Tuesday, November 13, 2007

Formally Reviewing Facilitated Communication

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Looking at Facilitated Communication

Facilitated Communication (FC) is used for individuals who have difficulty using vocal speech. It has been used for people with Cerebral Palsy, Down’s Syndrome, other health impairments, and autism. The premise is that FC is appropriate for people whom have specific motor issues, but are still able to make use of their arms, hands, and fingers. The individual is then paired with a trained facilitator. This person provides physical and/or other support that allows the person to communicate using a keyboard or pad.

FC had its origins in the 1977 in Australia. Rosemary Crossley, a teacher in a hospital used facilitated communication to elicit communication from 12 students with Cerebral Palsy. Later on this idea (Rosemary’s baby if you will) traveled to the United States and elsewhere.

Douglas Biklen, now the Dean of the College of Education at Syracuse University helped to popularize this idea in the US. He created the Facilitated Communication Institute at Syracuse. The center provided training, consultation, and advocacy for FC. It even produced t-shirts with the slogan "Not being able to speak is not the same as having nothing to say".

Controversies

The major concern in FC is that the individual being facilitated is not really doing the communicating. It has been argued that FC is just/usually an artifact of the facilitator’s communication. It can be argued that the same ideomotor phenomena we see with Ouija boards and dowsing rods is also in play here.

Another point is the abuse scandals surrounding FC. Skepdic claims that facilitators are taught that 13% of their clients have been abused. In my opinion a surprising number of facilitators have accused parents of abusing the client. Also unsurprisingly, most of these cases turn out to be garbage. And PBS Frontline episode from 1993 chronicles one such case proven to be false. However, the author of FC Wikipedia page reassures us that “numerous abuse allegations made via FC have been found to be valid” and then cites a paper with 4 cases with some degree of evidence out of 13 cases that were reviewed.

The Research

Much of the research in FC is qualitative as opposed to quantitative. This means that the research doesn’t attempt to answer whether FC is legitimate, but instead looks to how it affects the quality of life for the user or their family members. Some of the FC supporters also have the habit of forgoing peer review and publishing research in books as opposed to academic journals as seems to be the case for Biklen & Cardinal (1997).

In the quantitative realm, in general, as methodology shows increased control results tend to worsen. Biklen et al. (1995) argue that negative results tend to be associated with higher control, and that positive results tend to originate in naturalistic settings.

An example of positive results found in naturalistic setting would be Simon, Toll, & Whitehair (1994) which involved 7 students were reported prior to the study to be communicating via facilitation at levels far above what was previously thought possible given their level of intellectual ability. The authors found that 1 child out of the 7 could answer correctly on 2 of the trials.

Montee, Miltenberger, & Wittrock (1995) assessed FC for 7 adults in naturalistic conditions. Again, only 1 of the 7 subjects had any correct answers in the unknown or false conditions. The evidence suggested that facilitator control was active in the other conditions. Also, Vasquez (1995) involved a naturalistic setting. Among the 3 autistic children who participated in the study, no valid results were found in the facilitator blinded conditions.

There have been some other positive results such as Cardinal, Hanson, & Wakeham, (1996). The authors used 48 student and 3,800 trials. They randomly selected a word, presented to the student; the student had to type with the aid of their naïve facilitator. Other positive results can be found as well in the literature. Calculator and Singer (1992) have a letter to the editor of Topics in Language Disorders.

The negative results for FC include (Beck & Pirovano, 1996; Eberlin, McConnachie, Ibel, & Volpe, 1993; Regal, Rooney, & Wandas, 1994) as well as the largely negative studies already mentioned (Montee, Miltenberger, & Wittrock, 1995; Simon, Toll, & Whitehair, 1994). In addition, the large study, Howlin (1997) looked at 45 trials of FC involving over 350 participants. The data validated communication by 6% of the participants. The authors showed that over 90% of the cases were influenced by the facilitator. A large review by Mostert (2001) also showed mostly negative results.

Discussion of the Data

The data support the idea that FC may lead to authentic communication in a minority of cases. The data also support the assertion that the majority cases where FC is said to produce communication beyond what was previouly thought, are not authentic. Likewise the data support the criticism that facilitator influence is an active phenomena in the majority of cases in FC.

The data do not support the criticism of the negative findings offered by Biklen et al. that more naturalistic settings tend to produce better results. In fact the available data contradict this (Montee, Miltenberger, & Wittrock, 1995; Vasquez, 1995). No data are available to assess the claim that better results are obtained when the researchers attempt to reassure the participant. There is some data to validate the idea that FC users will improve if given time to practice the testing protocol (Cardinal, Hanson, & Wakeham, 1996). However, this repeated presentation may act over time as a sort of teaching process in and of itself. A group design where individuals are randomly sorted in a short and long testing group, has yet to be done, but is feasible. Such a design could help answer the question.

Champions and Critics

FC has has no lack of famous advocates and detractors. Critics of FC have included Carl Sagan, in “The Demon Haunted World: Science in Candle in the Dark”. The famous skeptic James Randy is a signatory of the anti- FC, BAAM petition. Also, numerous articles critical of FC have appeared in the two skeptical flagship magazines “Skeptic” and the “Skeptical Inquirer”.

On the other side we find Morton Ann Gernsbacher, the past president of the deeply scientific American Psychological Society, and is a sometime publisher in no less a prestigious journal than “Science”. Another noted advocate would be the late Arthur Leonard Schawlow the winner of the 1981 Nobel Prize for his work with laser spectroscopy. He and his wife felt the technique was helpful with their autistic son in the 1980s. I think it would be important to note some of the people who were users of FC have gone on to become adovcates of FC themselves.

Several groups have become advocates of FC. These include TASH and AutCom. Other groups such as The American Psychological Association, The American Association on Mental Retardation, the American Academy of Child & Adolescent Psychiatry, The American Speech-Language-Hearing Association, and the Behavior Analysis Association of Michigan, have offered positon statements agaisnt FC.

Review of the Defence of Facilitated Communication

Here I will look specifically at the claims offered by FC advocates. I will be blunt and say that I think this is weakest area of FC. Below, specific advocates are named and their comments will be scoured for merit.

Dr. Schawlow wrote

“However, most of these studies have given negative results because of serious flaws in their methods, resulting from a failure to understand what was being tested. In fact, all that these studies have shown is that it is possible to interfere with the process of facilitated communication.”

Dr. Schawlow proposes that in a more relaxed setting, positive results will be gained. This is directly in conflict with the data. Moreover, Dr. Schawlow asserts that the negative research proves it is possible to interefere with FC. Here he is assuming that positive results would have been found, had the protocal been different. This is assuming what he should be proving, or the fallacy of begging the question.

Dr. Schawlow wrote


“Clearly, there is an enormous amount of evidence that, under proper conditions, facilitated communication really does work.”

One might ask where is this enormous amount of evidence? Is it peer reviewed? This is where citations can should be given, they are absent in this case.
Dr. Schawlow then rebukes the skeptics by asserting

“It is scandalous that some people are using the unscientific "validation" experiments as an excuse to describe facilitated communication as fraudulent.”

And yet Dr. Schawlow has only ad hoc hyptheses to demonstrate why the controls were actually “fraudulent”. The data that could back his assertions are either absent or actually not in his favor.

Dr. Gernsbacher is the mother of a young man diagnosed with autism. She is a valued and important ally of autistic self-advocates. I will unashamedly profess my respect for her and her work. Her good example has been a model for me as a student. Her article debunking several baloney proofs of an autism epidemic, is an exercise in lucid thought. But she also has offered one opinion on FC that I think is fallacious.

She is reported to have answered a question concerning criticism of FC, by claiming the critics didn’t want to acknowledge the language capability of autistic persons. If this report is an accurate description, then Dr. Gernsbacher employed the psychogenic fallacy. She dismissed the criticism and shifts the focus onto the critics. Those who report this story as a “proof” to challenge criticisms of FC engage in the fallacious appeal to authority.

Finally we come to Biklen

Biklen writes

“Despite the controversy over facilitation, thousands of teachers, parents, and researchers continue to use the method nationally and internationally. We might ask why. What do practitioners point to as evidence that convinces them that the words typed are those of the people with disabilities, not of the facilitators?”

Biklen seems to have crossed the border into both a pragmatic fallacy (it look like it works) and an argumentum ad populum.

Biklen in one chapter, quotes a young man who proved in a non pulished replication of an earlier study that his communication is authentic. After proving the authenticity of his writing the young man was inspired to write the following:

“Today I retook the test, and I passed it, Mayer says brilliantly. But I feel sad. Sad for people who can't do it and are silenced. Sad for those who will run from the depressing truth that I was right and they were wrong. Sad that I will be fighting this fight for years to come. And sad that this was even necessary. Friends will celebrate, but then the work must continue.”

If this communication was not authentic, then a fascinating insight into the FC facilitators world view is revealed. But if so, I would argue that the young man severely misses the point of such testing. What does such an attitude tell us about the FC culture, if anything?

Conclusion

The data support the comment that FC may lead to authentic communication for some individuals with autism. The research suggests that these are the minority of cases. The research suggests that facilitator influence is an active factor in FC.

Caution is advised towards FC. I do not advocate the total dismissal of it. However, until safety guidelines are employed, there is reason to doubt the authenticity of communication by those who use it unless there other forms of communication also in use by the individual and at comparable levels.

References

Cardinal, D, N., Hanson, D, & Wakeham, J. (1996). Investigation of authorship in facilitated communication. Journal of Autism and Developmental Disorders. Mental Retardation. 34(4), 231-42.

Calculator, S.N. & Singer, K.M. (1992). Preliminary Validation of facilitated communication. Topics in Language Disorders (Letter to the editor), 12(6), 9-16.

Biklen, D. & Cardinal, D. N. (1997). Contested Words, Contested Science: Unraveling the Facilitated Communication Controversy. Teachers College Press, New York.

Biklen, D., with Richard Attfield, Larry Bissonnette, Lucy Blackman, Jamie Burke, Alberto Frugone, Tito Rajarshi Mukhopadhyay and Sue Rubin. Autism and the Myth of the Person Alone. New York University Press, (2005)

Beck, A.R. & Pirovano, C.M. 1996. “Facilitated Communicators’ Performance on a Task of Receptive Language.” Journal of Autism and Developmental Disorders, 26 (5), 497–512.

Eberlin, M., McConnachie, G., Ibel, S., & Volpe, L. 1993. “Facilitated Communication: A Failure to Replicate the Phenomenon.” Journal of Autism and Developmental Disorders, 23 (3), 507–530.

Howlin, P. Autism: preparing for adulthood. London: Routledge, 1997. pp. 5-6.

Montee, B, B., Miltenberger R, G., & Wittrock D. (1995). An experimental analysis of facilitated communication. Journal of Applied Behavior Analysis. 28, 189-200.

Mostert M.P. Facilitated communication since 1995: a review of published studies. Journal of Autism and Developmental Disorders, 2001, 31(3), pp. 287-313.

Regal, R.A., Rooney, J.R., & Wandas, T. 1994. “Facilitated Communication: An Experimental Approach.” Journal of Autism and Developmental Disorders, 24 (3), 345–355.

Simon, E, W., Toll, D, M., & Whitehair, P, M. (1994). A naturalistic approach to the validation of facilitated communication. Journal of Autism and Developmental Disorders. 24(5), 647-657.

Vazquez, C, A. (1995). Failure to confirm the word-retrieval problem hypothesis in facilitated communication. Journal of Autism and Developmental Disorders. 25(6), 597-610.

77 Comments:

Blogger jypsy said...

Conclusion

The data support the comment that FC may lead to authentic communication for some individuals with autism. The research suggests that these are the minority of cases. The research suggests that facilitator influence is an active factor in FC.


