Facilitated Communication

Facilitated Communication Training is a strategy which may enable some people with complex communication needs to learn how to point to things with increasing independence.  The Training process involves a communication partner offering physical touch or support to steady and control the movements but NOT direct them. Detailed information concerning the history of this AAC  (Augmentative and Alternative Communication )strategy, case studies, progress and validation check sheets and the recommended competencies from basic to Instructor training can be found in my book “A Slice of My Life – Facilitated Communication Training”.

The National  Standards project for the National Autism Centre of the United States classifies treatment strategies as Established, Emerging, Un-established and Ineffective/Harmful. Facilitated Communication is listed as one of the Un-established strategies.  Unless practitioners and most importantly, facilitators adhere to standards for best practice in the use of facilitated Communication then I fully expect FCT to remain in this category of interventions for people with complex communication needs.

What are Standards for Best Practice? 

In our society we all need to know what is good to invest our time, money and energies in. We need to know what the capabilities of a system are and what the potential barriers and catalysts are to us achieving our goals. Essentially we need to know what our options are for best and long term outcomes.

I have been a facilitator for twenty three years and have been delivering training for facilitators for eighteen years. The following comments are made on the basis of my readings, my experience and most of all the outcomes from role plays in my workshop training. These are the ten key areas I address in establishing Best Practice Guidelines for my practice and use of Facilitation.

• If a facilitator holds a low tech communication display then expect for errors to be made.
• If a facilitator allows keyboarding at a very fast rate, especially on a low tech display, then expect for errors and wrong interpretation of the person’s message.
• If a facilitator continually offers hand support  when  a lesser level of physical support is possible then don’t expect the facilitation user to develop independence.
• If an FCT user is not supported through cues, techniques or neuro-sensory investigations to ‘look’ at their display when communicating then they cannot expect to be seen as a credible communicator or to communicate independently.
• If the facilitator does at least three steps in the initiation of a conversation then don’t expect the facilitation user to develop independence

Example:

Facilitator:         “what did you do on the weekend?’

Facilitator:         (offers communication board)

Facilitator:         (takes the FC users hand)

Facilitator:         repeats the question

• Facilitation is about offering meaningful choices and physical support. It is NOT about spelling or literacy. Facilitators ought to be able to facilitate an FCT user without a communication display. If you don’t know how to do this then you need to come to a Basic FCT or an AAC workshop.
• If an FCT user cannot produce a validation portfolio then they should not have access to Medical Aide Subsidy Funding for an electronic communication display.
• Facilitators who support an FCT user to hit their communication displays using a heavy tap and/or a wrist flicking action should be held responsible in the short and long term for joint damage this technique may cause.
• Conversation skills often have to be taught so be sure to have access to punctuation, conversation repair strategies, intonation markers and questions on the communication displays. If you don’t know what this is about then you need to attend a Communication Display design workshop or do some reading on the subject.
• Facilitation is an access strategy and is not separate from the field of augmentative and alternative communication. However, it will become separated from AAC if the people facilitating fail to acknowledge this, fail to use best practice guidelines and sell the FCT users short through lack of common sense.