There's an unwritten tradition in the academic review of books: you must find some fault with the book you're discussing, or you'll be identified as an unsophisticated reader, unworthy of the task of critical review. However, this review will not follow in that tradition: Speechless is an amazing book, and I am unequivocally enthusiastic about it.

Since 1974, Rosemary Crossley has been on a shared journey of discovery with her non-talking fellow travellers; beginning in 1986, she has directed the DEAL Communication Centre in Melbourne, Australia, which has been responsible for much pioneering work in the application of facilitated communication training as a tool in the use of augmentative and alternative communication. This book provides an account of the lessons that Crossley and those with whom she has worked have learned over the course of more than 20 years' exploration.

Those who have heard Crossley speak, or who have read the book Annie's Coming Out (which she co-authored with Anne McDonald in 1980), already know of Crossley's gifts as a storyteller. She has the ability to describe long, tedious, complex, sometimes heartbreaking struggles in ways that are enthralling to her listeners or readers. Speechless was exciting to read -- I immediately became involved with, and eager to participate in, the frustrations, triumphs and setbacks of the 18 individuals whose clinical interactions with Crossley make up the majority of this book. One reason the book is so engaging is that Crossley clearly communicates her view of the people she writes about-- she obviously sees them as people who are wise, courageous, funny, resourceful and tenacious. (And although her writing is rather self-deprecatory, you can often catch glimpses that show all these qualities in Crossley as well.)

Another reason for this book's importance is its clarity. Crossley is writing about an area that is inherently complex and mysterious -- "Why are people the way they are?" -- and she is writing about individuals who have been a puzzle to the community at large, to the professionals who set out to help them, and even to themselves. Nevertheless, Crossley is able to describe the complexities of communication for these people. She writes of her understanding (and their understanding) of the underlying mechanisms involved, in a way that is easily comprehensible, even to readers new to the field. This is one of those rare books that speaks equally well to people who have never heard of facilitated communication before, and to those who have years of experience in its use.

For the person who is relatively new to the complexities of facilitated communication, Speechless provides a wealth of important information. The reader learns of how the approach has been developed over the years, of the early and ongoing controversies which have surrounded its use, and of the ways in which individuals' lives have been transformed in the face of these controversies. The chapter "On the Front Line" is very useful for the brief but devastating critique it provides of those experiments which "prove" that people are incapable of any communication on the basis of their failure to quickly master a single test.

Crossley is wonderful at demystifying several aspects of facilitated communication which are often troubling to the newcomer: "Where did he learn to read?" "If she's so smart, why does she need somebody to hold her hand to point?" "If he can talk, why does he have to type?" Crossley provided easily understood, common-sense ways of thinking about these issues, often grounded in the readers' own experiences. For example, the books second chapter discusses the social, behavioral and cognitive ramifications of growing up without speech:

Felix, aged fourteen months, was visiting his grandmother for Christmas. When his father carried him through the kitchen Felix pointed at a pot holder and said "Wahla," and every relative within earshot congratulated him as if he'd won the Nobel Prize. If he'd said "wahla" during playtime it would probably not have been recognized as a word attempt, much less understood, but when Felix said it he was looking at, leaning toward, and pointing at a round pot holder with a picture of three koalas (pronounced "ko-wahlas") on it. Supported by context and body language, his meaning was unmistakable, and there was much excitement and reinforcement of the "Yes, koalas" or "Three wahlas" variety. Felix knew he'd made a hit.

How many variables would have to be changed for us to stop recognizing that Felix was using our language and that what he was saying meant something? The connection between "wahla" and "koala" would probably have been missed if Felix hadn't been able to coordinate his pointing, eye gaze, and vocalization, or if he'd said "wahla" without indicating its referent, or if his attempt at "koala" hadn't been as close -- "ah-ah," say (pp. 33-4).

She shows that the "mystery" of the surprising communicative abilities of many people is based less on their behavior than on the fact that people with severe disabilities who communicate are violating the stereotypes often held of them. Crossley turns her critical eye on those stereotypes:  why should we assume that they hold any validity? In her chapter "Thoughts of Voices Never Heard," she provides a powerful critique of the concept of "mental retardation":

Tests of intelligence purport to assess how well you take information in, and what you are able to do with it, on the basis of what comes out. If nothing quantifiable comes out you are untestable. If anything quantifiable comes out you may be tested as though you have no disability, so that a six-year-old child with ten words of speech may be given a test requiring spoken answers and a teenager with no speech who perseverates and repeatedly points to the same spot may be given a test to be answered by pointing. Obviously, the child and the teenager won't do well on their tests. This isn't surprising. What is surprising is that the results are assumed to reflect what the child and the teenager are thinking and what they are able to learn, and are used as a basis of making decisions about their futures.

