Combating Pseudoscience in Autism Treatment: Facilitated Communication

The Association for Science in Autism Treatment has resumed publishing a quarterly newsletter, Science in Autism Treatment. The current issue features an interview with James Todd on the pseudoscience of "facilitated communication". Download Spring2010

From the interview:

If anything has changed, I think my personal approach has become more direct. I don‘t hesitate to say certain things that are true: That FC has failed every test of science; that it has never once worked under properly controlled conditions; and that facilitator control has been repeatedly shown to be its primary mechanism of operation. These things are the baseline. I believe it is a moral obligation to say that FC is a fundamental human rights violation. Its use not only prevents the person with autism from learning real, functional independent living skills, but it replaces the real person with a fantasy identity of someone else‘s making. All that said, we must be exceedingly careful in dealing with the parents and caretakers who have been taken in by these cruel frauds. Smart people can be fooled, and once it happens they are in a trap. They have multiple investments that simply cannot be divested without significant psychological cost. No one wants to admit being taken in by a fraud. No one wants to discover he or she could have done something better for a child. If it‘s FC, they will not want to admit they have been talking to themselves and not the child for months or years.

(thanks toJohn Wills Lloyd).

Update: in the comments below, there's a conversation between Kim Wombles and James Todd,in which Dr. Todd mentions RP, or the Rapid Prompting Method. Kim has just published a review of evidence for the Rapid Prompting Method. It doesn't pass the evidence-based test.

Comments

[KWombles]

Hah; I recently wrote a long, long article reviewing the literature of FC and have had some (ummm) interesting conversations with staunch supporters of FC: http://counteringageofautism.blogspot.com/2010/03/facilitated-communication-review-of.html

[KWombles]

I'm going to link to this and to the pdf over on the post. :-) Awesome additional information.

[James T. Todd, Ph.D.]

Liz & Kim:

Liz: Thank you for the posting about my ASAT interview and the quote. It is good to see others concerned about science in autism treatment. I have not received any direct responses from it, but we will see what is to come. Generally this sort of thing elicits emails and online fulminations to the effect that I am an awful person of one kind or another. Sometimes I am wished ill or even dead. Those are pretty harsh penalties for accepting some of the strongest evidence against a specific intervention in the entire developmental disabilities literature, and asking those who nevertheless continue to make the same extraordinary claims about the intervention to provide reasonable scientific evidence that their claims are credible.

Kim: That was a nice review on your site. After all the science on FC, it is amazing that FC is still being promoted and used. Too bad you couldn't have added more about RP=FC, given the heavy promotion RP will be getting with the rebranded "Sunshine Boy" movie on HBO this weekend. Those who've read a few books on the history of conjuring will see instantly that RP is a very old trick. But, the advocates of RP have been clever enough to avoid letting those knowledgeable in such things near it, preferring to proffer it through the a gullible media. To avoid arousing suspicion among the users, like the FC advocates, the advocates of RP have made sure that their procedures include no real controls against (or tests for) authorship of the output by the facilitator.

As for the responses to your item, I see you've met Mr. Golden and Ms. Brandl, among others. They do, indeed, have interesting perspectives on these matters. One of the responses I would like to see from them and their friends is an agreement to participate in honest, methodologically sound scientific tests of their claims.

Thanks again for the notice and postings.

Jim

[KWombles]

Jim,
Thank you. That would be informative, if they were to consent. It's not at all clear to me (despite FC proponents insisting it has) that FC has changed sufficiently to avoid facilitator co-opting, and I don't understand why, with assisted technology available, anyone interested in making sure the communication is indeed authored by the individual would continue to insist on the need for FC.

I hadn't heard of "Sunshine Boy." I'll have to look into that. And see what information is available regarding RP.

[Liz Ditz]

For viewers following along at home: Link to a discussion of the movie Sunshine Boy.

RP = Rapid Prompting. I haven't been able to find any blinded studies of Rapid Prompting.

Amanda Baggs on Tito, non-verbal folks with autism writing, but not on Rapid Prompting.

And as Kim has pointed out, with the advances in AAC (assistive and augmentive communication devices), why would anyone stick with FC or RP?

[Rajni]

i checked out the comments on RPM. As a mother of an adult son with autism (non vebal) I can vouch for the intrinsic value of this method. I am not RPM trained, and I don't use RPM but I use the pointing method with my son. he can use a keyboard and a letter board with no physical prompt from me. He is now learning to generalise this skill to different environments and different assistants. His OT and speech pathologist have helped and they can testify to his progress.