As an "ex-facilitator"...... I have no major objections to what you've written. I have only ever vouched for the validity of Alex's communication. He had a number of facilitators, including teachers, TAs (even substitute TAs), speech therapists etc, and even his sibling (who would have been 6-8yo at the time). Alex was obviously one of these "minority of cases" because he "proved himself" by going independent.

For anyone who believes that he was not communicating all along, I'd ask - "at what point was the communication *his* communication?". Was I influencing him when I held his wrist? when I touched his elbow? when I touched his shoulder? When he still had to be in the same room with me (whether or not I was paying him any attention, facing his direction etc) was I influencing him? Was his communication at that point truly *his* communication or was it not until he could independently type in his room, by himself?

I think, for my own sake, we should maybe define "influence" here.

Caution is advised towards FC. I do not advocate the total dismissal of it. However, until safety guidelines are employed, there is reason to doubt the authenticity of communication by those who use it unless there other forms of communication also in use by the individual and at comparable levels.

Can you give me an example of "other forms of communication also in use by the individual and at comparable levels" ?

10:30 AM  
Blogger Alyric said...

From Phil Schwartz (nicked from cnn.com - not sure where exactly)

"As with anything, the potential exists for fraud. But properly done, and properly understood, FC is nothing more than the minimum tactile-sensory support necessary for an individual to overcome apraxic barriers to keyboard use, or more generally, to pointing.

(The same tactile-sensory support can be used for pointing at picture-board or -book images, as for alphabetic keyboarding.)

The goal is to fade back and eliminate the tactile support, as continued practice leads to kinesthetic learning that overcomes the apraxia. (Think of the learning involved in developing the body-sense that keeps a bicyclist in balance.)

It's very much in the individual's interest to be able to type without tactile support, because with increasing independence in life-activities s/he will be in situations in which s/he'll need to be able to communicate spontaneously and without someone available to provide tactile support.

I was at the AutCom conference in Edmonton.

Many, if not most, of the folks there who were communicating via keyboard were doing so without tactile support, at least some of the time. Others were doing so with really minimal tactile input, such as constant pressure on a shoulder.

FC was misrepresented as some sort of "miracle cure" in the 1990s -- and then completely trashed on that basis.

It is *not* a "miracle cure". It is not even a miracle. It won't enable an individual without literacy to use an alphabetic keyboard meaningfully. It won't enable an individual without receptive verbal ability (the ability to understand *others'* speech) to communicate with other people who are using speech.

All it is, properly understood, is a means of overcoming specific apraxic barriers. In individuals with literacy and receptive speech, this enables interactive communication via keyboard"

Overcoming the apraxic barriers is key I think. Do behaviorists acknowledge that such exist and if so what do they recommend doing about it?

Time to revisit this, since this stuff is old. All of it's pre 2000 isn't it?

1:24 PM  
Blogger jypsy said...

From Phil Schwartz (nicked from cnn.com - not sure where exactly)

That would be http://edition.cnn.com/HEALTH/blogs/paging.dr.gupta/2007/10/giving-autism-voice.html

4:57 PM  
Blogger Interverbal said...

Jypsy,

What I mean, when I say "influence" is that the facilitator is the author of message attributed to the user, in part or whole.

As to other forms of communication, I would be agreeable to verbal-vocal speech, use of a voice output device, sign language, picture boards, and PECS. A person who occasionally indepedently types without FC would also be convincing in this regard. Perhaps there are other options that I am missing, but would probably accept.

By comparable levels, I mean that the person can express roughly the same ideas, thoughts, and observations in either modality.

5:34 PM  
Blogger Interverbal said...

H Alyric,

Thank you for outlining an explanation about how FC might work.

The question about ABA and apraxia, is a fine question. But it is a fine question for another thread.

I observe a difference between myself and others in terms of viewing mistakes made by FC facilitators. Others tend to view such people as frauds who fooled people. I tend to view such folks as people who cared a lot, but managed to fool themselves(and others).

FC was certainly trashed as being a miracle cure in the 1990s. However, this might be explained via reference to some of the claims of its advocates, Dr. Schawlaw comes to mind.

Although, we should note that more cautious statements were made by others, Biklen for example.

The research at the time didn't answer if FC was a miracle cure; the research answered the question of if the users were really the authors.

All the research is pre-2000. However, if nothing has meaningfully changed, then the old research stands.

If however the FC teaching protocal has made significant or even moderate change, then yes, some new research would be in order.

Also, if validation procedures have changed to align with blinded trials, then the research would need to be re-done.

If this is the case, then the negative research is no longer applicable. However, if so, then the supporting research also goes bye-bye. We start back from square 1. We would be evolving this new FC from a technique with little (but still existing support) to a technique lacking any research support.

So, what say you? Are the protocal and validation tehniques much different (better) now?

6:05 PM  
Anonymous mayfly said...

The clues being given are done subconsciously. The facilitator being unaware of doing so

6:14 PM  
Blogger jypsy said...

Alex would not have passed your "test". Until he was 6 1/2 he spoke 3 words and although his vocabulary began to build at that point he didn't speak in the sentences he was able to type in. He would often (after 6+) say the letter he was typing, but rarely the word. Although he could always type or print something independently, it did not "express roughly the same ideas, thoughts, and observations" as he did with sign, picture/word boards or speech. That is why FC was introduced - it gave him more freedom to express himself than these other methods did. His sign & picture vocabulary was limited to the choices he was given/taught.

As to influence - I do not consider Alex to have been fully independent until he was typing alone in the other room. That means I would still have considered myself to be a facilitator after all physical touch was gone (since he could not type if I was not in the room). While I may have "influenced" him at this point, in no way do I believe I was "the author of message attributed to the user, in part or whole." I could be reading, watching TV, working on the computer, all but asleep etc, I just had to be there.

The notion that you can influence a child's typing (autistic or not) by touching their elbow or shoulder, is one I just can't buy.

I have some really excellent video (VHS) of Alex communicating in various ways when he was young, including "FC". Someday I hope I can convert it to CD and share it.

5:28 AM  
Blogger KeithABA said...

Jypsy,

I don't think anyone here is doubting that your son is truly able to communicate using the keyboard.

Some questions that interest me are things such as, did you read a lot to your son when he was young? Was he able to look at books, text, letters, and pay attention to them? Did he express an interest in text, writing, or books prior to the use of the keyboard?

Prompting and fading is certainly something that is well documented in a lot of literature. The question (in my opinion) is more, what enabled your son to be able to spell, read, and form sentences?

What I see in your son's situation is more of an example of an augmentative device. I'm pretty sure where your son ended up with his abilities, is the goal of all FC programs. The question becomes how can research figure out why your son was able to do so, but the majority of other's couldn't fade the prompts.

Alyric:

If the facilitator is eventually able to fade out, it does not support the argument that the individual was "stuck" or had some form of a apraxia. Apraxia implies that that the individual had the ability to spell, read, and form complex sentences all along. They just couldn't execute the movements to do so. It would be very important in future research to seperate, the ability to move, from the ability to spell and form sentences. Up to this point, I've seen little of either.

7:10 AM  
Anonymous Deb said...

Here is a good video of Tito Mukhopadhyay using FC. At this point the only facilitation he needs is for his mother to say the last word or letter that he has spoken. This apparently allows him to refocus and write down the next word in his mind.

I also think that the other videos on his mother's site are useful. I would call this a form of FC as well: The kids are sort of gesturing at one of two pieces of paper in response to the questions being asked of them. In this case the "F" in the "FC" is that 1) there are lots of sensory prompts (questions being asked and reasked, paper being torn loudly, etc) and 2) the response required, at least initially, is just one of making large body movements rather than, say, pointing at a letter board, which comes later.

I am glad Soma Mukhopadhyay seems to have split from Portia Iverson, who seems to have taken her "method" and put it at the center of her own narcissistic circus.

7:37 AM  
Blogger Interverbal said...

Hi Jypsy,

Thak you for taking to share Alex's story.

I acknowledge that the assessment I proposed would not do justice to every user of FC. But I think the real test, is to use blinded trials. The assessment I propose based on other means of communication, is just a way of skipping the trials.

I am concerned support of the person's wrist of hand. I am less concerned about support of the elbow and I am not much concerned with pressure on the shoulder at all. Ditto for just holding the keyboard.

However, I am not going to make this absolute. Do you know the story of Clever Hans? It is the story of a horse who could apparently do simple addition. Lots of people were fooled, including highly educted people. It turns out that horse trainer was very subtlety telling the horse when to stop "couting".
Other skeptics have directly compared this to story to FC. It is possible that even elbow or shoudler pressure could accomplish this. Although that would not be first guess.

I feel another possibility is more likely. Several times now over the years I have come across a autistic child who could track eye gaze to identify the correct item. This is usually in receptive object labeling ("Show me the ____"). The child would watch where my eyes went and then pick out the correct item based on that.

7:40 AM  
Blogger jypsy said...

Jypsy,

I don't think anyone here is doubting that your son is truly able to communicate using the keyboard.


I don't think that was ever an issue. I think whether he *was* "truly able" before he was able to do it without me (or someone) touching him or in the same room with him is the issue.

Some questions that interest me are things such as, did you read a lot to your son when he was young?

Not as much as I would have liked, not as much as many parents read to their kids. We did have lots of book/cassette and book/video sets which, while they certainly can't replace a parent reading to their child, simulated the effect.

Was he able to look at books, text, letters, and pay attention to them?

Most definitely - except for the period (3 or 4 months) where he ripped every paper he could get his hands on. Even then, though books & magazines were put out of his reach, we "fed" him the newspaper & junkmail every day until he got the ripping out of his system. We had (have) *tons* of books including a lot of children's illustrated dictionaries and word books (The First 100 Words, The First 1,000 Words), sign books and books of every description. He especially liked the phone book, preferred the yellow pages to the white pages. Our house was labelled with little stickers. He attended a daycare a couple of half days a week that had lots of text labeled pictures on the walls - colours, numbers, body parts, seasons, animals, food etc etc. His earliest pictures we used for communication (though we didn't do PECS) were all labeled with the word for the object. I wish (and wished at the time) that we had had a TV with Closed Captioning on it. We got one a couple of years ago and Alex always watches TV with the volume very low (or muted) and the CC on.

Did he express an interest in text, writing, or books prior to the use of the keyboard?

Absolutely.

Prompting and fading is certainly something that is well documented in a lot of literature. The question (in my opinion) is more, what enabled your son to be able to spell, read, and form sentences?

No one taught him. It was there, shortly before his 4th birthday, when we started FC. Obviously, given the amount of exposure to text he was given and sought out, he taught himself. He is an excellent speller. He knows if a word is spelled wrong even if he doesn't know its correct spelling. When he was younger if he spelled a word wrong and didn't know the correct spelling, he could not move on to the next word until that word was correct. It was a number of years before he was able to carry on writing and go back to correct a misspelling. He could not speak a sentence until he was 11. Today he speaks very much like he writes (for example this blog post, pronoun reversal & all).


Deb -
I believe Tito would tell you that what he's doing is not FC.

7:58 AM  
Blogger ballastexistenz said...

The problem with the "Clever Hans" story is that it hasn't, as far as I know, been replicated when they've tried to teach other horses the same trick. Meaning the horse had to actively look for the cues, even though he was not actually adding. It also involves him pawing the ground a certain number of times, which is less complicated than typing. Not that I don't think influence can happen (I know it can, and I know some of how it can) with typing, but that I don't think it's directly comparable to a horse pawing the ground until he sees an unconscious cue from someone to stop.

