Facilitated communication

This article is about the pseudoscientific technique. For devices and processes that facilitate communication for people with communication difficulties, see Augmentative and alternative communication.

Facilitated communication

Alternative medicine
Claims	Disabled people may be able to communicate by pointing at letters or with a keyboard if physically held and assisted by an expert facilitator.
Related fields	Alternative medicine
Year proposed	Late 20th century
Original proponents	Rosemary Crossley
Subsequent proponents	Douglas Biklen

Facilitated communication (FC), or supported typing, is a scientifically discredited technique<ref name="Autism Wars">Vyse, Stuart (7 August 2018). "Autism Wars: Science Strikes Back". Skeptical Inquirer Online. Skeptical Inquirer. Archived from the original on 22 March 2019. Retrieved 28 November 2018.</ref> that claims to allow non-verbal people, such as those with autism, to communicate. 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 which they are unable to properly use if unfacilitated.<ref name="Facilitated Communication Is a Cult That Won’t Die">Auerbach, David (12 November 2015). "Facilitated Communication Is a Cult That Won't Die". Slate. Archived from the original on 26 September 2018. Retrieved 30 November 2015.</ref>

There is widespread agreement within the scientific community and among disability advocacy organizations that FC is a pseudoscience.<ref name="Review 2018">Hemsley, Bronwyn; Bryant, Lucy; Schlosser, Ralf; Shane, Howard; Lang, Russell; Paul, Diane; Benajee, Meher; Ireland, Marie (2018). "Systematic review of facilitated communication 2014-2018 finds no new evidence that messages delivered using facilitated communication are authored by the person with the disability". Autism and Developmental Language Impairments. 3: 239694151882157. doi:10.1177/2396941518821570.</ref> Research indicates that the facilitator is the source of the messages obtained through FC, rather than the disabled person. The facilitator may believe they are not the source of the messages due to the ideomotor effect, which is the same effect that guides a Ouija board.<ref name="Why debunked autism treatment fads persist">Lilienfeld; et al. (26 February 2015). "Why debunked autism treatment fads persist". Science Daily. Emory University. Archived from the original on 31 May 2019. Retrieved 10 November 2015.</ref><ref name="Ganz/Katsiyannis/Morin">Ganz, Jennifer B.; Katsiyannis, Antonis; Morin, Kristi L. (February 2017). "Facilitated Communication: The Resurgence of a Disproven Treatment for Individuals With Autism". Intervention in School and Clinic. 54: 52–56. doi:10.1177/1053451217692564.</ref> Studies have consistently found that FC is unable to provide the correct response to even simple questions when the facilitator does not know the answers to the questions (e.g., showing the patient but not the facilitator an object).<ref name="An experimental analysis of facilitated communication">Montee, B B; Miltenberger, R G; Wittrock, D; Watkins, N; Rheinberger, A; Stackhaus, J (1995). "An experimental analysis of facilitated communication". Journal of Applied Behavior Analysis. 28 (2): 189–200. doi:10.1901/jaba.1995.28-189. PMC 1279809. PMID 7601804.</ref> 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.<ref name="Making contact with a helping hand">Goldacre, Ben (5 December 2009). "Making contact with a helping hand". The Guardian. Archived from the original on 7 May 2020. Retrieved 10 November 2015.</ref>

Facilitated communication has been called "the single most scientifically discredited intervention in all of developmental disabilities".<ref name="Wichert"/> Some promoters of the technique have claimed that FC cannot be clearly disproven because a testing environment might cause the subject to lose confidence.<ref name="Palfreman, Jon (1993)">Palfreman, Jon (October 19, 1993). "Frontline: Prisoners of Silence". PBS. WGBH Educational Foundation. Archived from the original on June 22, 2018.</ref> However, there is a scientific consensus that facilitated communication is not a valid communication technique, and its use is strongly discouraged by most speech and language disability professional organizations.<ref name="Review 2018" /> There have been a large number of false abuse allegations made through facilitated communication.

Overview

Facilitated communication is promoted as a means to assist people with severe communication disabilities in pointing to letters on an alphabet board, keyboard or other device so that they can communicate independently. It has also been called "supported typing",<ref name="ISAAC Position Statement (2014)">International Society for Augmentative Alternative Communication (2014). "ISAAC Position Statement on Facilitated Communication: International Society for Augmentative and Alternative Communication". Augmentative and Alternative Communication. 30 (4): 357–358. doi:10.3109/07434618.2014.971492. hdl:10536/DRO/DU:30072729. PMID 25379709.</ref> "progressive kinesthetic feedback",<ref name="Lilienfeld, Marshall, Todd, Shane (2015)">Lilienfeld, Scott O.; Marshall, Julia; Todd, James T.; Shane, Howard C. (2 February 2015). "The persistence of fad interventions in the face of negative scientific evidence: Facilitated Communication for autism as a case example". Evidence-Based Communication Assessment and Intervention. 8 (2): 62–101. doi:10.1080/17489539.2014.976332. S2CID 145366255.</ref> and "written output communication enhancement".<ref name="Lilienfeld, Marshall, Todd, Shane (2015)"/> It is related to the Rapid Prompting Method (RPM),<ref name="Burling, Stacey (2004)">Burling, Stacey (May 17, 2004). "A pacesetting technique style for the autistic. She used the technique on her son. Some doubt the value of her methods". The Philadelphia Inquirer. Philadelphia, PA. p. C.1. Archived from the original on March 4, 2016. Retrieved March 18, 2015.</ref> also known as "informative pointing",<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /> which also has no evidence of efficacy.<ref name="Wombles, Kimberly (2015)">Wombles, Kimberly (18 February 2015). "Some fads never die – they only hide behind other names: Facilitated Communication is not and never will be Augmentative Communication". Evidence-Based Communication Assessment and Intervention. 8 (4): 181–186. doi:10.1080/17489539.2015.1012780. S2CID 143959563. Archived from the original on 12 January 2020. Retrieved March 18, 2015.</ref><ref name="AshaLeaderBlog">Travers, Jason (19 May 2015). "The Pseudoscientific Phenom<math>\wedge</math>Facilitated Communication<math>\wedge</math>Makes a Comeback". Leader Live. American-Speech-Language-Hearing Association. Archived from the original on 21 May 2015. Retrieved 10 April 2016.</ref><ref name="science20">Wombles, Kim (27 August 2014). "Why Rapid Prompting Method Still Doesn't Pass the Evidence-Based Test". Science 2.0. ION Publications LLC. Archived from the original on 11 December 2019. Retrieved 10 April 2016.</ref>

The person with disabilities, who is often unable to rely on speech to communicate, is called the communication partner, while the person holding their arm is called the facilitator. The facilitator holds or touches the communication partner's elbow, wrist, hand, sleeve or other parts of the body<ref name="Biklen, Douglas (1990)">Biklen, Douglas (1990). "Communication Unbound: Autism and Praxis". Harvard Educational Review. 60 (3): 291–314. doi:10.17763/haer.60.3.013h5022862vu732.</ref> while the communication partner points to letters of the alphabet on a keyboard or other device.<ref name="Schwiegert, Mary Beth">Schwiegert, Mary Beth (28 December 2000). "Will to succeed Lititz man battles autism – and goes to college". Lancaster New Era. Lancaster, Pennsylvania. p. D-1.</ref><ref name="Lilienfeld, Marshall, Todd, Shane (2015)" />

One device popular with early FC users was the Canon Communicator, which printed a tape of letters when activated.<ref name="Biklen, Morton, Gold, Berrigan, Swaminatham (1992)">Biklen, Douglas; Morton, Mary Winston; Gold, Deborah; Berrigan, Carol; Swaminathan, Sudha (1992). "Facilitated Communication: implications for individuals with autism". Topics in Language Disorders. 12 (4): 1–28. doi:10.1097/00011363-199208000-00003. S2CID 143895378.</ref><ref name="Dillon, Kathleen M. (1993)">Dillon, Kathleen M. (1993). "Facilitated Communication, Autism and Ouija". Skeptical Inquirer. 17 (3): 281–287.</ref><ref name="Dineen, Janice (1991)">Dineen, Janice (December 21, 1991). "How autistic Chloe stunned the medical world". Toronto Star. No. SA2 Edition. Toronto, Ontario. p. A1.</ref> 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. The companies settled and stopped mentioning FC in their advertising campaigns.<ref name="Boodman, Sandra (1995)">Boodman, Sandra G. (January 17, 1995). "Can autistic children be reached through 'Facilitated Communication'? Scientists say no". The Washington Post. No. Final Edition. Washington, D.C. p. z01. Archived from the original on March 2, 2017. Retrieved March 18, 2015.</ref>

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"<ref name="Biklen, Douglas (1990)" /><ref name="Green, Gina (1994)" /> but physical support helps them overcome this limitation. However, this claim is unsubstantiated. Research indicates that non-verbal autistics are unable to communicate due to intellectual disability.<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" />

The facilitator is depicted as helping the patient with pointing to letters, controlling involuntary arm movements, avoiding mistakes, initiating movement,<ref name="Jacobson, Mulick, Schwartz (1995)" /> verbal prompts, and moral support.<ref name="Schwiegert, Mary Beth" /><ref name="Mangiacasale, Angela">Mangiacasale, Angela (January 23, 1992). "New voice: system lets disabled communicate". The Ottawa Citizen. No. Final Edition. p. D3.</ref><ref name="Mostert, Mark (2012)">Mostert, Mark P. (18 June 2012). "Facilitated Communication: The empirical imperative to prevent further professional malpractice". Evidence-Based Communication Assessment and Intervention. 6 (1): 18–27. doi:10.1080/17489539.2012.693840. S2CID 143959332.</ref><ref name="von Tetzchner, Stephen (1997)">von Tetzchner, Stephen (1997). "Historical issues in intervention research: hidden knowledge and facilitating techniques in Denmark". European Journal of Disorders of Communication. 32 (1): 1–18. doi:10.3109/13682829709021453. PMID 9135710.</ref><ref name="Greenbaum, Kurt (1992)">Greenbaum, Kurt (September 27, 1992). "Autistic Method Disputed Researcher Says Child Not Helped". Sun-Sentinel. Fort Lauderdale, Florida. p. 8B.</ref> It is also claimed that the facilitator must believe in the patient's ability to communicate.<ref name="Kim, Rose (1992)">Kim, Rose (17 June 1992). "The magic touch keyboard technique helps severely disabled students learn to communicate". Los Angeles Times. No. Home Edition. Los Angeles, California. p. 3. Archived from the original on 2015-04-02. Retrieved March 18, 2015.</ref><ref name="Green, Gina (1995)">Green, Gina (Fall 1995). "An ecobehavioral interpretation of the facilitated communication phenomenon". Psychology in Mental Retardation and Developmental Disabilities. 21 (2): 1–8.</ref><ref name="Libman, Gary (1992)">Libman, Gary (17 November 1992). "A controversial technique may be the key to providing sufferers with a way to communicate unlocking autism". Los Angeles Times. No. Home Edition. p. 1. Archived from the original on 2015-04-02. Retrieved March 18, 2015.</ref> Former facilitator Janyce Boynton, who came to reject the technique after taking part in double-blind trials, later reported that her training<ref name="Facilitated Communication—what harm it can do: Confessions of a former facilitator" /><ref name="How facilitators control words" /> took for granted that the process worked, and that the complexity of facilitation made it hard to realise that messages were coming from her expectations and not from her patients:

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:

History

Keyboard of the type used in facilitated communication

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.).<ref name=":1">Pilvang, Maureen (August 2002). "Facilitated Communication in Denmark" (PDF). Seventh Biennial ISAAC Research Symposium. Archived (PDF) from the original on 2022-01-04. Retrieved 2020-10-04.</ref> Studies were made in Denmark in the 1960s and 1970s,<ref name="von Tetzchner, Stephen (1997)" /> but did not have an impact outside of the country,<ref name="von Tetzchner, Stephen (1997)" /> and the debate there died out in the early 1980s due to a lack of scientific evidence.<ref name="von Tetzchner, Stephen (1997)" />

In Australia, special educator Rosemary Crossley independently created facilitated communication in 1977,<ref name="von Tetzchner, Stephen (1997)" /> where it became popular largely due to her efforts.<ref name="Dillon, Kathleen M. (1993)" /><ref name="lilienfeld-2016" /><ref name="Alferink, Larry A.">Alferink, Larry A. (Fall–Winter 2007). "Educational Practices, Superstitious Behavior and Mythed Opportunities". Scientific Review of Mental Health Practice. 5 (2): 21–30.</ref><ref name="Palfreman, Jon (2012)">Palfreman, Jon (11 May 2012). "The dark legacy of FC". Evidence-Based Communication Assessment and Intervention. 6 (1): 14–17. doi:10.1080/17489539.2012.688343. S2CID 144395085.</ref><ref name="Well, Judith (1994)">Well, Judith (March 9, 1994). "Facilitation: How much of a helping hand?". Jerusalem Post. Jerusalem. p. 07.</ref> It was popularized in the United States beginning in the late 1980s by Arthur Schawlow and Douglas Biklen.<ref name="Wright, Pearce (1999)">Wright, Pearce (11 May 1999). "Obituary: How the laser changed our world: Arthur Schawlow". The Guardian. London, England. p. 18. Archived from the original on 12 January 2020. Retrieved March 18, 2015.</ref><ref name="Green, Gina (1994)">Green, Gina (1994). "Mental Miracle or Sleight of Hand?". Skeptic. 2 (3): 68–76.</ref><ref name="Biklen, Douglas (1990)" /><ref name="Dillon, Kathleen M. (1993)" /><ref name="Jacobson, Mulick, Schwartz (1995)">Jacobson, John W.; Mulick, James A.; Schwartz, Allen A. (September 1995). "A History of Facilitated Communication: Science, Pseudoscience, and Antiscience: Science Working Group on Facilitated Communication". American Psychologist. 50 (9): 750–765. doi:10.1037/0003-066x.50.9.750.</ref> FC has also received attention in Asia and Europe.<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /><ref name="Alferink, Larry A." /><ref name="Gifford, Aaron (2000)">Gifford, Aaron (October 9, 2000). "SU professor still pushes to validate his method". The Post-Standard. No. Final Edition. Syracuse, New York. p. B2.</ref>

Early users of facilitated communication praised it for its apparent simplicity.<ref name="Green, Gina (1994)" /><ref name="Kim, Rose (1992)" /><ref name="Green, Gina (1995)" /><ref name="Celiberti, David (2010)">Celiberti, David (Spring 2010). "Facilitate This: Part 1 of a Two-Part Interview with Dr. James Todd". Science in Autism Treatment. 7 (2).</ref><ref name="Ballon, Diana (1992)">Ballon, Diana (April 25, 1992). "A ray of sunshine for the Rain Man. A new technique for communicating with autistic children is being greeted with skepticism by some experts - but the anecdotal evidence is compelling". The Globe and Mail. Toronto, Ontario. p. D.8.</ref> It was promoted as a "teaching strategy"<ref name="Stengle, Bernice">Stengle, Bernice (5 September 1993). "Michael casts a spell". St. Petersburg Times. No. City Edition. St. Petersburg, Florida.</ref> that did not require objective evaluation or close monitoring.<ref name="Green, Gina (1995)" /> However, as early as 1991, more than 40 peer-reviewed studies had not only failed to demonstrate FC's efficacy, but indicated that any successes reported were due to facilitator influence.<ref name="MostertActivist">Mostert, Mark (2014). "An Activist Approach to Debunking FC". Research and Practice for Persons with Severe Disabilities. 39 (3): 203–210. doi:10.1177/1540796914556779.</ref> This influence is usually attributed to non-conscious movements,<ref name="Spitz, Herman">Spitz, Herman (1997). Nonconscious Movements: From Mystical Messages to Facilitated Communication. Routledge. ISBN 978-0-805-82564-0. Archived from the original on 2 April 2015. Retrieved March 18, 2015.</ref><ref name="von Tetzchner, Stephen (2012)">von Tetzchner, Stephen (June 25, 2012). "Understanding facilitated communication: Lessons from a former facilitator - Comments on Boynton, 2012". Evidence-Based Communication Assessment and Intervention. 6 (1): 28–35. doi:10.1080/17489539.2012.699729. S2CID 217511582.</ref> and it is thought that facilitators are genuinely unaware that they are controlling the communications.<ref name="Boodman, Sandra (1995)" /><ref name=BW>Brasier, L.L.; Wisely, John (December 18, 2007). "Abuse case hinges on a keyboard". McClatchy-Tribune Business News. Washington, D.C. Archived from the original on April 2, 2015. Retrieved March 18, 2015.</ref>

In 1994, the American Psychological Association (APA),<ref name="Rising, Gerry">Rising, Gerry (8 January 2001). "'Miraculous' autism treatment stirs concern". Buffalo News. No. Final Edition. Buffalo, New York. p. 2B.</ref><ref name="Riggott, Julie">Riggott, Julie (Spring–Summer 2005). "Pseudoscience in Autism Treatment: Are the News and Entertainment Media Helping or Hurting?". Scientific Review of Mental Health Practice. 4 (1): 58–60.</ref> passed a resolution cautioning against the use of facilitated communication, citing the lack of scientific evidence.<ref name="Boodman, Sandra (1995)" /> They also stated that information obtained via FC should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions.<ref name=BW/><ref name="Mann, Lisa Barrett (2005)">Mann, Lisa Barrett (February 22, 2005). "Oscar Nominee: Documentary or Fiction?; Film Resurrects Discredited Autism Tactic". The Washington Post. No. Final Edition. p. Health; F01. Archived from the original on April 2, 2015. Retrieved March 18, 2015.</ref><ref name="The Times (July 2000)">"Facilitated communication not reliable as evidence". The Times. London, England. July 29, 2000.</ref> In recognition of the continued scientific evidence against the technique, this was followed by similar statements from the American Academy of Child and Adolescent Psychiatry (AACAP),<ref name="Riggott, Julie" /> American Speech-Language-Hearing Association (ASHA),<ref name="Jacobson, Mulick, Schwartz (1995)" /><ref name=ECE>Emery Jr., C. Eugene (November 30, 1994). "FC Message Technique for the Handicapped Unproven, experts say *A national group of speech and language experts votes to warn its 80,000 members that tests show facilitated communication lacks scientific validity". Providence Journal. Providence, Rhode Island. p. D-09.</ref><ref name="Duchan, Judith (2001)">Duchan, Judith F.; Calculator, Stephen; Sonnenmeier, Rae; Diehl, Sylvia; Cumley, Gary D. (2001). "A Framework for Managing Controversial Practices". Language, Speech, and Hearing Services in Schools. 32 (3): 133–141. doi:10.1044/0161-1461(2001/011). PMID 27764404.</ref> and the International Society for Augmentative and Alternative Communication (ISAAC)<ref name=Schlosser_et_al_2014>Schlosser, R.; Balandin, S.; Hemsley, B.; Iacono, T.; Probst, P.; von Tetzchner, S. (2014). "Facilitated Communication and Authorship: A Systematic Review". Augmentative and Alternative Communication. 30 (4): 359–368. doi:10.3109/07434618.2014.971490. PMID 25384895. S2CID 207470234.</ref> In 1998, a British government report concluded that "the phenomenon fails to materialise once facilitator effects have been controlled. It would be hard to justify further research on this".<ref name="Making contact with a helping hand" /><ref name="Educational Interventions for Children With Autism: A Literature Review of Recent And Current Research">Jordan, Jones & Murray. "Educational Interventions for Children With Autism: A Literature Review of Recent And Current Research" (PDF). Institute of Education. DfEE. Archived (PDF) from the original on 17 April 2016. Retrieved 10 November 2015.</ref> 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. Key empirical findings consistently showed that the facilitator and not the client initiated communication."<ref name="Mostert, Mark P. (2010)" />

