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From time to time we receive letters asking if there is research
to support the use of facilitated communication as a form of augmentative
and alternative communication (AAC). The answer is yes. It is
certainly true that there are number of studies in which individuals have
not been able to demonstrate authorship. Yet there are also a number
of well controlled and carefully designed studies in which individuals have
been able to demonstrate authorship. There
are other instances where individuals have successfully moved from the point
of needing physical support to communicate to being able to type without physical
support. And still others have developed
the ability to speak the words before and as they type. In 1997 Doug Biklen and Don Cardinal co-edited
a book entitled Contested Words, Contested Science, published by Teachers
College Press, in which they examine the complexities of doing research on
the topic of authorship and where they recommend appropriate ways of conducting
controlled as well as observational studies. Since then, other studies have come out that
suggest still additional approaches.
Below is a listing of studies. One part is of studies that fail to demonstrate authorship and another
is of studies in which individuals do successfully demonstrate authorship.
Further, several documentaries have recently appeared in which authorship
of people who first learned to communicate with facilitation is confirmed
by virtue of the fact that these individuals are now seen typing without any
physical support/or speaking while typing and after typing.
Hopefully, these materials will help people in the field
of autism as well as related fields appreciate that the debate over facilitated
communication, like many debates in the social and behavioral fields, is complex
and worthy of continued exploration.
Duchan, J., Calculator, S., Sonnenmeier, R., Diehl, S.
& Cumley, G. (2001) A framework for managing controversial practices.
Language Speech and Hearing Services in Schools,
32, 133-141.
Terrill, C. (Producer/Director).
(2000). Inside story: Tito's story. [Documentary]. England:
BBC.
Wurzburg, G. (Producer/Director) (2004). Autism is a world. (Documentary). Atlanta: CNN.
Broderick,
A. A. & Kasa-Hendrickson, C. (2001). "Say just one word at first": the
emergence of reliable speech in a student labeled with autism. Journal
of the Association for Persons with Severe Handicaps, 26, 13-24.
"This article presents a qualitative,
interpretivist research study that documents the emergence, in the context
of typed expression, of increasingly useful and reliable speech for a young
person labeled with autism (13).
"Jamie has maintained his desire
to integrate speech with his typing, and is committed to pursuing this difficult
work, in spite of the ambivalence he feels about the ways that his speaking
affects others' perceptions of him. Jamie has been supported in this process
by his family's and his teachers' consistently high expectations of him and
their ongoing encouragement of and confidence in Jamie as a learner (23).
"Jamie's experience presents a challenge
to us as researchers, theoreticians, and educators to broaden the theoretical
and conceptual frameworks that we use in order to account for the complexity
of this young man's experience. We are challenged to account for Jamie's experience
by understanding it not as a model, nor as an exceptional or anomalous case,
but as a vision of possibility that may illuminate the experiences of others
whose language development falls outside of our current conceptual models
(23)
Calculator, S. & Singer, K. (1992). Preliminary validation
of facilitated communication. Topics in Language Disorders, 12, ix-xvi.
"The purpose of this study was to
validate the impact of facilitated communication on uncovering students' underlying
communication skills.Thus, this study was undertaken with the intention of
providing accurate diagnostic information on students as a basis for designing
appropriate educational programs (xi).
"No one would argue that the population
of children and adults who are currently using facilitated communication constitute
a diverse population.The risk of harming subjects by subjecting them to testing
may be more an artifact of the way in which such testing is conducted than
its mere use. The examiner who communicates a lack of expectation and creates
a negative testing environment is certainly one who could adversely affect
any child's performance (xvi).
Cardinal, D. N., Hanson, D. & Wakeham, J. (1996).
Investigation of authorship in facilitated communication. Mental Retardation,
34, 231-242.
"We examined whether facilitated
communication users, under controlled conditions, could transmit rudimentary
information to a naïve facilitator. Forty-three students across 10 classrooms
were shown a single randomly selected word with their facilitator out of the
room. The facilitator then entered the room and asked the student to type
the word, which was recorded exactly as typed and later evaluated; approximately
3,800 attempts were conducted over a 6-week period (231).
