A Number of Organizations Caution Against Use of FC and RPM

Following a thorough, year-long, peer-reviewed process based on systematic literature reviews, the American Speech-Language-Hearing Association (ASHA) recently adopted new position statements about Facilitated Communication (FC) (updated from 1995)

FC is a discredited technique that should not be used. There is no scientific evidence of the validity of FC, and there is extensive scientific evidence—produced over several decades and across several countries—that messages are authored by the "facilitator" rather than the person with a disability. Furthermore, there is extensive evidence of harms related to the use of FC. Information obtained through the use of FC should not be considered as the communication of the person with a disability.

and the Rapid Prompting Method (RPM)

Use of RPM is not recommended because of prompt dependency and the lack of scientific validity. Furthermore, information obtained through the use of RPM should not be assumed to be the communication of the person with a disability.

These position statements have received field wide acceptance. Both express lack of support for the practice in question, citing an absence of high quality science that proves its efficacy.

ASHA's position statements are far from the only ones raising concerns about FC and RPM. Other organizations share similar positions:

Discourage Use of FC

American Academy of Child and Adolescent Psychiatry (Approved by Council, October 20, 1993)

Facilitated Communication: "Studies have repeatedly demonstrated that FC is not a scientifically valid technique for individuals with autism or mental retardation. In particular, information obtained via (FC) should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions." *Endorsed by the American Academy of Pediatrics

American Academy of Pediatrics (Published August 1998; Reaffirmed December 2009)

Auditory Integration Training and Facilitated Communication for Autism: "Currently available information does not support the claims of proponents that these treatments are efficacious. Their use does not appear warranted at this time, except within research protocols."

American Association on Intellectual and Developmental Disabilities (Adopted by the American Association on Mental Retardation* Board of Directors, June 1994)

Position Statement on Facilitated Communication: "…the Board of Directors of the American Association on Mental Retardation (AAMR) does not support the use of this technique as the basis for making any important decisions relevant to the individual being facilitated without clear, objective evidence as to the authorship of such messages. The AAMR strongly encourages the use and further development of valid augmentative and alternative communication techniques and approaches." *AAMR is now the American Association on Intellectual and Developmental Disabilities (AAIDD).

American Psychological Association (Adopted in Council, August 14, 1994)

Resolution on Facilitated Communication: "…APA adopts the position that facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy."

Association for Behavior Analysis (1995)

Statement on Facilitated Communication: "FC is not to be confused with use of appropriately applied manual guidance or other prompts to teach communications and other skills, nor should it be confused with independent use of nonspeech communication systems that may involve letterboards, keyboards, or other symbol systems. It is the position of the Association for Behavior Analysis that FC is a discredited technique. Because of the absence of ample, objective, scientific evidence that FC is beneficial and that identifies the specific conditions under which it may be used with benefit, its use is unwarranted and unethical."

Association for Science in Autism Treatment

Facilitated Communication: "Research evidence, replicated across several hundred children with autism spectrum disorders, shows that the facilitators rather than the individuals with autism spectrum disorders control the communication and that FC does not improve language skills….Therefore, FC is an inappropriate intervention for individuals with autism spectrum disorders."

Autism & Asperger Förbundet (Autism and Asperger Association, Sweden) (June 19, 2012)

Warning about FC (Swedish: Avråder från FC): "The Autism and Asperger Association agrees that numerous studies have shown facilitated communication to be an unreliable and unproven approach. We advise against the use of facilitated communication for people with autism or mental retardation."

Behavior Analysis Association of Michigan (Adopted at the 1998 Annual Convention)

Resolution of the Behavior Analysis Association of Michigan against the use of "Facilitated Communication": "Numerous empirically based, peer-reviewed studies have demonstrated that facilitated communication is incapable of establishing 'unexpected literacy' or producing valid messages above the facilitated individual's previously established communicative level. Therefore, because it is the position of the Behavior Analysis Association of Michigan (BAAM) that the use of any augmentative communication technique must be based upon clear, objective, and scientifically valid evidence that the augmented communications of any individual are reliably and unambiguously attributable to that individual, BAAM does not support or endorse the use of facilitated communication as a form of therapy, communications system, or a means of making important decisions relevant to individuals whose communication is facilitated."

Heilpädagogische Forschung (Heilpädagogische Forschung Nr. 1 2003)

Resolution on Facilitated Communication (Deutsche: Gestützten Kommunikation): "Facilitated communication is consequently a technique whose effectiveness has been contradicted. Parents, educators, and therapists must be informed about the clear negative research results before they decide on FC. Since despite the clear findings it cannot ultimately be ruled out that very rare individuals can be facilitated to communicate, we encourage that in each isolated case the authenticity of the FC-messages be demonstrated under controlled conditions. This goes especially for public institutions, when school measurements, educational programs, living situations, etc. are changed based on FC-statements and whenever public funds for FC-support are demanded."

