Why is Facilitated Communication making a comeback? (Part II–a very bleak post)

It’s now time, in this series on autism, neurodiversity, and language learning, to return to two key criteria for autism in the most recent DSM (the DSM V), each of them tapping into deficits in what’s called Joint Attention:

  • Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
  • Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

The consequences of these deficits are potentially devastating. We’ve already considered (starting here) how, the more severe these symptoms, the more impaired any kind of language will be, whether spoken, written, typed, or signed; whether we’re talking about producing language or comprehending that of others. At the most severe end of the autism spectrum, there is an inability to use or to comprehend any form of symbolic language. This, in turn, limits communication to body language and (in cases where the person can grasp cause and effect and pictorial representations of objects/actions) to touching picture icons to communicate basic wants.


Such is the hard reality of severe autism, and of the severe limitations in Joint Attention that go along with it. But it gets worse.

Limited or absent Joint Attention means a limited connection to other human beings. It means a limited ability to grasp others as conscious entities. It means that when the person is communicating through body language or by touching picture icons, that communication is more a matter of expressive communication (as when a newborn cries out of distress) or of causal behavior (as when one pushes a button to ring a bell) than it is of deliberate, intentional communication. Absent Joint Attention, a severely autistic individual who cries out or bangs his or her head isn’t intentionally transmitting a message to another person, in the way that someone who yells “I’m really upset right now” might be. Absent Joint Attention, a severely autistic individual who pushes someone away or pulls them towards a desired object isn’t intentionally communicating “Go away” or “Give me that” in the sense of consciously attempting to get those words into the other person’s head. Absent Joint Attention, a severely autistic person who points to a picture of a pretzel on a Dynavox isn’t intentionally attempting to cause a thought about a pretzel to occur to someone nearby.

Limited or absent Joint Attention means limited or absent consciousness of other people’s minds; limited or absent consciousness of other minds, in turn, means limited or absent intentional communication.

But who, in their right mind, doesn’t wish it were otherwise? When we witness a person who makes little to no eye contact, who doesn’t produce words (in speech, text, or sign language), and who seems unresponsive to the language of others, isn’t it preferable to believe that this person, rather than having limited awareness of all these things, is actually fully aware but locked in? That their minds are fully intact, and that only their bodies are holding them back? That they desperately want to connect with us, if only their bodies would let them?

Who, in their right mind, wouldn’t prefer to believe that, if only such people were given the right kind of physical support, they would eventually communicate things like:

“The beauty of my mind is often ignored by my difficult body”

“I want people to understand that not speaking is not the same as not thinking”

“Until I learned to read and write, people thought I had no mind.”

I’ve selected these three statements deliberately. Each one is a statement that is purported to have been intentionally communicated by someone who is–whether rightly or wrongly–considered severely autistic and who uses–whether deliberately or only apparently–one or more variants of facilitated communication. In my next post, we’ll take a closer look.

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