Time for my promised close, critical look at specific instances of facilitated communication—FC for short.
But first, a preliminary note. In being critical in what is an extremely sensitive area, I don’t want to reveal names of kids and parents. I’ll provide links to material that’s been made publicly available–stuff posted on the Internet, mostly by or in collaboration with family members. But in what I write here, I’ll be avoiding names or abbreviating them.
Let’s start with a particular scene of facilitated communication reported a few years ago by the University of Pennsylvania college paper:
“Am I misusing college for my personal health?” D., 19, typed out on an iPad during a November interview. He guided his interpreter’s hand over the letters on an app he and his parents developed called iMean. He needs a steady hand to help him concentrate his thoughts into words and keep his autism from getting in the way of communicating. D., who takes two classes at Penn through the College of Liberal and Professional Studies’ Young Scholars program, has come to think of education as a form of healing.
“Popcorn!” D. would shout out in the middle of the interview, rapidly rubbing his thumbs against his fingers and shaking his head loosely. “Pop-corn,” he repeated slowly, the syllables snapping off his tongue like bursting kernels. At the same time, D. would be typing an eloquent reply about the nature of language and communication on his iPad with the help of his interpreter — either his father M. or 2014 College graduate K.
Here we see two tracks of communication: the facilitated track, which involves typed responses to questions about the nature of language and communication, and the un-facilitated track, which involves oral outbursts of “popcorn!” How do we reconcile these?
According to the research on FC, the most likely scenario here is that, while D is independently articulating the word “popcorn,” it’s one of his facilitators who is formulating the response about language and communication.
Furthermore, the research suggests, the facilitators are doing this unwittingly—i.e., without realizing that it’s their words rather than D’s. In a January, 2018 Forbes article about the abuses of FC, there’s a discussion of former facilitator Janyce Boynton:
Boynton believed at the time that what she was doing was real–as she puts it, she simply “did not want to believe that FC was a hoax.” She also makes it clear that many of the people she learned from sincerely believed that FC was real. Boynton herself was crushed when she realized that she–and not the severely autistic child who had been entrusted to her care–was typing all the messages.
D’s FC involves hand-over-hand guidance; watching this in action, it’s quite hard to tell who is guiding whom. One thing to look for is who is more consistently focused on the keyboard: the facilitator or their client.
Here are a couple of videos of kids using this kind of FC:
Other, more subtle forms of FC involve one or more of the following:
Variant I—The facilitator holds and moves the keyboard:
The facilitator holds up a letter board or keyboard in front of the client, and the client pushes on letters. Here there’s no hand-over-hand guidance, but generally the keyboard isn’t held still and, as the facilitator shifts it around, he or she may be unwittingly cuing the child about which letter comes next. In addition, some facilitators call out the letters as they are typed, sometimes milliseconds before the client has actually clearly made the selection.
Though typically the motivation behind FC is that the child isn’t able to speak, the last two videos feature a child who can–as you see from her pronunciation of the letters and from her brief words at the beginning of the last video.
Variant II—The facilitator pre-selects the responses:
The facilitator holds up two word cards in front of the client and the client points at/touches one of them in answer to a question. Here, too, the client may be cued by subtle movements of the word cards closer to or further away from his/her extended finger. We see this with the Rapid Prompting method, for example:
- example eight (4:37-)
Variant III: Word prediction and other subtle prompts
Here the screen is stationary and the typing independent–but with two sources of facilitation:
- a parent or therapist sitting nearby, eyes glued to the screen, sometimes with a hand on the client’s shoulder, occasionally giving oral prompts.
- some sort of word prediction software, such that the client only needs to type a few letters and then select the whole word from a small number of choices.
In the last video, we don’t see what’s actually being typed, and it looks like the child is hitting the same spot on the keyboard over and over again except when moving rightwards and apparently clicking a “speak” button.
Many of these cues are so subtle that it’s perhaps hard to believe that they’re really that influential. But then we must remember Clever Hans, the horse that could do arithmetic:
The horse got the right answer only when the questioner knew what the answer was and the horse could see the questioner. He observed that when [owner] von Osten knew the answers to the questions, Hans got 89 percent of the answers correct, but when von Osten did not know the answers to the questions, Hans answered only six percent of the questions correctly.
Pfungst [Oskar Pfungst, the psychologist investigating the case] then proceeded to examine the behaviour of the questioner in detail, and showed that [bold-face added] as the horse’s taps approached the right answer, the questioner’s posture and facial expression changed in ways that were consistent with an increase in tension, which was released when the horse made the final, correct tap. This provided a cue that the horse could use to tell it to stop tapping. The social communication systems of horses may depend on the detection of small postural changes, and this would explain why Hans so easily picked up on the cues given by von Osten, even if these cues were unconscious.
True, this is about horses, not humans, but then:
Pfungst carried out laboratory tests with human subjects, in which he played the part of the horse. Pfungst asked subjects to stand on his right and think “with a high degree of concentration” about a particular number, or a simple mathematical problem. Pfungst would then tap out the answer with his right hand. He frequently observed “a sudden slight upward jerk of the head” when reaching the final tap, and noted that this corresponded to the subject resuming the position they had adopted before thinking of the question.
Might there be similar physical cues in the various FC videos?
In my next post, I’ll move on to the facilitated messages. We’ll look at the various phrases and sentences that are being attributed to these and other individuals with autism, and what may really be going on underneath it all–and why.