A reader asked me the other day if I thought proponents of FC/S2C/RPM understood the difference between science and pseudoscience and, to be honest, I don’t know. Many of the pro-FC/S2C/RPM comments we get on this website or on social media contain mildly veiled or outright accusations that we’re the ones who don’t understand science. But, when we ask these commenters for what they consider to be reliably controlled studies to prove that facilitator-dependent techniques are free from facilitator influence and control, they generally respond with pro-FC anecdotes (personal accounts, YouTube videos, etc.) or articles that have nothing to do with FC authorship. (See Critiques of Pro-FC Articles and Misleading Articles)

Sid is not looking at the stencil letter board while his facilitator holds it in the air and calls out letters. His mother proclaims in the film that she “doesn’t care about the science.” (Spellers, 2023)

On occasion, someone will send us a journal article that is either an opinion piece or a poorly controlled study. And while some of these journal articles are “peer reviewed” (usually in a pay-to-play type journal), none of the articles we’ve received so far from pro-FC commenters qualify as reliably controlled studies. We’re told that quantitative methods are not the “end all or be all” in science and there are other forms of data collection. We don’t disagree. However, if we point out that quantitative methods are necessary to separate facilitator behaviors from those of their clients during letter selection (e.g., message-passing tests where facilitators are “blinded” from test protocols in order to determine communication independence), we’re accused of “moving the goal post” or being close-minded, or being part of a “debunker industry.”

I’d like to point out here that questioning the veracity of proponent claims regarding FC/S2C/RPM is part of the scientific process. The “debunking” of original touch-based FC came as a result of that process. It wasn’t, as proponents seem to believe, the initial goal of researchers. Evaluators picked their best facilitator-client pairs—and still failed to prove that the clients and not their facilitators were doing the communicating. It seems proponents are just unhappy that FC didn’t work in the “revolutionary” way they thought it would. (Scientists have known about the ideomotor response and the Clever Hans effect for over 100 years). S2C/RPM-style forms of FC have yet to undergo the same rigorous scientific process—largely because proponents refuse to participate—but the technique(s) share enough similarities with FC regarding facilitator cueing and control to raise serious concerns about their efficacy. (See Opposition Statements)

There is no question, however, that proponents are fiercely dedicated to their belief in FC/S2C/RPM. But is this inability or unwillingness to provide reliably controlled proof of their extraordinary claims of hidden literacy skills in individuals with profound autism or developmental disabilities born out of wishful thinking and an intense desire to want FC to work (in other words, credulity), or is it born out of a deliberate avoidance of the well-documented problems with FC that threaten to undermine proponent belief in facilitator-dependent techniques (in other words, willful ignorance)?

On the one hand, the articles or comments proponents send us often fall into the categories of anecdotes, testimonials, opinion pieces, newspaper accounts of FC/S2C/RPM “success” stories, ethnographic studies, and qualitative studies based on interviews conducted on individuals being subjected to FC/S2C/RPM. Proponents get credit for trying at least to offer up some “evidence” to back up their beliefs. I think a smaller number of these proponents know enough about scientific inquiry to use terms such as “peer review” and “qualitative and quantitative studies” when it suits their argument. Likewise, proponents seem (intuitively or deliberately) to understand enough about scientific inquiry to avoid data collecting techniques (e.g., reliably controlled tests) that have consistently identified major flaws in FC/S2C/RPM (e.g., facilitator cueing and control, prompt dependency, client inattentiveness, unexpected literacy skills). (See Systematic Reviews)

A facilitator stares intently at the letter board, holding onto the young woman at the elbow, while the young woman has her head turned and is looking away from the spelling activity. (Prisoners of Silence, 1993)

On the other hand, none of the data collecting strategies proponents use as proof of authorship include the tools (e.g., quantitative, reliably controlled measures) needed to objectively rule in or rule out facilitator control over letter selection. Facilitators are trained in FC/S2C/RPM workshops to “presume competence” in their clients and not question the veracity of messages produced while using the technique(s)—even, it appears, when the FC-generated messages contain major, potentially life-changing or harmful content: allegations of abuse, health or medical issues, guardianship issues, relationship issues (including sexual relationships and marriage), etc. Facilitators seem undaunted in their belief in and defense of FC/S2C/RPM despite well-documented cases of false allegations of abuse and facilitator crimes.

*The American Speech-Language-Hearing Association (ASHA) warns against* FC, as well as Rapid Prompting Method (RPM) and Spelling to Communicate (S2C). (*ASHA, 2018)*

I’d like to think most facilitators are truly credulous and, in a sense, victims of workshop leaders who fail to fully disclose to participants the dangers of using pseudoscientific and discredited techniques. Much of the information on our website, for example, is not available on pro-FC websites. But current-day proponents of FC/S2C/RPM seem to be practicing a type of willful ignorance when it comes to authorship. In other words, they know about the studies that reveal facilitator interference with letter selection but choose not to read the studies. Sometimes, they admit that authorship is a concern (in other facilitators, but not themselves), but then say they don’t care about the science. (See links to relevant blog posts below)

On some level, I understand facilitators’ fierce loyalty to a practice they believe in and stake their reputations on. I think most facilitators start out genuinely trying to help their clients or loved ones and, perhaps, get caught up in the pseudoscientific practice of FC/S2C/RPM without fully realizing what’s happening. And, I think, for some facilitators, doing something feels better than doing nothing, even though deep down inside, they may have doubts about authorship and/or suspect that the FC-generated messages are not always originating from their client or loved one. But good intentions and faith in FC/S2C/RPM do not protect facilitators from promoting pseudoscientific practices or from doing harm—however inadvertent—to their clients.

