Introduction to Supported Introduction to Supported CommunicationCommunication

Pascal ChengPascal ChengHarvey LavoyHarvey Lavoy

Tracy ThresherTracy Thresher2014 Midwest Summer 2014 Midwest Summer Institute: Inclusion & Institute: Inclusion &

Communication for AllCommunication for All June 23-24, 2014June 23-24, 2014

Elements of Support for CommunicationElements of Support for Communication

Adapted from Cardinal 2006

Visual attention (look Visual attention (look at keyboard)at keyboard)

Communication Communication supportsupport

Physical Physical SupportSupport

PositioningPositioning

Emotional Emotional SupportSupport

Partner skill Partner skill and trainingand training

Structured Structured ActivitiesActivities

Pointing skills of FC userPointing skills of FC user

Attitudinal and Attitudinal and behavioral behavioral supportssupports

Technology Technology and and EquipmentEquipment

Topics Topics Overview of Overview of

Augmentative / Augmentative / alternative alternative communicationcommunication

Definition and Definition and candidacy for FCcandidacy for FC

Understanding Understanding movement and FCmovement and FC

Overview of the FC Overview of the FC training processtraining process

Basic elements of Basic elements of the techniquethe technique

Simulated practice Simulated practice of facilitation of facilitation techniquetechnique

Getting started Getting started activities for new activities for new facilitatorsfacilitators

Documentation of Documentation of FC user skills incl. FC user skills incl. authorshipauthorship

What is facilitated What is facilitated communication?communication?

Strongest therapy for people with no Strongest therapy for people with no means of expression is sensational, means of expression is sensational, controversial, revolutionary, controversial, revolutionary, technically subtle FC. It involves technically subtle FC. It involves understanding movement lapses of understanding movement lapses of people and providing physical support people and providing physical support to help overcome them. Plastic nature to help overcome them. Plastic nature of users of FC requires topnotch of users of FC requires topnotch weaning of support towards ultimate weaning of support towards ultimate goal of independence.goal of independence.

Larry Bissonnette

What is facilitated What is facilitated communication/supported communication/supported

typing?typing?

Facilitated communication or Facilitated communication or supported typing is one of an array of supported typing is one of an array of augmentative and alternative methods augmentative and alternative methods of expression for people who cannot of expression for people who cannot speak, or whose speech is highly speak, or whose speech is highly limited (e.g. echoed, limited to one or a limited (e.g. echoed, limited to one or a few word utterances), and who cannot few word utterances), and who cannot point independently or reliably. point independently or reliably.

Facilitated Communication (FC) or Facilitated Communication (FC) or Supported Typing is a form of alternative Supported Typing is a form of alternative and augmentative communication (AAC) in and augmentative communication (AAC) in which people with disabilities and which people with disabilities and communication impairments express communication impairments express themselves by pointing (e.g. at pictures, themselves by pointing (e.g. at pictures, letters, or objects) and, more commonly, letters, or objects) and, more commonly, by typing (e.g. in a keyboard). by typing (e.g. in a keyboard).

Institute on Communication and InclusionInstitute on Communication and Inclusion

Structured facilitator training Structured facilitator training process process

Background info on FCBackground info on FC Simulated practice activitiesSimulated practice activities Modeling by experienced facilitatorModeling by experienced facilitator Initial practice with supervision from Initial practice with supervision from

experienced facilitatorexperienced facilitator Regular practice with FC user and Regular practice with FC user and

ongoing supervision from ongoing supervision from experienced facilitatorexperienced facilitator

Communication partner Communication partner activityactivity

1.1.Participants will break up into pairs. One Participants will break up into pairs. One will play the role of the communicator. The will play the role of the communicator. The other will be the listener with normal other will be the listener with normal speechspeech. The communicator will attempt to The communicator will attempt to communicate a message. DO NOT SHARE communicate a message. DO NOT SHARE WITH LISTENERWITH LISTENER

2.2.The message can be:The message can be:- A comment about the day- A comment about the day- A question to the listenerA question to the listener- Some news about something they have Some news about something they have

done recentlydone recently

Activity directions:Activity directions:2. The AAC user must attempt to 2. The AAC user must attempt to communicate the message without:communicate the message without:-speaking-speaking-writing-writing-signing-signing-drawing-drawing

The communication partner will The communication partner will attempt to determine what the attempt to determine what the message is.message is.

