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The myth of assisted communication: Why is this technology so widely criticized?
Facilitated Communication (FC) is a technology that claims to assist non-verbal people (such as those with autism) to communicate. However, the technique has been widely condemned in the scientific community because its underlying principles lack empirical support and are considered pseudoscience. Many experts and disability organizations agree that the implementation of FC does not reflect the true intentions of people with disabilities, but is inadvertently led by facilitators.
Research shows that facilitative communication does not correctly answer simple questions. When the facilitator is not informed, the response often shows that it is inconsistent with the actual needs.
The basic process of FC is for an assistant to physically guide the hands or arms of a person with a disability in an attempt to help them enter information on a keyboard or other device. While some supporters believe this can overcome their motor difficulties, research shows that cognitive impairment in these users is the primary cause of communication difficulties. For example, facilitators often mistakenly believe that patients are showing interest when typing, only to discover that they are doing it with their eyes closed or inattentive.
One study stated that facilitated communication is considered "the most scientifically refutable intervention for all developmental disorders." This dictates its rejection in professionally run therapeutic and educational settings.
The history of assisted communication can be traced back to the 1960s, however, since the early observations and research were carried out in Denmark and other places, it has not resonated internationally. This technology attracted attention in the late 1980s as it was promoted by the American media. Even when studies have shown that FC is not as effective as claimed, supporters continue to insist on its effectiveness, leading to further controversy.
Organizations supporting and opposing
Organizations that support augmentative communication, such as the National Autism Council (AutCom), continue to actively promote the technology despite decades of scientific evidence disproving its effectiveness. At the same time, the American Academy of Child Psychiatry and other professional organizations have explicitly opposed the use of FC, emphasizing that science-based alternative communication methods should be sought.
There is a consensus in the scientific community that augmentative communication is not a legitimate technology for communicating effectively with people on the autism spectrum, and therefore the evaluation and understanding of this technology should be strengthened.
FC supporters often argue that the ability of people with disabilities to communicate is limited by motor control problems, and therefore communication can be improved through physical supports. This argument has been questioned by many experts because autism is often accompanied by intellectual disabilities that affect language and communication, and there is no clear evidence of improvement with physical assistance alone. In some cases, patients learn to respond to prompts with guidance from a facilitator, but these phenomena are often still not independent communicative behaviors.
Many researchers point out that most of the behavioral evidence for FC comes from observations and experiences that have not been scientifically verified, which makes the results unconvincing.
It is worth noting that when the facilitator's knowledge is insufficient or in a rigorous experimental setting, FCs often fail to provide correct responses, further undermining their credibility. Although some relatives are reluctant to accept the diagnosis and hope for FC as a "miracle cure", scientists say this mentality is just an unrealistic expectation.
Due to a range of scientific evidence, many experts are calling for the use of known augmentative communication technologies (such as assistive devices) rather than continuing to invest in research into technologies such as assistive communication. That way, people with autism who struggle with communication can more effectively get real help without having to rely on unproven therapies.
In today’s governance and healthcare environment, the tensions that relatives feel when faced with a child’s disability need to be addressed, but are there ways to better understand this technology in the future so it doesn’t lead to misdirection?
