Why do some autism experts fall for Facilitated Communication?

Watching autism neurologist Margaret Bauman being taken in by Sue Rubin’s facilitated communication in Autism is a World got me thinking about other neurologists who have suffered similar fates. One in particular has long stood out to me: Mike Merzernich. After studying Tito, son of Soma, founder of the Rapid Prompting Method variant of FC, Merzenich has concluded that “Tito is for real,” and “I think there could be thousands, maybe tens of thousands of Titos out there.”

How can people who should know better about the neurology of autism have been so deluded? Doesn’t their own brain research conflict with the underlying assumptions of FC—namely, the assumption that autism is primarily a movement disorder?

People like Bauman and Merzenich show us just how compelling the latest forms of FC have become. In both Sue Rubin’s and Tito’s cases, the cues are subtle enough that those who aren’t trained to look for them—e.g., neurologists, as opposed to psychologists—may be completely oblivious. And if they’re sufficiently sure of themselves, and/or sufficiently incurious about the extant empirical research discrediting FC, they may remain oblivious, and stubbornly so, even as subsequent rigorous experiments, or the lack thereof, fail to support their views. [1]

It’s noteworthy that those most concerned about and outspoken against FC aren’t the hard scientists, but (assuming they haven’t drunk the FC Kool-Aid for personal reasons [2]) the psychologists, linguists and psycholinguists—especially those who know something about cuing and/or language acquisition. 

It’s also noteworthy that the the bulk of the skeptics aren’t hard-core academics at all, but practitioners: behavioral specialists, speech-language pathologists (with one ignominious exception), reading specialists, and (with one especially notable example, the founder of this very website), former facilitators. 

And, last but not least, magicians.

Thinking about these various professional categories, I’d say the key ingredients of FC skepticism are some combination of:

  1. awareness of the clinical criteria for autism (no, autism is not a motor disorder or a disorder of “intentional action”)
  2. knowledge of cuing effects and their power (knowledge of Clever Hans)
  3. an ability to discern subtle cuing (the subtle board movements, the hand on the thigh, the shifting head or torso…)
  4. familiarity with the Ideomotor Phenomenon (the facilitator doesn’t have to be consciously directing the messages in order to do so)
  5. awareness of the fallacy of “naive realism” (we can’t always trust what we see with our naked eyes)
  6. awareness of the prerequisites for language acquisition (people can’t just sponge it up without making eye contact and looking at what the speakers around them are looking at)
  7. awareness of the prerequisites for literacy acquisition (people don’t learn to read and spell simply by being surrounded by books, magazines, and print-rich packaging and advertisements)
  8. awareness of the prerequisites to knowledge acquisition (you can’t sponge up history and politics from a radio tuned to NPR without having had some prior structured learning of a core of basic background knowledge)

And, beyond all this, it helps to have a generally skeptical outlook about what one sees and hears.

I used to think that hard-core scientists would tend, at least, to meet that last criterion. Isn’t hard science all about waiting for hard evidence before drawing conclusions? 

But the more I think about it, the more it strikes me that there’s no reason why, say, a cell biologist, regardless of how empirically grounded and analytically rigorous her conclusions about cells, would think to doubt what she sees with her naked eyes outside her laboratory.

No matter how high her IQ and how logical her thinking, if may well strike her as unequivocally obvious that Tito, Sue Rubin, Ido Kedar, and Lucy Blackman are typing independently with their parents merely sitting nearby. 

No matter how high her IQ and how logical her thinking, it might take some magic—or a magician—to convince her otherwise.

[1] Bauman actually did co-author a single-subject FC study back in 1996 (Weiss, M. J., Wagner, S. H., & Bauman, M. L. (1996). A validated case study of facilitated communication) which had multiple design flaws. (Detailed concerns are listed here). She appears to have had nothing specific to say about the much more rigorous studies of n > 1 that roundly invalidate FC.

[2] Say, because they or someone close to them has a non-verbal child who uses facilitated communication.

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