Are Autistic Individuals “Tuning In” or “Tuning Out” During FC/S2C/RPM sessions?
Many opponents of Facilitated Communication (FC) (including me) hammer away at facilitator behavior: the physical, verbal, and auditory cues that facilitators, often inadvertently, exhibit that control letter selection. (See An FC Primer). If only proponents could understand how their own behaviors affect letter selection, we think, then, surely, proponents would change their behavior and, ultimately, stop using it.
Dr. Vaishnavi Sarathy facilitating with her son, Sid, while he looks away from the letter board. (Spellers, 2023).
Unfortunately, that’s not generally what happens. Facilitators rationalize away their behaviors and, as quoted in the movie “Spellers,” often “don’t care about the science.” Instead of addressing the well-documented problem of facilitator control in FC, proponents forge ahead under the guise of “presuming competence” and attempt to rebrand FC by changing its name. Spelling to Communicate (S2C) and Rapid Prompting Method (RPM) are currently among the most popular, though there is an ever-growing list (See our Home Page)
It is, therefore, necessary to extend the “conversation” about FC, as Katharine has done in her book “Students with Autism: How to Improve Language, Literacy and Academic Success,” to include the social and language deficits that define autism. If you have not read the book cover to cover, I highly suggest you do. By the time you get to the FC chapter, you should have a pretty good understanding of why FC/S2C/RPM can’t work as an independent form of communication.
Individuals with autism generally exhibit, to one degree or another, a number of idiosyncrasies that affect their acquisition of language.:
orienting to environmental sounds rather than voices (e.g., not attending to speech)
reduced joint attention
missing or misinterpreting facial expressions (e.g., by focusing on mouth rather than eyes
difficulty switching attention and tracking human interactions (e.g., following topic changes in a rapid conversation)
weak central coherence (e.g., focusing on specifics rather than the whole)
diminished social connectedness (e.g., sharing information with others)
reduced perspective taking (e.g., theory of mind or understanding the world from someone else’s view)
These idiosyncracies reduce language-learning opportunities in autistic individuals which, in turn, makes it implausible for those significantly affected to “incidentally” learn language and literacy skills or produce sophisticated FC-generated messages—and not just because facilitators are providing cues to their clients at rates much higher than proponents admit.
Charles Mury focuses on his snacks while placing his hand on top of the facilitator’s hand. She attends to the notepad as they use a hand-over-hand-style version of FC. (9News, 2022).
When a facilitator takes the wrist, elbow, shoulder, or other body part of a profoundly autistic individual to “facilitate”—or holds a letter board in the air for them to poke at—these individuals are likely to “tune out” rather than “tune in” to the activity. There is very little in an FC/S2C/RPM session itself that captures or sustains the attention of anyone except the facilitators and, given that attending and using one’s language skills can be hard work, it’s easy to see why an individual with profound language difficulties might prefer a passive, rather than active, role in the activity. (See Is This What Biklen Calls Independent Typing?)
FC/S2C/RPM sessions are, almost exclusively, initiated by the facilitator and not the individuals being subjected to them. Facilitators control access to the letter board, choose letter stencils (in S2C/RPM-style facilitation), pick the topic of conversation, ask/answer questions, and take extensive notes (often while their clients sit idly by). Facilitators are, essentially, doing most of the FC-generated “communicating.”
