Facilitated Communication and Other Fads That Won't Die

In Evidence-Based Communication Assessment and Intervention, Scott Lilienfeld and colleagues have an article titled The Persistence of Fad Interventions in the Face of Negative Scientific Evidence: Facilitated Communication for Autism as a Case Example."  Excerpts:

Traditionally, fads are defined as short-lived fashions that disappear about as abruptly as they emerged (Best, 2006; Paris, 2013; Vyse, 2005). Nevertheless, the fields of communication disorders, as well as clinical, counseling, school, and educational psychology, have often been bedeviled by a trend that has received scant attention— namely, the propensity of certain interventions to endure in the practice community well after researchers have discredited them (see also Kurzban, 2011, on “zombie psychology,” or erroneous ideas about the mind that will not disappear). In this article,
we examine a recent example of this phenomenon with an eye to better understanding its sources: the persistence and likely resurgence of facilitated communication (FC) for individuals with autism spectrum disorder (ASD) and other developmental disabilities.
....
Although FC was thoroughly discredited by controlled research by the mid-to-late 1990s, a convergence of evidence from multiple sources, including surveys of use, endorsement by academic and professional institutions, and coverage in the popular media, demonstrates that the FC meme has proven surprisingly resilient to scientific disconfirmation (see also Hagen, 2012). As conceptualized by Dawkins (1989), a meme is a unit of cultural transmission akin to a gene. Like many other memes, FC has survived in part by adopting new names (e.g., supported typing, assisted typing) or by mutating into newvariants (e.g., rapid prompting, informative pointing) in response to environmental changes (Gabora, 1996), such as adverse publicity. Indeed, the propensity of ineffective interventions to undergo only superficial rather than substantive changes in response to negative evidence is a frequent hallmark of pseudoscientific techniques, most of which lack the self-correcting property of scientific techniques (Finn et al., 2005; Lilienfeld et al., 2014).

• Best, J. (2006). Flavor of the month: Why smart peoplefall for fads. Berkeley, CA: University of California Press.
• Dawkins, R. (1989). The selfish gene. Oxford: Oxford University Press.
• Finn, P., Bothe, A. K., & Bramlett, R. E. (2005). Science and pseudoscience in communication disorders:Criteria and application. American Journal of Speech-Language Pathology, 14, 172–186.
• Gabora, L. (1996). A day in the life of a meme. Philosophica, 57(1), 53–90.
• Hagen, K. L. (2012). Speechless: Facilitated communication, a long-debunked pseudoscience, makes asurprising return. Skeptic, 17, 14–19.
• Kurzban, R. (2011, February 2). Zombie psychology:Bad ideas that simply refuse to die. The EvolutionaryPsychology Blog.http://www.epjournal.net/blog2011/02/zombie-psychology-bad-ideas-that-simplyrefuse-to-die  
• Lilienfeld, S. O., & Arkowitz, H. (2014). Why “just sono” doesn’t work. Scientific American Mind, 25,60–61.
• Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (2014). Scienceand pseudoscience in clinical psychology (2nd ed.).New York, NY: Guilford.
• Paris, J. (2013). Why is psychiatry prone to fads?Canadian Journal of Psychiatry, 58, 560–565.
• Vyse, S. (2005). Where do fads come from? In J. W.Jacobson, R. M. Foxx, & J. A. Mulick (Eds.), Controversialtherapies for developmental disabilities: Fad, fashion,and science in professional practice (pp. 19–30).Mahwah, NJ: Erlbaum.

Georgia: Pay Now or Pay Later

In Atlanta, WABE reports:

A popular state Senate bill requiring private insurers to cover autism treatment for young children was scrutinized Wednesday by members of a House committee. Representatives don’t want small businesses to pay more for insurance.

Under the bill, insurance companies would have to cover autism treatment coverage for children six years old and younger. Insurance Committee Chairman Richard Smith, R-Columbus, says small businesses can’t afford the extra costs.

