Facilitated Communication
Conclusions
Sponsored link.
Quotation:
"It is emptiness and hopelessness that make people vulnerable to
false prophets, cult leaders . . . who help them become true believers...again, secure in
the comfort of new absolutism." M.B. Smith
Topics in this section:
Sponsored link:
The following were extracted from various agency home pages and published statements:
 |
American Psychological Association: "...Peer
reviewed, scientifically based studies have found that the typed language output
(represented through computers, letter boards, etc.) attributed to the clients was
directed or systematically determined by the paraprofessional / professional therapists
who provided facilitated assistance... Furthermore, it has not been scientifically
demonstrated that the therapists are aware of their controlling influence...Consequently,
specific activities contribute immediate threats to the individual civil and human rights
of the person with autism or severe mental retardation...THEREFORE, BE IT RESOLVED
that APA adopts the position that facilitated communication is a controversial and
unproved communicative procedure with no scientifically demonstrated support for its
efficacy." 1 | |
The Autism Society of America: "Rather than endorsing
one treatment over another,...ASA chooses to let the decision remain in the hands of those
who know the individual with autism best. Parents, siblings, the individual with autism
himself and other primary caregivers are much more knowledgeable about their child or
adult with autism than anyone else." 2 | |
The Facilitated Communication In Maine: "The purpose
of Facilitated Communication In Maine is to promote the appropriate use of facilitated
communication through education, technical assistance, and support to people with
disabilities, parents, educators, speech and language pathologists support providers, and
other interested individuals." 3 | |
State of New York Office of Mental Retardation and Developmental
Disabilities: "... caution in its use is warranted because: (a)
research has indicated that apparent benefits of facilitated communication training are
infrequently verified; (b) research does not adequately identify the characteristics of
the people for whom this training holds substantial promise of enhanced communicative
independence; and (c) experience has demonstrated that sensitive communications arise at
clinically significant rates in the course of using facilitation."
4 | |
The Association for Persons with Severe Handicaps (TASH):
"Facilitated communication (also referred to as facilitated communication
training) is an alternative means of expression that has been used by individuals who
cannot speak or whose speech is limited and who cannot point reliably... THEREFORE,
BE IT RESOLVED THAT:
 |
TASH regards access to alternative means of expression an individual right.
|
|
...TASH encourages careful, reflective use of facilitated
communication. |
|
...TASH encourages use of multiple strategies, including, for example:
controlled designs; portfolio analysis; and transitioning to independent typing.
|
|
TASH urges that when allegations of abuse or other sensitive communication
occur, facilitators and others seek clarification of the communication and work to ensure
that users of facilitation are given the same access to legal and other systems that are
available to persons without disabilities. It is important not to silence those who could
prove their communication competence while using facilitation or any other method of
expression...." 5 |
| |
The Vermont Facilitated Communication Network: "The
mission of the Vermont Facilitated Communication Network is to support the use of
facilitated communication (FC) in Vermont by providing education, training and technical
assistance, developing resources, disseminating information, and guiding the development
and use of best practices." 6 | |
The American Academy of Child and Adolescent Psychiatry approved
a FC policy statement on 1993-OCT-20 which states, in part: "Studies
have repeatedly demonstrated that FC is not a scientifically valid
technique for individuals with autism or mental retardation. In
particular, information obtained via (FC) should not be used to
confirm or deny allegations of abuse or to make diagnostic or
treatment decisions." 7 | |
The American Academy of Pediatrics published a FC policy
statement in their 1988-AUG issue of Pediatrics (Vol. 102, Nbr. 2,
Pages 431-433). They studied two therapies for autism: auditory
integration training and facilitative communication. They concluded
that: "Currently available information does not support the
claims of proponents that these treatments are efficacious. Their use
does not appear warranted at this time, except within research
protocols. Concerning FC, they wrote: "As reviewed by
Jacobson et al, FC has been the subject of many controlled studies
with consistently negative findings, indicating that the technique is
neither reliably replicable nor valid." 8 | |
The American Association on Mental Retardation has apparently
issued a negative policy statement on FC. We have requested a copy
from the AAMR. |
Opinion can be divided among three main groups. Generally speaking, they are not
talking to each other:
|
Many skeptics believe that FC is a useless technique; it is quackery.
It has the potential of generating false accusations of abuse. It consumes time and effort
that can better be used applying techniques of value. They consider FC to be simply one
more psychological hoax, similar to Satanic Ritual Abuse (SRA), Recovered Memory Therapy
(RMT), Multi-Victim /
Multi-Offender (MVMO) ritual abuse cases in day care centers, abuse on board UFOs,
abuse in former lifetimes, Multiple Personality disorder (MPD),
Dissociative Identity Disorder (DID) and treatment of mental illness through Exorcism.
FC is useless technique, promoted by caring but deluded parents, caregivers and
professionals. |
|
Many proponents of FC are therapists, speech pathologists, and
specialists in special education. They suggest that it can be used with success by many
who are communication disabled. R. Crossley & J. Remington-Gurney estimate
that 70%. can be helped. 9 They say that people with autism are do not suffer from
“Significantly subaverage general intellectual functioning.” Rather,
their problem is "an expressive disorder, being some form of motor planning
problem (Crossley, 1993) or apraxia (Biklen, 1990) or dyspraxia (Maurer, 1992) or movement
disorder (Hill & Leary, 1992) coupled with aphasia or word-finding problems (Crossley,
1992)." In simpler language, "The theory is that many such individuals
do not have cognitive deficits at all, but instead have a presumed neuromotor impairment
that prevents them from initiating and controlling vocal expression."
