Vermont Allows Abuse Allegation Disclosures and Interviews Using a Discredited Technique

This is the third in a series exploring Vermont Department of Disabilities, Aging, and Independent Living’s (DAIL) commitment to Facilitated Communication (FC), a discredited technique that is supported at the state level. So, far, I have reviewed their commitment statement (blog post here) and guidelines (blog post here). Today, I will focus on Vermont’s Guidelines for Handling Allegations of Abuse Made While Using Facilitated Communication. 

Full disclosure, I have personal experience with this issue and will provide resources below discussing this further. 

Vermont Department of Disabilities, Aging and Independent Living (DAIL) supports the use of Facilitated Communication (FC) for conducting allegations of abuse interviews, despite evidence that FC-generated messages are facilitator authored and not the words of individuals being subjected to its use.

The stated purpose of these guidelines is

“to provide developmental disabilities service agencies with a clear process to follow in the event a person using facilitated communication (FC) communicates sensitive information or makes an allegation of abuse, neglect or exploitation. Because of the physical support used in FC and the potential for influence on a person’s communication, additional steps must be followed when reporting an allegation and investigating it.” (DAIL 2021)

The guidelines go on to state that the first step when these sensitive messages arise is “Confirming that an allegation has been made.”

I disagree. The first step should be to determine who is controlling the typed message(s). Facilitators are told not to test facilitated messages, and will most likely resist if this step is implemented, but at no time is it more important to determine authorship than when such sensitive information is divulged.

Since the latest systematic reviews (and those preceding them ) find no evidence that FC messages are independent, the likelihood of facilitator-control is too high to ignore. As difficult as it is to understand, facilitators, not the individuals with disabilities, are most likely authoring the messages, albeit unwittingly. Facilitator influence should be ruled out to prevent undue stress, anxiety, and harm to their clients and those being accused (usually family members or caregivers). The process should advance only if the allegations are being made independently by the client and without interference from a facilitator.

The guidelines recommend the use of more than one facilitator to confirm FC-generated messages of abuse. This is ineffectual for reasons I will outline and complicates the situation further. 

First, each of the facilitators involved would need to be tested in a controlled setting where they are blinded to test protocols to rule in or rule out facilitator influence over the messaging (again, the form of testing rejected by FC proponents). In the unlikely event these FC generated messages were deemed independent, there still is no guarantee that during a forensic interview the typed messages would be free from facilitator control. To date, no reliably controlled test has demonstrated independent authorship for any facilitator, regardless of duration of training or experience with FC. (See controlled studies here).

Second, facilitators may share information without realizing it. Facilitated messages containing the same or similar information does not guarantee independent authorship. Facilitators working with their supervisors, for example, come from a similar place of understanding about their client, including family background, nature of their disabilities, behavioral issues, and the like. FC-generated messages may contain information obtained days or weeks before the actual messages are typed onto the page without the facilitator’s conscious awareness. The fact that a facilitator is surprised by seemingly unexpected or unusual content or sentence structures does not guarantee that the messages were typed independently. Those who do crossword puzzles or participate in trivia games regularly have the experience of remembering information they’d seemingly forgotten they knew. This same process is in effect with FC. 

Third, facilitators are “primed” by workshop leaders to expect “sensitive” information with FC-generated messages, particularly from someone who is new to FC and, purportedly, communicating their wants and needs for the first time. However, according to Daniel Wegner in an article called “Clever Hands: Uncontrolled Intelligences in Facilitated Communication”, if facilitators know (or think they know) the answer to a question, they cannot help but type out the correct response. Additionally, the belief that FC could work increases the chance that it will work for people holding that belief. Once the seed of possible abuse or neglect is planted in the facilitators’ minds, for example, there is an increased likelihood that disclosures sensitive in nature will appear in the form of FC-generated messages.

Fourth, “Naïve” facilitators (facilitators new to the situation) called in to help confirm FC-generated allegations of abuse are aware of the topic, if not the details, and will, therefore, be primed to expect messages containing sensitive information. Again, they would need to be tested to rule in or rule out facilitator influence, without guarantee that the forensic interview itself would be free from facilitator influence. The likelihood that information obtained will contain sensitive information is high, but what happens if the accounts among the facilitators do not agree? Which account, then, is to be believed?

