Evidence-Based Practices
Evidence-based practices are those that have undergone a rigorous series of evaluations and peer reviews to determine validity and reliability. This is an on-going process and often involves controls that rule in or rule out weaknesses in the method or technique. This page also includes articles on the persistence of FC as a discredited technique and research integrity relating to FC.
2024
Friedman-Hauser, Gal, and Jacobson, Ma’ayan. (2024, August 14). Pursuing Justice for Children with Disabilities: Exploring the Risks of Augmentative and Alternative Communication (AAC) and Advancing the Field. International Journal on Child Maltreatment. DOI: 10.1007/s42448-024-00213-z
Wilcznynski, Susan M. (2024, August 15). A Practical Guide for Finding Interventions That Work for Autistic people: Diversity-Affirming Evidence-Based Practice (Critical Specialties in Treating Autism and other Behavioral Challenges). Academic Press. ISPN: 978-0443156328
This book “provides a socially valid, culturally sensitive, and person-centered resource to aid practitioners in guiding the selection of effective interventions.”
Stewart, Jan. (2024, August 30). Assistive Communication Tools and Technologies for Autistic Children. Today’s Parent.
This article discusses evidence-based tools that support a child’s communication needs (Augmentative and Alternative Communication) and contrasts them with Facilitated Communication (also known as supported typing, Spelling to Communicate, Rapid Prompting Method). The author also discusses some myths about AAC and emphasizes following the science when it comes to developing treatment plans for individuals with complex communication needs.
Thyagarajan, S., & Celiberti, D. (2024). A review of Questions to ask facilitators and yourself while observing FC/S2C/RPM sessions. Science in Autism Treatment, 21(8).
This article uses questions from a blog post Janyce wrote titled “Questions to ask facilitators and yourself while observing FC/S2C/RPM sessions.” The authors expand on these questions, adding questions to ask regarding communicator’s background, questions to ask regarding communicator’s use of the letter board and facilitator behavior, and questions to ask regarding final products (such as a complete essay. Neither list is meant to be comprehensive and should be adapted for each individual, but these lists should help people better evaluate FC/S2C/RPM sessions and reduce or eliminate facilitator cueing and control.
2023
Beals, Katharine. (2023). Autism Basics with Dr. Katharine Beals. Drexel University School of Education.
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
This article addresses the problem of adopting unsupported practices over well-established, evidence-based, high leverage practices for educating students with intellectual and developmental disabilities.
McMahon, Loren, F., Shane, Howard C., Schlosser, Ralf W. (2023, September 30). Using occupational therapy principles and practice to support independent message generation by individuals using AAC instead of facilitated communication, Augmentative and Alternative Communication, DOI: 10.1080/07434618.2023.2258398
This article discusses the role occupational therapists have in providing their clients with a standard of care in-line with their professional code of ethics. OTs have a specific knowledge base regarding upper extremity performance and can suggest evidence-based strategies that enable independent access to communication technology.
”The core values that serve as the foundation of OT practice, supporting patient equality, freedom, dignity, and truth, dictate that the use of FC does not align with ethical practice and cannot be used to treat patients.” (p. 6)
2022
Beals, K. (2022). Cutting-Edge Language and Literacy Tools for Students on the Autism Spectrum. IGI Global. ISBN: 9781799894438
This book covers the root causes of the language and learning challenges in autism, their consequences for language acquisition and literacy, and a variety of tools and strategies for addressing them, from teaching technologies to assistive technologies.
Beals, K. (2022). Students with Autism: How to Improve Language, Literacy, and Academic Success. John Catt Educational. ISBN: 9781915261373
Drawing on what the most current evidence shows about the nature of autism (including the most successful therapies), the author discusses implications for autism-friendly instruction in academic subjects.
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
The purpose of this systematic review was to evaluate the latest available evidence regarding augmentative and alternative communication (AAC) interventions in children from 0 to 6 years old diagnosed with various disabilities.
2021
Sobel, S. (2021, September). How Science Works (and Why Pseudoscience Fails). Skeptic. 26.3; 56-59.
This article discusses how a rigorous assessment of evidence and empirical investigation employing scientific methods can help prove or disprove what people know (or think they know) about proposed theories or hypothesis. These methods are contrasted with pseudo-scientific approaches that disregard objective evidence and rational thinking.
2017
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
This book reviews non-evidence-based interventions in the field of speech, language acquisition, and literacy skills, fluency, voice, attention, memory, and more. The authors also suggest evidence-based alternatives with demonstrated scientific support.
2016
Trembath, D., Paynter, J., Keen, D., and Ecker, U.K.H. (2016) “Attention: myth follows!” Facilitated communication, parent and professional attitudes towards evidence-based practice, and the power of misinformation. Evidence-Based Communication Assessment and Intervention.
The authors discuss parent and professional attitudes toward evidence-based practice, and the power of misinformation. They conclude: “countering FC requires a comprehensive and concerted effort, which must build awareness, capacity, and resilience within parents, professionals, and organizations to adopt only evidence-based interventions.”