"There were two main findings of
the study. First, under controlled conditions, some facilitated communication
users can pass information to a facilitator when that facilitator is not aware
of the information, and second, the measurement of facilitated communication
under test conditions may be significantly benefited by extensive practice
of the test protocol. This latter result could partially account for the inability
of several past studies to verify facilitated communication-user originated
input (238).
Emerson, A., Grayson, A., & Griffiths, A. (2001).
Can't or won't? Evidence relating to authorship in facilitated communication.
International Journal of Language & Communication Disorders, 36
(Supp), 98-103.
"Data for 14 of the participants
who have been introduced to FC is included in this paper.The summarized data
relate to the issue of 'authorship', i.e. the question of which of the communication
partners (facilitator or user) is really responsible for the emergent text.
The data come from two main sources- controlled tests (in the style of published
experimental studies) and transcripts or diary records of routinely occurring
FC sessions (99).
"Evidence from this project shows
similar findings to many of the published studies that conclude, having undertaken
controlled tests, that FC is not a valid strategy to use. However, evidence
from the same project also suggests that the overall picture with regard to
FC may be more complex than this. The same participants who do not provide
authorship evidence in controlled trials provide data which indicate that
they are authoring their communications when given the opportunity to communicate
about things of their own choosing (100).
Janzen-Wilde, M., Duchan, J., & Higginbotham, D. (1995).
Successful use of facilitated communication with an oral child. Journal
of Speech and Hearing Research, 38, 658-676.
"A 6 ½-year-old child's oral and
spelled utterances were compared over a 3-month period as he was trained to
use Facilitated Communication (FC), a method of augmentative and alternative
communication. The child's language with FC was significantly better than
his oral language in length of utterances, novelty of utterances, and syntactic
complexity. His language with FC also contained more function words and over
time was more intelligible and required less verbal scaffolding than his oral
communication. Evidence that he was authoring his own messages during his
facilitated spelling was found in his idiosyncratic use of language and his
ability to convey verifiable information that was unknown to the facilitator
(658).
"Andy's introduction to FC allowed
people to see areas of his competence that were previously unknown to those
around him. It is hoped that this study will promote further research to increase
understanding of FC and its role in language intervention. Such understanding
can only serve to benefit individuals like Andy, who have much to say (671).
Niemi, J. &
Karna-Lin, E. (2002). Grammar and lexicon in facilitated communication:
A linguistic authorship analysis of a Finnish case. Mental Retardation,
40, 347-357.
"This case study adds a new dimension
to the discourse on the authorship issue in facilitated communication. The
linguistic structure produced by a young Finnish man with severe cerebral
palsy was examined. Data are based on transcripts he produced from 1993 until
1996 after facilitated communication had been introduced to him. In the data
analysis, as explicit criteria for his idiosyncrasies, we used patterns typical
of children acquiring Finnish as their first language and those found in normal
slips of the tongue, acquired aphasia, and specific language impairment. Based
on the analysis (i.e. the idiosyncrasy and agrammaticality of word-forms and
sentences), we strongly suggest that his output can hardly be a product of
any other speaker of Finnish, including that of his facilitators (347).
"Even though this study has
a limited amount of data from a person using facilitated communication, our
results provide strong evidence for the claim that the text produced by facilitation
originates from the author, not from the facilitator (355).
Rubin, S., Biklen, D., Kasa-Hendrickson, C., Kluth, P.,
Cardinal, D., & Broderick, A. (2001). Independence, participation, and
the meaning of intellectual ability. Disability & Society, 16,
415-429.
"This article presents a non-speaking
person's perspectives on independence and the implications of newfound communication
abilities for her participation in the world and upon the meaning of intellectual
ability. The person with the communication disability also has autism and,
early in her life, was classified by school officials as 'severely retarded.'