Many people believed FC had passed its peak,<ref name="Oswald, Donald P. (1996)">Oswald, Donald P. (September 1996). "Book Review: Facilitated Communication: The Clinical and Social Phenomenon. Edited by Howard C. Shane. San Diego, CA: Singular Publishing Group. 1994. pp. 323". Journal of Behavioral Education. 6 (3): 355–357. doi:10.1007/BF02110136. JSTOR 41824137. S2CID 195215616.</ref> characterizing it as a fad<ref name="Oswald, Donald P. (1996)" /> and pseudoscientific.<ref name="Wombles, Kimberly (2015)" /><ref name="Normand, Matthew P. (2008)">Normand, Matthew P. (Winter 2008). "Science, Skepticism, and Applied Behavior Analysis". Behavior Analysis in Practice. 1 (2): 42–49. doi:10.1007/BF03391727. PMC 2846586. PMID 22477687.</ref> However, promotion of the technique continued, with supporters dismissing empirical investigations as irrelevant, flawed, or unnecessary, and calling FC an "effective and legitimate intervention".<ref name="Mostert, Mark P. (2010)">Mostert, Mark P. (2010). "Facilitated Communication and Its Legitimacy - Twenty-first century developments". Exceptionality. 18 (1): 31–41. doi:10.1080/09362830903462524. S2CID 143946477.</ref><ref name=MostertActivist /><ref name="Gardner, Martin">Gardner, Martin (January–February 2001). "Facilitated Communication: A Cruel Farce". Skeptical Inquirer: 17–19.</ref><ref name="Porter, Kayla">Porter, Kayla (14 August 2007). "Awakening the silence". McClatchy-Tribune Business News. Washington, D.C.</ref> As of 2014, the facilitated communication movement remained popular and it continued to be used in many countries.<ref name="Palfreman, Jon (2012)" /><ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /> Mostert writes:

All the newer pro-FC studies operate from the premise that FC works and is a legitimate practice to be used in investigating any number of other phenomena related to people with autism and other related severe communication problems. Such assumptions increasingly morph FC into a valid intervention among readers who are unaware of the empirical dismissal of the intervention and who might not be skilled in distinguishing solid from suspect research. In this regard, it is likely that FC will continue to reinforce the assumptions of efficacy among parents and practitioners. 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.<ref name="Mostert, Mark P. (2010)" />

Facilitated communication is closely related to the rapid prompting method (RPM), in which the facilitator holds the letter board instead of touching the patient.<ref name="Chandler, Michael (March 2017)">Chandler, Michael Alison (March 1, 2017). "The key to unlock their autistic son's voice". The Washington Post. Washington, D.C. p. A.1. Archived from the original on 3 December 2020. Retrieved 14 April 2017.</ref> Proponents of RPM deny similarities with FC and state that the prompts are "nonspecific".<ref name="Beach, Patrick (January 2008)">Beach, Patrick (January 20, 2008). "Understanding Tito". Austin Statesman. Austin, Texas. p. J.1.</ref> However, RPM contains subtle cuing that makes it highly susceptible to influence from the facilitator.<ref name="Chandler, Michael (March 2017)"/>

Other similarities between RPM and FC include: reluctance or refusal to test their claims in controlled settings (purportedly because the process breaks the trust between facilitator and client), presumed competence, reliance on anecdotal accounts as proof of efficacy, maintenance of practices, techniques and claims that are inconsistent with the known research, claims of extraordinary literacy or intellectual breakthroughs, unconscious verbal or physical cuing by facilitators to obtain the expected responses, and inadequate or non-existent protocols to account for the effects of the facilitator.<ref name="Tostanoski et al (August 2014)">Tostanoski, Amy; Lang, Russell; Raulston, Tracy; Carnett, Amarie; Davis, Tonya (August 2014). "Voices from the past: Comparing the rapid prompting method and facilitated communication". Developmental Neurorehabilitation. 17 (4): 219–223. doi:10.3109/17518423.2012.749952. PMID 24102487.</ref><ref name="Todd, James (Rapid Prompting)">Todd, James (2013). "Rapid Prompting". Encyclopedia of Autism Spectrum Disorders. pp. 2497–2503. doi:10.1007/978-1-4419-1698-3_1896. ISBN 978-1-4419-1697-6.</ref>

In 2019, a dispute about the use of Spelling to Communicate (S2C), a brand of RPM, developed between the Lower Merion School District and the parent of a child attending school there. The parents claimed the child was deprived of a free education because the district declined to pay for a private educational program based on S2C. In December of that year, the hearing officer in the Pennsylvania Office of Dispute Resolution found that there was no evidence that S2C enabled the child to communicate and thus the school district prevailed.<ref>Vyse, Stuart (March–April 2020). "A Small Victory of Science in Suburban Philadelphia". Skeptical Inquirer. 44: 5. Archived from the original on 2020-05-05. Retrieved 2020-03-07.</ref>

Organizations supporting and opposing facilitated communication

Supporters

In 2010, Autism Spectrum Disorders: A Reference Handbook mentioned the Autism National Committee (AutCom), a parent-led nonprofit, as the main example of an organization that continued promoting facilitated communication, despite research in the mid-1990s which found that facilitators were doing the communicating rather than the children themselves.<ref>Bernier, Raphael; Gerdts, Jennifer (2010). Autism Spectrum Disorders: A Reference. Santa Barbara, California: ABC–CLIO. pp. 71–72. ISBN 978-1-59884-334-7.</ref> As of 2022, AutCom continues to state on its website that it "[stands] with autistics, along with their families, friends, and allies, and others who know and respect them, who are working to gain a reliable, autonomous voice", and lists methods it supports including "Facilitated Communication Training (FCT), Rapid Prompting Method (RPM), Spelling to Communicate (S2C), or Informative Pointing Method".<ref>"AutCom Statement on Facilitated Communication" (PDF). Autism National Committee. Retrieved 2022-10-04.</ref> Other organizations supporting FC have included the Association for Persons with Severe Handicaps (TASH) and the Autistic Self-Advocacy Network (ASAN).<ref>Auerbach, David (November 12, 2015). "Facilitated Communication Is a Cult That Won't Die". Slate. Retrieved 2022-10-04.</ref>

Opponents

Organizations opposing facilitated communication include:

• The American Academy of Child and Adolescent Psychiatry (AACAP)<ref name="Riggott, Julie" />
• The American Academy of Pediatrics (AAP)<ref name="ISAAC Position Statement (2014)" /><ref name="Scientific Review (2005)" />
• The American Association on Intellectual and Developmental Disabilities (AAIDD), previously called the American Association on Mental Retardation (AAMR)<ref name="ISAAC Position Statement (2014)" /><ref name="Scientific Review (2005)" />

The Board of Directors concludes that rather than helping people express their thoughts, desires, and choices, FC and RPM have the potential to effectively take away people’s voices. This is due to the risk of facilitator influence/authorship as well as the potential to displace efforts to access scientifically valid communication modes, such as those associated with the field of Augmentative and Alternative Communication (AAC).

— AAIDD<ref name="AAIDD">"Facilitated Communication and Rapid Prompting Method". AAIDD. Archived from the original on 10 January 2021. Retrieved 9 January 2021.</ref>

• The American Psychiatric Association Council of Representatives (APACR)<ref name="ISAAC Position Statement (2014)" /><ref name="Scientific Review (2005)">"Commission for Scientific Medicine and Mental Health News Release". Scientific Review of Mental Health Practice. 4 (1): 58–60. Spring–Summer 2005.</ref>
• The American Psychological Association (APA)<ref name="Rising, Gerry" /><ref name="Riggott, Julie"/>
• The American Speech-Language-Hearing Association (ASHA)<ref name="Jacobson, Mulick, Schwartz (1995)" /><ref name=ECE/><ref name="Duchan, Judith (2001)" />

It is the position of the American Speech-Language-Hearing Association (ASHA) that use of the Rapid Prompting Method (RPM) is not recommended because of prompt dependency and the lack of scientific validity. Furthermore, information obtained through the use of RPM should not be assumed to be the communication of the person with a disability.

— ASHA<ref name="ASHA">Association (ASHA), American Speech-Language-Hearing (2018). "Rapid Prompting Method". American Speech-Language-Hearing Association. Archived from the original on 3 December 2020. Retrieved 9 January 2021.</ref>

• The Association for Behavior Analysis International (ABAI)<ref name="Riggott, Julie" /><ref name="Scientific Review (2005)" />
• The Association for Science in Autism Treatment<ref name="ISAAC Position Statement (2014)" />

While the lack of evidence from previously conducted studies does not necessarily indicate that RPM is not effective at developing communication skills and reducing stereotypic behaviors in learners with autism, use of this intervention should not be used or recommended by practitioners until the claims made can be substantiated by peer reviewed research studies.

