Facilitated Communication

Stephen Barrett, M.D.
September 16, 2004

Facilitated communication is a process in which a “facilitator” supports the hand or arm of a severely handicapped person who spells out a message using a typewriter, a computer keyboard, or other device containing a list of letters, numbers, or words. It is alleged to help individuals strike the keys they desire without influencing the choice of keys. Some speech therapists and other special-education providers are using this procedure for nonverbal individuals with autism or severe mental retardation. Proponents claim that it enables such individuals to communicate. However, many scientific studies have demonstrated that the procedure is not valid because the outcome is actually determined by the “facilitator.”
[1,2] In one study, for example, autistic patients and facilitators were shown pictures of familiar objects and asked to identify them under three types of conditions: (a) assisted typing with facilitators unaware of the content of the stimulus picture, (b) unassisted typing, and (c) a condition in which the participants and facilitators were each shown pictures at the same time. In this last condition the paired pictures were either the same or different, and the participant’s typing was “facilitated” to label or describe the picture. No patient gave a correct response when the facilitator had not been shown the picture. The researchers concluded that the facilitators were not aware that they were influencing the patients [3]. The American Psychological Association has denounced facilitated communication and warned that using it to elicit accusations of abuse by family members or other caregivers threatens the civil rights of both the impaired individual and those accused [4]. Critical statements have also been issued by the American Academy of Child and Adolescent Psychiatry, American Speech-Language-Hearing Association, American Association on Mental Retardation, and Association for Behavior Analysis. In 1994, the Federal Trade Commission settled charges that two companies had made false and unsubstantiated claims about “facilitated communication” devices they had marketed [5].

  1. Mulick JA and others. Anguished silence and helping hands: Autism and facilitated communication. Skeptical Inquirer 17:270-280, 1993.
  2. Wheeler DL and others. An experimental assessment of facilitated communication. Mental Retardation 31:49-59, 1993.
  3. Jacobson JW, Mulick JA, Schwartz AA. A history of facilitated communication: Science, pseudoscience, and antiscience: Science Working Group on Facilitated Communication. American Psychologist 50:750-765, 1995.
  4. American Psychological Association. Resolution on facilitated communication. Aug 14, 1994.
  5. Marketers of “facilitated communication” devices agree to settle FTC charges. FTC news release, Dec 15, 1994.

This article was posted on September 16, 2004.