Writing, Typing, Letter Boards and Word Selection
This area of communication includes any methods that involve the use of writing, typing, using letters boards, or any other means of letter or word selection. These potential means of communication can be missed out when considering methods of expressive communication, but they are viable options for a number of non-verbal people.
I wonder if the reasons behind why these methods are not considered more often is three-fold, with the first reason being that people think they are “too difficult” for those who are non-verbal to use, the third being the lack of information on how to teach someone how to use these methods, and the third being the controversy that has arisen following methods that are related to this area including Facilitated Communication and Rapid Prompting Method.
Whilst writing may seem like an out-dated method in the computer age, it should not be discounted as some people find that the actual process of writing out the letters and words has a stablising effect that helps them to process what they want to say. It can also be easily transported since all you need is paper and a pen or pencil. However, it does require the most fine motor skill out of the methods.
Typing can be made easier through the use of larger keyboards, and if combined with a text-to-speech program on a computer then words can be read out by a synthesised voice. Even without this program, other people can still read what the person is communicating. This method has allowed many people who do not speak to connect to the wider world through the internet and online communities. This method is the most bulky of the methods, especially as it is usually attached to a computer.
Letter boards and word selection kind of fall under the same broad area – word selection tends to lead to letter selection or the use of letters boards, although this is not always the case. There are some apps which are based on word selection, and there are apps which offer a customisable letter board. Outside of apps, words and letters can be written on paper for the individual to touch or point at, or printed letter boards or letter stencils can be used. This area is where the majority of the controversy lies because these are the methods used by Facilitated Communication (FC) and Rapid Prompting Method (RPM).
Why are FC and RPM so controversial?
To discuss this is to first define them. FC is a method used where the individual wishing to communicate is physically supported and physically guided to touch words, letters or pictures in order to communicate. The person supporting and guiding them typically places a hand on the user’s hand, wrist, or arm to support the movement of the arm. Rapid Prompting Method is quite similar but whilst there is physical support in the early stages, there is typically less touching of the user and more holding of the letter board or stencil in the later stages.
I’m sure many of you can already see one of the main problems associated with these methods and that is “How do we know who is communicating?”. Early on in its lifespan, people questioned FC (and still question FC and RPM) because the sentences produced were typically completely grammatically correct and display reading levels and levels of insight that are far beyond the age of the user. In the height of FC’s use, children as young as six were regularly producing full paragraphs with full and correct grammar and punctuation. Understandably, FC was throughly tested, and often when placed under scrutiny or assessed using various tests, what research has found is that largely it is the supporting partner who is dictating what is chosen and not the non-verbal individual. So there is no communication at all, just a hand that is being moved under the guise of communication. Additionally, there have been a number of instances where allegations of sexual abuse have been made through the use of FC and subsequently proven to be false, and this has only served to fuel the scepticism towards the methods due to the damage and impact these accusations have had on people’s lives.
However, there are some instances where people do claim to have learnt how to independently type or otherwise communicate through the initial use of FC or RPM, and video footage and real-life evidence supports their ability to independently communicate. Some people claim that these individuals could have been taught to type or point to a letter board independently through other means but it’s hard to know that retrospectively. Physical disabilities or outward perceptions of someone’s capabilities do not dictate someone’s mental capabilities, and it is possible that some people may benefit and learn to communicate through the use of FC and RPM. However, what they are not are the all-wonderful methods of communication that they were often heralded as, and their use should be undertaken with a lot of consideration.
Disclaimer: The opinions and information provided in this post are my own, and based on personal, educational, and work-based experience. They do not reflect the opinions of any of the authors of the content referenced in this post. I am not affiliated or supported by any organisation, and this is meant to be an educational series of posts. The information posted here is not a substitute for advice and information provided by your own GP, speech and language therapist, occupational therapist or other professional in the field of autism, and should not be taken as such.