Chapter 23

w8Chapter23.docx

Chapter 23

Based on the readings and videos, write a paper (no more than 4 pages), describing how you would argue against FC and rapid prompting. Talk in your paper about what is wrong with those methods, and how these methods go against our scientific world view. Use the position statements and other resources you find compelling.

The Video is all about Rapid Prompting. I’m not able to download it but I will explain more in our chatroom.

AUT574ASHAPostionStatementonFacilitatedCommunication.docx

ASHA Facilitated Communication Position Statement

About This Document This position statement is an official policy of the American Speech-

Language- Hearing Association (ASHA). It was developed after select and widespread peer review by ASHA's Speech-Language Pathology Division: Diane Paul-Brown, division director; Louise Zingeser, branch director. Crystal S. Cooper, 1994–1996 vice president for professional practices in speech-language pathology, served as monitoring vice president. The contributions of Stan Dublinske, director, Professional Practices Department, and Kelley Turnbull, departmental assistant, Professional Practices Department, are gratefully acknowledged. The Legislative Council adopted this statement in November 1994 (LC 51-94). For additional information, please refer to the technical report on facilitated communication (Facilitated Communication Subcommittee of the Ad Hoc Committee on Auditory Integration Training and Facilitated Communication, 1994, October).

Facilitated communication is a technique by which a “facilitator” provides physical and other supports in an attempt to assist a person with a significant communication disability to point to pictures, objects, printed letters and words, or to a keyboard. Personal accounts and qualitative descriptions suggest that messages produced using this technique may reveal previously undetected literacy and communication skills in people with autism, and other disabilities. When information available to facilitators is controlled and objective evaluation methods are used, peer-reviewed studies and clinical assessments find no conclusive evidence that facilitated messages can be reliably attributed to people with disabilities. Rather, most messages originate with the facilitator. Moreover, facilitated communication may have negative consequences if it precludes the use of effective and appropriate treatment, supplants other forms of communication, and/or leads to false or unsubstantiated allegations of abuse or mistreatment.

It is the position of the American Speech-Language-Hearing Association (ASHA) that the scientific validity and reliability of facilitated communication have not been demonstrated to date. Information obtained through or based on facilitated communication should not form the sole basis for making any diagnostic or treatment decisions.

ASHA strongly supports continued research and clinical efforts to develop scientifically valid methods for developing or enhancing the independent communication and literacy skills of people with disabilities.

Speech-language pathologists are autonomous professionals who are responsible for critically evaluating all treatment techniques in order to hold paramount the welfare of persons served in accordance with the ASHA Code of Ethics. Speech- language pathologists should inform prospective clients and their families or guardians that currently the scientific validity and reliability of facilitated communication have not been established, and should obtain their informed consent before using the technique.

AUT574ASAPolicyStatementonFacilitatedCommunication.docx

ASA Policy Statement on Facilitated Communication

Autism Society of America 7910 Woodmont Avenue Suite 300 • Bethesda, MD 20814-3067 301.657.0881 • fax: 301.657.0869 www.autism-society.org FACILITATED COMMUNICATION

Extensive media coverage has chronicled facilitated communication. Early claims of high success rates have since been drastically toned down, and reckless talk of "miracles" is now muted. FC is a controversial subject. The advocates of FC are adamantly supportive of FC, while the opponents are just as adamantly opposed to it. There is little common ground. Here is what each side says: Facilitated communication is one of several communication options that may be appropriate for use with individuals with autism. Originated in Melbourne, Australia by Rosemary Crosley, the method was introduced to the United States in 1989 by Douglas Biklen, Ph.D., Director of Special Education at Syracuse University.

The technique involves a "facilitator" who supports the hand, arm, or shoulder of a communicatively impaired individual. This method assists the person with impairment to extend an index finger and either point to or press the keys of a typing or other communication device. If successful, the individual who was previously unable to communicate can then do so through typing or spelling out words. The level of communication ability expressed through "FC" varies from individual to individual, and not all persons with whom the technique is applied are successful in communicating. The question of authorship remains a concern in light of research studies that indicate either conscious or unconscious facilitator influence. Scientific evidence favors the position that the words produced through FC invariable come from the facilitator and are not independent communication. Critics believe that if the individual is actually typing with out facilitator influence, any trained facilitator should achieve a comparable typing ability in that individual. Numerous carefully controlled experimental studies, some of which were performed by researchers who initially were believers in FC, show that it is not the individual who determines what is said. Advocates of facilitated communication reject articles citing these studies on the basis that a controlled testing environment negates the trust level required in FC. Advocates counter the argument of facilitator influence with arguments of improper testing conditions and report evidence of individuals typing information of which facilitators had no prior

