Interrogating Neurotypical Bias in Facilitated Communication, Rapid Prompting Method, and Spelling 2 Communicate Through a Humanistic Lens

Abstract

Purpose of ReviewMinimally-speaking autistic individuals can be effectively supported through evidence-based augmentative and alternative communication (AAC). Instead, some families/clinicians rely on facilitator-dependent techniques such as Facilitated Communication (FC), Rapid Prompting Method (RPM), and Spelling 2 Communicate (S2C). Research evidence unequivocally demonstrates that FC messages are generated by the neurotypical facilitator rather than the autistic individual. Although it is empirically unknown who is authoring messages generated with RPM or S2C, the technique has been compared along many dimensions to FC, and analyses of publicly available video-taped interactions of RPM and S2C indicate that facilitators tend to move the display and cue autistic individuals. Given the persistence and increased use of FC/RPM/S2C, this paper explores the consequences of neurotypical biases through a humanistic lens by drawing insights from postcolonial theory.Recent FindingsOur analyses reveal that there is a particular way in which the representation of autistic persons becomes a variation of the able or neurotypical society. If we admit the evidence that FC does not provide access to the voice of the person/s purportedly speaking, we would be committing “epistemic violence” against these persons by continuing these techniques. That is, we might do violence by distorting the will and desire of the very people that we seek to understand and include. Ventriloquism, a metaphor evoked by others to characterize facilitator-dependent techniques, is used here to scrutinize further the dynamics of the process involved in such situations.SummaryTo prevent (or at least minimize) the stifling of autistic voices through procedures resembling ventriloquism, violence to the will of autistic persons, and epistemic harms, all our disciplinary and clinical efforts should converge to enable the rights of autistic individuals who have little or no functional speech to express their will and to amplify their voices using evidence-based AAC methods.