3 They
have learned the alphabet and words by watching television and/or by observing their
siblings. But they have not been able to speak or write because of their neuromotor
deficiencies. |
|
Many critics of FC are research psychologists. They feel that FC can be
meaningfully used
only by a few atypical individuals. These are people with a severe communication
disability, are able to speak only a few words or not at all, and yet have been able to
make use of FC - starting in a fully-guided mode and gradually progressing to full
independent typing. |
OCRT stands for the Ontario Consultants on Religious Tolerance,
the sponsors of this Web site.
We note that experts in the field have come to diametrically opposed conclusions about
FC. These are typically intelligent, caring, dedicated professionals with impressive
academic qualifications and decades of practical experience. Yet they have come to totally
different sets of beliefs. So we have little reluctance at expressing our own opinions.
With the present level of knowledge, we may be as likely to be correct as anyone.
We have tentatively concluded that:
|
The skeptical position cannot be defended. There are a very few people who have been
diagnosed with autism, who have few or no vocal skills, and yet can use FC effectively.
They communicate valid messages with minimal support from a facilitator - perhaps just the
touch of a finger on the shoulder. Some are eventually able to eventually type independently. |
|
The main question regarding FC is not whether it works. The question is what percentage
of the autistic population will find it to be a useful technique. |
|
Autism is a generic label applied to persons who exhibit a group of symptoms. The vast
majority are diagnosed correctly as having a severe intellectual deficit. For them, FC is
useless as anything other than a game. A small minority are of near normal (or
even superior) intelligence but are unable to speak because of a neuromotor impairment.
Some of the latter can proceed to independent typing, by using FC as a temporary crutch. |
|
When FC is first introduced to a person with autism or other communication disability,
it is essentially a game. The facilitator determines all of the material that is produced.
The vast majority of users remain stuck at this level forever. |
|
A small minority of users, after gaining experience at FC, are able to contribute some
input to the typing. The facilitator is able to withdraw (fade back) support until the
user is essentially typing on their own. |
|
A very small minority are able to progress until they eventually are able to type
independently. Some, if given the necessary support, are able to graduate from high school
and even enter college or university. |
|
Some institutions prohibit FC. They prevent their autistic and other communication-challenged clients from even trying the technique. This is of little consequence to most
of their clients - those who can never progress beyond using FC as a game. But there
exists a small minority that could use it to interact with the world. If FC is banned,
then they will be forever trapped in a communication prison due to their lack of
ability to speak. |
These conclusions would seem to be compatible with all of the evidence turned up during
all FC validation studies:
|
Much of the communication comes from the facilitator, not the user. |
|
The facilitators do not seem to be aware that they are influencing much of the typing. |
|
Users generally fail almost all objective testing. |
|
A few users are able to demonstrate FC. |
|
A small minority of users are able to use FC and pursue an advanced education. |
Unfortunately, we suspect that few agree with us. Essentially all of those active in FC
seem to fall into the skeptic or proponent group. It may take a decade before the truth
about FC becomes obvious. Unfortunately, almost all experts are taking extreme positions;
few are working towards attaining a consensus. In the meantime, many people are going to
suffer from the present impasse:
|
many parents and care-givers will have their hopes raised by proponents of FC, only to
see them dashed. |
|
among the small minority of autistic children that can really benefit, some will remain
cut-off from FC. |
The human toll will remain unacceptably great until a consensus is attained
on the effectiveness of FC.
References:
-
American Psychological Association, "Resolution on Facilitated
Communication," 1994-AUG-14. Reprinted at: http://web.syr.edu/~thefci/apafc.htm
-
"Facilitated Communication," Autism Society of America, at: http://www.autism-society.org/packages/
-
Facilitated Communication In Maine is at: http://130.111.120.13/~cci/fcmaine/fcw96b.html
-
"Guidelines for Facilitated Communication Training," by the State
of New York Office of Mental Retardation and Developmental Disabilities is reprinted
at: http://www.autism-society.org/packages/fc_guidelines.html
-
TASH, "Resolution on Facilitated Communication,"
1994-DEC. Reprinted at: http://web.syr.edu/~thefci/tashfc.htm
-
Vermont Facilitated Communication Network is at: http://www.uvm.edu/~uapvt/faccom.html
-
"Policy statement: Facilitated Communication," at: http://www.aacap.org/publications/policy/ps30.htm
-
"Auditory Integration Training and Facilitated Communication for
Autism (RE9752)," at: http://www.aap.org/policy/re9752.html
-
R. Crossley & J. Remington-Gurney, "Getting the words out;
Facilitated Communication Training," Topics in Language Disorders, (1992) 12, 4,
Pages 29-45.
Copyright © 1998 to 2100 incl., by Ontario Consultants on
Religious Tolerance
Latest update: 2001-DEC-6
Author: B.A. Robinson
| |
Page Translator:
