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The Facilitator’s Touch

Listen_to_me_by_rachellove147-d34d13dNote: Thank you to Bruce for this raw post, written from experience as only a parent can write. We are all facilitators for our children with autism.  In some fashion. This post delves deep into the use of Facilitated Communication.   KIM

By Bruce Dalziel

My dear wife Mary still has dreams in which suddenly Matthew speaks.  She dreams she is somewhere ahead of him-- perhaps driving a car with him in the back seat, or with her back turned towards his at a family party-- when he speaks a complete sentence, with perfect diction, such as “I always prefer that we drive this way as opposed to the highway.”  In the dream, Mary asks, “Who said that?” and Matt says “I did,” or someone says “Matt did;” Mary is the only one in this dream who did not know Matt could talk.

This dream has precedents in our lives-- when Matt was 2 ½ he said “no” quite clearly to his grandmother, and that same month he said the word “bubble” perfectly at a birthday party.   Today at 30, Matt has a good heart, a strong mind, and a wide vocabulary, and he is able to type to communicate basic needs, but he has not actually spoken again since. 

When Matthew was diagnosed at age three, in 1990, autism was only beginning to be understood as a developmental disability. Its incidence has increased fifty-fold since.  Doctors could tell us Matt was autistic, but not why.  We found ourselves unlikely pioneers on an unexpected frontier.  No one could tell us what caused it.  Autism is defined in terms of symptomatic behaviors, including impaired communication and social skills, with no single identified cause, despite lots of theories.  Yet the mystery gave us some hope that the secret of the tomb could be discovered, and that Matt’s disability somehow could be cured.  Like cancer patients chasing clinical trials, for Mary and me at that time, it was that or die trying.

Before Matt was diagnosed, like most Americans, we knew little more about autism than what we learned from Dustin Hoffman’s portrayal of the precocious character Raymond in Rain Man, which premiered just after Matt was born.  That is to say, we viewed autism as a curiosity, like Outsider Art.   The Who’s rock opera Tommy presented a darker view: Tommy falls into a catatonic autistic-like state because of extreme childhood trauma linked to his mother, reflecting outdated 1950’s psychological theory suggesting autism is caused by “refrigerator mothers”, who are somehow unable to love their children. 

In our house, this was always a laughable premise. Mary is all love all the time, especially for her dear boy and his younger sister Suzanne.  Indeed, Mary literally taught Matt to love. It was like a D-Day assault, or maybe the Macarthur plan is a better metaphor. I am not sure I can describe it more precisely than as a singularly intimate focus or as a supernatural force.   We had both read a memoir called “The Siege” by Clara Claiborne Park, a mother of a child with autism, who took an aggressive behavioral approach to breaking through to her child.  Like Joan of Arc, Mary took up the sword. 

Matt’s view of the world was distorted and enormously frustrating.  Mary stood right in front of him, offering her full presence at every moment, and absorbing his pain.  She nursed him for sixteen months, which was his only consolation at the time, since he did not suck his thumb and he had no use for toys or stuffed animals that might comfort other children.  They developed a deep connection. 

Mary taught him how to give a hug, and that other people sometimes needed hugs.  She was constantly explaining other people’s behavior to him, especially emotions:  “Suzy is crying because she is sad.  She is sad because her game got knocked over.  Can you give Suzy a hug?” Though Matt is still autistic, over a long period of time, Mary’s approach was wildly successful in building his empathy and self-confidence. 

Mothers of children with autism have a heroic creative fire.  They will try anything to make life better for their children, and they develop their own deeply informed prescription for what needs to be done to meet the needs of one singular individual, who is different even from all others with autism.  These mothers are willing to change family diets radically, wrangle with insurance companies, bully school boards, restructure their family dynamics, move to other school districts or other states if necessary, all to facilitate this relentless quest.

Beyond Mary, there was no one in the world that was a better friend and advocate for Matt than his sister Suzanne.  Two years his junior, she had to grow up quickly to become the big sister he needed.  She also needed time of her own with us, which could be interrupted at any moment.   She loved to play games involving stories and imagination.  She made up a game she would make us play again and again.  “Let’s pretend I was a baby and you did not know I could talk,” she would say.  The plot then might vary a bit, but it always started with cooing and gurgling, and ended with our dramatic wonder and joy that this beautiful little baby had been hiding the fact that she could talk all along.     

Most people were kind to our dysfunctional family.  Sometimes though, we got the sense that some people believed we harried caregivers were perhaps part of the problem.  We endured lectures from relatives and strangers about proper parenting.  While some might offer great advice for modern families, our situation was post-modern, nearly bursting with ironic twists and practical relativism.  We were saddened by a diminishment of some friendships, as some parents decided that Matthew’s challenges were more than their healthy families could bear.  

