Who Communicates in Facilitated Communication?

Burgess, C.A., Kirsch, I., Shane, H., Niederauer, K.L., Graham, S.M., & Bacon, A. (1998). Facilitated communication as an ideomotor response. Psychological Science, 9, 71-74.

Overview:

Autism

Autism is a developmental disability that severely affects how a person interacts with the world. Autistic children and adults have impaired communication, social interaction, and reasoning. Autism is usually diagnosed at a very early age, generally by the time a child is one to three years old. Children with autism may be very sensitive to sensory stimulation (e.g., screaming when held), have very delayed language development (e.g., never respond to or attempt to produce speech), exhibit bizarre social behavior (e.g., totally ignore a care giver or other person), and engage in self-stimulating behaviors (e.g., constantly rocking back and forth). Although very little is known about the causes of autism, it appears to be due to neurological and/or biological brain abnormalities and may have a genetic component.

There is no "cure" for autism. Through behavior modification, children can acquire more socially appropriate behaviors and develop some communication skills. Sometimes autistic symptoms improve as children grow up. With extensive therapy and education, a number of autistic children grow up to lead somewhat independent lives.

Facilitated Communication

One of the more debilitating problems in autism is a severe communication deficit. The cause of this deficit is not well understood, however, and therefore it is very difficult to design appropriate remediation. Rosemary Crossley, director of the DEAL Communication Centre in Australia, has developed a controversial approach for helping people who have severe communication problems communicate. This approach is called facilitated communication. Facilitated communication involves using a communication device and a specially trained person who helps facilitate use of the device. In many cases, this consists of a facilitator providing physical support of a communicator's hand or wrist while that person points to letters or words on a communication board or types on a keyboard.

The premise behind facilitated communication is that the language disabled person has the capacity to communicate but cannot use the communication device (the board or keyboard) appropriately. No research has been able to determine whether this premise is correct, but many autistic people (as well as others with severe communication disorders) have been trained in facilitated communication. A few autistic people have benefited so greatly from facilitated communication that they have completed college degrees. Some autistic people have written essays, stories, and poems using facilitated communication. Other autistic people have revealed allegations of physical and sexual abuse through facilitated communication.

Facilitated communication has adamant supporters. It also has equally adamant opponents. Given what we know about language and communication, it is difficult to believe that a language disabled person could have a communicative intent and be totally unable to express it in any way. For example, a paralyzed person may not be able to speak or gesture but can communicate with subtle facial expression changes. Is an autistic person, who shows absolutely no social interaction simply unable to communicate or does this person actually have nothing to communicate? Are communications arising from facilitated communication generated by the communicator or are they generated unconsciously by the facilitator, much the way Ouiji board "predictions" are made? Burgess, Kirsch, Shane, Niederauer, Graham, and Bacon (1998) examined the issue of whether facilitated communication could be a result of automatic writing, an unconscious generation of communication on the part of the facilitator.

Article Summary

Have you ever used a Ouija board? Many people have communicated with spirits and other unseen beings. Or have they? People who experience Ouija board spelling are often unconsciously generating the communication without the benefit of spiritual guidance. A number of researchers believe that this Ouiji board phenomenon, or automatic writing, also occurs with facilitated communication. That is, the facilitator may be unconsciously generating the message that the communicator is presumed to be expressing.

In light of the controversy over who is doing the communicating in facilitated communication, Burgess, Kirsch, Shane, Niederauer, Graham, and Bacon (1998) designed a study in which they used a confederate to simulate a language disabled person and trained students to facilitate communication by the confederate. Because the controversy surrounding facilitated communication has to do with whether the communicator or the facilitator is doing the communication, the confederate in Burgess et al.'s study made no attempt to communicate.

Undergraduate students were trained in facilitated communication using a videotape that is used to train facilitators and excerpts from a television news magazine program on facilitated communication. Students in the positive-information group also viewed a videotape excerpt depicting facilitated communication as a revolutionary new technique for unlocking communication abilities in autistic and other severely language disabled people. Students in the controversial-information group viewed an excerpt elaborating the controversy surrounding facilitated communication.

Following training, the participants were given an opportunity to practice facilitated communication with a young woman described a having developmental disabilities, including an inability to speak. The young woman, "Jackie," was really a normally functioning college student who was a confederate in the study.

The participants were given information about Jackie's siblings, where she grew up, and her favorite foods and activities. The information was different for each participant and the confederate did not know what information was provided.

The participant then met Jackie who was seated at a computer terminal, stared straight ahead past the computer monitor throughout the session, and did not make eye contact with the participant. The participant was instructed to grasp Jackie's hand and position it above the computer keyboard. The experimenter asked questions about Jackie corresponding to the information the participant was given and the participant facilitated Jackie's typed responses on the keyboard. After facilitating Jackie, participants rated the extent to which the communications originated from themselves and from Jackie.

Burgess et al. obtained a meaningful, readable response for over one-half of the questions. As well, almost all of these responses were identical to the information that had been given to the participant. Each participant "facilitated" at least one response to the questions. Although Jackie, the confederate, did not know what the information was and never looked at the keyboard, the participants were very confident that Jackie had been doing the communicating. These findings are very similar to those obtained in studies of trained facilitators working with language disabled people. Interestingly, there were no differences in response correctness or communication origin ratings between students in the positive- and controversial-information groups.

Burgess at al. concluded that the facilitated communications were a result of automatic writing. The confederate had no communication intention but the facilitator was not aware of having generated the response. Although this study does not completely discount facilitated communication, it does cast doubt on the claims that all facilitated communications come from the communicator.

For Instructors

Links to the Lecture

Jacobson, J.W., Mulick, J.W., and Schwartz, A.A. (1995). A History of Facilitated Communication: Science, Pseudoscience, and Antiscience: Science Working Group on Facilitated Communication. American Psychologist, 9,. 750-765. A reprint of this extensive review article on facilitated communication is also available on-line.

Prisoners of Silence (WGBH Frontline October 19, 1993, 60 min.)

For Students

About the Authors

Irving Kirsch is a professor of clinical psychology at the University of Connecticut. He studies hypnosis, cognitive behavioral therapy, and placebo effects. Howard Shane is Director, Communication Enhancement Center at the Children's Hospital, Boston.

About the Journal

Psychological Science is a journal of the American Psychological Society, devoted to scientific research in psychology. Many different types of psychological research are published in this journal.

Links to Life

Rosemary Crossley, who developed facilitated communication, is Director of the DEAL Communication Centre in Australia. This web site describes facilitated communication in detail and includes links to stories and poems written using facilitated communication. The Facilitated Communication Institute at Syracuse University is a major North American facilitated communication center.

On the other hand, many people are very critical of facilitated communication. Two reprints on-line are Green (1994) and Jacobson, Mulick, and Schwartz (1995).

The Autism Society of America provides a balanced consideration of facilitated communication.