Facilitated Communication Helping Autistic Children

Facilitated Communication is a nearly-debunked approach to communication with non-verbal people on the autism spectrum. It involves the use of a keyboard and a "facilitator" whose job is to support the autistic person as they type their responses to questions, thoughts, and concerns. In some cases, the support involves the physical touching of the autistic person's arms.

Mother and child typing on computer
Hero Images / Getty Images

How Supporters of FC Describe the Process

The Syracuse University Department of Education's Institute of Communication and Inclusion continues to teach FC as a legitimate form of communication. Here is how they describe what they now call "supported typing":

Facilitated Communication (FC) or Supported Typing is a form of alternative and augmentative communication (AAC) in which people with disabilities and communication impairments express themselves by pointing (e.g. at pictures, letters, or objects) and, more commonly, by typing (e.g. in a keyboard). The method involves a communication partner who may provide emotional encouragement, communication supports (e.g., monitoring to make sure the person looks at the keyboard and checks for typographical errors) and a variety of physical supports, for example, to slow and stabilize the person’s movement, to inhibit impulsive pointing, or to spur the person to initiate pointing; the facilitator should never move or lead the person.

It often is referred to alternatively as Facilitated Communication Training because the goal is independent typing, nearly independent typing (e.g., a hand on the shoulder or intermittent touch) or a combination of speaking with typing - some individuals have developed the ability to read text aloud and/or to speak before and as they are typing. Typing to communicate promotes access to social interaction, academics, and participation in inclusive schools and communities.

History of Facilitated Communication

Facilitated communication was first conceived of by Australian Rosemary Crossley, an employee of St. Nicholas Hospital in Melbourne, Australia. By the 1980s interest in this approach was growing. If legitimate, FC could potentially "unlock" the minds of nonverbal people, making it possible for them to communicate their thoughts, ideas, and needs.

During the 1990s, great interest in FC led to what seemed like extraordinary outcomes: people with no apparent engagement in the world were suddenly expressing complex thoughts and ideas. In some cases, they were also describing instances of sexual abuse. After much controversy, researchers found that the individuals who were thought to be "communicating" were almost certainly being physically guided by their facilitators.

In 1994, the American Psychological Association officially stated that there was no scientific evidence supporting FC. The American Speech-Language-Hearing Association and American Academy of Pediatrics issued similar statements. Their concerns — that FC could actually do harm — were supported when several autistic individuals, using FC, supposedly claimed they had been raped by their caregivers. After much investigation and heartache, the cases were dismissed.

Despite negative findings and controversy, interest in FC continued. Syracuse University, which had founded a Facilitated Communication Institute, conducted research. Documentaries, including the 2005 Academy Award-nominated Autism Is a World, kept public interest strong. Researchers at Syracuse, as well as the University of Kansas and the University of New Hampshire (among others) continue to research FC with the understanding that it is a legitimate field of study.

The Case Against FC

In general, mainstream practitioners reject FC, and organizations including the American Speech-Hearing-Language Association, the American Psychological Association, and others have specific policies stating that FC is an unproven technique that has the potential to cause more harm than good.

Those people who reject FC claim that the FC facilitator — who physically supports the arm or hand of the typer — is, in fact, tapping out his own conscious or unconscious thoughts. Occasionally, those thoughts have included unfounded claims of abuse against parents and caregivers.

To explain the FC phenomenon, some researchers have compared FC to an Ouija board. An Ouija board is a board with letters on it. Two people place their fingers on a marker, and spirits of the dead are supposed to guide their hands to letters on the board, spelling out a message from beyond the grave. Very often a message is, in fact, spelled out — but research has shown that the users themselves are unconsciously moving their hands.

The Case for FC

Those people who support FC as a real tool for communication with nonverbal individuals on the autism spectrum have reviewed available research themselves. Most of the time, supporting studies have focused on individual case studies. To prove that the typer is, indeed, typing his own thoughts, they asked questions that the supporter could not possibly answer. In some cases, the typer actually typed out answers that made perfect sense.

The Institute for Communication and Inclusion lists many peer-reviewed case studies like those described above, most dating from the early and mid-1990s when FC was most popular. In addition, a new but similar technique called "Rapid Pointing" has helped raise new interest in the approach. Rapid Pointing is described in detail in Portia Iversen's book Strange Son, and FC can be seen in action in the video Autism: The Musical. 

It is extremely tempting for the parent of a child with nonverbal autism to try FC (or Rapid Pointing). The idea that there is a mind trapped inside your child, just waiting for the tools to emerge, is extraordinarily compelling.

Is It Really a Good Idea to Try FC?

While there are certainly organizations and institutions that will provide FC training (including Syracuse University), FC is not the first choice for communication.

Before getting involved with FC, it makes sense to try teaching a child with autism to use better-known, better-understood techniques. Some options include picture cards, American Sign Language, electronic tools such as augmentative speech devices, digital pads, and, of course, ordinary (unsupported) typing. Not only are these techniques less controversial, but they're all more widely usable and understood.

If, however, more typical tools have failed, FC may be a possible direction to try. If you do try FC, be sure to investigate the provider and the therapist thoroughly to ensure you're not the victim of a scam. You should also consult with your child's physician or psychiatrist; some may even invite the FC clinician into the office to observe the technique.


7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Basics About Typing to Communicate. Syracuse University Institute on Communication and Inclusion.

  2. Who We Are. Syracuse University Institute on Communication and Inclusion.

  3. Hemsley B, Bryant L, et al. Systematic Review Of Facilitated Communication 2014–2018 Finds No New Evidence That Messages Delivered Using Facilitated Communication Are Authored By The Person With Disability. Autism & Developmental Language Impairments. 2018;(3).  doi:10.1177/2396941518821570

  4. Andersen M, Nielbo KL, Schjoedt U. et al. Predictive minds in Ouija board sessions. Phenom Cogn Sci. 2019;18; 577–588. doi:10.1007/s11097-018-9585-8

  5. Moore JW, Fletcher PC. Sense of agency in health and disease: a review of cue integration approaches. Conscious Cogn. 2012;21(1):59-68.  doi:10.1016/j.concog.2011.08.010

  6. Przybyla O. Facilitated Communication in Autism. A Case Study. Logopedia Silesiana. 2019;(8):351-362.

  7. Chen GM, Yoder KJ, Ganzel BL, Goodwin MS, Belmonte MK. Harnessing repetitive behaviours to engage attention and learning in a novel therapy for autism: an exploratory analysis. Front Psychol. 2012;3:12. doi:10.3389/fpsyg.2012.00012

Additional Reading

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.