“I Amn Not a Utistivc on Thje Typ” (“I'm Not Autistic on the Typewriter”)

Reading between the Lines: A Case Study on Facilitated Communication

This is a qualitative study that examines the facilitated communication method within the context of general communication. “Reading” another person, or understanding the intent and meaning of an individual's communication, is a complex process that encompasses verbal and nonverbal messages. Various strategies employed by both the facilitated communication user and communication partner to interpret and clarify messages are examined in depth.

“School's Not Really a Place for Reading”: A Research Synthesis of the Literate Lives of Students with Severe Disabilities

Developmental and connectionist research describing a student's development of competent reading and writing skills commonly evokes the image of a normative ladder to literacy. Each rung of the ladder is believed to constitute certain sets of increasingly complex subskills. It is believed that cognitive mastery is required prior to the next step up the ladder. For people labeled with severe mental retardation, subskill mastery is often considered an intellectual impossibility. Hence, literacy is denied. In this research synthesis, however, we suggest that people with severe intellectual limitations can be understood as symbolic, and specific literacy skills can be supported. We use the term research synthesis to describe the textual weaving of two sources of understanding: (a) qualitative stories garnered from six students who were research participants and (b) published autobiographical and biographical stories by people with disabilities or their parents. These two sources of understanding underscore that a deeply caring relationship characterized by intimacy is of central importance when constructing as symbolic and literate a person labeled as having severe mental retardation.

Facilitated Communication

This study examined types of support in Facilitated Communication with 12 non-verbal individuals with autism. Literacy tasks of graduated difficulty that included letter identification, word comprehension, labelling and sentence completion were employed to address the possible presence of literacy under three conditions of support: physical, emotional and mental. Although full facilitator support resulted in high performance levels on all tasks, emotional and physical support alone yielded unintelligible or minimal output. Thus, contrary to proponents' claims as to the importance of physical and emotional support, facilitated output hinges crucially on facilitator-provided mental support. In this study this was true regardless of task difficulty and motor requirement complexity, arguing against the technique's relevance to overcoming motor or emotional problems and demonstrating literacy in individuals with autism.

Voices from the past: comparing the rapid prompting method and facilitated communication

OBJECTIVE

This article briefly reviews the history and damage caused by facilitated communication (FC) and highlights the parallels between FC and the Rapid Prompting Method (RPM).

BACKGROUND

FC involves a therapist (or facilitator) supporting the hand of a person with autism while a message is typed on a letter board. FC is widely acknowledged to be a pseudoscientific, unsafe, and unethical treatment for people with autism. RPM is a more recent intervention for people with autism that involves the facilitator holding and moving the letter board while the individual with autism moves their own hand. Those who espouse the perceived benefits of FC and RPM make strikingly similar claims of hidden intelligence and extraordinary communication abilities in people with autism following treatment.

CONCLUSION

Clients, proponents, and practitioners of RPM should demand scientific validation of RPM in order to ensure the safety of people with disabilities that are involved with RPM.

Facilitated communicators' performance on a task of receptive language

Most controlled studies of facilitated communication (FC) have not validated it. One task, however, on which positive effects of FC have been demonstrated without facilitator influence is the Peabody Picture Vocabulary Test-R (PPVT-R). The present study investigated if the use of FC could be validated for either a group of subjects with autism or a group with severe to profound cognitive impairments, on the PPVT-R when facilitators were effectively screened from all visual and auditory stimuli. Additionally, the effect of mode of input-auditory or visual-on subjects' performance was investigated. Results did not validate the use of FC for the administration of the PPVT-R nor did they show any notable advantage of one mode of input over another.

Failure to confirm the word-retrieval problem hypothesis in facilitated communication

Two hypotheses were raised and empirically tested to account for the failure of previous controlled validation studies to find evidence of literacy in nonspeaking persons with autism using facilitated communication: (a) The naming tasks used in other studies have triggered specific "word retrieval" problems, or anomia, and (b) a perceptual problem, visual agnosia, prevents subjects from recognizing objects without touching them. Three nonspeaking autistic children who had used facilitation for at least 2 years were evaluated with four experimentally controlled tasks, over a period of 5 months. In descriptive and object handling tasks, and in a traditional picture identification task, subjects failed to type correct answers when facilitators were blind; one subject, however, occasionally engaged in signing and vocalizations that were context-appropriate. Results reflected a generalized language deficit, rather than isolated word-finding or perceptual difficulties, and were consistent with many previous studies revealing facilitator cuing. Questions are raised about inconsistencies in pseudo-correct scores, a measure of facilitator influence, reported here and in previous research.

