ASHA tells House Human Services panel RPM lacks evidence and raises authorship concerns

Diane Paul, senior director for clinical services in speech-language pathology at the American Speech-Language-Hearing Association (ASHA), told the Vermont House Human Services Committee that ASHA does not recommend the rapid prompting method, or RPM, citing concerns about prompt dependency and unresolved "authorship" questions.

"Information obtained through RPM should not be assumed to reflect the authentic communication of a person with a disability," Paul said, arguing that when another person controls or significantly influences the communication process "we cannot be confident that the words produced are truly those of the individual." Paul described RPM as a practice that commonly uses a handheld letterboard whose movement can inadvertently cue a communicator.

Paul distinguished RPM from other augmentative and alternative communication (AAC) options that ASHA supports, including stationary keyboards and speech-generating devices. She said the association endorses multimodal approaches and literacy instruction when the communicator's authorship of messages can be demonstrated. "We support communication approaches that aim to build independent self-directed communication," she said.

Committee members asked Paul whether peer-reviewed studies presented by a prior witness supported RPM. Paul said ASHA's systematic reviews found no scientific studies that met criteria for demonstrating RPM's validity and that published work to date has not established authorship testing results. "When we did our position statement, we did a systematic review of the literature and came up with what's known as an empty review," she said.

Members raised questions about accommodating people with motor impairments who cannot use a stationary device. Paul said if a person can point to letters, they can generally point to a stationary board or keyboard and urged use of stationary supports or props rather than a held board. On testing authorship, one committee member said simple checks (for example, asking a question the facilitator does not hear) would clarify whether the communicator is independently producing answers.

Paul emphasized ASHA's support for research into authorship verification and repeated that the association does not oppose spelling or letterboards per se, but objects to facilitator-dependent methods whose outputs cannot be reliably attributed to the communicator. She closed by urging evidence-based practice and offering ASHA as a resource for policymakers.

The committee indicated it will continue to consider testimony and related materials, including any peer-reviewed research and authorship protocols, before acting on House Joint Resolution 9.