How might touch reduce the cognitive load of FCed typers?
Proponents of facilitated communication—specifically, of the classic, touch-based variant of FC—have come up with all sorts of reasons for why facilitators need to hold the wrists, arms, or other body parts of facilitated individuals while they type.
Per FC proponents, physical touch is used to
provide physical stabilization (e.g., for tremors in the arm or finger)
give tactile feedback (for those with deficits in body awareness)
pull back or slow down the person’s typing hand (to prevent perseveration on letters and on letter sequences)
keep typers calm and focused
·express emotional support.
Excluded from this list, of course, is the real reason for physical touch in FC: namely, that touch is how facilitators (however unwittingly) control the typed-out messages—i.e., by cueing the facilitated individuals about which letter to select.
In a recent article in Frontiers in Neuroscience, FC proponents[1] offer a novel justification for touch in FC (Nicoli, Pavon, Grayson, Emerson, & Mitra, 2023):
reducing the “cognitive load” of the typer.
In particular, the authors declare, FC may reduce the typer’s “sensorimotor workload… thereby freeing up shared cognitive resources for the linguistic elements of the task.” The source of the sensorimotor workload? “Typing while sitting.”
Rodrigo O. Sanchez, CC BY-SA 3.0, via Wikimedia Commons
The authors spend about 3000 words describing the myriad sensorimotor and complexities of typing while sitting—complexities that, though I am at this very moment doing precisely this (typing while sitting) I had no idea of. The next 2000 words discuss how concurrent motor and cognitive tasks like typing while sitting can potentially undermine one another (i.e., typing potentially undermines sitting, and sitting potentially undermines typing): a consequence of the cognitive resources they share, particularly in people with limitations in executive functioning (planning, working memory, and control of attention).
The next thousand words explain how touch can help with the postural control required when people type while sitting, “thereby reducing cognitive load” and freeing up resources for typing out appropriate, linguistically well-formed messages. The authors acknowledge that non-humans could also provide cognitive-load-reducing touch, as with the back of a chair or a robotic arm (they cite Oudin, 2007’s report of assisted typing via a mechanical arm, which Janyce discusses here). But only humans, they claim, can optimize the effects of touch by adjusting to shifts the typer makes in his posture or sitting position. Of course, humans are also better at unwittingly cueing linguistic messages than either mechanical arms or chair backs are.
The authors’ next two thousand words describe how developmental disabilities are associated with sensorimotor deficits and difficulties with executive functioning. A final section concludes that the facilitator’s touch may serve to free up cognitive resources for linguistic expression, or, in their words: “supportive touch might reduce the computational workload of generating and typing linguistic content by assisting the sensorimotor processes of typing.”
For all their extensive and seemingly comprehensive discussion of sensory-motor challenges, executive functioning challenges, and the presence of these challenges in individuals with developmental disabilities, nowhere do the authors mention the language and literacy challenges that also commonly come with developmental disabilities. Nowhere do the words “language,” “vocabulary,” “grammar,” “syntax,” or “literacy” appear. The word “word” is used only in the context of typed words; the word “linguistic” is used only to describe tasks and output, not difficulties; and the word “spelling” is used only in connection with tasks and recall, not in connection with whether a person actually has any spelling knowledge to recall.
Instead we get ruminations like:
Deficits in planning would limit the strategies available for organizing the content to be typed (narrating an event, answering a question…), deficits in verbal fluency would impair finding the lexical target of a conceptual referent, and working memory impairment would influence typing effectiveness at the sentence and word level. People with executive dysfunctions may find it difficult to maintain the to-be-typed sentence, or even the graphemic string…
The assumption, of course, is that non-speaking, developmental disabled individuals who depend on facilitation, however deficient their planning skills, however dysfluent their language, still have the linguistic ability to narrate events, answer questions, comprehend “lexical targets,” construct sentences, and sequence graphemes (letters) into words.
Nor do the authors mention the most likely way in which supportive touch might reduce computational workload: namely, by cueing the facilitated individuals about which letters to type. Such cues, experiments have shown, are ones that facilitators cannot help but convey, even if they’re completely unaware of doing so (see Spitz, 1997 for a review). This means that the most likely effect of supported touch is to free a facilitated person’s cognitive resources, not for the linguistic elements of the task, but from the linguistic elements of the task. The supportive touch, in other words, keeps the facilitated person from having to do any linguistic work at all.
