Communication, part II

Ok, so she can communicate.

When an infant is hungry or in pain, for instance, s/he will make certain noises, have certain reactions. New parents (usually) quickly learn to interpret some of these sounds and act appropriately. At first, one wonders what the sound or cry means, and then tries everything until the feedback from the infant shows that the correct solution was at hand. When that cry or sound is reproduced later, the appropriate action is tried first to solve the problem. Thus, the infant is communicating with the parent and the parent learns this from the infant’s feedback.

If Pearlsky is crying as if in pain, I first wiggle and tug on her ears. If she cries out louder, I a) feel like shit and b) know that we are dealing with an ear ache. If there is no reaction, I will reposition her or press on her belly, etc. She is communicatiing she is in pain, I am looking for feedback. This is how I learned that certain cries and sounds mean she is hungry.

If she is on her play table and I hear a certain level of complaining (ok, ‘bitching” at me) and I respond “I’ll get you in a minute, Pearlsky,” she will often stop making the sounds. Yes, communication.

But this is all feeback based, guesses on my part, guesses as to what her “messages” are. The messages are not encoded with letters, are not phoneme based (words), nor are they built up of any elements, hence probably not language. There are a few sounds, mainly differentiated by tone and pitch, that appear to have certain meanings. Does she think, “I am hungry, let me make sound number 2”? I doubt it. These are basic, instinctual sounds that very well may spontaneously happen.

So yes, she does communicate. But we need more.

Let’s take a quick note of three animals …

Clever Hans, a horse, showed communication in the early 1900’s in Germany … (see a great NY Times article here) …

Hans was a horse owned by a Herr Wilhelm von Osten, who was a gymnasium math teacher, an amateur horse trainer andphrenologist, and something of a mystic. Hans was taught to add, subtract, multiply, divide, work with fractions, tell time, keep track of the calendar, differentiate musical tones, and read, spell, and understand German. Von Osten would ask Hans, “If the eighth day of the month comes on a Tuesday, what is the date of the following Friday?” Hans would answer by tapping his foot. Questions could be asked both orally, and in written form. Von Osten exhibited Hans throughout Germany, and never charged admission. Hans’s abilities appeared on page six of the New York Times. ~Wikipedia

Although the secret to Clever Hans’ cleverness was finally discovered and it appears the horse did not have independent thought, it was capable of doing specific actions for specific reasons. Communication? It was found that when Herr von Osten was not in the room, Hans failed at the task. The horse was picking up on subliminal clues.

It is not completely clear, but generally believed that Alex the parrot had some command of language and communication as did Washoe the chimpanzee who was able to use American Sign Language. Those who do not think that Washoe was demonstrating independent thought say …

… that the chimpanzees are not using language, but rather simply using these signs as a means to an outcome, rather than to express meanings or ideas.

We will get pack to our furry friends, but now lets look at Facilitated Communication.

The following information is from The Inclusion Institute at Syracuse University:

Facilitated communication training is useful for teaching individuals who cannot speak or point reliably due to neuro-motor problems such as impulsivity, regulation of movement, poor eye/hand coordination, and difficulty with initiation and sustainment of movement to develop effective pointing skills.

The person who provides support is called a facilitator. A facilitator can be a teacher or other professional, a family member or a friend. This support is highly individualized, based on specific needs. Thus it does not look the same from person to person.

The person who receives the support is called the FC user or simply the communicator.

Examples of Support

Facilitated Communication involves a communication partner, typically called a facilitator, (e.g. teacher, speech pathologist, friend, parent) providing multiple methods of support that may include, but are not limited to the following:

1.    Physical Support:

Physical support may include the following: assistant in isolating the index finger, stabilizing the arm to overcome tremor; backward resistance on the arm to slow the pace of pointing or to overcome impulsiveness; a touch of the forearm, elbow, or shoulder to help the person initiate typing, or pulling back on the arm or wrist to help the person not strike a target repetitively.

2.    Emotional Support:

Emotional support involves providing encouragement, but not direction, as the person points to communicate.

3.    Communicative Support:

Various forms of prompts and cues to assist the FC user to stay focused in the communication interaction, to provide feedback to the FC user on the content of their message, and to assist the FC user in clarifying unclear messages.

