Facilitated Communication

Facilitated Communication Standards and Best Practice Christi Kasa-Hendrickson Darlene Hanson Don Cardinal

Practice Structure Attitude Best Practice Elements of Facilitated Communication fall into three categories Facilitated Communication Training Standards 2000

Elements of FC Structure Attitude Practice FC USER Practice Attitude Structure Facilitated Communication Training Standards 2000

Attitude Elements Facilitated Communication Training Standards 2000

Principles &Best Practice: Attitude Citizenship and Presuming Competence • Citizenship is membership in a community • Citizenship carries with it a presumption that a person's interests and those of her or his community are somehow intimately linked with each other. Facilitated Communication Training Standards 2000

Principles &Best Practice: Attitude Right to communicate • That all people have a means of communication which allows their fullest participation in the wider world • That people can communicate using their chosen method and that their communication is heeded by others. Facilitated Communication Training Standards 2000

Principles &Best Practice: Attitude Empowering FC user -- Questions to ask: • "Am I determining the pace or am I allowing the facilitated communication user to determine the pace?", • "Am I getting a third person's attention or am I teaching the facilitated communication user how to do that?” • "Am I determining who reads or hears what the facilitated communication user has typed, or am I letting the facilitated communication user determine who receives his or her communication?" Facilitated Communication Training Standards 2000

Principles &Best Practice: Attitude Total communication approach • Not meant to replace current successful communication methods • Meant to enhance and expand current communication opportunities • Many people who type also use some speech, sign, prepared communication boards Facilitated Communication Training Standards 2000

Practice Elements Facilitated Communication Training Standards 2000

Elements of Facilitated Communication Training Created by Cardinal 2006 Monitoring (look at keyboard) Emotional Support Control Difficult Behavior Physical Support Ergonomics Comm. Partner Device Correction Strategy Structured Activities Pointing Facilitated Communication Training Standards 2000

Principles &Best Practice: Practice Elements of FC Training: Physical Support • Physical support may include the following: • Assistance in isolating the index finger; • Stabilizing the arm to overcome tremor; • Backward resistance on the arm to slow the pace of pointing or to overcome impulsiveness; • A touch of the forearm, elbow, or shoulder to help the person initiate typing; or pulling back on the arm or wrist to help the person not strike a target repetitively. Facilitated Communication Training Standards 2000

Principles &Best Practice: Practice Elements of FC Training: Emotional Support • Emotional support involves providing encouragement, but not direction, as the person points to communicate. Elements of FC Training: Communicative Support • Various forms of prompts and cues to assist the FC user to stay focused in the communication interaction, to provide feedback to the FC user on the content of their message, and to assist the FC user in clarifying unclear messages. Facilitated Communication Training Standards 2000

Principles &Best Practice: Practice Introducing the Technique • Follow the recommendations of the assessment regarding choice of hand, type of support, and seating. • Plan in advance the choice and position of device(s), and appropriate activities for getting started. • Establish a regular schedule by which the practice of pointing through facilitation can develop. • Clearly explain to the communicator what is being done and why, and have the use of the technique demonstrated either by an experienced facilitated communication user, or through use of a video. Facilitated Communication Training Standards 2000

Principles &Best Practice: Practice Introducing the Technique • Use challenging material that is meaningful to the communicator. • Structure activities to maximize the success of the communicator.･Provide varied and open ended activities, allowing for the opportunity for complex communication. • Treat the person as a competent communicator, one who has ideas and feelings to share. • Support the communicator in avoiding or interrupting verbal and typed echoes when they interfere with communication which accurately expresses the communicator's intent. • Support the communicator in controlling difficult behavior. • Work with a patient, positive, and persistent attitude. Facilitated Communication Training Standards 2000

Structure Elements Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Assessment • An individual needs to be identified as a candidate • Those who support that individual need to show commitment to the training process. Both of these elements begin with the assessment. Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Questions that drive the Assessment • What are the current communication strategies? (candidacy) • How have people developed the communication to this point? (environment) • How does this person interact with the printed word? (starting point for the exploration) • Does support make a difference? (benefit) Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Determining Candidacy? • Facilitated communication is a type of Augmentative/Alternative Communication (AAC) for people who do not speak or whose speech is highly limited and disordered, and who cannot point reliably • The method has been used by people with autism, Down syndrome, cerebral palsy, pervasive developmental disorders, and other developmental disabilities Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Collaborative Team Approach Support and commitment from an aid user's team (program planning team, circle of support, etc.) is critical to long term success with augmentative/alternative communication (AAC) and facilitated communication training. Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Independence • A primary, long-term goal of facilitated communication training is independent communication. • This goal involves･being able to access communication aids without physical support; • being able to initiate the process of communication with others; and･exercising control over the content of one's communication.The fading of physical support should begin at the outset of the training process, with both facilitators and facilitated communication users aware of the importance of this goal. Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Competency Based Facilitator Training • All facilitators should participate in on-going training and support Multiple Facilitators--Each FC user should have several facilitators • to reduce dependence on a particular facilitator, • to increase independent communication, and • for there to be sufficient examples of valid and authentic communication to document in a portfolio. Technical Assistance • Team problem solving with experienced facilitators Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Documentation • Portfolio Approach • The portfolio documents over time instances of novel communication. It is important to note that validation represents a set of skills to be learned in the process of becoming a competent, responsible communicator; it is not a test of the user's abilities. • In addition to the facilitated communication user's portfolio, a portfolio of the facilitators' training, skills, and abilities should be kept, documenting each facilitator's progress through competency training. This documentation should be used to determine the facilitator's level, and which supports he or she is prepared to provide for the facilitated communication user. Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Validation, Authorship • If the use of more formal validity testing is pursued, careful consideration needs to be given to such factors as the types of tasks used, the familiarity and naturalness of the test environment, the experience level of the facilitator, and both the facilitator and facilitated communication user's feelings about doing the test. Facilitated Communication Training Standards 2000

Principles &Best Practice: Structure Sensitive Information • Any sensitive information should be verified through clarification across multiple facilitators. • Sensitive information should be discussed carefully with a team of skilled facilitators. • It is important that the FC user develop an independent strategy for yes/no as quickly in the training process as possible. Facilitated Communication Training Standards 2000

Best Practice: Concluding Thoughts Learning to type and to use all of the best practice elements is complex. Remember the following: • Set goals • Work and problem solve with a team • Stay focused and positive • Create games and strategies that can be successful each time your practice • Set aside time to practice as well as remembering to use typing in the thousand opportunities that come up throughout the day. Facilitated Communication Training Standards 2000

Facilitated Communication