Activity Directions:Activity Directions:3. After completion of the activity, the 3. After completion of the activity, the pairs will share their experiences with pairs will share their experiences with the larger group:the larger group:

(Communicator) What was it like (Communicator) What was it like trying to rely on limited means to trying to rely on limited means to communicate your message?communicate your message?

(Partner) How easy/difficult was it to (Partner) How easy/difficult was it to understand the person’s message?understand the person’s message?

““The most important principles The most important principles for supporting people to for supporting people to communicate have little to do communicate have little to do with equipment or elaborate with equipment or elaborate instructional techniques.instructional techniques.

They are the attitudes and skills They are the attitudes and skills of the people they are talking of the people they are talking with: their communication with: their communication partners…partners…

“…“…The more supportive a The more supportive a communication partner is of a communication partner is of a person’s efforts to person’s efforts to communicate, the more communicate, the more effective that person will be.”effective that person will be.”

Pat MirendaPat Mirenda

Guiding principles for Guiding principles for supporting communicationsupporting communication

Access to all forms of AAC including Access to all forms of AAC including FC is a basic civil right.FC is a basic civil right.

Presumption of competencePresumption of competence is is the starting point for supporting the starting point for supporting people who have difficulty with people who have difficulty with communication.communication.

The Right to The Right to CommunicateCommunicate The right to communicate is both a basic human right The right to communicate is both a basic human right

and the means by which all other rights are realized. and the means by which all other rights are realized. All people communicate. In the name of fully realizing All people communicate. In the name of fully realizing the guarantee of individual rights, we must ensure: the guarantee of individual rights, we must ensure: 

that all people have a means of communication which that all people have a means of communication which allows their fullest participation in the wider world;allows their fullest participation in the wider world;

that people can communicate using their chosen method; that people can communicate using their chosen method; andand

that their communication is heeded by others.that their communication is heeded by others.

TASH Resolution on the Right to Communicate, 2000TASH Resolution on the Right to Communicate, 2000

Presumption of CompetencePresumption of Competence

Assume that a child has intellectual ability, provide Assume that a child has intellectual ability, provide opportunities to be exposed to learning, assume the opportunities to be exposed to learning, assume the child wants to learn and assert him or herself in the child wants to learn and assert him or herself in the world... Presuming competence is nothing less than world... Presuming competence is nothing less than a Hippocratic oath for educators. It is a framework a Hippocratic oath for educators. It is a framework

that says, approach each child as wanting to be fully that says, approach each child as wanting to be fully included, wanting acceptance and appreciation, included, wanting acceptance and appreciation,

wanting to learn, wanting to be heard, wanting to wanting to learn, wanting to be heard, wanting to contribute. contribute.

Douglas Biklen, 2012Douglas Biklen, 2012

Larry Bissonnette

“Fastening labels on people is like leasing cars with the destinations determined beforehand.”

“Unless someone makes a jump by going outside the handicapped person’s previous stage of communication, there is no way the speechless person can do so. Failure is no crime. Failure to give someone the benefit of the doubt is.”

Anne McDonald, Annie’s Coming Out, 1980

Christy Brown – “My Left Christy Brown – “My Left Foot”Foot”

“This is Christy Brown, my son. Genius. “

Christy’s father.

Understanding Understanding Augmentative/alternative Augmentative/alternative

communication and FCcommunication and FC

What is AAC?

Augmentative and Alternative Communication (AAC) refers to all forms of communication that enhance or supplement speech and writing. In simpler terms:

•Augmentative Communication supplements or adds to verbal and nonverbal communication.

•Alternative Communication is for people with no verbal and minimal nonverbal output.

Vt. AAC Resource Guide

Examples of AACExamples of AAC

GesturesGestures Body actionsBody actions Head shakingHead shaking Facial Facial

expressionsexpressions

SigningSigning Use of Use of

communication communication boardboard

Use of electronic Use of electronic devicedevice

Eye gazeEye gaze

Many ways to Many ways to communicatecommunicate

Total Communication Total Communication Approach:Approach:

A full system of strategies which A full system of strategies which might include sign language, might include sign language, simple gestures and facial simple gestures and facial expressions, single words and expressions, single words and phrases, and use of electronic phrases, and use of electronic devices.devices.