A study in the 1990s found that, as a group, relative to other parents, parents of kids with autism were “anxious, impulsive, aloof, shy, over-sensitive, irritable and eccentric”.  Fair enough, I suppose, but I am not sure we were unusual in any of these regards before we had children with autism.  Maybe that’s what happens when everyday is a vigilance test to keep your beloved child from running out into traffic, and every night you lie in bed wide awake, worrying that he well might sneak downstairs to try to cook, turn the gas stove on, and burn the house down.  

It was very difficult to get information about autism at that time.  It was thought to be rare and had not been nearly as extensively studied as it would soon come to be.  The internet was just getting started really, and there were virtually no on-line resources for parents of children with autism.  Life was too hectic to travel to obscure academic symposia, hoping some professor’s presentation might provide a clue.   We attended as many parent education seminars as we could to understand our son’s disability, but really it remained one big mystery at that time.

We met other similarly grieving parents, and bonded, primarily on the basis that none of us wanted to be in this position, and we would do anything to change it. This was our new tribe.  It was here that we met the Gastons, Eileen and Rick, both whip-smart, ambitious attorneys approximately our age, and their sons Andrew and Danny.  Andrew was Matt’s age, and was diagnosed at about the same time.  We became close friends quickly, sharing hopes and frustrations, as well as information on emerging therapies.  

In 1992 we became aware of exciting research by Douglas Bicklin and his associates at the University of Syracuse.  They were getting remarkable results with a technique developed in Australia in the 1970s called Facilitated Communication (FC).  In FC, a trained person called a “facilitator” lightly holds the hand, wrist, or elbow of a non-verbal person typing on a keyboard. Rather than pushing, the facilitator’s hand is to remain a neutral force on the hand of the communicator, or even pulling it back just a bit to allow the communicator to retain control. The premise is that this passive support of out-of-control gross motor skills can enable people with cognitive disabilities, especially autism, to access and demonstrate previously undetected literacy and numerical skills.  Autistic people seemed to be constantly cutting through a clutter of sensory overload, so intuitively this made sense to us:  if we could just control the neurological static, clearer signals might emerge and be heard.

Matt’s disability did not diminish his intellect, and he taught himself to read very young.  He loved numbers and letters.  He especially loved children’s dictionaries, with their colorful pictures of each word in alphabetical order.  He would write in these books, first tracing over each printed word, then writing the word underneath the printed text, then writing all of the words on the inside cover of the book.  He very quickly picked up on the value of using a picture board to communicate basic needs, starting with a picture of French fries.  Over time those picture boards became pictures of keypads on paper, on which Matt “typed” out requests, without facilitation.  He learned rudimentary sign language as well, even inventing a few of his own, such as a move like a baseball umpire’s call of “Safe”, which he used to announce that he was “done” with whatever task he was assigned.  He used this sign often.  Matt’s non-verbal communication skills were strong relative to his peers, and we were convinced that they might be an advantage in learning FC.   

Doug Bicklin’s team was based at The Syracuse University Facilitated Communication Institute, where business was booming.  When we learned there was a substantial waiting list, we begged for a priority appointment on the basis that Matthew was an ideal candidate: they did not need to teach him to type; he typed independently already!   We were beyond excited when the admissions counselor agreed. 

Set in a beautiful campus environment, the newly built institute was a vibrant center of cutting edge FC research, and more recently had become a Mecca for FC training.  Demand for hands-on seminars was so robust that the sessions needed to be held in the ballroom of a hotel in town.  After an initial lecture, we were assigned an enthusiastic FC trained graduate student to help train all three of us.

“Tell me about this book,” she asked Matt, placing her hand gently on his wrist.  He did not want to do it and tried to leave his chair several times.  Finally, the facilitator was able to hold him more firmly, and she showed Matt a picture in the book, and asked him to describe it. As the facilitator supported his arm, he miraculously typed:

The Mouse is on the shelf. 

The mouse is holding wood.

Amazed, I switched places with the Facilitator, excited for my training to begin.  I sat right next to Matt, cradling his forearm gently in the palm of my hand.  “What’s in this picture Matt?” I asked.  Matt looked at the picture briefly, then around the room, patiently, as if inspecting the building, perhaps surveying the quality of the ceiling construction, as his arm hung mid-air.  Nothing happened.  Then Mary tried and she failed too.  But we were undeterred-- it was only our first day of training-- this was a practiced skill one could not expect to gain overnight.

