Here, as promised is the full text of my critique:
Jaswal et al’s Eye-tracking Reveals Agency in Assisted Autistic Communication (Scientific Reports, May, 2020) reports an experiment that tracks the eye movements of autistic individuals while they point to letters on held-up letterboards in response to questions. The eye-tracking data, the authors argue, indicates that it is the autistic individuals, rather than the person holding up the letterboard, who are the agents/authors of the typed-out messages. This study, however, is based on faulty assumptions that undermine both its rationale and its conclusions: assumptions about test performance; about prerequisites for certain linguistic skills; about a disconnect between speech-based vs. typing-based communication skills; about what it would take for someone to point to letters based on cues from the person holding up the board; and about the study’s central premise: the agency of eye gaze.
The held-up letterboard is one of several related, controversial interventions used with non-speaking individuals. In these interventions, a “facilitator” or “assistant” holds or touches part of the person’s body, or holds up a keyboard or letterboard for them, while the person points to letters and spells out messages. Both contact-based facilitation and held-up-board-based assistance leave wide open the possibility of cuing—e.g., by physical pressure or board movement—and thus raise questions about who is directing the messages. The ideomotor illusion can cause facilitators/assistants to unwittingly project their own movements onto the person they are assisting; Clever Hans-like cuing effects may convey subtle signals that further guide typing. These psychological phenomena raise the possibility that messages are unwittingly directed by the facilitator/assistant.1
The most direct way to validate authorship is through “message passing” tests involving prompts that the facilitator has not seen ahead of time. For contact-based facilitation, studies dating back to the 1990’s indicate that facilitators do in fact guide typing.2,3,4 Results show that the overwhelming majority of typed responses—when they occur—are based on prompts that the facilitator witnessed, and not on prompts that only the typist witnessed, strongly suggesting that the facilitator is the actual author. As for assistance via held-up letterboards, practitioners have yet to participate in rigorous, published, message passing experiments.5
To explain why they have eschewed message passing tests in favor of expensive eye-tracking equipment and painstaking coding of eye-gaze data, Jaswal et al claim that message-passing tests are problematic. They state that (1) “tests that fail to take into account a group’s unique developmental history can underestimate or misrepresent the abilities of members of that group”; (2) non-speaking autistic children miss out on communicative experiences necessary for message passing; and (3) anxiety and lack of familiarity with the test setting may further impede performance.
In support of the first claim, the authors turn to the field of cultural studies, citing a classic paper by Labov and another by Cole and Bruner that date back to the 1970s. These papers discuss how test performance may be affected by cultural context.6,7 The authors also cite Heinrich and Norenzayan, who discuss how empirical psychology has been has been skewed by subjects coming predominantly from industrialized western societies.8 Neither these papers, nor Jaswal et al, connect the dots to message passing tests or to individuals with autism.
Regarding the second claim, the authors state that children who can talk, in contrast to non-speakers, “receive years of prompting and feedback from adults on how to report information their interlocutor does not know.” This, they assert, “is the essence of a message passing test.” (Actually, it is information that is unfamiliar to the facilitator, not to the person asking questions, that is essential to message passing). Their one citation, Nelson and Fivush (2004), specifically addresses autobiographical memory; message passing tests typically involve semantic memory (identifying the names of objects; answering factual questions).9 Furthermore, as Nelson and Fivush note, children report autobiographical memories “at about 18-20 months of age”—well before the hypothetical “years of prompting and feedback” that the authors claim is prerequisite.10 As for reporting information that their interlocutor does not know, as Baker and Greenfield (1988) found, children as young as 17 months, even at the one-word stage, use language to highlight new information.11
The author’s third claim is that the “unfamiliar experimental setting”, combined with “elevated levels of anxiety common in autism”, may help explain difficulties with message passing tests. The anxiety defense is belied by (1) the care taken in many of the tests to make subjects as comfortable as possible12 (in particular, there is no mounting of eye-trackers to subjects’ heads), and (2) the unlikelihood that anxiety would lead—let alone enable—subjects to type out something that the facilitator saw and the typist didn’t. As for “unfamiliar test setting” issues, the authors cite Cardinal et al’s (1996) study in which message passing performance improved over multiple sessions.13 Error rates, however, remained high, and the study has been criticized for several design flaws.14
Jaswal et al, moreover, fail to explain why the subjects were able to deliver the often lengthy responses to the open-ended questions reported in this study when pointing to letters on a letterboard via hunt-and-peck-style typing, but not when articulating words through speech (a much less time-consuming process). The authors state that “all but one participant was reported to be able to speak using short phrases or sentences” but “none could respond verbally to open-ended questions of the type they were asked in this study.” There is, however, no officially recognized language disorder that combines extant oral skills with pragmatic skills that only emerge during hunt and peck typing.
