by Ashton Schneider
Facilitated Communication, also known as Supported Typing, is a communication technique that was created to assist severely autistic or other communication impaired individuals in sharing their thoughts, feelings or ideas.¹ Proponents of this technique, which include family members, teachers, and assistants of those with autism, believe that these individuals are not actually mentally disabled but have a rich inner life. They claim severely autistic individuals are cognitively the same as any other typically developed person and that their disability stems from an inability to simply make the physical movements required for communication (e.g: controlled movement of the vocal cords or hands, etc).²
The Facilitated Communication (FC) technique itself is employed by a facilitator who assists the disabled individual, the communicator, in pressing the keys on a keyboard or letter board while giving verbal encouragement. This is done by forming the person’s fingers into a fist with the index finger extended and supporting the elbow, gripping the wrist, sleeve of a shirt, or hand and then guiding the arm forward toward the keyboard. FC became popular in the United States in the 1980’s and 1990’s. It was largely promoted by a man named Douglas Biklen, a professor at Syracuse University in New York, who learned the technique while in Australia from Rosemary Crossley.³ It is mostly used with individuals on the more severe end of the autistic spectrum who are characterized by profound difficulties with communication, social skills, and in entertaining abstract concepts. Many of these people also have repetitive, jerky movements or an intellectual disability.⁴ The current understanding of autism is precisely why this belief is such an extraordinary one; if we are to believe that Facilitated Communication does what Biklen claims it does, then we would need to completely change how we define autism. (For additional information about FC and the controversy surrounding it I have provided links below.)
Evidence supporting FC is of the anecdotal variety. Demonstrations of the technique have shown what appears to be the communicators typing out full, intelligible sentences. They could carry on conversations with those speaking to them, answer questions, and tell of how they had felt trapped for so long before FC was available to them. Their statements also seemed to make sense coming from someone with a disability who has not been able to communicate up until now.²
Some criticisms can be made after simply observing a few demonstrations of FC in action. For starters, in a few instances the disabled individual isn’t even looking at the letter board or keyboard, and this may continue for the majority of the time in which they are supposedly communicating. Secondly, in other demonstrations it appears as though the facilitator assisting the communicator is doing quite a bit of assisting. So much so, that it looks as if the facilitator is doing more than just guiding the hand or arm and is actually just using the communicators hand to type.² The most damning evidence, however, comes in the form of a series of experiments conducted to test just who is doing the communicating. One in particular, done by Smith, Haas, and Belcher (1994), consisted of presenting either matching or differing pictures, objects or messages to the facilitator and communicator. Communicators were told to describe what they had seen through the use of varying levels of FC (no help, hand over hand support with error prevention, and hand over hand support without error prevention). Correct answers were obtained only when both the facilitator and communicator saw the same image and a full support style of FC was used. ⁵,⁷
When it comes to FC, several cognitive mechanisms and social factors are responsible for the creation and maintenance of the belief. For starters, confirmation bias, where a person bends ambiguous data to fit what they already believe, plays a heavy role in turning observations of the technique being performed into “hard evidence” that these individuals must be the ones communicating. Secondly, avid supporters make use of post hoc excuses to explain away why some people cannot get FC to work, or why certain experiments fail to find any evidence in support of the technique.² This works to insulate the claim from being testable in the future because it makes it unfalsifiable. Thirdly, and especially in the case of Biklen himself, cognitive dissonance plays a role. He has put a lot of time and effort into promoting this technique, as well as put his reputation on the line and as such is unlikely to admit that it is a pseudoscience despite the overwhelming evidence suggesting exactly this. Additionally, Biklen, who first brought FC to the United States, has a PhD and because of this is able to influence others beliefs because he occupies a position of authority.⁶ Socially, believers in FC come from a community of people who have loved ones with autism or who work with them closely. It’s no surprise then, that these individuals would want to very much believe in FCs credibility as it provides them with the opportunity to communicate with loved ones who previously were unable to do so. Being surrounded by staunch believers enhances a person’s motivation to believe, as well.