Matt’ speech teacher Louisa also went to Syracuse, and came back to teach her Speech Therapy students FC.  Imagine our delight when, in response to three pictures, Louisa reported that Matt typed the following sentences “by himself answering my questions”, using the FC technique.

Frog is wearing a hat. The Frog is green.

It is a bag for candy.  The bag is for Halloween.

Mouse.  The mouse is wearing a hat and a mask.

This was a very exciting day!  Louisa was making progress with many of Matt’s classmates as well. Matt’s friend Andrew was the real star of her FC efforts.  Louisa, Rick and Eileen were all able to facilitate with Andrew extremely well. After Matt spent a rare night away from us at Andrew’s house, Louisa facilitated a note from Andrew that read:

Tuesday 5/23/93  I had a good day today.  I was calm all day.  I told Mojo Matt that I had fun with him on Sunday at the Hotel Gaston.  He told (SMELL MINT. I HAVE TO STOP.) me he had fun too.  I know he made my day.  I’m so happy to have a friend!  It’s a Monotoning. It’s good for me.  I’m so lucky!  I’m tired now.  The End!

Andrew was only five years old, but “monotoning” seemed a perfectly invented word to help the world understand his needs in managing sensory overload. It seemed he was breaking through a barrier of crippling sensory chaos to a quieter place where he could communicate.  We started to think of him as a gifted young man.  A medium whom Eileen consulted told her that Andrew had psychic powers which would be revealed over time. 

Eileen scrapbooked every note Andrew wrote.  Much of what he reported was about sensation, and they used this tool to learn about him.  Mary and I scratched our heads a bit sometimes though, as when five year old Andrew told Eileen that he liked her black stockings because they looked “whory”.  Matt had a pink glove fetish himself, sometimes insisting women put them on, but he had no vocabulary for it. Where would Andrew have learned that word?   Another parent friend of ours discovered that her formerly non-verbal six-year-old son typed perfectly in Italian, just like his mother.  The apparently studious young man explained, through FC, that he had found her college text books in the basement, and had read them cover-to-cover. 

Mary and I were also a bit crestfallen that Matt would not communicate with us  through FC.  I am his best friend on the planet, Mary thought.  Why won’t he talk to me?   Other parents were having similar experiences of success at school but none at home.  Matthew, who started out strong when the game was new, was increasingly disinterested.  He wanted to play with the keyboard, preferably by himself. He started to get angry with Louisa for continuing the game.  To her credit, it was Louisa who told us that she did not think Matt was taking to FC, that the struggles were exceeding the value of the communication, and that she was no longer doing FC with all of her students. For the students for whom the techniques appeared to be working, she continued to facilitate.  I think she viewed it as genuine communication.  

In the wake of our own disappointing results, skeptical articles we ran across, the “whory” stockings, and the Italian-speaking savant, we began to have serious doubts.  These doubts were largely supported by a 1993 PBS Frontline feature called “Prisoners of Silence,” which questioned FC and emerging sexual abuse claims gathered through the technique. 

But this contrary evidence was viewed with deep suspicion by many of us, because miracles seemed to be happening all around us every day.  I myself recall distinctly watching Rick facilitate a conversation with Andrew in a McDonalds when Andrew was having a complete meltdown.  Rick was right in his face in a good way and I must say that they did in fact communicate somehow, and that Andrew was calmer and better off for it.  Perhaps this ritual of listening and acceptance worked well for them whether it was based on fact or not.  In any case, at that time, I did not think it would be wise or kind to contradict people reporting positive results; no sour grapes for our dear friends based on our own disappointment. 

That changed when Louisa was promoted to be Principal for Matt’s school, and she decided to form a men’s support group for fathers of children in her program.  It was exciting at first for me to think that perhaps after a few meetings we could maybe just hang out and talk about other stuff, to get away from all the tension at home with other men who would truly understand and appreciate that luxury.  What I had not considered was that the group would include just two seasoned Dads-- me and Rick-- plus four other Dads who were new to the game with fresh diagnoses, and many unanswerable questions.  They needed all the help and advice we could give them, so the floor was given to me and Rick. 

I went first, but I don’t really remember what I said.  I probably recommended finding physical activities to do together which did not require a lot of communicating.   I may have talked about the importance of respite with your wife in preserving marriage, and giving time to other siblings.  I most likely encouraged these young fathers to include their autistic child in all of life’s activities, even though it was incredibly difficult and stressful.  But I was not really listening to what I was saying, because as I was talking, I had a clear premonition of what would happen next.

It was Rick’s turn.  I squirmed as he told the tale of how FC had changed Andrew’s life, that underneath his autism he was in fact gifted in both language and math.  The other dads leaned forward, hanging on his every word.   This was the miracle they all wanted to hear, the one for which they had literally prayed. 

