Few unsubstantiated and thoroughly discredited treatments for persons with developmental delays have the longevity and support that facilitated communication (FC) has enjoyed. FC involves a "therapist" providing physical support, usually at the hand, wrist or arm, for typing out messages on a keyboard to a person with limited communicative skills. The facilitator is said to facilitate communication by allowing the facilitated person to express themselves through this assistance. The physical guidance provided to the person with communication impairment is, according to FC proponents, a means of unlocking the communication that sits trapped within them.
FC was brought into the US by Douglas Biklen of Syracuse University. In the early 1990s he founded the Facilitated Communication Institute. Given that people with autism often have impaired communicative skills, FC was proclaimed as a means of providing a voice to those without one. With a fairly brief workshop, Biklen unleashed facilitators unto the world with miraculous results. The silent were now speaking. Children who never participated in regular educational activities were soon earning high marks with their facilitators at their sides. Families were given new hope that their children would thrive and prosper with this treatment. This was, unfortunately, false hope.
Many well established researchers and clinicians were skeptical of the plausibility of FC from the beginning. How could a person seemingly communicate at a high level after a few minutes with a facilitator? Why were they able to communicate so effortlessly and often without even being oriented towards the keyboard at which their faciltators were guiding their fingers towards letters or icons? Research soon emerged showing that FC was a bogus therapy. Most of the 40 or more controlled evaluations of FC involved a blinded investigation of whether the faciltator or facilitated were the source of communication. For example, a facilitator might, at times, be shown the same object as the facilitated but, at other times, they are shown different objects. It has been well established that the source of communication is the facilitator not the facilitated.
When FC came along, a few parents at the New England Center for Children insisted that this new technique be used with their children. There had not yet been published debunking of FC and our administration agreed to test whether FC would be an effective treatment. Several of NECC's speech therapists were trained by Biklen and colleagues but a trial of the intervention was developed and implemented by Gina Green and Becky MacDonald. Our test showed that FC did not produce any communication by the faciliated children. As a result of our test, FC was dismissed as a plausible communication technique and our suspicions were confirmed by numerous investigations.
So given this information FC quickly died and has vanished from the world of communication interventions. Or that is what should have happened. FC is still around and still thriving. There is no sound scientific evidence that FC is a valid communication training procedure. Despite this, Biklen has been named the Dean of the School of Education at Syracuse. FC has been promoted by CNN, Newsweek, and Time magazine. FC is seemingly here to stay.
In Time magazine's coverage of FC in 2006 ("Inside the Autistic Mind") it is stated that, "Other classic symptoms--a lack of emotion, an inability to love--can now be largely dismissed as artifacts of impaired communication. The same may be true of the supposedly high incidence of mental retardation." I'm certain that a caregiver would like to believe that a rich social and emotional life in their child can be released with simple physical assistance in typing out messages on a keyboard but that is misleading. FC has also been used as a means of lodging unsubstantiated claims of abuse against caregivers. A 1992 PBS Frontline documentary, "Prisoners of Silence" (directed by Jon Palfreman), depicts the devastation to families and false hopes brought by this technique. The Behavior Analysis Association of Michigan's Jim Todd, has also closely followed and documented a number of allegations of abuse launched as a result of accusations by a facilitator (e.g., http://www.baam.emich.edu/baammainpages/whtnew.htm#allchargesdropped).
The potential costs of adopting FC are many. Besides the false hope and false accusations there is the time and resources wasted on it that could otherwise be spent providing the education and support that could help persons with impaired communication skills. It is for these reasons that a number of organizations have issued position statements on FC. These include the American Psychological Association, the American Academy of Pedicatrics, and the American Speech-Language-Hearing Association. These organizations clearly state that FC is not a valid treatment.
Additional resources on this topic are provided below:
Jacobson, J.W., Foxx, R.M., & Mulick, J.A. (2005) Facilitated Communication: The ultimate fad treatment. In J.W. Jacobson, R.M. Foxx, & J.A. Mulick (Eds.), Controversial therapies for developmental disabilities. Mahwah, NJ: Lawrence Erlbaum Associates.
Jacobson, J.W., Mulick, J.A., & Schwartz, A.A. (1995). A history of Facilitated Communication: Science, pseudoscience, and antiscience. American Psychologist, 50, 750-765.
Mostert, M. P. (2001). Facilitated Communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders, 31, 287-313.