In conclusion, advocates of Facilitated Communication have made some pretty extraordinary claims; and while it’s entirely understandable how a person can come to believe in the extraordinary, the evidence doesn’t always warrant the strength of the belief. Claims that revolutionize everything that we know about a concept require much more than anecdotes, authority, and a large number of very convinced believers to make them truly persuasive to a rightfully skeptical audience. It may provide us a great deal of comfort or joy to believe in an idea but if this is based on a lie or a misconception, it could prove to be much more damaging than the truth itself in the long run.
References:
1) Syracuse University website: http://soe.syr.edu/centers_institutes/institute_communication_inclusion/what_is_supporte d_typing/default.aspx
2) FRONTLINE: Prisoners of Silence video: https://www.youtube.com/watch?v=CzCGux7qD1c
3) American Speech-Language-Hearing Association website: https://www.asha.org/policy/tr1994-00139.htm
4) Autism speaks.org: https://www.autismspeaks.org/blog/2012/01/09/all-children-deserve-access-communi cation
5) Lilienfeld, S.O., Lynn, S.J., & Lohr, J.M.(Eds).(2015). Science and Pseudoscience in Clinical Psychology.(2nd ed.)New York, NY: The Guilford Press.
6) Syracuse University Page on Douglas Biklen: http://soe.syr.edu/about/member.aspx?fac=15
7) Smith, M., Haas, P.J., & Belcher, R.G. (1994). Facilitated communication: The effects of facilitator knowledge and level of assistance on output. Journal of Autism and Developmental Disorders, 24(3), 357-367. Retrieved from: http://web.a.ebscohost.com.proxy.lib.ohio-state.edu/ehost/pdfviewer/pdfviewer?vid=1 &sid=e49158f8-7254-4ea4-9fed-7eeed5135968%40sessionmgr4009
8) Special thanks to Dr. Michael Vasey for discussions in class regarding FC: https://psychology.osu.edu/people/vasey.1
I enjoyed the part when you talked about Facilitated communication being largely based on anecdotal evidence; which just goes to show that it could never be experimentally tested. Also, it was crazy to hear how many advocates for Facilitated communication made these extraordinary claims, and gained a following knowing that it wasn’t a real form of communication.
Well they did end up doing several experiments looking at which of the two was responsible for the communication but there may be more that address other weak points in the claim. (I can’t recall off of the top of my head though.) I only made reference to one but there are actually quite a few studies mentioned in the Lilienfeld book Science and Pseudoscience in Clinical Psychology listed in my references. The first time that I saw the video I was actually a little shocked that people believed in it so passionately, but when you take into account the excitement over finally being able to connect with a loved one and what the ability to communicate implies, it begins to make more sense. It really brings to your awareness just how much we take communication for granted. I was also under the impression that the people who advocated for it very much believed in its power as well so I wouldn’t say that they knew it was an illusion. They were just over eager, I think, because if it were true it would have been revolutionary.
I liked reading this post and have actually never heard of Facilitated Communication, so everything I learned was brand new and interesting. I was surprised that this existed, however, I can definitely see how this has supporters. I don’t think people realize the power of the person guiding the autistic individual and I also think confirmation bias might play a role. The fact that it has been disproven and that proponents use anecdotes as support goes to show how pseudoscientific it is.
I’m glad! I found it super interesting as well the first time I had the opportunity to learn about it. If you ever find the time I definitely recommend sitting down and watching the Frontline video on the subject listed in my references. You get multiple chances to see the technique in action and there are also stories that delve into specific families and how FC has harmed them.
Ashton, as someone who works with kids who have autism, I found your blog post to be very interesting. In the beginning you share how proponents of this technique believe that these individuals are not actually mentally disabled but have a rich inner life. From my experience working with individuals who have autism, I can testify to them having a very rich inner life, but there are also so many more factors that go into their diagnoses that affect more than their mental inner world.
