augmentative and alternative communication (AAC)

[Amy Waller]

I've been away from my email for a few days, but I wanted to respond to
Jim's message since Jim brings up a communication technique with which I
would imagine some people on this list may not be familiar.  Facilitated
communication (FC) refers to a technique in which a person who cannot speak
due because of a  disability receives facilitation to use a keyboard or
other communication device to communicate.  For example, a facilitator
might hold an individual's arm or shoulder to allow the person to use a
finger to touch letters on an alphabet display.  The facilitator might
begin by giving an intensive level of support (such as supporting the
individual's hand or wrist); over time the support can be decreased and
might involve merely touching the elbow or shoulder.  Another important
aspect of this technique is that it requires the facilitator to assume the
communicative competence of the individual even though the individual may
have a label such as "profoundly mentally retarded."  This technique was
developed in Australia by a clinician who used it first with a woman with
cerebral palsy who had never communicated.  An American, Doug Biklin,
visited Australia and the center where this technique was developed for
several months and decided that it might work with people with autism.  (If
memory serves, he based his thinking at least in part on a theory that
people with autism have limb apraxia and may not be able to use a finger
pointing response without facilitation, at least at first.)  Not
surprisingly, this caused a great deal of controversy.  The controversy
concerns who is actually communicating a message:  the facilitator or the
facilitatee?  (Some people have likened this communication technique to
using a Ouija board.)  Although a few individuals have gone from the use of
facilitated communication to independent communication (i.e., they are now
able to use a keyboard or other device without any sort of facilitation),
many individuals seem to continue to need various levels of facilitation in
order to communicate.  Most of the experiments that have been done to try
to determine who is controlling the communication have shown that the
facilitator is (probably unconsciously) controlling the communication.  In
the US (and elsewhere, if I'm not mistaken) this communication technique
caused further controversy when a number of individuals using FC accused
caregivers of abuse and a number of these cases went to court.

Many people in the AAC community have distanced themselves from FC because
it does not seem to provide a way for people with disabilities to truly,
independently communicate.  (The exceptions, of course, are those
individuals who used FC but now communicate effectively without
facilitation.  One question, though, is whether these individuals could
have learned to communicate without the use of FC. )  FC is not a method I
would recommend.

Having said all that, though, FC is a fascinating topic that raises
some interesting questions, and the article Jim mentions certainly sounds
interesting.

Amy

>In response to Amy's introduction, let me mention an interesting cultural
>study of the use of AAC technology for very different purposes, i.e. social
>control and the legitimation of divine authority.  If FC passes as a type
>of AAC, this use of AAC would be for a kind of divination.
>
>Bilu, Y., and Yehuda C. Goodman. (1997.). What does the Soul Say?
>Metaphysical Uses of Facilitated Communication in the Jewish Ultraorthodox
>Community. Ethos, 25/4:, 275-407.
>
>-- Jim
>
>Jim Wilce
>      Assistant Professor of Anthropology and Coordinator of Asian Studies
>        Northern Arizona University
>        Box 15200
>        Flagstaff, AZ 86011-5200
>
>fax 520/523-9135
>office ph. 520/523-2729
>email jim.wilce at nau.edu
>http://jan.ucc.nau.edu/~jmw22/ (includes information on my 1998 book,
>Eloquence in Trouble: The Poetics and Politics of Complaint in Rural
>Bangladesh)
>http://www.nau.edu/asian

________________________
Amy Waller
awaller at earthlink.net
Sarasota, FL