Facilitated Communication - History

History

Facilitated communication first drew attention in Australia in 1977, when Rosemary Crossley, a teacher at St. Nicholas Hospital, claimed to have produced communication from 12 children diagnosed with cerebral palsy and other disabilities and argued that they possessed normal intelligence. These findings were disputed by the hospital and the Health Commission of Victoria; however, in 1979 one of Crossley's students, Anne McDonald, left the hospital after successfully fighting an action for Habeas Corpus in the Supreme Court of Victoria. After continuing controversy the Victorian Government closed the hospital in 1984-1985 and rehoused all the residents in the community. Crossley and McDonald wrote a book about the experience called "Annie's Coming Out" in 1984.

Facilitated communication gained further exposure when Nobel laureate Arthur Schawlow used it with his autistic son in the early 1980s and felt that it was helpful. His experience and its effects on the disability community are described on the Stanford University website:

They became champions of the technique and were largely responsible for introducing it to the United States, where it remains controversial.

In 1989 Douglas Biklen, a sociologist and professor of special education at Syracuse University, investigated Rosemary Crossley's work in Australia. She was then Director of DEAL Communication Centre (since renamed the Anne McDonald Centre), then Australia's only federally funded centre for augmentative communication. Biklen helped popularize the method in the USA and created the Facilitated Communication Institute at Syracuse University.

After starting to use the method in Syracuse, Biklen reported startling results in which students with severe autism were said to be producing entire paragraphs of clear and age-appropriate language. This produced an explosion of popularity; the method spread across the United States—especially because of its seeming success with people with autism. Facilitated communication was strongly embraced by many parents of children with disabilities, who hoped that their children were capable of more than had been thought. (Most of the foregoing discussion is referenced in Jacobson et al., 1995).

Critics raised questions. For example, some autistic FC users appeared not to be looking at the keyboard while typing (which is contrary to training standards for FC). Still others used vocabulary that was said to be beyond their years and/or education, many producing poetry of varying complexity.

A concern arose when some of the communications accused the parents of children with autism of severe sexual and/or physical abuse. In late 1993, a Frontline (PBS) documentary highlighting these concerns was televised, comparing FC to Ouija. Most allegations were not proven true. The New York Commission on Quality of Care and Advocacy for Persons with Disabilities had received 21 allegations of abuse by 1995, and all but 1 were not pursued for lack of proof or physical impossibility. A 1995 study of 13 allegations found that "there is enough evidence to legally prove the allegations of sexual abuse of three children, and one additional child's perpetrator confessed..... Although there may not have been enough evidence for legal prosecution, there were seven children whose cases were determined to be indicative of abuse by CPS. The indication rate for abuse and neglect in this series is consistent with the upstate New York indication rate of approximately 47%" and said that "the results of this study neither support nor refute validation of FC". FC proponents responded with criticisms of negative bias. Sexual abuse accusations via facilitated communication have been frequently, though not invariably, rejected as valid evidence in courts of justice, and many autism societies recommend against using FC evidence to confirm or deny such allegations.

Around the same time, controlled studies were done on the method, some of which found valid communication through FC but many of which reported that it was the facilitator who was unconsciously producing the communication. By the late 1990s, FC was widely regarded as a fringe therapy, with some calling it pseudoscientific. FC retained acceptance in some treatment centers in North America, Europe and Australia.

The Association for Science in Autism Treatment reviewed the research and position statements and concluded that the messages typed on the communication device were controlled by the facilitator, not the individual with autism, and FC did not improve their language skills. Therefore, FC was reported to be an "inappropriate intervention" for individuals with autism spectrum disorders.

TASH (2000) stated: "The question of authorship can become particularly controversial when the subject of what has been communicated concerns sensitive issues ... (TASH) encourages rigorous and ongoing training for people who decide to become facilitators; encourages careful, reflective use of facilitated communication; encourages facilitators to work in collaboration with individuals with severe disabilities to find ways of monitoring authorship when using facilitation."

The Autism National Committee (AutCom) in 2008 issued a position paper in favor of FC, saying that the criticism is based in "flawed studies that are poorly designed and/or whose results are incorrectly extrapolated to the entire population of FC users", and saying that while facilitator influence is real and should be avoided, “The benefit of FCT in leading to FC as an acceptable and valid form of AAC has been established by (1) the number of individuals on the spectrum who are typing independently today; (2) the studies in which at least some messages were passed correctly; and (3) practical applications when individuals' messages about pain, discomfort, choices, and other personal information have been successfully addressed."

Current position statements of certain professional and/or advocacy organizations do not support the use of facilitated communication because of their objections that it lacks scientific validity or reliability. These organizations include the American Speech-Language-Hearing Association, American Academy of Pediatrics (AAP), American Psychiatric Association (APA), American Psychological Association (APA), Association for Behavior Analysis International (ABAI), American Academy of Child and Adolescent Psychiatry (AACAP), American Association on Mental Retardation (AAMR; now the American Association on Intellectual and Developmental Disabilities; AAIDD), Behavior Analysis Association of Michigan (BAAM), and Heilpädagogische Forschung. ABAI calls FC a "discredited technique" and warns that "its use is unwarranted and unethical."