Facilitated communication
Facilitated communication has been widely adopted throughout North America in special/vocational education services for individuals with developmental disabilities who are nonverbal. A basic premise of facilitated communication is that people with autism and moderate and profound mental retardation have "undisclosed literacy" consistent with normal intellectual functioning. Peer reviewed, scientifically based studies have found that the typed language output (represented through computers, letter boards, etc.) attributed to the clients was directed or systematically determined by the paraprofessional/professional therapists who provided facilitated assistance. (Bligh & Kupperman, 1993; Cabay, in press; Crews et al., in press; Eberlin, McConnachic, Ibel, & Volpe, 1993; Hudson, Melita, & Arnold, 1993; Klewe, 1993; Moore, Donovan, Hudson, 1993; Moore, Donovan, Hudson, Dykstra & Lawrence, 1993; Regal, Rooney, & Wandas, in press; Shane & Kearns, in press; Siegel, in press; Simon, Toll & Whitehair, in press; Szempruch & Jacobson, 1993; Vasquez, in press; Wheeler, Jacobson, Paglieri & Schwartz, 1993). Furthermore, it has not been scientifically demonstrated that the therapists are aware of their controlling influence.
Consequently, specific activities contribute immediate threats to the individual civil and human rights of the person with autism or severe mental retardation. These include use of facilitated communication as a basis for a) actions related to nonverbal accusations of abuse and mistreatment (by family members or other caregivers); b) actions related to nonverbal communications of personal preferences, self-reports about health, test and classroom performance, and family relations; c) client response in psychological assessment using standardized assessment procedures; and d) client-therapist communication in counseling or psychotherapy, taking therapeutic actions, or making differential treatment decisions. Instances are widely noted where use of facilitated communication in otherwise unsubstantiated allegations of abuse has led to psychological distress, alienation, or financial hardship of family members and caregivers. The experimental and unproved status of the technique does not preclude continued research on the utility of facilitated communication and related scientific issues. Judicious clinical practice involving use of facilitated communication should be preceded by the use of fully informed consent procedures, including communication of both potential risks and likelihood of benefit.
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.
References:
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Bligh, S. & Kupperman, P. (1993). Evaluation procedure for determining the source of the communication in facilitated communication accepted in a court case. Journal of Autism and Developmental Disorders, 23, 553-557.
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Cabey, M. (in press). A controlled evaluation of facilitated communication with four autistic children. Journal of Autism and Developmental Disorders.
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Crews, W. D., Sanders, E. C., Hensley, L. G., Johnson, Y. M., Bonsventura, S., & Rhodes, R. D. (in press). An evaluation of facilitated communication in a group of nonverbal individuals with mental retardation. Journal of Autism and Developmental Disorders.
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Eberlin, M., McConnachic, G., Ibel, S., & Volpe, L. (1993). Facilitated communication: A failure to replicate the phenomenon. Journal of Autism and Developmental Disorders, 23, 507-530.
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Hudson, A., Melita, B., & Arnold, N. (1993). Brief report: A case study assessing the validity of facilitated communication. Journal of Autism and Developmental Disorders, 23, 165-173.
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Klewe, L. (1993). An empirical evaluation of spelling boards as a means of communication for the multihandicapped. Journal of Autism and Developmental Disorders, 23, 559-566.
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Moore, S., Donovan, B., & Hudson, A. (1993). Facilitator-suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders, 23, 541-551.
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Moore, S., Donovan, B., Hudson, A., Dykstra, J., & Lawrence, J. (1993). Evaluation of facilitated communication. Eight case studies. Journal of Autism and Developmental Disorders, 23, 531-539.
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Regal, R. A., Rooney, J. R., & Wandas, T. (in press). Facilitated communication: An experimental evaluation. Journal of Autism and Developmental Disorders.
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Shane, H. C., & Kearns, K. (in press). An examination of the role of the facilitator in "facilitated communication". American Journal of Speech-Language Pathology.
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Siegel, B. (in press). Assessing allegations of sexual molestation made through facilitated communication. Journal of Autism and Developmental Disorders.
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Simon, E. W., Toll, D. M., & Whitehair, P. M. (in press). A naturalistic approach to the validation of facilitated communication. Journal of Autism and Developmental Disorders.
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Szempruch, J., & Jacobson, J. W. (1993). Evaluating the facilitated communications of people with developmental disabilities. Research in Developmental Disabilities, 14, 253-264.
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Vasquez, C. (in press). A multi-task controlled evaluation of facilitated communication. Journal of Autism and Developmental Disorders.
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Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. (1993). An experimental assessment of facilitated communication. Mental Retardation, 31, 49-60
Resolution on cigarette smoking
WHEREAS tobacco is a legally available consumer product that is demonstrably harmful to health when used as intended;
WHEREAS tobacco is an established risk factor for morbidity and mortality;
WHEREAS more than one million teenagers begin smoking each year, a rate of approximately 3000 per day which has not declined appreciably over the last decade (1), and 90 percent of young smokers report that they become regular smokers before age 18 (2);
WHEREAS psychological scientists study human and animal behavior, and our research domain encompasses the full spectrum of issues related to tobacco use, including: how people decide whether or not to use tobacco products and what are the different factors that enter into that decision (such as cultural factors, minors' access to tobacco products, tobacco industry advertising, cost); psychopharmacological aspects of nicotine, i.e., understanding modes of addiction and what changes it causes in the central nervous system; identifying ways to prevent people from engaging in risk-taking behaviors such as tobacco use; identifying effective community interventions for bringing about widespread changes in behavior; and treating tobacco addiction individually and within the community; and
WHEREAS psychological scientists have contributed substantially to the body of research knowledge in these areas;
THEREFORE, BE IT RESOLVED that the American Psychological Association supports the tobacco and smoking objectives set forth in, "Healthy People 2000-National Health Promotion and Disease Prevention Objectives for the Nation," and intends to encourage federal, state and local policies to minimize recruitment to, and facilitate abstinence from, the use of tobacco, including but are not limited to: 1) restricting illegal access of youth to tobacco products by supporting a range of direct and indirect mechanisms to discourage use and restrict access; and 2) fostering research on behavioral, psychological, pharmacological, and toxicological components of addiction, smoking prevention and intervention, and smoking cessation methods.
References:
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U.S. Department of Health and Human Services. Strategies to Control Tobacco Use in the United States: A Blueprint for Public Health Action in the 1990's. DHHS Publication No. (NIH) 92-3316, 1991.
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Pierce, Naquin, Gilpin, Giovino, Mills and Marcus, "Smoking Initiation in the United States: A Role for Worksite and College Smoking Bans," Journal of the National Cancer Institute, Vol. 83, pp. 1009-1013 (1991).