2015
Shane, Howard C., et.al. (2015). Enhancing Communication for Individuals with Autism: A Guide to the Visual Immersion System. Brookes Publishing. ISBN: 978-1-59857-221-6
Smith, Tristram & Iadarola, Suzannah (2015). Evidence base update for autism spectrum disorder, Journal of Clinical Child & Adolescent Psychology, 44 (6), 897-922. DOI: 10.1080/15374416.2015.1077448
This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in 2008. It identifies two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA+ DSP) and 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training).
2014
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
This article discusses reasonable standards of proof in evaluating the evidence for a practice. With regard to FC, the authors conclude: ''In summary, we find no convincing evidence in the published, peer-reviewed literature to uphold FC as efficacious. The studies that purport to prove the validity of FC have, with a few exceptions, used inappropriate methods for proving cause and effect or poorly controlled experiments.”
2009
Whalon K. J., Al Otaiba S., Delano M. E. (2009). Evidence-based reading instruction for individuals with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(1):3-16. DOI: 10.1177/1088357608328515
This review synthesizes the literature on reading instruction for children with ASD that encompasses one or more of the five components of reading. The review includes 11 studies with 61 participants ages 4 to 17 years. Results indicate that children with ASD can benefit from reading instruction consistent with reading research. This includes systematically instructing all primary sound-letter relationships in a logical and sequential manner.
2006
Rogers, S. J. (2006). Evidence-based interventions for language development in young children with autism. In T. Charman & W. Stone (Eds.), Social & communication development in autism spectrum disorders: Early identification, diagnosis, & intervention (p. 143–179). The Guilford Press.
The purpose of this book chapter is to review the main types of empirically supported language interventions that have successfully taught preschool-age children with autism, age 5 or under, to use spoken language, and to consider the strengths and relative weaknesses of each approach. Includes a discussion of what works best for minimally-verbal and non-verbal children with autism.
2005
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.
Simpson, R. (2005, August). Evidence-based practices and students with autism spectrum disorders. Focus on Autism & Other Developmental Disorders, 20 (3). DOI: 10.1177/10883576050200030201
This article discusses issues and factors that relate to identifying and using effective practices for students with autism-related disorders.
2004
Schlosser, Ralf W. and Raghavendra, Parimala. (2004, March). Evidence-Based Practice in Augmentative and Alternative Communication. Augmentative and Alternative Communication. 20 (1), pp. 1-21.
This article discusses the need for an evidence-based practice (EBP) approach to clinical and educational practice and decision-making. The authors propose a definition of EBP in AAC and outline a process stakeholders can use to identify and implement EBP treatment plans.
2003
Condillac, R., and Perry, A. (2003). Evidence-based practices for children and adolescents with autism spectrum disorders: Review of literature and practice guide. Children’s Mental Health. Ontario. Toronto, ON.
This comprehensive review describes a range of interventions and practices utilized in autism and summarizes the evidence base for each. The section on facilitated communication notes: “The research does not provide support for the validity of FC. The more methodologically rigorous the research design, the more clear-cut the lack of validity. Research has consistently shown that it is the facilitators (not the clients) who determine the content of the typed messages (though unconsciously).”
2001
Schlosser, Ralf W. (2001, December 31). The Efficacy of Augmentative and Alternative Communication. Brill Academic Publishers.
This book discusses essential tools for evaluating the validity of augmentative and alternative communication methods and tools to help researchers and practitioners develop evidence-based plans for their clients. It includes information about research design and formulating questions for scientific inquiry.
1994
Whitehurst, G.J. and Crone, D.A. (1994, September 1). Article commentary: Social constructivism, positivism, and facilitated communication. The Journal of the Association of Persons with Severe Handicaps, 19, 191-195. DOI: 10.1177/154079699401900306
The authors compare constructivist arguments of FC proponents with the conclusions made by researchers who have challenged FC within a positivist framework. They disagree with the pro-FC arguments of Biklen and Duchan, noting “even though the process of constructing scientific knowledge is strongly affected by human social, emotional, and cognitive processes, it also involves matters of fact that cannot be ignored.”
Persistence of Discredited Technique:
2018
Ganz, J., Katsiyannis, A., Morin, K.L. (2018). Facilitated communication: The resurgence of a disproven treatment for individuals with autism. Intervention in School and Clinic, 54 (1), 52-56. DOI: 10.1177/1053451217692564
From the abstract: “A description of the technique is provided along with a summary of the research that disproves facilitated communication. Legal issues related to the use of facilitated communication in school settings are outlined along with recommendations for critically evaluating any potential intervention or treatment.”
Novella, S. (2018, March 14). Facilitated communication rears its ugly head again. Science-Based Medicine.
Steven Novella notes: '“The deeper lesson for the professional community is the harm that is done from adopting even promising methods too soon. What tends to happen is that they become embedded in the infrastructure. Before long there are institutes dedicated to the technique, seminars, specialists, even continuing education credits. The trappings of legitimacy can be acquired very quickly. A new generation trained in the technique, and convinced by confirmation bias and their own anecdotes, may find it difficult to abandon the technique later. “
Sobel, S. (2018). Facilitated communication redux: Persistence of a discredited technique. Skeptic, 23 (3).