The narrative focuses especially on the concepts of independence, participation,
and intellectual competence or intellectual performance, and their relationship
to the concepts of democracy, freedom, and identity, all from a non-essentialist
perspective. In addition, the article addresses practical questions about
how, from her perspective, the non-speaking person developed the ability to
communicate without physical support (415).
"Rubin: Because of the way we move
and our lack of speech we were assumed to be retarded. I was thought to be
retarded (but) all this changed.once I could type without support.My very
existence challenged beliefs about mental retardation. Able to type independently.my
presentations (at conferences) were acts of advocacy (419).
Sheehan, C. & Matuozzi, R. (1996). Investigation of
the validity of facilitated communication through the disclosure of unknown
information. Mental Retardation, 34, 94-107.
"Three individuals (8, 10, and 24
years old with diagnoses of autism and mental retardation) participated in
a message-passing format to determine whether they could disclose information
previously unknown to their facilitators. Results reveal valid facilitated
communication from each participant (94).
"The data from the current study
lead us to caution that a phenomena as complex as facilitated communication
eludes a cursory exploration. Each participant was able to disclose information
accurately and deftly at times and was wholly inadequate in his or her attempts
at other times.The developing picture of an individual's validity profile
replete with the patterns of required support, inconsistency, language impairment,
and strides towards independence may well be the only reasonable evaluation
of a validity confidence level (104)."
Tuzzi, A.,
Cemin, M. Castagna, M. (2004) "Moved deeply I am" Autistic language in texts
produced with FC. Journees internationals d'Analyse statistique des Donnees
Textuelles, 7, 1-9
"Using texts produced through
Facilitated Communication (FC), this work is aimed at identifying the characteristic
features of the language used by autistic subjects and understanding when
these distinctive elements may distinguish it from the language of facilitators.
Preliminary results shows that autistic subjects actually use a special
style of writing; this finding supports the hypothesis that texts are the
fruit of individual production of autistic subjects, not inevitably influenced
by facilitators. This first work,
based on a restricted sample which is not necessarily representative, is important
because it has permitted to better specify criteria by which subjects, texts,
analyses to carry out and software to be employed will be chosen in future
studies." (1)
Weiss, M., Wagner, S., & Bauman, M. (1996). A validated
case study of facilitated communication. Mental Retardation, 34, 220-230.
"The case of a 13-year-old boy with
autism, severe mental retardation, and a seizure disorder who was able to
demonstrate valid facilitated communication is described (220).
It is tempting to offer conjecture
about why this procedure or these individuals were able to reveal valid communication
with facilitated communication. However, we find it far too premature to draw
any such conclusions. Rather, we have chosen to highlight for consideration
a small number of factors that may have been relevant (227).
Zanobini, M.
& Scopesi, A. (2001). La comunicazione facilitata in un bambino autistico.
Psicologia Clinica dello Sviluppo, 5, 395-421
"Studied facilitated communicative interactions among a 7-yr-old autistic boy, his mother, and his teacher. Data on communication was obtained by observation of 28 interactions in natural situations. The Ss' verbal productions were transcribed and evaluated according to context and situation, stylistic consistency, and interaction with mother or teacher.
"The Sphinx Lexica Edition software
program (1998) was used. The results show evidence of stylistic consistency
but variation according to location at home or school and interaction with
mother or teacher. The results suggest that the boy's original and peculiar
linguistic behavior may indicate a degree of linguistic independence from
facilitation. Implications for improving facilitated communication for autistic
children are discussed."
Bebko, J., Perry, A., & Bryson, S. (1996).
Multiple method validation study of facilitated communication: ii. individual
differences and subgroup results. Journal of Autism and Developmental Disabilities,
26, 19-42.
"Potential
individual variations in the effectiveness of a shared communication method,
facilitated communication (FC), were examined among 20 students with autism
and related disorders" (p. 19) who were the students of a regional program
specializing in autism, ranging in age from 6 to 21 years. Sixteen staff members
at the program who received "a typical 2-day FC training program" (p. 22)
served as facilitators. Data collection began "after staff training and 11/2
months of using FC" (p. 26). "To minimize the limits or disadvantages of a
single method, we used multiple methods, including auditory or visual input,
and simple pointing response to pictures or words, as well as typing" (p.
