Resolution on Facilitated Communication by the American Psychological Association Adopted

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Resolution on Facilitated Communication by the American Psychological Association Adopted in Council, August 14, 1994, Los Angeles, CA 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; Crews et al., in press; Eberlin, McConnachie, 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 preferences, 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 unproved 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. References: (1) Bligh, S. & Kupperman, P. (1993). Evaluation procedure for determining the source of the communication in facilitated communication accepted in a court case. Journal of Autism and Developmental Disorders, 23, 553-557. (2) Cabay, M. (in press). A controlled evaluation of facilitated communication with four autistic children. Journal of Autism and Developmental Disorders. (3) Crewe, W. D., Sanders, E. C., Hensley, L. G., Johnson, Y. M., Bonaventura, S., & Rhodes, R. D. (in press). An evaluation of facilitated communication in a group of nonverbal individuals with mental retardation. Journal of Autism and Developmental Disorders. (4) Eberlin, M., McConnachie, G., Ibel, S. & Volpe, L. (1993). Facilitated communication: A failure to replicate the phenomenon. Journal of Autism and Developmental Disorders, 23, 507-530. (5) Hudson, A., Melita, B., & Arnold, N. (1993). Brief report: A case study assessing the validity of facilitated communication. Journal of Autism and Developmental Disorders, 23, 165-173. (6) Klewe, L. (1993). An empirical evaluation of spelling boards as a means of communication for the multihandicapped. Journal of Autism and Developmental Disorders, 23, 559-566. (7) Moore, S. Donovan, B., & Hudson, A. (1993). Facilitator-suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders, 23, 541-551. (8) Moore, S. Donovan, B., Hudson, A., Dykstra, J., & Lawrence, J. (1993). Evaluation of facilitated communication: Eight case studies. Journal of Autism and Developmental Disorders, 23, 531-539. (9) Regal, R. A., Rooney, J. R., & Wandas, T. (in press). Facilitated communication: An experimental evaluation. Journal of Autism and Developmental Disorders. (10) Shane, H. C., & Kearns, K. (in press). An examination of the role of the facilitator in "facilitated communication". American Journal of Speech-Language Pathology. (11) Siegel, B. (in press). Assessing allegations of sexual molestation made through facilitated communication. Journal of Autism and Developmental Disorders. (12) Simon, E. W., Toll, D. M., & Whitehair, P. M. (in press). A naturalistic approach to the validation of facilitated communication. Journal of Autism and Developmental Disorders. (13) Szempruch, J., & Jacobson, J. W. (1993). Evaluating the facilitated communications of people with developmental disabilities. Research in Developmental Disabilities, 14, 253-264. (14) Vasquez, C. (in press). A multi-task controlled evaluation of facilitated communication. Journal of Autism and Developmental Disorders. (15) Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. (1993). An experimental assessment of facilitated communication. Mental Retardation, 31, 49-60. PM Subject: FC Press Release From: INTERNET:BZG.APA@email.apa.org, INTERNET:BZG.APA@email.apa.org To: James A. Mulick, 72345,1721 Date: Tue, 23 Aug 1994, 3:03 PM Subject: FC Press Release Sender: bzg.apa@email.apa.org From: BZG.APA@email.apa.org (Gladue, Brian) To: 72345.1721@COMPUSERVE.COM (-) Subject: FC Press Release Date: Tue, 23 Aug 94 15:03 ********************************************************* Date: August 24,1994 Contact: Steve Blommer Public Affairs Office (202) 336-5700 FACILITATED COMMUNICATION NOT A SCIENTIFICALLY VALID TECHNIQUE FOR INDIVIDUALS WITH AUTISM OR MENTAL RETARDATION APA Adopts New Position On Controversial Procedure WASHINGTON -- The American Psychological Association (APA) last week adopted the position that facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy. 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. This technique 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. It has been claimed that this process enables persons with autism or mental retardation to communicate; however, scientifically based studies have repeatedly demonstrated that this is not a valid technique for individuals with profound developmental disabilities. "From a scientific standpoint," stated Brian A. Gladue, Ph.D., senior scientist for the APA, "the overwhelming evidence arguing against the wide and vast claims of facilitated communication is more than compelling. And this resolution by APA is yet another example of how scientists and practitioners in psychology work together on issues that serve the best public interest." Furthermore, the APA stated that using facilitated communication as a basis for actions related to nonverbal accusations of abuse or mistreatment by family members or other caregivers could contribute to threats to the civil and human rights of the person with autism or severe mental retardation as well as those accused. 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 most serious problem with facilitated communication is that people using it are susceptible to a strong illusion of communication where, in fact, there is none," said James Mulick, Ph.D., professor of pediatrics and psychology, The Ohio State University and Children's Hospital, Columbus, Ohio. "Psychologists are now in a much better position to help and protect people with autism and severe mental disability from being misused and inappropriately influenced by this false training technique." The experimental and unproved 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 its potential risks and benefits. The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 124,000 researchers, educators, clinicians, consultants and students. Through its divisions in 48 subfields of psychology and affiliations with 57 state and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare. # # #

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