“How do I go back home and say by the way, we just voted to raise your insurance premium,” Smith says.

But Sen. Charlie Bethel, R-Dalton, says the costs for taxpayers is much higher without the treatment because studies show early autism intervention is successful. He says it’s more expensive to educate in a special needs classroom versus a regular one.

“If that business is in that precarious of a financial position, I kind wonder whether they’re going to be able to pay their property taxes when all these children show up in elementary school and cost the district an extra $10,000, $12,000, $14,000 per year,” Bethel says.

Neurodiversity and Cure

Elizabeth Picciuto writes at The Daily Beast:

“The idea of a cure for autism doesn’t make sense. Autism isn’t a disease or an injury; it’s a neurodevelopmental disability that shapes our brains differently,” Julia Bascom told me via email. Bascom is director of programs for the Autistic Self-Advocacy Network, or ASAN, an advocacy organization run by and for autistic people.

She continued, “If I can’t talk, does it make sense to look for a pill for that, or should my speech therapist help me learn how to type or sign instead? Is flapping my hands or intensely and obsessively loving something ‘weird’ or wanting to be by myself the psychological equivalent of diabetes, or is it a natural and beautiful part of human diversity?”
...

Just as homosexuality used to be seen as a disorder but is now accepted as part of the range of human diversity, a neurodiversity proponent sees the classifying of autism as a disorder as a socially intolerant mistake. C.M. Lim is a research associate at the Centre for Biomedical Ethics, National University of Singapore who just published a paper on the debate between treating and accommodating autism in the journal Bioethics. He thinks autism and homosexuality are fundamentally disanalogous in this way.

“[Until] the 1970s, because of then-prevalent theories of homosexuality, it remained an important factual matter whether homosexuality was in fact associated with being defective in other areas of everyday life, including social effectiveness. It was important for members that they were in fact equally socially effective as heterosexuals. The neurodiversity claims do not assert for equal social effectiveness, but rather that autistics can be socially effective if society changes to accommodate their differences,” Lim told me in an email. “Also, what is practically involved in accommodating gay people and autistics differ significantly.”

The article links to this study:

 Dev Psychol. 2013 Jan;49(1):59-71. doi: 10.1037/a0028353. Epub 2012 Apr 30.
Deficit, difference, or both? Autism and neurodiversity.
Kapp SK1, Gillespie-Lynch K, Sherman LE, Hutman T.

The neurodiversity movement challenges the medical model's interest in causation and cure, celebrating autism as an inseparable aspect of identity. Using an online survey, we examined the perceived opposition between the medical model and the neurodiversity movement by assessing conceptions of autism and neurodiversity among people with different relations to autism. Participants (N = 657) included autistic people, relatives and friends of autistic people, and people with no specified relation to autism. Self-identification as autistic and neurodiversity awareness were associated with viewing autism as a positive identity that needs no cure, suggesting core differences between the medical model and the neurodiversity movement. Nevertheless, results suggested substantial overlap between these approaches to autism. Recognition of the negative aspects of autism and endorsement of parenting practices that celebrate and ameliorate but do not eliminate autism did not differ based on relation to autism or awareness of neurodiversity. These findings suggest a deficit-as-difference conception of autism wherein neurological conditions may represent equally valid pathways within human diversity. Potential areas of common ground in research and practice regarding autism are discussed

As the study forthrightly acknowledges, however, the sample was self-selected, so the results are not necessarily representative of opinion among autistic or non-autistic people.

More on a Journal Controversy

Paul Jump reports at Inside Higher Ed:

A senior psychology professor has strongly denied any wrongdoing after a blog highlighted what it claimed was his high self-citation rate in papers published in journals he edited.

Johnny Matson, a professor at Louisiana State University and an expert in autism, was the founding editor in chief of the Elsevier journals Research in Developmental Disabilities (RIDD) and Research in Autism Spectrum Disorders (RASD).