There is indeed valor in discretion. Were I little bit kinder to my friend, or wiser perhaps, I might have kept my doubts to myself at this moment, or saved them for a separate discussion. But as I looked around at my fellow unfortunates, I could not let them go through the emotional rollercoaster of a miracle dream doomed to be dashed.    I felt compelled to tell the truth, or at least the truth as I knew it. 

I let Rick finish without interrupting him.  It was quiet for a moment. Then, almost in a whisper, without looking up, I mumbled,  “but there is some controversy about it,” and hoped to leave it at that. 

Louisa looked up at me, startled, but said nothing.  Did she have her own doubts at his point?  I am not sure, but she must have known by then it was controversial.  It seemed like a century before anyone said anything, and there was a palpable sense of danger in the air.  Then Rick cleared his throat, looked me in the eye, and asked earnestly, “What do you mean?” 

I stuttered, then mumbled that skepticism about the technique was becoming widespread in academia (Yes I said academia—ugh, this was no time to be high brow).  I said that Mary’s and my experiences and those of other parents were confusing as well.  Rick became more pointed.  “Are you saying that you do not believe in Facilitated Communication?”

“I don’t know,” I stammered, a lie by then.  “It’s probably a good way to teach typing, but some studies suggest a kind of Ouija Board effect”.  I immediately regretted the metaphor of this banal parlor game; its plastic planchette guided by imagined spirits; not wrong as a comparison perhaps, but unkind and poorly timed.

 He looked shocked, staring at a space just above my head, as he processed it all.  “If you don’t believe in Facilitated Communication, then you don’t believe Andrew can…”  His voice trailed off, as a blush of hatred rose, or was it just grave disappointment, and silently abated, like a cloud rolling over a friendship on a vast prairie, blown away in thin trails of gray vapor, forever, gone.

Soon thereafter Matt changed schools and we did not see the Gastons after that.  In his early 20’s, Andrew became famous as an Outsider Artist working in plastic tape, stencils, and Lego.  His work is colorful and was well reviewed.  His Mom provided the facilitation he needed to become an artist, gathering his materials and publicizing his work online and in gallery shows, but Andrew created the work.

 One of the reviews incidentally revealed that Andrew has a vocabulary of less than 50 words, so apparently the Gastons had their own realization about FC by and by.    

Do I feel in anyway good about that—about being quicker than some others to detect the illusion of FC?  No.  I lost.  Mary lost.  Matt lost.  Andrew lost.  Louisa lost.  Rick and Eileen lost.  We all lost.  Our son, and all of our sons, were briefly someone else underneath who they are, someone else they could be, someone more average, or even better than average.   Then, again, they were not, just like Flowers for Algernon. 

But to keep it in perspective, we only lost a dream and some friends; we still had our lives and dignity.  Around this same time, a sixteen-year-old autistic girl, Betsy Wheaton, produced lurid allegations of sexual abuse against her father and brother through FC with a trained Facilitator, Janyce Boynton, for which they were arrested and tried, humiliating the family.  The press followed the lurid details closely, bringing the kind of public outrage one would expect, given the horrendous allegations.

For the trial, Speech Pathologist and FC skeptic Howard Shane developed a simple efficacy test.  In a series of double-blind trials, Janyce and Betsy viewed pictures of objects independently.  In some of the trials they viewed the same object, while in other trials they viewed different objects.  Jayce was asked to facilitate with Betsy to identify the objects they were seeing.  When they viewed the same object, the facilitation seemed to work- Betsy seemed to identify them correctly.  But when they viewed different objects, the facilitation invariably produced what Janyce had seen, not what Betsy had seen.  Janyce was unwittingly controlling Betsy’s typing with her facilitating touch, as she had done when the allegations had been produced.   The case was dismissed.  Janyce herself was devastated by these results and her revealed delusion. She apologized to the family, later working to remove FC from the school system where she lived.   

There were a host of similar FC sexual abuse claims from the early 1990s through the later 2000’s.  Shane’s efficacy test was used in many of these cases to discredit the technique.  In 1994, the American Psychological Association declared FC an “unproved communicative procedure with no known demonstrated support for its efficacy”.  James Randi, renowned skeptic and scientist, calls FC “cognitive bias at work—a textbook example”

Yet FC persists, still used by trained speech therapists in many schools across America.  Some hold-out advocates stress the importance of proper technique, while others see using the scientific method to search for verifiable truth itself as demeaning to participants, who must endure the mantle of bigoted outsiders’ doubts, potentially violating their civil rights. In 2014, a pharmaceutical executive was convicted of manslaughter for her role in killing her eight-year-old autistic son, after he communicated to her via FC “I need lot of drugs to die peacefully…  I wish u do it soon”. 

