Facilitated Communication Training

Rosemary Crossley and Anne McDonaldFacilitated Communication Training (FCT) was first used in Australia by Rosemary Crossley in the 1970s. Ms. Crossley developed the method to assist Anne McDonald, a teenager with cerebral palsy, in communicating. Since that time, FCT has been used worldwide with people with many different disabilities, both developmental and acquired.

Facilitated Communication Training (FCT) is a specific strategy within the field of Augmentative and Alternative Communication (AAC).

It is a system of supports designed to enable a person who cannot effectively speak and whose independent hand skills are unreliable to make choices, express wants and needs, and engage others by pointing to communication symbols. The system of supports includes physical support, emotional support and communicative support. The person who provides these supports is called a facilitator.

One position
Another position
Yet a​nother position

The facilitator provides resistive touch in order to slow the person's movement down, give the person time to think, and coordinate the use of their eyes with the movement of their hand. The ultimate goal of FCT is independent pointing.

The degree of independence achieved by the communicator, however, varies from one individual to another. Independence is achieved through a series of steps where support is faded. (Photos illustrate various levels of support. The most support in the top photo to least in the bottom photo. )

The method, referred to as Facilitated Communication Training, serves as a reminder to all who use the technique that support changes over time and is faded toward independent pointing.

The other supports provided by a facilitator are as critical as the physical resistance. The facilitator provides encouragement through words and a positive attitude in order to help motivate the communicator to develop their expressive ability. The facilitator also structures the practice for easier access and provides tangible building blocks of interesting and meaningful communication. Both the facilitator and the communicator work at 'getting started' and then 'skill building' toward fluid and open conversation.

The facilitator monitors the process of communication in order to free up the communicator to focus on and express his or her message. This means watching the communicator's overall posture, facial expression, use of the eyes and movement. The facilitator has to be ready to adjust support when one or more of these change or become disorganized. For example, if the communicator looks away from the target or speeds up the movement to the target, the facilitator has to be ready to stop or in some way interrupt the process and get the communicator back on track to using more effective motor planning patterns.

Learning to be a facilitator takes training and practice. It requires a commitment of regular time with a communicator who currently uses the method or a person who would be considered a good candidate. For more information on candidacy, see the Assessment Q&A.

If you are interested in becoming a facilitator, you are strongly encouraged to work with an experienced facilitator and trainer, seek out introductory training, connect with others who use the method and, in particular, talk with a communicator who has been using the method for a while. This will help you understand the potential of the method and the steps required to achieve that potential.