One needs only to look at Donald Routh’s commentary in the Journal of Pediatric Psychology to get an idea of what many think of this method … “Commentary: Facilitated Communication as Unwitting Ventriloquism.” Furthermore, the National Institutes of Health (NIH) offers this abstract:

An experimental assessment of facilitated communication.
Ment Retard. 1993 Feb;31(1):49-59
Wheeler DL, Jacobson JW, Paglieri RA, Schwartz AA.

Autism Program, O. D. Heck/Eleanor Roosevelt DDSO, Schenectady, NY 12304.

This report presents a quantitative study of facilitated communication. Participants were 12 people living at an institutional autism program and 9 people who provided them with facilitated communication support. These subjects were the 12 most competent producers of facilitated communication in the program. They were shown pictures of familiar objects and asked to type the names of the objects under three conditions: (a) assisted typing with facilitators unaware of the content of the stimulus picture, (b) unassisted typing, and (c) a condition in which the participants and facilitators were each shown pictures at the same time. In this last condition the paired pictures were either the same or different, and the participant’s typing was facilitated to label or describe the picture. These participants were unable to succeed in the tasks without facilitator assistance. On trials when the facilitators and participants had different pictures, the only “correct” labels were for pictures shown to the facilitators and not shown to the participants. This finding demonstrates that the facilitators were unknowingly determining what was typed.

One of the best papers I have seen, and freely available to read here, is “Clever Hands: Uncontrolled Intelligence in Facilitated Communication” from the Journal of Personality and Social Psychology, 2003, Vol. 85, No. 1, 5 – 19 by two Harvard Professors and one from the University of Virginia. If you have any interest, please read it, but the first and last lines of the paper give it away. The title is a play on the horse, Clever Hans, mentioned previously in this post, a communicating animal that turned out to be secretly controlled by his owner, even though the evidence is the owner did not realize it. And then the last sentence of the paper … “In the right circumstances, each of us might lead others to know what we know and do what we want–even while we fail to realize that we are pulling the strings.”

To be even handed about it, there are studies that show that FC does work.

A validated case study of facilitated communication.
Ment Retard. 1996 Aug;34(4):220-30.
Weiss MJ, Wagner SH, Bauman ML.

Department of Neurology, Massachusetts General Hospital, Harvard University Medical School, Boston 02114, USA.

The case of a 13-year-old boy with autism, severe mental retardation, and a seizure disorder who was able to demonstrate valid facilitated communication was described. In three independent trials, short stories were presented to him, followed by validation test procedures with an uninformed facilitator providing physical support to the subject’s arm. In Trials 1 and 3, several specific answers were provided that clearly indicated that the young man, not the uninformed facilitator, was the source of the information. Moreover, some responses seemed to imply that the subject was employing simple inferential and abstract reasoning. This case study adds to the small, but growing number of demonstrations that facilitated communication can sometimes be a valid method for at least some individuals with developmental disabilities.

And I have heard of other studies where later in life the disabled individual was able to somehow communicate on their own and validated the FC that occured in the past (if anyone has a reference, please offer it).

Now, when I do facilitated communication with Pearlsky, she almost always says …

Daddy is the smartest, greatest, and best dad in the world and all his friends say he is incredibly sexy and wonderful too.

When her mother does it with her, all she says is …

Daddy is a putz.

So, you decide. We have not tried FC and I do not know if we will, I am actually on the fence. Maybe if the correct team came along we would investigate it.

Then there is operant behaviour, something first defined and investigated by B.F. Skinner who was one of the best-known psychologists in the behaviorism school. Skinner theorized that organisms were often influenced in behavior by consequences, and that previous consequences would have an affect on future behavior. Remember the animals I referenced an hour ago in this post? Many believe that they do not truly understand language, they are just using the signs or words as a means to an end. Well, what is wrong with that?

What if I put a big switch in front of Pearlsky and tell her she will be fed when she hits it. Then, when she hits the switch I feed her, if she does not, well, she goes hungry. After a few days she may hit the switch for food. Communication! Maybe not, but, what is wrong with that (other than the visit from social services)? If it works, do I care if it is operant behavior or the start of communication? Do I care if Washoe the chimp really knows language or that he gets his needs via sign language for whatever reason?

So where do we go from here?

I have no idea. I just wish she’d tell me she loves me. Or tells me to f–k off. Either way, I’d be the happiest man alive.