Organizations with Policies Opposing the Use of Facilitated Communication
Since 1995, major health, education, and advocacy groups have adopted position statements opposing the use of FC, citing lack of evidence, concerns about facilitator influence, and potential and real harms caused by false allegations of abuse. Some organizations consider the use of FC a violation of human rights. Increasingly, organizations are adding RPM (and its variants) to their opposition statements, citing lack of scientific evidence.
American Academy of Child and Adolescent Psychiatry (AACAP)
“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.” Approved by Council, October 20, 1993. Reviewed June, 2008. To be reviewed June, 2013.
Source: American Academy of Child and Adolescent Psychiatry Policy Statement: Facilitated Communication
American Academy of Pediatrics
“In the case of FC, there are good scientific data showing it to be ineffective. Moreover, as noted before, the potential for harm does exist, particularly if unsubstantiated allegations of abuse occur using FC. Many families incur substantial expense pursuing these treatments, and spend time and resources that could be used more productively on behavioral and educational interventions.”
Source: Auditory Integration Training and Facilitated Communication for Autism (1998). Reaffirmed December, 2009. Retired 2017.
In January, 2020, the AAP published an article called “Identification, Evaluation, and Management of Children with Autism Spectrum Disorder” that replaced the 1998 statement.
”Current scientific evidence does not support the use of facilitated communication in which a nonverbal individual is guided to communicate. This differs from AAC, in which the individual is taught to communicate independently.” p. 26
American Association on Intellectual and Developmental Disabilities (AAIDD)
On January 9, 2019, The Board of Directors of the American Association on Intellectual and Developmental Disabilities (AAIDD) announced that based on current scientific evidence, it “does not support the use of Facilitated Communication (FC) or the Rapid Prompting Method (RPM) as modes of communication for people with disabilities. In the case of FC, there is no scientific evidence supporting its validity, and there is considerable evidence that the messages are authored by the facilitator rather than by the individual with a disability. In the case of RPM, there is lack of scientific evidence for its validity, and concerns about message authorship similar to those for FC have been raised.”
American Psychological Association (APA)
“The short version of this long story is that study after study showed that facilitated communication didn’t really work. Apparently, the positive results that had generated so much enthusiasm were the results of a subtle process in which well-intended facilitators were answering questions themselves - without any awareness that they were doing so. Based on the findings of carefully controlled studies of facilitated communication, the American Psychological Association issued a resolution in 1994 that there was “no scientifically demonstrated support for its efficacy.”
Source: Facilitated Communication: Sifting the Psychological Wheat from the Chaff: If psychological research does not always give us hoped-for answers, it does help us sift potent reality from wishful thinking and focus our energy on real solutions. (2003)
From Chapter XI: Scientific Affairs
Facilitated communication is a process by which a facilitator supports the hand or arm of a communicatively impaired individual while using a keyboard or typing device. It has been claimed that this process enables persons with autism or mental retardation to communicate. Studies have repeatedly demonstrated that facilitated communication is not a scientifically valid technique for individuals with autism or mental retardation. In particular, information obtained via facilitated communication should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions.
THEREFORE, BE IT RESOLVED that APA adopts the position that facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy.
American Speech-Language-Hearing Association (ASHA)
“It is the position of the American Speech-Language-Hearing Association (ASHA) that Facilitated Communication (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 the use of FC. Information obtained through the use of FC should not be considered as the communication of the person with a disability.”
Source: ASHA Position Statement: Facilitated Communication (August 2018)
“It is the position of the American Speech-Language-Hearing Association (ASHA) that use of the Rapid Prompting Method (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.”
Source: ASHA Position Statement: Rapid Prompting Method (August 2018)
Association for Behavior Analysis International (ABAI)
“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.”
Arizona Comprehensive Medical and Dental Authorization Program Guideline
“CMDP has determined Sensory Integration Training, Auditory Integration Training, and Facilitated Communication are not medically necessary services for children with autism or developmental delays.”
”The American Academy of Pediatrics (AAP) released a policy statement regarding Auditory Integration Training and Facilitated Communication for Autism in August 1998. The policy states, ‘Both therapies (AIT and FC) seek to improve communication skills. 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.” The AAP published a statement of reaffirmation for this policy on May 1, 2006.”
