Systematic Reviews
The purpose of systematic reviews for Facilitated Communication and Rapid Prompting Method is to evaluate their efficacy, or lack thereof, based on extant empirical studies. Controls are necessary to ensure that the communications are those of the individuals with disabilities and not their facilitators. Early on, these reviews identified weaknesses in proponents’ approaches to testing, providing an opportunity to make improvements in their evaluative approaches. However, proponents have, largely, abandoned the blinded test procedures needed to address authorship. To date, proponents have provided no evidence that FC in any of its forms produces independent communication. Rather, facilitators not only influence but control the written output.
2019
Schlosser, R.W., Hemsley, B., Shane, H. et al. (2019).Rapid prompting method and autism spectrum disorder: Systematic review exposes lack of evidence. Review Journal of Autism and Developmental Disorders, 6, 403–412.
The purpose of this systematic review was to examine the effectiveness of the rapid prompting method (RPM) based on the empirical demonstration of its effects. Claims that RPM is effective for enhancing motor, speech and language communication, and decreasing problem behaviors in individuals with autism spectrum disorder could not be corroborated. No studies met the inclusion criteria. Researchers called for controlled studies of RPM. Authors outlined criteria to ensure the effectiveness of future studies, including determining whether literacy skills could be demonstrated through the provision of evidence-based approaches.
2018
Hemsley, B., Bryant, L., Schlosser, R.W., Shane, H.C., Lang, R., Paul, D, Banajee, M., Ireland, M. (2018). Systematic review of facilitated communication 2014-2018 finds no new evidence that messages delivered using facilitated communication are authored by the person with disability. Autism and Developmental Language Impairments, 3, 1-8. DOI: 10.1177/2396941518821570
This systematic review was conducted to inform the 2018 updated of the 1995 American Speech-Language-Hearing Association Position Statement on FC. Existing systematic reviews up to 2014 revealed no evidence that FC-generated messages were authored by the individual with disability. Authors conducted a search for evidence-based studies pertaining to authorship and FC. The review team concluded that there were no new studies on authorship and no evidence that FC is a valid form of communication for individuals with severe communication disabilities.
Saloviita, T. (2018). Does Linguistic Analysis Confirm the Validity of Facilitated Communication? Focus on Autism and Other Developmental Disabilities. 33 (2), 91-99. DOI: 10.1177/1088357616646075
The purpose of this article was to review several studies that claim to support the use of Facilitated Communication based on idiosyncrasies found in the texts produced. Results indicated that, because of the logical circularity of the reasoning proposed in the studies, no decisive evidence that validated FC was presented. In addition, the idiosyncrasies found were better explained as by-products of the unusual writing process itself. Finally, the studies did not fulfill the quality standards proposed by the FC field itself. The authors state further: “Accordingly, there is no need to resort to the miraculous explanations provided by FC supporters.”
Nine studies met the criteria for the study. The following three studies contained no formal comparison material to check the supposed uniqueness of the texts produced:
Biklen, D., Winston Morton, M., Nina Saha, S., Duncan, J. Gold, D., Hardardottir, M., and Rao, S. (1991). “I AMN NOT A UTISTIVC ON THJE TYP” (“I”m not autistic on the typewriter”). Disability, Handicap & Society. Volume 6, 161-180. DOI: 10.1080/02674649166780231
Janzen-Wilde, M.L., Duchan, J.F., and Higginbotham, D.J. (1995, June). Successful Use of Facilitated Communication with an Oral Child. Journal of Speech and Hearing Research. 38 (3), 658-676. DOI: 10.1044/jshr.3803.658
Niemi, J. and Karna-Lin, E. (2002). Grammar and lexicon in facilitated communication: A linguistic authorship analysis of a Finnish case. Mental Retardation. 40 (5), 347-357. DOI: 10.1352/0047-6765(2002)040<0347:GALIFC>2.0.CO;2
Two Studies compared the facilitated texts with those written by facilitators:
Bernardi, L. and Tuzzi, A. (2011). Statistical analysis of textual data from corpora of written communication-New results from Italian Interdisciplinary Research Program (EASIEST). In M. Mohammedi (Ed.), A comprehensive book on autism spectrum disorders (pp. 413-434).
Tuzzi, A. (2009). Grammar and lexicon in individuals with autism: A quantitative analysis of a large Italian corpus. Intellectual and Developmental Disabilities. 47, 373-385. DOI: 10.1352/1934-9556-47.5.373
Three studies referred to some standard lexicon:
Scopesi, A., Zanobini, M., and Cresci, L.R. (2003). Aspetti semantici e stilitici della produzione di un bambino autistico in situazione di communicazione facilitata [Semantic and stylistic aspects of the texts produced by a child with autism through facilitated communication]. Rivista di Psycolinguistica Applicata, 2 (3), 83-105.
Tuzzi, A., Cemin, M., and Castagna, M. (2004). “Moved deeply I am.” Autistic language in texts produced with FC. Journees internationales d’Analyse statistique des Donnees Textuelles, 7, 1097-1105.