19)
"Findings
differed across methods, but there was little clear support for the validity
of FC in enhancing communication over communication that students produced
independently. Significant facilitator influence of responses was found, but
was far less extensive than in other studies" (p. 20). Especially in the Headphones
design, in which "the task for students.was simply to point with facilitation
to the one of three pictures.which corresponded to a word presented auditorily
through a small desk-top speaker" (p. 25), "less evidence of facilitator influence
was found" (p. 33). A further analysis of students' responses under
this design "demonstrated clearly that for all but Student 19 either the students
were determining the response being made.or that responses were essentially
randomly distributed among the alternatives available, either case indicating
no facilitator influence (p. 34). "However, an 'abdication' pattern of responding was found for some students,
in which high performance observed with independent responding was lessened
on trials when FC was introduced" (p. 20).
Bomba, C., O'Donnell, L., Markowitz, C., &
Holmes, D. (1996). Evaluating the impact of facilitated
communication on the communicative competence of fourteen students with autism,
Journal of Autism and Developmental Disorders, 26, 43-58.
"The purpose
of this study was to evaluate facilitated communication (FC) as an augmentative
or alternative communication system for 14 students attending the Eden Institute"
(p. 43) - "a behaviourally oriented, educational program serving students
with autism ages 3 to 21" (p. 46). Three facilitators, "who had at least 2
year's experience working with students with autism" (p. 48), were involved
in the study. Two of them "received training in facilitated communication
by attending a training workshop conducted by Schubert (1992) of Syracuse,
NY" (p. 48) and the other was trained by one of these two.
Using both
a standardized vocabulary test and a "protocol of 30 questions designed specifically
for this study" (p. 49), a pretest was administered to all participants. The
protocol contained questions "whose answers are objective and presumably known
to both the facilitator and participant" such as Yes/No questions, object
labeling, and simple personal questions (e.g., What is your name?), as well
as "those that encouraged open-ended conversation" (p. 49) such as "How do
you feel about your parents?" and "How do you feel about being autistic?"
(p. 56). Following the pretest, "each participant received 10 weeks of individualized,
daily instruction in FC" that "lasted a minimum of 5 minutes and a maximum
of 25 minutes" (p. 51). Finally, "[a]t the conclusion of the instructional
condition, the pretest was readministered as a posttest" (p. 51).
"For 13 of
the 14 participants, pre- and posttest results were identical; no items were
answered correctly" (p. 53) for both the vocabulary test items and the protocol
question items, revealing that "10 weeks of instruction in FC did not significantly
improve the participants' ability to use this system" (p. 53).
Cabay, M. (1994). Brief report: A controlled
evaluation of facilitated communication using open-ended and fill-in questions.
Journal of Autism and Developmental Disorders, 24, 517-527.
This study involved "four students enrolled in the day school program" (p.
519), ranging in their age from 9 years to 17 years, with "diagnosis of autism
or autistic-like traits" (p. 519). They used FC at school "for 3 months or
more" (p. 519). Two facilitators participated in the study - one who "had
provided occupational therapy for 2 years to the subjects she facilitated
with" (p. 519) and another who "had worked daily in the classroom for 6 months
with the subjects she facilitated with" (p. 519).
Ten cards "with fill-in or short-answer questions" (p. 520) and ten blank
cards were randomly presented to the subjects in two conditions: one "where
the facilitator was aware of which card was presented" and another "where
the facilitator was unaware of which card was presented" (p. 520).
This study did not support the validity of FC as, "[w]hile 95% of the responses
were correct when the facilitator knew which item was presented, only 19%
of the responses were correct when the facilitator was unaware of which item
was presented.. Most of the incorrect responses (62%) when facilitators were
unaware of what was presented resembled correct answers to possible items.
Since the facilitators knew the item pool, this suggests they could have been
guessing what the items were and thus influencing the answers accordingly"
(p. 523).