— ASAT<ref>"Rapid Prompting Method (Position Statement)". asatonline.org. Association for Science in Autism Treatment. Archived from the original on 10 January 2021. Retrieved 10 January 2021.</ref>

• The Federal Trade Commission (FTC)<ref name="Jacobson, Mulick, Schwartz (1995)" />
• Heilpädagogische Forschung<ref name="ISAAC Position Statement (2014)" />
• The Institute on Disability (IOD) at the University of New Hampshire<ref name="FC Vyse 2015">Vyse, Stuart (2015-05-11). "Facilitated Communication: The Fad that Will Not Die". Skeptical Inquirer. CSICOP. Archived from the original on 2017-06-02. Retrieved 20 May 2017.</ref>

Historically, the IOD has engaged in research and training activities related to FC. These activities were never a substantial part of our work and have waned considerably in recent years. The IOD is no longer providing resources or pursuing activities related to FC.

— IOD<ref name="FC Vyse 2015"/>

• The University of Northern Iowa<ref name=Gazette2/>
• The International Society for Augmentative and Alternative Communication (ISAAC)<ref name="ISAAC Position Statement (2014)" />

...given ISAAC's mission to promote the best possible communication abilities and opportunities for persons with limited or no functional speech, ISAAC does not support FC as a valid form of AAC, a valid means for people to access AAC, or a valid means to communicate important life decisions. The weight of evidence does not support FC and therefore it cannot be recommended for use in clinical practice.

— ISAAC<ref name="ISAAC Position Statement (2014)" />

• National Institute for Health and Care Excellence (NICE)<ref name = NICE>"Do Not Do Recommendation". NICE. Archived from the original on 26 June 2018. Retrieved 25 June 2018.</ref>

Do not provide 'facilitated communication' for adults with autism.

— NICE<ref name = NICE/>

• The New York State Department of Health<ref name="Scientific Review (2005)" />
• The New Zealand Ministries of Health and Education<ref name="ISAAC Position Statement (2014)" />
• The Scottish Intercollegiate Guidelines Network<ref name="ISAAC Position Statement (2014)" />
• Socialstyrelsen (The National Board of Health and Welfare, Sweden)<ref name="ISAAC Position Statement (2014)" />
• Speech-Language and Audiology Canada (SAC)<ref name="SAC">"Use of Facilitated Communication and Rapid Prompting Method" (PDF). Speech-Language & Audiology Canada. Archived (PDF) from the original on 8 March 2021. Retrieved 9 January 2021.</ref>

There is a lack of substantive research evidence demonstrating that FC and RPM are valid forms of augmentative or alternative communication ... Research studies show that facilitators consciously and/or unconsciously influence the message being communicated ... thereby exposing people with communication disorders to risk of harm by preventing genuine self-expression ... For these reasons, SAC members and associates should not use FC and RPM in clinical practice.

— SAC<ref name="SAC"/>

• Speech Pathology Australia<ref name="ISAAC Position Statement (2014)" />
• The Swedish Autism and Asperger Association<ref name="Gunther, Maria">Gunther, Maria (July 20, 2014). "Schools using the controversial method for autistic children". DN.se.</ref>
• The Victorian Advocacy League for Individuals and Disabilities Inc. (VALID)<ref name="ISAAC Position Statement (2014)" />

Claims and evidence

The Anne McDonald Centre, a facilitated communication centre in Melbourne, Australia, directed by Rosemary Crossley

There is widespread agreement within the scientific community and multiple disability advocacy organizations that FC is not a valid technique for communicating with those with autism spectrum disorder.<ref name="Review 2018"/> Instead, research indicates that the facilitator is the source of the messages obtained through FC (involving ideomotor effect guidance of the arm of the patient by the facilitator).<ref name="Why debunked autism treatment fads persist" /><ref name="Ganz/Katsiyannis/Morin" /> Studies have consistently found that FC is unable to provide the correct response to even simple questions when the facilitator does not know the answers to the questions (e.g., showing the patient but not the facilitator an object).<ref name="An experimental analysis of facilitated communication"/>

While video tapes exist that appear to show disabled people communicating through FC, or who have used it as a means to learn independent typing, these videos are widely regarded as inaccurate and misleading. According to one researcher, "You can edit videotape and show whatever you want. They'll show you a close-up of the finger moving across the keyboard... but you're not getting what else is going on."<ref name="Mann, Lisa Barrett (2005)" />

Authorship of messages

Researchers attribute the facilitators' beliefs about authorship to the ideomotor effect (also called the Clever Hans or Ouija effect).<ref name="Hyman, Ray (1999)">Hyman, Ray (Fall–Winter 1999). "The Mischief Making of Ideomotor Action". The Scientific Review of Alternative Medicine. 3 (2). Archived from the original on 2015-08-20. Retrieved 2015-03-23.</ref><ref name="Spitz, Herman" /><ref name="Dillon, Kathleen M. (1993)" /><ref name="Green, Gina (1994)" /> While proponents say that FC should never involve guiding the patient, researchers attending an FC class in 1993 observed that physical force was used to prevent the patients from moving their hand away from the keyboard.<ref name="Mulick et all" /> Facilitators may also influence movements without realizing it.<ref name="Gardner, Martin" /> Researcher Gina Green stated: "Very subtle influence can affect people's behavior. It doesn't even have to be touch. It can be the slightest sound, the slightest visual cue."<ref name="Dillow, Gordon (1993)">Dillow, Gordon (24 January 1993). "Teacher says method that helps disabled ruined him. Courts: Autism sufferers, using a 'facilitator' to communicate, accused teacher of sexual assault. Charges dropped but he plans to sue for $2.5 million". Los Angeles Times. No. Home Edition. Los Angeles, CA. p. 1.</ref> 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.<ref name="Green, Gina (1994)" />

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,<ref name="Greenbaum, Kurt (1992)" /> falling asleep,<ref name="Green, Gina (1995)" /> or otherwise not paying attention.<ref name="Schwiegert, Mary Beth" /><ref name="Stengle, Bernice" /> In other cases, the communication partners spoke words that conflicted with the words being typed.<ref name="Palfreman, Jon (1993)" /> Individuals described as highly competent would also give wrong answers to simple questions or information that they should have readily known (e.g. the name of the family dog, the names of family members, the spelling of their own name) but which facilitators did not.<ref name="Biklen, Douglas (1990)" /><ref name="MH021692">Paul Heinrichs (February 16, 1992). "Suffering at the hands of the protectors". The Sunday Morning Herald. Archived from the original on January 22, 2018. Retrieved October 21, 2015.</ref>

Proponents of the technique believed that patients who had not been taught reading, writing or mathematics were capable of writing down complex thoughts and solving multiplication problems.<ref name="von Tetzchner, Stephen (1997)" /><ref name="Kim, Rose (1992)" /><ref name="Stengle, Bernice" /><ref name="Biklen, Schubert (1991)">Biklen, Douglas; Schubert, Annegret (November–December 1991). "New Words: The Communication of Students with Autism". Remedial and Special Education. 12 (6): 46–57. doi:10.1177/074193259101200607. S2CID 145504550. Archived from the original on April 2, 2015. Retrieved March 18, 2015.</ref> Patients have also been claimed to write books and poetry,<ref name="Dickerson, Brian (2008)">Dickerson, Brian (17 March 2008). "Brian Dickerson Column: A legal horror show tears Oakland Co. family apart". McClatchy-Tribune Business News. Washington, D.C.</ref><ref name="Reischman, Rick">Reischman, Rick (31 December 2007). "Region Brief". Daily Record. Wooster, Ohio.</ref> advocate for better treatment of people with disabilities,<ref name="McKechnie, Howell (1993)">McKechnie, Gary; Howell, Nancy (March 14, 1993). "The world according to David: A controversial new approach may be allowing David Graham Perry and thousands of others to communicate for the first time in their lives or it may be offering false hope". Orlando Sentinel. No. 2* Edition. Orlando, Florida. p. 10.</ref> express a desire to get married,<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /><ref name="Libman, Gary (1992)" /> have sexual relations,<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /><ref name="Todd, James (2012)">Todd, James T. (13 July 2012). "The moral obligation to be empirical: Comments on Boynton's "Facilitated Communication - what harm it can do: Confessions of a former facilitator."". Evidence-Based Communication Assessment and Intervention. 6 (1): 36–57. doi:10.1080/17489539.2012.704738. S2CID 143043194. Archived from the original on 12 January 2020. Retrieved March 18, 2015.</ref><ref name="Sundstrom, Kathy (2014)">Sundstrom, Kathy (October 17, 2014). "Carer: "I fell in love": Grandma guilty of indecent dealing". Sunshine Coast Daily. Queensland, Australia. Archived from the original on January 13, 2020. Retrieved March 18, 2015.</ref> decide important medical issues, and, in some cases, report abuses allegedly occurring in their homes.<ref name="Alferink, Larry A." /><ref name="Papp, Leslie (1996)">Papp, Leslie (21 January 1996). "Autism 'miracle' a nightmare for family". The Toronto Star. No. Sunday Second Edition. Toronto, Ontario, Canada: Toronto Star Newspapers, Ltd.</ref><ref name="Spake, Amanda (1992)">Spake, Amanda (31 May 1992). "Skeptics and Believers; The Facilitated Communication Debate". The Washington Post. p. W22. Archived from the original on 2 April 2015. Retrieved March 18, 2015.</ref> According to psychologist Adrienne Perry, "The adult or child with autism is made a 'screen' for a facilitator's hostilities, hopes, beliefs or suspicions".<ref name="Papp, Leslie (1996)" />