Zonabini, M. and Scopesi, A. (2001). La comunicazione facilitata in un bambino autistico [Facilitated communication of a child with autism]. Psicologia Clinica dello Sviluppo, 3, 395-421.
One used matched controls as reference:
Bernardi, L. and Tuzzi, A. (2011). Analyzing written communication in AAC contexts: A statistical perspective. Augmentative and Alternative Communication, 27, 183-194. DOI: 10.3109/07434618.2011.610353
The author writes: “The consequence of the FC writing process is that the expressions finally produced are typical of neither the participants’ nor the facilitators’ communication styles. Proponents of linguistic argument see this incompatibility as proof that facilitators cannot be authors of the texts. It remains unnoticed that the same argument can be used for the participants’ side, too. The differences between communication by persons with autism obtained via FC compared with their independent communication is striking. When young people with autism write independently, their texts do not contain the idiosyncrasies reported in FC studies (e.g., Dockrell, Ricketts, Charman, & Lindsay, 2014). If anything, the texts are defined by the lack of those “creative” features so uniformly reported in FC.” (p. 97).
2014
Schlosser, R.W., Balandin, S., Hemsley, B., Iacono, T., Probst, P., Von Tetzchner, S. (2014). Facilitated communication and authorship: A systematic review, Augmentative and Alternative Communication. 30 (4), 359-368. DOI: 10.3109/07434618.2014.971490
This systematic review was conducted to inform the 2014 International Society for Augmentative and Alternative Communication’s (ISAAC) position statement on FC. Existing systematic reviews, plus studies with quantitative experimental data were considered in the review. Results indicated unequivocal evidence for facilitator control over FC-generated messages. The review team concluded that FC is a technique with no validity.
2010
Mostert, M. (2010). Facilitated communication and Its legitimacy — Twenty-first century developments. Exceptionality: A Special Education Journal, 18 (1), 31-41. DOI: 10.1080/09362830903462524
The purpose of this systematic review was to analyze extant efficacy literature since 2001. Although FC had largely been empirically discredited, the author found that FC literature showed an acceptance of the technique and a propensity to ignore empirical findings. In addition, more recent literature had moved to a working assumption that FC was an effective and legitimate intervention. The author suggest that FC is one of the best exemplars of how practice can become absolutely dissociated from empirical research.
The article (above) provides a review of the following:
Emerson, A., Grayson, A., and Griffiths, A. (2001, May). Can’t or won’t? Evidence relating to authorship in facilitated communication. International Journal of Language & Communication Disorders, 36 (s1), 98-103. DOI: 10.3109/13682820109177866
Niemi, J., and Karna-Lin, E. (2002). Grammar and lexicon in facilitated communication: A linguistic authorship analysis of a Finnish case. Mental Retardation, 40 (5), 347-348. DOI: 10.1352/0047-6765(2002)040<0347:GALIFC>2.0.CO;2.
Wegner, D.M., Fuller, V.A., and Sparrow, B. (2003, July). Clever hands: uncontrolled intelligence in facilitated communication. Journal of Personality & Social Psychology, 85 (1), 5-19. DOI: 10.1037/0022-3514.85.1.5
2008
Wehrenfennig, A., & Surian, L. (2008). Autismo e comunicazione facilitata: Una rassegna degli studi sperimentali [Autism and facilitated communication: A review of the experimental studies]. Psicologia Clinica dello Sviluppo, 12(3), 437–464.
The authors examined the experimental studies that assessed the effectiveness of this method applied to children with autism and discussed the forensic implications and some hypotheses about the learning mechanisms involved.
Findings: “Most studies reveal that the content of the children’s messages was affected by information known by the person that helps the child during FC activates. Overall, the results of the studies and some ethical problems suggest that one should be extremely cautious in considering FC as a primary method of intervention for communication deficits in autism and point out its inadequacy in legal proceedings.”
2005
Probst , P . (2005) . “Communication unbound – or unfound ” ? Ein integratives Literatur-Review zur Wirksamkeit der ‘ Gest ü tzten Kommunikation ’ ( ‘ Facilitated Communication/FC ’ ) beinichtsprechenden autistischen und intelligenzgeminderten Personen . Zeitschrift f ü r Klinische Psychologie, Psychiatrie un
Translation: 'Communication unbound - or unfound'? - An integrative literature review on the effectiveness of 'Facilitated Communication' ('FC') in non-verbal autistic and intellectually impaired individuals.
The purpose of this article was to review the literature on the effectiveness of Facilitated Communication used on non-verbal autistic and intellectually impaired individuals. Researchers conducted an international search and concluded that FC presented itself as an invalid procedure showing traits of “pseudo-scientificity” with a “high risk of harmful psychological and social side effects.” The authors did not recommend its use.
2002
Kezuka, Emiko. (2002). A History of the Facilitated Communication Controversy. Japanese Journal of Child and Adolescent Psychiatry.
