Facilitated communication

Facilitated communication (FC) is a method that purports to help people with speech or expressive problems to point to spell out words and sentences. The goal of the method is to enable the person to use an augmentative communication device independently. Usually, the facilitator holds the person's hand, wrist or arm in his hand, prompting the patient to pick out letters on a letterboard or keyboard. The facilitator prompts the client to point to letters and puts slight pressure back on the hand, wrist or arm as the client points toward the communication device.

Concerns

Nevertheless, serious questions regarding FC soon began to surface. For example, some autistic FC users appeared not to be looking at the keyboard while typing. However, proponents argue that autistics have trouble looking at something directly and have greater periphial vision to compensate, and one study suggested that some FC users first scan the keyboard and then type while looking elsewhere http://www.communi-care.org/html/vortraege_en.htm#grayson.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Still others used vocabulary that was apparently beyond their years, many producing poetry of varying complexity. The question naturally arose: how is it that many speaking adults still cannot read but developmentally-disabled children and adults are able to learn written letters, words, and grammar? Proponents argue, citing Chomsky, that the building blocks for language, written or otherwise, are already part of one's brain at birth; that grammar can be picked up by listening to people talk around them; and that autistics in particular are more observant because they are so often regulated to a passive role. Charles Martel Hale, Jr., the co-author of the pro-FC autobiography I Had No Means To Shout!, is a severely autistic man who claims he learned the alphabet from watching Wheel of Fortune.

Related Topics:
Chomsky - Alphabet - Wheel of Fortune

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

A major concern arose when some of the communications emanating from FC accused the parents of autistic children of severe sexual and/or physical abuse; not all such allegations were proven true. (In an evaluation of claims of sexual abuse from children using FC, some children did show evidence of abuse, and the pattern of abuse paralleled the patterns seen in the nondisabled, speaking population http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7951807&query_hl=1). Also disturbing were the reports about facilitated persons that apparently were able to "mind read" the thoughts of their facilitators http://www.omygad.com/YechielSitzman/ http://www.findarticles.com/p/articles/mi_m2843/is_n5_v22/ai_21076519. In late 1993, a Frontline (PBS) documentary highlighting these concerns was televised http://www.pbs.org/wgbh/pages/frontline/programs/transcripts/1202.html; FC proponents responded with criticisms of negative bias http://home.vicnet.net.au/~dealcc/FrontA.htm.

Related Topics:
Frontline (PBS) - Bias

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Shortly afterwards controlled studies were done on the method, a majority of which found that it was the facilitator who was unconsciously producing the communication (review of studies until 1995). In these negative studies, practitioners were unintentionally cueing the facilitated person as to which letter to hit, so the resulting letter strings did not represent the thoughts of the students but the expectations of the facilitators. However, some controlled studies did show positive results (i.e., valid authorship by the FC user, e.g. by relaying information unknown the the facilitator) http://soeweb.syr.edu/thefci/shortbib.htm, and much debate ensued among scholars and clinicians http://soeweb.syr.edu/thefci/mrrev.htm. FC practitioners continue to argue that the emergence of independent typing in some FC users is evidence of the technique's validity http://soeweb.syr.edu/thefci/2-2bik.htm, http://www.breaking-the-barriers.org/stories_jamie.htm, http://www.sue-rubin.org/. Even FC users and proponents do admit that there is a possibility of people "guiding" users, consciously or unconsciously, that it does happen; they argue, however, that there are many cases where the facilitator is only assisting, and cite "fading" as proof of this.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Harvard University psychologist Daniel Wegner has argued that facilitated communication is a striking example of the ideomotor effect http://www.quackwatch.org/01QuackeryRelatedTopics/ideomotor.html, the well-known phenomenon whereby individuals' expectations exert unconscious influence over their motor actions (Daniel Wegner). Other theorists (Maurer and Donnellan) argue that autism is largely a movement disorder, and that there exists a synchronistic "dance" to communication in all mammalian social interaction which accounts for the anomalies in validation studies (http://www.autcom.org/rethinking.html).

Related Topics:
Harvard University - Ideomotor effect

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

By the late 1990s, FC had been discredited in the eyes of a majority of scientists http://www.asatonline.org/about_autism/autism_info09.html and in most educational and treatment centers in North America. In parts of Europe, it has apparently retained greater acceptance. Within the past few years, FC has mounted a comeback in some North American clinical settings. It was inspired by a 60 Minutes II program in the spring 2003 about people with autism who are assumed to have learned to type independently through the use of FC. Scientists at the MIND Institute studied those autistics and were interviewed for the program. They concluded that it is likely that most classically diagnosed autistics are misdiagnosed as being retarded, and in fact most likely are very intelligent.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~