Specialized forms of AACSpecialized forms of AAC

Selecting through Selecting through touching, pointing, touching, pointing, etc. pictures, etc. pictures, symbols, words and symbols, words and letters to letters to communicate a communicate a messagemessage

Sign Sign languagelanguage

Specialized communication Specialized communication aidsaids

What isWhat is the best physical access strategy ?the best physical access strategy ?

Using an eye gaze boardUsing an eye gaze board

Pointing skills are often required to Pointing skills are often required to use communication aids and devices.use communication aids and devices.

Facilitated Communication/supported Facilitated Communication/supported typing is a form of augmentative typing is a form of augmentative alternative communication (AAC) in alternative communication (AAC) in which people are provided with which people are provided with physical supportphysical support to help them develop to help them develop effective effective pointing skillspointing skills for for communication using pictures, communication using pictures, symbols, letters and words.symbols, letters and words.

What is Facilitated What is Facilitated Communication/Supported Communication/Supported

Typing?Typing?

The level of complexity of pointing The level of complexity of pointing skill needed depends on what is skill needed depends on what is being communicated and what being communicated and what

communication aid/device is being communication aid/device is being used.used.

Choosing what methods or Choosing what methods or modes of communication to modes of communication to

useuse

Using multiple modes:Using multiple modes:

• I might greet someone with a hand I might greet someone with a hand wavewave

• I might show them some pictures of my I might show them some pictures of my vacation to share informationvacation to share information

• I might point to a picture or word for a I might point to a picture or word for a snack I wantsnack I want

• I might make a comment or share an I might make a comment or share an opinion by spelling a message outopinion by spelling a message out

Larry – Speech and TypingLarry – Speech and Typing

““Personally, my speech relays to others Personally, my speech relays to others what my stomach needs while my typing what my stomach needs while my typing promotes what my brain visualizes as promotes what my brain visualizes as

intelligent thought.”intelligent thought.”

Within any activity, people will be Within any activity, people will be communicating for different communicating for different

purposes:purposes: Expression of needs/wantsExpression of needs/wants

Sharing information Sharing information

Social Closeness relationshipsSocial Closeness relationships

Social Etiquette social routinesSocial Etiquette social routines

What kind of communication What kind of communication happens at a restaurant?happens at a restaurant?

4040

Who can benefit from the Who can benefit from the use of FC/supported use of FC/supported

typing?typing?

FC is helpful for those who cannot FC is helpful for those who cannot speak or whose speech is highly speak or whose speech is highly limited (e.g. echoed from others or limited (e.g. echoed from others or limited to one or a few word limited to one or a few word utterances) and for who people utterances) and for who people who cannot point independently or who cannot point independently or reliably. reliably.

AssessmentAssessmentThe assessment process for FC The assessment process for FC involves determining if there are involves determining if there are specific physical/movement specific physical/movement problems affecting a person’s problems affecting a person’s ability to point independently or ability to point independently or reliably and if so, what physical reliably and if so, what physical support strategies can help the support strategies can help the person to overcome those person to overcome those problems and improve their problems and improve their pointing skills.pointing skills.

Examples of movement Examples of movement difficultiesdifficulties

Difficulty isolating an index fingerDifficulty isolating an index finger Pointing without lookingPointing without looking Pointing too quicklyPointing too quickly Difficulty with extending arm/handDifficulty with extending arm/hand Initiating movement to pointInitiating movement to point Difficulty with new motor tasks, i.e. Difficulty with new motor tasks, i.e.

typing novel communicationtyping novel communication Hitting the same selection or series of Hitting the same selection or series of

selections, e.g. automatic words and selections, e.g. automatic words and phrases, repetitivelyphrases, repetitively

Q W E R T Y U I O P delete

A S D F G H J K L

Z X C V B N M , .

space

Observe the person doing Observe the person doing a variety of activities a variety of activities involving pointing. Look involving pointing. Look for physical problems that for physical problems that might be affecting might be affecting pointing.pointing.

Point to the picture of “pizza”.

Milk Juice

Tea Soda

Can you point to the word, “milk”

Which drink comes from a cow?Which drink comes from a cow?