I am also still curious about one other aspect of influence — that is, it is far easier to influence my speech than my typing, which is one among many reasons I consider speech too unreliable to undergo actual communication with. I have heard similar things from other autistic people (who don't use FC, some of whom don't use independent AAC of any kind either). I suspect this is often a byproduct of learning speech more rapidly than learning what it's for or learning speech more rapidly than receptive language, although I have no data to prove that and wouldn't know where to begin. (I used to also use typing in a similar way, but I made the shift to actual near-100% communication with typing relatively easily once the shift happened, and the same never occurred with speech.)

So my question is, why is it that people assume that our speech (when present) is uninfluenced when so many of us state that it is heavily influenced too much of the time to be relied on as an actual communication of our own thoughts?

7:59 AM  
Blogger KeithABA said...

Deb:

Rapid Prompting Method is a whole other ballgame than FC. I appreciate your comments, but I don't think this is the post to disucss RPM since so I'll refrain from any comments.

Interverbal:
There are definate examples of "suddle" stimulus control. There was a presentation at FABA last year that was really interesting. A computer program was designed so that it mimicked responding of a student on receptive identification trials from an array of three objects. The computer was programmed so that it only correctly identified specific items when they were placed in 1 of the 3 possible positions. For example red was only identified correctly in the middle position. The subjects had control over where they placed the objects, and were blind to the computer's programming. The subjects over time began placing the card in the same position that corresponded to the correct answer. Contingencies of reinforcement can have amazing effects on peoples behavior.

8:14 AM  
Blogger jypsy said...

Hi Jypsy,Thak you for taking to share Alex's story.I acknowledge that the assessment I proposed would not do justice to every user of FC. But I think the real test, is to use blinded trials.

a little late for that :)

The assessment I propose based on other means of communication, is just a way of skipping the trials.

I would wonder why, if they could communicate the same thing some other way, why they wouldn't.

I am concerned support of the person's wrist of hand.

So am I.

I am less concerned about support of the elbow and I am not much concerned with pressure on the shoulder at all. Ditto for just holding the keyboard.However, I am not going to make this absolute. Do you know the story of Clever Hans? It is the story of a horse who could apparently do simple addition. Lots of people were fooled, including highly educted people. It turns out that horse trainer was very subtlety telling the horse when to stop "couting".Other skeptics have directly compared this to story to FC.

I know the reference but not the whole story. Was the trainer doing it on purpose? Was this subconscious influence or conscious dishonesty? I believe both are possible and have likely happened with different people involved with FC and while I might be persuaded that there is an amount of subconscious influence going on I'd have a hard time believing that there is that amount of dishonesty going on.

It is possible that even elbow or shoudler pressure could accomplish this. Although that would not be first guess.I feel another possibility is more likely. Several times now over the years I have come across a autistic child who could track eye gaze to identify the correct item. This is usually in receptive object labeling ("Show me the ____"). The child would watch where my eyes went and then pick out the correct item based on that.

Like I said, I can only talk about my own experience and you'de be really reaching if you were trying to apply that to Alex. As I recall (might be time to dig out some videos) I often stood behind him when he typed (touching his elbow/arm/shoulder). He looked at the keyboard when he typed. I don't think a kid could track eye gaze to a specific key on a keyboard most especially the tiny keyboard of a Canon Communicator. He got his first notebook - our first computer - in grade 2 (7yo).

Have you ever tried to manipulate a child's typing on a keyboard by holding their wrist, elbow or shoulder? I would suggest people try it.

8:27 AM  
Blogger KeithABA said...

Jypsy:

Thank you so much for answering my questions. It really sounds like a large part of that exposure to text must have been at least correlated with his ability to spell/write.

When you say, "No one taught him. It was there, shortly before his 4th birthday, when we started FC. Obviously, given the amount of exposure to text he was given and sought out, he taught himself."

I think that might be slightly underestimating your efforts to teach! It would be very odd to assert that spelling could be a behavior that was "innate." If this was the case, what would account for different languages? Why wouldn't your son be spelling in spanish?

I really think the time you spent with him, exposing him to text, and his interest in text were some of the predictors that he would be able to spell in the future. Or at least those factors influenced his ability to "teach himself." That is a difficult thing to research, because until he was able to type by himself, how would anyone ever know if he knew how to spell???

"I think whether he *was* "truly able" before he was able to do it without me (or someone) touching him or in the same room with him is the issue. "

Like I asserted previously, I don't really beleive that someone can "teach themself," to spell/write. This opinion being based upon studying language development in typically developing children as well as children with some form of developmental dissability. (again in my opinion) Either something about the way you interacted with him, taught him to be able to spell/write, or something about using the FC device taught him to spell/write. Seperating those things out is what the research should be all about.

I also just want to add, while you and your son's experiences are truly amazing and inspiring, I can't accept one case as being proof that FC is the way to go with all children with autism.

8:41 AM  
Anonymous Deb said...

Keith and jypsy, why is RPM a completely different ballgame than FC? Isn't it all about the prompting in both cases? Aren't they both about 1) keeping a communicator "on task" and "present in their body" by providing sensory input and 2) making things physically easier for a communicator who needs help getting their body to do something that is difficult for them.

Here's my take, which is not inconsistent with the research findings, I think:

1) Autistic and NT individual are the same, with the exception of some very significant neurological differences (sometimes small...sometimes large). These neurological differences lead to developmental differences, often including the ability to communicate easily through "normal" channels.

2) All kids, autistic or NT, learn communication skills using a process in which facilitator influence is initially a significant factor. As they develop (as ALL kids do), this influence tends to becomes less and less. Depending on neurology, motivation, and effort, this may be a much slower and more tedious process for some. For some individuals, communication (faciliated or otherwise) may never be possible, for some, it may be just barely possible, and for some, it may be entirely possible.

3) Neurological differences and associated developmental differences can lead to a number of behavioral and intellectual differences. These are influenced, to a large degree, but the extent to which communication pathways are open/identified/utilized.

4) In all cases a child's communication potential is worth maximizing. FC may not work for everyone, but it is always worth a try.

5) Sadly, the inability-to-will-ones-body-to-do-something and delayed-processing (both neurolgical differences) are often confused with lack-of-understanding (an intellectual difference) or lack-of-potential-to-communicate.

Here's more Tito stuff. I'd like to hear more from Alex and jypsy. I wish more parents would know about people like Alex and Amanda and Tito, rather than seeing the crap that Autism Speaks puts out.

9:24 AM  
Blogger jypsy said...

Deb said:
Keith and jypsy, why is RPM a completely different ballgame than FC?

I said "I believe Tito would tell you that what he's doing is not FC.", I didn't say they were "completely different ballgame(s)" or different at all. In fact, Tito did (say they were different) when I asked him what the difference was between the two. It was a private email that I will not repeat here but if you ask him yourself he'll likely tell you.

Keith:
I think of myself to be more like an "enabler" than a "teacher". Perhaps that is the definition of a good teacher....

you said
"I also just want to add, while you and your son's experiences are truly amazing and inspiring, I can't accept one case as being proof that FC is the way to go with all children with autism."
and I completely agree. Nothing, IMHO, is "the way to go with all children with autism." Neither is FC a "cure", a "treatment" etc. It is a communication tool, one of many that Alex used.

9:51 AM  
Blogger ballastexistenz said...

Like I asserted previously, I don't really beleive that someone can "teach themself," to spell/write. This opinion being based upon studying language development in typically developing children as well as children with some form of developmental dissability. (again in my opinion) Either something about the way you interacted with him, taught him to be able to spell/write, or something about using the FC device taught him to spell/write. Seperating those things out is what the research should be all about.

Uh... have you ever heard of hyperlexia? It's really common in autistic people.

12:52 PM  
Blogger KeithABA said...

"Uh... have you ever heard of hyperlexia? It's really common in autistic people."

Could you please point me to some literature that that says hyperlexia is associated with writing/spelling?

Further hyperlexia is "supposedly" being able to pronounce but not "comprehend." The characteristics also include difficulty with communicating.

So are you attempting to diagnose Jypsy's son with Hyperlexia and attributing his ability to communicate by typing to this diagnosis?

1:10 PM  
Blogger Interverbal said...

Hi Amanda,

I agree that Clever Hans, is an exceptional horse, and that the subtle cueing that happened there to get him to stomp, is much simpler than typing. However, I think the Clever Hans story illustrates the fact the subtle cues can determine behavior and can be missed, even by really smart people. By far the most interesting part about the Clever Hans story is that Han's owner, disagreed with the negative findings and continued to display Hans.

I really don't know why people would assume autistic speech is uninfluenced. If I had to wrangle a guess, I would say that whereas some people would assume we could easily detect influence in vocal speech, maybe they are not so bold with typing, especially when the hand is being held by another person.

4:44 PM  
Blogger Kassiane said...

Just about ANYTHING on hyperlexia states that it is reading-which doesn't have to be spoken, I'm sure everyone here is capable of SILENT reading-above receptive language, with accompanying text based skills.

Like spelling.

And writing.

Think it through logically. If you can read, you can tell if you spelled something wrong, because it LOOKS wrong.

American Hyperlexia Association mentions it, repeatedly, if you can't believe actual hyperlexic people.

-Reading since age 2.

4:57 PM  
Blogger Interverbal said...

Hi Jypsy,

"Like I said, I can only talk about my own experience and you'de be really reaching if you were trying to apply that to Alex."

Nope, no danger of that. I am really just trying to hash out some ways that influence could have been exerted in the cases where such was proven.

Clever Hans owner doesn't appear to be a fraud. He does appear to be a man who accidently fooled himself (and others).

"Have you ever tried to manipulate a child's typing on a keyboard by holding their wrist, elbow or shoulder? I would suggest people try it."

Not for typing, but certainly for hand writing. Especially when a student is first learning. G's and e's are brutal for some learners

4:58 PM  
Blogger Interverbal said...

I am going to agree that hyperlexia seems to be self-taught. Although, I think one needs certain materials for this to occur.

In other words, if a child doesn't have access to the sight of letters and examples of the sounds the letter makes, the I don't think it is goong to happen.

Kassiane writes "Think it through logically. If you can read, you can tell if you spelled something wrong, because it LOOKS wrong."

Hmmmm... I am not sure how far one is going to get with that argument, if the language in question is English. There have been several reform attempts in the past to try to match the spelling more to the pronounciation. I myself just mangled a word with a latin "bt" spelling just a few posts above.

5:09 PM  
Blogger jypsy said...

"Kassiane writes "Think it through logically. If you can read, you can tell if you spelled something wrong, because it LOOKS wrong."

Hmmmm... I am not sure how far one is going to get with that argument, if the language in question is English."


And/or if the speller in question is me! I assure you I can read (not getting into what MS has done to that ability) but my spelling has always sucked. Alex certainly did not inherit his spelling ability from me. Alex's Aspie brother spells worse than I ever did and although he is not the best reader and struggled with reading in his early school years, he does read and is taking the academic English course (in Grade 12 now).

I can tell if I spelled something wrong because it looks 'underlined in red'. My good spelling is an illusion brought to you by spellcheck.

5:47 PM  
Blogger Kassiane said...

I should have been more clear:

For an automatic decoder (and I have never been anythng else so I don't KNOW how other people read) if something is spelled wrong it LOOKS wrong. I can't do phonics. I CAN tell if I misspelled something, even if I cannot fix it.

I've no idea how this works in someone who isn't "born reading".

7:04 PM  
Blogger jypsy said...

I CAN tell if I misspelled something, even if I cannot fix it.

That accurately describes Alex

7:20 PM  
Blogger ballastexistenz said...

For an automatic decoder (and I have never been anythng else so I don't KNOW how other people read) if something is spelled wrong it LOOKS wrong. I can't do phonics. I CAN tell if I misspelled something, even if I cannot fix it.