Source: Arizona Department of Child Safety. 6/3/19
Association for Science in Autism Treatment
“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 the FC does not improve language skills. Therefore, FC is an inappropriate intervention for individuals with autism spectrum disorders.”
Source: Facilitated Communication. Association for Science in Autism Treatment.
Autism & Asperger Förbundet (Autism and Asperger Association, Sweden)
Translation: “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.”
Source: Warning About FC. Available as a pdf.
Autism New Jersey
“Unfortunately, some methods that have been proposed to treat autism have not been proven effective for individuals with autism. A review of the available research on best practices leads Autism New Jersey to not recommend certain treatments: Psychoanalysis, Facilitated Communication, Auditory Integration Training/Therapy, and Secretin.
Source: Autism New Jersey Position Statements
Behavior Analysis Association of Michigan (BAAM)
“…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, communication system, or a means of making important decisions relevant to individuals whose communication is facilitated. In particular, communication arising from the use of facilitated communication should not be used to confirm or deny accusations of abuse, neglect, or other crimes, and should not be used to make decisions concerning treatment, diagnosis, housing, or custody.”
Source: Resolution of the Behavior Analysis Association of Michigan on “Facilitated Communication.” (1998)
Canadian Paediatric Society
“Therapies that are considered risky and ineffective include hyperbaric oxygen therapy, chelation, secretin, and the use of certain herbal products. Antibiotics, antifungals, and facilitated communication strategies are also considered to be ineffective for treating ASD.”
Source: CPS Position Statement: Post-diagnostic management and follow-up care for autism spectrum disorder. (2019)
Centre for Augmentative & Alternative Communication
“Since there is a possibility that these methods therefore undermine the agency of the person with limited speech by attributing to them messages composed by the facilitator, it is the position of the Centre for AAC that
1. FC cannot be regarded as a valid form of AAC and it use in clinical practice is strongly discouraged by the Center for AAC, and that
2. until clear and unequivocal evidence becomes available that shows that the messages composed through RPM and S2C are authored by the person pointing to the letters and not the person holding the board, neither method can be regarded as a valid form of AAC and their use in clinical practice is strongly discouraged by the Center for AAC.
Source: Position statement on expressive methods of communication for persons with limited speech that require the input of a trained supporter. (2023)
Department of Communication Sciences and Disorders, Syracuse University
“The Department of CSD does not offer, study or affiliate itself with Facilitated Communication (FC) or Supported Typing (ST).”
Source: Department of Communication Sciences and Disorders Syracuse University webpage.
Heilpädagogische Forschung
“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 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.”
Source: Resolution zur Gestützten Kommunikation (engl.: Facilitated Communication/FC)
Information Autism
“There is a significant amount of research evidence to suggest that facilitated communication provides no benefits for autistic individuals. All of the high quality evidence indicates that any communication is created by the facilitator, not the aid user.”
Source: Facilitated Communication and Autism. Information Autism (2022)
International Society for Augmentative and Alternative Communication (ISAAC)
“In conclusion, 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.”
Source: ISAAC Position Statement on Facilitated Communication (2014)
Irish Association of Speech & Language Therapists (IASLT)
“FC and its variants such as RPM, remain illegitimate and ultimately undermine the voices of individuals with communication impairments.”
Source: IASLT Position Statement on the Rapid Prompting Method (May 2017)
National Autism Society (UK)
For some forms of AAC, there is no evidence to show whether they are effective, ineffective, safe or harmful.
For others, there is some evidence of harm or ineffectiveness. For example, we do not believe that facilitated communication is an appropriate intervention for autistic people, as there is evidence that it is ineffective and can lead to significant harm.
Source: Understanding and developing communication. National Autistic Society.
National Council on Severe Autism
NCSA enthusiastically supports efforts to improve independent communication by all those with severe autism, whether the communication is verbal, gestural, written, or through devices such as Alternative and Assistive Communication (AAC) technologies or a keyboard. We cannot support, however, a technique known as Facilitated Communication (FC)…We also urge caution with regard to newer variants of FC such as the Rapid Prompting Method (RPM) and Spelling to Communicate (S2C). Like FC, these methods rely on the intervention of a partner to facilitate the communication, and therefore carry the risk of conscious or unconscious prompting by the intermediary.
For full statement: NCSA Position Statement on Facilitated Communicationsition Statement on Facilitated Communication.
