FC/S2C/RPM: Selling the Illusion
After watching a WHYY segment that featured an uncritical look at a young man being subjected to Spelling to Communicate (S2C) and reading Katharine’s blog post about involuntary muscle movements, it occurred to me how similar the facilitator’s job is to that of a performer “selling” the audience on a magic trick.
The methods of billet reader, medium Bert Reese. From “Seeking the Explanations of Reese’s ‘Mind Reading.’” (Edward Marshall, 1910; New York Times).
Billet reading is a trick used by performers such as mentalists, magicians and (alas) spiritualists and psychics where an audience member writes a random word, statement, or picture on a piece of paper and seals it in a security envelope. The performer then takes the sealed envelope from the audience member and, seemingly telepathically, reveals its contents, often to the delight and surprise of those watching. The trick can be accomplished in different ways, but these performers are aware of the power of distraction, deception, and illusion to win their audiences over. The difference between a magician and a charlatan is that the magician tells people that what they are about to experience is an illusion or act of trickery. Charlatans want their audience to think the mind-reading is real.
Just like those mentioned above, all facilitators face the problem of breaking down the barriers of skepticism in order to prime prospective users to buy into the illusion of Facilitated Communication (FC). FC is a belief system. There is no scientific evidence that facilitator-generated messages are the words of individuals with disabilities. Even by proponent standards, it is a “technique of last resort.” FC in all its variantly named glory builds dependence on the facilitator, not independence for the person being subjected to it. The weight of evidence suggests that facilitators are inadvertently providing the individual with physical, verbal, and auditory cues that control which letters are selected. Facilitators won’t admit their involvement with the typing activity nor are they able to explain “how” FC works (often attributing it to a “miracle”), but they know enough not to test the technique in any meaningful way. Reliably controlled tests, to date, have ruled in facilitator control, not ruled it out.
Therein lies their conundrum.
Fortunately for the facilitators, their job of turning skeptic into believer is likely partially done when parents show up for that first consultation or a prospective facilitator signs up for that University workshop. I say this not to blame anyone for wanting FC to work. With proponents claiming to have the key to unlocking the silence of individuals with profound autism or other disabilities with 100% success rates—something evidence-based programs cannot promise—the emotional desire to try it can override rational feelings that FC just might be too good to be true.
According to the article “Clever Hands: Uncontrolled Intelligences in Facilitated Communication,” believing FC could work increases the chances that it will work. Like audience members attending a magic show, hopeful parents, caregivers, or service providers showing up for their first FC session have, wittingly or not, given the “trained” facilitator permission to convince them of the illusion.
The facilitator holds the letter board in the air while the client points with a pencil or stick. Along with moving the board subtly to increase accuracy of letter selection, this facilitator also appears to be cuing with the hand not holding the board. (WHYY, April 20, 2022).
Next, when facilitators help the person type out an unexpected word or phrase soon after the FC sessions start, the barrier of skepticism further erodes and softens into the realms of emotion and belief.
Gigi Jordan’s six-year-old son typed out “I want to aggressively punish God” on his first day of typing, with her holding his hand. Reports indicate she had difficulty accepting her son’s diagnosis of autism. This first facilitator-generated message seemed to confirm her anger about having a profoundly disabled child.
The Jordan case is, admittedly, an extreme example, and I expect most parents would take their child and run in the other direction if these were the first facilitated words.
In a less dramatic and more typical fashion, Soma Mukhopadhyay, in “A Mother’s Courage,” uses the Rapid Prompting Method (RPM), a series of stenciled letter boards and a pencil that easily catches in the holes of the boards to facilitate with her client, Keli. With her assistance, Keli types out “p-i-a-n-o” when she asks what he would like to learn. Even though Keli is looking at the ceiling for most of the interaction, Soma facilitates “I make songs” as his mother, sobbing, watches the interaction. To me, it’s a heartbreaking scene, particularly with the knowledge that Keli and his family’s primary language was not English. Within a few sessions he and Soma were facilitating perfectly spelled answers in a language he was only exposed to occasionally at his home in Iceland. Language and literacy skills need to be taught. They are not innate and don’t just appear fully intact when someone holds another person’s hand or puts a letter board in front of them to poke at with a stick.
In the case of the WHYY interview, Julie and Warren Cramer reportedly became believers when their son, Matthew, typed out “Elizabeth”—the name of his facilitator. Elizabeth Vosseller is, arguably, among the top proponents of FC, in her promotion of S2C. Had she facilitated Matthew’s name or the names of his parents, the result might be unremarkable. It is likely Matthew had been exposed to that information previously. If, however, he successfully facilitates the somewhat complicated name of a person he just met? That’s much more impressive. It’s also likely Vosseller’s movements of the board are subtly fluid, since she, presumably, has facilitated the letter sequence e-l-i-z-a-b-e-t-h often and, almost automatically, knows how to move the board backwards or forwards, up or down, to increase the chances her new clients will hit the target letters on the first try.
Next, Vosseller introduces Matthew to a lesson about how amber fossilizes over 130 million years. This would, likely, be a subject well outside of Matthew’s experiences and education and doubly surprising if he could answer questions about the topic. But, of course, Vosseller knows the answers to any questions that might be asked and she assists him in selecting the right letters in the correct sequence by holding the board in the air and, as the image above shows, possibly providing hand cues to visually aid in letter selection. Any skepticism by the parents seems to have fallen away when he, under Vosseller’s guidance, typed out “amber” and “fossilization.”
