Chicago Medical Malpractice Lawyer Blog

Resolution on Facilitated Communication
by the
American Psychological Association
Adopted in Council, August 14, 1994, Los Angeles, CA

Facilitated communication (FC) has been widely adopted throughout North America in special/vocational education services for individuals with developmental disabilities who are nonverbal. A basic premise of facilitated communication is that people with autism and moderate and profound mental retardation have "undisclosed literacy" consistent with normal intellectual functioning. 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 (Bligh & Kupperman, 1993; Cabay, in press; Crews et al., in press; Eberlin, McConnachie, Ibel, & Volpe, 1993; Hudson, Melita, & Arnold, 1993; Klewe, 1993; Moore, Donovan, & Hudson, 1993; Moore, Donovan, Hudson, Dykstra, & Lawrence, 1993; Regal, Rooney, & Wandas, in press; Shane & Kearns, in press; Siegel, in press; Simon, Toll, & Whitehair, in press; Szempruch & Jacobson, 1993; Vasquez, in press; Wheeler, Jacobson, Paglieri, & Schwartz, 1993). 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. These include use of facilitated communication as a basis for a) actions related to nonverbal accusations of abuse and mistreatment (by family members or other caregivers); b) actions related to nonverbal communications of personal preferences, self-reports about health, test and classroom performance, an family relations; c) client response in psychological assessment using standardized assessment procedures; and d) client-therapist communication in counseling or psychotherapy, taking therapeutic actions, or making differential treatment decisions. Instances are widely noted where use of facilitated communication in otherwise unsubstantiated allegations of abuse has led to psychological distress, alienation, or financial hardship of family members and caregivers. The experimental and unproved status of the technique does not preclude continued research on the utility of facilitated communication and related scientific issues. Judicious clinical practice involving use of facilitated communication should be preceded by the use of fully informed consent procedures, including communication of both potential risks and likelihood of benefit.

Facilitated communication is a process by which a facilitator supports the hand or arm of a communicatively impaired individual while using a keyboard or typing device. It has been claimed that this process enables persons with autism or mental retardation to communicate. Studies have repeatedly demonstrated that facilitated communication is not a scientifically valid technique for individuals with autism or mental retardation. In particular, information obtained via facilitated communication should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions.

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.

References:

(1) Bligh, S. & Kupperman, P. (1993). Evaluation procedure for determining the source of the communication in facilitated communication accepted in a court case. Journal of Autism and Developmental Disorders, 23, 553-557.

(2) Cabay, M. (in press). A controlled evaluation of facilitated communication with four autistic children. Journal of Autism and Developmental Disorders.

(3) Crewe, W. D., Sanders, E. C., Hensley, L. G., Johnson, Y. M., Bonaventura, S., & Rhodes, R. D. (in press). An evaluation of facilitated communication in a group of nonverbal individuals with mental retardation. Journal of Autism and Developmental Disorders.

(4) Eberlin, M., McConnachie, G., Ibel, S. & Volpe, L. (1993). Facilitated communication: A failure to replicate the phenomenon. Journal of Autism and Developmental Disorders, 23, 507-530.

(5) Hudson, A., Melita, B., & Arnold, N. (1993). Brief report: A case study assessing the validity of facilitated communication. Journal of Autism and Developmental Disorders, 23, 165-173.

(6) Klewe, L. (1993). An empirical evaluation of spelling boards as a means of communication for the multihandicapped. Journal of Autism and Developmental Disorders, 23, 559-566.

(7) Moore, S. Donovan, B., & Hudson, A. (1993). Facilitator-suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders, 23, 541-551.

(8) Moore, S. Donovan, B., Hudson, A., Dykstra, J., & Lawrence, J. (1993). Evaluation of facilitated communication: Eight case studies. Journal of Autism and Developmental Disorders, 23, 531-539.

(9) Regal, R. A., Rooney, J. R., & Wandas, T. (in press). Facilitated communication: An experimental evaluation. Journal of Autism and Developmental Disorders.

(10) Shane, H. C., & Kearns, K. (in press). An examination of the role of the facilitator in "facilitated communicatio". American Journal of Speech-Language Pathology.

(11) Siegel, B. (in press). Assessing allegations of sexual molestation made through facilitated communication. Journal of Autism and Developmental Disorders.

(12) Simon, E. W., Toll, D. M., & Whitehair, P. M. (in press). A naturalistic approach to the validation of facilitated communication. Journal of Autism and Developmental Disorders.

(13) Szempruch, J., & Jacobson, J. W. (1993). Evaluating the facilitated communications of people with developmental disabilities. Research in Developmental Disabilities, 14, 253-264.

(14) Vasquez, C. (in press). A multi-task controlled evaluation of facilitated communication. Journal of Autism and Developmental Disorders.

(15) Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. (1993). An experimental assessment of facilitated communication. Mental Retardation, 31, 49-60.

As a Chicago medical malpractice lawyer I have represented the family of an autistic child for severe damage to the child caused by the use of facilitated communication (FC). As soon as I saw that Dr. Sanjay Gupta was being considered for Surgeon General I was both surprised and dismayed. Dr. Gupta has actively supported facilitated communication (FC) as a valid means of helping autistic people communicate. FC has been thoroughly discredited by the scientific community, a fact which Dr. Gupta chooses to ignore. It appears that Dr. Gupta has been chosen for his good looks and his ability to entertain the public with medical anecdotes and not his scientific credentials. This President has promised to put science back in its rightful place. By supporting FC Dr. Gupta has demonstrated that he is no scientist.

I have written a letter to the Obama administration and everyone else I can think of in opposition to this appointment. Please feel free to copy it and/or expound on it and send it to the members of the Senate Health Committee. The letter and committee members are listed below:

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