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Section
3
Ethical Issues: Facilitated Communication in
Persons with Autism
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In the last section, we discussed four ethically questionable
possible results of hypnosis. 1. Clients create memories; 2. Distort existing
memories; 3. Incorporate cues from leading therapist questions; and 4. Incorporate
therapist beliefs. We also examined the path the client might take to resolve
their supposed sexual abuse.
In this section we will examine
facilitated communication with autistic children trauma and its possible ethical
misuse.
♦ #1 The Facilitator
As you may know already, facilitated communication, also known as FC, is a procedure that supposedly allows
those afflicted with cerebral palsy and autism to express their thoughts. Invented
in Australia by Rosemary Crossley, FC involves a special education teacher known
as a "facilitator" who supports the arm of the autistic child and senses
where the hand of a cerebral palsy client wants to go on a keyboard and guides
their finger there. Suddenly, those clients thought to have IQs around retarded
levels can write essays on Shakespeare and calculus.
According
to Eleanor Goldstein in "Confabulations: Creating False memories-Destroying
Families," FC is only successful when the facilitator knows the answer already
and FC has been proved a fraud in controlled experiments, even though it was created
with honorable intentions. In these experiments, an autistic child and a facilitator
are shown different objects. Invariably, the facilitator types what she has seen,
not what the autistic child has seen. When only the autistic child was shown an
object, the correct answer was never typed.
♦ #2 FC and Sexual
Abuse
Unfortunately, FC has been used to uncover false allegations of sexual
abuse. In over 70 cases across North America, Europe, and Australia, autistic
children have typed out messages such as, "Dad suk my prik." Syracuse
University education professor Douglas Biklen, an FC advocator, may be responsible
for these kinds of discoveries as it was he who suggested to facilitators to be
on the lookout for sexual abuse. In his 1993 book Communication Unbound, he claims
that 13 percent of his students alleged sexual abuse through FC.
More
strikingly, some FC, facilitated communication, proponents have written that "There
is almost a 100 percent likelihood that a disabled child will be molested before
he or she is eighteen. Facilitated Communication is confirming these statistics."
Even though these numbers seem skewed, can you see how they inevitably influence
facilitators into suspecting that their autistic clients are being molested at
home?
In some cases, autistic girls with intact hymens have supposedly been subjected
to hundreds of parental rapes. As you can see, the facilitator has inadvertently
transferred their expectations into their work with the autistic client. By expecting
sexual abuse and looking diligently for it, the facilitators unknowingly make
the probability of finding indications of abuse even higher. However, these indications
by the client are more than likely from the facilitators own conscience.
♦ #3
Misuse of Authority Unintentionally, the facilitators have misused their
authority in their work with physically and mentally disabled children. This is
in violation of Standard 1.14 of the NASW code of ethics which states, "When
social workers act on behalf of clients who lack the capacity to make informed
decisions, social workers should take reasonable steps to safeguard the interests
and rights of those clients." These rights are the same as the rights of
all people such as freedom of religion, freedom of speech, and, most appropriately,
the right to privacy.
Consider the ethical dilemma if indeed the mentally disabled clients are not being represented accurately, accusations of sexual abuse could
lead to an undue violation of privacy. Also, if the facilitators are not capable
of representing the client's thoughts properly, then the facilitators are enacting
an excessive amount of authority. The facilitators are, unfortunately, not projecting
the thoughts of the clients, but merely foretelling their own expectations. Because
of their confidence in the efficacy of the procedure, facilitators do not consider
that the words typed are not the words of their client.
Although
this isn't a direct example of false memory generation, FC can serve as a metaphor
for the repressed memory search. Even though the facilitator might not be consciously
creating incidences of abuse, it is their words and not the client's that they
are typing. Likewise, therapists dealing with autistic children might not know
that they are implanting false memories of abuse into their clients.
♦ #4
The Case of Clever Hans
A simple demonstration can be seen in the case of Clever Hans, a horse
who supposedly could memorize geography, history, science, and literature. Bear
with me, as I know this seems a strange metaphor. Hans would tap his foot a certain
number of times for each letter. Many eminent psychologists and zoologists believed
in the horse's genius. However, it was soon discovered that Hans could not answer
questions when blind folded.
Hans was reading the reactions of the scientists and
his owners (such as a raised eyebrow or nod) that changed when he had reached
the correct number of hoof taps. Hans was being influenced by subtle cues just
as hypnotic subjects and supposed repressive memory clients can pick up whether
they are doing as their therapist expects.
Because clients believe in the infallibility
of their therapist, any kind of positive reaction from the therapist becomes a
sign of healthful growth. Clients will utilize this method, thinking they are
becoming more mentally healthy by fulfilling the therapist's wishes.
In
this section we discussed facilitated communication and its possible ethical misuse
related to the trauma of sexual abuse.
In the next section, we
will examine using dream interpretation and sleep paralysis as a mode of recovering
repressed memories.
Reviewed 2023
Peer-Reviewed Journal Article References:
Dayan, J., & Minnes, P. (1995). Ethical issues related to the use of facilitated communication techniques with persons with autism. Canadian Psychology/Psychologie canadienne, 36(3), 183–189.
Guest, J. D., & Ohrt, J. H. (2018). Utilizing child-centered play therapy with children diagnosed with autism spectrum disorder and endured trauma: A case example. International Journal of Play Therapy, 27(3), 157–165.
Himmerich, S. J., Ellis, R. A., & Orcutt, H. K. (2020). Application of PTSD alcohol expectancy symptom clusters to the four-dimensional model of PTSD: Support from moderations of the association between symptoms of posttraumatic stress and alcohol use. Psychological Trauma: Theory, Research, Practice, and Policy, 12(4), 347–355.
Quigley, S. P., Blevins, P. R., Cox, D. J., Brodhead, M. T., & Kim, S. Y. (2019). An evaluation of explicit ethical statements in telehealth research with individuals with autism spectrum disorder. Behavior Analysis: Research and Practice, 19(2), 123–135.
QUESTION
3
In what way can statistics that espouse the prominence of the sexual
abuse trauma in disabled autistic children create an ethical dilemma in
the use of FC? To select and enter your answer go to .
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