Bronze-level article

Facilitated communication

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Facilitated Communication (FC) is a scientifically discredited[1][2] technique whereby a paraprofessional called a "facilitator" tries to help a nonspeaking person communicate by pointing or typing. The best known victims targets of FC have been people with autism; however, others have suffered the same fate, such as those with intellectual disabilities and cerebral paralysis.[3] This technique has given false hope and grief to many, with zero validated results.[4]

The movement in favor of FC seems to have peaked in the 1990s and was severely impacted by a scathing Frontline report on PBS.[5]

Syracuse University used to maintain an "institute", the Institute on Communication and Inclusion[6] (originally called the Facilitated Communication Institute until 2006[7]), for the teaching and study of FC. Despite the fact that FC is used primarily for disabilities of the mind, the institute is not hosted by the psychology department, which should not be surprising given that the American Psychological Association takes an official stand against FC.[8] Syracuse University has since shut down this institute.

Origins

The very earliest records of FC seem to date from Denmark in the 1960's, and was primarily targeted at individuals with cerebral paralysis. It didn't take hold there (because it simply doesn't work, and the Danish are well able to smell out what is rotten in their kingdom[9]), but, like a pandemic of bad ideas, it later spread to Australia[10] and the US[11], achieving only a relatively minor presence in Europe and Asia.[12]

One of its earliest proponents/super-spreaders is Rosemary Crossley, a lovely, lovely woman who attempted to, and inserted herself into the lives of disabled people as a white knight black guard would, asserting, for example, that they had consented to sterilization via FC[13]; attempting to cross state lines with a woman with cerebral paralysis for a conference on disability (despite the fact that she was non-verbal, that her parents hadn't given permission, and that Crossley had actually been forbidden to contact said woman.[14]) She also tried to have the father of a disabled, non-verbal woman charged with sexual abuse, on the grounds that the daughter had relayed such "facts" to Crossley via FC.[15] Unfortunately, there are no records of her facing prosecution for her actions.

Debunker's toolkit

There are a few ways to check authorship:

  • Say or show something to the disabled person with the facilitator in a different room. Have the facilitator come back. Can the disabled person say what happened, even though the facilitator doesn't know? This is the most reliable way to check. Studies consistently find that the non-verbal person cannot communicate any information unless that information is known to the facilitator.
  • See if the person is looking at what they're typing.
  • Notice if their "voice" (word choice and tone) is consistent even with different facilitators.

Study of FC

Since the facilitator is used to communicate, it's easy to fall into circular logic (FC works because the facilitator told us that FC works). The best way to study the validity of FC is to show or say something to the disabled person when the facilitator is not in the room, and then see if the disabled person can use the facilitator to say what they saw or heard. Which, of course, doesn't ever happen.[16]

Evidence against FC

The facilitator believes that they are not the source of the messages due to the ideomotor effect, the facilitator's natural twitches and movements can direct the disabled person's hand, similar to the use of dowsing and ouija boards.

Publication of controlled studies peaked in the 1990s, with the universal failure to validate the technique. The only "positive" studies were either testimonials, or very small and poorly controlled experiments, making their validity completely dubious.[17][18][19][20]

Facilitated communication is opposed by many medical organizations, including the International Society for Augmentative and Alternative Communication (ISAAC).[21] ISAAC summary on FC noted that:[21]

  • Support for FC is entirely anecdotal.
  • Systematic reviews showed that FC authorship was attributable to the facilitators, not the persons with the disability.
  • Several allegations of sexual abuse were associated with FC.
  • The use of FC may be in violation of several articles of the United Nations Conventions on the Rights of Persons with Disabilities.

Evidence for FC

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Risks

The risks of misusing FC are serious:[22]

  • Falsely leading people to believe their loved one is talking to them
  • Diverting funds and time from legitimate techniques
  • Making decisions (clinical, legal, or personal) based on FC communication, without clear proof of authorship
  • Dozens of false allegation of abuse have been made through FC

False allegations made using FC

There have been cases where allegations of abuse have stemmed from reports obtained by FC, only for it to be discovered that the facilitator was making the allegations.[23]

One in particular is the case of "Carla", who was removed from the care of her family several times because of reports of abuse made via FC. In her case and several others, the communication was tested and found to be invalid, showing essentially that the facilitator, rather than the subject, made the allegations, leading to pain for the family and subject, and expense for the state.[24][25] The court system has consistently taken a rather dim view of FC, in the US at least.[26]

