 You've done a fair bit of work in the past looking at a particular case that we're interested in for this course, and that is facilitated communication. Can you tell us a bit about what it is and what people have done in the past to look at it? Sure. The basic argument is that largely people with autism, not necessarily autism because it's spread to other disorders, but typically autistic kids who are non-communicative. The problem is not that they don't have something to say. The problem is that they have difficulty getting it out, and the facilitated communication is an idea to facilitate their communication to help them get their communication out. And the problem, according to this view, is that the biggest problem these kids have is they can't initiate a conversation, they can't initiate communication. And so the argument for facilitated communication is what you do is with a little bit of help, help them type on a keyboard, just move their arm a little bit to get them started. The idea is if you can get them started, then they can type out messages that are sensible, that are full sentences, paragraphs, and so on from these kids that you thought really had nothing to say, or in the past people have thought they had very little to say. They weren't capable of communicating. The general logic of facilitated communication is if you can get the kids started, if you can get the movement started, and if you can stop them from just continuously hitting the same button once they've started, so they have this perseverative problem where if you hit a C, then you hit a C again and again and again, you can't get out of that loop. So you start them off with a little bit of help, just moving their hand for them or their arm for them, and then you pull them back once they've hit a letter. And so this initial starting motion and stopping them from keeping repeating the same thing, start them on the next letter, and so on, and then these kids can now communicate in ways that they weren't able to communicate before, because you're just facilitating the beginning and the ending of the communication. Sounds like facilitated communication then would be quite useful. So previously, the autistic individuals weren't able to communicate, 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've got these kids who aren'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. 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. And so when, say, the pair of them write a poem, right? Because the client is not able to write the poem without the help of the facilitator. So when the pair of them write the poem, who's the author? You have two people involved in that situation, and the fundamental question you have to answer, you have to figure out the answer to is, who's the communication coming from, right? Is it coming from the facilitator, or is it coming from the client? So if you've got this pair going to high school, right, going to the math courses and writing essays in English and all that sort of stuff, come graduation day, who do you give the diploma to? Do you give the diploma to the facilitator or to the client? So how do you find out where the communication is coming from? Well you have to, you can't, in that naturally occurring situation, right? You have to find some situation, you have to get control over the situation. 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. And that's what a lot of the research, well basically all of the research that's been done, all the scientific research that's been done on facilitated communication uses that technique. Make sure people have different pieces of information. The client has one piece of information, the facilitator has another piece of information, and you interrogate the pair of them, you ask them a question, and see which one of those things comes out. 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 Hex 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. Wow, so the denominator you're referring to, just the number of opportunities that the autistic individual has to demonstrate that they're the ones that are communicating, and under all of those circumstances, none of those opportunities have come to fruit. Precisely, yeah. 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. 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. And so yeah, it's still being used, not to the extent that it would have been without this evidence, I think. And I think there's a lot of competent therapists who are not using it that have sort of learned the lesson in some sense. 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 Schenectady, 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 they felt wonderful, right? And they decided, when people started criticizing this technique, they decided, OK, we're going to show them how this works, right? So they ran this study, they set up the situation where they make sure that the client has different information than the facilitator, they look to see who the information is coming from, and the data are very clear. It's coming from the facilitator. Any information that's coming over the paratheum 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. And 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. I don't like it, but we have to. We have no choice in this matter. And the parents and everybody else who's involved had to take that route. So are the facilitators then being malicious? Is that what's happening? I don't think so. I mean, in most cases, probably not. I mean, maybe that's happening in some cases as well. But there's no need to assume that. We have a long history in psychology of people influencing the behavior of others without being aware of it. There's a study by Rosenthal and Jacobson back in 1968 called the Pygmalion Effect. Pygmalion in the classroom was the name of the study. And it's named after the George Bernard Shaw play, right? And what they did was they brought an experimenter into a classroom, an elementary school classroom. And they went through and they wrote down a bunch of stuff and gave the kids a bunch of tests. And they came back to the teacher and said, little Jimmy and Jane and Ralphie and so on, they picked out a bunch of kids and said, they're due for an intellectual growth spurt. So the idea was these kids were about to blossom. They're about to have this big, like a physical growth spurt, only intellectual. And then they came back at the end of the year and they tested all the kids again. And lo and behold, these kids that they said were due for an intellectual growth spurt, in fact, had advanced significantly more than the rest of the kids in the class. The hitch is, they just pulled those names out of a hat. They had no way of predicting intellectual growth spurs or anything like that, they just made it all up. So what happened? Well, the argument was that the teachers, although they claimed not to be, were treating these kids differently. So if you know little Jimmy's ready for an intellectual growth spurt, right, and he's not quite