Perhaps it’s just me, but I read Freddie deBoer‘s refutation of Facilitated Communication with a kind of rising horror, that a parent or trusted adult could so take advantage of a disabled person to commit this kind of fraud:

“Facilitated Communication” by Faure P, Legou T and Gepner B is licensed under CC BY-SA 4.0 .

Stop me if you’ve heard this one before: The New York Times has again casually endorsed facilitated communication, or FC, a relentlessly-discredited practice that plays on the desperation and credulousness of parents of severely disabled children. As in the past, they’ve done this while barely seeming to understand that they’re doing something controversial at all. The culprit this time is a review of the new novel Upward Bound “by” Woody Brown, a man with severe autism who has been nonverbal his entire life and dictated his book through FC, which is also the means through which he earned a masters degree and other remarkable feats. Brown, like so many others who have been “saved” through FC, was found to have all manner of remarkable intellectual abilities once someone else was “facilitating” his communication.

The review describes Brown “tapping letters on a board” while his mother interprets and voices the words. That is the textbook structure of FC: a disabled person who cannot otherwise communicate produces output while a facilitator mediates, guides, or stabilizes the process. Or so proponents claim. Without the facilitator, the disabled person is mute; with their guidance, they suddenly become remarkably verbally proficient, often learned and verbose. If you’re new to the FC debate, you should trust your skepticism: the fact that the mother has to be present and participating, the fact that Brown cannot manipulate the board without the mother’s involvement, the fact that he has never been subject to rigorous research that involves “message-passing” or “double-blind” tests … This is the inconvenient, damning reality.

Message passing, or double-blind, tests are simple and remarkably effective. Information is provided to both the disabled person and the facilitator, often in the form of pictures or individual words, with both the facilitator and the test subject receiving the same information some times and discordant information other times. That is to say, the disabled person and the facilitator will sometimes both be shown a star or a watermelon or a flower or a bird, while at other times one might get the star picture while the other gets the bird, etc. If the disabled person genuinely crafts their responses, this should be a trivially easy test to pass: the facilitated communication will produce the information that the disabled subject received. And yet very close to literally 100% of the time in rigorous research, across dozens of studies with thousands of combined attempts, interactions produce the information the facilitator received and not the information the disabled person received. Surveying the literature, the consistency of this finding is remarkable — and there is no coherent explanation for how this could happen if indeed FC results in messages being sent from a conscious and alert test subject. Instead, these findings are perfectly consistent with Occam’s razor and the assumption that the facilitator is the one speaking.

Thanks to this overwhelming body of research literature, professional societies have tended to be unusually blunt about FC. The American Speech-Language-Hearing Association, the leading professional body in this field, states unequivocally: “Facilitated Communication (FC) is a discredited technique that should not be used”. It continues: “There is no scientific evidence of the validity of FC, and there is extensive scientific evidence … that messages are authored by the ‘facilitator’ rather than the person with a disability”. This is not a marginal view; it reflects decades of careful studies across multiple countries. There are many other statements from relevant medical organizations and expert bodies that reach the same conclusion, which is to be expected, considering that the evidence points in only one direction. Are the facilitators deliberately engaging in fraud? No, it’s very likely that they’re being sincere, at least in the large majority of cases. The explanation is the ideomotor effect, the same unconscious motor influence that drives Ouija boards. The facilitator is not deliberately faking communication but unknowingly producing it, usually to satisfy their own desperate longing to connect with the disabled person.

So how did we get here? I guess the Times feels like it’s fine to smuggle in flagrant pseudoscience under the guise of a book review. Hey, it’s just a book review! But I’m afraid that claims of fact that appear in the paper’s pages are the paper’s responsibility, and this review represents a profound journalistic failure. The review treats FC as valid, when in fact FC has been exhaustively discredited for decades. In doing so, it does something worse than merely misinform; it participates in a harmful fiction that exploits vulnerable families and misrepresents disabled individuals. As I’ve said before, this issue is difficult to address in part because the families who fall for FC are so sympathetic. And the FC community goes to great lengths to enable this form of wishful thinking; they’ve created a number of superficially-different approaches to avoid scrutiny and defy the debunkings of the past, including avoiding the term “facilitated communication” itself. They now tend endorse tools like letter boards and techniques like “spelling”, which they claim are fundamentally different. But it’s all still FC, all still a matter of a verbal and cognitively-unimpaired adult “interpreting” the language of a severely disabled person and producing language that they’re consistently and conspicuously incapable of producing on their own.