Autism

While proponents of FC claim that autism is primarily a motor control problem that can be overcome with physical support,<ref name="Biklen, Douglas (1990)" /><ref name="Green, Gina (1995)" /><ref name="Well, Judith (1994)" /> this view is not accepted by the scientific community.<ref name=reviewofcaa>Beals, Katharine (2020). "Review of Communication Alternatives in Autism: Perspectives on Typing and Spelling Approaches for the Nonspeaking". Journal of Evidence-Based Social Work. 17 (3): 361–367. doi:10.1080/26408066.2020.1729284. S2CID 239764348.</ref><ref name=bealsreview>Beals, Katharine (2021). "Book Review: Biklen, D. (2005). Autism and the myth of the person alone". Research on Social Work Practice: 1–5. doi:10.1177/10497315211003952. S2CID 233228576.</ref> Autism is often accompanied by intellectual disabilities affecting language and communication which cannot be overcome by supportively holding someone's hand.<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /><ref name="Calculator, Stephen (1999)" /> Facilitators reject objective data and use public opinion and qualitative studies<ref name="TraversVoice">Travers, Jason; Tincani, Matt; Lang, Russell (September 2014). "Facilitated Communication Denies People With Disabilities Their Voice". Research and Practice for Persons with Severe Disabilities. 39 (3): 195–202. doi:10.1177/1540796914556778.</ref><ref name="CardinalMaturingFC">Cardinal, Donald; Falvey, Mary (September 2014). "Facilitated Communication Denies People With Disabilities Their Voice". Research and Practice for Persons with Severe Disabilities. 39 (3): 189–194. doi:10.1177/1540796914555581.</ref> to promote FC's efficacy despite contradicting a long history of autism research.<ref name="Oswald, Donald P. (1996)" /><ref name="Cuff, John Haslett (1993)">Cuff, John Haslett (19 October 1993). "Television "Prisoners of Silence: A Shocking look at autism research". The Globe and Mail. Toronto, Ontario. p. C.4.</ref><ref name="SingerStandardsofProof">Singer, George; Horner, Robert; Dunlap, Glen; Wang, Mian (September 2014). "Standards of Proof: TASH, Facilitated Communication, and the Science-Based Practices Movement". Research and Practice for Persons with Severe Disabilities. 39 (3): 178–188. doi:10.1177/1540796914558831. S2CID 145757011.</ref> In some cases, patients learn to give specific responses to cues from the facilitator, such as in cases where the facilitator only touches their shoulder or does not touch the patient at all.<ref name="Riggott, Julie" /> Proponents also say that a few individuals using FC have developed the ability to type independently or with minimal support,<ref name="Broderick, Kasa-Henderson (2001)">Broderick, Alicia A.; Kasa-Handrickson, Christi (Spring 2001). ""Say just one word at first": The emergence of reliable speech in a student labeled with autism". Journal of the Association for Persons with Severe Handicaps. 26 (1): 13–24. doi:10.2511/rpsd.26.1.13. S2CID 144645577. Archived from the original on 2 April 2015. Retrieved 19 March 2015.</ref> but these claims are anecdotal and have not been substantiated.<ref name="Lilienfeld, Marshall, Todd, Shane (2015)" /><ref name="Wombles, Kimberly (2015)" /><ref name="SPA (2012)">"Augmentative and Alternative Communication Clinical Guidelines". Speech Pathology Australia. The Speech Pathology Association of Australia Limited. September 2012. Archived from the original on 2015-03-10. Retrieved March 19, 2015.</ref> Many facilitators deny they are influencing their communication partners' movements, even when faced with evidence to the contrary.<ref name="Palfreman, Jon (2012)" /><ref name="Riggott, Julie" />

According to the American Academy of Pediatrics (AAP) clinical report, Identification, Evaluation, and Management of Children With Autism Spectrum Disorder, published in January, 2020, the "Current scientific evidence does not support the use of facilitated communication in which a nonverbal individual is guided to communicate. This differs from augmentative and alternative communication, in which the individual is taught to communicate independently."<ref>Hyman, Susan L.; Levy, Susan E.; Myers, Scott M.; Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics (2020-01-01). "Identification, Evaluation, and Management of Children With Autism Spectrum Disorder". Pediatrics. 145 (1): e20193447. doi:10.1542/peds.2019-3447. ISSN 0031-4005. PMID 31843864. Archived from the original on 2020-11-14. Retrieved 2020-12-16.</ref>

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. The only evidence of success is the transcript of apparent communication.<ref name="Mulick et all"/> In some cases of autism, parents reject the diagnosis and say that their child's disability is physical rather than developmental, and with FC or RPM their beliefs are confirmed.<ref name="Vyse2018">Vyse, Stuart (2018). "The Enduring Legend of the Changeling". Skeptical Inquirer. 42 (4): 23–26.</ref><ref name=bealsreview /> 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". They add that "people with handicaps can be valued members of their families and communities without resorting to appeals to miracle cures" and that genuine help is available, but "advances in treatment and understanding come at the price of rigorous training, dedication to accuracy and scientific standards, and objective verification of all treatment claims".<ref name="Mulick et all">Mulick, James; Jacobson, John; Kobe, Frank (1993). "Anguished Silence and Helping Hands: Autism and Facilitated Communication". Skeptical Inquirer. 17 (3): 270–280.</ref>

Bernard Rimland, a research psychologist who founded the Autism Research Institute of San Diego and the Autism Society of America, asked "How is it possible that an autistic kid can pick up the last tiny crumbs of potato chips off a plate but not have sufficient motor coordination to type the letter E?"<ref name="Boodman, Sandra (1995)" /> 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.<ref name="Healey, Michelle (2011)">Healey, Michelle (6 April 2011). "New film gives voice to a nearly silent minority". Gannett News. p. ARC. Archived from the original on 2015-04-03. Retrieved March 18, 2015.</ref> Why, when technology allowed people with severe disabilities the opportunity to access independent communication with even the slightest movement (e.g., an eye wink, movement of an eyebrow, a puff of air into a straw), would a facilitator need to hold their hand?<ref name="Palfreman, Jon (1993)" /><ref name="Lilienfeld, Marshall, Todd, Shane (2015)" />

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.<ref name="Wichert">Wichert, Bill (2015-10-02). "Professor found guilty of sexually assaulting disabled man". NJ.com. Archived from the original on 2019-02-07. Retrieved 4 October 2015.</ref> 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." Sherry's was the first article published in a Disability Studies journal which thoroughly critiqued Stubblefield's actions, a noteworthy contribution because Stubblefield had also been in Disability Studies and had previously published about FC in the journal Disability Studies Quarterly.<ref>Stubblefield, Anna (25 October 2011). "Sound and Fury: When Opposition to Facilitated Communication Functions as Hate Speech". Disability Studies Quarterly. 31 (4). doi:10.18061/dsq.v31i4.1729.</ref> Sherry suggested that some of the defenders of Stubblefield (and FC more broadly) are either her personal friends or work in institutions which receive substantial income from providing FC.<ref>Sherry, Mark (2016). "Facilitated communication, Anna Stubblefield and disability studies". Disability & Society. 31 (7): 974–982. doi:10.1080/09687599.2016.1218152.</ref> A newspaper editorial from Syracuse University, where the techniques relevant to the case had been taught, called it "inexcusable" and "embarrassing" that the university continues to support FC after over 25 years of research has discredited it.<ref>Editorial Board (2016-04-12). "Syracuse University's reinforcement of facilitated communication inexcusable, concerning". The Daily Orange. Syracuse University. Archived from the original on 2016-04-15. Retrieved 13 April 2016.</ref>

Opposition to research

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)<ref name="Biklen, Morton, Gold, Berrigan, Swaminatham (1992)" /><ref name="Jacobson, Mulick, Schwartz (1995)" /> in order to back up their claims.<ref name="Biklen, Douglas (1990)" /><ref name=ECE/> However, because cueing is often subtle and it is not always possible to observe the influence of the facilitator, informal observations and facilitator reports have proven unreliable in determining authorship.<ref name="Riggott, Julie" /><ref name=reviewofcaa />

Parents and researchers who questioned FC's effectiveness and supported evaluating FC by objective methods have been accused of being "oppressors of the disabled," told they were narrow-minded, outmoded, evil, jealous they were not the ones to discover FC,<ref name="Green, Gina (1995)" /> and, in some cases, accused of hate speech for advocating a more studied approach.<ref name="Wombles, Kimberly (2015)" /><ref name="Mostert, Mark (2012)" /><ref name="Stubblefield, Anna (2011)">Stubblefield, Anna (2011). "Sound and Fury: When Opposition to Facilitated Communication Functions as Hate Speech". Disability Studies Quarterly. 31 (4). doi:10.18061/dsq.v31i4.1729. Archived from the original on April 2, 2015. Retrieved March 19, 2015.</ref> Proponents claim that testing is demeaning to the disabled person,<ref name="Biklen, Douglas (1990)" /> that the testing environment creates performance anxiety,<ref name="Goldman, Daniel (1993)" /> or that those being facilitated may purposely produce nonsense, refuse to respond, or give wrong answers to counteract the negative attitudes of those who are skeptical of the technique.<ref name="Crossley, Remington-Gurney (1992)">Crossley, Rosemary; Remington-Gurney, Jane (August 1992). "Getting the words out: Facilitated communication training". Topics in Language Disorders. 12 (4): 29–45. doi:10.1097/00011363-199208000-00004. S2CID 144141846. Archived from the original on April 2, 2015. Retrieved March 19, 2015.</ref>