Some of the (many) other harmful effects of FC

The abuse and rape of DJ

One case involved a woman (Marjorie Anna Stubblefield) sexually abusing a disabled man, "DJ", claiming that he had given consent through FC. Stubblefield, then 41, was the chair of the philosophy and ethics department at a Rutger's University, and a proponent, through her academic work, of the rights of those affected by racism and disability[27] (yes, we kid you not). "DJ" was an African-american man, eleven years her junior, with severe intellectual disabilities and cerebral paralysis than rendered him unable to walk, have any sort of fine motor abilities, control over his bodily functions, and completely dependent on others for his survival. Through FC, of which she was a proponent, and the belief that the notion of intellect is just a tyrannical oppressive social construct[27], Stubblefield "discovered" he actually was of normal intelligence, and able to readily communicate with her (despite never having said a word in his life). Not content with parading him at conferences as a "success story" that validated her superior intellect FC, she one day showed up at his house and that of his relatives (who were also his guardians), grabbed DJ's hand, and told the relatives she and DJ had something to tell them: they were in love. She them admitted she had had sexual intercourse with him. When DJ's brother regained his composure and asked if maybe Stubblefield had taken advantage of DJ, she was in turn rendered speechless herself. Eventually she facilitated DJ to "communicate" that "No one’s been taken advantage of. I’ve been trying to seduce Anna for years, and she resisted valiantly." He then typed another message, directed at Stubblefield, which simply read "Kiss me", which she did. The brother then walked out feeling as if he had slipped into the Twilight Zone.[27]

Of course, DJ's family were sickened, and realised Stubblefield wasn't a serious professional helping DJ's free his intellect and agency from his other disabilities. She was, of course, told to go away and to never haunt them again. And, of course, she couldn't do that - she kept harassing DJ's family, going as far as promising she'd divorce her then-husband (who was initially unaware of all of this), make DJ her husband and take of him forevermore.[27] Eventually, she began threatening to take over the custodianship of DJ from his family, making them (understandably) reach their limit, and alert the authorities.[28] Stubblefield pleaded not guilty to the charges in the ensuing court case, and attempted to use FC to prove that DJ was capable of, and had given his consent. The court failed to accept her rubbish claims, and real experts verified DJ was unable to give any kind of consent. She was found guilty of first-degree aggravated sexual assault, sentenced to 12 years in prison, and registered as a sex offender.[29] Three years later, she managed to get a retrial, and the sentence was reduced to time served[30], meaning she only completed 1/4 of her original sentence. In a separate lawsuit, she was ordered to indemnify DJ and his family to the tune of four million dollars.[31] So far, there seems to be no record that she has paid the full amount, or indeed any of it.

The murder of Jude Mirra

FC was also misused in the horrifying case of Jude Mirra, a young autistic boy. Jude's mother would move his hand while the boy wasn't even looking at the screen on which he was supposedly typing. Through facilitated communication, Jude supposedly claimed to have been physically abused in bizarre ways by his father. (Police found no corroborating evidence, and Jude had no injuries.) Yet the mother insisted that her son really had been abused, and this was one of the factors that led her to murder him in order to "protect" him from further abuse.[32] She claimed they "said goodbye to each other," and that Jude asked to be killed, yet it wasn't Jude talking.[33][34] This flagrant abuse of FC by a delusional woman shows the necessity of clear proof of authorship.

Similar disproven communication methods

The following alleged communication methods for non-verbal people are also scientifically disproven (or are just idle rebrandings of FC[35]):

  • Rapid Prompting (aka "Soma Rapid Prompt Method")
  • Supported Typing (this was the subject of a Frontline documentary, which exposed it for the fraud it was)