I've no idea how this works in someone who isn't "born reading".


Likewise.

Here's a quote about me (and my brother) by my mom:

Amanda’s oldest brother was riding in the car strapped into his car seat when he spontaneously read “milk” on a truck passing by. He was fascinated too by the game show” Concentration” dancing to the music and playing the game when he could barely walk…So it was no surprise when Amanda was an early reader . The most common way I remember Amanda falling asleep was with a book on her face or chest and a cat curled up by her side as she read herself to sleep in her crib.

I don't remember learning to read, the way some people don't remember learning to talk. I have the same thing going on with spelling, and the strangest thing is that I can glance at a whole paragraph of words, without understanding a single one, and know that somewhere in there is a misspelled (at least according to standardized spellings) word, and then have to hunt for it.

I've noticed my spelling going downhill since using speech output devices, because I often have to type a word in a deliberately misspelled way to get the thing to pronounce it correctly.

But, likewise, I wasn't taught to read any more than most people are taught to speak. (And I was consciously taught speech, after I lost it the first time around.) I was shocked when I first discovered that most people learn to read in school. It's completely alien to me.

I might be able to teach someone meanings and purposes of written words, but I am not sure I could teach someone to read itself. It is easier to teach someone something you had trouble learning, than to teach someone something that has come naturally.

10:17 PM  
Blogger ballastexistenz said...

I wrote: It is easier to teach someone something you had trouble learning, than to teach someone something that has come naturally.

Which reminded me of what I told a man who used facilitated communication (typed rapidly, at least rapidly for one-finger typing, with minimal elbow support) when he asked me how to become an independent typist.

I told him that since I had always been an independent typist (and even spoken at one point, etc), then I wasn't the best person to ask. I told him to ask someone who'd gone from physical support to independence, because they would know all kinds of little details about the process that I just don't, because I've never been through it.

10:20 PM  
Anonymous mayfly said...

Trials show that when the facilitator and client are separated, or are given different information, the ability to use an FC device plummets.

There is certainly purposeful influence in the early stages. The manual I read says the facilitator is to correct obvious mistakes, and to finish words when they are also obvious. I might not have the above exactly right, but I believe the gist of it is fairly stated.

Does anyone know if any trial has included users of FC devices where the facilitator was not touching the client, but simply present in the same room.

Autistics are generally not know for picking up subtle clues from people.

11:47 PM  
Blogger jypsy said...

"The manual I read says the facilitator is to correct obvious mistakes, and to finish words when they are also obvious. I might not have the above exactly right, but I believe the gist of it is fairly stated."

No one who facilitated Alex did this. One of the reasons I usually put FC in quotation marks when I discuss our use of it is because, although it looked like FC, and fit the basic definition, I'm not convinced that it encompasses everything that FC is said to be.

Also, none of Alex's facilitators were trained by anyone other than me or those I had "trained" and I was not trained.

5:10 AM  
Blogger KeithABA said...

ballastexistenz:

"But, likewise, I wasn't taught to read any more than most people are taught to speak."

I think our definitions of taught are quite different here. I am assuming you are considering being taught sitting down, doing formal lesson plans, studying, phonetics....etc.... "EVERYONE," is taught language, the parameters of doing so are just different across people.

To assume that people aren't taught to speak implies that language is innate. I don't think you will find any evidence anywhere that this is true. You must be exposed to environmental contingencies to learn to use speech. If language was truly self taught, you wouldn't be bound to the language you were raised around. People who grow up in spanish speaking families, speak spanish. People who grow up in English speaking families, speak english. People in bilingual families, are often bilingual.

I completely disagree that just because someone can look at a word, and possibly pronounce it, it means that they can also express their thoughts by typing. Those are completely different behaviors.

Jypsy:

Thank goodness for spell check!

"No one who facilitated Alex did this. One of the reasons I usually put FC in quotation marks when I discuss our use of it is because, although it looked like FC, and fit the basic definition, I'm not convinced that it encompasses everything that FC is said to be."

I think this further supports the agrument that FC does not have good research support. And while it may help some kids, I don't think it was FC, but rather that the individual leanred to type!

This ties back to my original opinion that teaching a child to type with a keyboard can be a fantastic skill for expressive communication. This doesn't mean that FC is the only way to do so! Or that if someone learned to type because someone else helped them do so, it automatically falls under FC.

And it also further's the argument that you are quite the "enabler."
:)

6:42 AM  
Blogger Alyric said...

"To assume that people aren't taught to speak implies that language is innate. I don't think you will find any evidence anywhere that this is true. You must be exposed to environmental contingencies to learn to use speech. If language was truly self taught, you wouldn't be bound to the language you were raised around. People who grow up in spanish speaking families, speak spanish. People who grow up in English speaking families, speak english. People in bilingual families, are often bilingual."

Just about every linguistics department in the country would disagree with that simple statement. This is behaviorist lore and I'd really like to see the agreement from genuine linguists about that.

Oh and with Kassiane - of course it 'looks wrong' if it's mis-spelled and especially in English, which has no predictability whatsoever.

7:22 AM  
Blogger Interverbal said...

Almost all linguists would agree that pre-school aged chidlren have a special innate capacity for language that fades over time.

Some linguists would argue that minds grow as opposed to being taught.

This is a 40 year old debate. There is science on both sides. Some of the science is shared e.g. (exclusivity). Some of the science is claimed to be a proof by one side or the other, but really isn't, not even close (development of new languages). Some of the science truly is a support of one side or the other.

Either theory is plausible, neither is confirmed. That is simply where it is at right now.

And although I fall squarely on the behavioral end of this debate (I was a article coder in a comprehensive published review of all existing verbal behavior studies a 3 years back) I won't attempt to claim the finality of our theory. Now whether it is the better theory..... hmmmmm now thats up for debate.

7:56 AM  
Blogger jypsy said...

Kassiane said...
"For an automatic decoder (and I have never been anythng else so I don't KNOW how other people read) if something is spelled wrong it LOOKS wrong."

and Amanda added....
"I have the same thing going on with spelling, and the strangest thing is that I can glance at a whole paragraph of words, without understanding a single one, and know that somewhere in there is a misspelled (at least according to standardized spellings) word, and then have to hunt for it."

And that reminded me of Alex's older brother once telling me that he can look at a page of computer code and the error jumps out at him, something his peers and fellow (College) students at the time couldn't do. Although not diagnosed, he does have his traits. Currently he works as a Unix Systems Analyst in the head office of a major Canadian Bank. Without Alex's need for a computer to communicate his brother would not have had one in his life until many years later and would likely not be where he is today. (He's almost exactly 2 years older than Alex so was almost 9 when he first got his hands on a computer and he took to it like a fish to water)

Amanda also said....
"I've noticed my spelling going downhill since using speech output devices, because I often have to type a word in a deliberately misspelled way to get the thing to pronounce it correctly."

I used to have to re-write some of Alex's writing if his laptop was going to do his "oral presentation" to the class and he was often rather unhappy with me having to do so. I especially remember his presentation on Sting in grade 10.... Sting has a daughter named Fuschia.... I don't remember how I ended up spelling it but I do recall the correct spelling wasn't going to cut it! It was not long after Alex decided he was going to speak his oral presentations and accommodate his classmates & teacher who couldn't understand his speech by putting the text of his talk up on an overhead. He continued to use an overhead or powerpoint type slides to accompany him and accommodate his audience right through high school and to this day (when he was a guest speaker at the 2006 PEI Marathon, when he presents awards at the RoadRunner banquet etc)

I do not edit, or even encourage Alex to edit, any mistakes he makes in his blog posts. I (we all) did (encourage him to) when he was in school. If he's writing something important I would but I leave his blogging alone. It isn't proper grammar but it's quite properly Alex.

8:10 AM  
Blogger jypsy said...

This is from Alex's old web page and discusses the independent work he did when he used "FC". It doesn't meet that requirement of "express roughly the same ideas, thoughts, and observations" but does demonstrate a level of ability his peers did not share at the time.

"He always had some level of independent typing. At first the alphabet and the numbers 1-20. He typed a lot of gibberish by himself but all of a sudden he started typing "pumpedi" all over the place. It took me a while, and many pumpedis later, to realize what he was typing was "Pumped!", the name of a kids sports show on the sports channel that he really enjoyed. Not being able to find the "!" he used "i". His first independent word. (Note: this all took place on an electronic typewriter loaned to him from the owner of a daycare centre when he was 3)
His first independent sentence came in grade 2 when, in the midst of the teacher talking about how odometers work, he leaned forward and typed "one day i come to to see matthew". Matthew was "MJ" (his TA)'s son. She also did respite work for me, taking him home some weekends. He was asking to go for the weekend and he certainly did!! He printed it out, cut it out and brought it home to me. Alex continued to use FC until grade 4 when he insisted on totally independent typing. The quality of his work has gone down some but NO ONE will dispute the work is his. He's always done math and most of his spelling with a pencil."

8:20 AM  
Blogger ballastexistenz said...

What I mean by "being taught" is explicit teaching. Not lesson plans (I'm not that ignorant), but setting out to actually teach something, rather than mere exposure to the thing. Nobody used anything remotely school-like to teach me to speak, but they did in fact explicitly teach me to speak.

They did not explicitly teach receptive language, however, and that became a major disparity that continues to a more minor degree to this day -- my receptive vocabulary is even now only 80% of my expressive vocabulary, at least according to this way of measuring it.

I was not explicitly taught to read, however. At all. I was just exposed to reading material. Merely being exposed to something is not the same thing as being taught explicitly no matter how you try to justify it as still being "teaching".

8:27 AM  
Blogger KeithABA said...

Interverbal: "An innate capacity for language," is completely different than saying that language develops without being taught.

I am crossing my fingers that a linguist will come a long and reply. Someone who is a linguist, please come and verify that, "Language will develop without external stimulation." "That you can learn to speak spanish without being exposed to spanish speakers." Of all the literature in Linguistic's I've read, that is not the case, but I would welcome the comments of an expert.

Alyric, you consistently claim to be an expert in every field you comment on. Instead of speaking for, "Every linguist in the country," why not invite a linguist to comment.

8:56 AM  
Blogger KeithABA said...

ballastexistenz:

I never implied that you were ignorant because our definitions of "taught," appear to be different.

There is a difference as you stated, "but setting out to actually teach something, rather than mere exposure to the thing."

In my opinion, being taught simply means, you weren't doing something, then you were exposed to some sort of contingency, now you are doing that thing.

The intent of a teacher does not matter. I like cats. If I am with a child and I say, "Hey look, there's a cat." Later the child is watching t.v. and a cat food commercial comes on. The child says, "Cat."

Excluding other instances and contact with the word "cat," my statement, "Hey look, there's a cat." May have taught the child to label cat.

If I said "Mira! el gato." Later the same commercial comes on. The child may say, "Gato."

If that statement was all it took for that child to say, "Cat," then I would say that my statement effectively "taught" the child to say cat.

So you can see from those examples, our definitions of "taught" are different.

9:52 AM  
Blogger ballastexistenz said...

But children do pick words up just by watching other people talk to each other, as well. It doesn't need to be even as explicit as "Look, there's a cat," spoken to the child. Two people can be talking about a cat in the child's presence and the child can pick up on what they're talking about.

You seem to be saying that if learning takes place, then whatever stimuli the learner is responding to is 'teaching', but that sounds circular. And I do maintain there's a serious difference between the everyday interactions that children learn from, and someone actually setting out to make sure a child learns a specific thing.

And also that most people would probably know what I'm talking about, but not what you're talking about, with the word usage here. It's taking things to the ridiculous to claim that anyone on this thread said that children could learn languages without ever being exposed to them. What was meant was that most children can learn a language by being exposed to it in everyday use, instead of having someone deliberately teach them the language.