The fatal flaw in intelligence testing is that we don't know what intelligence is or where it resides. Sure, we've got a general concept, as we've got general concepts of beauty and pain, but having a concept of intelligence doesn't mean that it is a tangible, measurable entity. At best, intellectual impairment is no more than the shadow cast by real neurological and physical and sensory and social abnormalities, as we might make a wobbly rabbit in a shadow play; if we want to know what is not illusion, we must look not at the rabbit but at the fingers.

I am not just saying that we should redraw the boundaries of mental retardation and exempt from the label or move up a grading or two those who can, with the communication techniques we have now, demonstrate their capacity. I am saying that the notion that we can meaningfully compact the strengths and weaknesses of an individual into two or three digits, or even into two categories like "retarded" and "normal," is intellectually bankrupt and must go.

"But the Emperor has nothing on at all!" said a little child.

And under the clothes there is no Emperor (pp. 279-80).

By the end of the book, the reader is likely to have come a long way toward seeing people with disabilities as individuals about whose competence and potential presuppositions must not be made.

For the person with extensive experience using facilitated communication, Speechless is likely to be a useful, validating and challenging book. Crossley, after all, has been the pioneering clinician in this field for over 20 years -- all of us, in the work we do, are her students. Unlike both the research literature on facilitated communication and the accounts in the popular press, which have tended to focus on individuals with autism, Speechless describes Crossley's work with individuals with a wide range of diagnoses: cerebral palsy, autism, Down syndrome, traumatic brain injury, encephalitis, Rett syndrome, PKU, and post-stroke receptive aphasia. Clinicians faced for the first time with individuals with different kinds of disabilities than those with which they are exprienced will find Crossley's narratives in Speechless both a boost to their creativity, and a warning that they need to park their presuppositions about "how FC is done" at the door.

In Speechless, as in her earlier book Facilitated Communication Training, Crossley consistently demonstrates the necessity of working with facilitated communication within the broader context of what is known about supporting non-speech communication in general. She has frequently been a supportive but critical observer of the ways in which facilitated communication has come to be used in North America. Her chapter entitled "On the Front Line" gives her view of the strengths and weaknesses common in FC use here-- it's a chapter that every FC user and facilitator in the United States would do well to read and discuss within local FC-using communities, as a springboard for some very useful, and possibly uncomfortable, self-reflection. Primarily, however, FC users and facilitators will find Speechless to be a wonderful sourcebook for appropriate practice, for the theoretical underpinnings of that practice, and for a vision of what true collaboration among the FC user, the facilitator, and the clinician can look like. I found myself most facinated by those points in the narrative when Crossley wrote about herself at her "pushiest." At times, Crossley demanded that her clients try things that they themselves were sure they could not do. At those times when a "nicer" person might have given up in hopes of having an easier time of it another day, Crossley might easily push ahead, letting her confidence in the person, the powerful trust that had already been established in the relationship, and her bulldog's tenacity help the person over a seemingly insurmountable obstacle.

A useful feature of Speechless is that it describes work with people who are met with the widest range of pre-suppositions in their interactions with the community at large. For example, she discusses Bridget, a woman who, following a stroke,

...did not tell people she could not understand them. She pretended she did understand, and gave all the right body language responses, smiling and nodding to show she was following. If the person she was talking to stopped talking and waited for a response Bridget responded to what she thought had been said. If it was just a brief predictable interaction she would often be quite successful (p. 236).

In an earlier chapter, she speaks of Derek:

He had no speech and no smile, he gave little evidence of being aware of his surroundings, and his usual posture could be characterized as decorticate rigidity... The only action which to a stranger seemed to be anything like a response was that he did swallow food if it was pushed to the back of his mouth, though even that had been described as a reflex movement (p. 48).

The people with whom Crossley has worked cover the range from those who, it is assumed, communicate far too effectively to be able to make use of any augmentative approach, to those who are presumed to have no cognitive capacity for language whatsoever. Crossley's work thus provides effective conterexamples to those who might argue that facilitated communication training and other associated tools may perhaps be useful for some disabled individuals, but "couldn't possibly work with ________[fill in label here]." In this, as in many other areas, practitioners may find Speechless an important tool not only for understanding best practices in our field, but also for finding ways to describe what we do so that those from outside the field will understand.

Seventeen years ago, Annie's Coming Out introduced many of us to facilitated communication; the book has remained a timeless classic, a celebration of people's deep desire to be heard and to be free regardless of the odds. With Speechless, Crossley has written a fitting sequel -- we are all richer for being able to share in that experience.

• Crossley, R., & McDonald, A. (1980) Annie's Coming Out. Melbourne:  Penguin Books.
• Crossley, R. (1994). Facilitated Communication Training. New York:  Teachers College Press.

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