A Sad, Enraging Story About the Pseudoscience of Facilitated Communication

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The heartbreaking thing about facilitated communication, the subject of a long, must-read article by David Auerbach on Slate, is who it targets: parents and other caretakers of nonverbal disabled people, often those with autism. For those of us who don’t have someone like this in our life (I don’t), it’s hard to imagine what it must be like to love someone, watch them struggle, and wish, more than anything, that you could communicate with them, that you could understand what is going on inside their head.

That’s what FC promises. As Auerbach puts it, “A facilitator [physically] supports a disabled person to assist him in communicating through a keyboard or other devices.” If you’re a believer, this technique, which is now a few decades old, has produced miracles in which profoundly disabled people have turned out to be eloquent communicators of rich life philosophies; scholarly articles and books have been co-authored by individuals thought to have the intellectual capacities of young children until FC unlocked them from their prisons of noncommunication.

But as Auerbach points out in a devastating article, FC has been shown, over and over and over, to be bunk. It produces a “Ouija board effect” in which the facilitator, not the disabled person, unwittingly (in most cases) produces the messages in question. In some cases, these messages have included shocking allegations of sexual abuse, leading to false charges being pressed against caretakers; in the shocking Anna Stubblefield case written up recently in the Times by Daniel Engber, it led to a facilitator (as she tells it) becoming convinced she was in the midst of a consensual, reciprocal romance with a 35-year-old man who wears diapers and had never said a word. Following her conviction on sexual-assault charges, she faces 10 to 40 years in prison.

Because FC swept so quickly into various communities of parents and caretakers (autism-focused ones, in particular), the hype greatly outpaced the science. Auerbach excerpts from a book by Laura Schreibman, “FC is truly unusual in that it enjoyed tremendous popularity and widespread use before it was ever put to the scrutiny applied to other new treatments … akin to widespread use of a brand-new vaccine or drug before it has passed rigorous testing and approval by the FDA.” But whenever it has been tested in a rigorous way — by, for example, constructing an experiment in which the disabled person is asked to communicate the content of a message the facilitator doesn’t have access to (neutralizing the Ouija board effect) — it has failed. Over and over and over.

The point of Auerbach’s article is partly to highlight this failure — although by now FC has been so discredited that numerous respected scientific organizations have come out against it, including the American Psychological Association and the American Academy of Pediatrics. But more urgent is his reporting on the way FC is still — long after the scientific Establishment has delivered a resounding, carefully considered no on it — being used in many settings (often under different, more PR-friendly names), and receiving millions of dollars in taxpayer-funded grants from the Department of Education and elsewhere. Many of the strongest proponents have no real training in psychology; some of them believe FC allows for the communication of telepathic messages from disabled individuals to their caretakers.

It’s probably the case that many of these proponents really do believe it works. Auerbach makes a strong case for this community basically being a cult at this point, albeit one that has infiltrated many mainstream educational institutions. But what FC’s pushers believe doesn’t really matter; the point is that, much like David Perlmutter offering up autism-treating snake oil, FC is pseudoscience preying on vulnerable people, and often with disastrous repercussions. Auerbach’s article is one of the more important pieces of science writing published in 2015, and you should read it.