, it has since been widely discredited due to concerns about the facilitator’s influence on the messages produced and the lack of scientific evidence supporting its effectiveness.

Origins and Early Development
Rosemary Crossley and Early Use:
1970s Australia: FC was first introduced by Rosemary Crossley, an Australian teacher who worked with individuals with severe physical disabilities at the St. Nicholas Hospital in Melbourne. Crossley developed the technique to help patients who had difficulty controlling their motor functions communicate by guiding their hand movements to point to letters or words.

Annie McDonald: One of Crossley’s first and most well-known students was Annie McDonald, a young woman with cerebral palsy. Crossley believed that McDonald had untapped cognitive abilities and introduced FC to help her communicate. After purported success with McDonald, Crossley began to promote FC as a breakthrough method for helping nonverbal individuals communicate.

Spread to the United States:
Douglas Biklen: In the 1980s, Douglas Biklen, a sociologist and educator at Syracuse University in New York, learned of Crossley’s work and became a major proponent of FC in the United States. Biklen believed that many individuals with autism and other severe disabilities had undiscovered intellectual potential, and he saw FC as a way to unlock their communication abilities.

Mainstream Adoption: Biklen and other advocates promoted FC through conferences, training programs, and media appearances. By the late 1980s and early 1990s, FC had gained attention in schools, clinics, and families across the U.S., and it was embraced as a potential breakthrough in autism therapy. The method was even used in some special education settings, with facilitators helping students produce written work, answer questions, and participate in classroom activities.

Initial Optimism and High Expectations
Hope for Communication:
Unlocking Hidden Intelligence: FC was embraced by many families and educators as a way to help nonverbal individuals with disabilities express their thoughts and feelings for the first time. Proponents believed that the technique was unlocking the hidden intelligence of people who had previously been thought to be incapable of communication.

Claims of Success: Some individuals using FC appeared to produce complex and coherent messages, leading to claims that the method was helping people reveal a previously unrecognized intellectual capacity. There were reported cases of individuals using FC to express emotions, describe their inner experiences, and even engage in academic tasks.

Media Attention
Widespread Media Coverage: During the early 1990s, FC gained significant media attention, with several high-profile stories in newspapers, television programs, and magazines. Positive accounts of FC were often highlighted, showcasing the apparent success of individuals who, through facilitated typing, were able to communicate for the first time. This media coverage contributed to the growing popularity of the technique in both the United States and other countries.

The Rise of Criticism and Scientific Scrutiny
Early Doubts and Challenges:
Skepticism from the Scientific Community: Despite the initial optimism, FC quickly attracted skepticism from many scientists, educators, and speech-language pathologists. Critics raised concerns about the lack of rigorous scientific studies validating the technique and questioned whether the facilitators were unconsciously influencing the responses.

Ideomotor Effect: The primary concern was that the facilitators, rather than the individuals with disabilities, might be the ones producing the typed messages, either consciously or unconsciously. This phenomenon is known as the ideomotor effect, where subtle, involuntary movements influence the outcome of an action. Some compared FC to Ouija boards, where participants unintentionally guide the pointer to certain letters or symbols.

Controlled Studies and Discrediting of FC:
Controlled Testing: In the early 1990s, several controlled studies were conducted to determine whether the messages generated during FC were truly coming from the disabled individuals or from the facilitators. In these studies, individuals using FC were shown images, objects, or information that the facilitator could not see, and they were then asked to communicate what they had seen.

Results of the Studies: The results of these studies overwhelmingly showed that the messages produced during FC were almost always influenced by the facilitator, rather than the individual with disabilities. When the facilitator did not have access to the same information as the individual, the responses were typically incorrect or incoherent. These findings cast serious doubt on the validity of FC as a communication method.

American Psychological Association: By the mid-1990s, numerous professional organizations, including the American Psychological Association (APA), the American Speech-Language-Hearing Association (ASHA), and the American Academy of Pediatrics, issued statements concluding that FC was not a scientifically valid method of communication and should not be used as a primary means of communication for people with disabilities.

The Controversy Deepens: Legal and Ethical Issues
Allegations of Abuse:
Accusations of Abuse: One of the most troubling aspects of the FC controversy arose when some individuals using FC began to type out allegations of sexual abuse against family members, caregivers, and teachers. In many of these cases, the accusations were later found to be false, with the messages likely being the result of facilitator influence rather than the true statements of the individuals.

Legal Cases: Several high-profile legal cases emerged in which parents or caregivers were accused of abuse based on messages generated through FC. In many instances, families were torn apart and individuals were wrongfully charged or investigated before the accusations were proven to be baseless. These cases heightened the ethical concerns surrounding FC, as it became clear that facilitators were often unintentionally leading to harmful and false accusations.

Ethical Concerns
Exploitation of Vulnerable Individuals: Critics argued that FC was unethical because it gave false hope to families and exploited vulnerable individuals with disabilities. By claiming that nonverbal individuals were typing complex messages, facilitators and proponents of FC were seen as taking advantage of the emotional and financial investment of families seeking ways to communicate with their loved ones.

Undermining Other Methods: The widespread promotion of FC also diverted attention and resources away from other, more effective communication methods, such as augmentative and alternative communication (AAC) systems, which are based on scientifically validated techniques. AAC methods, such as communication boards or devices that use symbols or speech output, are widely supported by speech-language pathologists and provide individuals with disabilities reliable ways to communicate.

Decline of FC and Ongoing Debate
Decline in Popularity:
Scientific Consensus: By the late 1990s, the scientific consensus against FC was firmly established, and its use began to decline in most educational and clinical settings. Although some advocates continued to support FC, its credibility had been severely damaged by the studies demonstrating facilitator influence and the legal and ethical controversies that arose from its use.

Alternative Communication Methods: As FC lost favor, other methods of communication, including speech-generating devices, picture exchange systems, and more advanced AAC technologies, gained widespread acceptance. These methods are based on evidence-based practices and have been shown to effectively help individuals with disabilities communicate.

Continued Support in Some Communities:
Ongoing Advocacy: Despite the overwhelming evidence against FC, there are still some communities and organizations that continue to support its use. Proponents argue that, in some cases, FC has allowed individuals to express themselves in ways that other communication methods do not. However, these claims are largely anecdotal and are not supported by the broader scientific community.

Controversy in Education and Therapy: Some families and educators continue to use FC, particularly in private settings, despite the controversy and lack of scientific validation. This has led to ongoing debates about whether FC should be completely abandoned or whether further research might identify contexts in which it could be effective.

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