New York State Health Department
“Because of the lack of evidence for efficacy and possible harms of facilitated communication, it is strongly recommended that facilitated communication not be used as an intervention method in young children with autism.” [Evidence Rating D1 = Opinion/No evidence meeting criteria]
Source: Department of Health Chapter IV (continued) - Other Experiential Approaches.
“Because no adequate evidence ha been found supporting effectiveness, and because possible harms have been associated with this intervention, it is strongly recommended that facilitated communication not be used as an intervention method for young children with autism.”
Source: Clinical Practice Guideline: Quick Reference Guide for Parents and Professionals. Autism/Pervasive Developmental Disorders. Assessment and Intervention for Young Children (Age 0-3 years). Sponsored by New York State Department of Health. Division of Family. Health Bureau of Early Intervention. (1999). Available as a pdf.
National Institute for Health and Care Excellence
“Do not provide facilitated communication for adults with autism.
Source: Autism spectrum disorder in adults: diagnosis and management. Clinical guideline [CG142. Section 1.4.3). (2016)
New Zealand Ministries of Health and Education
“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. (Recommendation 4.5.2).
Source: New Zealand Autism Spectrum Disorder Guideline. Available as a pdf.
Ontario Association for Behaviour Analysis, Inc.
“Finally, Table 10 provides a list of interventions that are not evidence based, designated in red. This includes a number of interventions for which there is little or no evidence on which to base decisions and/or the quality of the research is very poor. In some cases, there are sufficient studies of good quality to show the intervention to be ineffective or harmful (e.g., facilitated communication).”
Source: Evidence-based Practices for Individuals with Autism Spectrum Disorder: Recommendations for Caregivers, Practitioners, and Policy Makers. (2016)
raising children.net.au
Research shows this approach [FC] is ineffective or can be harmful.
There’s no evidence that autistic children communicate more or better because of this therapy. Children might become more passive and less likely to initiate communication because of this therapy.
Source: raisingchildren.net.au
Scottish Intercollegiate Guidelines Network
Facilitated communication should not be used as a means to communicate with children and young people with ASD.
Non-Pharmacological Interventions for Adults: Facilitated communication should not be used as a means to communicate with adults with ASD.
Source: Assessment, diagnosis and interventions for autism spectrum disorders. Scottish Intercollegiate Guidelines Network. June 2016. Available as a pdf.
Speech-Language & Audiology Canada (SAC)
“There is a lack of substantive research evidence demonstrating the FC and RPM are valid forms of augmentative or alternative communication. Research studies show that facilitators consciously and/or unconsciously influence the message being communicated, thereby exposing people with communication disorders to risk of harm by preventing genuine self-expression. For these reasons, SAC members and associates should not use FC and RPM in clinical practice.”
Source: Official Statement From Speech-Language & Audiology Canada (SAC): Use of Facilitated Communication and Rapid Prompting Method (January 2018)
Speech Pathology Australia
Speech Pathology Australia supports the position statements of the American Speech-Language-Hearing Association (ASHA) concerning Facilitated Communication (FC) and Rapid Prompting Method (RPM) on the basis that these techniques do not foster independent communication. ASHA states that “facilitated communication (FC) is a discredited technique that should not be used” and “the use of Rapid Prompting Method is not recommended because of prompt dependency and lack of scientific validity.” There is now sufficient scientific evidence to support the view that facilitated communication does not provide a valid means of communication and it is the position of Speech Pathology Australia that facilitated communication should not be used.
Source: Speech Pathology Australia’s Position on Facilitated Communication March 2020. Speech Pathology Australia.
Victorian Advocacy League for Individuals with Disability, Inc. (VALID)
“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.”
Source: VALID Position Statement on the Use of Facilitated Communication. Available as a pdf.
World Federation of Occupational Therapists (WFOT)
The WFOT has not published a specific position in relation to facilitated communication or other similar communication methods. WFOT does not however endorse the use of interventions that are not supported by evidence.
WFOT advocates for the use of best available evidence to inform occupational therapy practice. The application of evidence to ensure best practice is one of six competency areas in the ‘WFOT Minimum Standards of Education of Occupational Therapists’ that are expected to be met by all graduates of occupational therapy education programs worldwide for approval by the Federation.
Guiding Principles for the Use of Evidence in Occupational Therapy. Source: WFOT Secretariat, email 4/25/2022.