How Effectively does the Ideomotor Response Explain Cueing in Facilitated Communication? - Part 1
Today’s blog post is Part I in a series where I discuss the topic of the ideomotor response in relation to the problem of cueing in Facilitated Communication (FC). I think it’s important to understand what the ideomotor response can and cannot do in explaining the extent to which facilitators provide cues during letter selection (regardless of whether they’re holding onto the client in some way or holding on to a letter board positioned in the air). Hint: the ideomotor response, though often used interchangeably with a phenomenon known as the Clever Hans effect, has very little to do with the long-term cueing and sophisticated output that occurs in all forms of FC (Spelling to Communicate, Rapid Prompting Method, Supported Typing, etc.).
Michael Faraday, Public domain, via Wikimedia Commons
The idea of the ideomotor response—or “involuntary motor activity caused by an idea”—is not new. Psychologist/physiologist William B. Carpenter is credited with coining the term in 1852 and the ideomotor response is a well-documented phenomenon often associated with dowsing and automatic writing. (See Ray Hyman’s How People are Fooled by Ideomotor Action and Herman Spitz’s Nonconscious movements: From mystical messages to facilitated communication).
Early critics of FC, recognizing the technique as a form of automatic writing often associated with the use of a planchette or Ouija board, (see Kathleen Dillon’s Facilitated Communication, Autism, and Ouija) suggested that the ideomotor response (e.g., “unconscious” or “nonconscious” muscle movements) could account for at least some of the physical cueing facilitators provide to their clients during letter selection while tugging on a shirt sleeve, providing backwards pressure after letter selection, and the like. The ideomotor response could also come into play when the facilitator thinks of the letter “A,” for example, and, without realizing it, moves his/her hand toward the left (on a QWERTY keyboard) or, when a letter board is held in the air, moves the letter board in the direction that allows their client or loved one easier access to the letter “A.” These are split second actions and the research indicates that, for the most part, facilitators are unlikely to be fully aware of their own movements.
Testing facilitator control by measuring the pressure exerted by participants during letter selection. (Kezuka, 1997)
A 1997 study by Emiko Kezuka seemed to confirm the idea of physical (but subtle) cueing caused by the motor activity of the facilitators (emphasis mine). By connecting the facilitator and client’s fingers using rods and/or ribbons, Kezuka was able to measure changes in pressure as the pairs in the study selected letters on keyboard. For example, if the client’s outstretched finger moved away from the desired letter, the facilitator tensed up (or applied pressure to stop the movement), but if the client’s outstretched finger hovered over the desired letter, the facilitator relaxed. With time and practice, the client learned to interpret this relaxation or easing of pressure as a cue to press down on the target letter (e.g., following the path of least resistance). Kezuka asserted that these cues (and the “success” of FC) had less to do with physical or emotional “support,” as claimed by proponents, than changes in pressure exerted by the facilitator(s) as the client’s finger reached (or, at times overshot) the desired letter. Like other controlled tests of FC before and after Kezuka’s study, the facilitators appeared to be unaware of the extent to which they applied or released the pressure cues, or the extent to which a combination of cueing and operant conditioning (e.g., positive reinforcement after a desired interaction with the letter board) played a part in teaching participants to point to the desired letters on cue. (Kezuka, 1997)
Note: Kezuka also reported on “numerous visual cues” detected during close examination of the facilitation process, which, as it turns out, are crucial in explaining the extent to which facilitators control letter selection. These visual cues included “movement of the sender’s fingers above the cart, wavering of the head, and stopping of the eyes in the vicinity of the correct answer” (Kezuka, 1997, p. 591) and are just some of the ways facilitators cue their clients perhaps without fully realizing it. (See An FC Primer)
Researchers testing FC validity at the O.D. Heck Center by blinding the facilitator from seeing images presented to the person being subjected to FC (Prisoners of Silence, 1993).
But, as Daniel Wegner, Valerie Fuller, and Betsy Sparrow noted in their 2003 article Clever Hands: Uncontrolled Intelligence in Facilitated Communication, the ideomotor phenomena “tend to be small” and seldom accounted for the “lengthy and multi-staged actions” seen in the production of “long and complicated” FC-generated communications. (Wegner et al, 2003, p. 6). The authors of the study discuss alternative explanations for facilitator cueing, which I will discuss later in this series.
For now, this brings us to two questions:
1) How can facilitators control letter selection and not be consciously aware of the extent to which they do so; and
2) If the ideomotor response doesn’t fully explain how facilitators can produce long and complicated (FC-generated) messages, then what other factors could explain this phenomenon?
Part of the answer to the first question lies in directives by the leadership not to test FC. Even if facilitators could be fully aware of their own behaviors 100% of the time during letter selection activities (which they cannot), facilitators are discouraged from entertaining the idea that they might be controlling letter selection—even if done inadvertently. Occasionally, proponents might admit that facilitator cueing does adversely affect independent letter selection—as founder Douglas Biklen did in the 1993 documentary Prisoners of Silence—but these accusations almost always refer to someone else’s ability to facilitate and not their own. I think it’s safe to say that all practicing facilitators think they are the exception when it comes to being able to “support” their clients or loved ones (e.g., by holding onto them and/or holding a letter board in the air) without influencing or controlling letter selection.
