facilitated communication in autism interventions is strict "NO" . - Dr Kondekar

By Dr Kondekar Santosh, Autism and therapies
The evidence against Facilitated Communication is among the strongest in autism intervention research. More than 30 years of controlled studies have consistently found that when the facilitator does not know the correct answer, the facilitated communicator is generally unable to produce it. This indicates that the messages originate from the facilitator, usually through unconscious influence (the ideomotor effect), rather than from the autistic individual.

Key evidence:

Study Design &Main Finding

1. Wheeler et al., 1993:  Double-blind message-passing 
Correct responses occurred only when the facilitator knew the answer.
2. American Psychological Association (1994 Position Statement) Expert review
Concluded there is no scientific evidence supporting FC.
3.American Academy of Child and Adolescent Psychiatry (1998; reaffirmed) Practice parameter
 FC should not be used because of lack of evidence.
4.American Academy of Pediatrics Clinical Report Evidence review
Advises against FC because it lacks validity.
5.American Speech-Language-Hearing Association Position Statement
FC is a discredited technique and should not be used.
6.International Society for Augmentative and Alternative Communication Position Statement
 Rejects FC due to lack of scientific support.
7.Mostert, 2001 Systematic review of 40+ studies
Nearly all controlled studies failed to support FC.
8.Schlosser et al., 2014 Systematic review
No reliable evidence that messages originate from the autistic individual.


Major controlled studies

1. Wheeler DL, Jacobson JW, Paglieri RA, Schwartz AA. (1993) "An experimental assessment of facilitated communication." Journal of Autism and Developmental Disorders, 23(3):507–530. This landmark double-blind study demonstrated that correct responses occurred only when facilitators knew the answer.

2. Eberlin M, McConnachie G, Ibel S, Volpe L. (1993) Facilitated communication: A failure to replicate. Controlled testing again showed responses depended on facilitator knowledge.

3. Hudson A, Melita O, Arnold N. (1993) Brief Report: A case study assessing facilitated communication. Independent communication disappeared under blinded conditions.


Systematic reviews

Mostert MP. (2001) Facilitated Communication Since 1995: A Review of Published Studies. Journal of Autism and Developmental Disorders, 31(3):287–313.

Conclusion:

Reviewed over 40 controlled investigations.
Almost every scientifically rigorous study failed to validate FC.
Positive reports were limited to uncontrolled case reports.

Schlosser RW et al. (2014) Facilitated Communication and Rapid Prompting Method. Review concluded there is no convincing evidence supporting message authenticity.

Professional organizations rejecting FC

• American Psychological Association (1994) "No scientifically demonstrated support exists for facilitated communication."
• American Academy of Pediatrics Recommends evidence-based augmentative communication methods instead.
• American Speech-Language-Hearing Association States FC should not be used because it lacks scientific validity.
• American Association on Intellectual and Developmental Disabilities Rejects FC because evidence indicates facilitator influence.
• International Society for Augmentative and Alternative Communication Advises against FC and recommends evidence-based AAC methods.

Why FC appears to work

The best-supported explanation is the Ideomotor Effect. The facilitator unknowingly guides the individual's hand or arm, similar to what occurs with Ouija boards or facilitated dowsing. Neither the facilitator nor the individual is necessarily aware of this influence.

Overall scientific consensus

The evidence against Facilitated Communication is considered high quality because it is based on repeated, blinded, controlled experiments that have been replicated across multiple countries and research groups. Consequently, FC is regarded as a discredited intervention, and evidence-based alternative and augmentative communication (AAC) methods are recommended instead.

other therapies that shouldnot be used in autism kids are as below:

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