Do Critics “Presume Lack of Competence”? Part V – Review of Broderick and Kasa-Hendrickson
Today’s blog post is the fifth in a series discussing Alicia A. Broderick and Christi Kasa-Hendrickson’s position that critics of Facilitated Communication (FC) “presume lack of competence” in their clients. As we’ve seen in the previous blog posts (linked below), this statement appears to be an attempt to distance themselves from facilitator-focused research studies that disprove proponent claims of independence in FC and reliably document facilitator influence and control over FC-generated messages.
A List of Syracuse University’s FC “Master Trainers” from the “Institute on Communication and Inclusion” before the page was removed from the website and the ICI renamed for the third time. (n.d. Syracuse University).
Alicia A. Broderick earned both a M.S. and Ph.D. in Education from Syracuse University. Christi Kasa-Hendrickson, earned her M.A. in Special Education at Chapman University, and a Ph.D. in Teaching and Leadership at Syracuse University. She was also listed as one of Syracuse University’s “master trainers” in FC on their website, although the list of “master trainers” has since been removed. Both Broderick and Kasa-Hendrickson collaborated with Douglas Biklen, founder of the Facilitated Communication Institute at Syracuse University, to produce a documentary called “Inside the Edge: A Journey to Using Speech Through Typing,” which features Jamie Burke, the subject of their written case study.
For “Say Just One Word at First”: The Emergence of Reliable Speech in a Student Labeled with Autism, Broderick and Kasa-Hendrickson chose “qualitative, interpretivist” methods (e.g. open-ended interviews and/or client observations) to describe “the emergence of reliable speech” in their client, Jamie Burke. The authors claim that Burke’s long-term (eight-year) exposure to Facilitated Communication (FC) and, later, a text-to-speech device called a Lightwriter caused an “almost explosive” emergence of speech when he was 13 years old.
This case study is, as Broderick and Kasa-Hendrickson point out, not an authorship study. Indeed, the authors want readers to think their client, Jamie Burke, has been typing “independently” since the age of five with the support of a facilitator.
Sadly, Broderick and Kasa-Hendrickson’s definition of “independence” cannot be trusted to mean “by himself” or “without interference from a facilitator.” The authors concede that their “independent” clients can receive “minimal support” (e.g., touch from the facilitator on the back of the neck or shoulders).
Images from “Inside the Edge” showing Jamie Burke’s facilitators “supporting” him at the forearms and shoulders, despite claims that his typing is “free from physical touch.” (Inside the Edge, 2002).
Although they claim that Burke’s typing is both “independent” and “free from physical touch” by the facilitators, “Inside the Edge” shows Burke (at age 15) being touched at the wrist, forearms, elbows, and shoulders by his facilitators while he extends pointer fingers toward the keyboard. (See review here). Not only do the facilitators maintain constant eye contact with the keyboard (a red flag for facilitator control), but they also push and pull Burke’s arms and shoulders in ways that appear to direct letter selection.
Since most of the examples in the article attributed to Burke are either FC-generated messages (e.g., denoted in All CAPITALS) or words Burke reads that were facilitated first (e.g., denoted in ITALICIZED ALL CAPITALS), it is impossible to distinguish Burke’s thoughts and feelings from those of his facilitators. Broderick and Kasa-Hendrickson provide no baseline information to assess Burke’s independent skills, nor do they provide reliably controlled evidence that the FC-generated words are Burke’s alone. Saying that FC works because people subjected to FC say it works is not proof that the words generated are free from facilitator control.
In addition, Broderick and Kasa-Hendrickson claim that Burke’s speech “emerged” during the nine-month study. However, it appears they forgot to gather baseline information of spoken language skills before the observation period. They also did not include post-testing at the end of the study for comparison. Despite collecting 35 hours of videotaped and transcribed material, they failed to provide an objective way to prove their claims that Burke’s speech had changed during that time.
On close reading, Broderick and Kasa-Hendrickson’s definition of “emergent” and “reliable” speech is, largely, contingent on Burke’s ability to read aloud the words crafted with “support” from his facilitators (e.g., typed FC generated messages). We don’t, for example, know if he can independently (e.g., without facilitator influence) spell the words he reads. The short sampling of Burke’s independent spoken language provided in the written article is not enough to gauge his abilities, but the authors and his mother report that at least some of his “spontaneous” speech is echolalic. Here, too, their assessment of Burke’s functional spoken language may not be as reliable as one would hope, given that facilitators are trained to ignore or minimize spoken language in lieu of the facilitated messages, so they may not have recognized pragmatic speech if/when it occurred.