Sadly, no one—not the producers, reporters, parents, educators, or administrators at the Charter School he’s now attending—seem interested in learning whether Matthew’s unexpected language and literacy skills are his own or a result of facilitator cuing. Unlike mentalists and magicians, who consciously practice their tricks, facilitators may or may not be aware of the extent to which they control the facilitated output. By degrees, they are taught to ignore their internal doubts about whether they are cuing their clients. Criticizing FC is, to proponents, akin to hate speech, so they soon learn not to openly express doubts. Facilitators want to be included in, not excluded from, that inner circle where FC magically “opens up” their client’s or loved one’s internal world.
To parents or prospective facilitators who already want to believe in FC, these displays of “unexpected” literacy and language seem to crystallize their belief in the technique. They may be aware that FC is not accepted by the scientific community, but as I mentioned earlier, FC promises something that evidence-based techniques or life skills programs cannot: the key to “unlocking the silence” of non-verbal or minimally speaking individuals. This is a powerful psychological motivator and, I believe, helps people emotionally override any concerns they have that the messages typed via FC may be facilitator controlled.
I tend to believe that most facilitators are not purposefully being deceptive, despite similarities between magic tricks that exploit the ideomotor effect and the automatic writing of FC output. Facilitators are, after all, the first in line to fall for the illusion. And, from personal experience, I know that FCed messages can “feel” real to the facilitator.
What concerns me is that facilitators must, by now, know about the concerns critics have regarding cuing and deliberately choose to do nothing about it. I understand that asking questions about authorship and testing FC in meaningful ways threatens to shatter the illusion. However, from my perspective, facilitators are setting themselves up for catastrophe if and when parents or others outside the tight-knit FC circle start to notice that the facilitated messages contain incorrect, incongruent, or fabricated information (whatever the content).
In this example from the pro-FC film The Reason I Jump, a mother and daughter sit on a park bench using S2C. The facilitator holds the letter board in the air and provides hand signals to cue her daughter in typing out “We could finally tell each other how we felt.” The young woman being subjected to facilitation, on the other hand, verbally speaks the words “Let me go home. No more! No more!” Simultaneously, the movie narrator (representing the voice of a 13-year-old boy who “wrote” a book under the facilitation of his mother) tells viewers “Please don’t assume that every word I speak is what I intend to say. Making words with your mouth isn’t the same as communication.” Viewers are told to ignore the young woman’s spoken words and accompanying non-verbal communication (e.g., gestures and body movements) and take seriously only the typed, facilitator-generated messages.
But, hypothetically, what if, like in the Anna Stubblefield case (see Facilitator Crimes), a facilitator typed the exact same words “We could finally tell each other how we felt,” but followed up with unwanted sexual advances? Would the person’s verbal request of “Let me go home. No more! No more!” be honored? Or would they be ignored because the typed, facilitator-controlled messages confirmed in the mind of the facilitator a desire for the intimate contact?
FC may seem harmless enough to some people, but facilitators are affecting the lives of actual human beings and the illusion they are perpetuating is much more serious than a magic trick meant to entertain on a Friday night out.
Organizations such as the American Speech Language Hearing Association (ASHA) oppose the use of FC and RPM, stating their members have an ethical and professional obligation to notify their clients of the danger in using these techniques and educate them about evidence-based communication interventions. Their website states:
SLPs also have an ethical responsibility to inform clients, family members, caregivers, teachers, administrators, and other professionals of empirically supported treatments for communication for individuals with communication limitations and to advocate for these treatments.
Being skeptical does not mean you cannot be tricked. I saw a version of billet reading a few years ago. The magician still fooled me even though I knew two different ways in which the trick could be done.
I think, for the most part, facilitators think they are doing right by their clients. They believe in their product and their sincerity helps “sell” FC to prospective customers. (See here for the financial costs of RPM). It is unfortunate that sincerity is not proof of authorship.
Whether or not facilitators want to admit it, the technique of FC is an illusion. By design, it cannot qualify as independent communication because facilitator control is integral to how FC “works.” Surprising revelations from “tests” like the ones I’ve described do not prove authorship, even when, visually and emotionally, it seems like it does.
Matthew L. Tompkins in The Spectacle of Illusion writes:
Magicians have long known, and scientists are becoming increasingly aware, that misdirection can encompass much more than simply influencing where a spectator looks. Used effectively, misdirection can affect not just what we see, but how we reason and remember. Most of us recognize that we cannot always trust our eyes, but a deeper, more uncomfortable truth is that we cannot always trust our minds. (p. 14)
Proponents continue to promote FC, claiming it works because people using FC say it works. When it comes to the lives of people with profound communication difficulties and their families, this kind of “proof” is not enough. Alarmingly, proponents are making major life decisions using FC: housing, health, relationships, gender identity, education, and more. In addition, the media, always in search of feel good stories, uncritically promotes FC user “successes” and further advances pseudoscientific practices. Just last week, national news outlets ran a story about a non-speaking individual who graduated from Rollins College as valedictorian. None of them mentioned that the person was subjected to RPM throughout her college career and that the coursework was completed with facilitator “support.” (More about that in future blog posts).
The weight of the evidence regarding FC is that facilitators, not their clients or loved ones, are controlling the messages. Defiantly promoting techniques opposed by major educational, health, and advocacy organizations does nothing to prove that FC is valid. Purposefully avoiding blinded testing and hiding behind the mantra of presuming competence does nothing to prove that FC unlocks hidden language or literacy skills in individuals with profound communication difficulties.
It is long past time that proponents either stand by the faith of their convictions and participate in reliably controlled tests or stop perpetuating this sophisticated and harmful illusion.