We are no longer shocked that people cling to bad science.  And there is no sin in being deceived, only sadness.  The most serious errors made in FC were in refusing to let go of an illusion, as unfortunately some still do today.  All of us—family, friends, teachers, and therapists,--  try to “facilitate” the lives of the disabled people we care for as best we can.  If there is a lesson, perhaps it is only that we parents of kids with autism need to hold on tightly to our skepticism, to channel our “anxious, impulsive, aloof, shy, over-sensitive, irritable, and eccentric” natures, to demand scientific verification, especially when it is most difficult, when we so, so, much want to dream and believe.

Bruce Dalziel is a former finance and technology executive, who is currently pursuing a doctoral degree in Arts and Letters at Drew University. Bruce also serves on the board of Our House Inc., a housing and day program provider, and on the investment committee of PlanNJ, a service and trust provider, to people with disabilities.

Comments

Dalia Shkedy

Dear Bruce, I would like to thank you from the bottom of my heart for being honest about your experience with FC. When a drug is tested for effectiveness they use what is called a double-blind test. That means that both the doctor and the patient do not know if the patient was given a placebo or the drug. The reason for this is called the placebo effect where the patient believes that they are cured but in fact they just received a sugar pill. Just recently, the American Association of Speech and Language Association joined 4 other countries in condemning FC and RPM as treatments that cause harm. These techniques are the words of the facilitator and not of the child. Unfortunately, I have met many parents who believed it was their children’s voices only to lose years in which they could have actually taught their kids and given them their own voice. Imagine the pain of a parent who has invested years in a sham only to find out that their dreams and hopes of their children communicating have actually evaporated.

Every time someone points out that FC and RPM are detrimental for our kids, the “believers” attack and are adamant that it is not a scam and that you have insulted their kids and have doubted their kid’s competence. The sad part is that it is the parents themselves who are doubting that their children are able to perform without anyone’s assistance. It is the parents who are disabling their children and do not believe that they are capable of independent communication. The promoters walk around telling fables about motor planning issues and other scientific mambo jumbo. They point to the books and blogs that have been written by others using FC and RPM.

BUT THIS IS ALL PART OF THE BIG LIE. If you analyze these “works” you will find the language and emotions too sophisticated for the teenager. You will find that these children are perfectly able to navigate an iPad and find their favorite videos or music but somehow do not possess the motor planning to communicate. These unfortunate parents see what they want to see and so want their children to succeed that they fool themselves that FC and RPM are working.

If parents were truthful with themselves, they would be shocked at the harm they are causing by using FC or RPM. I have seen too many kids who have either developed a dependency on someone holding their hand to do anything or worse yet are those who have developed a hatred for the keyboard. It will take years just to undo the damage and once again give these children (or sadly at that point adults) their own voice back.
Bruce, thank you so much for saying the “emperor has no clothes” and joining those who have been saying it for so many years.

Dalia Shkedy, a proud Mom of Ethan, a 22 year old nonverbal son with autism. He has found his voice and can type 65 words a minute independently. Years ago I realized that it was so easy to attribute all of my words to my son. I chose to show other parents that unconditional love and acceptance is the only way we will get the world to see how truly gifted our children are. They are just different. Verbal ability does not equal intelligence. Just be honest.

Jenny

Thank-you for sharing this. I want to share an experience I had, and maybe compare apples to pears. I volunteered one year to help an autism classroom during music time, which at that school meant the music teacher coming to their classroom for an hour or so. Some children, due to their auditory processing challenges (or talent to appreciate only on-key music) could not always tolerate the music teacher's shakey, off key voice or loud/fast music lesson choices - though she was a loving teacher and very knowledgeable of music technicalities. So I was to occupy these children in the attached eating room during music time with the class assistants rotating 1-2 kids in at a time, as opposed to the kids having to put on their noise cancelling headphones.

