PEDIATRICS Vol. 116 No. 1 July 2005, pp. 289 (doi:10.1542/peds.2005-0713)
Response to "Scientifically Unsupported and Supported Interventions for Childhood Psychopathology: A Summary"
Rita RubinRobert A. Rubin, PhD
Whittier, CA 90603
To the Editor.
We were surprised that the American Academy of Pediatrics would publish an article with so many inaccuracies.1 Although we don't know about all treatments for autism, we do know about facilitated communication (FC). Our daughter, Sue Rubin, who has autism, started using it in 1991 with physical support at the wrist. After 5 years of fading support, she started typing independently, although she still needs a facilitator nearby to keep her focused. She graduated from high school with honors, got 1370 on the SAT test, and is now a junior at Whittier College, taking 1 class each semester. Our daughter is now able to inhibit a lot of the destructive autistic behaviors that ruled her life, enjoys the friendship of both disabled and nondisabled peers, is successful academically, and lives a full, productive life because of FC.
As for the inaccuracies, the facilitator does not "guide" the person's hand movements. He or she offers resistance so that the FC user is moving against, not with, the facilitator's movement. Next, controlled studies do not "demonstrate overwhelmingly that FC is ineffective and that the resultant communications are a product of inadvertent control." Several studies do show facilitator influence; however, the most extensive study that has been done was by Cardinal et al.2 In that study of 43 subjects, 75% were able to pass information to a naive facilitator. There are also many smaller studies that validate FC. After our reference list is a bibliography of studies that validate FC. To understand how some studies could show that it clearly does not work and others could show that it clearly does work, Biklen and Cardinal compiled and edited Contested Words, Contested Science: Unraveling the Facilitated Communication Controversy.3 In a nutshell, the anti-FC crowd continually tests the hypothesis that facilitator influence is possible, which it certainly is. That does not mean, however, that influence is the only possibility, just as the existence of instances of plagiarism and "cooking" of data in the scientific and medical communities does not mean that all research is invalid. On the other hand, those who have been open to facilitation as an effective method test the hypothesis that valid communication by the FC user is possible, which has also been established in numerous publications. Because the 2 hypotheses are essentially unrelated, it is not surprising to see articles supporting both positions coexisting.
The next item we take exception to is "gratuitously raising the hopes of the parents." Why is it better to dash the hopes of parents? When Sue was 15 months old, the neurologist told us she would never walk. He was wrong, and how helpful was that? Does it help to tell us our children are retarded so we shouldn't offer them academics in school? They have a right to the core curriculum. In Whittier, California, where Sue went to public school, 
200 children are using FC from preschool to transition, and they are accessing age-appropriate academics. Approximately 30 adults in the agency that supports Sue use FC daily. Our children are able to tell a doctor what hurts, have an accurate vision test, form friendships, and as adults choose what job they would like and where and with whom they would like to live.
The last item to which we would like to respond is: "FC has resulted in numerous uncorroborated allegations of sexual and physical abuse against these parents." The study that we don't see cited is that by Botash et al,4 who found that the percentage of uncorroborated allegations using FC was no different from allegations made by speaking children. In fact, they recommended that people pay attention to allegations made during FC. In our area, because so many children and adults use FC, policies are in place to deal with such allegations.
REFERENCES
- Lilienfeld SO. Scientifically unsupported and supported interventions for childhood psychopathology: a summary. Pediatrics.2005; 115; 761
–764
[Abstract/Free Full Text] - Cardinal D, Hanson D, Wakeham J. Investigation of authorship in facilitated communication. Ment Retard.1996; 34 :231 –242[Web of Science][Medline]
- Marcus E, Shevin M. Sorting it out under fire: our journey. In: Biklen D, Cardinal D, eds. Contested Words, Contested Science: Unraveling the Facilitated Communication Controversy. New York, NY: Teachers College Press; 1997
- Botash A, Babuts D, Mitchell N, O'Hara M, Manuel J, Lynch L. Evaluations of children who have disclosed sexual abuse via facilitated communication. Arch Pediatr Adolesc Med.1994; 148
:1282
–1287
[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics
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