The House, Thursday, February 8, 2024

Rep. Jim Kofalt (R - Hills 32)Thank you, Mister Speaker. Mister Speaker I would like to ask my colleagues to imagine for a moment what it might be like if you were never able to speak. You have the capacity for language. You can understand it and you can even think it, but for your entire life, you have never been able to speak. Now, imagine on top of that you have a neurological condition that inclines you not to make eye contact with people. People around you see someone who appears to be staring off into space. They assume perhaps that you are not very intelligent. This is the fate that many people with autism and specifically with apraxia suffer from. They are locked in a prison of non communication for their entire lives. Now imagine that somebody comes to you and says I know you are smart. I know you are in there. I have found a way to teach people to communicate, people like you and I'm going to work with you, and we can do this. I have never met somebody yet who can't do it. Gregory Tino, a young man who lives in the Philadelphia area describes that as the day that his life began. He wrote that several years ago people thought he had the intellect of a 3-year-old, then he learned to use a letter board. He has since learned how to use a keyboard. He types on a keyboard. His iPad and his Apple iPhone speak for him. Gregory has written four books. He has his own blog, The Autistic Mind Finally Speaks. In the hearing on this bill, we had people ask, so in the early stages of this process do you have to teach people letters? They said oh no, they already know the letters. In fact, one parent testified that her son knows Spanish. We have no idea how he knows Spanish, but he likes to answer some of the questions in Spanish. This bill would create a modest pilot program to make Spelling to Communicate available to families in New Hampshire. The total money authorized under this bill would be $250,000 over two years, roughly the equivalent of one full time person for two years. After three years, the bill repeals itself. There were two primary arguments made against this bill. Number one, this is facilitated communication. The answer is no it's not. There is a methodology called facilitated communication that was discredited years ago because the communication was not coming from the person with autism. It was coming from the helper. That was discredited. Spelling to Communicate enables free and independent communication. I've seen it myself. People typing on a keyboard. No one is sitting with them. No one is helping them. They are fully communicating, answering questions from an audience. The second criticism is that there is a lack of studies. There are a number of studies in progress about this methodology. I would argue though that for $250,000 we could invest in a tremendously promising innovation. Innovation doesn't wait five, ten, fifteen years for a raft of peer reviewed studies to come out. We have an opportunity today for a very modest amount of money to create a program and expand options for people and families with autism. I'm asking you. I'm asking my colleagues to give innovation a chance. The much better rebuttal to the argument that there are no peer reviewed studies is the long list of highly accomplished people who have discovered this and who's lives have changed as a result. I mentioned Gregory Tino who has a blog and who has authored four books. Vince Rinicella is a political blogger. He aspires to be the first non speaking US Senator. J.B. Handley co-authored a book called Underestimated and was the subject of, one of many subjects of the award-winning film Spellers that came out early last year. Ido Kedar whose book, Ito in Autism Land, has become reading material for courses on disabilities studies. Thomas Pruyn, disability rights activist and blogger. Mitchel Robbins, another disability rights activist who describes this as a human rights issue. Ian Nordling, who has been named to the Youth Advisory Council in Herndon, VA and sits on the advisory council of the I-ASC. Hari Srinivasan, who was told over and over again that he would not amount to much and he certainly would not go to college. Today he is a PhD student in UCAL Berkeley's prestigious psychology program. His writing has appeared in Time, Newsweek, Fortune, the Boston Globe, Psychology Today, The Daily Californian, two anthologies and numerous other publications. Elizabeth Bonker, she has autism and has never been able to speak. She uses an iPad to type. She was named valedictorian in 2022 of Rollins College in Florida. She has since gone on to found an organization called Communication4All. Elizabeth describes this by saying that communication is a human right. That is the mission of her organization. She also sits on the Advisory Board of the National Autism Society as Hari Srinivasan. That doesn't include the numerous New Hampshire residents whose lives have been changed by this. What I hear from parents is that for the first time my son or daughter can explain to the doctor exactly what is wrong with them. It gives them dignity. I heard a story of one young man. The first thing he said when he could spell was, "Mom, could you ask dad to stop telling me, asking me if I need to go potty. I'm 21 years old." This is about dignity. It's about independence. I can't tell you how many people I've heard from who said we have worried all of our lives what is going to happen to our son or daughter when we are not around any more. For the first time ever, we know that he can communicate. She can communicate. They won't have that utter and complete dependency on us anymore. If this bill passes today, it will go on to the Finance Committee. This House will have another opportunity to hear about the bill, hear objections to the bill and vote on it again. I'm asking my colleagues today to give innovation a chance. Give people with autism and apraxia a chance and press the red button so that an alternate motion can be made. Thank you, Mister Speaker.