I decided to stay with the physics of music, since it was technically still music time: sound and vibration, to see who liked and responded to which sound makers and musical instruments.. Every child in that class was what I would consider non verbal, in layman's terms. Receptive understanding many times, but no coherent verbal conversation, maybe periodic individual words from one or two of them on a good day. I brought bags of things for them to try hands on, some repeatedly, some new things each time.
One item was an electric typewriter. It became a regular must bring item. It made a soft whirring sound when plugged in, some kids seemed to love the pressure and clicking of the keys when they ran their fingers over it or pounded it until it locked up and I would fix it, another loved to hit two keys with his two pointer fingers until it reached the end of the bar and got a soft and lovely ding at which point he would hit the return key and laugh and smile every time. All of them seemed to love turning the roller up and down when the paper was in there - a soft thumping sound and feeling for each line of paper until it got into position - low level percussion instrument.
One child, probably the oldest of them, particularly enjoyed the typewriter. He would look through the bags to find it once he knew what it did. I saw him type a word on his own the very first day, not just bang on keys, and immediately thought, wow, I think this is a kid conversation in his head that needs to come out. I found out he like disney, I think it was toy story, if I recall correctly. He was so excited when I walked into class, and so patient waiting his turn on the typewriter, always wanted more than one turn on it, which of was fine with me since not all of them cared about the typewriter at all. I would ask him a question out loud, never pointing to anything, touching him or prompting him in any way, only following his subject according to the word he typed. He would type a word. I would comment. He would type one or two word answers to a question. Not ever spelled correctly, but the words when said out loud were phonetically correct and made sense in the context of the question.. I would say the word out loud, like "I see you typed the word "kowboy" and then I would say, "I sure liked that cowboy in the movie Toy Story" and then "great! this is how the word "kowboy" is spelled in books" and then I would type the correct spelling underneath where he typed his own version of it, so he could see both ways. "What was that cowboy's name?" He would type woodee. I'd say "Oh yea, Woody! I liked Woody! Let me show you how Woody spells his name", and I would type Woody underneath his typed "woodee". It was definitely 2 way communication about the spelling (written expression) of his thoughts.
Here's what is interesting to me, in the context of this article. That boy only typed with one pointer finger. He used his opposite hand to hold the wrist of the hand of the typing finger to hold it steady, on his own. He didn't always need to do that, maybe about 75% of the time. He helped himself, it seemed to me, when his typing hand wouldn't quite cooperate, which is to say I would watch his finger would hover, moving side to side, over 2-3 keys on one line (not up and down between lines on the key board), at which point he would grab his own wrist to hold his typing hand steady, and then hit the letter he wanted typed. I was never in a rush, so there was no need to direct or prompt him, he was steering his time on the typewriter. Push, click, thump on paper, wow! a letter appears on the paper. And then a word! Immediate gratification in multiple ways.

Several of the kids seemed to like the pushing pressure on the keys and resulting sound and visual results, but were not typing actual words, but he went way beyond that. I kept those typewriter pages for the longest time after I no longer volunteered as a reminder that just because a child can't talk out loud, doesn't mean they can't communicate. I sent some of them home in his backpack, so his parents would know.

I've never seen a modern communication device for non-verbal autism, but since then I have often worried that if their keys are too sensitive, that a machine could be too quick to type a letter before the child could control any physical shaking and hovering as they try for the correct key. This boy was very slow and definitely deliberate and had a plan as he zoomed in on the key he wanted to press. So maybe there is merit to the idea that stabilization is relevant somehow in some cases, but that it shouldn't be done by another person, in order to avoid false correlation. And for some reason it brings to mind talk I've heard about types of exercises used by programs like Brain Balance. Don't they try to reconnect different sides of the brain or something? I'm foggy on the details, but what if using one hand to hold the other steady makes a temporary connection in the brain that facilitates expressive language in the moment? Does it mesh the cognitive and physical at the same time, drowning out non-relevant stimulation?