Thanks for your comment Julia. I very much wanted to include more about autism because I felt like my explanation was limited in this post. I made the decision to try and talk about the signs and symptoms that were more relevant to the technique I was critiquing but I do understand that it leaves a lot out. Is there anything you would personally add? Also, the phrase rich inner life is probably too vague and up for interpretation. In my mind it refers to things like what a person needs to do mentally in order to create things like poetry or write a book, or an awareness or understanding at the level that non-severely autistic people function. I understand autism is on a spectrum, and although I’m not as familiar with it, my statement was more referring to those with severe autism. It’s my understanding that they would not be able to do things like write a novel because they don’t have the ability to do the mental gymnastics required. Does this corroborate with your experience and how would you define rich inner life?
I think it’s so fascinating that there are so many people out there jumping at the bits to find a way to “normalize” those with Autism and other diagnoses. These kinds of “treatments” stem from people who are uncomfortable with the differences those with diagnoses have. In reality, these people have their own, rich experiences and have the opportunity to live perfectly happy lives as they are, without being “treated”. The best thing that can be done for anyone in the world, including those with Autism, is to respect and honor their choices and celebrate their diversity! Stop trying to fix what isn’t broken!!
Hey Grace,
This is a great perspective on it. I think that you are right, people try to normalize it by coming up with crazy treatments or looking for answers that may not exist and that is not fair to the individual with the disorder. We should not be taking anything away from them and what they are capable of. At the end of the day, you are right, respect is the most important thing.
Charlie
I feel like it also just makes things better for the people on the giving ends of these kinds of treatments, not the receiving end. It gives families and caretakers a way to feel more connected to people with Autism, who may fall anywhere on the spectrum of verbal to non-verbal communication. People with Autism and similar diagnoses shoudln’t have to adjust themselves to fit into expectations of the world, the world and society need to fix their expectations and what they consider “normal”.
Ashton,
This was a really interesting topic. I have never heard of facilitated conversation until this course so it was cool to learn something new. Once again, it is a reoccurring theme that I am not sure how people buy into this stuff. This is something that can cause serious harm and to me it is placing entirely to much power into the hands of one person.
Facilitated communication appears to be harmless because family members want to believe they are able to communicate with nonverbal loved ones. However there are a lot of negatives in believing it actually is effective. Because facilitated communication hasn’t been proven effective, we are essentially putting words into disabled people’s mouths and saying things that they wouldn’t actually say. You mentioned at the end of your post that although it provides ease of mind, it’s not true that we can communicate this way with people of severe disabilities and I completely agree.
This is an interesting concept that I was totally unfamiliar with until reading this essay. I like the idea, but I’m not sure I’m a proponent. Because most of the evidence is anecdotal, I can’t really get on board with it. I think maybe it started as a way to help family/friends of those with social disorders cope with the fact that they would not be able to communicate with them “normally,” or in the way they are used to communicating.
This always made me so sad! I totally understand why people would want to believe in this, because if someone you loved lost the ability to communicate with you it would be devastating and I know I would do everything I could just for them to be able to communicate. But I also don’t think this should be able to go on and be a thing because it’s giving false hope to people and even maybe false communication.
I really enjoyed reading this post! My best friend’s younger brother has autism and growing up, I spent much time with him and their family. I remember watching a special on TV about FC and thinking how great it was if it was actually functional and what this could me for people like him. The more I learned about it and especially after reading this post, made me realize how much of an extraordinary belief this actually is. I understand why people would want to believe in something like this, but unfortunately it doesn’t have the studies to back it up.
Fc is one of those too good to be true miracles that we all want to believe in. We want to believe that we found a way for autistic people to communicate. We want to be responsible for improving their lives and letting them be more normal by communicating with others. In reality, the people assisting with FC are the ones doing the communication, or they are at least significantly guiding the conversation. Without the facilitator present. correct answers were never given.
This was very interesting and something I had not heard about before reading your post. I feel like the thought and efforts behind this communication technique are awesome. The idea and concept behind it open a lot of doors. The evidence showing that the facilitator is doing most of the work is somewhat of a let down, considering the possibility of being able to communicate with these people. Even if it does not work they way it was planned, or even at all, it could still at least be a step in the direction towards a better communication system.