Facilitated communication
The technique involves a facilitator guiding the disabled person's arm or hand in an attempt to help them type on a keyboard or other such device that they are unable to properly use if unfacilitated.
[6] In addition, in numerous cases disabled persons have been assumed by facilitators to be typing a coherent message while the patient's eyes were closed or while they were looking away from or showing no particular interest in the letter board.
[18][19][20] However, two American companies were later charged by the Federal Trade Commission for making "false and unsubstantiated claims" that the device could enable disabled people to communicate using FC.
[21] Proponents of FC claim that the reason people with autism cannot communicate effectively involves motor issues such as apraxia, and that they "lack confidence in their abilities"[16][22] but physical support helps them overcome this limitation.
[31][33][32]Scott Lilienfeld, the Dobbs Professor of Psychology at Emory University, writing in The Neuroethics Blog, admonishes practitioners of mental health practice not to ignore their "epistemic duties – responsibilities to seek out and possess accurate knowledge about the world", and wrote: Ultimately, the proponents of facilitated communication very much wanted to help individuals with autism.
[34]Techniques similar to FC appeared around the 1960s, with early observations regarding facilitated teaching of children with autism being published by Else Hansen (Denmark), Lorna Wing (England), and Rosalind Oppenheimer (U.S.).
[7][55] By 2001, it was reported in a comprehensive review of peer-reviewed literature that "Facilitated Communication (FC) had largely been empirically discredited as an effective intervention for previously uncommunicative persons with disabilities, especially those with autism and related disorders.
These perceptions will continue to be reinforced by professional organizations such as the Facilitated Communication Institute at Syracuse University, a fairly wide acceptance of FC internationally, and the vacuum created by few if any future solid empirical studies that are likely to dissuade the faithful.
"[80] Guidelines for facilitators instruct practitioners to expect the emergence of hidden skills and sensitive personal information, to use anecdotal data to validate authorship, to avoid objective scrutiny.
[22] Some observers have reported that while the facilitators were watching the letter board, their communication partners were often distracted, staring off into space, rolling around on the floor,[27] falling asleep,[29] or otherwise not paying attention.
[26][28][43][82] Patients have also been claimed to write books and poetry,[83][84] advocate for better treatment of people with disabilities,[85] express a desire to get married,[11][30] have sexual relations,[11][86][87] decide important medical issues, and, in some cases, report abuses allegedly occurring in their homes.
"[99] Belief in facilitated communication is promoted by its status as a claimed "miracle cure" presented when parents are undergoing stress and grief from learning that their child has a disability.
[100][91] Researchers James Mulick, John Jacobson and Frank Kobe state that FC is used to "...stroke their hopes with empty promises, regardless of their sincerity, while reaping personal or political rewards and working hard to prevent systematic verification of their claims".
"[21] Howard Shane, director of the Center for Communication Enhancement at Children's Hospital in Boston and an associate professor at Harvard Medical School, finds it "curious that those being facilitated can only create [these] insightful comments" when helped by an assistant.
[9][11] Testifying in the Anna Stubblefield court case, psychology professor James Todd called facilitated communication "the single most scientifically discredited intervention in all of developmental disabilities" and that every methodologically sound study of FC has shown it to be invalid.
[8] Writing about that case in the journal "Disability and Society", Mark Sherry voiced similar concerns about FC's lack of scientific validity, calling it a "sham", "hoax" and a "fraud."
[104] Members of the FC movement rely on anecdotal and observational data (e.g., the existence of unique spellings or unexpected skills or revelations made during the communication session)[18][23] in order to back up their claims.
Some of the tests were conducted as a direct response to cases involving sexual abuse allegations made through facilitated communication against parents, teachers, and caregivers of people with disabilities.
[22][26][116] In 1994, Thistledown Regional Centre in Ontario, Canada conducted an internal study of 20 people with autism and stopped using FC when the results showed facilitator influence was "contaminating the messages being produced.
In 1997, reflecting on the trajectory FC has taken in several countries, including Denmark, the U.S. and Australia, von Tetzchner wrote:In the struggle to keep up to date with an increasing number of published papers, both researchers and practitioners tend to forget history.
In order to avoid making the same mistakes over again, the issues and processes underlying the rise and fall of facilitating techniques--as well as other intervention methods--in various countries should have a natural place in research reviews.
[125] Stories of purported successes are still reported in magazines such as Reader's Digest,[59] in movies[37][49][50][101][126][127][128] and plays,[129] and on television shows such as ABC's 20/20 Prime Time Live with Diane Sawyer.
[22][25][29][37][52][130] Thousands of people—teachers, parents, speech pathologists, psychologists—struggling to find a way to communicate with individuals who, otherwise, demonstrated little ability to use words to communicate—adopted FC with "blinding speed" with little public scrutiny or debate.
As such, FC serves as a case study in how the public and, alarmingly, some professionals, fail to recognize the role of science in distinguishing truth from falsity and its applicability to assessing the value of treatment modalities.
In 2009, Randi responded in an interview for the Rom Houben case, where it was shown that messages from a Belgian man who was believed to be in a coma for 23 years were generated by the facilitator, "Our prize is still there.
"[136] In 2018, following the release of a statement from scientists and academics arguing FC had long been discredited and calling it an "invalidated and demonstrably harmful practice", UNI announced it would stop supporting the conference.
Couple that with mandatory abuse reporting laws, mix in a little bit of crusading zeal to "save" people with disabilities from mistreatment, and you have a potent set of antecedents for facilitators to produce allegations.
[144][145] The victim was identified as D.J., a 33-year-old African-American man with severe mental disabilities who cannot speak, has cerebral palsy, and is unable to stand independently or accurately direct movements of his body.
[147][148] In July 2017, an appeals court overturned her conviction and ordered a retrial,[149][150] and in 2018 she pleaded guilty to "third-degree aggravated criminal sexual contact" and was sentenced to time served.
[152] In 2014, Martina Susanne Schweiger of Queensland, Australia, received an 18-month suspended jail sentence for two counts of indecent dealing with a 21-year-old client with severe autism with whom she worked at a disability services home.