getting something, well, you spend a little bit of extra time because you have these higher expectations of them. And we know if you have higher expectations of kids, they're gonna live up to them, right? Or at least they're gonna attempt to live up to them, right? And so a little bit higher expectations get a little bit higher results, right? A little bit higher performance. And that's what happened, right? And so that's an experimental expectancy effect. The experimenters were kind of expecting this outcome. In this case, the experimenters are the teachers in the classroom. It's their expectations that the kids are living up to. Sounds very similar to the clever Hans effect. Is that, I can't remember the details exactly, but something about a horse being able to read the signals provided by the trainer. Do you know that example? Yeah, back in the late 1800s, so the turn of the previous century, a guy named Wilhelm von Austin. He was a retired school teacher. He thought the so-called dumb animals, as they were called at the time, were getting short-tripped. They were a lot smarter than people thought they were. And so he trained this horse to do all kinds of amazing things. So the horse could tell you what time it was, he could do arithmetic, he could convert fractions to decimals and decimals to fractions. You could ask him questions like, well, if it's 25 to eight, where's the little hand on the clock? What numbers is it between? And so on. And they had these big commissions of inquiry who came to check out Hans and make sure that there wasn't some fraud going on and so on. And he passed all the tests. How does the horse respond in this case? Well, actually, a psychologist named Oscar Funks came along and figured out what was going on and what was going on in this case. I mean, Hans was very clever, but he couldn't talk, right? Wasn't Mr. Ed. So what he would do is he would just tap his foot to answer a question. What Oscar Funks established was that Hans could answer the questions if anybody in the audience knew what the answer was. Von Oster didn't need to be there, right? But someone had to know the answer to the question. And the way he tested this is he would ask one person to whisper a number in Hans's ear, another person to whisper a number in the other ear, say three and two, right? And they would ask Hans, add those two numbers. What's the sum of those two numbers? And Hans would go, just keep going. Because no one was telling him when to stop. Someone always told him when to stop. And the way they did that, Hans was very clever, not in the way that people thought, but he was very tuned to very subtle movements of people. So as Hans started to approach the right answer, people would just lean forward a little bit in anticipation of that answer. And so if he's going to five, you know the answer is five, you go one, two, three, four, oh man, he's gonna make it there, five, now, not nearly as big, but there were very subtle movements, but that's what Hans was picking up on. And once Funks figured this out, he could ask to give whatever answer he wanted, simply by making these movements deliberately. So Hans was picking up on these subtle cues from the people around him, none of whom knew they were doing this, right? There's no reason to believe that Vaughan Austin, who was the guy that was, who had trained Hans, knew that he was queuing Hans the answers, right? He was, he had a point to make, sure, but he wasn't a fraud, he wasn't making money off this. He just thought Hans was as clever as he was and didn't realize that he was doing the actual queuing himself, or other people in the audience were doing the queuing when Vaughan Austin wasn't there because they'd often test without Vaughan Austin being there. As you would think, well, maybe he's up to something fishy, take him out of the room, test Hans, Hans works just fine, right? As long as somebody knows the answer because they give those subtle little cues as to where he should be going. And if you think about facilitated communication, you've got someone holding onto your sleeve or holding onto your arm, helping you reach out and point and touch a keyboard, very easy for that person without meaning to, to be guiding your hand in a particular direction. And so the client is simply sort of passing on the movements that have been started by the facilitator. So that's how you get the information from the facilitator out through the client. So someone might argue then that, you know, what's the harm in that kind of, 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, you know, 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 and, well, 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. And uttered the first consonant of the sign, he was going kuh, kuh, kuh, kuh. And the facilitator who was watching the kid's hand on the keyboard completely ignored that information and he typed out balloon or something instead. So you have these legitimate attempts to communicate that are missed because people are focused on the bogus stuff. 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 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, 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, right? So those are the kinds of costs that I think have been born largely by these poor autistic kids, right? But by society in general as well. Who should be doing these sort of experiments? Is it Syracuse University who developed facilitated communication or should it be to us, should the experiments be up to us to conduct to demonstrate that there's nothing to this technique? So should we be the police here or should the people who are developing these techniques actually come up with some evidence that they, in fact, work, good scientific evidence that they work? I think it's the people who are developing the techniques really should be doing this, but of course, this is one of a whole series of these kinds of treatments where people have come up with these ideas, everybody jumps on the bandwagon, it looks at first blush like something wonderful is happening and no one really stops to take a skeptical view. I mean, you mentioned sort of being cynical about it, but that's not what I'm suggesting. I don't suggest that you be cynical and don't believe anything. What I'm suggesting is you need to take a skeptical view. You say, okay, let me see some evidence, right? How can we make sure that this technique really is working? And when you're doing drug studies, you got to come up with some evidence that your drug is an effective drug before you're allowed to market and so on. I think that's less true of people coming up with therapeutic techniques as opposed to therapeutic drugs, but there has been a number of other cases where the same sort of thing's gone on, right? So I have movement desensitization retraining was developed as a way of treating post-traumatic stress disorder and phobias and so on, which basically says you set the person down, you get them in this nice, relaxed state teaching some relaxation