Facilitated communication is a particular strategy used to help some individuals access augmentative communication devices. Individuals who might benefit have motor difficulties or motor planning problems that are helped by a facilitator who provides physical support. While some people demonstrate unexpected literacy, many use the technique as they learn to read or as they expand their literacy skills. Facilitated communication can be used to help people access devices using pictures or symbols.

Rosemary Crossley, a pioneer in the development of facilitated communication, often refers to the method as facilitated communication training. Crossley uses this term because people often need a great deal of instruction - both in accessing a communication device and in learning communication skills. Crossley (1993) defines facilitated communication training or FCT as:

No mode of communication should be used to the exclusion of all other forms. This is true of facilitated communication as well. Speech, gestures, signs, independent pointing, body language, and behavior can all be forms of functional communication. Facilitated communication can augment, and in some cases enhance, these other modes. Many individuals, however, are able to achieve their most sophisticated communication through facilitation.

FC has two major components:

Physical support is provided at the hand or arm, helping the individual to initiate pointing or to point accurately. Over time the support is usually faded back. Many individuals now communicate with just a hand on their shoulder or even independently.

Facilitators do not guide. Instead they provide backwards resistance only.

Facilitators have many responsibilities. Among the things they may do are to:

In addition to these physical accommodations facilitators provide a great deal of positive support and encouragement. The facilitator conveys the expectation that his/her communication partner is intelligent and will succeed. Facilitators talk to the FC speaker using the same language they would with anyone else his/her age. Good facilitators remain positive avoiding terms such as "Wrong," "Incorrect," or "No." Through his/her actions, speech, body language, the facilitator conveys a belief in the speaker’s competence. The facilitator also conveys his/her belief in the speaker’s intelligence by offering him/her choices and by selecting appropriate learning materials.

It should not be surprising that a facilitator’s approach, attitude, and style would influence his/her partner’s communication. All forms of augmentative communication - indeed all communication - take place within a social context. That context affects the quality and substance of shared messages. Communication is a collaborative process emerging from, among other things, the culture, the immediate context, partner’s interactional styles, the attitude of communication partners attitude towards each other, interactional style of partners, and partners’ personalities (Johnson, Baumgart, Helmstetter, & Curry, 1995). Failed attempts to communicate in the past might make these attitudinal factors particularly significant for a person with limited speech who is trying to communicate in a new way.

Many people have difficulty understanding why physical support may be necessary for people to type. Biklen (1990) and Crossley (1988) believe that individuals have failed to type independently in the past because of motor planning problems. The neurological problems that make speech difficult may also make it difficult to initiate and carry out many other motor activities, including pointing to pictures, symbols, or letters to spell words. A great deal of evidence now indicates that many people with autism and other developmental disabilities have movement disturbance and motor planning difficulties. The existence of dyspraxia and other movement disorders in individuals with autism has been well documented (Leary and Hill, 1996, Donnellan & Leary, 1995; Hill & Leary, 1993; Damasio & Maurer 1978). Many of the symptoms we associate with autism are seen in people with other movement disorders (Leary & Hill, 1996). The motor planning difficulties that may make it difficult for some people to speak may also make it difficult for them to engage in other voluntary motor sequences that they need to access an augmentative device (Prizant, 1996). Facilitated communication is, in part, an accommodation for motor planning difficulties.

Motor skills and motor planning are often confused. They are not identical although motor planning problems can make it difficult to learn new motor skills. Persons with motor planning difficulties have difficulty sequencing new motor patterns. This can make it difficult to speak or to engage in other motor activities required to communicate.

A number of myths surround facilitated communication. These include:

A number of recent studies demonstrate that this technique clearly can work with some people Baldac, & Parsons, 1997; Cardinal, D., Hanson, D., & Wakeham, J., 1996; Intellectual Disabilities Review Panel, 1989. Marcus, E. & Shevin, M., 1997; Olney, 1997; Sheehan, C. & Matuozzi, R., 1996; Vasquez, C. 1994; Weiss, M., Wagner, S. & Bauman, M.; 1996. Biklen and Cardinal (1997) provide an outstanding summary and analysis of the research in their new book Contested words, contested science: Unraveling the facilitated communication controversy.

Facilitated communication should not be viewed as a miracle or a cure for disability. It is simply a technique that has proved to be very beneficial in helping some individuals access augmentative communication systems.