References

  1. Facilitated communication and authorship: a systematic review by R. W. Schlosser et al. (2014) Augment. Altern. Commun. 30(4):359-68. doi:10.3109/07434618.2014.971490.
  2. Autism Wars: Science Strikes Back, Skeptical Inquirer
  3. https://slate.com/technology/2015/11/facilitated-communication-pseudoscience-harms-people-with-disabilities.html
  4. https://skepticalinquirer.org/2018/11/autism-wars-science-strikes-back/
  5. Prisoners of Silence, directed by Jon Palfreman (October 19, 1993) Frontline (archived from February 5, 2009).
  6. Who We Are Institute on Communication and Inclusion, Syracuse University (archived from July 10, 2019).
  7. Facilitated Communication Institute Syracuse University (archived from February 3, 2016).
  8. http://www.apa.org/about/division/cpmscientific.html#4
  9. http://www.shakespeare-online.com/quickquotes/quickquotehamletdenmark.html
  10. https://doi.org/10.1080%2F17489539.2012.688343
  11. https://doi.org/10.1037%2F0003-066x.50.9.750
  12. https://pubmed.ncbi.nlm.nih.gov/9135710/
  13. https://www.parliament.vic.gov.au/papers/govpub/VPARL1992-94No75.pdf
  14. https://www.theage.com.au/national/carer-revisits-battleground-of-annies-coming-out-20110509-1efv6.html
  15. http://members.optusnet.com.au/~dealcc/DEALPages/Dwyerarticle.html
  16. https://www.jstor.org/stable/41824050?seq=1
  17. Mostert, M P. Facilitated communication since 1995: a review of published studies.Journal of Autism & Developmental Disorders. 31(3):287-313, 2001 Jun.
  18. Wheeler DL, Jacobson JW, Paglieri RA, Schwartz AA.An experimental assessment of facilitated communication. Mental Retardation, 1993 Feb;31(1):49-59.
  19. Michael Eberlin, Gene McConnachie, Stuart Ibel,and Lisa Volpe. Facilitated communication: A failure to replicate the phenomenon. Journal of Autism and Developmental Disorders.Volume 23, Number 3 September, 1993.
  20. Elliott W. Simon, Donna M. Toll and Patricia M. Whitehair. A naturalistic approach to the validation of facilitated communication.Journal of Autism and Developmental Disorders. Volume 24, Number 5 October, 1994
  21. 21.0 21.1 ISAAC Position Statement on Facilitated Communication Augmentative and Alternative Communication 30(4):357-358. doi:10.3109/07434618.2014.971492.
  22. http://www.skeptic.com/eskeptic/06-05-25.html
  23. Not Just the Wendrows: Sex Abuse Cases Dismissed After Facilitated Communication
  24. Gorman B.J. Facilitated communication: rejected in science, accepted in court-a case study and analysis of the use of FC evidence under Frye and Daubert.Behavioral Sciences & the Law. 17(4):517-41, 1999.
  25. SHARON L. HOSTLER, JANET H. ALLAIRE and RICHARD A. CHRISTOPH.Childhood Sexual Abuse Reported by Facilitated Communication. Pediatrics. 1993;91;1190-1192.
  26. Department of Social Services ex. rel. Jenny S. V. Mark S., 593 N.Y.S.2d 142 (N.Y. Family Court, 1993) Although his case does not relate directly to employment, it does relate to the testifying of persons with communication difficulties in court in general under the ADA. In 1993 this New York family court held that a child or children with autism, who allegedly had been sexually abused, would not be permitted to testify in court through the use of facilitated communication because:
    • (a) facilitated communication is not a form of communication that is generally accepted within the scientific community;
    • (b) the use of facilitated communication is not required by the ADA.
    (REF: 1993 MPDLR 17(4), p. 385)
  27. 27.0 27.1 27.2 27.3 The Strange Case of Anna Stubblefield
  28. https://web.archive.org/web/20150402171541/http://www.dailytargum.com/article/2014/04/former-rutgers-newark-philosophydepartment-chairwoman-to-appear-in-court-for-alleged-sexual-abuse-o
  29. http://www.startribune.com/sentencing-for-prof-convicted-of-sex-abuse-of-disabled-man/365390581/
  30. https://www.nj.com/essex/index.ssf/2018/05/anna_stubblefield_sentenced_for_second_time.html
  31. https://www.nj.com/essex/2018/03/ex-rutgers-newark_prof_admits_criminal_sexual_cont.html
  32. Mother Kills Autistic Son to Spare Him from Fictional Abuse
  33. New York businesswoman guilty of manslaughter in son's death - CNN
  34. Gigi Jordan Describes Last Moments With Her Son - Wall Street Journal
  35. The Pseudoscientific Phenom — Facilitated Communication — Makes a Comeback