1. Facilitated Communication
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Facilitated Communication
Standards and Best Practice
Christi Kasa-Hendrickson
Darlene Hanson
Don Cardinal
Facilitated Communication Training Standards 2000

2. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Attitude
Structure
Best Practice Elements of Facilitated Communication fall into three categories
Practice
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

3. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Elements of FC
Structure
Attitude
Practice
FC USER
Practice
Attitude
Structure
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

4. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Attitude Elements
Citizenship
Presumption of Competence
The Right to Communicate
Empowering the Facilitated Communication User
Total Communication
How would you work with a team who is not presuming competence? How do you make sure a team is empowering the communication user
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

5. Principles & Best Practice: Attitude
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

6. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

7. Principles & Best Practice: Attitude
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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?"
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

8. Principles & Best Practice: Attitude
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

9. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Practice Elements
Pointing
Ergonomic Setup
Communication Partner
Establish a regular schedule
Physical Support
Use challenging material
Prompts and Cues
Activities to Maximize Success
Encouragement and Emotional Support
Varied and open ended activities
Monitoring
Treat the person as a competent
Saying each letter as it is indicated
Avoid interrupting verbal and typed echoes
Device correction strategies
Control difficult behavior
Reliability Check
Patient, positive, and persistent attitude
These are the easiest it is nuts and bolt, more easily controlled and implemented. Choices when to fade when to get a different piece of equipment. How to use the independent communication… what should we do now. How do you make decisions and problem solve on the spot. How do you teach others to do this…
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

10. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Elements of Facilitated Communication Training
Created by Cardinal 2006
Monitoring (look at keyboard)
Emotional Support
Control Difficult Behavior
Physical Support
Ergonomics
Comm. Partner
Some elements of FC can be easily viewed, yet, some, like emotional support need another “view.” Others, like physical support are viewable, but unable to show its multi-dimensional characteristics.
Device Correction Strategy
Structured Activities
Pointing
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

11. Principles & Best Practice: Practice
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

12. Principles & Best Practice: Practice
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

13. Principles & Best Practice: Practice
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

14. Principles & Best Practice: Practice
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

15. Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
Structure Elements
Assessment
Independence
Competency-based Facilitator Training
Multiple Facilitators
Technical Assistance
Documentation
Portfolio Approach
Validation, Authorship and Authenticity
Sensitive Information
Job responsibility of the trainer… make sure that the assessment is complete, making sure that people are documenting.. How can they best carry out their job responsibility… How can you best carry out this process. Where Darlene is now and where she is going… In other areas of your job how do you make sure people are doing their job…
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

16. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

17. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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)
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

18. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

19. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

20. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

21. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

22. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

23. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

24. Principles & Best Practice: Structure
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000

25. Best Practice: Concluding Thoughts
Kasa-Hendrickson, C. & Hanson, D., 2008
Cardinal, D., 2006
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.
Cardinal, D., 2006
Facilitated Communication Training Standards 2000
Facilitated Communication Training Standards 2000