Terence Hines - Pseudoscience and the Paranormal

Autism is a developmental behavioral disorder. Its cause remains unknown, most likely because there are probably multiple causes. Autism develops early in childhood and is characterized by a wide variety of behavioral abnormalities including “failure to relate to others, lack of speech, and intolerance of chance” (Rathus 1999, p. G3), as well as self-stimulation (i.e., rocking, hand-waving) and, in some cases, retardation. These symptoms are devastating to the family. In the mid-1980s a new “miracle cure” for autism roared into the popular media. This was facilitated communication (FC). The technique was developed in Australia by a nurse named Rosemary Crossley. It was brought to the United States by Douglas Bikien, a special education professor at Syracuse University, who opened the Facilitated Communication Institute at Syracuse in the early 1990s.

According to the proponents of FC, autistic individuals’ only real problem was an inability to communicate verbally. They were, it was held, just as intelligent, if not more intelligent, than normal individuals. In order to tap into this intelligence, all that was needed was some sort of device that would allow them to communicate in a nonverbal manner. The device of choice was a standard keyboard or letter board. But the autistic individual couldn’t use the board by herself. When simply given a letter board, no communication resulted. Rather, the facilitator had to hold the individual’s hand and give support for the movements pointing to individual letters and numbers. It was via such pointing that questions were answered. And it was via such pointing that report after report of miracles appeared, many of them uncritically ballyhooed in the media. Parents of children who had been uncommunicative for years reported their children producing completely grammatical, perfectly worded answers to all sorts of questions. Children who had never even been given any reading instruction were said to be able to read perfectly. The evidence for this was that they could, through FC, answer questions about material they had supposedly just read. Other children produced stories, songs, and poems. Others took, and got very high grades in, classes in literature and mathematics—subjects they had never before studied. Truly, this seemed a miracle cure for autism and the parents’ totally understandable enthusiasm fueled an almost religious movement that promoted FC.

Unfortunately, these “miracle” reports so widely touted by FC proponents as proof that FC was really effective were nothing more than anecdotes told by parents or FC facilitators themselves. Like the proponents of so many other failed treatments, they let the anecdotes, testimonials, and general excitement of being at the spearhead of a wonderful new treatment get ahead of any actual scientific research to determine whether the treatment actually worked. This was a classic case of putting the cart before the horse. It was not just excited parents and trainers who jumped on the FC bandwagon prior to any objective evidence. In their comprehensive article on the history and scientific status of FC, Jacobson, Mulick, and Schwartz (1995) note that those uncritically accepting FC included “some communications disorders and special education professionals” (p. 754) who, presumably, should have known better.

In the early 1990s, research began to appear that carefully evaluated the effects of FC. The major question was whether it was the patient who was producing the impressive responses spelled out on the letter boards, or whether these responses were actually being made—albeit unconsciously—by the facilitators. Facilitators swore up and down that they were not the source of the answers, but it had been noticed that FC tended not to work well at all when the patient knew (or should have known) the answer to the question, but the facilitator did not know. It was an easy matter to set up experimental situations in which patients were shown the correct answer to spell out but the facilitator was not. For example, a common paradigm was to use a task in which the patient was shown a picture of a common object and the task was to spell out the object’s name. This was something that the patients could almost always do under uncontrolled conditions. But in the experimental conditions, the picture of one object was shown to the patient and the facilitator was shown a picture of a different object. Of course, if FC had been real, the patients should have easily typed (or pointed to) the letters spelling out the name of the object they had been shown. This never happened. Time after time after time, the patients easily typed out the name of the picture they had not seen, but that the facilitator had seen (Jacobson, Mulick, and Schwartz 1995). From a scientific point of view, this should have been the end of FC. The proponents could have written it all off as a noble effort, but one that happened to be wrong. This happens all the time in science. You get an idea, which often seems, at the time, like a brilliant one that just has to be right. You talk to others about it and they agree. Then you go and test it. Damn! Another beautiful theory, as someone once said, killed deader than… well, killed dead by cold, ugly data. So you move on.

But FC would not die so easy a death. Soon after the negative results began to appear, FC proponents began to argue that FC was, somehow, immune to normal scientific investigation techniques. Several instances of such “special pleading” are given by Jacobson, Mulick, and Schwartz (1995, p. 759). Basically, the argument was that FC should not be held up to the same scientific standards as other therapies because it was a special “post-modern” idea (i.e., Sailor 1994, quoted in Jacobson, Mulick, and Swartz).

There was another defense of FC mounted by its proponents. They argued that FC patients failed to provide evidence of real reading, understanding, or whatever when carefully tested because such testing was “confrontational,” and so disrupted and disturbed the patient that performance dropped to zero. This argument suggests the image of some cruel storm trooper-type researcher, perhaps complete with monocle and jackboots, shouting at the poor, terrified patient, “You vill type out ze vords or you vill be sent to ze Russian front!” Perhaps this was actually the image this defense was intended to send. In fact, the testing was done in very low-key situations, sometimes by the very same facilitators who had facilitated successfully with the patients, and who had the patient’s full trust just moments before. The argument is a red herring—what I call the “Oh, didn’t I tell you? It doesn’t work on Tuesdays” defense. As soon as disconfirming research appears, the proponents suddenly discover that the research couldn’t possibly have worked because of some factor that they never bothered to mention to anyone as having the slightest relevance before. This defense was also used, it will be recalled, by the proponents of Therapeutic Touch when research showed that practitioners could not detect a human energy field.

Even if it didn’t really work, FC might seem a fairly benign procedure—one that couldn’t do any real harm. If it made the patient happy (but how would you really know that?) and made the parents or caregivers happy to think that they really were communicating with a bright, intelligent individual, what was the harm? At one level, the harm is somewhat theoretical and has to do with the value of truth. The research showed that the answers in FC were coming from the facilitator, not the patient. So those who continued to believe in FC were living a delusion. They were also creating in their own mind a human being who did not exist, and ignoring the very real human being who did exist and very likely had very different needs and wants from the one they interacted with in their delusion.