Mostert wrote in 2001, "FC proponents must be encouraged to subject their claims to further scientific verification, the claims of anecdotal evidence notwithstanding. If any small part of FC is ever to be found effective or even plausible, it is abundantly clear that only by careful use of controlled experimental methods will this be established."<ref name="Mostert, Mark (2001)">Mostert, Mark (June 2001). "Facilitated Communication Since 1995: A Review of Published Studies". Journal of Autism and Developmental Disorders. 31 (3): 287–313. doi:10.1023/a:1010795219886. PMID 11518483. S2CID 6842817.</ref> The only way to determine whether communications are truly independent is to perform controlled testing, where the facilitator does not already know the answers to questions and, therefore, cannot inadvertently or purposefully cue their communication partner to obtain the desired answer.<ref name="Wombles, Kimberly (2015)" /><ref name="Boynton, Janyce">Boynton, Janyce (April 17, 2012). "Facilitated Communication - What harm it can do: Confessions of a former facilitator". Evidence-Based Communication Assessment and Intervention. 6 (1): 3–13. doi:10.1080/17489539.2012.674680. S2CID 144642290.</ref><ref name="Goldman, Daniel (1993)">Goldman, Daniel (July 13, 1993). "New Treatments for Autism Arouse Hope and Skepticism". The New York Times. No. Late Edition. p. C.1. Retrieved March 19, 2015.</ref> Even if the facilitator feels like they are not moving the other person's hand, they can still be providing cues that lead to specific letters on the keyboard.<ref name="Dillon, Kathleen M. (1993)" /><ref name="Todd, James (2012)" /><ref name="Kezuka, Emiko">Kezuka, Emiko (October 1997). "The Role of Touch in Facilitated Communication". Journal of Autism and Developmental Disorders. 27 (5): 571–593. doi:10.1023/a:1025882127478. PMID 9403373. S2CID 22082973.</ref>

In 1992, when FC was fairly new to the United States, Douglas Biklen was quoted in The Washington Post as saying he "welcomed scientific studies", but the article went on to say:

he doesn't want to do them. He's an educator, not a psychiatrist, and like other educators who have written about facilitated communication, he is comfortable with the fact that there is often a lag time between the application of a new method and its scientific validation.<ref name="Spake, Amanda (1992)" />

Although proponents say that FC is difficult or impossible to objectively test, psychologist James T. Todd wrote:

the determination of authorship in FC involves a straightforward application of basic experimental methods described comprehensively by Mill (1843) more than a century and half ago, but understood for millennia. We are not speaking of obscure or controversial techniques. We are speaking of authorship validation by selectively presenting different information to two people then observing what is produced.<ref name="Todd, James (2012)" />

Blind testing

Despite the FC community's reluctance to participate in testing, researchers outside the community set up blinded experiments to identify who was doing the communicating. 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.<ref name="von Tetzchner, Stephen (1997)" /><ref name="Dickerson, Brian (2008)"/><ref name="Shane, Kearns (1994)">Shane, Howard C.; Kearns, Kevin (September 1994). "An Examination of the Role of the Facilitator in "Facilitated Communication"". American Journal of Speech-Language Pathology. 3 (3): 48–54. doi:10.1044/1058-0360.0303.48.</ref><ref name="Twachtman-Cullen">Twachtman-Cullen, Diane (1997). A Passion to Believe. Boulder, Colorado: Westview Press. ISBN 978-0-813-39098-7.</ref><ref name="Seebach, Linda (2008)">Seebach, Linda (23 September 2008). "Charlatans to the rescue". Wall Street Journal. No. Eastern Edition. New York, New York. p. A.27. Archived from the original on 12 January 2020. Retrieved March 19, 2015.</ref> However, a number of controlled evaluations were also conducted by clinicians, researchers, and program administrators who were considering the use of FC, but wanted an objective, empirical basis for deciding what role, if any, FC would have in their programs.<ref name="Green, Gina (1994)" />

The O.D. Heck Center in Schenectady, New York was one of the first in the United States to go public with their findings,<ref name="Green, Gina (1994)" /> which were that their clients produced meaningful responses through facilitated communication only when their facilitators had access to the correct responses.<ref name=ECE/> The report also ruled out issues of confidence or skepticism on the part of the evaluators. All twelve participants (people with disabilities) were chosen for the evaluation because their facilitators believed in their ability to communicate through FC. The study demonstrated that the communication partners were "systematically and unknowingly" being influenced by their facilitators. The researchers wrote:

In fact, the nature of the findings permits us to assert that their output in facilitated communication was not only influenced, but was controlled and determined by the facilitators. To all appearances, these participants had been producing thoughtful communication, and several had consistently engaged in interactive conversations using facilitated communication. Many people serving these individuals believed that this output reflected the valid expressions of the participants.<ref name="Boodman, Sandra (1995)" /><ref name="Wheeler, Jacobson, Paglieri, Schwartz (1993)">Wheeler, Douglas L.; Jacobson, John W.; Paglieri, Raymond A.; Schwartz, Allen A. (February 1993). "An experimental Assessment of Facilitated Communication". American Association on Mental Retardation. 31 (1): 49–60. PMID 8441353.</ref>

The result of the O.D. Heck study seemed so startling, especially in light of the positive response FC was getting in the popular press, that Frontline featured the story in its 1993 "Prisoners of Silence".<ref name="Palfreman, Jon (1993)" /><ref name="Palfreman, Jon (2012)" /><ref name="Riggott, Julie" /><ref name="Scientific Review (2005)" /><ref name="Cuff, John Haslett (1993)" /> In 1993, Genae A. Hall, research director for the Behavior Analysis Center for Autism, wrote:

The fact that facilitators often control and direct the typing has been called "facilitator influence," which seems to be a misnomer. "Facilitator influence" suggests that the disabled person is emitting verbal behavior, and the facilitator is exerting partial control (or "influence") over that behavior. Although partial control certainly may occur when fading prompts within structured teaching programs, such control has not been demonstrated in most cases of FC. Rather than influencing the typed messages, the facilitator appears to be the sole author of those messages. Thus, the focus of analysis is shifted from the disabled person's behavior to the facilitator's behavior.<ref name="Hall, Genae (1993)">Hall, Genae A. (1993). "Facilitator control as automatic behavior: a verbal analysis". The Analysis of Verbal Behavior. 11 (1): 89–97. doi:10.1007/bf03392890. PMC 2748555. PMID 22477083.</ref>

Multiple other double-blind studies were being conducted at the same time,<ref name="Green, Gina (1995)" /> and whenever conditions were adequately controlled to prevent the facilitator from knowing the answers to questions, the results revealed facilitator influence, if not direct authorship.<ref name="Green, Gina (1994)" /><ref name="von Tetzchner, Stephen (1997)" /><ref name="Heinrich, Paul (February 1992)">Heinrich, Paul (February 16, 1992). "State 'tortured' family - Landmark case finds experts' naivety 'tragic'". Sunday Age. No. Late Edition. Melbourne, Australia. p. 1.</ref>

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."<ref name="Papp, Leslie (1996)" /> By 1995, these results had been replicated by researchers worldwide in at least 24 studies in credible, peer-reviewed research journals using multiple different methods that ensure the facilitator does not know or cannot guess the expected message, or does not look at the letters.<ref name="Green, Gina (1995)" />

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. When an intervention claimed to have exceptional effects disappears, the likely reason is lack of positive results.<ref name="von Tetzchner, Stephen (1997)" />

By 2005, more than 50 controlled studies and blind tests had been conducted, in addition to numerous controlled tests conducted in legal cases. The studies consistently showed "without a doubt" that the messages obtained through facilitated communication were controlled by the facilitators and not their communication partners.<ref name="Riggott, Julie" />

The vast majority of evidence now indicates that facilitated communication is not scientifically valid. However, this information has not stopped many individuals from using this technique under various circumstances and furthermore, advocating for its effectiveness.<ref>Kreidler, Marc (April 28, 2016). "Syracuse, Apple, and Autism Pseudoscience | Skeptical Inquirer". Archived from the original on June 20, 2019. Retrieved June 20, 2019.</ref> The overwhelming majority of studies conducted on the efficacy of this technique has revealed that any "positive" results indicating that facilitated communication has worked can be attributed to the facilitators themselves.<ref name=reviewofcaa /> Be it the facilitator attributing their own beliefs and views onto the individual, or creating a pseudo-personality for the disabled individual based on their previous encounters with them, it is clear that the facilitator is really the one doing all the communicating.<ref name=bealsreviewjaswal>Beals, Katharine (2021). "A recent eye-tracking study fails to reveal agency in assisted autistic communication". Evidence-based Communication Assessment and Intervention. 15 (1): 46–51. doi:10.1080/17489539.2021.1918890. S2CID 236600771.</ref>

The American Psychological Association (APA) issued a statement in 1994 that there was "no scientifically demonstrated support for its efficacy."<ref name="APA FC statement">"Facilitated Communication: Sifting the Psychological Wheat from the Chaff". American Psychological Association. Archived from the original on 16 November 2020. Retrieved 17 March 2018.</ref> Finally, even further defining facilitated communication as a pseudoscience, the APA issued a statement indicating that facilitated communication studies have repeatedly demonstrated that it is not a scientifically valid technique and that it is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy.<ref name="APA FC statement" />