That he could read the facilitated words does not lessen the possibility that the words generated in emails, during interviews, and in other situations were authored by the facilitator, even if inadvertently. Many individuals with autism can read words without comprehending them. In addition, it appears that Burke read some words (from rote memory?) but 1) appeared to lack phonemic awareness as he came upon words that were unfamiliar and, 2) misread words that looked similar without seeming regard for content (e.g. sight/said, more/means, one/are). Broderick and Kasa-Hendrickson note that Burke relied on his mother for auditory cues when he got “stuck” with his reading. It would have been informative to know to what degree Burke could decode words, plus read with comprehension and fluency without a facilitator’s assistance.
Jamie reads a pre-programmed message as his mother, Sheree, holds the Lightwriter. (Inside the Edge, 2002)
The article is unclear about when Burke was introduced to the Lightwriter but, in using the device, Burke began to repeat words as the facilitated messages were read aloud. Although some of these words may have been echolalic, this would be expected, as Augmentative and Alternative Communication (AAC) often supports the spoken language of clients who use it. However, when Speech/Language Pathologists talk about emergent speech, language. and literacy skills, they, generally, are discussing children much younger than 13 years old. Could it be that Burke’s spoken language abilities had “emerged” over time and without attracting attention from his facilitators? Perhaps they only noticed his “emergent” speech when he responded verbally to the Lightwriter.
I believe this case study was an attempt by Broderick and Kasa-Hendrickson to “prove” that FC is a legitimate form of AAC that leads to the emergence of “reliable” speech. And, though, it appears that Burke may have benefitted from access to a text-to-speech device, the authors fell short of proving their claims.
One reason that the American Speech-Language Hearing Association (ASHA) and the International Society for Augmentative and Alternative Communication (ISAAC) reject FC as a legitimate form of AAC is because the technique builds dependence on the facilitator, not independence for the individuals being subjected to it.
Despite failing to demonstrate Burke’s independence while typing or the degree his spoken language was “emergent,” Broderick and Kasa-Hendrickson did a fair job at documenting just how reliant Burke is/was on his facilitators, even after eight years of “practice.” As Green and Shane pointed out, there is no evidence that “fading” support from an assistant/facilitator should take years and years and years. And, it seems, for Burke, there is no end in sight.
Next time, I will summarize my thoughts about this series and the differences I see between the approaches of critics vs. proponents in determining authorship in FC.
Note: Broderick and Kasa-Hendrickson cited these specific studies in their article Say Just One Word at First”: The Emergence of Reliable Speech in a Student Labeled with Autism as “proof” that critics “presume lack of competence” in individuals being subjected to FC:
Calculator, Stephen N. and Singer, Karen M. (1992, November). Letter to the editor: Preliminary validation of facilitated communication. Topics in Language Disorders. Vol 13 (1); ix-xvi.
Green, Gina; Shane, Howard C. (Fall, 1994). Science, Reason, and Facilitated Communication. Journal of the Association for Persons with Severe Handicaps, vol. 19(3), 151-72.
Jacobson, J.W., Mulick, J.A., Schwartz, A.A. (1995, September). A history of facilitated communication: Science, pseudoscience, and antiscience. Science working group on facilitated communication. American Psychologist, 50 (9), 750-765.
Wheeler, D.L., Jacobson, J.W., Paglieri, R.A., and Schwartz, A.A. (1993). An experimental assessment of facilitated communication. Mental Retardation. Vol 31 (1), 49-60.
You can read all the blog posts in this series at these links (I’ll make them “live” as they are published over the next few weeks).
Do Critics of FC “Presume Lack of Competence”? Part I: Calculator and Singer
Do Critics of FC “Presume Lack of Competence”? Part II: Green and Shane
Do Critics of FC “Presume Lack of Competence”? Part III: Jacobson, Mulick, and Schwartz
Do Critics of FC “Presume Lack of Competence”? Part IV: Wheeler, Jacobson, Paglieri, and Schwartz
Do Critics of FC “Presume Lack of Competence”? Part V: Review of Broderick and Kasa-Hendrickson
Do Critics of FC “Presume Lack of Competence”? Part VI: In Sum, No.