Let’s try typing the name of the Let’s try typing the name of the town you live in…town you live in…

Determine physical support Determine physical support strategies that will help to strategies that will help to remedy the problems and remedy the problems and improveimprove the person’s pointing the person’s pointing skillsskills

The person may not be able to The person may not be able to isolate an index finger and may isolate an index finger and may need physical support initially to need physical support initially to develop this skill.develop this skill.

The person may also be unable to pull the The person may also be unable to pull the hand back after making a forward hand back after making a forward movement and/or sequence forward and movement and/or sequence forward and back movements unless the pointing hand back movements unless the pointing hand or limb is steadied and supported….but not or limb is steadied and supported….but not directed.directed.

““The facilitator must slow me down and The facilitator must slow me down and pull my arm back to help me start again pull my arm back to help me start again so that I can point to the correct letter I so that I can point to the correct letter I am going for. I would not be able to type am going for. I would not be able to type the words I really want without the firm the words I really want without the firm resistance of the facilitator.”resistance of the facilitator.”

LARRYFEELBETTERHAPPY

GOINGHOMEPINESTWINOOSKIVT

SITDOWNCHAIRTVONSUPPER

CORNSTACKPOTATOSION

PLAINSPEESICETEESPIE

BANANASMILKBEER

PRINT

Independent typing is not always reliable:

In addition to physical support, the In addition to physical support, the communication partner may provide emotional communication partner may provide emotional encouragement, and a variety of encouragement, and a variety of communication supports (e.g. verbal prompts communication supports (e.g. verbal prompts and feedback)and feedback)

The goal of facilitated communication The goal of facilitated communication training is independent communication, training is independent communication,

i.e. pointing and typing.i.e. pointing and typing.

Levels of supportLevels of support IndependenceIndependence

Photos – Institute on Communication and Inclusion

The effect of movement The effect of movement difficulties on difficulties on

communicationcommunication

Writing ExerciseWriting Exercise Write while moving opposite foot in Write while moving opposite foot in

counter-clockwise direction on floorcounter-clockwise direction on floor Name and addressName and address Your favorite activity to do in the Your favorite activity to do in the

summer and whysummer and why Copy this sentence Copy this sentence exactly:exactly:

I am tirred of beeing misunderstandoo.I am tirred of beeing misunderstandoo.

Sue Rubin Sue Rubin “Movement issues for me are a connection difficulty. I hear you ask me to complete a task, but my legs stay put. Through the use of FC I have been better able to get my body to engage in a task. Typing requires thinking and focus. My body has been trained to focus on movement when asked to do something or asked to respond. “

““Movement is essential to Movement is essential to communication. I am unable to communication. I am unable to speak because of apraxia, a speak because of apraxia, a movement disorder. I can type movement disorder. I can type because the movement of one because the movement of one finger going up and down is much finger going up and down is much easier than speaking or sign easier than speaking or sign language. Adding a series of language. Adding a series of movements as in sign language movements as in sign language would be dreadfully frustrating for would be dreadfully frustrating for me. Even simple movements are me. Even simple movements are tryingtrying at times.at times.”

““It is a grounding of both my physical It is a grounding of both my physical issues with where my body is in space issues with where my body is in space and telling my motoring to type to go and telling my motoring to type to go slow. Pay attention to the output with slow. Pay attention to the output with trusted touch. I am less anxious. trusted touch. I am less anxious. Therefore I can truly type my own Therefore I can truly type my own thoughts. That is the basis of the physical thoughts. That is the basis of the physical support to create a functional typing support to create a functional typing rhythm.”rhythm.”

Physical support can help Physical support can help with:with:

RegulationRegulation ControlControl Body awarenessBody awareness OrganizationOrganization ConnectionConnection FocusFocus

My impulse control problems, my way My impulse control problems, my way of going too hard at the letters and my of going too hard at the letters and my problems with perseveration, are things problems with perseveration, are things I need help from my facilitators…I need help from my facilitators…

Tracy Thresher:Tracy Thresher:

Basics of supportBasics of support

Physical supportPhysical support Communicative supportCommunicative support Emotional supportEmotional support

