Facilitated communication and people with brain injury : three case studies

  • Noella Joslyn

    Student thesis: Master's Thesis


    This study examines facilitated communication as it was experienced by three people who were affected by acquired brain injury.
    Facilitated communication is a type of augmentative communication purported to allow persons with a severe communication impairments to communicate. The assumption is made that people with global apraxia can communicate if given physical support. The technique usually involves a facilitator providing physical support to the arm, hand or elbow of the person with the severe communication impairment to assist them to point to objects, pictures, printed letters and words or to a keyboard. Facilitated communication is a controversial method because it is difficult to establish the existence, or extent of the facilitator’s influence in the communication of the person with a disability. Although much of the research on facilitated communication has been conducted with people with intellectual or developmental disabilities, research on the use of the technique with people with brain injury offers several advantages. Firstly, most people with brain injury were known to be competent communicators prior to the brain injury. Secondly, many recover sufficiently to allow a retrospective examination of the issues that faced them when they were using the technique. Thirdly, there can be a large amount of data available about the person’s diagnosis, their prognosis and the course of their history following the event. Consequently, the current study uses _a case study methodology to explore the application of facilitated communication with people with brain injury and draws on personal recollections of people with brain injury, interviews with families and medical and therapist reports.
    The three people interviewed in the study displayed varying language and memory abilities. They indicated a preference for independent communication techniques and they reported frustrations with using facilitated communication. They quickly rejected the method when speech began to appear even though their speech was inadequate for communication purposes, for two of them, for an extended period. One of the interviewees reported that facilitator influence was overwhelming at times but not always present. Two of the interviewees felt that facilitated communication gave them a start in their recovery process. Two of the interviewees reported that meaningful exchanges with others occurred only with speech.
    In addition to these findings the study, although not experimental, was able to shed light on some of the contentious issues surrounding facilitated communication. The method is reported to be designed to overcome the motor difficulties of the disabled communicator by providing physical assistance to individuals with poor fine motor control thus breaking the perseveration cycle that can be present . However the task of coping with facilitator influence may actually require some motor skills. Also, the physical effort involved in using facilitated communication for some individuals may have been underestimated by its supporters. However the study has shown that some individuals with severe communication impairments felt that facilitated communication had some merit but saw their ability to communicate independently as the significant achievement in their recovery.
    Date of Award1997
    Original languageEnglish

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