For those who do not know, I work at a program which, among other things, provides services in training autistic persons. I admit that I’m not an expert in the area of autism, and there is much that I do not know or understand, but my experience in this area has exposed me to some very disturbing psuedoscientific claims.
One of the most disturbing that I have seen is something known as “Facilitated Communication.” Facilitated Communications (Or FC, also known as assisted typing, assisted communications, alternative and augmentative communication and by other similar terms) came about in the 1970’s after the hypothesis was advanced that persons with autism do not have any kind of mental, emotional or cognitive disability, but instead are perfectly capable of understanding and interacting with the world as anyone else, but cannot do so because their body will not let them or because the interface between their brain and body somehow distorts their actions.
This idea is entirely false. Autism does not involve any physical disability and persons with autism generally have perfectly functional fine motor control and are entirely capable of manipulating objects, typing and so on. In reality, autism is a developmental condition that has an especially pronounced effect on the development of social skills and communications. Persons with autism commonly lack the ability to communicate and to properly perceive and display appropriate social cues.
The effects of autism can be extremely mild or severe. Indeed, there is an entire “spectrum” of possible effects and different individuals experience these differently. Some individuals are perfectly capable of following directions, interacting with others and behaving normally in most situations, but do experience some level of difficulty in social situations, anxiety and difficulty with subtle cues. Others are more severely disabled, unable to understand basic communications or conduct themselves in a normal manner. Some become obsessed with repetitive behavior, are prone to being withdrawn or cannot understand basic tasks and normal instructions.
It’s not uncommon for autistic to be speech impaired. Again, this runs the gamut. Some can speak as well as anyone else, while others have trouble finding words and correctly using grammar. It’s not uncommon for communication-impaired autistic to become extremely agitated when they are asked to speak more than a few brief words. Some autistic are able to understand spoken communications with reasonable accuracy, but cannot find the proper words to express concepts back.
It is important to recognize that these issues are not the result of some kind of physical problem. Although genuine pathological speech difficulties can exist in autistic, this is not the reason why severely autistic persons cannot communicate easily. The problem exist regardless of the medium. An autistic person who cannot find the proper words to speak will not be able to find the proper words to type or point to them on a chart.
Facilitated Communications ignores this proven fact. Its champions claim that autistics simply need some help in getting their fingers to the correct key or the correct letter on a chart. As such, a “facilitator” is provided whose job it is to help guide their hand to the correct letter. Of course, this presents a huge problem. As long as the facilitator is guiding their hand, it’s impossible to know whose choice it was to pick a given letter or word. In fact, in many cases, just looking at the action, it seems undeniable that the facilitator is the one moving their hand.
This does not mean that the facilitator always knows that they are making the decision, the ideomotor effect plays a big role and can make it seem very convincing, even to the facilitator, that the words are coming from the disabled individual. Worse still, most disabled individuals embrace the attention and praise that facilitated communications offers them, even if they are not really communicating.
Regardless of what the facilitators and clients may say (and you can’t tell who is saying it anyway), double-blind studies have provided rock-solid evidence to contradict these claims.
Amazingly, despite this evidence being available back in 1993, Facilitated Communications has only grown in popularity.
Facilitated communications has some very staunch advocates. Worse still, the otherwise respectable University of Syracuse has a very active program in promoting FC. Millions of dollars have been sunk into this and similar programs and the result has been the widespread use of this largely discredited method.
Facilitated Communication (FC) or Supported Typing is a form of alternative and augmentative communication (AAC) in which people with disabilities and communication impairments express themselves by pointing (e.g. at pictures, letters, or objects) and, more commonly, by typing (e.g. in a keyboard). The method involves a communication partner who may provide emotional encouragement, communication supports (e.g., monitoring to make sure the person looks at the keyboard and checks for typographical errors) and a variety of physical supports, for example to slow and stabilize the person’s movement, to inhibit impulsive pointing, or to spur the person to initiate pointing; the facilitator should never move or lead the person.
It often is referred to alternatively as Facilitated Communication Training because the goal is independent typing, nearly independent typing (e.g., a hand on the shoulder or intermittent touch) or a combination of speaking with typing – some individuals have developed the ability to read text aloud and/or to speak before and as they are typing. Typing to communicate promotes access to social interaction, academics and participation in inclusive schools and communities.
The person who provides support for communication is called a facilitator or communication support person. A facilitator can be a teacher or other professional, a family member or a friend. The person who receives the support is called the communication aid user or FC User.
It should be noted that while the stated goal is independent typing, this is often not achieved. Even if the individual does eventually reach the point where they can type with minimal interactions of the facilitator, the possibility that they are using non-verbal cues and simply responding to the facilitators direction cannot be discounted. In fact, the idea that a person would be fully capable of writing long and complex statements, but only when someone is leaning over them, goes against all we know about autism and also basic reason.
So very systematic and focused in the work and my learning showing my intelligence and depth of many subjects to the all folks who did not believe in my smartness. I find much serenity and lots of peace on my day to day activities can’t do so without facilitated communication. The enhacnement of a very cloistered life to openness and more solid durable communication.
Sujit Kurup, High School student and FC user, June 2010.
“Without FC I am imprisoned in a body that cannot reveal who I really am. This form of communication has changed my life and it is no full of possibilities and opportunities for me to be heard in the world.”
Tyler Fihe, college student and FC user.
Powerful statements, but lets not forget, we don’t actually know that these are coming from the individual and not the facilitator.
FC clients have gone to college with their facilitators (usually at state expense) and obtained employment, with a facilitator in tow the entire time. They have also made some disturbing and unfounded accusations, such as sexual abuse, which turned out to be entirely false and nothing but a figment in the imagination of the facilitator.
But not all institutions have accepted Facilitated Communications. In 1994, amid the growing popularity of FC, the American Psycological Association passed a resolution including the following language:
Facilitated communication is a process by which a facilitator supports the hand or arm of a communicatively impaired individual while using a keyboard or typing device. It has been claimed that this process enables persons with autism or mental retardation to communicate. Studies have repeatedly demonstrated that facilitated communication is not a scientifically valid technique for individuals with autism or mental retardation. In particular, information obtained via facilitated communication should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions.
THEREFORE, BE IT RESOLVED that APA adopts the position that facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy.
It is long past time for the promoters of facilitated communications to show some real evidence and for the validity of this concept to be evaluated based on solid, controlled, scientific testing. As emotionally appealing as some claims may be, if they are false, they are worthless or worse. If that is the case (which it certainly seems to be) then there should be no tolerance for otherwise respectable universities, therapeutic programs or government departments to be involved in this nonsense.
I should finally note that nobody at my place of work regularly uses facilitated communications, and if they did, I might need to resign from work completely. However, prospective clients sometimes come through with their “facilitator.” In such cases, there’s not much I can do, as saying something is not going to change any minds or result in anything other than an ugly confrontation. That said, it’s an issue I sometimes grapple with.
- A report on FC and allegations that have been made of sexual harassment – From 20/20
- A video posted by the parents of an autistic child (Note their enthusiasm about facilitated communications, it’s heartbreaking)
- A promotional video on FC from FC advocates
- Info from Neurologica blog (by our friend and fellow skeptic, neurologist Dr. Steve Novella)
- Full transcript from the 1993 Frontline video (seen above)
- A 1994 resolution from the American Psychological Association on Facilitated Communications (they reject it0)
- Autism Watch, part of the Quack-Watch family of sites provides information on FC
This entry was posted on Thursday, January 31st, 2013 at 10:12 am and is filed under Bad Science, Education, Obfuscation, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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