knowledge, or with individualized communication-styles differing from that of the facilitator. Proponents tell of remarkable gains in academic achievement and social acceptance by individuals with disabilities in the school systems, while critics are concerned that schools are using tax dollars for a technique that is not scientifically validated. Advocates cite cases of individuals with autism achieving independent typing status as a rationale for continued support the technique, and argue that denying an individual "FC" is denying him the dignity of communicating his own thoughts, feelings and ideas. Critics question authorship in light of research studies which suggest either conscious or unconscious facilitator influence, they argue that the thoughts and ideas believed to be that of the individual typing may in fact be those of the facilitator. Thus the denial of communication is compounded by manipulation. Critics argue that further research should be conducted before the use of FC spreads. The Autism Society of America supports a policy of parent choice when determining the appropriateness of all treatment options currently available to the autism community. The ASA Board of Directors believes that every family should be allowed the opportunity to investigate and select treatment options they believe are most appropriate for their family member with autism. Since autism varies widely in its manifestation from individual to individual, no one therapy or method will work for all individuals with autism. ASA attempts to provide parents with information on all aspects of a treatment or procedure, to help them become educated in order to make a decision based on the unique and individualized needs of the person with autism.

Rather than endorsing one treatment over another, thereby characterizing methods as "best" or "worst", "good" or "bad", 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. The Society believes that our function is to distribute current information from which decisions can be made, provide guidance as to the decision making process, but not make those decisions on behalf of the total autism community. The autism professional community currently disagrees about the validity of facilitated communication. As we expect this controversy to continue while more research and a variety of newer testing methods are devised to further define the procedure, the Autism Society of America neither condemns nor condones facilitated communication. However, as with any treatment option, we urge interested individuals to thoroughly investigate this technique and the situations in which it may be applied, to educate themselves to the pros and cons of the treatment option, before making a decision on the appropriateness of the use of "FC" with a son, daughter, sibling or patient. We hope the enclosed materials aid you in that effort.

ABAIStatementofFC1.pptx

Statement on Facilitated Communication, 1995

A technique, known as Facilitated Communication (FC), has been promoted and disseminated as a method for “revealing” undisclosed intellectual competence in persons diagnosed with autism, moderate to profound mental retardation, or other disabilities.

FC is a technique wherein a facilitator touches the hand, arm, or shoulder of a person with communication deficits while they jointly point to symbols, letters, or words.

Claims have been made that this technique permits many people with severe disabilities to communicate at levels far exceeding those demonstrated by any other means.

These claims have been based on descriptive and qualitative reports or personal accounts. Numerous peer-reviewed scientific evaluations, however, indicate clearly and compellingly that FC does not allow persons diagnosed with disabilities to communicate at enhanced levels.

The source of apparent communication is the facilitator, although most facilitators report that they are not aware that they are the source.

To date, there is no objective, scientifically sound evidence that FC has any direct therapeutic benefit. The use of FC to “communicate” entails serious risks, including:

1) Violating the rights of people with disabilities to autonomy, privacy, genuine self-expression, self-determination, protection from experimentation without informed consent, and appropriate education and treatment;

2) Promoting dependence rather than independence in people with disabilities;

3) Misusing human and material resources that could be better spent on other interventions, e.g., time spend employing FC interferes with the use of communication systems that have a scientifically documented history of success;

4) Fostering expectations about people with disabilities that are unlikely to be realized;

5) Taking actions related to medical or other treatments, living and work arrangements, personal relationships, test and classroom performance, and other decisions about people with disabilities without objective verification that the communications represent their own wishes and competencies;

6) Promulgating false allegations of abuse and mistreatment, resulting in emotional distress and unnecessary legal and financial difficulties for many people with disabilities, their families and others. Thus the use of FC directly threatens the human and civil rights of the person whose communication is purportedly “facilitated,” and may also jeopardize the rights of others.

Autism, mental retardation, and other disabilities can result in diverse and often marked deleterious effects on adaptive behavioral development and communication skills. Parents and other caregivers of persons manifesting these conditions consequently are highly motivated to seek and obtain service that offers any promise of being effective in ameliorating these conditions. As a result, such caregivers are vulnerable to those who promote ineffective methods.

FC is not to be confused with use of appropriately applied manual guidance or other prompts to teach communications and other skills, nor should it be confused with independent use of nonspeech communication systems that may involve letterboards, keyboards, or other symbol systems.

It is the position of the Association for Behavior Analysis that FC is a discredited technique. Because of the absence of ample, objective, scientific evidence that FC is beneficial and that identifies the specific conditions under which it may be used with benefit, its use is unwarranted and unethical.

A task force authorized by the Executive Council of the Association for Behavior Analysis generated the above statement concerning the technique called Facilitated Communication (FC). Members of the task force independently reviewed the scientific literature concerning FC and agreed unanimously to the content of the statement. The Executive Council unanimously approved the statement in 1995, and it is the official position of the Association for Behavior Analysis.

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