Physical SupportPhysical Support

Provides physical support Provides physical support in responsein response to to specific hand function/movement issuesspecific hand function/movement issues For example, slowing down a person who is For example, slowing down a person who is

pointing too fast or molding a person’s pointing too fast or molding a person’s fingers back from their index fingerfingers back from their index finger

For low muscle tone/strength, pulling a For low muscle tone/strength, pulling a person’s hand back above their board or person’s hand back above their board or device so that that they can reach device so that that they can reach selectionsselections

Physical SupportPhysical Support

Pulls hand back from the Pulls hand back from the communication device to a neutral communication device to a neutral position, ie. not side to sideposition, ie. not side to side

Provides backwards resistance only, Provides backwards resistance only, does not move co-actively with the does not move co-actively with the personperson

Physical SupportPhysical Support

Provides minimal level supportProvides minimal level support

Creates opportunities for pointing Creates opportunities for pointing with less physical supportwith less physical support

NO GUIDING - waits for the person to NO GUIDING - waits for the person to initiate the movementinitiate the movement

Physical SupportPhysical Support Positions the communication device Positions the communication device

at an accessible angle and height at an accessible angle and height for the personfor the person

Physical SupportPhysical Support

Regularly monitors whether the Regularly monitors whether the person is looking at the person is looking at the communication device communication device

Monitors pace and rhythm of Monitors pace and rhythm of person’s pointing movement and person’s pointing movement and adjustsadjusts physical support to physical support to accommodate changes: accommodate changes:

Physical SupportPhysical Support

uses more backwards pressure to uses more backwards pressure to slow the person down if they begin slow the person down if they begin pointing too rapidly pointing too rapidly

pulls the person’s hand back and pulls the person’s hand back and brings to a pause to interrupt the brings to a pause to interrupt the pattern of hitting the same selection pattern of hitting the same selection over and over (perseveration)over and over (perseveration)

Communication SupportCommunication Support

Provides Provides skill remindersskill reminders to the person to the person about their movement, e.g. “Slow about their movement, e.g. “Slow down”, “Reach more for the letters”down”, “Reach more for the letters”

Provides Provides promptsprompts and and cuescues to help a to help a person get started, maintain their person get started, maintain their focus or continue an interaction, e.g. focus or continue an interaction, e.g. “What’s the next letter?”, “Keep “What’s the next letter?”, “Keep going”, “Look at what you are doing”going”, “Look at what you are doing”

Communication SupportCommunication Support

Provides Provides feedbackfeedback on what pictures, on what pictures, words, letters a person has pointed to, words, letters a person has pointed to, e.g.”G-O-space-N-O-W, go now”e.g.”G-O-space-N-O-W, go now”

Provides Provides feedbackfeedback on content of on content of messages and asks clarifying messages and asks clarifying questions, “So you want to go now?” questions, “So you want to go now?” “Yes”, “Tell me where you want to go”“Yes”, “Tell me where you want to go”

Emotional SupportEmotional Support

Conveys high expectations and belief Conveys high expectations and belief in the person’s competence, “I know in the person’s competence, “I know you can do this”you can do this”

Maintains a calm and respectful Maintains a calm and respectful attitudeattitude

Offers encouragement and positive Offers encouragement and positive feedback to build confidence feedback to build confidence

What kind of training What kind of training activities are used when activities are used when

getting started?getting started?

Set WorkSet Work

Set work is any structured Set work is any structured activity which where the activity which where the responses are predictable responses are predictable and the information is and the information is shared between the shared between the facilitator and facilitator and communicator.communicator.

Set WorkSet Work

Builds confidence in both Builds confidence in both communicator and facilitatorcommunicator and facilitator

Allows facilitator to learn the Allows facilitator to learn the movement patterns of the movement patterns of the communicatorcommunicator

Helps facilitator to “get a feel” for Helps facilitator to “get a feel” for the right support techniquethe right support technique

Set WorkSet Work

Very structured activities will be used Very structured activities will be used with new FC speakers and new with new FC speakers and new facilitators.facilitators.

The speed at which one moves from The speed at which one moves from predictable to open communication predictable to open communication will vary across FC users and will vary across FC users and facilitators. Flexibility is critical.facilitators. Flexibility is critical.