Fifth, none of these guidelines protect family members, social workers, caregivers, educators, and others from being falsely accused of abuse by FC-generated messages. Neither does it stop even well-meaning facilitators from producing these accusations. By 1995, there were reports of at least five dozen false allegations of abuse, including those from founder Rosemary Crossley and 8 of her trained facilitators. While many of the cases go unreported in the newspapers due to settlements outside the court, they do continue today. (See False Allegations of Abuse here and Facilitator Crimes here). 

As with the other Vermont guidelines I have reviewed so far, facilitators are urged to inform agency personnel about FC “so that he or she understands how the method works prior to meeting with the person.” This raises issues of informed consent (prior blog post here). Surely human services agents, police, lawyers, judges, and other people in authority would want to know that FC is a discredited technique before they proceed with their investigations would they not?

In addition organizations such as American Pediatrics Association, American Speech-Language-Hearing Association, American Psychological Association, American Association on Intellectual and Developmental Disabilities, and many others (found here) have statements opposing its use. Many of these statements include cautions against using FC for important life decisions, including allegations of abuse. 

None of these warnings appear in Vermont DAIL’s guidelines.

References and Recommended Readings:

Bligh, S., & Kupperman, P. (1993). Evaluation procedure for determining the source of communication in facilitated communication accepted in a court case.Journal of Autism and Developmental Disorders, 23, 553-557. DOI: 10.1007/BF01046056

Boynton, J. (2012). Facilitated Communication—what harm it can do: Confessions of a former facilitator.Evidence-Based Communication Assessment and Intervention, 6:1, 3-13. DOI: 10.1080/17489539.2012.674680

Hudson, A., Melita, B. and Arnold, N. (1993). Assessing the validity of facilitated communication: A case study.Journal of Autism and Developmental Disorders, 23, 165-173. DOI: 10.1007/BF01066425

Lilienfeld, S.O. (2005). Scientifically Unsupported and Supported Interventions for Childhood Psychopathology: A Summary. Pediatrics, 115 (3), 761-764. 

Lilienfeld, S.O. (2007). Psychological Treatments That Cause Harm. Perspectives on Psychological Science, 2, 53. 

Mostert, M. (2012). Facilitated Communication: The empirical imperative to prevent further professional malpractice. Evidence-Based Communication Assessment and Intervention, 6 (1), 1-10. DOI: 10.1080/17489539.2012.693840

Palfreman, J. (2012) The dark legacy of FC. Evidence-Based Communication Assessment and Intervention, 6 (1), 14-17. DOI: 10.1080/17489539.2012.688343

Shane, HC & Kearns, K. (1994). An examination of the role of the facilitator in facilitated communication. American Journal of Speech and Language Pathology, 50, 750-765. DOI: 10.1044/1058-0360.0303.48

Siegel, Byrna. (1995). Brief report: Assessing allegations of sexual molestation made through facilitated communication. Journal of Autism and Developmental Disorders. Vol 25 (3); 319-326. DOI: 10.1007/BF02179293

Sigafoos, J. and Schlosser, R. (2012) An experiential account of facilitated communication. Evidence-Based Communication Assessment and Intervention, 6 (1), 1-2. DOI: 10.1080/17489539.2012.710992

Todd , J.T. (2012) The moral obligation to be empirical: Comments on Boynton's “Facilitated Communication—what harm it can do: Confessions of a former facilitator”. Evidence-Based Communication Assessment and Intervention, 6 (1), 36-57. DOI: 10.1080/17489539.2012.704738

Von Tetzchner, S. (2012) Understanding facilitated communication: Lessons from a former facilitator—Comments on Boynton. Evidence-Based Communication Assessment and Intervention, 6 (1), 28-35. DOI: 10.1080/17489539.2012.699729

Vyse, S. (2018). An Artist with a Science-Based Mission. Skeptical Inquirer.