Science & Pseudoscience Review in Mental Health

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Facilitated Communication: Courts say "No"

From Autism Research Review International, Vol. 6 no 3, 1992

In the first court decisions in the U.S. involving allegations of sexual abuse purportedly made via facilitated communication (F/C), two New York judges made independent rulings that allegations made by F/C could not be considered as evidence because the validity of F/C has not been established.

In the first case, in Ulster County, a 16 year-old autistic girl with no speech had allegedly accused her father and grandfathers of sexual molestation, using F/C (the father told ARRI that both grandfathers had been dead many years. The "facilitator" had never bothered to ask about them.). There was no physical evidence, nor any other kind of evidence, to support the allegations. Both parents faced criminal charges--the father, for alleged molestation, and the mother, for not reporting the father. The case was before the court for over 10 months.

On September 15, Judge K. K. Peters issued her verdict: that allegations made by F/C lack the credibility required to press charges against persons accused of wrongdoing. One day later, Judge M. R. Buck issued a similar decision in an Onondaga County case.

In the second case, a 10-year-old Down Syndrome girl was said to have used F/C to accuse her father of sexual molestation. Although this girl had some capacity to speak, the allegations were (purportedly) made only through the "facilitator," and never through speech. The father was forced to move out of the family home in January and faced a jail sentence if the allegations were found to be true. Again, there was no physical evidence of abuse.

Annette Muir, a lawyer assigned by the Court to represent the child's interests, was reported by the Syracuse Herald Tribune to have said that she is convinced there was no abuse: "Her teacher misinterpreted the communication because she was 'brainwashed' by the Biklen group."

Douglas Biklen, a leading advocate of F/C, was disappointed by the rulings. The Syracuse Post-Standard quoted him assaying, "It's a very frustrating situation . .Why should a person with a disability be disallowed... because there is not enough research..... even when they can validate their can themselves." But in Australia, where F/C has a longer record in the legal system, Professor Alan Hudson of Melbourne was quoted as saying, "in the past 12 months I've been involved in either conducting or acting as a consultant for ... 12 [F/C] cases. Eleven of those have been completed and there wasn't one where the assessment team concluded that the person could communicate using facilitated communication." Newsweek (9-21-92) notes that in some cases, children from Spanish- or Hindi-speaking homes allegedly have made accusations in fluent English.

Alan Zweibel, attorney for the family of the autistic girl, said, "My clients have been horribly damaged by the accusations ... It is their intent to seek legal redress from the government agencies involved and those who have so cavalierly forced invalid and untested treatment upon a community of individuals so vulnerable to manipulation." It seems likely at this point that a great deal of litigation will ensue nationwide as accused families begin to seek damages from their accusers. The director of one nationally known, highly regarded program told ARRI that she is having informed consent forms prepared to protect her agency from the fallout from the forthcoming legal battles between the accused and the facilitators.

Policy of the American Academy of Child & Adolescent Psychiatry, approved on October 20, 1993. This policy has been endorsed by the American Academy of Pediatrics as well.

Facilitated communication (FC) 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 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.

American Association on Mental Retardation - Position Statement on Facilitated Communication adopted by the American Association on Mental Retardation (AAMR) Board of Directors, June 1994:

Whereas, Facilitated Communication (FC) 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 a person with autism or mental retardation to communicate. A substantial number of objective clinical evaluations and well controlled studies indicate that facilitated communication has not been shown to result in valid messages from the person being facilitated.
Therefore, be it resolved that the Board of Directors of the American Association on Mental Retardation (AAMR) does not support the use of this technique as the basis for making any important decisions relevant to the individual being facilitated without clear, objective evidence as to the authorship of such messages. The AAMR strongly encourages the use and further development of valid augmentative and alternative communication techniques and approaches.

American Psychiatric Association - The American Psychiatric Association (APA) Council of Representatives issued a press release August 24, 1994 including the following resolution adopted by the Council:

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; Crew et.al. in press; Eberline, McConnachic, 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 preference, self-reports about health, test and classroom performance, and 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 unproven 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.