Rep. Corinne Cascadden (D - Coos 5)Thank you, Mister Speaker. HB 1553 is to allow the Department of Education to purchase a commercial program to service students who are identified on the autism spectrum or diagnosed with apraxia. The program, Spelling to Communicate, is intended for students who are enrolled in an individu- alized education program and not necessarily public schools. Autism spectrum disorder means a developmental disability significantly affecting verbal or non-verbal communication and social interaction, usually evident by age 3. Autistic children have difficulty understanding what others are thinking or feeling, get anxious about social situations, have difficulty making friends or prefer to be on their own. They may seem blunt, rude or not interested. Behavioral approaches are implemented on changing behaviors by understanding what happens before and after that behavior. Behavioral approaches have the most evidence for treatment systems of autism spectrum disorder. They've become widely accepted among educators and healthcare professionals and are used in many schools and treatment clinics. A notable behavioral treatment for people with autism spectrum disorders is called applied behavior analysis, known as ABA. ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. The progress is tracked, and it is measurable. Apraxia on the other hand is a speech disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though the command is understood, and students are willing to perform the tasks. The best treatment known is sign language and/or digital literacy via keyboarding on a computer. Now comes Spelling to Communicate, a program that implements a facilitated communication. The technique of facilitated communication requires an adult to hold a letter board and the student must use a pointer to spell out the words. It's reinforced by physically moving the student's hand. This method has been proven ineffective by multiple scientific studies. The American Speech-Language-Hearing Association, also known as ASHA, does not support this program because it requires physical guidance and prompting, and it creates dependence on another person. It lacks research and scientific evidence and focuses on spelling, not speech. The Association for Science in Autism Treatment has conducted many studies in the 1990's and the 2000's on facilitated communication programs such as Spelling to Communicate. Repeated evidence refuted the use of this program. Regardless of the name of any facilitated communication program that requires ongoing support from a facilitator, the Association opposed and rejected. Spelling to Communicate should not be considered as a valid means of communication. After having a discussion with a board-certified behavioral analyst who specializes in services for children with autism, she was clear that, "It is unfathomable that a New Hampshire department would consider this program as a technique that has no scientific research to support it and has been scientifically discredited as a technique." Now, this is not to say that Spelling to Communicate didn't work with some. Why would we want our public dollars to be spent on such a program that has no scientifically based evidence of positive results and involves physical contact and reinforcement. This program and house bill is not in the best interest of our students. I urge my colleagues to support the bipartisan committee recommendation to ITL House Bill 1553. Thank you, Mister Speaker.

Speaker PackardThe motion before us is the majority committee report of Inexpedient to Legislate on HB 1553. A division has been requested. Rep. Kofalt has requested it. Members take your seats. The House will be in order. The motion before us is the majority committee report of Inexpedient to Legislate on HB 1553. This is a division vote. The Chair recognizes Rep. Kofalt for a parliamentary inquiry.

Rep. Jim Kofalt (R - Hills 32)Thank you, Mister Speaker. Mister Speaker, if I know that numerous Spelling to Communicate beneficiaries are spelling and communicating independently with keyboards. Furthermore, if I know this bill does not offer grants to any single vendor or organization. If I know that the National Autism Society has come out in support of this bill. And if I know that this would make New Hampshire the first state in the country to formally introduce Spelling to Communicate into our schools. And, finally Mister Speaker, if I know that this bill will go to Finance and it will come back to the House and we will have an opportunity in the meantime to learn a great deal more about Spelling to Communicate, would I then press the red button so that a new motion can be made? Thank you, Mister Speaker.

Speaker PackardThe Chair recognizes Rep. Balboni for a parliamentary inquiry.

Rep. Peggy Balboni (D - Rock 38)Thank you, Mister Speaker. If I know as a former special education teacher, that public school districts already provide a variety of evidence-based speech and language services to students with Autism and Apraxia based upon their individual needs. And I know that the American Speech-Language- Hearing Association, the American Association on Intellectual and Developmental Disabilities and other medical organizations do not support facilitated communication programs like Spelling to Communicate because there is no scientific research to support its efficacy, then would I now press the green button to agree with the bipartisan committee recommendation to ITL? Thank you.

Speaker PackardThe motion before us is the majority committee report of Inexpedient to Legislate on HB 1553. This is a division vote. If you are in favor, you'll press the green button. If you are opposed, you'll press the red button. Voting stations will be open for 30 seconds. Have all members present had an opportunity to vote? The House will attend to the state of the vote. 202 voting Yea, 178 voting Nay the committee report is adopted.