I can't tell if you really didn't know what was meant when people started talking about that, or if you are responding the way you are for the sake of argument.

12:10 PM  
Blogger Jannalou said...

Jumping in with the 'taught language' thing.

I've taught kids to speak in ABA programs, and I've done it just in everyday life. Everyday life is way easier and more natural. I currently nanny an 18-month old boy who is learning new words every day. I use the technique (natural to most and drilled into us ABA therapists) of repeating words slowly and clearly when I want him to repeat me, but I don't push things at all - it's not that important (he'll get there when he's ready).

As to reading, my mother taught me when I was three, and I was interested in books long before then. She used some sight-reading books to teach me, I picked up the idea from there, and I was reading adult books by grade three and spelling at a high school/university level by grade five. Phonics came naturally to me, as did spelling, simply because of my exposure to printed materials. On top of that, I understand proper grammar because I was exposed to quality literature from a very young age. I may not be able to label the parts of a sentence, but I can definitely tell you if it's grammatically correct and how to fix it if it's incorrect!

My mother teaches piano using the method developed by Shinichi Suzuki. It basically takes the idea that "Japanese children speak Japanese" to the extreme idea that a lot of exposure to something can grant knowledge. And it works. Children learn to play complicated pieces in much less time through their exposure to the recordings (daily listening) and plenty of practice. And this with a 15 minute weekly lesson to start.

1:21 PM  
Blogger Interverbal said...

Great discussion! I would be interested to know what folks think the differences between a taught lesson and picking something up from everyday usage consist of? And how this relates to FC?

12:36 PM  
Blogger Jannalou said...

A taught lesson is like what I do with the child I am nannying, anytime I target a word specifically to get him to say it (he now says please & thank you, with prompting). But picking something up from everyday usage is more like... when you read a word for the first time and figure out its meaning based on the context. Nobody's explicitly taught you what it means, but you know it anyway.

It pertains to FC because of the claims that people make regarding people who supposedly can't read being able to type in full sentences when using FC.

9:01 AM  
Blogger KeithABA said...

"But children do pick words up just by watching other people talk to each other, as well. It doesn't need to be even as explicit as "Look, there's a cat," spoken to the child. Two people can be talking about a cat in the child's presence and the child can pick up on what they're talking about."

I couldn't agree with you more!!!

And no, I'm not just describing "taught" for the sake of argument. It is very relevant when you start to say someone "taught" themselves. That's where things like intent start to come in.

Either example with the word cat illustrates "learning." I think that we could agree on?

In the example with the cat, if two people were just talking about the cat, and the child learned cat, did the child "teach themselves?"

Tying back to the topic, we were discussing how Alex (Jypsy's son) could have come to learn to spell/type to communicate. There was discussion over weather he "taught" himself.

This is very relevant to the discussion because how would Alex have learned to spell without exposure to textual stimuli. Now this is where "taught" comes back into play. If teaching is "actually setting out to make sure a child learns a specific thing," then how did Alex learn to spell?

One response was, "he taught himself." So then teaching yourself means that you, "picked it up from exposure," versus being taught "someone set out to teach you a specific thing."

In the first example "picking it up from exposure does not mean that it developed innately. This is why I asked about his interest in books, text, and being read to. I believe that Jypsy's reading to him, talking to him, perhaps sounding out words that were listed on the page are all a vital part of his learning to spell/write. Regardless of weather her intent was for him to learn to spell, those interactions are likely at least partially responsible for his ability to spell/write.

So, it is very important to identify why some autistic children learn to spell/write while other's don't. And this is a very important part of what might make FC appropriate for some, but not others.

Phew! Sorry for the long post but this is a good discussion.

9:30 AM  
Blogger jypsy said...

"One response was, "he taught himself." So then teaching yourself means that you, "picked it up from exposure," versus being taught "someone set out to teach you a specific thing.""

That would be my working definition.

A couple of other notes - when Alex began to speak in grade 1, at 6 years, 2 months of age, he could read aloud anything you gave him and asked him to read read aloud. He was nowhere near able to express himself verbally at that point.

I may suck at spelling but I can spot a "weather" that is supposed to be a "whether" and most cases like that. My own downfall is "its" & "it's"....

9:54 AM  
Blogger Alyric said...

"Alyric, you consistently claim to be an expert in every field you comment on."

Lord, how rude! Listen up Keith. This is the Hub and we expect not only a certain standard of sensible comment, a certain amount of politeness is also a requirement.

I am not nor ever have been an 'expert' on anything. We clash and will continue to clash because I find behaviorist dogma quite unpalatable and am not going to hesitate to say so where relevant.

In any case, Jonathon answered the question beautifully and we disagree all the time too. For us , I suspect it's a bit of a game. You take yourself just a tad too seriously.

The language 'instinct' is as Jonathon stated a 40 year old debate and as I recall, Skinner lost the first round in that debate with Noam Chomsky's famour review of "Verbal Behavior". Apparently you missed it.

Now getting back to the point - I asked Jonathon what behaviorist's think of the 'apraxia' question that Phil Schwartz rhinks is central and so do I. Since it's absolutely essential to this discussion, what is the behaviorist stance? If there is such a thing and I've seen references to such but not looked into it further, then surely ABA therapists are acting unethically in not bringing in speech language pathologists to examine this and make appropriate recommendations. Too important a point to leave for another day, IMO.

12:22 PM  
Blogger KeithABA said...

You conveniently left out the rest of that quote.

"Instead of speaking for, "Every linguist in the country," why not invite a linguist to comment."

And I will stick to my guns on that one.

While you may find my statement rude, I find your posting of blanket statetments and use of language to be quite offensive as well. Yet I have not attempted to debunk your character as you have just done to me.

For example:
Alyric

"behaviorist dogma"

"...would disagree with that simple statement. This is behaviorist lore..."

"'hang on a sec', this is just the prejudice to be expected from the behaviourist school of thought. Remember - no respect for the innate, autonomy etc."

"I know you think that people are more tabula rasa than that,"

These being just a few examples. Did you ever think that your choice of words could be slightly offensive to others before accusing me of being too rude for the HUB?

2:17 PM  
Blogger Alyric said...

Well, I'm sorry that you are so offended. However, lore, dogma and 'school of thought' are really quite accurate descriptors of something that is not Science but belief, articles of faith - capisce?

And of course you can stay on your side of the linguistic fence if you want to. Feel free.

However, returning to the topic - what is your stance on apraxia?

2:43 PM  
Blogger Kassiane said...

re: Learning innately.

I learned to read at age 2. My parents decidedly did not set out to teach me to read, particularly at age 2. They had books, which I looked at. I sat on their laps while they read (murder mysteries and the newspaper). They read to me, but there was no sounding out. My mother CANT, she's an automatic decoder too...neither of us has that ABILITY.

It's about as inborn as any of my skills get--see text, know what it says.

Re: apraxia...I don't understand how anyone can NOT "believe in" apraxia. That's like not believing in blindness. It's pretty clear that some people's bodies don't do what their told, isn't it? Have I been blessed with knowing some very NOT coordinated people or something?

6:12 PM  
Blogger Tera said...

My grandma taught me to read when I was 3, during a few-hour period while my mom was doing errands. (I had certainly been read to a lot before then, watched a lot of "Sesame Street," etc). I read phonetically, in an NLDish way.

But like Jannalou, I learned good grammar (and writing in general) from being exposed to it. Many people who are good writers say they learned to write by reading.

I got lots of failing grades on assignments where we had to label parts of a sentence. I could write grammatically correct sentences, however.

It was only after learning Latin that I finally understood parts of sentences--because I didn't know the language and a word was spelled differently depending on the part of speech it was. A non-autistic, non-LD friend said that she didn't understand parts of speech until she took Latin also.

In high school teachers made us all write "five-paragraph essays." I had a lot of trouble writing them. I had never seen one outside the classroom before. I eventually got the five-paragraph essay drilled into me, but it was always unnatural and made no sense to me at all.

1:20 PM  
Blogger Jannalou said...

Totally off-topic:

Tera, what is a "five-paragraph essay"? I understand the structure of an essay and have written many over the years, but I haven't heard this term before.

On topic:

I don't find the arguing to be beneficial. KeithABA, you are taking more offense than necessary to Alyric's comments and descriptors. I have to say that the phrases you're taking offense at are fairly good descriptors of the ABA school of thought at this point in time, as it pertains to autism. The science just isn't there, much as its acolytes wish it was.

I don't throw behaviourism out the window, but I do see where & when it is most useful. Not everything can be best described as behavioural in nature, and it is best to keep behavioural techniques in the background to be used when necessary.

9:49 AM  
Blogger Interverbal said...

I did warn everyone to expect some bluntness in this thread. Bluntness can travel in many directions.

I was worried that the data and criticisms I offered of FC, could get buried under a mountain of disagreement over ABA issues. Judging by the current direction, this fear was justified.

I want to keep ABA and FC seperate. If folks want to discuss or debate ABA, then please head to an ABA thread.

3:46 PM  
Anonymous Ballastexistenz said...

Yes, apraxia does exist, although it's dubious (as with the agnosias and aphasias) whether it is useful to apply the standards of conditions acquired through injuries to previously-typical brains to people who either:

1) Experienced the injury so early that all development has moved around it in ways that don't happen as much in adults.

2) Were born with brains that function atypically in ways that can resemble people with adult brain injuries but are also different because they're functional differences rather than caused by an injury to a previously-typically-functioning structure.

I don't know that they have any good terms yet for difficulties with movement or differences in the form movement takes, that autistic people might experience. They tend to get lumped (depending on all sorts of factors) under categories that usually refer to something different. Like...

Apraxia, dyspraxia, atypical parkinson's (like that guy at the conference was diagnosed with), parkinson-like, catatonic, just plain "movement disorder", etc. (And the same person can be labeled with one or more than one of those depending on who's doing the looking.)

I've had very rapid eyeball-"diagnoses" of catatonia, as well as more reasoned ones, been told it's parkinson-like, been told by one neuropsychologist "What you describe would sound like apraxia if you'd had a stroke or something, maybe you ought to read up on it," etc. Of course, it's become nearly impossible to read up on apraxia recently because "apraxia of speech" has become such a common diagnosis in children (even though it might not be the best descriptor for it) that many people use "apraxia" synonymously with that and it's difficult to find other sorts (like, say, the original definition of the word) in search engines.

But what all those things mean (when applied to me), have to do with a certain kind and level of difficulty with (or impossibility of) voluntary movement where automatic/triggered or involuntary movement is often less impaired or even above average, and in which there are also some odd involuntary responses and freezing that go on. (And the fact that the gap between the two has widened rather than lessened over time. And in my case there is probably some degree of brain damage involved although I was already experiencing more difficulty before the brain damage.)

And I have a hard time believing anyone could think these things simply don't happen. But then, you never know.

When I'm doing something that resembles what gets called "FC", it's usually related to those sorts of things. Someone assisting me to get started, the same way service dogs have been trained to do for people with Parkinson's, and that my cat can do for me.

(And my cat has been observed doing this by many people. I have been trying to figure out how to simulate it for a video, because I can't work a camera at the times when I'd need the kind of help she gives, and she's smart enough to tell the difference between me faking it so someone can watch her help me, and me really needing her help, and she won't respond to faking except by possibly increased irritation with me. The good thing about a cat is that nobody ever believes she's the one writing something if what she's doing is helping get my arms moving.)

10:44 AM  
Anonymous Anonymous said...