Crews, W., Sanders, E., Hensley, L., Johnson,
Y., Bonaventura, S., & Rhodes, R. (1995). An evaluation of facilitated
communication in a group of nonverbal individuals with mental retardation.
Journal of Autism and Developmental Disorders, 25, 205-213.
The purpose of this study was "to provide an additional quantitative evaluation
of FC via use of a message-passing paradigm" (p. 206), in which words, common
objects, and numbers were presented both visually and auditorially. The results
indicated that six of eight subjects, who were "nonverbal individuals with
mental retardation" (p. 206), resided in state facilities, and had used FC
for 6 to 9 months prior to this study, "failed to correctly pass any messages
(i.e., items) to the facilitators via FC across 18 trials" (p. 211). "Limited
positive outcomes were observed in two individuals with both mild mental retardation
and cerebral palsy; however, the results were questionable in one subject"
(p. 213).
Eberlin, M., McConnachie, G., Ibel, S., & Volpe, L. (1993). 'Facilitated communication': A failure
to replicate the phenomenon. Journal of Autism and Developmental Disorders,
23, 507-529.
This study
involved 21 subjects with a diagnosis of Autism or of Pervasive Developmental
Disorder, ranged in age from 11.3 years to 20.2 years. All subjects were new
to FC and were familiarized to the FC process during the "initial exposure
session..[that] lasted between 20 and 30 minutes" (p. 519). Ten persons served
as facilitators in this study who "had volunteered for this project and .had
expressed enthusiasm about FC" (p. 511). Before the project began, facilitators
received 4 hours training by two of the authors who "had attended workshops
on FC conducted by Biklen or his associate Schubert" (p. 517). In addition,
"[s]upervision of each facilitator-subject pair was provided by the authors"
(p. 518) throughout the project.
A baseline,
pre-, and post-test situation utilized two types of dependent measures. One
was a standardized vocabulary test, which "begins with 14 individual color
pictures requiring expressive identification, then progresses to printed words
requiring definitions" (p. 515), and another was a "structured interview questionnaire
designed by the authors that asked initially yes/no and simple, concrete answers,
progressing to more open-ended questions asking about preferences and feeling
states" (p. 515). During the test administrations, "visual and auditory screening
procedures were used to insure that the facilitator was unaware of the test
questions" (p. 514). "Following the pretest, subjects received 20 hours of
FC training (40 half-hour session)" (p. 519).
"[A]fter initial
exposure to FC no student demonstrated unexpected literacy or improved communicative
ability" (p. 525). Also, "after 20 hours of FC training no student demonstrated
emerging literacy skills or communicative competence that exceeded their already
established communicated abilities" (p. 526). Finally, the results of the
"post-warm-up test" where "the facilitators were able to see and/or hear the
questions posed to the client" (p. 520) indicated that "some facilitators
influenced the subject's typed responses while facilitating" (p. 526).
Klewe, L. (1993). Brief report: An empirical
evaluation of spelling boards as a means of communication for the multihandicapped.
Journal of Autism and Developmental Disorders, 23, 559-566.
This article "deals with the experimental-psychological examination conducted
to distinguish between facilitator influence and original productions by patients"
(p. 560) - a research carried out in Denmark by Copenhagen County interdisciplinary
research group as one of four examinations with 17 patients who "ranged in
age from 24 to 43 years, with 9 having cerebral palsy, and 7 on daily convulsion
medication" (p. 560). Four of these 17 patients "regretted their earlier consent"
(p. 560) and did not participate in this study. Ten facilitators, who "had
all used spelling board with the patients in question for a long time" (p.
561), participated in the examination.
Using 15 pictures (12 with "objects within the patients' world" (p. 561)
and 3 blank), experimental settings included 3 series: (A) a setting where
"both the patient and the facilitator could see the pictures," (B) a setting
where "a screen was added .so that the facilitator could not see the pictures
being shown," and (C) a setting where the screen remained and "each was shown
the pictures but not in the same order" (p. 561).