Guidelines for using set Guidelines for using set workwork

Method of structuring activities from Method of structuring activities from ones which require very predictable ones which require very predictable responses, e.g. spell the word, “cat” responses, e.g. spell the word, “cat” to ones where the responses are to ones where the responses are very open, e.g. “What would you very open, e.g. “What would you like to talk about today?”like to talk about today?”

The Language LadderThe Language Ladder(adapted from Rosemary Crossley)(adapted from Rosemary Crossley)

ConversationConversation Self ExpressionSelf Expression Open ended QuestionsOpen ended Questions Less PredictableLess Predictable Predictable workPredictable work

Set WorkSet Work Set work does not mean doing the same Set work does not mean doing the same

activity over and over such as typing name and activity over and over such as typing name and addressaddress

Ideas for set work can be found in everyday Ideas for set work can be found in everyday activities, e.g. reading a story and answering activities, e.g. reading a story and answering comprehension questions, practicing spelling comprehension questions, practicing spelling words, doing a crossword puzzle, making words, doing a crossword puzzle, making choices from a menu, etc.choices from a menu, etc.

For school age individuals, the use of FC can be For school age individuals, the use of FC can be incorporated into many different academic incorporated into many different academic activitiesactivities

Acrobat Violinist

Lawyer Accountant

Can you point to the word______”

Which person performs in a circus?

Fill in the blank/ predictable:

A large astronomical body that revolves around the sun is called a _______ (planet).

Fill in the blank/open:

One of the planets in our solar system is ______.

Multiple choice/ closed choices:

““Do you want strawberry, Do you want strawberry, chocolate or vanilla ice cream?”chocolate or vanilla ice cream?”

Multiple choice/limited range:

““What is your favorite flavor of What is your favorite flavor of ice cream?”ice cream?”

Open Questions/Shared Knowledge: “Tell me what is happening in the picture.”

Participation in everyday Participation in everyday conversationconversation

8787

Documenting progress with Documenting progress with communication skillscommunication skills

AuthorshipAuthorship

Who is the author of a Who is the author of a message produced message produced through facilitated through facilitated communication?communication?

Message passingMessage passing

The FC user conveying information The FC user conveying information that is unknown to their that is unknown to their facilitatorfacilitator

ResearchResearch

Negative studies in the 1990’s all used message passing as the method to prove “authorship”

Most FC users in these studies fail to pass messages successfully

Double blind studies show facilitator influence

“Conclusive evidence that FC is not a valid communication technique”

Research – Studies that have Research – Studies that have demonstrated authorshipdemonstrated authorship

Used diverse research methodologiesUsed diverse research methodologies Message passingMessage passing Video eye tracking (2001)Video eye tracking (2001) Linguistic analysis of FC user typing Linguistic analysis of FC user typing

(2001-2009)(2001-2009) Evidence of speech before and during Evidence of speech before and during

typing (2001, 2009)typing (2001, 2009)

Studies with successful Studies with successful message passingmessage passing

Weiss, Wagner, and Bowman (1996)Weiss, Wagner, and Bowman (1996)

Cardinal, et al. (1996)Cardinal, et al. (1996)

Sheehan and Matouzzi (1996)Sheehan and Matouzzi (1996)

What we have learned about What we have learned about message passing:message passing:

FC users can do message passing FC users can do message passing successfully under the right conditionssuccessfully under the right conditions

Not presented as test of competenceNot presented as test of competence Practice over time with a taskPractice over time with a task Occur in natural environmentsOccur in natural environments FC user choice in message passing tasksFC user choice in message passing tasks Feedback to FC user on performanceFeedback to FC user on performance FC user performance can be variableFC user performance can be variable Facilitator skill is criticalFacilitator skill is critical

How can a person How can a person demonstrate demonstrate

authorship of their authorship of their communication?communication?

Understanding Message PassingUnderstanding Message Passing

For many FC users it’s a “test” of For many FC users it’s a “test” of their ability to communicatetheir ability to communicate

Singled out and put on the spotSingled out and put on the spot Through message-passing we Through message-passing we

connect with others, reliable people, connect with others, reliable people, truth tellerstruth tellers

Learned over time with practiceLearned over time with practice Requires specific skillsRequires specific skills

Special Issues for FC UsersSpecial Issues for FC Users

Lack of experienceLack of experience Passive observersPassive observers Familiar routines with little changeFamiliar routines with little change Thrown into situations and expected Thrown into situations and expected

to performto perform High risk stakesHigh risk stakes Systematic practice of message-Systematic practice of message-

passing skillspassing skills

What can facilitators do to What can facilitators do to support FC users to be in support FC users to be in

control of their communicationcontrol of their communication

Minimizing Negative Minimizing Negative InfluenceInfluence

Provide backwards resistance onlyProvide backwards resistance only

Pull back to a neutral positionPull back to a neutral position

Provide the minimal amount of Provide the minimal amount of support necessary - work towards support necessary - work towards independence!independence!

