Transcript Facilitated Communication

Facilitated
Communication (FC)
(Should Facilitated Communication still
be used? Can it be relied upon?)
Nicole Saunders
November 22, 2005
What is Facilitated
Communication?
 Facilitated communication is a procedure in
which a facilitator uses some degree of
physical assistance to help a client spell out
messages by touching letters on a letter
display (Biklen, 1990).
 A Facilitator normally supports a client's hand,
wrist or arm while that person uses a
communicator to spell out words, phrases or
sentences (Autism Society Canada, 2005).
 An alternative means of expression for
people who cannot speak, or whose speech
is highly limited and who cannot point
reliably. The method has been used as a
means to communicate for individuals with
severe disabilities, including persons with
labels of mental retardation, autism, Down
syndrome and other developmental
disabilities. (Facilitated Communication
Institute)
Where did it all begin?
 Australia 1970  Rosemary Crossely started (FC) by
encouraging a woman which was diagnosed with
cerebral palsy to communicate by acting as her
facilitator (National Autistic Society, 2004).
 Crossely then went on to establish in 1986: DEAL
Communication Centre in Melbourne
 DEAL was based on the theory that the language skills
of people with autism and other communication
disorders were not as impaired as previous notion
(National Autistic Society, 2004).
 Late 1980’s  Douglas Biklen introduced to
the United States (University of Syracuse)
 Biklen obtained a Ph.D. in Social Science from
Syracuse University in 1973.
 Biklen was on a research project in Australia,
while he was there he observed Crossely’s
work. He returned to the United States where
he presented FC to speech therapists and
special educators working with nonverbal
autistic students.
Biklen’s Research
 Once Biklen and some colleagues tried the
technique they reported to find unbelievable
results. Nonverbal students were
communicating to others.
 It was said that their reports did not “present
accounts of consistent benefit of the technique
were unambiguous or standardized measures
of communication used for baseline and
posttreatment performance assessment.”
(Montee et al., 1995)
Controversy Grew while
FC use spread
 As Biklen and colleagues published their
findings, many people became excited.
FC brought them feelings of hope to have
a chance to communicate with loved
ones which was always a hopeless
dream before.
 Institutions were established and
programs to facilitated communication
were developed.
Stories
 Jeff Powell a student at Baker high school in
Syracuse ("Autism held me hostage for
seventeen years but not any more because
now I can talk.")
 ["I cry a lot about my disability ... It makes me
feel bad when I can't do my work by myself."
Andrew, age 6]
 [Please heed my need. I need to heed others. I
this reason think the world they need heed like
we heed brothers." Manny, 2nd grade]
(Palfreman, 1993)
Facilitated
Communication a hoax?
 As time went by more and more studies
were disproving the positive belief of FC.
 Many studies were showing that the
facilitator was actually the one typing the
message.
 Ethical issues are also a concern.
For Example:
Wheeler, Jacobson, Paglieri, and Schwartz (1993)
 Pictures manipulated by using a T-screen apparatus
(showed different pictures to the student and the
facilitator
 Showed:
 (a) the client-facilitator pair typed the name of the
picture correctly only when the facilitator was shown
the same picture
 (b) the pair never typed the name of the picture
correctly when the facilitator was not shown the same
picture
 (c) when the facilitator was shown a picture that was
not the same as the picture shown to the client, the pair
typed the name of the picture shown to the facilitator.
Other studies that
demonstrated the same thing
 Hudson, Melita, & Arnold, 1993
 Moore, Donovan, & Hudson, 1993
 Moore, Donovan, Hudson, Dykstra, &
Lawrence, 1993
 Regal, Rooney, & Wandas, 1994
(Montee et al., 1995)
“Research has consistently shown that it is the facilitators (not the
clients) who determine the content of the typed message (though
unconsciously).” as outlined by Condillac and Perry, (2003)
Ethical Issues presented
(Dayan & Minnes, 1995)
 RESPECT FOR THE DIGNITY OF
PERSONS
 A) Informed ConsentFacilitator consent rather then the
students consent.
b) Confidentiality- third party
 2. Responsible caring- evaluate potential risks
and benefits of a treatment and to do no harm.
a) IQ testing- may mislead results and create
higher expectations of individual which can
lead to depression, lower self esteem etc.
Alternative- Raven's Progressive Matrices and
the Leiter International Performance Scale (Do
not require verbal responses.)
b) Chance of Mis-use and Mis-interpretation
Ex. Cases of reported child abuse.
Reaction?
 In the beginning the participants of FC
did not pay any attention to the
disproving results. Their own personal
experiences with their loved ones
communicating to them provided a wall in
which they could ignore the accusations
of FC. No one wanted to believe that
their loved ones in truth could not
communicate.
Biklen’s Reactions
 “Biklen (1993b) claims that (a) experimental
arrangements cause clients to become anxious or
resistant in facilitated communication sessions, thus
impairing their performance; (b) testing destroys the
rapport and trusting relationship between the client and
facilitator, which also impairs performance; (c)
facilitators were not adequately trained in experimental
studies; (d) clients had not been in facilitated
communication training long enough to be tested; and
(e) the autistic subjects in experimental studies had
word-finding difficulties (aphasia) and, therefore, that
naming pictures or activities is not a valid way to
evaluate facilitated communication.” (Montee et al.,
1995)
Research to compensate
for Biklen’s concerns