"There was a distinct relation between picture and answer in almost all
cases [(i.e., 95%)] in series A where the facilitators could see the pictures
shown to the patients. In series B and C, where the facilitators could not
see the pictures seen by the patient, there was a lack of relation between
the picture seen by the patient and the answer in almost all cases [(i.e.,
only 2% of all responses in each setting)]" (p. 562). Moreover, "[i]n series
C only two answers out of 108 (2%) were related to the patients' pictures,
but 43 out of 108 (40%) were related to the facilitators' pictures" (p. 563),
suggesting the facilitators' influence.
Montee, B., Miltenberger, R., & Wittrock,
D. (1995). An experimental analysis of facilitated communication. Journal
of Applied Behaviour Analysis, 28, 189-200.
This study "evaluated the authorship of messages produced through facilitated
communication by 7 adults with moderate or severe mental retardation and their
facilitators. The clients had been reported to be communicating fluently through
facilitated communication" (p. 189) and they "had been using facilitated communication
for 6 to 18 months" (p. 191). The study utilized two evaluation formats, naming
pictures and describing activities that the client engaged with the research
assistant in a separate room for approximately 5 minutes. In both formats,
the following three conditions were conducted: "(a) the facilitator and client
had access to the same information [(Known condition)], (b) the facilitator
did not have access to the picture or activity [(Unknown condition)], and
(c) the facilitator was given false information about the picture or activity
[(False condition)]" (p. 189).
For the naming pictures format, "the mean percentage of correct responses
in the known condition was 75%, and in the unknown and false conditions the
mean percentage was 0% and 1.8%, respectively. In 66% of the trials for the
false condition, the subjects typed the picture seen by the facilitator" (p.
195). For the describing activities format, "the mean percentage of correct
responses in the known condition was 87%, and in the unknown and false conditions
the mean percentage was 0%. In 80% of the false condition trials, the client
typed the activity that was correct for the facilitator" (pp. 195-196). Overall,
"[t]he results showed that the clients typed the correct answer only when
the facilitator had access to the same information, never typed the correct
answer when the facilitator had no information or false information, and typed
the picture or activity presented to the facilitator when it was different
from the one experienced by the client" (p. 189).
Moore, S., Donovan, B., Hudson, A., Dykstra,
J., & Lawrence, J. (1993). Brief report; Evaluation of eight case
studies of facilitated communication. Journal of Autism and Developmental
Disorders, 23, 531-539.
This assessment involved 8 disabled individuals with a diagnosis of moderate
to severe intellectual disability, who had used FC for 17 to 33 months, ranged
in age from 22 to 41 years, and 4 facilitators who "had been trained by personnel
from the DEAL Communication Centre in Melbourne" (p. 534). For each facilitator-client
pair, 10 short-answer questions were developed by the facilitator and were
asked of the subjects under three conditions. Condition A "contained 5 questions
randomly selected from the original 10" that were "asked verbally of the subject
by the facilitator" (p. 533). Condition B "contained remaining 5 questions"
(p. 533) that were presented as prerecorded questions to both the subject
and facilitator via earphones. Condition D "contained all 10 questions randomly
ordered" where "the subject heard a question but the facilitator heard only
music" (p. 533).
The assessment was discontinued with 2 of 8 subjects due to the lack of
meaningful responses during the procedure. For the remaining 6, "correct answers
were provided for Condition A. In Condition B there was a small reduction
in the number of correct responses, but there were still sufficient correct
responses to demonstrate that the introduction of the earphones did not prevent
correct responding. In Condition D the failure of any subject to achieve the
critical level of four correct responses precludes the drawing of the conclusion
that any one of them can communicate using the technique" (pp. 536-537). Based
on a significant gap of the performance between Condition A/B and Condition
D, facilitators' influence was also suspected for 2 of 4 facilitators.
Regal, R., Rooney, J., & Wandas, T. (1994).
Facilitated communication: An experimental evaluation. Journal of Autism and Developmental Disorders,
24, 345-355.
