Why Facilitated Communication is not Assistive Technology

By Annabel Gabriel

Introduction

Assistive technology (AT) is a tool that enables individuals with disabilities to perform tasks they otherwise would not be able to. Communication devices and techniques are a major component of AT. It is essential that individuals are able to independently communicate with others to increase their quality of life. A technique introduced intended to serve as AT communication is facilitated communication. Facilitated communication is a technique that has been discredited and has proved to be harmful for users [1]. 

What is Assistive Technology?

AT is a tool that is used to increase or improve the physical capabilities of a person with disabilities. AT can be physical tools such as adaptive switches, prosthetics or positioning devices, but can also be communication devices such as screen readers and talkers. AT can aid in communication, seeing, hearing, mobility, writing, and many other tasks. AT is essential for people with disabilities because it aims to improve independence [2]. 

AT is intended to be used independently by the user. This aims to increase autonomy and enhance quality of life by providing independence that would not be possible otherwise. Increased independence can improve problem solving skills, emotional maturity, and confidence. It is essential that people with disabilities are able to act with autonomy to encourage these developmental skills. In addition, these actions have to be verified as coming from the user [3].

AT also aims to improve the quality of life of people with disabilities. By reducing barriers to communication or independence, individuals are able to interact with others without restrictions. This can improve a sense of belonging and allow individuals to feel more in control and connected with others, greatly increasing their quality of life [4].

What is Facilitated Communication?

Facilitated communication (FC) is an alternative communication technique that involves a person with disabilities being aided by a facilitator. FC involves people with developmental disabilities such as autism, cerebral palsy, or developmental delay being supported physically in order to communicate. This technique involves the facilitator supporting the individual’s wrist, arm or hand while they point to letters, words, or symbols on a communication device. The facilitator is often used to help support posture or emotions. The goal of this technique is to allow individuals to spell or point to words to allow non-verbal individuals to communicate [1][5].

Why is Facilitated Communication not AT?

Facilitated communication does not allow for autonomy and independence. It relies on the facilitator to perform the communication. Communication devices under AT must have an action that is verified as coming from the user, not a facilitator. By using a facilitator, the user is not performing the action themselves. This defeats the purpose of AT because AT intends to stimulate problem solving skills through encouraging independent actions [5].

Additionally, FC allows the facilitator to influence and change the messages produced by the individual. This has led to numerous concerning claims that have later proved to be false. After being introduced, there has been no conclusive evidence in the last 30 years that points to the benefits of FC. It is inconclusive if FC provides access to communication or achieves the independence desired. This has been extensively reviewed by multiple peer-reviewed studies that concluded FC messages are authored by the facilitator not the individual with disabilities. This means that FC is not AT because:

1. It does not allow the disabled individual to act independently.

2. The message cannot be proved as discernibly coming from the user [5][6].

Adding on to the issue of augmentation of messages and lack of autonomy, FC is not covered under any type of insurance including medicare. FC is an expensive service that can be especially hard to pay for out of pocket by caregivers [7][8]. 

Alternative Ways of Communication

Although FC is not considered a proper communication device under AT, there are many augmentative and alternative communication devices (AAC). These tools are designed to assist individuals with difficulties communicating independently. This can include devices such as:

• Picture Exchange Systems and Printed Boards: These devices allow limited communication through a set of unchangeable symbols.

• Sign Language: This technique allows communication by the user through manipulation of their hands.

• Mobile devices with AAC Apps: These apps act as picture exchange systems but allow the ability for the words and pictures to be read out, stored, or changed.

• Speech-Generating Devices: These are programs on a computer or mobile device that include an app with a voice [9][10].

High tech AAC devices such as mobile and speech-generating devices are able to be adapted to accommodate multiple manipulation types. Types of method can include: touching the screen or button, eye gaze, head tracking, switches or mouse control, scanning, and EMG switches [10].

These devices are often most beneficial for individuals with autism, apraxia, or developmental delay. These devices overall are able to provide a way of support for those who struggle with verbal communication [9].

Conclusion

AT is a way of encouraging independence in people with disabilities. Types of AT can include mobility, entertainment, or communication devices. There are many communication devices intended to reduce barriers for people with disabilities, enabling their connections with others. Although there are many communication types, facilitated communication is considered a discredited technique with no scientific evidence backing its use. Overall, facilitated communication is considered a harmful communication technique that discourages independence.

References:

[1] American Speech-Language-Hearing Association, “Facilitated Communication,” Asha.org, 2015, doi: https://doi.org/10.1044/policy.PS2018-00352.

‌[2] Assistive Technology Industry Association, “What is AT?,” Assistive Technology Industry Association, 2025. https://www.atia.org/home/at-resources/what-is-at/

‌[3] Adeline, “Encouragement of Independence: A Pathway to Self-Reliance and Growth,” Parenting Tips, Sep. 06, 2024. https://parenting.ra6.org/encouragement-of-independence.htm

[4] https://www.facebook.com/bytefora, “Empowering Lives: The Role of Adaptive Switches for Individuals with Disabilities,” Bytefora, Oct. 26, 2024. https://bytefora.com/empowering-lives-the-role-of-adaptive-switches-for-individuals-with-disabilities/

[5] D. Celiberti and K. Daly, “Facilitated Communication,” Association for Science in Autism Treatment, 2020. https://asatonline.org/for-parents/learn-more-about-specific-treatments/facilitated-communication/

‌[6] “Facilitated Communication: A Price Too High To Pay,” Science 2.0, Aug. 27, 2014. https://www.science20.com/countering_psychology_woo_and_science_asds/facilitated_communication_price_too_high_pay-75597 (accessed Feb. 08, 2026).

[7] N. Atwell, “What Is Facilitated Communication? - Everything You Need,” Word SCR, Aug. 29, 2025. https://wordscr.com/what-is-facilitated-communication/ (accessed Feb. 08, 2026).

‌[8] “Cigna Medical Coverage Policy-Therapy Services Sensory and Auditory Integration Therapy -Facilitated Communication.” Accessed: Feb. 08, 2026. [Online]. Available: https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/cpg149_sit_ait_fc.pdf

‌[9] “What Is an AAC Device, and How Does It Help with Speech?,” Expressable. https://www.expressable.com/learning-center/speech-and-language-issues/what-is-an-aac-device-and-how-does-it-help-with-speech

‌[10] i-autism, “What Are AAC Devices? The Ultimate Guide on Pros, Cons, Types and Costs,” i-Autism, May 18, 2024. https://i-autism.com/what-are-aac-devices/#google_vignette (accessed Feb. 08, 2026).