Previous proponents

Pat Mirenda, professor in the Department of Educational and Counseling Psychology and Special Education at the University of British Columbia and co-author David R. Beukelman, Barkley Professor of Communication Disorders at the University of Nebraska-Lincoln, had included FC in early versions of their textbook Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs. These versions are quoted in pro-FC literature. However, they decided not to include FC in revised versions, and in 2015 Mirenda stated, "I came to recognize (painfully, to be honest) that my advocacy stance biased me to interpret what I saw on videotapes as independent typing even though other explanations were more plausible (e.g., subtle prompting, resulting in an ideomotor effect), and that, even if independent typing did occur subsequent to FC exposure, only correlational—but definitely not causal—evidence exists with regard to its relationship to FC. In short, I do not endorse FC as a communication or instructional technique, and I do not support its use."<ref name="Mirenda, Pat (2015)">Mirenda, Pat (13 January 2015). "Comments and a personal reflection on the persistence of facilitated communication". Evidence-Based Communication Assessment and Intervention. 8 (2): 102–110. doi:10.1080/17489539.2014.997427. S2CID 144689055.</ref>

Stephen N. Calculator of the University of New Hampshire, an early proponent of FC, later distanced himself from the movement because he could not replicate claims of independent communication in his own research studies.<ref>Calculator, S; Hatch, E (1995). "Validation of facilitated communication: A case study and beyond". American Journal of Speech-Language Pathology. 4 (1): 49–58. doi:10.1044/1058-0360.0401.49. ISSN 1058-0360.</ref> He described the importance of determining the extent of facilitator influence: "The consequences of falsely attributing messages to communicators, rather than facilitators, continue to have significant financial, social and moral ramifications. Facilitators must take extraordinary precautions to assure that they are not unduly influencing messages and thereby impinging on communicators' freedom of speech. The rights of individuals to express their thoughts and ideas should not be circumvented by facilitators who communicate for them, unwilling or not."<ref name="Calculator, Stephen (1999)">Calculator, Stephen (October 1999). "Look Who's Pointing Now: Cautions Related to the Clinical Use of Facilitated Communication". Language, Speech, and Hearing Services in Schools. 30 (4): 408–414. doi:10.1044/0161-1461.3004.408. PMID 27764351.</ref>

Janyce Boynton, who at one time was a strong FC proponent, is now one of FC's leading critics. In the early 1990s, she was the facilitator for a non-speaking high school girl with autism who seemed to describe having been sexually abused by her parents, resulting in the girl and her brother being removed from their home. However, systematic testing by Howard Shane revealed that the girl could not have been the author of the messages. The case was described in the 1993 PBS Frontline documentary "Prisoners of Silence". Unlike many in the FC-proponent community, Boynton accepted the evidence from Shane's testing and other well-controlled scientific studies. She stopped using FC, convinced her school administration to implement a system-wide prohibition on its use, and apologized to the falsely accused parents of the girl she had worked with. In a presentation at the CSICON meetings in 2019, Boynton argued that most FC facilitators are well-meaning but are caught up in a belief system that leads them to discount the overwhelming evidence that FC does not work.<ref name="CSICON2019">Frazier, Kendrick (April 2020). "The foibles of FC". Skeptical Inquirer. 44 (2): 12–13.</ref> She maintains a clearinghouse of professional articles and media coverage about FC, and helped in convincing the University of Northern Iowa to stop sponsoring an annual workshop that included instruction in FC.<ref name="Vyse 2">Vyse, Stuart (7 August 2018). "Autism Wars: Science Strikes Back". CSI online. Center for Scientific Inquiry. Archived from the original on 22 March 2019. Retrieved 29 November 2018.</ref> As stated by another member of that group (Stuart Vyse), "this is just the beginning. There are a number of other universities and governmental organizations that tacitly or explicitly endorse FC and/or its related techniques, and Ms. Boynton and her allies have their eyes on a number of these future targets".<ref name="Vyse 1">Vyse, Stuart (16 November 2018). "An Artist with a Science-Based Mission". CSI Online. Center for Inquiry. Archived from the original on 1 December 2018. Retrieved 29 November 2018.</ref>

In 2006, Belgian neurologist Steven Laureys claimed that Rom Houben, a comatose man, was able to type out thoughts on a keypad with the help of facilitated communications. However, when independent tests demonstrated that FC could not produce the correct answers to questions if the facilitator had not been in the room, he agreed that Houben had not been communicating.<ref>Marshall, Michael; French, Christopher (2018-02-05). "Why communication from a 'locked-in' child is a miracle we must question". The Guardian. www.theguardian.com. Archived from the original on 2018-04-26. Retrieved 26 April 2018.</ref>

Presentation in the media

Stories of purported successes are still reported in magazines such as Reader's Digest,<ref name="Gardner, Martin" /> in movies<ref name="Palfreman, Jon (2012)" /><ref name="Riggott, Julie" /><ref name="Mann, Lisa Barrett (2005)" /><ref name="Healey, Michelle (2011)" /><ref name="Murray, Steve">Murray, Steve (May 21, 2005). "The world of autism as seen from the inside". The Atlanta Journal-Constitution. No. Home Edition. p. Living; 3C.</ref><ref name="McCabe, Bruce (1994)">McCabe, Bruce (16 October 1994). "Autism and feelings". The Boston Globe. No. City Edition. Boston, Massachusetts. p. 3.</ref><ref name="Shales, Tom">Shales, Tom (14 October 1994). "Third-place CBS hauls out yet another lame movie on Sunday". Buffalo News. No. City Edition. Buffalo, New York. p. C10.</ref> and plays,<ref name="Ruth, Jim (2001)">Ruth, Jim (January 2001). "Will to survive Autistic man's struggle mirrors a new drama". Sunday News. Lancaster, Pennsylvania. p. H-1.</ref> and on television shows such as ABC's 20/20 Prime Time Live with Diane Sawyer.<ref name="Green, Gina (1994)" /><ref name="Mostert, Mark (2012)" /><ref name="Green, Gina (1995)" /><ref name="Palfreman, Jon (2012)" /><ref name=ECE/><ref name="Gorman, Brian J. (1998)">Gorman, Brian J. (1998). "Facilitated communication in America: Eight years and counting". Skeptic. 6 (3): 8.</ref> 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.<ref name="Green, Gina (1994)" /><ref name="Green, Gina (1995)" /> Eric Schopler, then director of an autism education program at the University of North Carolina, Chapel Hill and editor of the Journal of Autism, described promoting facilitated communication with no empirical evidence as "reckless".<ref name="Brown, Molly T. (1992)">Brown, Molly T. (28 July 1992). "The typed voice helping the nonverbal communicate". Buffalo News. Buffalo, New York. p. C:1.</ref>

Describing this rapid rise in popularity, particularly in the United States, doctors John W. Jacobson, James A. Mulick, and Allen A. Schwartz wrote:

The general acceptance of FC by the public and segments of the professional community has called into question the rigor with which educational and therapeutic interventions are evaluated in publicly funded programs and the ability of many professionals to critically assess the procedures they use. 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.<ref name="Jacobson, Mulick, Schwartz (1995)" />

James Randi, a magician familiar with the ideomotor effect commonly attributed to dowsing and later linked to FC,<ref name="Spitz, Herman" /><ref name="Burgess, et al (1998)">Burgess, Cheryl A.; Kirsch, Irving; Shane, Howard C.; Niederauer, Kristen L.; Graham, Steven M.; Bacon, Alyson (January 1998). "Facilitated Communication as an Ideomotor Response". Psychological Science. 9 (1): 71–74. doi:10.1111/1467-9280.00013. S2CID 145631775.</ref> was called in to investigate facilitated communication at the University of Wisconsin at Madison in 1992, and later called it "a crock that does more harm than good by raising false hopes among families of autistic children".<ref name="Greenbaum, Kurt (1992)" /><ref name="Gardner, Martin" /> The James Randi Educational Foundation has offered a million-dollar prize "to a valid demonstration of facilitated communication." 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."<ref name="Keim, Brandon">Keim, Brandon (24 November 2009). "Reborn Coma Man's Words May Be Bogus". Wired. Archived from the original on 12 January 2014. Retrieved March 19, 2015.</ref>

Institutional support

Syracuse University

In 1992, Syracuse University founded the Facilitated Communication Institute to promote the use of FC. Douglas Biklen was appointed as the institute's first director. In 2010, the name was changed to the Institute on Communication and Inclusion (ICI). It is part of the Center on Disability and Inclusion of the School of Education. According to the ICI website, the Institute "... is an active research, training, and support center, and the nation’s leading resource for information about communication and inclusion for individuals who type to communicate." The Institute carries out training and research in FC and publishes scholarly articles, books, and films.<ref>Gorman, Brian J. (1998). "Facilitated Communication In America: Eight Years and Counting". Skeptic. 6 (3): 64–71.</ref><ref>Burke, Michael (2016-04-11). "Double Talk". The Daily Orange. Archived from the original on 2019-11-08. Retrieved 30 October 2019.</ref>

University of Northern Iowa

From 2014 through 2018, the University of Northern Iowa (UNI) held the Midwest Summer Institute that focused on "inclusive schools, employment and daily living, as well as communication and supported or facilitated typing for people with autism spectrum disabilit[ies] and other complex communication needs."<ref name="courier-2014">"UNI to host inclusion, communication event". The Courier (Waterloo, Iowa). May 5, 2014. Archived from the original on 29 October 2019. Retrieved 29 October 2019.</ref> 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.<ref name=Gazette1>Miller, Vanessa. "'Facilitated communication' conference draws fire at University of Northern Iowa". The Gazette. The Gazette, Cedar Rapids, IA. Archived from the original on 16 June 2018. Retrieved 16 June 2018.</ref><ref name=Gazette2>Miller, Vanessa (November 13, 2018). "University of Northern Iowa drops controversial conference". The Gazette. Archived from the original on November 14, 2018. Retrieved November 13, 2018.</ref>

