Treatments That Cause Harms

On the surface, facilitated communication seems like a fairly innocuous technique being promoted by well-meaning people who want to make a difference in the lives of individuals with disabilities. However, there are unintended consequences to using unsupported interventions that may harm the very individuals they are trying to help.

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

This article offers basic guidelines for distinguishing scientifically supported from unsupported treatments for individuals with autism, ADHD, and conduct disorder.

“FC is premised on the notion that autistic children suffer not from an intellectual and affective impairment but from an exclusively motor impairment termed developmental apraxia, which impedes their ability to speak properly. Hence, with the aid of a facilitator who guides their hand movements, these children can ostensibly type out complete sentences on a computer keyboard or letter pad. Nevertheless, controlled studies demonstrate overwhelmingly that FC is ineffective and that the resultant communications are a product of inadvertent facilitator control over the child’s hand movements. Although this “ideomotor effect” has been well documented by researchers for decades, the proponents of FC never considered it as an alternative explanation for FC’s seemingly remarkable effects. In addition to gratuitously raising the hopes of the parents of autistic children, FC has resulted in numerous uncorroborated allegations of sexual and physical abuse against these parents". p. 762.

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

This article is a discussion of hazardous treatments for individuals within the medical and mental health professions. In it, the author outlines methodological obstacles standing in the way of identifying potentially harmful therapies (PHTs) and discusses the implications of PHTs for clinical science and practice.

“FC has been associated with at least five dozen allegations of child sexual abuse against the parents of autistic children, the substantial majority of which have never been corroborated (Jacobson, Mulick, & Schwartz, 1995). In these cases, the facilitated communications were ostensibly generated by facilitators themselves, who may have either suspected familial abuse or harbored implicit causal theories about a link between early abuse and subsequent autism. Nevertheless, it is not known whether FC generates more false abuse allegations than other suggestive techniques (e.g., repeated questioning and prompting of children) for unearthing abuse (Botash et al., 1994). pp. 59-60.

Witkowski, T. (2016, July 20). Psychology Led Astray: Cargo Cult in Science and Therapy. Brown Walker Press. ISBN: 978-1627346092

This book examines problems in psychological research and psychotherapeutic practice, including a chapter on questionable practices in the treatment of children (e.g., educational kinesiology, attachment therapy, trauma debriefing, Facilitated Communication, Dolphin therapy).

Review of the book:

Radford, B. and Frazier, K. (2017, January-February). Psychology Led Astray: Cargo Cult in Science and Therapy. Skeptical Inquirer. 41 (1); 61.