On a side note, I came to think music and sound specific to each child's desires is a blessing. The smiles and greetings from the kids I worked with were tell tale. Eventually every child had a turn, whether they had sound sensitivities or not, often if they were having a bad day in the classroom. It could help reset their mood. One boy really enjoyed the ukulele which he would lay on his lap, just the right size, but it had to be tuned before I brought it to class. The only two words I ever heard him say (aside from my first day there, when he walked up to me and said "you are really big", which may have really meant "that's a really bright red coat" since I was brighter that day, but no taller or wider than anyone else in the room. The teachers all stopped what they were doing, their jaws on the floor, as none of them had ever heard the child speak any word at all, which made me decide I was in the right place at the right time) was "deetar" which was his word for "guitar" which is what he called a ukulele (which also had a red jacket, interestingly - maybe red was his color) When I brought in the real guitar, he looked at it and looked at me, and said "where deetar?" He wanted nothing to do with the real guitar, indeed, seemed to see no correlation between the two when I tried to tell him this was a guitar. After that I would bring both in, because string strumming and plucking was popular among them. Also, whether they walked them down box stairs we built up, or pulling and releasing them, or balancing them on two hands, every child loved the soft humming or zinging vibrations of the slinky, so much so that I bought them all slinkys for a goodbye present when I left. One girl only wanted to play a toy piano I brought in and would make it play the same preprogrammed song over and over, but only the first 5 or 6 seconds of it. I would have given it to her at the end of the year but I was worried it would drive her parents crazy. Others kids used it and liked to find the drum rhythm they preferred, but it was definitely the girl's instrument of choice, preferred even to the real keyboard I brought in.
A few of them tried the harpsicord, but none of the young ones seemed to gravitate to it. Our music and sounds attracted the attention of a couple students in the older autism classroom, and that teacher would sometimes ask if a student of theirs could come in for a few minutes. A girl from that class liked to strum the harpsicord while I changed the notes. Several kids loved the pretend clarinets. A Tibetan singing bowl was interesting for a moment but none of them could make it sing and they (and I) lost interest quickly. The crib music box from my own child, with soft slow, single note at at time, music from Bach, Beethovan, and Brahms was well loved: they could control which song they could hear as they held it in their hands. I started trying speaking softer, slower, one syllable words, slightly spacing them out - not in a demeaning way, but in a way to allow them to absorb and process each word, trying to mimic the music box.
It was all further enlightenment that each child was so truly different from the next, and that there may never be any one-sized fits all solution to the communication challenges in autism, but there will always be a path of joy waiting to be defined, and that when given the chance many will express their preferences, which in many kids may reveal a pathway to communication. Whether and how we choose to respond and share seems so important to me, and its a two way street. The smiles and hugs I got walking into that classroom made those days ones to look forward to on my calendar. Now I've come to believe if education isn't bringing happiness and excitement and eliciting interest, maybe a different path would be a better choice, there is more than one way to skin a cat.

That being said, I think one also has to take into account, AT ALL TIMES, the state of the child physiologically, at any given point in time, when determining the success of a treatment or intervention. A child that fluctuates - improves and regresses on their goals - may not necessarily be proving that an intervention is a failure for all. No one knows for sure what a child's nutritional status is week to week, what stress induced hormones are present in the body week to week, toxic exposures in the air, food, and water he or she has had week to week, level of inflammation or histimine or antibodies week to week, functioning of the liver week to week, or ,even if detoxing, where those toxins are migrating to before they leave the body, from week to week etc. We KNOW that changing the body changes the response. But yes, there are unavoidable facilitator biases to be acknowledged, too, as the blinded study proves. As always, the parent knows the child best, and should be the one to determine what is tried, and when one must move on to a different resource, be ready to discuss the decision and why, while simultaneously allowing other parents the leeway to try the same. Time and money constraints will stop any given family from continuing an intervention that doesn't work for them within their own parameters.

Nika Stirling

Dear Bruce,
Marylin Chadwick of University of Siracuse, during her recent interview stated that authenticity of authorship of FC users is revealed over time. With persistence and daily practice over the course of many years, FC users can become completely independent of facilitator and attend mainstream classrooms and colleges along with their neurotypical peers and even aquire skills necessary to achieve a profession and become strong self advocates. Please refer to unitedforcommunicationchoice.org for further information, watch documentaries “DEEJ”, “Unspoken”, “Wretches and jabbers”. I hope you will change your mind and help your son to find his voice. It’s never too late.

Zahra Ghorishi

I recently heard Sue Rubin (autism is a world) speak about FC. She spoke about how FC taught her that words mean something and have value. She went from severe disabled class to eventually college. She now types independently without the touch of anyone. I’m sorry that there are cases of bad facilitators, or Well meaning one who may guide their students. But there are also many cases of Sue Rubins, Dillans,, jami Burke, Hari, who started with FC and now are in college or beyond and communicate independently. Don’t throw away the baby with the bath water!!!

Saritha

I feel sometimes kids cannot generalize their skills with different people which is taken as inability to perform rather than looking at anxiety and sensory overload perspective. From the article that is what I understood. My kid with minimal speech can not generalize even verbally spoken words across people that does not mean she does not know to say it.

We do rpm with my kid and it took me an year to get where she did with the rpm practitioner in couple of months. I feel it’s because of me learning to do it in a correct way and her anxiety not to disappoint me.

Silvia Martinez

Dear Writer

I have two kids who are affected by autism. One can clearly tell me what is wrong. My other son A can’t always tell me. They are days were he can be nonverbal and RPM gives him a voice. On days he needs it. You see how the article can be offensive from my view.


Your article can your views but also note we are in times in this generation with needs and have more resources at our Dispositions. Don’t doing harm for those who do have clearly have seen great use of FC/RPM or whatever the choice everyone and every child is different from autism.

