Facilitated Communication (FC) is a technique whereby individuals with speech or communication impairments type on a computer keyboard while receiving physical support and encouragement from facilitators. In recent years, experts have disputed whether people with disabilities are being facilitated to express their own communicative intentions, or whether the source of the output is that of the facilitators. Thus, the International Society for Augmentative and Alternative Communication (ISAAC) formed an Ad Hoc Committee on FC to synthesize the evidence base on this issue in order to develop a position statement.
Publication in a peer-reviewed journal was required for inclusion in the systematic review. Materials in languages other than English, German, French or Italian were excluded due to lack of resources for translation. Literature that met the following criteria (deemed “level one”) provided scientific evidence: Quantitative experimental studies (or systematic reviews of such studies) that involved an a priori controlled manipulation of knowledge/stimuli presented to the facilitator and FC used by the individual in an attempt to empirically establish who was authoring the messages.
Three previous systematic reviews met Level 1 criteria for inclusion. A recent high quality systematic review (Probst, 2005) synthesized 23 studies and found overwhelming evidence for facilitator control in FC. In 2008, Wehrenfennig and Surian published a review of the same studies and concurred with Probst’s conclusions. The ISAAC committee identified four additional Level 1 studies not included in the prior reviews. Results of all three reviews provided unequivocal evidence for facilitator control, that is, that messages generated through FC were authored by the facilitators rather than the individuals with disabilities. They concluded that FC has no validity.
1 Wetherby AM, Guthrie W, Woods J, Schatschneider C, Holland RD, Morgan L, et al. Parent-implemented social intervention for toddlers with autism: an RCT. Pediatrics. 2014;134(6):1084-93.