A naturalistic approach to the validation of facilitated communication

By manipulating the facilitator's knowledge of a student's just-completed activity, facilitated communication ability and the extent of guiding were assessed. Seven students diagnosed with mental retardation and their facilitators participated in the study. All 7 students were purported at the start of the study to be communicating via facilitation at levels far above what was previously thought possible given their level of intellectual ability. A large degree of facilitator guiding was revealed for each of the 4 facilitators. Minimal evidence of facilitation was found for 4 of the 7 students. One of the 7 students demonstrated validated facilitated communication on two trials.

Facilitated communication: the effects of facilitator knowledge and level of assistance on output

Investigated facilitated communication with 10 adults with autism, and specifically examined the effects of facilitator influence and level of assistance as a function of facilitator knowledge of experimental stimuli. Six men and four women with autism served as subjects, ranging in age from 14 years to 51 years of age. Each subject had 6 experimental sessions, 2 with no help, 2 with partial assistance, and 2 with full assistance. Within each session, the facilitator had knowledge of the experimental stimuli in one half of the trials. Results revealed no cases of correct responding independent of facilitator knowledge of correct answers. Additionally, facilitator control was apparent in numerous cases in which typed output matched stimuli to which the facilitator, not the subject, had been exposed. Results suggest that clinical and educational use of the procedure should be curtailed pending further experimental investigation.

Issues raised by facilitated communication for theorizing and research on autism

There is considerable disagreement in the literature and among clinicians about the success of facilitated communication, a new method of augmentative communication being used with people diagnosed autistic. Some claim almost everyone exposed to it achieves success, basing their claims upon their observations and experiences of naturally occurring facilitated interactions. Others claim minimal or no success, basing their claims on their observations of facilitated interactions under controlled experimental conditions. I argue here that both claims can be valid and that FC users with autism are sometimes competent and other times incompetent, depending upon the conditions under which they are evaluated. I support my argument by offering a collaborative view of communication in place of the commonly held view that communication involves passing messages over an invisible conduit. Given the assumption that facilitated communication does allow for the expression of unexpected competence for many with autism, I describe various unusual phenomena being revealed by facilitation and FC users and offer some theoretical approaches for explaining these phenomena. I then propose some research ideas for studying the phenomena associated with FC and offer them as suggestions for how we might proceed in our efforts to develop our understanding of when and how it works for people with autism.

Facilitated communication: a failure to replicate the phenomenon

Twenty-one subjects participated in a study of Biklen's and Crossley's hypothesis that persons with autism show unexpected literacy and improved communication ability through the process of facilitated communication (FC). Repeated measures of literacy were conducted at (a) a baseline test of communicative ability before FC; (b) a pretest with facilitation; and (c) a posttest with facilitation after 20 hours of training. At both the pretest and posttest, the facilitators were screened from hearing or seeing the questions or pictorial stimuli. Although some facilitators reported newfound communicative abilities during training sessions, no client showed unexpected literacy or communicative abilities when tested via the facilitator screening procedure, even after 20 hours of training. Separate analyses indicated that some facilitators influenced the communicative output of their clients.

Evaluating facilitated communications of people with developmental disabilities

A quasi-experimental message-passing procedure was used to assess the validity of the facilitated communication (FC) by people with autism and mental retardation or with mental retardation. The 23 participants were classified as having intellectual skills within the range of severe to profound mental retardation. Message-passing consisted of showing and verbally labeling a picture of a familiar object with the facilitator absent, and subsequent facilitation to generate a label or description of the object. Three-trial blocks were conducted with each participant on two different days. Blocks were conducted in the participants' normal FC setting, with their facilitators of choice, and no special apparatus was used. No participant was able to accurately label or describe the object shown to them with facilitation. Possible reasons for findings set forth by proponents of FC and findings from the emerging quantitative literature on FC are considered.