Abuse allegations and facilitator misconduct

Further information: List of abuse allegations made via facilitated communication

There have been instances in which facilitated communication produces allegations of sexual or physical abuse.<ref name="Spake, Amanda (1992)"/> Often, the alleged abuse is sexual and contains "extensive, explicit, pornographic details."<ref name="Green, Gina (1994)"/><ref>Shane, Howard C., ed. (1994). Facilitated Communication: The Clinical and Social Phenomenon. Singular Publishing Group. ISBN 978-1-565-93341-5.</ref> It is not known whether FC generates more abuse allegations than other suggestive techniques.<ref name="Hall, Genae (1993)"/><ref name="Lilienfeld, Scott O. (2007)">Lilienfeld, Scott O. (March 2007). "Psychological Treatments that Cause Harm". Perspectives on Psychological Science. 2 (1): 53–70. CiteSeerX 10.1.1.531.9405. doi:10.1111/j.1745-6916.2007.00029.x. PMID 26151919. S2CID 26512757.</ref>

Researchers suspect that facilitators involved in this type of case may, mistakenly, believe there is a link between early abuse and autism, or suspect familial abuse for other reasons.<ref name="Hall, Genae (1993)" /><ref name="Lilienfeld, Scott O. (2007)" /> As Green wrote in a 1995 article:

suggestions about sexual abuse permeate the culture. Just watch Oprah or Phil [Donahue] almost any time or scan the pop psychology section at your local bookstore. 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.<ref name="Green, Gina (1995)" />

In 1993, Frontline's "Prisoners of Silence" featured the story of Gerry Gherardi of North Carolina who was accused, through FC-generated messages, of sexually abusing his son. Despite protestations of innocence, Gherardi was forced to stay away from his home for six months.<ref name="Palfreman, Jon (1993)"/> The charges were dropped when court-ordered double-blind tests showed that Gherardi's son could not write.<ref name="Koehler, Robert (1993)">Koehler, Robert (19 October 1993). "TV Review 'Prisoners' Puts Autism Technique to the Test". Los Angeles Times. No. Home Edition. Los Angeles, California. p. 9.</ref> In the same year, Rimland reported in a New York Times article that he knew of about 25 cases where families were accused through facilitated communication of sexually abusing their children.<ref name="Goldman, Daniel (1993)"/>

By 1995, there were 60 known cases,<ref name="Lilienfeld, Scott O. (2007)" /><ref name="Margolin, K.N. (1994)">Margolin, K.N. (1994). "How Shall Facilitated Communication be Judged? Facilitated Communication and the Legal System". In Shane, Howard C. (ed.). Facilitated Communication: The Clinical and Social Phenomenon. San Diego, CA: Singular Publishing. pp. 227–257. ISBN 978-1-565-93341-5.</ref> with many others settled without reaching public visibility. Since then, the number of cases continues to increase. In addition to accusations of sexual abuse, facilitators have reportedly fallen in love with their communication partners and, relying on FC for consent, initiated sexual, physical contact with people in their care,<ref name="Lilienfeld, Marshall, Todd, Shane (2015)"/><ref name="Sundstrom, Kathy (2014)"/> raising serious ethical and legal problems.<ref name="Todd, James (2012)"/>

Anna Stubblefield case

In 2015, Anna Stubblefield, a Rutgers University–Newark philosophy professor, was found guilty of aggravated sexual assault against a man with severe mental disabilities. A proponent of facilitated communication, Stubblefield's web site described her as "certified as a Facilitated Communication Trainer by the FC Institute at the School of Education, Syracuse University. She provides motor planning support for communication and literacy for adults and children."<ref>Stubblefield, Anna (June 27, 2010). "Archived University Website of Anna Stubblefield". Anna Stubblefield. Archived from the original on June 27, 2010. Retrieved October 4, 2015.</ref> Stubblefield stated that the two of them had a mutually consenting relationship established through facilitated communication. At the time the investigation began in 2011, Stubblefield was the chair of Rutgers-Newark's philosophy department, whose professional work centered on ethics, race, and disability rights,<ref name="NYTM102015">Daniel Engber (October 20, 2015). "The Strange Case of Anna Stubblefield". The New York Times Magazine. Archived from the original on October 20, 2015. Retrieved October 21, 2015. ...the judge ruled that facilitated communication failed New Jersey's test for scientific evidence.</ref> but she was subsequently put on administrative leave without pay and removed as chair of the philosophy department.<ref name="Wichert, Bill (2015)" /><ref name="Zambito, Thomas (2014)" />

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. Based on his disability, his mother and brother were appointed his legal guardians.<ref name="NYTM102015" /> Stubblefield stated that she had successfully communicated with him, determining he was of normal intelligence. She subsequently brought him to conferences where she "held him out as a success story". In 2011, she revealed to his mother and brother that she had had sexual relations with D.J. and said that they were in love, attributing consent to messages received while facilitating. However, testing of D.J. by family members failed to establish the ability to communicate, and Stubblefield was thanked but denied further access to D.J. She continued to attempt to maintain contact with D.J. and began challenging control of D.J.'s legal guardians over him.<ref name="NYTM102015" /> In August 2011, the family contacted the police.<ref name="Wichert, Bill (2015)">Wichert, Bill (January 8, 2015). "New Jersey: Judge OKs document detailing Rutgers professor's sexual relations with mentally disabled man". NJ Advance Media. New Jersey Online LLC. Archived from the original on 2 April 2015. Retrieved 21 March 2015.</ref><ref name="Szteinbaum, Sabrina">Szteinbaum, Sabrina. "Former RutgersNewark philosophy department chairwoman to appear in court for alleged sexual abuse of mentally handicapped man". The Daily Targum. New Brunswick, New Jersey. Archived from the original on April 2, 2015. Retrieved March 21, 2015. Dead link as of October 22, 2015</ref>

Stubblefield pleaded not guilty to the charges and said that FC revealed D.J. was mentally capable, while prosecutors said that FC was scientifically discredited and that D.J. did not have the ability to consent to sexual relations.<ref name="Wichert, Bill (2015)" /><ref name="Zambito, Thomas (2014)">Zambito, Thomas (April 25, 2014). "Judge questions 'consent' defense in case of Rutgers-Newark professor accused of sexual assault". NJ Advance Media for NJ.com. New Jersey Online LLC. Retrieved March 21, 2015. Dead link as of October 22, 2015</ref> Experts evaluating D.J. testified he did not have the intellectual ability to consent to sexual activity.<ref name="Wichert"/> Facilitated communication testimony from D.J. was not allowed as the technique was ruled unreliable under New Jersey law.<ref name="NYTM102015" /> After a three-week trial, the jury found Stubblefield guilty of two counts of first-degree aggravated sexual assault.<ref name="NYTM102015" /> After conviction, the judge revoked bail, saying that she was a flight risk,<ref name="NYTM102015" /> and she was sentenced to 12 years in prison.<ref name="startribune.com">"Professor who abused disabled man sentenced to prison". Associated Press via Star Tribune. Retrieved 15 January 2016.</ref> This included requiring her to register as a sex offender.<ref name="startribune.com" /><ref>David Porter, Associated Press (15 January 2016). "Professor who abused disabled man gets 12 years in prison". Times Union. Associated Press. Retrieved 16 January 2016.</ref> In July 2017, an appeals court overturned her conviction and ordered a retrial,<ref name=":0">Napoliello, Alex (11 May 2018). "No more prison for ex-Rutgers professor who sexually assaulted disabled student". NJ.com. Archived from the original on 3 October 2018. Retrieved 2 October 2018.</ref> and in 2018 she pleaded guilty to "third-degree aggravated criminal sexual contact" and was sentenced to time served.<ref name=":0" /> In October 2016, the family was awarded $4 million in a civil lawsuit against Stubblefield.<ref>Moriarty, Thomas (2018-03-19). "Ex-Rutgers prof admits it was a crime to have sex with disabled man". NJ.com. Archived from the original on 2018-03-19. Retrieved 20 March 2018.</ref>

Martina Susanne Schweiger case

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. The client required 24-hour support and was not able to speak, write or use manual sign-language.

Schweiger believed the client expressed love for her through FC, which she claimed to reciprocate. She also believed the client, again through FC, indicated a desire to have sex. On one occasion, Schweiger removed her clothes in front of her client. On another, she "play wrestled" with him, touching his penis with her hands and mouth. She confessed her actions to her employer. After hearing reports from Alan Hudson, psychology professor at RMIT University, that FC "did not work for the young man", Judge Gary Long of Maroochydore District Court found Schweiger guilty of the charges, indicating that FC was neither reliable nor accurate as a method of communication.<ref name="Sundstrom, Kathy (2014)" /><ref name="Sundstrom, Kathy (2014b)">Sundstrom, Kathy (17 October 2014). "Mother angered by suspended sentences". Sunshine Coast Daily. Queensland, Australia. p. 4. Archived from the original on 2 April 2015. Retrieved March 19, 2015.</ref>

See also

Films

• Annie's Coming Out – based on the case of Anne McDonald
• Autism Is a World
• Deej
• Wretches & Jabberers

External links

• Dunning, Brian (May 10, 2022). "Skeptoid #831: Facilitated Communication Isn't". Skeptoid.