Nor do the authors themselves do much linguistic work. Instead of discussing the various linguistic challenges that are likely to limit non-speakers with developmental disabilities, they expend their cognitive energies elsewhere, dazzling us with passages like these:
Visual information is particularly salient in the detection of self-motion as movements of the head through a visible environment generate flows of optical elements across the entire visual field (Lee and Lishman, 1975; Dijkstra et al., 1992). Anterior-posterior head motion produces radial optical flow whereas medial-lateral head motion generates lamellar flow (Warren, 2010). When these visual signals are available, the body sways less in both planes (Edwards, 1946; Paulus et al., 1984, 1989). Indeed, the ratio of body sway between eyes-open and eyes-closed conditions, the Romberg quotient, is a clinical indicator of postural stability (Romberg, 1853). Research suggests that the maintenance of balance (for example, keeping the body’s center of mass within the base of support) involves both exploratory and corrective body sway. Exploratory sway generates perceptual information (including optical flow) that guides the compensatory sway that corrects drifts toward instability (Riccio et al., 1993; Riley et al., 1997).
Dazzling the reader—and perhaps also the journal editors—with thickets of technical terminology and high-level concepts is reminiscent of Jaswal et al. (2020)’s pro-FC eye tracking paper. Head-mounted eye trackers, meticulous codings of hours of video, graphs of anticipatory eye gaze fixation patterns—all instead of a simple, low-tech message-passing test that would have settled matters once and for all.[2]
This paper’s introductory lit review, at least, acknowledges the long legacy of message-passing failures. But none of its subsequent claims about supportive touch can explain why facilitation fails when the facilitator doesn’t know what the facilitated person’s response should be. How, for example, would the facilitator’s touch fail to reduce cognitive load in cases where the facilitator hasn’t seen the image that the facilitated person is being asked about? The most this paper could explain, assuming its (untested) hypotheses are true, is why facilitated individuals are unable to type without the support of facilitators. But in no way does this explanation rule out facilitator control of letter selection. Indeed, as the authors themselves acknowledge: “The existence of the presented pathway for cognitive load reduction does not negate the possibility of specific cueing by the facilitator’s touch.”
But then they go on to propose that the most likely effects of the facilitator’s touch on the FCed person’s typing is a “co-creation” process that is analogous to someone who helps a mobility-impaired person walk, or to the scaffolding provided by a teacher in helping a student complete a not-yet-fully-mastered task.
Such analogies, however, collapse under scrutiny. A mobility-impaired person, assuming she can communicate independently, can tell you if you’re directing her somewhere she doesn’t want to go. And most students routinely undergo un-facilitated testing that establishes what they can do on their own. But when what’s being facilitated—and, quite likely, facilitator-controlled—is communication itself, and when facilitators and parents routinely refuse to allow un-facilitated (or facilitator-blinded) testing, there are no safeguards against “supportive touch” extending beyond mere support to out-and-out control.
NOTES
1. The two lead authors, Giovanni Nicoli, Giulia Pavon, are both members of, and received funding from, Vi Comunico Che Penso, described in the article as “a charitable organization whose mission includes supporting the development of facilitated communication.” Two other authors, Andrew Grayson and Anne Emerson, have a track record of pro-FC writing (see, e.g., Emerson, Grayson, & Griffiths, 2001). All five authors hail from Nottingham-Trent University, also home to Matthew Belmonte, another FC proponent.
2. Unsurprisingly, the authors reference Jaswal et al.’s paper: “Others have used eye-tracking methods (Grayson et al., 2012; Jaswal et al., 2020) to show that users anticipatorily fixate the to-be-typed key, and so are actively involved in the process.” More surprisingly, they cite FC critiques as sources on the use of FC to support typing: “A number of techniques seek to assist individuals with DD to type text on a keyboard or to point to textual or pictorial information on a screen by providing them with supportive touch on the torso or arm (Lilienfeld et al., 2014; Schlosser et al., 2014; Beals, 2022).” We are left wondering whether they actually read these articles.
REFERENCES
Emerson, A., Grayson, A., and Griffiths, A. (2001). Can’t or won’t? Evidence relating to authorship in facilitated communication. International Journal of Language & Communication Disorders, 36 (s1), 98-103. DOI: 10.3109/13682820109177866
Jaswal, V. K., Wayne, A., and Golino, H. (2020). Eye-tracking reveals agency in assisted autistic communication. Scientific Reports. 10:7882. doi: 10.1038/s41598-020-64553-9
Nicoli G, Pavon G, Grayson A, Emerson A and Mitra S (2023) Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities. Frontiers in Integrative Neuroscience 17:1181025. doi: 10.3389/fnint.2023.1181025
Oudin, N., Revel, A., and Nadel, J. (2007). Quand une machine facilite l’écriture d’enfants non verbaux avec autisme. Enfance 59, 82–91.
Spitz, H. (1997). Nonconscious Movements: From Mystical Messages To Facilitated Communication. Routledge.
