Facilitated Communication and Autism Ranking: Mildly Hazardous Limited negative evidence

Risks and Safety


Facilitated communication is a highly controversial intervention that has been the focus of reports by the American Association on Mental Retardation, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry and The International Society for Augmentative and Alternative Communication.

All are highly critical of this approach and strongly recommend that it should not be used. All the available evidence indicates that communication is created by the facilitator, not the communication disabled person. There is also evidence that facilitated communication can, in a few cases, lead to significant harm.

The International Society for Augmentative and Alternative Communication (2014) noted that:

“The use of FC appears to be in violation of several articles of the United Nations Conventions on the Rights of Persons with Disabilities (i.e., Articles 12, 16, 17, and 21) as it has been shown to prevent individuals without sufficient spoken language from using their own “voice.” With the use of FC, the messages may be attributed to facilitators. For persons with limited or no functional speech, the use of FC risks the loss of valuable assessment and intervention efforts, time, and resources that might otherwise have been expended to implement AAC systems and strategies that are empirically validated and do not leave doubt about authorship”.


There are some contraindications (something which makes a particular treatment or procedure potentially inadvisable) for facilitated communication. For example, according to the Ann McDonald Centre website, accessed on 15 March 2017,

“Facilitated communication training generally isn’t considered as an option for an individual if they:

  • have fluent functional speech
  • have a fluent alternative communication strategy
  • have the potential to acquire manual signing or handwriting skills easily
  • can clearly and unambiguously select sequences of items from communication displays in order to create sentences
  • are able to use other direct or indirect access options such as headpointers or scanning systems effectively (some people can’t use these means because of physical control problems, some can’t use them for practical reasons - people who walk instead of using wheelchairs, for example, have trouble carrying a scanning system around with them)".
31 Oct 2017
Last Review
01 May 2017
Next Review
01 May 2020