It is helpful to actually read and analyze the sources cited. The "controlled" studies that supposedly support FC are hardly support. Weiss et al. could not get a top-performing middle school student to get more than about 70% on a second-grade test after practicing the answers and throwing out a session from the data analysis. You could say that they had actually invalidated the child's previously reported performance. Sheehan's subjects failed to provide correct answers on about 90% of the trials, and an indeterminate number right answers only came after prompting. Cardinal hid how bad his results really were by averaging the top score out of 18 sessions. Any subject who got just one more answer correct out of 90 tries over baseline was said to have improved. It doesn't look like his subjects did better than about 10% overall either. None of these studies included a condition to test for facilitator influence. None adequately protected for bias and influence, with the observer and facilitators often in possession of the answers. These studies are worthless as support for FC--unless simply having a study, no matter how bad, is "support." Perhaps there is a logical fallacy in "Interverbal's" list to describe making an argument based on evidence that only appears to be evidence.

5:49 PM  
Blogger Interverbal said...

Anonymous,

Thank you for the helpful information. I am away from article acess right now, so I can't confirm or deny your comments.

You write "Perhaps there is a logical fallacy in "Interverbal's" list to describe making an argument based on evidence that only appears to be evidence."

You have me exactly right, I based my conclusions on what appeared to be evidence. I accept your criticism. It may be that the research design was not adequate to answer the question. I will write a response in several days after I have reviewed the articles.

You will find no "logical fallacy" to describe "making an argument based on evidence that only appears to be evidence". That would be a design problem, not a logical fallacy.

Thank you for your time.

7:09 PM  
Blogger Jim Butler said...

But [Gernsbacher] also has offered one opinion on FC

Do you have a citation for this, or for anything she has written about FC?

A cursory look at a google search of (gernsbacher "facilitated communication") shows nothing, with the exception of your blog post at #1! Please verify your source. The last thing this topic needs is more confusion.

Apart from that issue, thanks for your review, which I thought was well-reasoned and informed, qualities that FC discussion absolutely need more of.

P.S. - Anonymous above has not fairly represented aspects of the controlled studies by Weiss et. al. I don't have time right now to explain why, but I do recommend actually reading them, and not relying on others' summaries, which (cf. facilitator influence) may introduce extraneous bias.

I also shake my head in wonderment at why FC proponents have not dedicated time to replicating the Weiss study design with other FC users. Going to either extreme of uncritically embracing FC (not too common these days) or rejecting FC (far too common) is not scientifically supportable.

12:15 AM  
Blogger Jannalou said...

Going to either extreme of uncritically embracing FC (not too common these days) or rejecting FC (far too common) is not scientifically supportable.

Very true. Tell that to the Pro-ABA folks, the chelationists, the New Agers, etc. All of these groups do this. Why? Because that's how people are. We all believe things and embrace things without having all the information firmly in hand. It's part of being human. The problem is that all too often that faith gets imposed on others to a damaging extent. And that goes for ABA, FC, DAN!, and all politics and religion - and probably nearly everything else under the sun.

11:58 AM  
Blogger KeithABA said...

Jannalou:

"Very true. Tell that to the Pro-ABA folks, the chelationists, the New Agers, etc. All of these groups do this."

From reading Interverbal's post, and reviewing the literature, I thought there was a middle ground? Wasn't that the whole point of the original post? That:

"The data support the comment that FC may lead to authentic communication for some individuals with autism. The research suggests that these are the minority of cases. The research suggests that facilitator influence is an active factor in FC."

I can't speak for chelationists, or new agers, but "Pro-ABA folks" would be exhilarated to use FC if there was better research to demonstrate it's efficacy. But there's not...

So far, there are not a lot of single subject or group subject studies that show FC to be very effective.

I also think that people, in general, aren't drawing the line between FC and an augmentative device. I have worked with several people who use augmentative devices, and they are some of the best technology I've ever seen. Just because someone is typing on a keyboard, doesn't mean it is FC.

1:06 PM  
Blogger Interverbal said...

Hi Jim,

Dr. Gernsbacher’s comments were paraphrased by autistic advocates who heard her speak. These comments have been mentioned on several closed or limited membership discussion groups.

If I several people who have stated or repeated this claim were participants of this post’s thread. They are welcome to correct me. Also, if Dr. Gernsbacher contacts me and indicates the paraphrase I gave is not correct. I will be happy to remove modify it.

My wording was very careful….. I will maintain it as is, at this time.

I would be highly interested in any rejoinder you care to give over the comments made by anonymous. I think the criticisms s/he gave sound quite damaging.

I notice that you also have a written about FC recently. I think there may be some real problems with your attempt to connect the APA criticism of FC with behavior analysis. However, this may not be the time and place to address that.

7:20 PM  
Blogger Jim Butler said...

Hi Interverbal,

Great thread. This is a bad time for me to be posting, since I'm going out of town for a few days (and bringing my son, no small endeavor). I hope you'll forgive my offering a reply and then disappearing for about a week. Will be happy to pick this up when I get back.

(1) Re Gernsbacher -- caveats about hearsay and "owning one's own words" aside, in essence, what she says sounds like an accurate depiction of criticisms by Jacobson and others: that the sudden appearance (via FC) of language in a supposedly-"retarded" population is suspicious. (See Biklen, Harvard Educational Review, 1992:62, p. 242). A reasonable enough point. Extraordinary claims require extraordinary evidence. But in 2007, it seems to me, it's not so extraordinary to assert that nonverbal autistic people should not be presumed to be retarded.

(2) Anonymous's criticisms of studies from 1996. Remember, anonymous is taking the extreme position that these studies are not merely flawed (is any study not somehow flawed?), but worthless. This is an absurdly blindered position, as I think you agree. First off, Weiss: have you read the paper? Basically, a 13-year-old boy was read a brief passage and then asked to describe the passage with a naive (i.e, hadn't heard the passage) facilitator. On two trials he got nearly everything correct. One trial was aborted because the boy expressed anxiety. The criticisms of that study by Mostert (2001) and Jacobson et. al. (link via Google books) come up short, imo. Their main criticism is that somehow the facilitator wasn't really blinded, even though nothing in the paper suggests this flaw. I'll let you read the student's responses, and you can decide whether they somehow invalidate the possibility of doing 5th-grade work (what a bizarre leap on anonymous's part).

As for the others, the blinding seemed reasonable enough in Cardinal et. al. I don't have time to go back and read the third one, nor do I have the statistics chops to comment further.

(3) FC and behaviorism: this relates to the first point, that some behaviorists are reluctant to acknowledge the language abilities of nonverbal autistic people. I'm not a social scientist, but doesn't this have something to do with the "cognitive revolution"? I seem to remember Gernsbacher saying something to this effect in an article in TASH Connections; she reflected on the bias exhibited by psychologists toward people like her son. Wade Hitzing said some similar things in his response to the APA resolution on FC, as I mentioned in my blog post (thanks for reading). Did you disagree with his comments?

Gotta go. Thanks again for revisiting FC with an open, and evidence-focused, mind. One final thing: I wouldn't knock Biklen and Cardinal for publishing a book (Contested Words, Contested Science). Peer-review is generally better, sure, especially for contentious material, but a book published by a scholarly press with a series editor has come weight. As do the anecdotes that people like me can provide about message-passing. We should be using the less-than-gold-standard evidence as a basis for better studies, as well as hints on how to proceed in real life. What we shouldn't do is ignore and dismiss them, as Anonymous and others seem inclined to do.

The only criticism I have of FC advocates is that they (we, from now on) haven't focused enough on peer reviewed studies. Acceptance of FC depends on many things, and surely a firm evidence base is one of them.

regards,
Jim Butler

8:49 PM  
Blogger Jim Butler said...

to revise my comment above:

The only criticism I have of FC advocates is that they (we, from now on) haven't focused enough on peer reviewed studies.

And also the overpromotion in the past, sure. But that was a long time ago and can't be undone. The lack of research can be remedied.

9:07 PM  
Blogger Jim Butler said...

KeithABA, above, cites an important passage from your post:

"The data support the comment that FC may lead to authentic communication for some individuals with autism. The research suggests that these are the minority of cases. The research suggests that facilitator influence is an active factor in FC."

Agree with sentences 1 and 3, for sure, but I don't see how 2 follows. How do we know that we can make such an extrapolation? It's like studying piano lessons, for example. Who's teaching, what are the teaching methods, who are the students, what is being measured, etc.

9:30 PM  
Blogger Jim Butler said...

Well, I'm up late with a moment to spare and a typical insomiac's one-track mind, so here's a little more commentary:

Skepdic claims that facilitators are taught that 13% of their clients have been abused.

Never heard that before. Wonder where the author got that from?

It seems that a surprising number of facilitators have accused parents, often the father, of abusing the client. Also unsurprisingly, most of these cases turn out to be garbage.

Do you have a source for these statements? I'm not asking snarkily. I don't question the veracity of numerous anecdotal accounts of false allegations of abuse made via FC. I want to know to what degree such allegations have been reliably measured and compared with allegations made by the speaking population. As with message-passing and facilitator influence, allegations of abuse are a crucial aspect of FC, and deserve proper study.

However, the author of FC Wikipedia page reassures us that “numerous abuse allegations made via FC have been found to be valid” and then cites a paper with 4 cases with some degree of evidence out of 13 cases that were reviewed.

Hmmm, I might have been one of the authors of that statement. :-) I remember hashing it out with another editor. The article referenced is by Botash et. al. Here's a link to the abstract, and here's a review of that article from Syracuse's FCI Digest. Let's pause for a moment to digest these. :-)

I need to get a copy of Botash, because the commentary made in this bibiography from the FCI is remarkable, assuming it's accurate:

(Botash et. al.) ... A medical team's evaluation of cases in which individuals using facilitation purportedly made allegations of abuse. Several individuals were found to have medical evidence of abuse. The pattern of evidence in this group parallels the patterns seen in the nondisabled, speaking population (who had made allegations of abuse) in the region in which the study was conducted.

If that is true, and holds to be true in further study, then FC has gotten an unfairly bad reputation. (What's the name of the fallacy that may be in play here? Argument by generalization, or something.)

Surprisingly, the Botash article appears to be the sole attempt at quantitatively sampling claims of abuse made via FC, as one will see from a Pubmed search for ("facilitated communication" abuse).

In light of the above, I haven't formed an opinion on the degree to which FC, as opposed to other forms of communication, may pose the threat of false allegations of abuse. Nor do I see hpw any reasonable person could form such an opinion from the data cited here.

Also of interest are these advisory comments by several prominent FC proponents.

3:02 AM  
Blogger Interverbal said...

Hi Jim,

No problem, we all get busy, take your time. In the meantime here are a few comments for you to think about.

You write “But in 2007, it seems to me, it's not so extraordinary to assert that nonverbal autistic people should not be presumed to be retarded.”

I agree that non-verbal people should not be presumed to be retarded. But that does not mean they should be presumed to have expressive writing ability. That doesn’t follow.

You write “Anonymous's criticisms of studies from 1996. Remember, anonymous is taking the extreme position that these studies are not merely flawed (is any study not somehow flawed?), but worthless.”

S/he might take such an extreme position, but we don’t know that, and even if s/he does it has no bearing on his/her argument here. S/he offered very specific criticisms. These are what should be addressed.

You write “This is an absurdly blindered position, as I think you agree.”

I think we should review the evidence, then form an opinion based on what the evidence indicates. I have no problem either accepting or rejecting FC based on such evidence.

You write “FC and behaviorism: this relates to the first point, that some behaviorists are reluctant to acknowledge the language abilities of nonverbal autistic people.”

If one reviews the behavior analytic literature one can find research in behavior analysis teaching non-vocal students to use sign and PECS. Some behavior analysts have worked with students using voice output devices. Keith made this point nicely a few posts up. Evidently, the behavior analysts who were the researchers and journal editors accepted the premise that non-verbal autistic students could still communicate using other modalities.