But facilitators are in a poor position to detect facilitator cueing—especially in themselves. Think, for a moment how intricately involved they are with the letter selection process. As Genae Hall outlined in a 1993 article, at a minimum, facilitators are tasked with:
Holding the person’s hand so that the index finger is isolated,
Positioning the person’s arm
Providing backwards pressure as each letter is selected
Pulling the person’s hand back after each selection
Pulling back from obvious errors and perseverative patterns
Establishing and maintaining a typing rhythm
“Under such conditions,” Hall wrote, “it seems quite possible that they [the facilitators] would fail to notice their own behavior (i.e., would not ‘feel’ that they were doing the typing) and would fail to edit the behavior. The unedited material might then seem strange or ‘uncharacteristic’ of the facilitators and be attributed to the disabled individuals.” (Hall, p. 92-93)
As Jon Palfreman, producer of Prisoners of Silence, wrote in a 2012 article called “The Dark Legacy of FC”:
The miracle [of FC] was alleged to work like this: A teacher, parent, or care worker lightly holds the hand of the nonverbal autistic child and, by smoothing out his/her jerky movements, ‘facilitates’ the typing of letters on a board or typewriter. As written messages come forth, children previously labelled as intellectually disabled are reclassified as ‘literate.’ Now seen as potentially of normal intelligence, there is nothing to prevent the children (accompanied by a facilitator) being mainstreamed in mathematics and biology classes with their peers. Biklen and other proponents claimed that FC gave countless thousands of nonverbal autistic individuals a voice, a way to be included in society. (Palfreman, 2012, p. 1)
FC-founder Douglas Biklen and one of is “trained” facilitator look at the keyboard while the student looks away and engages in self-stimulation behaviors. (Syracuse training video, 1991)
But, as researchers began to focus on facilitator behaviors under reliably controlled conditions (e.g., where facilitators were blinded from test protocols), they noticed and documented a broader range of cueing that could not be characterized by the small, non-conscious muscle movements associated with the ideomotor response. These include but are not limited to shifts in body position, head nods, hand signals, and changes in vocal tone or rate. They also noted that facilitators maintained constant eye contact with the letter board while those being subjected to FC did not. Often referred to as the Clever Hans Effect, these physical, auditory, and visual cues explain how facilitators can and do cue their clients or loved ones during letter selection, again often without fully realizing the effects of their actions. (See Clever Hans: It’s not about the horse).
Also emergent in the literature are descriptions of facilitators that give clues as to the (psychological) mindset of facilitators and how that may contribute to a belief in FC that allows them to rationalize away “the misses” or times when the FC messages are erroneous and remember “the hits” or times when the FC messages match their expectations. Here, researchers suggest that belief in FC (e.g., that it could work) increases the chances that it will “work” in those individuals. Wegner, Fuller, and Sparrow’s study addresses this issue and seems to back up observations found in Cheryl A. Burgess, et. al.’s 1998 article “Facilitated Communication as an Ideomotor Response” and Diane Twatchman-Cullen’s 1997 book “A Passion to Believe: Autism and the Facilitated Communication Phenomenon” (see Katharine’s review of the book here).
I will be discussing alternative explanations for cueing, automatism, and the facilitator mindset in future blog posts in this series..
References and Recommended Reading
Burgess, C.A., Kirsch, I., Shane, H., Niederauer, K.L., Graham, S.M., Bacon, A. (January 1998). Facilitated Communication as an Ideomotor Response. Psychological Science, 9(1), 71-74. https://www.jstor.org/stable/40063250
Kezuka E. (October 1997). The Role of Touch in Facilitated Communication. Journal of Autism and Developmental Disorders, 27(5), 571-593. DOI: 10.1023/A:1025882127478
Hyman, Ray. (2003, August 26). How people are fooled by ideomotor action. Quackwatch.
Palfreman, J. (2012) The dark legacy of FC. Evidence-Based Communication Assessment and Intervention, 6 (1), 14-17. DOI: 10.1080/17489539.2012.688343
Spitz, H. (1997). Nonconscious Movements: From Mystical Messages to Facilitated Communication. Routledge. ISBN 978-0805825633
Twachtman-Cullen, Diane. (1997). A passion to believe: Autism and the facilitated communication phenomenon (Essays in Developmental Science). Boulder, Colorado: Westview Press. ISBN 978-0813390987
Wegner, D.M., Fuller, V.A., and Sparrow, B. (2003, July). Clever hands: uncontrolled intelligence in facilitated communication, Journal of Personality & Social Psychology, 85 (1), 5-19. DOI: 10.1037/0022-3514.85.1.5