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PTSD & other Traumas: Ethical Issues in Using Recall
3 CEUs PTSD & other Traumas: Ethical Issues in Using Recall

Section 3
Ethical Issues: Facilitated Communication in
Persons with Autism

Question 3 | CE Test | Table of Contents | PTSD CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, & MFT CEU

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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.

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.

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. 

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 CE Test.

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