1.
(Montee et al., 1995)
7 pairs (client-facilitator)
Normal setting
12- 24 activities, 24 pictures presented to each client
Three conditions:
The facilitator and client had access to the same
information
2. The facilitator did not have access to the picture or
activity
3. The facilitator was given false information about the
picture or activity.
Results
 Activity  80% of the time in the false
condition trials (unknown to the
facilitator), the client answered (typed)
the correct answer of the facilitator.
 When the facilitator knew what was
presented to the student, the students
answered correctly 87%
Results continued
 Picture  When the facilitator knew what
was presented to the student, the student
answered correctly 75% of the time.
 66% of the trails when the student was
presented with a different picture then the
facilitator, the student answered correctly
for the facilitators picture
 Biklen published Facilitated
Communication Digest which included
outlines for the use of FC.
 Perhaps the technique is useful however,
the faultiness is within the teaching of
how to correctly use FC.
 Biklen, (1993c) also states that controlled
studies by Calculator & Singer, 1992;
Vazquez, 1994; Weiss, Wagner &
Bauman, in press all prove FC works
properly
 Accusations of sexual abuse slowly
began to change individuals perception
and belief’s about FC.
Today
 Institutions still promoting and teaching
FC
Ex. Syracruse University, Indiana Institute
on Disability and Community
 Autism Society Canada 
“Experts report that FC as a stand-alone
program approach is ineffective and potentially
harmful for individuals with ASD.” (Autism
Society Canada, 2005)
 American Psychological Association
“THEREFORE, BE IT RESOLVED that APA
adopts the position that facilitated
communication is a controversial and
unproved communicative procedure with no
scientifically demonstrated support for its
efficacy.” (APA online, 1994)
Graduate Studies
 Patricia Minnes, (Developmental
disabilities) Ph.D. in Developmental
Psychology Queen’s University
References

APA online: American Psychological Association: Council Policy Manual :
Scientific Affairs., 1994
http://www.apa.org/about/division/cpmscientific.html#6
 Autism Society Canada: Communication systems., 2005
http://www.autismsocietycanada.ca/approaches_to_treatment/communication_systems
/index_e.html

Biklen, D. (1990). Communication unbound: Autism and praxis.Harvard

Educational Review, 60, 291-315.
Biklen, D. (1993c). Questions and answers about facilitated
communication.Facilitated Communication Digest, 2, 10-14.

Condillac, R. & Perry, A. (2003). Evidence Practices for Children and Adolescence
with Autism Spectrum Disorder: Review of literature and practice guide.

Dayan, J., Minnes, P. (1995). Canadian Psychology. Ethical issues related
to the use of facilitated communication techniques with persons with
autism

Montee, B.B., Miltenberger, R.G., & Wittrock, D. (1995) Journal of Applied
Behavior Analysis. An experimental analysis of facilitated communication,
28, 189-200.
 National Autistic Society: Facilitated Communication., 2004
http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=297&a=3285
 Palfreman, Jon. PBS Frontline: Prisoners of Silence., October 19, 1993
http://www.pbs.org/wgbh/pages/frontline/programs/transcripts/1202.html
 Syracuse University: Introducing teaching and leadership
http://soeweb.syr.edu/Teaching/intro_tl/biklen_i.html
 University of Syracuse, Facilitated Communication Institute: Facilitated
communication
http://soeweb.syr.edu/thefci/
 Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. (1993).
An experimental assessment of facilitated communication.Mental
Retardation, 31, 49-60
Discussion:
 What do you think…
 1. Facilitated communication began to be
used before any significant testing of
validity was conducted.
 2. Even after all of the negative evidence
provided in study after study, FC is still
practiced and taught today.