"Nineteen participants in a day treatment program for the developmentally
disabled participated in this validation study of facilitated communication
(FC)" (p. 345). They ranged in age from 23 to 50 years, "5 were autistic,
and 4 had cerebral palsy" (p. 348), and all "were rated regular users of this
communication method" (p. 347). There were 6 facilitators worked with the
19 subjects in this study. "An information-passing design was used
requiring short-term recall of one randomly selected stimulus card at a time.
Cards varied by the shape, the color of that shape, and the number of that
shape used on each card" (p. 345). The results indicated that "[n]o facilitator
and no client performed at levels that exceeded chance expectations" (p. 350),
failing "to validate facilitated communication for the group as a whole, any
individual facilitator, or any of the subjects" (p. 345).
Shane, H., & Kearns, K. (1994).
An examination of the role of the facilitator in 'facilitated communication',
American Journal of Speech-Language Pathology, September, 3, 48-54.
The purpose
of this investigation, "initiated by a local attorney in order to obtain information
about the subject's (DM's) communication status for the purpose of resolving
pending litigation" (p. 49), was "to determine whether messages expressed
via FC by a 38-year-old man who was nonspeaking and mentally retarded were
produced by this individual or by his facilitator" (p. 48). DM was introduced
to FC by a 25-year-old female who "was a supervisor in a sheltered workshop
in which DM worked for the past 4 years" (p. 49). The facilitator had successfully
completed a "1-day facilitated communication workshop" provided by "personnel
from the Syracuse University Facilitated Communication Institute" (p. 49)
and "described herself as an experienced facilitator who has assisted several
other individuals" (p. 50)
Using familiar settings and conditions that "were identical to those employed
during all previous FC events" (p. 50) between DM and the facilitator including
a "Compaq 286 computer keyboard and monitor" (p. 50), the experiment was conducted.
Testing procedures involved two conditions "in which the facilitator and the
subject viewed or heard the same (shared) or different (unshared) information"
(p. 50). For a task of labeling color photographs of everyday items, 10 trials
were made in shared conditions and 10 trials were made in unshared conditions,
in which the facilitator was prevented "from knowing that the picture had
been changed, so it appeared to the facilitator as though DM was viewing the
same picture she had just viewed" (p. 50). For a task of answering prerecorded
questions about shown photographs, questions were "presented through separate
headphones" (p. 50) to DM and to the facilitator. A total of 20 trials for
this task consisted of 10 shared trials (i.e., DM and the facilitator received
an identical question) and 10 unshared conditions (i.e., They received a different
question). For a labeling objects task, a half of trials (five items) were
done in shared conditions and another half were done in unshared conditions,
in which "DM was brought to an adjoining room and shown a common object" (p.
51) followed by rejoining "the facilitator in the test room and was asked
to label, through FC, the item he had just seen" (p. 51). Finally, DM participated
in two events with an examiner in an adjoining room while "the facilitator
remained in the original test setting" (p. 51) (i.e., unshared events) and
"was asked to describe what had occurred in the adjoining room through FC"
(p. 51).
Regarding the labeling photographs task, "[w]hen DM and the facilitator
viewed identical pictures and were asked to label them, a correct response
was always produced" while "responses in the unshared condition always reflected
information contained in pictures viewed only by the facilitator" (pp. 51-52).
Regarding the task of answering questions about photographs, "all typed responses
were correct" (p. 52) in the shared condition. All 10 responses under the
unshared condition were incorrect, which "always represented answers to questions
posed to the facilitator alone" (p. 52). Regarding the object labeling task,
correct responses were only produced in the shared condition and "[a]ll responses
to the unshared trials were incorrect" (p. 52). Lastly, responses to the unshared
events that had occurred in an adjoining room "consisted of an unintelligible
string of typed letters followed by one off-target and irrelevant response"
(p. 52). Based on several factors such as the fact that "the subject was cooperative,
interactive, and friendly" (p. 52) throughout testing, it was believed that
"these findings generalize to other more naturalistic communication interactions
by this subject" (p. 52).
Smith, M., & Belcher, R. (1993).
Brief report: facilitated communication with adults with autism. Journal
of Autism and Developmental Disorders, 23, 175-183.