You write “I'm not a social scientist, but doesn't this have something to do with the "cognitive revolution"?”

In my opinion, not so much, although Dr. Gernsbacher did try to attach the spoken language issues in autistics and the cognitive revolution. I disagree with her analysis here as well.

Did I disagree with Wade Hitzing’s response? Yes, you could say that. I quote him below:

“While I understand that the APA has the right to issue resolutions, even misguided ones, like the one on FC, I do have suspicions about the motivations of at least some of the proponents of the FC condemnation. I believe that some of my behavior analysis colleagues are piqued that people outside the operant camp looked inside the "black box" (See Note 2)”

Argumentum ad hominem. No points.

“and found something important that we had missed for lo these many years. I think that many of them find it hard to accept that they have worked with these folks for 25 to 30 years and weren't able to accomplish, in fact didn't even try to accomplish, what a bunch of special educators have achieved.”

Psychogenic fallacy; still no points.

“It must be very disconcerting to face the fact that at least some of the people with autism that we subjected to our simplistic "ignore and redirect programs" were smarter than many of us.”

Psychogenic fallacy, yet again.

“At least some of them were behaving according to complicated, idiosyncratic rules they had invented rather than merely engaging in simple "escape" or "attention seeking" behavior.”

Begging the question (no proof offered here).

As far as I can tell, Wade doesn’t offer us a single valid point in this paragraph. I think he is trying very hard to assign the “problem” to be inside the APA folks, as opposed to focusing on the argument.

“I wouldn't knock Biklen and Cardinal for publishing a book (Contested Words, Contested Science). Peer-review is generally better, sure, especially for contentious material, but a book published by a scholarly press with a series editor has come weight.”

I think books are great venues to discuss and synthesize ideas. However, I don’t think they are such good places to publish new research. The problem here is that the safeguard of peer review gets bypassed. I have both research integrity and ethical problems with that. So, I don’t knock Biklen & Cardinal for writing a book, but I do indeed knock their book for publishing un-peer reviewed research.

You write “Agree with sentences 1 and 3, for sure, but I don't see how 2 follows. How do we know that we can make such an extrapolation?”

Only a small portion of the mutli-subject research shows an effect and generally only for a portion of the persons in the study. I reviewed this in detail in my blog post. I refer you to that.

“It's like studying piano lessons, for example. Who's teaching, what are the teaching methods, who are the students, what is being measured, etc.”

The research generally only shows if authentic authorship was occuring and/or if facilitator influence was present. What you seem to be asking is what do individual facilitators do that leads to effective FC. That is a question the advocates of the theory must offer themselves. It is their (your) burden.

That is all for now.

7:49 AM  
Blogger KeithABA said...

In response to Jim,

"FC and behaviorism: this relates to the first point, that some behaviorists are reluctant to acknowledge the language abilities of nonverbal autistic people."

Durand, V. M. (1999). Functional communication training using assistive devices: Recruiting natural communities of reinforcement.Journal of Applied Behavior Analysis,. 32, 247-267.

This is an interesting article (there's 5 students, and the design is a multiple baseline across subjects). If anyone wants to talk about the design, go back the post about group vs. single subjects.

This pertains to FC because, a keyboard offers a much different form of language than a board with programmed options. The keyboard offers pretty much infinite possiblities for what the person can say. The communication board is selection based, one can only say what the options are.

I would much rather see individuals use a keyboard, because they could say so much more. The question is how do you select who is a candidate to use the FC device, if it only works with a minority of individuals? It seems somewhat harmful to try and take the approach of, "it can't hurt to try it."
http://people.uncw.edu/kozloffm
/fads.html (a great paper by the way)

There are a wealth of articles on FCT being effective, many breaking down what makes FCT effective, changing motivation during FCT training, use of vocal vs. sign vs. pecs in relation to FCT.

Interverbal summed it up when he said, "Evidently, the behavior analysts who were the researchers and journal editors accepted the premise that non-verbal autistic students could still communicate using other modalities."

What behaviorsts are reluctant to acknowledge is that non-verbal children have the ability to form complex sentences, use grammer, spelling. This reluctance could certainly be proved wrong, but up to this point, the research just isn't convincing.

9:25 AM  
Anonymous Anonymous said...

Jim Butler says I have not fairly represented aspects of the controlled study by Weiss, Wagner, and Bauman (1996) Not so. I have been more than fair. More fair than Butler, who says things like I have made a "bizarre leap" to claim that the study invalidates fifth-grade-level work. He has not only failed to read the original study carefully, but hasn't read my much shorter summary closely either. The Weiss study explicitly says the subject got As and Bs in 6th and 7th grade work, which I summarized with the term, "middle school." Nowhere did I say "5th grade." There is no fifth grade middle school around here, at least. And, the garbled responses reported in the study are hardly characteristic of such a good student. Butler also says the child "got nearly everything correct." Not so--unless 72% correct "is nearly everything"--and that is after throwing out one of three sessions and making allowances for all kinds of typing errors.
It seems that more analysis necessary, so I will take the time to add a little bit more fair representation of a study may be one of worst Mental Retardation has ever published, but that Butler inexplicably holds in such high esteem that he posts mentions of it where ever it seems he can:

http://www.cnn.com/HEALTH/blogs/paging.dr.gupta/2007/10/giving-autism-voice.html

In the Weiss study, a 13-year-old, top-performing middle school student was barely able to type coherent answers to a few simple, second-grade-level questions about some one-paragraph-long social stories after practicing the answers in advance of each test. There were a total of three trials conducted over a period of seven months. The first trial seemed to work. The second did not, so its data were thrown out. The experimenters themselves cited the possibility of facilitator influence in the second trial. The third trial seemed to work. Then they stopped. This is what we in the methodology business call a "quit while you're ahead" study. The astonishing result: About 72% (13 of 18) of the answers were apparently fully correct. Of course, that result comes after throwing out a full third of the sessions. Do we ask why facilitator influence was cited as a reason to reject the data from the second session but not used dismiss the answers given in the other two sessions (p.225)? We should.

Possibilities for bias? Let me count the ways! The supposedly "uninformed facilitator" had been facilitating with the child for up to 30 hours per week for 15 months before the study, and continued to do so during the study. The authors were also observers and facilitators. The observers knew the answers in advance and were present when the tests were done. No one tested to see if the names and events used in the stories were stock items from the experimenters' or teachers' repertoires. These Kohlberg-style stories always seem to be about kids breaking things in the house and then lying about it. There's hardly a chance in the world that a facilitator with a few clues could guess the elements and outcome of such a rare and cunningly complex narrative thread, especially not when some of the questions have multiple correct answers and imply obvious consequences. A video crew was on hand at one point, and the producer also participated in the creating material for the study. Obviously, there would have been no pressure at all to make FC work for the TV people. There were an indeterminate number of practice sessions conducted before the subject was put into the experiment itself (p. 228). That fact was omitted from the Methods section (p. 221-222) where a mention of it might have prompted someone to ask about other hidden procedures. The amateurishness of the whole endeavor is underscored by the experimenters including a member of the TV crew in the protocol and conducting one of the three trials at the subject's home. Apparently, over a period of seven months, the Harvard team was unable to adjust their schedules to conduct three whole, entire sessions in one place.

I won't even mention the spurious scientism. Yes I will--but just one item of several. Confronted with the finding that a list of three items was reproduced in a different order than originally presented, the researchers not only invoked the “serial position effect” to explain the reordering, but actually suggested that the reordering was additional evidence of hidden cognitive capacity and therefore of FC (p. 227). The serial position effect in a list with three items? I have a copy of Ebbinghaus's 1885 Memory: A Contribution to Experimental Psychology in my hand, the book the authors should have cited instead of the textbook summary they did, and I can't find that version of the serial position effect in there. So, if reordering a three-item list is significant, what can't be evidence for FC? Nothing apparently. Would reproducing the list in the right order invalidate FC? I doubt it. For Weiss et al., even wrong answers are evidence FC (rather than possible facilitator influence). When the subject/facilitator typed a statement about something that was not in the story, the researchers claimed the wrong answer indicated "higher-order processing" (p. 227). A skeptic might suggest that the wrong answer was evidence of extrapolation and cue-seeking by the facilitator. If that wrong answer were not enough to demonstrate how smart the child was, changes in spelling from one condition to another were described as "phonemic transformations" (p. 227)--more cognitive processing. Since we already know that FC is completely valid (it says so in the article's title), it would not be fair to offer the counterargument that because the different spellings were done by two different facilitators, facilitator influence might have been involved.

And, we must not forget the most fatal of the study's multiple fatal flaws: The experimenters decided in advance to not to run any tests for facilitator influence, employing a protocol that under uncontrolled and unspecified conditions supposedly "worked" (p. 228). They said that this was done to make the conditions as similar to ordinary FC experiences as possible (p. 228). Why mess with success? Because a validation study is supposed to test whether an apparent success is a real success? Back in the day, when "valid" meant something, that's what we thought. In the late 20th century, apparently not. Thus, we are confronted with a study that is supposed to validate FC but does not include a necessary condition for doing a proper source validation. That makes every claim by the authors about independent communication (and every denial of facilitator influence) into an inference at best, and a baseless assertion most of the time. It invalidates the title as well. What it all means is that the study was little more than another FC demonstration. We don't need a study for that. We can just go to a Ralph Savarese book signing at the mall.

Let's summarize what has gone before: Under the controlled conditions, after practicing with the material, using his own experienced facilitator who worked with him up to 30 hours per week, a 13-year-old child who got top grades in middle school using FC could only do C-minus level work answering questions that wouldn't stump an eight-year-old. Supposedly this middle school student, who wrote sixth- and seventh-grade essays with FC for his excellent grades (p. 222), could only show evidence of "implied logical inferences" (p. 226) and "simple inferential abilities" (p. 226) along with lots of garbled typing. This only occurred in a study that didn't properly test for facilitator influence and simply expects us to believe that no biasing and contamination could have occurred because the authors made a few attempts to control for these things. It is not a "bizarre leap" to conclude that if we were to accept the validity of the FC in the study, we have to reject the validity of the reported middle school FC performance of this student.

Here is a link to a reasonably correct version of the Weiss study, in case anyone is interested:

http://www.behavioralpediatrics.com/papers/facilitated_communication.htm

There are implications to this beyond Weiss et al. being a bad study that doesn't show what it claims to. One implication is that after 20 years, the proponents of FC are still unable to produce genuine evidence that their trick really works. Cardinal and Sheehan, with their lack of experimental controls, 90% wrong answers, and failure to test for facilitator influence, only hurt the case. I'd say that the evidence shows that FC is a big load of nothing. Of course, if we accept the results of these studies as evidence that FC works, we have to conclude that FC is, at best, an extremely unreliable communications method that is slow to develop and only works with a fraction of the people it is tried with. If that is true, what are to we make of all the instant FC that happens at the workshops and conferences, where a child who has never spoken or read before supposedly types some variation of "I love you mommy" for desperate parents who are willing to pay for a "private consultation." It happened at the Autcom conference in Edmonton--task Char. Marilyn Chadwick did it for Time Magazine. Harvey Lavoy does it at workshops. I would hate to suggest that the FC people want to have it both ways--but it might be so.

8:31 PM  
Blogger Jim Butler said...

Just a quickie, to acknowledge and say thanks for the detailed replies. More to follow, but for now:

Inter -- you will note that Anon indeed used the term "worthless". As in, "These studies are worthless as support for FC". It was not a gratuitous inference on my part.

Keith -- I think this is well put:

What behaviorists are reluctant to acknowledge is that non-verbal children have the ability to form complex sentences, use grammer, spelling. This reluctance could certainly be proved wrong, but up to this point, the research just isn't convincing.

