Nov 08 2012

Facilitated Communication Persists Despite Scientific Criticism

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19 Responses to “Facilitated Communication Persists Despite Scientific Criticism”

  1. Bronze Dogon 08 Nov 2012 at 1:55 pm

    I remember one student at my school who was wheelchair bound from her physical difficulties, barely able to move. She couldn’t speak, and had a “keyboard” that was a plastic tray with big letters on it, and someone who worked with her who was probably an FC. She didn’t participate much, I rarely saw her use the keyboard, and the only attempt at speech I recall was a stuttered “A-AH!” which was allegedly an answer to the teacher’s question. When the assistant “interpreted” it, giving the correct answer and the teacher responded, “That’s what I thought she said.” I really wondered how they could possibly have gotten anything out of that. Looking back with what I know now, I suspect it was the assistant who was doing everything.

  2. Chewon 08 Nov 2012 at 2:43 pm

    FC is being relabeled “supported typing”. http://skepdic.com/facilcom.html#new

  3. BillyJoe7on 08 Nov 2012 at 2:55 pm

    “No one is helped by a comforting illusion.”

    I think I know what you mean, but the sentence as it stands is a self-contradiction.
    People are actually helped by comforting illusions, which is why they persist.

  4. slotaagon 08 Nov 2012 at 4:53 pm

    As a speech pathologist, one of my core responsibility is to help people with communication impairments. Facilitated communication is an unfortunate stain on the profession. When l happen upon reports of FC’s use, all sorts of anger rises up in me. What upsets me most about FC is if the person happened to have intact linguistic skills, the facilitator is communicating their own message, not the message of their client. Not only is FC void of evidence supporting its use, but its use is ethically and morally bankrupt.

  5. Jared Olsenon 09 Nov 2012 at 5:45 am

    From what I’ve read, there seems to have been quite a number of cases where innocent parents are accused of sexual abuse through FC. If it’s actually the therapist doing the ‘talking’, why are so many of them ‘talking’ about sexual abuse? What does this say about the FC’ers themselves? Was Freud right after all?

  6. Todd W.on 09 Nov 2012 at 12:59 pm

    It may be worth mentioning the 1993 Frontline episode “Prisoners of Silence” that covered FC in depth. Part 1 can be found here.

    @Jared Olsen

    Those who are disabled to a significant degree and who are, on top of that, nonverbal are easy prey for sexual predators. In the case of the FC sex abuse allegations, maybe the facilitator saw some minor bump or bruise that raised concern or anything, really, that planted the seed of doubt in their minds. In an environment where we have news reports of sex crimes, Law and Order: SVU marathons and countless other suggestions of the abuse of vulnerable people, not to mention the possibility that the facilitator themselves may have experienced it directly or know someone who was abused, those doubts can quickly build on each other to the point where they are, unknowingly, authoring allegations. They may genuinely be concerned for their client’s welfare, but, road to hell, good intentions and all that.

    We saw the same thing during the “recovered memory” craze. Lots and lots of therapists finding that their clients were sexually abused as children. Many unwittingly planted those false memories in their patients’ minds so that the patients themselves actually believed it, too. And then it turned out that it was all made up and “recovered memory” therapies were useless and dangerous nonsense.

  7. Karl Withakayon 09 Nov 2012 at 6:06 pm

    RE: “No one is helped by a comforting illusion.”

    I’ve been looking for an opportunity to post this somewhere:

    Dialog from the “That’s not my Penguin” episode of the now cancelled show Awake :

    (Background: Michael a police officer and patient of Dr Evans recently was involved in a hostage situation in a psychiatric facility. He reached a point in the situation where he had an opportunity to get the hostage taker to surrender involving a choice of two options: get the man to realize he was deluded, or feed into and divert his delusion.)

    Dr. Judith Evans (Psychiatrist/Psychologist):

    “So you had an opportunity to help this patient to see the truth, but you chose instead to perpetuate his denial. Why?

    Detective Michael Briten (Patient):

    “How would he be better off thinking of his sister in the ground somewhere rather than thinking of her free, [pause] liberated, [pause] waiting for him? Explain to me what exactly is so great about seeing reality for what it is.”

    Dr. Judith Evans:

    “You’ve more or less summed up the reason why every major religion has some version of an after life.”

  8. isleson 11 Nov 2012 at 12:10 pm

    Thank you for this post. I know a number of otherwise science-minded autism advocates who don’t seem to apply their skepticism to FC. I respect them and don’t want to upset them, but for many of the reasons that other autism quackery needs to be recognized, this does too.

  9. Davdoodleson 11 Nov 2012 at 11:57 pm

    “We did simple tests, like asking the child questions and watching her behavior to see whether what she expressed through FC conformed to how she was behaving in real life. We looked for spelling and syntax errors in her communications. We looked for turns of phrase that might be attributed to her own unique outlook on life. We consciously tried putting minimal pressure on the child’s arm when we worked with her.”

    We did everything except any of the dozens of simple tests that would obviously work.

    Ask her something the ‘facilitator’ would not know. Her first childhood pets name etc.

    Show her a word the ‘facilitator’ can’t see and ask her to repeat it.