"The purpose
of this work was to explore the use of facilitated communication with adults
with autism with no or minimal verbal skills" (p. 176). Eight male adults
ranged in age from 19 to 36 who all lived in "group residences for adults
with autism" (p. 177) participated in the study. All facilitators attended
"workshops held by proponents of facilitated communication" (p. 176) Each
subject received 20 to 30 minutes training on facilitated communication for
the duration of 6 to 12 weeks with the frequency of 1 to 3 times per week.
Within these sessions, subjects were asked to type or copy named letters,
hand-printed letters, answers to simple questions (e.g., What is your name?),
written answers, and answers to open-ended questions.
"In all instances, typed communications from
verbal subjects were at or below the level of their verbal communication..
There was no evidence of unexpected literacy skills. Subjects with no known
literacy skills who were thought to be unable to read or write typed only
random letters. Subjects with known literacy skills typed words, phrases,
or sentences comparable to what one would expect given their literacy skills"
(p. 181). "[T]he use of procedures to avoid coactivity" (p. 181) as well as
the avoidance of "error prevention procedures" (p. 182) were thought as explanation
for the failure of this study to replicate claims about facilitated communication.
Szempruch,
J., & Jacobson, J. (1993). Evaluating
facilitated communications of people with developmental disabilities. Research
in Developmental Disabilities, 14, 253-264.
"A quasiexperimental message-passing procedure was used to assess the validity
of the facilitated communication (FC) by people with autism and mental retardation
or with mental retardation" (p. 253). The 23 subjects, ranging in age from
21 to 74 years, had the experience of using FC from 2 to 13 months. For the
6 facilitators participated in this study, "[t]he primary source of training
in FC.was Syracuse University" (p. 258).
"Message-passing consisted of showing and verbally labeling a picture of a
familiar object with the facilitator absent, and subsequent facilitation to
generate a label or description of the object. Three-trial blocks were conducted
with each participant on two different days. Blocks were conducted in the
participants' normal FC setting, with their facilitators of choice, and no
special apparatus was used. No participant was able to accurately label or
describe the object shown to them with facilitation" (p. 253).
Wheeler, D., Jacobson, J., Paglieri, R., & Schwartz, A. (1993). An experimental assessment of facilitated
communication. Mental Retardation, 31, 49-60.
"This report
presents a quantitative study of facilitated communication" (p. 49). Twelve
individuals with a diagnosis of autism, ranging in age from 16 to 30 years,
participated in the study. They all lived at an institutional autism program
where "[t]he use of facilitated communication proliferated rapidly" (p. 50)
since a few clinical staff members became interested in it and began to use
the technique in 1991. "All participants had been using facilitated communication
for at least 5 months and for as long as one year" (p. 50). There were also
9 facilitators involved in the study.
"They were shown pictures of familiar objects and asked to type the names
of the objects under three conditions: (a) assisted typing with facilitators
unaware of the content of the stimulus picture, (b) unassisted typing, and
(c) a condition in which the participants and facilitators were each shown
pictures at the same time. In this last condition the paired pictures were
either the same or different, and the participant's typing was facilitated
to label or describe the picture" (p. 49)
"A total of 180 trials allowed for demonstration of valid facilitated communication:
the 10 facilitated condition trials for all 12 subjects (120 trials) and 50%
of the distractor condition trials (60 trials: those where the participant
and facilitator had different cards). Of these 180 trials, there were no clear
correct responses to the participant's stimulus card" (p. 54). Of 120 trials
in the facilitated condition, 80 were "incorrect responses that consisted
of recognizable object labels that were unrelated to the stimuli" (p. 55).
Such incorrect object labeling "also occurred in the distractor condition,
with a total of 52 such responses (43% of trials)" (p. 55). "In the trials
within the distractor condition when different stimulus cards were shown to
the participant and the facilitator, there were 12 responses that were judged
to be correct to the card shown to the facilitator . and no responses judged
correct to the participant's card. This represents 20% of possible responses..
[which] clearly demonstrate facilitator influence" (p. 55).