What about the possibility that experimental subjects are pointing to letters based on cues from the assistant? According to the authors:
On a cueing account of a letterboard user’s performance, the assistant would need to deliver a cue that identified which of 26 letters to point to, and the user would need to detect, decode, and act upon that cue. Each of these steps would take time and would be subject to error, especially given the subtlety of the cues the assistant is hypothesized to deliver and the 26 cue-response alternatives.
Completely overlooked here is the most obvious means of cuing: board movements that bring specific letters closer to the person’s extended finger. This involves no decoding whatsoever and speeds up rather than slows down the typing.
Subtle board movements are evident in the study’s supplemental videos, and this highlights a final problem. Even if you accept the authors’ justifications for eschewing message passing tests, and even if you somehow rule out the possibility of board-holding assistants providing cues, a non-stationary letterboard calls into question the study’s central premise: the purported agency of the subjects’ eye gaze. Were subjects intentionally looking at letters, or were letters shifting into their lines of sight? That is something that no eye-tracking equipment, no matter how sophisticated, can answer.
Unless, of course, the board is placed on a stationary surface. But why stop there? If the ultimate goal is to test authorship via eye gaze, why not do so directly, by using the kind of eye-tracking software that lets subjects type with their eyes rather than their fingers—as hundreds of children around the world are successfully doing every day.1. Wegner, Daniel M., Fuller, Valerie A., & Sparrow, Betsy Clever Hands: Uncontrolled Intelligence in Facilitated Communication. Journal of Personality and Social Psychology. 85, 5-19 (2003).
2. Moore, S., Donovan, B., & Hudson, A. Facilitator-suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders, 23, 541–552 (1993).
3. Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. An experimental assessment of facilitated communication. Mental Retardation, 31, 49–59 (1993).
4. Saloviita, T., Lepannen, M., & Ojalammi, U. Authorship in facilitated communication: An analysis of 11 cases. Augmentive and Alternative Communication, 3, 213-25 (2014).
5. Tostanoski, A., Lang, R., Raulston, T., Carnett, A., & Davis, T. Voices from the past: Comparing the rapid prompting method and facilitated communication. Developmental Rehabilitation, 17, 219–223 (2014).
6. Labov, W. The logic of nonstandard English in Language and Poverty: Perspectives on a Theme (ed. Williams, F.) 153–189 (Academic Press, 1970).
7. Cole, M. & Bruner, J. S. Cultural differences and inferences about psychological processes. Am. Psychol. 26, 867–876 (1971).
8. Henrich, J., Heine, S. J. & Norenzayan, A. The weirdest people in the world? Behav. Brain Sci. 33, 61–83 (2010).
9. Nelson, K. & Fivush, R. The emergence of autobiographical memory: A social cultural developmental theory. Psychol. Rev. 111, 486–511 (2004).
10. Nelson, K. & Fivush, R. The emergence of autobiographical memory: A social cultural developmental theory. Psychol. Rev. 111, 484 (2004).
11. Baker, N. D. & Greenfield, P. M. The Development of New and Old Information in Young Children’s Early Language. Language Sciences, Vol 10, No 1, 3-34, (1988).
12. Saloviita, T., Lepannen, M., & Ojalammi, U. Authorship in facilitated communication: An analysis of 11 cases. Augmentive and Alternative Communication, 3, 213-25 (2014).
13. Cardinal, D. N., Hanson, D. & Wakeham, J. Investigation of authorship in facilitated communication. Ment. Retard. 34, 231–242 (1996).
14. Mostert, Mark P. Facilitated Communication Since 1995: A Review of Published Studies. Journal of Autism and Developmental Disorders, Vol. 31, No. 3, 287-313 (2001).
In the comments below, I will post the reviewer responses I received from Scientific Reports, along with their reasons for not publishing this critique.