I'd add that what convinced me was meeting and learning about people who have FC'd and gone on to type independently.

Anon -- Great that you dug up that link to the text of the Weiss study so everyone can read it.

Sorry I misstated the grade level of the subject as 5 when it was actually 6 or 7. It certainly was a sloppy mistake on my part. Guess I just didn't read the paper carefully, as you said. And such a basic error -- 5 vs 6 or 7, I mean, that's kindergarten, right? And here I am claiming I've graduated college, etc., when I can't distinguish between 5 and 6 or 7!

Speaking of basic errors, you wrote:

The astonishing result: About 72% (13 of 18) of the answers were apparently fully correct. Of course, that result comes after throwing out a full third of the sessions.

Your last sentence is wrong. The failed second section was the source of 4 of the 5 incorrect statements. In the other two trials,

Kenny was highly accurate in his responses to questions during the first and third trials with the physical support of an uninformed facilitator. During Trial 1, there were three characters in the story, and each was named correctly, as was the game played, the location of the game, and events that took place during the game. Results from Trial 3 showed similarly high levels of precision.

Kenny named the characters in the story with one incorrect name ("BOB JIM" rather than Tom and Jim). All other responses were precisely accurate, including the object of desire in the story, how the object was procured, and the subsequent events.


So, in other words, we have a kid who takes three simple tests. He chokes during one of them (unimaginable for an autistic kid to do that -- anxiety in an autistic kid? You'd think he had an IEP or something), and on the others passes them as well as I probably would have, with 5/6 and 7/8 respectively. From this, you make inferences about his schoolwork???

But hey. We all screw up simple things from time to time, don't we. The important thing is not to screw up the stuff that really matters. Like, was the FCing kid in 5th vs 6th grade. Or, was the kid's name in the story Bob or Jim. Or, what was the central quantitative finding of a scientific paper. You know, the small stuff.

More to follow, in detail, I promise, but later. Gotta get some sleep before my flight, so I'll look forward to seeing you all next week.

2:31 AM  
Blogger Interverbal said...

Hi Jim

My source for my statements about disclosure of abuse using FC was the Botash article. I made a passing reference to it in my blog post as well. Only 4 out of the 13 had corroborating evidence. I maintain my earlier statements and I strongly disagree with the editors decision to list the Botash article as a support in thr FC Wikipedia page.

The argument by generalization, which I am more familiar with as the “argument from small numbers” isn’t in play here. In order for this fallacy to be shown, the FC advocates would have to demonstrate in research that most of the allegations of abuse are true. That effort is on them.

You want to know ho any reasonable person could form a directional opinion on FC and abuse. I formed mine after reading Botash and some of the stories about the false allegations. One again, extraordinary claims require extraordinary proof. I do not think the evidence is supportive so far. I maintain my statement in my blog post.

Also, yes, anonymous did state that the studies were worthless. However, it still has no bearing on his/her argument.

7:31 AM  
Blogger Jannalou said...

KeithABA,

Sorry it took me so long to get back to you about this.

You state, "Pro-ABA folks" would be exhilarated to use FC if there was better research to demonstrate it's efficacy. Aside from the fact that I have seen absolutely no evidence of this in the ABA camp, that wasn't the point of my statement.

When I said Going to either extreme of uncritically embracing FC (not too common these days) or rejecting FC (far too common) is not scientifically supportable. Very true. Tell that to the Pro-ABA folks, the chelationists, the New Agers, etc. All of these groups do this. I wasn't talking specifically about the science. Perhaps that wasn't clear.

I was specifically talking about how people tend to embrace things full-on without full evidence either way. ABA-only folks do it, too. You can't tell me that ABA is as efficacious as it is purported to be, since most people only quote the lone study, which has yet to be properly replicated (and never will, since aversives "aren't used" anymore).

My point had nothing to do with combining approaches and everything to do with how we choose what we will believe and then enforce that to an exclusionary and damaging extent.

11:28 AM  
Anonymous Anonymous said...

I appreciate the helpful clarification of the results of the Weiss study.

From now on I will make sure that I note that the subject answered all of the questions incorrectly in the second trial--after having giving mostly correct responses in the practice session with a facilitator who knew the answers. I will also make sure to point out that the experimenters stopped the second session early, after the subject gave four consecutive wrong answers, rather than asking six or seven questions as in the other two sessions. When speaking of the nervousness the subject supposedly complained of in the second session, I will make sure to quote the authors of the study, who said "Clearly, it is possible that these words came from the uninformed facilitator and not Kenny" (p. 225). I will also quote the statement in the discussion section, "Witness the fact that during Trial 2, Kenny did not show valid communication" (p. 229). One thing I won't do is court an accusation of arguing by analogy by comparing the subject's supposed complaints about nervousness to Uri Geller's whining on the Johnny Carson show when Carson replaced Geller's prepared spoons with real ones.

After doing these things--pointing out that the subject in the Weiss study got no correct answers in the second test session after doing so well in practice, adding for the sake of completeness that the experimenters terminated the session early--I will have to question why a team of researchers who set out to do a validation study, who knew that facilitator influence might be a problem, who blamed facilitator influence for contaminating a full third of their three reported sessions, did not include a test for facilitator influence. Their answer is an excuse, not a reasonable justification, for leaving out the very condition that would have turned their FC demonstration into a real experimental analysis: "The reason that we avoided a distractor-type procedure was that it would be dissimilar from the common use of facilitated communication. We believed it prudent and necessary to not tamper with the phenomenon as it was reported to exist." It is hard to believe that a group that included a Harvard neurology professor couldn't have come up with an unobtrusive test for facilitator influence.

But this will not do. We are now getting unacceptably snotty and directly questioning the experimenters' methodological and conceptual skills rather than the adequacy of the experimental design to answer the main question--the validity of FC. The clear fact is that the experimental procedures in Weiss are not sufficient to support the claim that valid facilitated communication had been demonstrated. There are rules to these things, standards at least. Those rules include testing for the action of known sources of contamination and assuming that unknown sources of contamination are also present, testing for those as well. And, in Weiss, the conditions of the experiment were exactly those under which facilitator influence was known to occur. The experiment was set up that way; facilitator influence was assumed and cited by the researchers themselves. Yet, as we have repeatedly noted, there was no test done to reveal facilitator influence, and only weak preventive measures against it.

To accept that this study shows valid FC, the reader must adopt the researchers' own unjustified confidence in the completeness of their protective procedures and their false definition of validity. Not telling the main facilitator the stories was just the first step, not the last. In seven months, with ongoing interaction between various members of the experimental team and the subject, practice sessions of uncertain number with unspecified content, consolidation sessions, TV crews showing up, and who knows what else, a lot of incidental information can get around. There are all kinds of other types of contamination that even skilled experimenters can miss (and good experimenters always assume they are missing something). The substantial and highly revealing literature on bias and contamination in psychological experiments should not be ignored. In lieu of reading that, we can always just remember that James Randi became famous relying on the overconfidence of people who controlled for only the obvious mechanisms of contamination and assumed that they were too careful to allow troublesome confounds to disqualify their demonstrations. Plus, getting the right answers is not enough. "Right" answers are all too common and can occur for all the wrong reasons, especially when they are expected and desired. It matters little that the readers or the experimenters cannot figure out where contamination might have occured. Even a score of 100% would not make the reported communication in the Weiss experiment any more "valid." A perfect result could have been due to facilitator influence or other forms of contamination. And, "validity," what does that mean in Weiss? The authors of Weiss use the term "valid" when the expected response occurred, saying at one point that the incorrect responses were not valid. That's not validity; that is correspondence. In a source validation test, we are concerned that the source of the information has been properly identified and other sources excluded. Content accuracy is actually not a necessary element in validation and non-repudiation, and can be obfuscating when too much weight is placed on it--which is exactly why the FC world puts so much weight on it. The failures of the Weiss procedures to properly deal with all these things is not in doubt. Likewise, it is not a matter of how the questions were answered. The necessary procedures to answer the main question in Weiss were not done. Weiss needs to be abandoned as evidence that FC works. It showed that FC looks like what it looks like. It showed that the subject was unable to reproduce under test the high level of academic performance claimed for him. It doesn't show "valid" FC. If the Weiss study has any lasting value at all to science, it will be as an excellent lesson in what not to do.

8:42 AM  
Blogger Interverbal said...

I have recently finished reading Weiss et al. I am removing this study from my review.

My reasons are explained in a new post here:

http://interverbal.blogspot.com/2007/11/facilitated-communication-further.html

7:48 AM  
Blogger jypsy said...

A few days ago I bought a DVD recorder for myself (and family) for Christmas. It's stashed away until then but, come the new year, I'll be starting to copy over our VHS home movies onto DVD and will be able to share some of Alex's early years, including his FC, with y'all.

9:45 AM  
Anonymous Anonymous said...

For possible added understanding of the process and the relationship between the person typing and the person providing physical support or sititng next to the typer, check out the links below.

http://ezinearticles.com/?expert=Mary_Ann_Harrington


http://ezinearticles.com/?Autism---Matching-Vibration,-and-Entrainment-of-Brain-Wave-Frequency&id=562627

10:28 PM  
Blogger Ettina said...

"By comparable levels, I mean that the person can express roughly the same ideas, thoughts, and observations in either modality."

Umm, I don't use FC, but *I* don't meet that criteria. My writing is better than my speech (this despite having no significant language delay). I noticed this when I tried to dictate a story into a microphone instead of just typing it. Also, under stress this disparity is even more evident, as speech gets impaired much more than writing.
I thought the whole point of FC was that they could communicate better that way than in other ways. Why would you even bother with FC if they could communicate just as well independently?

6:01 PM  
Blogger Interverbal said...

Hi Ettina,

Thanks for visiting. It has been a while, I think.

As to your concern, I think I was careful to say that if a person was an independent typer, and that their ability in this regard was roughly equivalent to how they do under facilitated conditions then I will likely not have concerns.

Thanks Ettina

6:38 PM  
Anonymous Anonymous said...

Hi,
I saw Lucy Blackman type at a convention in 1996. She was very articulate and was answering questions by audience members.

Her mother sat next to her as she typed similar to other individuals who hit keys on their own but need someone close by.

I was wondering when if she still needs someone next to her when she writes or can she do it independently . If so is the caliber of her writing at the same level?


Thanks,

8:04 PM  
Blogger Marion said...

I have written guidelines for FCT which can be accessed at http://www.contactcandle.co.uk/a_brief_guide_to_fct.htm

All the best

Marion

1:43 PM  
Blogger Interverbal said...

Hi Marion,

Thank you for sharing this. I wish you well in your quest to establish professional standards. And while I do not necessarily agree that your proofs are sufficient, I appreciate seeing an attempt at establishing safeguards within the FC community itself. I have quoted the portion I believe is most relevant to this thread.




19. A log of anecdotal evidence of validation should be kept with all regular clients wherever possible.

Anecdotal evidence may include:

Ø Similar patterns of spelling and errors with multiple facilitators.

Ø Typing about similar topics or themes with multiple facilitators.

Ø Consistent style of typing with multiple facilitators.

Ø Instances of independent and/or initiated communication.

Ø Sharing of information not known to the facilitator.

Ø Behaviour or actions which confirm typed communication e.g. going to the refrigerator immediately after typing "I'm hungry".

A fuller list of examples is available from the contactcandle@btinternet.com

FCT users should not be subjected to message passing tests or asked to take part in controlled validation experiments without their informed consent and the opportunity to practice the skills required over a period of time prior to testing. Testing should never be carried out in the early stages of facilitation training or during the early training of new facilitators. This is because no one can be assumed to have competence enough to undertake such a task in the early stages of an FCT programme.

8:41 PM  

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