 It sounds like facilitated communication then would be quite useful. So previously the autistic individuals weren't able to communicate, they were kind of locked in in a sense and unable to communicate with their parents or their loved ones. It sounds like it could be really, really the holy grail for parents of autistic kids. Is it? Well, it looks like it's really life changing, right? Because you got these kids who weren't able to communicate, they can't say even a single word to you. And with the help of the facilitator, now they're able to tell you what they did on the weekend, they're able to write poetry, they're able to go to school, finish high school, and so on, right? So the impression that you get if you see this stuff in action is wow, this is huge, right? We're freeing these kids. As you say, these kids who have been locked in, we've got the key man, we unlock that door, they're out, they're communicating, and it sounds wonderful, absolutely. Yeah. Interesting. So obviously we're introducing this topic as for a reason, it's not all it's cracked up to be. Can you tell us what the problem is exactly with this technique? Sure. There's one really critical question that has to be answered here, and it turns out to be a very simple question once you calculate what that question is, but you have two people involved here. You have a facilitator who's guiding the movements of the client, and then you have the client. So the two people involved have different pieces of information. And then if you interrogate that pair, so you ask them to type out something with the help of the facilitator, right? If they each have different information in their heads, you can tell by which information you get out of the pair, who it came from. So what you would do is set up a scenario, for example, where the facilitator who's guiding the arm of the autistic individual sees, for example, a photograph of a pair of socks, and the autistic individual sees something else, say, a pair of keys. And so you have these two differences. They're seeing two different things, and then you see what comes out in terms of the communication. If it's the socks, then it's the facilitator. If it's the keys, then it's the autistic individual. And that's the sort of experiment that's been done in the past? Exactly, multiple times. So in the early 1990s, there's a whole raft of these experiments. This is when facilitated communication was getting popular, and there's a whole raft of these kinds of experiments that tested this idea by making sure you have different pieces of information in the two individuals, look to see what comes out. And across all the experiments, there were different denominators in terms of the results that came out. That is, there were different numbers of trials on which you could get information, or evidence of information from the client, right? So one study by Wheeler and his colleagues at the HEC Center that was using this technique, if I remember correctly, I think it was about 140. I can't remember, it might have been 160. But there's 140, say, of these trials on which you could have gotten information coming from the client, and they got information clearly coming from the client on zero of those trials, none at all. And throughout all these studies that have been done, the numerator never changes. The denominator may change. Maybe it's 60 trials. Maybe it's 30 trials. Maybe it's 45 trials. But the number of trials where you actually get solid evidence of information coming from the client in all those cases is zero, none. What happened? I mean, what's the fallout of this? Did they just stop doing facilitated communication, or what happened after these sort of experiments came to light? I think some of the steamroller effect of this procedure dissipated, right? But it's still the case that people are using facilitated communication these days. And this is what, 20 years after the bulk of that really unequivocal evidence has come in to say that the technique is not working. There's an interesting study by, one of the major studies that was done in the early 90s, done by Doug Wheeler and his colleagues at the OD Hex Center in, I think it was connected in New York. And they were using this technique, and they were having wonderful results, or at least they thought they were having wonderful results with it. And you can imagine being one of these therapists working with these kids, right? So you come in to work, and you're talking to these kids who, for the last four or five years, you haven't been able to get a word out of. And now they're telling you about what they did on the weekend, they're joking with you, you're having conversations with them. You imagine, as a therapist, how rewarding that is. I mean, that's why you got into the business in the first place, was to be able to do this kind of thing. And it felt wonderful, right? And they decided, when people started criticizing this technique, they decided, okay, we're going to show them how this works, right? So they ran this study, they looked to see who the information is coming from, and the data are very clear. It's coming from the facilitator. The information that's coming over the pair of them at all is coming from the facilitator, not from the client. And they're absolutely devastated. But to their credit, they stopped using facilitated communication. They said, we can't, in good conscience, use this technique, no matter how good it makes us feel, no matter how good it makes the parents feel, it's wrong. These kids are not communicating. We're kind of acting like they are, but they're not really. They were absolutely devastated. But I mean, I think it's a real testament to their integrity of the therapist at this place that they said, we're going to have to go back to square one. So someone might argue then that, what's the harm in that kind of case? I mean, particularly with facilitated communication. I mean, you have parents who are, they haven't communicated with their children. I've seen reports of this, the child can report, for example, I love you, mom. And I mean, is it that bad? I mean, what's the harm in doing that sort of thing? Well, there's a few of them, actually, I think. The first is, we lost, I don't know how many person years of research time into the causes, the procedures, what goes on in autism. Because remember, at the time, people were saying, look, if this facilitated communication is working, then we have to fundamentally rethink what autism is. It's not at all what we thought it was, it's something completely different. It's not this maybe withdrawal from the world and those sorts of things. It's a communication problem. And that's all it is, and we just need to allow people to communicate. Well, people went off and started studying this stuff, and it was a wild goose chase. We spent, I don't know, how many millions of dollars, how many, like I say, person years of research time off chasing this wild goose chase. Right, so the societal cost. Because those people could have been actually investigating worthwhile avenues rather than these goofy ones. There are costs to the individuals involved, because if you focus on this bogus communication, you may miss communication they actually are able to do. And there's a lovely description of that in the report on that study by Wheeler and his colleagues from the HEC Center, where they said at one point, there's one kid who was shown an item, let's say it was a car. And the child pointed at the car, made a manual sign for the car. This kid knew sign language, so made manual sign for a car, whatever that is, right. And uttered the first consonant of the sign, he's going kuh, kuh, kuh, kuh. And the facilitator, who is watching the kid's hand on the keyboard, completely ignored that information and he typed out balloon or something instead, right. So you have these legitimate attempts to communicate that are missed because people are focused on the bogus stuff, right. So that's a cost to those individuals because they're not able to communicate. You're blocking the real communication with the bogus stuff, with the stuff that's not real. And I think there's another piece and I have a hard time sort of describing it. But I think there's a sense in which this bogus belief that there's some more intact individual inside the person that you're able to access denies the validity of the person who actually is in there, right, who may not be able to communicate. Who may not have in some sense anything to say in the sense of being able to write poetry and so on, but so what, they're still human beings. They're still valuable real people who deserve respect and proper treatment and so on for who they are, not for who you'd like to believe they are.