In general, I don’t enjoy exchanges with proponents—especially on social media—but not because people disagree with me or perhaps send me information that I haven’t seen before. I actually don’t mind an exchange of information. I see it as an opportunity to learn something new.

However, from my perspective (as a former facilitator who changed her mind about FC when given access to evidence-based information from people outside the FC community), proponents’ purpose in seeking out my posts seems only to denigrate experts in the field of Speech/Language Pathology, linguistics, psychology, and autism research, as well as professional organizations like the American Speech-Language Hearing Association (ASHA) and the American Association on Intellectual and Developmental Disabilities (AAIDD) that oppose the use of FC/S2C/RPM, and me. We (critics) are told that our views are outdated and that the FC/S2C/RPM proponents are going to “win.” The intent of these exchanges (aka bullying tactics) seems to be to shut down all discussion about the problems with facilitator cueing that have been a part of FC from its inception and have gone unanswered by the very people making these extraordinary claims. Proponent comments are often impassioned, I’ll give them that, but, they don’t ever get to the heart of the matter, which is facilitator influence and control. This statement from Finn et al. in a 2005 article called Science and Pseudoscience in Communication Disorders: Criteria and Applications rings true for me:

information about the nature and treatment of disorders should be developed through research and other empirically based activities, not solely through any of the many other possible ways of knowing (e.g., faith, authority, or introspection).” (p. 172)

In closing, I don’t know what to say about proponents who at times seem credulous and at others seem willfully ignorant about the promotion and use of FC/S2C/RPM. I have personally experienced proponents weaving and dodging, deflecting and dancing around the question of authorship when it arises. And, regardless of their motives, I’d love to see proponents respond directly to questions of authorship (aka facilitator behavior) using quantitative methods instead of anecdotes, testimonials and ad hominem attacks (none of which are evidence).

*FC met 8 out of 10 pseudoscience criteria in 2005. (Finn et al., 2005)*

I didn’t elaborate on the Finn et al. article in this blog post, but taking a closer look at their 10 criteria may help answer the question of whether FC/S2C/RPM are pseudoscience. They thought so in 2005—way before I started regularly researching and actively speaking out against the technique(s) in 2012. I encourage you to read the article in full, but here are their criteria so, perhaps, you can investigate for yourselves:

Untestable: Is the Treatment Unable to be Tested or Disproved?
Unchanged: Does the Treatment Approach Remain Unchanged Even in the Face of Contradictory Evidence?
Confirming Evidence: Is the Rationale for the Treatment Approach Based Only on Confirming Evidence, with Disconfirmed Evidence Ignored or Minimized?
Anecdotal Evidence: Does the Evidence in Support of the Treatment Rely on Personal Experience and Anecdotal Accounts?
Inadequate Evidence: Are the Treatment Claims Incommensurate with the Level of Evidence Needed to Support those Claims?
Avoiding Peer Review: Are Treatment Claims Unsupported by Evidence That has Undergone Critical Scrutiny?
Disconnected: Is the treatment approach disconnected from well-established scientific models or paradigms?
New Terms: Is the Treatment Described by Terms that Appear to be Scientific but upon further examination are found not to be scientific at all?
Grandiose Outcomes: Is the treatment approach based on grandiose claims or poorly specified outcomes?
Holistic: Is the treatment claimed to make sense only within a vaguely described holistic framework?

References and Recommended Reading

Controlled Studies

Systematic Reviews

Bowen, Caroline and Snow, Pamela. (2017). Making Sense of Interventions for children with Developmental Disorders: A Guide for Parents and Professionals. ISBN 978-1-907826-32-0

Finn, P., Bothe, A.K., and Bramlett, R.E. (2005, August). Science and Pseudoscience in Communication Disorders: Criteria and Applications. American Journal of Speech-Language Pathology. Issue 14 (3), pp. 172-186. DOI: 1058-0360/05/1403-0172.

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.

Leonet, Oihana, et. al. (2022, July 6). A Systematic Review of Augmentative and Alternative Communication Interventions for Children Aged From 0 to 6 Years. Language, Speech, and Hearing Services in Schools. 1-27. DOI: 10.1044/2022_LSHSS-21-00191

Singer, G.H.S., Horner, R.H., Dunlap, G., and Wang, M. (2014). Standards of proof: TASH, facilitated communication, and the science-based practices movement. Research and Practices for Persons with Severe Disabilities, 39 (3), 178-188. DOI: 10.1177/1540796914558831

Travers, Jason C. and Pennington, Robert C. (2023). Supporting Student Agency in Communication Intervention: Alternatives to Spelling to Communicate and Other Unproven Fads. Teaching Exceptional Children. DOI: 10.1177/00400599231171759

Select Blog Posts

A critique of United for Communication Choice’s “fact” page

A review of the movie Spellers: a documercial for Spelling to Communicate

Another problem for FC: pseudoscientific fallacies about science

Another side effect of FC: Alternative Facts

Are people who question FC/S2C/RPM evil?

At what point was Anna Stubblefield culpable for her actions?

Can facilitators NOT cue their clients, even if they wanted to? (Hint: It’s not likely)

Critical questions the CBS LA Reporters apparently forgot to ask about FC

How motivated reasoning enables support for facilitated communication

Is S2C really a (Christmas) miracle?