Written by:
Jamaun Willis, MEd, BCBA
Endicott College

review of facilliatedcommunication.org

Photographed by Djordje Petrovic (pexels.com)

Facilitated communication (FC) is a controversial technique used to assist individuals with severe communication impairments, such as those with autism or other developmental disabilities, in engaging with those around them. With FC, a facilitator provides physical support to the individual by holding their hand or arm, supposedly aiding them in typing or pointing to letters on a keyboard or communication device. Given the abundance of misleading information about Facilitated Communication and the risk of harm to the autism community, a website was created to serve as a clearinghouse to counter these messages. Facilitatedcommunication.org is a comprehensive go-to online resource that provides resources, research articles, portrayals in the media, and possible activism opportunities. This website also lists various terms that have been associated with FC such as Rapid Prompting Method, supported typing, typing to communicate, informative pointing, spelling to communicate, hand-over-hand, motor communication, and speaking with eyes. Some of these terms are co-opted from legitimate methods, but the common component remains the facilitator’s control over communication. It also provides resources for parents, educators, and reporters, and discusses various topics related to FC.

Research
This website features an extensive section on the research exploring the efficacy and legitimacy of facilitated communication. This includes systematic reviews, controlled studies, and critiques of articles that are supportive of FC. The convergent finding from multiple studies indicates that there is no reliable evidence to support the claim that FC allows for independent communication by individuals with disabilities. The studies cited span from 1993 to 2019, involving various methodologies and participant groups, all leading to similar conclusions about the ineffectiveness of FC as a communication method. Facilitatedcommunication.org emphasizes the importance of practices that have undergone rigorous evaluations to establish their validity and reliability. It highlights the ongoing process of peer review and the necessity of controls to address methodological weaknesses. Several articles and research papers are cited that discuss reasons for the persistence of FC as a discredited technique and the importance of research integrity. Collectively, the findings indicate that FC does not align with ethical practice and is not supported by evidence-based research.

Facilitatedcommunication.org emphasizes the importance of controlled studies in determining the authorship of messages produced via FC. These studies are crucial for assessing how much control each individual has over the typing activity. Several studies have produced results suggesting that it is the facilitators who have more control over the communication produced than the individuals that they are assisting. For example, studies that have examined FC performance during test taking show that when facilitators are unaware of test content, the communication produced tends to reflect the facilitators’ knowledge, not that of the individuals they are serving. Despite the evidence from controlled studies, proponents of FC argue that the studies are outdated and have declined to participate in new testing that could address the influence of facilitators during typing.

Evidence-Based Practices

There are alternative communication interventions that are evidence-based and have proven efficacy for individuals with autism and developmental disabilities (e.g., manual sign language, graphic symbols, and gestures). Occupational therapy principles and practices are suggested to support independent message generation using Augmentative and Alternative Communication (AAC). A variety of sources from books to scholarly articles are presented, covering topics such as language and literacy tools for students with autism, systematic reviews of AAC interventions, and the contrast between scientific methods and pseudo-scientific approaches.

In addition, a broad array of articles, critiques, and ethical issues suggest that pseudoscientific communication methods could potentially harm the rights and voices of individuals with disabilities. Other articles discuss the impact of neurotypical biases towards FC communication methods, advocating for evidence-based Augmentative and Alternative Communication (AAC) approaches that respect the autonomy and voice of non-speaking autistic individuals. Several articles listed as supporting FC are critiqued for having methodological flaws, such as circular reasoning, unsupported claims, and biased characterizations of FC critics. These critiques suggest that these articles lack scientific integrity and do not provide reliable evidence for the efficacy of FC.

FC in the Media

This website also addresses the portrayals of FC and illustrates how FC has been misrepresented as effective in media such as books, movies, news articles, and YouTube. The website lists several books and movies that fall into the “human interest” category, which promotes the idea that FC can unlock communication for non-speaking individuals with autism. The site highlights movies that often receive acclaim without proper scrutiny such as Spellers (2023), The Reason I Jump (2020), Influence (2018), Deej (2017), and Far from the Tree (2017) to name a few. These films suggest FC is a legitimate communication method for individuals with disabilities. The website’s authors counter that these findings are both misleading and lack evidence-based support. Examples of media stories are also presented that have uncritically presented FC and its variants, failing to address the controversies and lack of empirical testing surrounding these methods. Some of these news articles include a CBS news report on the story of a non-speaking man and another about how it took a woman with autism 25 years to find her voice, now she’s telling her story by the Washington Post to name a few.

Harms

Despite initial positive perceptions, controlled studies have shown that FC is ineffective. The website calls for awareness of the unintended consequences of such unsupported interventions and promotes the use of scientifically validated treatments. The use of FC has led to false hopes for families of communication by loved ones and, in some cases, unfounded allegations of sexual abuse against parents of autistic children. The communications of the individuals are often guided by the facilitators, not the individuals, due to the well-documented phenomenon that involves non-conscious muscle movements called the ideomotor response. There has been scientific scrutiny that provides evidence and guidelines for distinguishing scientifically supported interventions from unsupported ones. Despite being discredited, FC continues to be used. Facilitatedcommunication.org argues that FC creates an illusion of ability rather than addressing the actual needs of persons with disabilities and showcasing their strengths more authentically.

FC may generate stories that may seem inspirational but are prejudicial. By celebrating “hidden intelligence,” FC implies that genuine disabilities are undesirable and should be overcome, rather than accepting individuals as they are. Facilitatedcommunication.org advocates for genuine acceptance and appreciation of persons with disabilities. They argue against the need for individuals to display hidden intelligence to be valued and instead call for celebrating their real achievements and contributions. This website encourages a realistic assessment of individuals with disabilities, focusing on their actual history and experiences, rather than wishful thinking or superficial measures like FC.

FC has been linked to numerous false allegations of abuse, with at least 60 cases by the mid-1990s. The technique, which often involves a facilitator assisting a person with disabilities to communicate, has led to serious financial, social, and emotional harm to those wrongly accused. Facilitatedcommunication.org provides accounts of people affected by false allegations due to FC, emphasizing the damage to families, educators, caregivers, and individuals with disabilities. The persistence of FC’s use despite the documented harms is also examined. Several highlighted cases show the legal battles and financial burdens faced by individuals falsely accused through FC. These include cases from various countries, with some resulting in settlements and others in dropped charges due to the unreliability of FC.

In conclusion, Facilitatedcommunication.org provides a plethora of resources for parents, educators, and reporters to assist with navigating FC. They stand firmly against FC and promote more authentic approaches to understanding and supporting individuals with disabilities. This website outlines various ways individuals can act against the promotion of FC, which includes writing to university officials, journalists, and reviewing pro-FC books or movies to raise awareness about the lack of scientific evidence supporting these practices. Facilitatedcommunication.org is a reliable source of evidence against the use of FC. Learning about the dangers of its use and the misinformation spread by its proponents is vital for the preservation of precious time and resources, as well as protecting individuals’ right to evidence-based and effective treatment options.

Citation for this article:

Willis, J. (2024). A review of the website FacilitatedCommunication.org. Science in Autism Treatment, 21(7).

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