Irish Association of Speech & Language Therapists [PDF] (IASLT Council May 2017)

Position Statement on the Rapid Prompting Method: "FC and its variants such as RPM, remain illegitimate and ultimately undermine the voices of individuals with communication impairments."

International Society for Augmentative and Alternative Communication (November 7, 2014)

ISAAC Position Statement on Facilitated Communication: "Given ISAAC's mission to promote the best possible communication abilities and opportunities for persons with limited or no functional speech, ISAAC does not support FC as a valid form of AAC, a valid means for people to access AAC, or a valid means to communicate important life decisions. The weight of evidence does not support FC and therefore it cannot be recommended for use in clinical practice."

Lakes Region Community College (Procedures for Accessing Disabilities Support Services)

Facilitated Communication: "While determination on the appropriateness of reasonable accommodations is made on a case by case basis by the Disabilities Coordinator in consultation with the instructor, the Colleges do not accept a scientifically discredited technique, such as facilitated communication, as meeting the academic standards or demonstrating student competency. In distinguishing between augmented communication and facilitated communication, in particular, the College must be satisfied that all work is being done by the student and not by an intermediary agent."

Maine Administrators of Services for Children with Disabilities (February 2000)

Report of the MADSEC Autism Task Force: Facilitated Communication: "Accumulated peer-reviewed, empirically-based research studies have not supported the effectiveness of facilitated communication. Equally important, the research has substantiated the potential for great harm….Researchers may consider further investigation using research protocols, with particular care to protect subjects and their families against harm. It is not recommended that professionals consider the use of facilitated communication."

New York State Department of Health (1999)

Facilitated Communication: "Because of the lack of evidence for efficacy and possible harms of using facilitated communication, it is strongly recommended that facilitated communication not be used as an intervention method in young children with autism."

New Zealand Ministries of Health and Education (March 2008; updated July 2016)

New Zealand Autism Spectrum Disorder Guideline: Recommendation on Facilitated Communication: "There has been considerable controversy about whether the facilitated output is from the person with ASD or is under the influence of the facilitator. A large number of quantitative studies show facilitator influence. There is no scientific validation of Facilitated Communication and it is not recommended."

Scottish Intercollegiate Guidelines Network (June 2016)

Assessment, Diagnosis and Interventions for Autism Spectrum Disorders: "Facilitated communication should not be used as a means to communicate with children and young people with ASD."

Speech-Language & Audiology Canada [PDF] (January 16, 2018)

Official Statement: Use of Facilitated Communication and Rapid Prompting Method: "SAC does not support use of facilitated communication and/or rapid prompting method by its members and associates in clinical practice."

Victorian Advocacy League for Individuals with Disability (2012)

Position Statement on the Use of Facilitated Communication: "As an advocacy group for people with intellectual disability, VALID's primary concern is to empower people to assert their rights and to be free from all forms of manipulation, exploitation and abuse. VALID is deeply concerned that despite consistent independent, empirical evidence against the use of 'Facilitated Communication', the practice still continues without appropriate safeguards….The overwhelming research evidence indicates that Facilitated Communication emanates from the facilitator and not the client and should therefore be referred to as 'automatic' or 'false communication' not facilitated communication."

Speech Pathology Australia (2012)

Augmentative and Alternative Communication Clinical Guideline

"To date, there is no substantive evidence to support theory argued to underpin FC that the people who use the method have an underlying movement disorder that warrants facilitation….

As a result, FC remains an approach with little supportive evidence and a preponderance of evidence that contraindicates its use, and its use is not recommended. Speech pathologists need to be aware that the act of using FC to 'facilitate' a person to point to letters, words, or messages might expose the person with complex communication needs to undue influence, manipulation, and exploitation…."

Discourage Use of RPM

Irish Association of Speech & Language Therapists [PDF] (IASLT Council May 2017)

"IASLT wish to put on record our position in relation to this method - primarily our concern that there is no evidence to support its use….IASLT's concern is that as a method it is closely related to the technique known as: 'Facilitated Communication' (FC) which has been proven to be ineffective and not evidence based….FC and its variants such as RPM, remain illegitimate and ultimately undermine the voices of individuals with communication impairments."

Speech-Language & Audiology Canada [PDF] (January 16, 2018)

Official Statement: Use of Facilitated Communication and Rapid Prompting Method: "SAC does not support use of facilitated communication and/or rapid prompting method by its members and associates in clinical practice."

Speech Pathology Australia (2012)

Augmentative and Alternative Communication Clinical Guideline: "Facilitated Communication (FC), also referred to as 'supported typing' or 'assisted typing', involves a facilitator touching the person with disability's hand, elbow, shoulder, body, keyboard or alphabet board ('rapid prompting')….To date, there is no substantive evidence to support theory argued to underpin FC that the people who use the method have an underlying movement disorder that warrants facilitation. As a result, FC remains an approach with little supportive evidence and a preponderance of evidence that contraindicates its use, and its use is not recommended."