Harshita

My son learned the alphabet when he was two and started identifying written words when he was four. He started working with a few educators who continued his academic education and used a type of FC. In his written communication at that time he mostly just kept demanding chocolates but otherwise was using writing to answer academic questions. At age nine he entered puberty and stopped writing and would break pencils and tear paper. When he was 11 we met Soma (RPM) and in the first session itself he was able to use the letterboard to have conversations with her and write a poem. Then the ipad came into being and we were early adopters. After that he worked with many different teachers many of whom had no FC training whatsoever. He learned to type independently over time. A few years ago he accused a teacher of abuse. I took it up with the Principal and lo behold the teacher admitted to hitting him. It was amazing to have my nonverbal son's voice validated in this way. He is now 20 and attends college with an aide. He loves studying and can spend upto 8 hours a day with textbooks. I wouldn't diss either RPM or FC based on one disappointed parents experience

Megs

Many say RPM (Rapid Prompting method/Soma) is today's FC. After reading this I see many similarities in methods... especially the part where the facilitator can get the child to communicate but others can not, the need to guide the hand, large amounts of money being spent for training and conferences and so on. I hope parents aren't being taken advantage of yet again with this seemingly new version of FC.

Shelley Tzorfas

A well written snapshot of your time and struggles. We all know that there are large differences in young people with Autism, aka who had chemical Brain Encephalitis resulting in parts of the brain Over-working and parts of the brain Under-working or defunct. It is an illogical battery of cells and vessels that get damaged in each person. Some people are better at rewiring this hodge- podge taking place in the brain, while others are not. Conceptually at this moment in time, I believe that there are some kids who can grunt and scream that can learn to be partially verbal. One associate had a young middle school age daughter. I suggested "Da" for Yes even though Da is from the Russian language. The father got a "No" sound from her which was understandable and consistent. The challenge is to get a clear verbal sound for "Yes" and one for "No." It does not matter that the student might pick up a word for it in Italian, Korean, or from Brazil. Communicating in his or her way of saying "Yes or No" opens the world for them and others.

Briannomi

It's not just FC. Nowadays there is the promise of Ipad applications to fix autism. So many supplements. So many therapies. They may have a place, but they are not the magic bullet that is so often claimed.

Yes, have hope always for your child. Keep trying to help your child recover from autism. But keep your eyes wide open, and look at critical information, both sides of every issue.

https://autismgenesis.wordpress.com/

John Stone

I remember meeting c.1996 a woman who told me that her non-verbal late teenage son had written several essays which had been “certified as authentic”. I was certainly worried by the idea that they would be any more authentic by virtue of being certified.

Jeannette Bishop

Yes, very interesting. Thank you!

This sentence... "But when they viewed different objects, the facilitation invariably produced what Janyce had seen, not what Betsy had seen." If Betsy was doing the typing or pointing, how does this invariability happen if Betsy is not either very attuned to Janyce's expectations through sense of touch and maybe other senses, or ... is this evidence that motor neurons in our injured (and maybe everyone) can be directed by someone else?

John Stone

This is getting rather away from the topic. Hans, I think there were quite a few brave people already in 2005 but there is no doubt landscape is changing.

Bruce, this is a very interesting account. I was never comfortable with the idea. I suppose there was some question whether it might have a use, but the potential for abuse was so evident. It always occurred to me that facilitators could make stuff up although I wasn’t particularly thinking at the time of malicious stuff. But perhaps it was it always just junk?

Hans Litten

Posted by: Angus Files | October 12, 2018 at 10:02 AM

We have them running scared. Cant you see that ? We are the leaders and we are too many for them now. It was easier to deal with us back in 2005 when Liz Birt was one of the few brave ones.
I challenged 5 political female representatives last night to take the Gardasil vaccine themselves because its now recommended for adults (up to age 45 - generally the upper child bearing age).
I haven't checked if the CDC is saying for adult males too. I do hope so. I will challenge all the eligible MPs then within the 23-45 age range.

It will be interesting to see how the Monsanto appeal decision goes.
If they overturn the previous decision, as is highly possible, then its about the activist reaction.

The thing is if IG_Monsatan wins the appeal, then apparently it cannot be challenged again, and this strategy has been assumed to have been part of their ploy all along. IG_Bayer.

GM food testing has led to rats living 50% shorter miserable lives (Seralini).

Always remember they put mercury in our mouths and fluoride in our water.
And subsequently since those early days a myriad of other wonderful ways to poison us.

Laura Hayes

Bruce,

An excellent read. Thank you for sharing it with us here on AoA.

Angus Files

We felt we were pioneers until Jackie from JABS informed us in the 90`s she knew of a lady who had been campaigning for 30 years and her son was aged 40...saying that there has been more progress made but still no stopping the evil spreading.

Pharma For Prison

MMR RIP

Hans Litten

Very interesting Bruce , thankyou.
I wish you well.

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