    Etc-blah-not-rocket-science.
    .

  10. superdaveon 13 Nov 2012 at 9:05 am

    Having read this post I am now convinced that FC probably can never work. But if such a patient existed, someone with language skills and enough motor control to be detected by another human being reliably, then it seems likely to me that this person could benefit much more from a technological solution than a human facilitator.

    One of my personal heroes is the guitar player Jason Becker, who has lost almost all of his motor control due to ALS. He is able to communicate using a coded language and the use of small ability he has to roll his eyes. Watching a video of this communication happening in real time is hundreds of times more convincing than anything I have ever seen with FC.
    https://www.youtube.com/watch?feature=player_embedded&v=DL_ZMWru1lU#!

    (even this communication is 100% convincing, but much better than any FC I have seen)

  11. superdaveon 13 Nov 2012 at 9:06 am

    I meant isn’t, not is in that last sentence

  12. DevoutCatalyston 13 Nov 2012 at 10:21 am

    Were it real, I would expect FC to produce independent communication initiated by the communicator as quickly and as easily as other augmentative communication strategies such as PECS. I worked with an adult loved one with severe cognitive impairment and in under 3 hours of training he could communicate a basic want — I want a taco — without further assistance in using his new communication book. He quickly generalized to where he would ask for favorite activities, foods, people — still does. That was ten years ago and these days he does not write sonnets nor file affidavits, but will go to the swimming pool this afternoon based on his own volition and use of a communication strategy that is at his command. FC is a massive failure right before your very eyes, and gets in the way of the disabled person’s development.

  13. Steven Novellaon 13 Nov 2012 at 10:58 am

    DC – I agree. If using FC mainly allowed people that were thought to be non-communicative due to severe developmental disorder to communicate some basic needs and feelings, that would be somewhat plausible (based on the individual, of course). It defies all logic, evidence, and common sense, however, to argue that a person that appears to be severely cognitively impaired is actually well above average in intelligence and maturity, and somehow learned to read and write without being specifically taught how to do so.

  14. Bronze Dogon 13 Nov 2012 at 12:07 pm

    One thing that sticks out to me when FC comes up is the wishful thinking and Just World Hypothesis. A lot of people want to believe that every disadvantaged child has some amazing hidden talent to balance out their disabilities to make life fair. FC is seductive because it reinforces the idealistic fantasy. Kids who’ve lost their language ability suddenly turn out to be poets, making their parents proud when it’s actually the adult facilitator doing the work.

    It leaves me wondering how many disadvantaged children might be unhappy as a result of being treated like a puppet and have their genuine desires covered up by the FC.

  15. Todd W.on 13 Nov 2012 at 1:53 pm

    I’ve been posting some comments over at TPGA, questioning the validity of FC and trying to be as respectful as I can, but I’ve been having a bit of blowback from folks. I looked at some of the “studies supporting FC” from that ICI and a thought occurred to me after seeing the studies validating FC by using eye tracking: why not use eye tracking assistive technology instead of typing with the aid of a person? There are so many ways to go about helping people communicate who are non-verbal, it just seems…I don’t know…wrong (can’t find the best word to describe my feelings here) to stick with something that has so much evidence against it and so much potential for harm, whether that is false accusations, time taken away from learning other skills, or time taken away from learning to actually communicate independently.

  16. Todd W.on 13 Nov 2012 at 1:54 pm

    Feel a bit frustrated and depressed about the whole thing…

  17. Steven Novellaon 13 Nov 2012 at 2:15 pm

    Eye tracking systems for communication already exist. If eye tracking were a reliable indicator for these subjects, they could just use existing eye-tracking devices to communicate. The whole point of FC is that an intelligent agent needs to be in the loop to be the actual source of the communication.

  18. Todd W.on 13 Nov 2012 at 3:42 pm

    @Steven Novella

    Exactly the point I tried to make over at TPGA. I included a link to one such device, as an example. Here’s hoping that helps make my point to some of the commenters there.

  19. arthurgoldenon 30 Dec 2012 at 8:07 am

    You write: “An excellent documentation of the nature of self-deception involved in FC comes from a recently published commentary by a former FC user… Janyce Boynton” and and later write: “In Boynton’s case the deception of FC led to tragedy when her client started to “communicate” that she was the victim of sexual abuse by her parents and brother. Such cases, unfortunately, continue to occur.”

    You are correct that this commentary was recently published – in 2012 – but you do not state that the sexual abuse charges were made 20 years ago in 1992. The Wendrow case took place in November 2007 and a case in Wales recently came to light which took place in October 2010. My own extensive inquiry shows that such cases are very rare and it is misleading for you to write that “Such cases, unfortunately, continue to occur.” As a retired lawyer, I have found about the same number of cases of sexual abuse charges through Facilitated Communication that have been substantiated than those that have not. What is a much greater tragedy is the so numerous cases of all types of abuse of nonverbal persons who are denied any means of communication, even though such communication may not be perfectly reliable and such cases have to be carefully investigated, just as verbal communication by competent adults about abuse is about as likely to be false as true.

    Arthur Golden

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