An overview of the history of FC, the evidence discrediting it, harms it can cause, organizational policy statements against its use, and reasons for its persistence. The promotion of FC by a state governmental agency in Vermont is addressed.
Vyse, S. (2018, March 1). The enduring legend of the changeling. Skeptical Inquirer.
Reviews the history of beliefs related to changelings. In our times “If anything, our expectations about childbirth and parenthood are greater than those of couples in the middle ages.[2] When children don’t meet these expectations, parents sometimes find a different demon to blame…In other contemporary cases, parents of developmentally disabled children reject the diagnosis of autism and claim their children have a physical—rather than a developmental—disability. They are delighted to find out that with the help of facilitated communication (FC) or a variant of FC, such as rapid prompting method…Unfortunately, the overwhelming evidence of research on facilitated communication shows that the language-competent adult facilitators are unconsciously typing out the messages, and the children are not communicating at all. It is a Ouija-like phenomenon.”
2016
Elliott, J. (2016, July 20). The battle over a controversial method for autism communication. The Atlantic.
Provides an overview of evidence debunking FC and related prompting methods, along with a discussion of reasons for the persistence of such techniques. The author concludes: “The unknowns of autism often move parents and families of autistic individuals in a swirl of powerful guilt, uncertainty, and fear. But that swirl also involves hope—hope that beneath a child’s autistic symptoms is a child yearning to communicate with the world. FC’s offer to fulfill that hope is what gives the practice its power, despite compelling scientific evidence against its ability to deliver.”
2015
Auerbach, D. (2015, November 12). Facilitated communication is a cult that won’t die. Slate.
This is a broad and in-depth review of the background of FC, the scientific research discrediting it, and the harms resulting from its use. The author discusses reasons for its persistence despite being debunked by science, and concerns that it is actively being pushed into public schools and other settings.
Emory Health Sciences. (2015, February 26). Why debunked autism treatment fads persist. Science Daily.
Summary of an article by(lead author)Scott Lilienfeld and others: The authors examine “a number of potential reasons for the surprising persistence of FC and other autism fads. They note that the inherent difficulties in treating autism may give rise to an understandable desire for quick fixes of many kinds. Lilienfeld and his colleagues underscore the pressing need for experts in the autism field to better educate the public about not only what works for the condition, but what does not.”
Vyse, S. (2015, May 11). Facilitated communication: The fad that will not die. Skeptical Inquirer.
An overview of the debunking of FC, and a discussion of reasons for its persistence, including: renaming and repackaging, media campaigns and support from certain academic quarters. The author also discusses how “new waves of unreason” have provided a boost for the discredited practice of FC.
2014
Hemsley, B. and Dann, S. (2014) Social media and social marketing in relation to facilitated communication: Harnessing the affordances of social media for knowledge translation. Evidence-Based Communication Assessment and Intervention, 8 (4), 187-206. DOI: 10.1080/17489539.2015.1023988
From the abstract: “In order to illustrate how social media are being used to spread information about FC, we present a limited scan of two social media sites—TwitterTM and YouTubeTM—for information about FC. In this paper we discuss barriers to evidence and facilitators for FC in social media and consider the role that social marketing might play in relation to FC. Clinical implications for using social media to counter FC and directions for future research are discussed.”
Lilienfeld, S., et.al. (2014). The Persistence of fad interventions in the face of negative scientific evidence: Facilitated communication for autism as a case example. Evidence-Based Communication Assessment and Intervention, 8 (2), 62-101. DOI: 10.1080/17489539.2014.976332
From the abstract: “Although FC was scientifically discredited by the mid-to-late 1990s, data we review demonstrate that it is still frequently administered in clinical and educational settings. We examine evidence for FC’s (a) continued use as an intervention for autism, (b) persistence in academic and institutional settings, (c) popularity in online and print sources, (d) promotion in the media, and (e) ongoing risk to caregivers accused of sexual abuse. We analyze the sources of these troubling developments, explore their ethical implications, and offer recommendations for addressing the spread of FC and other fad interventions.”
Mirenda, P. (2014) Comments and a personal reflection on the persistence of facilitated communication, Evidence-Based Communication Assessment and Intervention, 8 (2), 102-110. DOI: 10.1080/17489539.2014.99742
Per the abstract, the author offers “both a personal reflection and additional explanations for the persistence of misinformation about FC. Based on both cognitive and implementation science research, suggestions for how to construct and present refutations of FC are also included.”
Research Integrity:
Dougherty, M.V. (2018, January). Contested authorship, self-plagiarism, and the scholarly record: In the aftermath of plagiarism. In book: Correcting the Scholarly Record for Research Integrity, pp. 197-219. DOI: 10.1007/978-3-319-99435-2_7
Discussion of standards used in evaluating contested authorship, focusing on the case of an American philosophy professor who utilized FC.