exercises and you have them start to think about the things that are traumatic to them. You keep them relaxed as you're doing this, but at the same time, you give them a fixation point, something to look out like my finger, you move it back and forth really quickly and they're supposed to track this with their eyes and this balances out something in their hemispheres and so on and makes the treatment much work much better and so on, except it's all nonsense, right? When you actually do the studies, that makes no difference. It's a technique that we've known about for, I don't know, 50, 60 years called systematic desensitization. You train a person up to be relaxed, you can't be relaxed and anxious at the same time, so then you sort of introduce the idea of the thing that makes you anxious in a gradual way and it doesn't cause so much anxiety anymore after you've done this training. You get equally good results with or without the eye movement stuff, right? But again, that was another technique that came in, it was in vogue for a while, people were paying big bucks to be trained in this, the therapists themselves are like, $2,500 to get trained at the first level of this, right? And they're flocking to do this, right? But that gets ahead of the actual evidence so then when the evidence comes in, it's like, well, no, but turned out to have been a waste of time. And there was a case more recently kind of related to this, the case of facilitated communication about locked-in syndrome. So there was an individual, I think, who was in a coma and people thought that he could communicate when in fact he couldn't. Do you know the details on that one? A little bit, I got a guy named Rob Hubin in, I think it was Belgium who had been in a coma for something like 23 years and he was given a number of tests and there were a neurologist there to decide that he wasn't really in a coma that something about his brain activity suggested that he wasn't actually a comatose, he was just unable to communicate and sort of along came a facilitator who would help him out and had him tapping away on this keyboard about what it was like to be locked in and all these sorts of things, right? But if you watch any of the video of this poor fellow, first of all, it had to splint his finger so that it wouldn't damage his finger from doing all this typing. But he's typing away, his eyes are closed, he's not really paying any attention and the facilitator is so often in these cases is focused on the keyboard and looking at the keyboard and helping him type things and so on. One of the things this research has done, I think, is to make people a little bit quicker to ask those questions about is this really communication coming from this guy, right? So we know enough and there's enough people around now who can kind of say, wait a minute, wait a minute, this guy may have been locked in, he may not have been locked in but that information that's coming from this facilitator doesn't count as evidence that he can communicate, right? It just has no evidential value, it's anecdotal evidence and the situation is not controlled in such a way that you can tell who the communication's coming from and that's a big distinction. I'm very sympathetic on the part of the autistic individuals and of the parents that if there's anything to this technique whatsoever, if they can communicate, then we should give them the benefit of the doubt but I think some of the allegations that came out of the facilitator communication were fairly serious. Can you tell us a bit about those? Yeah, there is one case where a young woman through facilitated communication accused basically her whole family of sexually abusing her. Now, that's a case where legally as well as scientifically and morally, you really wanna know where those allegations are coming from, you really wanna know whose thoughts those are because there's a big difference. If someone says, I've been sexually abused, well, you gotta do something about that, right? That's first-hand sort of evidence. If you say, I think maybe so-and-so is being sexually abused, well, that's a whole different, it has a whole different evidential value, right? Sort of legally as well as scientifically. And what was happening is we were getting these sort of allegations of sexual abuse from this pair of people, the client and the facilitator and Betsy was pulled away from her family, made a ward of the court and so on while all this was kinda sorted out. What happened in that case was exactly the same kinds of evidence was gathered, as was gathered in the scientific studies. Communication expert came in to establish whether in Betsy's case, this is the young woman's name, Betsy, the information was coming from her or it was coming from the facilitator. So he did a number of the same kind of ideas, make sure that the two of them see different pictures and see which pictures come out. He did another version of the test where he took Betsy out of the room and gave her something, a key, for example, and then brought her back into the room and then asked her, what did I show you out there? And he wasn't able to get an answer. When he just pulled out a key and said, what's this? He was able to get an answer because the facilitator was present that second time when he pulled the key out. So it became clear fairly quickly if you controlled the situation properly so you could answer that fundamental question. Remember, the fundamental question is who's the communication coming from? That's the legal question as well. And it turned out that in that case, all the information was coming from the facilitator. There was nothing that was coming from Betsy in that case. So in that case, the charges were dropped and it became, because there was no evidence, there was no evidential value to these sort of sideways-going claims that Betsy had been abused. So the name of the course is the science of everyday thinking. Do you have any advice for the people who are taking the course on how to improve their everyday thinking? I think at least part of the answer is a healthy skepticism. The rallying cry of the cynic is bullshit. That I just don't believe anything. That's not what I'm suggesting. What I'm suggesting is being skeptical. Let's see some proof. I wanna see some evidence. So particularly when you see these kinds of claims, where's the evidence? How can we know this for sure? I think part of being skeptical is keeping an open mind, right? But demanding evidence and not jumping to conclusions, not making up your mind too early that either this is a wonderful thing or it's completely bogus, right? Let's get some evidence before we make those decisions. So that's maybe a bit unsatisfying. Then you're not gonna get a quick answer. There's no quick way of coming to the correct answer but I think part of the way of being in your everyday thinking is look for evidence. Take some time. Don't jump to conclusions. Try and find some evidence first and then make up your mind. My name is Scott. I think about evidence.