Earlier this month the journals came to the attention of Dorothy Bishop, professor of developmental neuropsychology at the University of Oxford. Bishop learned that she was on the editorial board of RASD, although she said that she had no recollection of agreeing to such a position. According to Matson, Bishop did give her permission to be added to the board.

Bishop then looked into the journals, setting out her resulting claims in a blog posting, including that Matson is an author on more than 10 percent of the papers published in RASD since the journal was established in 2007. At around that time his citation count also began to shoot up (according to the Scopus database, he has published 117 papers in RASD and 133 in RIDD, founded in 1987).

Bishop also claims that, according to Thomson Reuters’ Web of Science, just over half of Matson’s citations are self-citations -- much higher than the rates of other autism experts she looked at.

In a comment on the blog post, Michael Osuch, publishing director for neuroscience and psychology journals at Elsevier, insisted that under Matson’s editorship all papers in both journals were reviewed, and that his own were handled by one of the journals’ associate editors. He added that Matson and all associate editors stepped down at the end of 2014

Suspension Data

Christina Samuels writes at Education Week:

Eighteen percent of secondary students with a disability served an out-of-school suspension in 2011-12, according to data collected by the U.S. Department of Education, but behind that number are enormous variations in suspension rates at the district and state level.

A civil rights advocacy group's analysis of the data released Monday shows that Florida, at 37 percent, leads all other states in suspending students with disabilities at the secondary level. Florida also led the nation that year in suspensions overall, both at the elementary and secondary level, at 5 percent and 19 percent, respectively, said the Center for Civil Rights Remedies.

The state with the lowest suspension rate for secondary students with disabilities was North Dakota, at 5 percent, said the group, a part of the Civil Rights Project of the University of California, Los Angeles. (We've requested comment from Florida and will add it when we get it.) [UPDATE(4:40 p.m.): Cheryl Etters, the spokeswoman for the Florida Department of Education, said in an email that "decisions regarding discipline policies as well as student suspensions are made at the district level." She deferred to individual districts for any information on their suspension policies.]

Virginia Committee Votes to Raise Age Cap in Insurance Mandate

Jacob Geiger reports at The Richmond Times-Dispatch:

Members of the powerful Senate Commerce and Labor Committee on Monday unanimously backed a bill that could help 5,000 Virginia children receive health insurance coverage for autism treatments.

Del. Thomas A. “Tag” Greason, R-Loudoun, sponsored House Bill 1940. The measure would require health insurers, health care subscription plans and health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorders in children ages 2 to 10.

The bill passed the House this month on a 63-35 vote. Virginia is one of 38 states that require health insurance plans to cover autism treatment.
...
After the committee vote, Greason told supporters of the bill that he expects it to quickly receive Senate approval. Because of the amendment, the bill must be approved again by the House of Delegates. Greason said he did not anticipate any problems getting that approval before the Assembly session ends this weekend.

Four years ago the delegate sponsored a bill that led to the current law which mandates coverage for children age 2 to 6.

Autism Speaks, an advocacy group for children with autism and their families, said the extension in coverage is needed because the average age for diagnosis in Virginia is 6 to 7.

Stan Lee

A number of posts have discussed autism and popular culture. From ComicBook.com:

Stan Lee is best known for his writing skills, not his artistic skills. However, that fact didn’t stop the Marvel Comics legend from drawing Spider-Man for an eight-year-old autistic boy, who is a big fan of the character.

According to the New York Times, one of Stan Lee’s neighbors approached him about drawing a Spider-Man picture for eight-year-old Jamel, after reading an article about him. Jamel has autism, and he didn’t speak until he was in preschool. Jamel recently celebrated his eighth birthday with a huge Spider-Man party.

“This was a unique experience,” explained Lee. “Corky [Lee's neighbor] called me and said there was a little boy. She wanted a sketch, so I did one.”

Lee also quipped, “I’m not known as an artist, which is lucky for the world.”

Lee’s neighbor then mailed the sketch to a New York Times reporter, who delivered the framed sketch to Jamel in his family’s East Harlem apartment.