Minimizing cuing and Minimizing cuing and control of responses control of responses

through FCthrough FC Wait for the FC user to initiate Wait for the FC user to initiate

movementmovement

Avoid trying to anticipate what words Avoid trying to anticipate what words a FC speaker might usea FC speaker might use

Always clarify responses that you are Always clarify responses that you are not sure aboutnot sure about

Minimizing cuing and Minimizing cuing and control of responses control of responses

through FCthrough FC Encourage FC user to control the flow Encourage FC user to control the flow

of conversationof conversation

Develop awareness of how and when Develop awareness of how and when a FC user might be looking for cuesa FC user might be looking for cues

Minimizing cuing and Minimizing cuing and control of responses control of responses

through FCthrough FC Teach FC users protest strategies Teach FC users protest strategies

where they can inform their where they can inform their facilitators when they are being facilitators when they are being influenced or when they want to influenced or when they want to change their wordschange their words

Work with other facilitators to Work with other facilitators to compare your techniquecompare your technique

Guiding principles for the Guiding principles for the use of FCuse of FC

Specific guidelines and standards Specific guidelines and standards are needed to support the use of are needed to support the use of FC. FC.

Evaluation of a person’s progress Evaluation of a person’s progress with FC can be done through with FC can be done through observation and documentation.observation and documentation.

Documenting progress Documenting progress and successand success

Evaluation of a person’s progress Evaluation of a person’s progress with FC can be done through with FC can be done through observation and documentation of observation and documentation of the content of their communication the content of their communication and their actual pointing and typing and their actual pointing and typing skills over time. This can be part of a skills over time. This can be part of a communication portfolio.communication portfolio.

Pointing and related skills Pointing and related skills that can be improved that can be improved through the use of FCthrough the use of FC

Index finger isolation Index finger isolation and extensionand extension

Visual focusVisual focus Accuracy of pointingAccuracy of pointing Upright seating Upright seating

positionposition Development of Development of

deliberate rhythmdeliberate rhythm Maintaining slow, Maintaining slow,

even movementeven movement

Decreasing Decreasing impulsive or impulsive or automatic automatic movementmovement

Initiating movementInitiating movement Organization of Organization of

movements – movements – arm/hand arm/hand positioningpositioning

Attention to taskAttention to task

Portfolio Approach to Portfolio Approach to Documentation for FCDocumentation for FC

Structured way of collecting Structured way of collecting information information over timeover time on an on an individual’s progress with FC focusing individual’s progress with FC focusing specifically on authorship, and specifically on authorship, and independenceindependence

FC user is directly involved in the FC user is directly involved in the portfolio documentation processportfolio documentation process

Portfolio ApproachPortfolio Approach

Is best done when there are adequate Is best done when there are adequate supports in place for FC for an supports in place for FC for an individual, e.g. multiple, trained individual, e.g. multiple, trained facilitators; regular opportunities to facilitators; regular opportunities to use FCuse FC

Methods of collecting info can include Methods of collecting info can include the use of forms, logs, transcripts and the use of forms, logs, transcripts and videotapesvideotapes

What is documented?What is documented?

Instances where the person has done Instances where the person has done successful message passing, i.e., successful message passing, i.e., conveying information unknown to conveying information unknown to the facilitatorthe facilitator

Demonstrations of independent Demonstrations of independent pointing and typingpointing and typing

What is documented?What is documented?

Patterns of unique typographical errors Patterns of unique typographical errors and creative/phonetic spellings; and creative/phonetic spellings; unusual syntax and expressionsunusual syntax and expressions

Similarity of communication style Similarity of communication style across facilitatorsacross facilitators

Correlation between speech and typingCorrelation between speech and typing