Many individuals, however, are able to achieve their most sophisticated communication through facilitation. 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.
In addition to these physical accommodations facilitators provide a great deal of positive support and encouragement. That context affects the quality and substance of shared messages. 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. 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.