The purpose of this article was to review the history of the FC controversy based on published literature and personal interviews with people involved with the issue in the U.S. and Australia. The author concludes that: (a) there is no evidence that FC works; (b) future research needs to make clear the mechanism of facilitators’ illusions that the communications are coming from the disable people; and (C) people who are involved in FC need to consider some ethical issues associated with the use of FC.
2001
Mostert, M. (2001, June). Facilitated communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders, 31 (3), 287-313. DOI: 10.1023/A:1010795219886
This systematic review examined published FC studies since major reviews conducted in 1995. The earlier studies clearly established that proponents’ claims were largely unsubstantiated and the using FC as an intervention for individuals with complex communication needs was not recommended. While fewer relevant studies were available, the findings of new studies support the conclusions of previous reviews.
The article also provides provides a critique and discounts the following two studies:
Cardinal, D.N., Hanson, D., and Wakeham, J. (1996, August). Investigation of authorship in facilitated communication. Mental Retardation, 34 (4), 231-42.
Weiss, M.J., Wagner, S.H., and Bauman, M.L. (1996, August). A validated case study of facilitated communication. Mental Retardation, 34 (4), 220-30.
1995
Jacobson, J.W., Mulick, J.A., and Schwartz, A.A. (1995, September). A history of facilitated communication: Science, pseudoscience, and antiscience. Science Working Group on Facilitated Communication. American Psychologist. 50 (9), 750-765.
The purpose of this article was to discuss the history of FC, which included a small number of anecdotal and descriptive reports claiming efficacy. The authors also explored the fact that messages typed out appeared to result in unexpected literacy skills and normative or superior intellectual skills of people with lifelong histories of severe communication difficulties and developmental delays. Controlled research using single and double blind procedures in laboratory and natural settings with a wide range of clinical populations revealed that the response in FC-generated messages are controlled by the assistants or facilitators.
1994
Felce, David. (1994). Facilitated Communication: Results from a Number of Recently Published Evaluations. British Journal of Learning Disabilities. Vol. 22
This article provided a summary of nine published evaluations (detailed on the Controlled Studies page)
Bligh, S. and Kupperman, P. (1993) Facilitated communication evaluation procedure accepted in a court case. Journal of Autism and Developmental Disorders 23, 553-7.
Datlow Smith, M. and Belcher, R.G. (1993) Facilitated communication with adults with autism. Journal of Autism and Developmental Disorders 23, 175-83.
Eberlin, M., McConnachie, G., Ibel, S. and Volpe, L. (1993). Facilitated communication: A failure to replicate the phenomenon. JournalofAutism and Developmental Disorders 23, 507-30.
Hudson, A., Melita, B. and Arnold, N. (1993). A case study assessing the validity of facilitated communication. journal of Autism and DevelopnrenfalDisorders 23, 165-73.
Klewe, L. (1993). An empirical evaluation of spelling boards as a means of communication for the multihandicapped. Journal of Autism and Developmental Disorders 23, 559-66.
Moore, S., Donovan, B., Hudson, A., Dykstra, J. and Lawrence, J. (1993a). Evaluation of eight case studies of facilitated communication. Journal of Autism and Developmental Disorders 23, 531-9.
Moore S., Donovan, B. and Hudson, A. (1993b). Facilitator- suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders 23, 541-52.
Szempruch, J. and Jacobson, J.W. (1993). Evaluating facilitated communications of people with developmental disabilities. Research in Developmental Disabilities 14, 253- 64.
Wheeler, D.L., Jacobson, J.W., Paglieri, R.A. and Schwartz, A.A. (1993). An experimental assessment of facilitated communication. Mental Retardation 31, 49-59.
All nine evaluations reported the same thing: that the “facilitator, albeit unknowingly, shapes the message and provides the knowledge of language and literacy reflected in the apparent communication from the individual.”
Three findings were consistent across the studies:
Individuals did not communicate anything with FC that they could not have done by other means (e.g., no evidence of unexpected language or literacy abilities or evidence FC enhanced communication).
Authors did not report that facilitators showed any awareness that the communications being produced were in any way problematic.
Tests designed to show whether the facilitator was shaping the message suggested that this was the case.
1992
Prior, Margot and Cummins, Robert. (1992). Questions about Facilitated Communication and Autism. Journal of Autism and Developmental Disorders. Vol. 22 (2); 331-337.
The purpose of this article was to discuss the state of FC in Australia—which had been in existence about 8 years before Douglas Biklen started promoting it in the U.S.
”There is evidence that facilitators can impose their own communications on clients…and there is no hard evidence of independent communication from otherwise noncommunicating clients where the facilitator cannot be aware of the response asked of the client.”
Questions were raised about diagnosis (or misdiagnosis) of individuals with autism, unexpected literacy, physical assistance for clients who appeared to have requisite motor skills to point to a letter board on their own, discrepancies in the spontaneity and creativity of facilitated children as compared to non-facilitated autistic children, and facilitator thoughts or cues reportedly insinuating themselves into the client’s communication.