Facilitated Communication
Authors: McLean James 
Published: July 2014

My summary reaction to the controversy at hand is that the success of the Biklen and Crossley procedures cannot be discounted on the basis of present knowledge about autism. I know that Calculator also agrees that there is every possibility that literacy skills have been ignored, and even suppressed, by past treatment practices and past segregation policies. Professional tolerance (let alone encouragement) for the use of any communication mode except speech is a relatively new stage for professionals in speech and language. We need only look at our past practices of denigrating manual sign language among people who are deaf to realize how egocentric people without disabilities have been.

Overall, however, I think Calculator is right to point out the need for empirical efforts to objectify the procedures and provide a better understanding of the process and the theoretical basis for facilitated communication. I have long championed the notion that treating human problems at only the procedural level, with no understanding as to the theoretical or empirical bases of the treatment, is less than professional and, indeed, is dangerous behavior. Biklen also reflects this awareness, however. He posits his praxis rationale with some support from the literature (Grandin & Scariano, 1986; Oppenheim, 1974). It seems premature to dismiss it as readily as Calculator seems to do. Clearly, however, the proponents of facilitated communication need to do a more complete and rigorous job of objectifying their procedures and more fully describing the people for whom this procedure is "successful." Surely there are extant communication and cognitive abilities among the successful users of these procedures that could be identified and differentiated from the abilities present among those for whom the procedures are less successful. For example, one might look at the recent literature that describes the intentional communication repertoires of nonspeaking people with autism as a guide to some possibly productive taxonomies for describing the pre-treatment behavior of people who showed literacy after experience with facilitated communication procedures (see, for example, Wetherby & Prutting, 1984; Wetherby, Yonclas, & Bryan, 1989). Any extant speech repertoire needs to be carefully described and analyzed. Objective measures of children’s receptive language and reading abilities are also needed. Clearly, being able to predict differential success in the use of facilitated communication procedures would go a long way in helping to establish both empirical and theoretical bases for them.

Although it really isn’t necessary, I say to Calculator, have faith. If it turns out that some time is spent in the process of clinically testing these procedures, it is the price we pay to ensure that we do not dismiss ideas and procedures that are unconventional in terms of past practices and past knowledge. If your concerns about these procedures are valid, empiricism will win out over superstition and emotionalism. Neither clinicians, nor consumers of clinical services, can be sustained for long without documented success... success that is measured not only in the research laboratories, but in clinical settings as well. Denying a procedure its opportunities for validation in the clinical arena is not a desirable step. Not all empiricism is found in the laboratory, and not all truth is found in formal research.