The individuals being subjected to FC sometimes, but not always comply by allowing the facilitator to hold their hand (or, in S2C/RPM-style FC, by extending their own hand toward the letter board). However, quite often, these individuals exhibit verbal and non-verbal behaviors indicating they 1) don’t understand the purpose of the activity; or 2) don’t want to participate. (See “No more! No More!” and Trapped in a Corner)
In addition, I’ve noticed (by analyzing FC/S2C/RPM videos) that facilitators are likely to over-prompt their clients:
at the start of sessions (e.g., the facilitator waves the letter board in the person’s face)
when the facilitator pulls the letter board away during letter selection (e.g., to correct a mistake or redirect the individual)
at the end of a letter sequence (e.g., when the facilitator pulls the letter board away or selects a different stencil)
During these key moments, instead of focusing intently on the letter board, facilitators shift their body position slightly, look at their client, smile or provide verbal reinforcement. Sometimes, the clients, during these “rest” periods from poking at a letter board, reach out to their facilitators (e.g., touch their face, tilt their heads toward them). Though fleeting, these moments during the FC/S2C/RPM session are the closest examples of joint attention and social interaction that occur throughout the whole activity. (See Are You Sure You’re Not Being Cued?)
S2C proponents in particular advertise that their clients don’t need to know how to spell to be “successful” with the letter board. Facilitators are taught by instructors that their clients don’t need direction instruction and (somehow) innately know how to spell. (That’s not what the research tells us). The purpose of S2C, then, appears to be to teach those being facilitated to point (with facilitator cues) for ever-increasing periods of time.
Soma Mukhopadhyay (inventor of Rapid Prompting Method) takes notes as her student, Samantha, sits trapped in a corner. (Samantha & Soma, YouTube 2018)
These clients also learn (overtly or covertly) that in the middle of an FC/S2C/RPM session (when most of the letter selection happens), all they need to do is comply. In some cases, like in this Supported Typing video (see around 59 seconds in), individuals are actually discouraged—not encouraged—from interacting with the letter board or keyboard by themselves. As stated previously, the facilitators do most of the work here-on-in. They stare intently at the letter board, call out letters, take copious notes, and completely miss their clients’ off-task behaviors (e.g., staring off into space, stimming, closing their eyes). The more “practiced” clients might even learn to look at the letter board to some extent and appear to be “communicating” their own thoughts and words.
We already know that the rapid pace of S2C, RPM, and, perhaps to a lesser degree, traditional touch-based FC causes problems for facilitators as they call out letters they think are selected, rather than the ones that are (See examples here and here). But, it also raises questions about whether the autistic individuals can process letter selection as quickly as facilitators claim. The research on autism, as Katharine points out in her book, makes rapid attention-shifting behaviors unlikely.
Proponents market FC/S2C/RPM as a legitimate form of Augmentative and Alternative Communication (AAC), but facilitator-dependent techniques ignore or downplay the social and language deficits that define autism. These techniques can, for example, make individuals on the severe end of the spectrum look more neurotypically able to participate in regular education classrooms or complete Common Core assessments—as long as they are with their facilitators—while, masking severe social and language deficits that preclude them from completing educational tasks independently (e.g., without interference from a facilitator).
The goal of AAC is to “move severely autistic individuals from purely behavioral expressions of wants and needs (reaching, grabbing, cries of distress) toward intentional communication.” (Beals, 2022) But this takes direct instruction and plenty of opportunities to practice these skills in a variety of settings—much more than the oft-reported rapid (and miraculous) success that comes with FC/S2C/RPM.
To me, it seems the “success” of FC/S2C/RPM is dependent on facilitators who not only cue their clients to aid in letter selection, but wittingly or not, end up doing most of the work during letter selection activities: controlling the letter board, choosing the topic of discussion, directing when the session starts and stops, correcting “errors” by taking the letter board away, and the like. (See Back to School Edition: At What Point Do Accommodations Start Resembling Facilitated Communication?). In addition, the practice of FC appears to ignore or downplay the documented social and language deficits that define autism. FCed individuals, it appears, are not rewarded for selecting letters independently—and without facilitator interference—but for complying to an activity (e.g., tuning out) while facilitators do the lion’s share of the “communicating.”
I’d love to see reliably controlled studies that explore this topic further.
Recommended Reading:
Beals, Katharine (2022). Students with Autism: How to Improve Language, Literacy and Academic Success. John Catt.
Recommended Viewing:
Autism Basics by Dr. Katharine Beals