Standards of Proof

Abstract

TASH's historic commitment to advocacy and science has enabled it to be a trusted voice for people with severe disabilities and their families. We review recent developments in the controversy over facilitated communication (FC) in light of major contextual continuities and changes in the past two decades. A series of scholarly reviews of the literature on controlled experiments have established a preponderance of evidence that FC is not reliably an expression from the individual who receives facilitation. Evidence indicates that the facilitator is the usual source of the text. We discuss the standards of proof of efficacy that must apply before an intervention should be endorsed by a national organization that aims to have a major impact on policy and practices. The need for controlled experiments in evaluation interventions is discussed. The central concern in establishing efficacy of a practice is to rule out other plausible explanations for an outcome. The main concern in establishing effectiveness is replication under real-world conditions. The science-based practices movement has been taken up by most of the helping professions contributing to the education and support of people with severe disabilities. The movement aims to identify practices and catalog them in terms of the trustworthiness of the evidence supporting them. The movement has led to establishing standards for determining when an intervention can be said to be efficacious. We urge TASH to join this movement and, in light of a commitment to science-based practices, argue that it should withdraw its stated endorsement of FC, which is not supported by science-based research. Keywords science based practices, research methods, values, facilitated communicationWe offer this article from our perspective as longtime TASH members deeply committed to the vision of TASH as an organization combining values and science to advocate ". . . for human rights and inclusion for people with significant disabilities and support needs-those most vulnerable to segregation, abuse, neglect and institutionalization" (TASH-About, n.d., para. 1). Our aim is to focus on the controversy over facilitated communication (FC). Our concern, however, goes beyond this particular issue. It more broadly addresses the importance for TASH of joining the "science-based practices" movement and to exercise due diligence in determining when a practice can be said to be science-based. TASH should uphold the widely accepted standards for judging the efficacy of a practice when such evidence exists. When it does not, TASH should

The Uses of Qualitative Research

“…These criteria include the following: (a) specific descriptions of participants and settings (which help to address context), (b) precise description and measurement of dependent variables, (c) measurement of the fidelity of implementation of the independent variable, (d) the use of a baseline phase, (e) specific steps to ensure internal validity and experimental control, and (f) attention to external and social validity. Singer, Horner, Dunlap, and Wang (2014) echoed these elements as essential for meeting the criteria for EBP and questioned the sufficiency of qualitative research designs in identifying EBP. However, Brantlinger, Jimenez, Klingner, Pugach, and Richardson (2005) asserted that experimental, qualitative studies provide a perspective, grounded in systematic study, that can meet the criteria of evidence-based knowledge produced for the explicit purpose of advancing policy and practice.…”

Establishing the State of Affairs for Evidence-Based Practices in Students With Severe Disabilities

“…In the present case, we are concerned about TASH's policies and support of EBPs. Singer et al (2014) suggested that for 40 years TASH has been at the forefront of promoting better quality of life for persons with severe disabilities and their families. Given that responsibility, it would not seem to be in the best interest of TASH (or any organization focused on the needs of persons with severe disabilities) to support practices which are not validated, and practices where there is contradictory, controversial, or insufficient convincing evidence.…”

“…In addition, in some cases, these unfounded procedures have done harm to individuals with severe disabilities by denying them proven behavioral, medical, or therapeutic interventions (Engber, 2015;Singer, Horner, Dunlap, & Wang, 2014;Travers, Tincani, & Lang, 2014).…”

“…In some cases, when established scientific evidence is lacking, unsupported or ineffective fads have been accepted as appropriate instructional procedures (e.g., Lilienfeld, Marshall, Todd, & Shane, 2015;Mostert, 2001Mostert, , 2010. In addition, in some cases, these unfounded procedures have done harm to individuals with severe disabilities by denying them proven behavioral, medical, or therapeutic interventions (Engber, 2015;Singer, Horner, Dunlap, & Wang, 2014;Travers, Tincani, & Lang, 2014).…”

Evidence-Based and Values-Based Practices for People With Severe Disabilities

“…At best, failed practices entail opportunity costs such that time and resources are wasted on useless efforts. At worst, disproven methods risk doing outright harm (Engber, 2015;Lilienfeld et al, 2015;Singer, Horner, Dunlap, & Wang, 2014). If they are practiced in the name of VBPs, they risk doing damage to an advocacy movement.…”