The first stage in working toward the use of a word/picture grid is to label EVERYTHING possible throughout the house/classroom. This is so that the written words are linked immediately and directly to the experience of those things- ie: the TV has the small label 'tv' on it door handle has 'handle', shoes have 'shoe' on each etc. Remember do not be in the person's face about getting proof they can read. This is their life and their abilities are not public trophies, however proud or caring you may feel. These socially invasive attempts can compel emotionally self-protective people to set out to get you off their back by proving no interest or ability. Not everyone learns by reinforcement, many learn in their own world, in their own way, their own discovery. Your role is to put the information available for easy discovery. Being in someone's face about it defeats the objective in allowing others to discover it 'as theirs' and 'for themselves'.

The second stage is picture grids with small words written at the base of each picture (the smaller the word, the more cohesive and more likely to be read… ie: 'the fine print' that makes you curious). Each page of the picture grid should have a theme… ie: Megan likes to eat…, Megan wants to go….(park, home, see grandma, shops, toilet, her room, etc), Megan is happy when… (home, food, colors, music, mirror, etc), Megan is upset when… (toilet, noise, lights, food, speaking, mess, clothes, etc), Megan says… (drink, food, clothes, toilet, toys, good, bad, angry, happy, sad, lights, noise, speaking, mum, dad, not, etc).

To begin, the facilitator controls the communicator's hand, making the finger point and quietly speaking the sentence out loud as thought spoken out loud to oneself) and going for answers the facilitator might assume the communicator might think/feel. Whilst using the communicator's finger to do this apparent 'self dialogue' the facilitator should feel for whether the communicator's hand is pulling away in resistance or willingly moving toward typing out the assumed answer. At no time should the facilitator draw interpersonal attention to the sense of intention on the part of the communicator, which would raise exposure anxiety. Instead, the facilitator can clarify with, for example, 'did the finger mean chips?' and head toward the 'yes', 'no' section to feel for the emotional response of the communicator through facilitation. By addressing the finger and not the person, the facilitator minimizes the possibility of sabotaging the technique by heightening exposure anxiety and its involuntary avoidance, diversion, retaliation responses. The same is true of praise, which may be counterproductive in getting self-protective people to relax about opening up. Many people with Exposure Anxiety begin to pull away from any activity that is so clearly desired as a social connection by the environment.

Once the person is able to use the word/picture grid book with facilitation, gradually reduce the size of the pictures and increase the size of the word label per picture to eventually take the place of the picture (i.e.: you can use a color photocopier to reduce pictures).

In addition, include as part of a communication book full of word/picture grids, a laminated printout of a typewriter keyboard page to eventually make more detailed sentences. At first, again, assume each sentence the communicator 'might' have wanted to say could they emotionally/socially dare to have done so. Sound out each letter out loud phonetically as you use the communicator's finger to typed the assumed communication. Keep the process slow and hold the finger back between each new letter feeling subtly for any feeling of the communicator's emotional prompt in the direction of any part of the letter board (but draw no overt attention to this). As the communicator progressively dares to take over the control of the communication, prompting each new letter, begin to subtly fade out physical support over time, coming back in and taking over if exposure anxiety causes them to reject their own expression when made too aware/responsible for it. Eventually fade out control from finger support to elbow support, to a hand on the shoulder as support, to eventually an occasional gentle intermittent tap on the shoulder and, hopefully, eventually to just standing nearby. This controversial technique is called Facilitated Communication and works primarily by getting around the problems associated with Exposure Anxiety. Exposure Anxiety is a social-emotional developmental phase in which the direct interpersonal confrontation initiated by others and the conscious awareness/responsibility for ones actions/communication can cause involuntary avoidance, diversion and retaliation responses. The reliance on peripheral vision over directed looking and the use of singing or muttering to disguise one's intent even from oneself in order to get the self protection response off one's back is common. The use of self abuse as a kind of emotional blackmail is sometimes commonly used to get the facilitator to take over again when Exposure Anxiety has climbed too high and one cannot, in this self protective state, dare the humility of asking directly for help. It is also common that some people with severe Exposure Anxiety will initially only allow one person exclusively to be their facilitator. These are all common responses and shouldn't put a good facilitator off from trying this approach. Exposure Anxiety can make otherwise capable people appear severely impaired in communication or control over their behavior. This should be no reason for assuming that just because someone has been unable to show his or her learning that learning, even as the pure accumulation of pattern, has not taken place at some level. A good facilitator will see FC as a program to eventually enable people to take over their own indirectly confrontational technique of communication.

q	w	e	r	t	y	u	i	o	p
a	s	d	f	g	h	j	k	l
z	x	c	v	b	n	m		yes	no

NB: For further information about techniques for communication with people with severe Exposure Anxiety you can read about in my book Exposure Anxiety: The Invisible Cage, but on FC in particular there is a chapter in my book Autism: An Inside Out Approach and a personal account in Like Color To The Blind.

Good luck on the adventure.