Niemi and Kärnä-Lin (2002) reported an interesting example of the use of facilitated communication in a 21-year-old Finnish man, Tuomas, who had severe motor and communication disabilities. The authors reported an analysis of Tuomas' written productions during facilitated communication over a 3-year period. Most of the material discussed was limited to that produced with his mother, although some were produced with his speech therapist or aide. It is notable that a book has been published based on these productions and attributed to Tuomas as an account of his life.
The authors presented several kinds of evidence that Tuomas was the source of this written material. First, the writing included systematic and idiosyncratic word and grammatical usage. They argued that this kind of production could not be the creation of an adult Finnish speaker. Second, they reported a variety of semantic idiosyncrasies and use of swear words. Third, they argued that the facilitators were unlikely to be the source of the messages because “It seems unlikely that the facilitators could have systematically been this resourceful and consistent; and never would they be this grossly abusive” (p. 353). Finally, they concluded that the author of the written productions is Tuomas. They speculated that the idiosyncratic nature of the written productions may reflect brain damage akin to Wernike's aphasia.
Science requires that, in order to make conclusions, alternative explanations are considered and that hypotheses are generated and tested. Are these data evidence that Tuomas is the author of the writing?
The authors repeatedly asserted that the facilitators were unlikely to be the authors because of the idiosyncratic nature of the writing and because abuse of Tuomas was unlikely. This suggests two possible alternate hypotheses.
First, the facilitators, knowingly or unknowingly, may indeed be the authors of the productions. Researchers have shown that facilitators are the potential source of messages (Wheeler, Jacobson, Paglieri, & Schwartz, 1993). The strength of Niemi and Kärnä-Lin's (2002) conviction that this was not the case in this example is not evidence that the writing was not produced by the facilitators. There are several details that point to this possibility. Toumas only produced written material with his mother and a few other facilitators. The authors suggested that this was because they were the only facilitators who knew how to work with him well. An alternative explanation is that these facilitators inadvertently produced the writing themselves.
The authors also described that when facilitated communication was first employed, Tuomas had only used a few approximations to spoken words: gestures, pictures, and Bliss symbols to ask for food and drink and respond yes and no. They presented no evidence that Tuomas had any use of grammar prior to the introduction of facilitated communication. Yet they go on to describe that within a few weeks full sentences were being produced, including some of the idiosyncrasies of the written productions mentioned above. Such rapid production of relatively mature language in someone with previously little evidence of grammar is remarkable. Indeed, it raises the possibility that these productions are from the facilitators rather than Tuomas.
The authors noted that the use of facilitated communication with Tuomas led to several important consequences for the facilitators. His label of mental retardation was removed from his records. He attended high school and writing courses. He apparently produced moving messages such as “My whole existence as a person has become possible through writing.” His 1999 book, according to the authors, was published by an important Finish publisher.
The second explanation, hinted at by Niemi and Kärnä-Lin (2002), is that the facilitators knowingly produced the material. They dismissed this possibility because they claimed abuse of Tuomas is unlikely. However, abuse and exploitation are relatively common experiences in the lives of people with disabilities, and this possibility should not be dismissed because it is so distasteful.
None of the data presented by Niemi and Kärnä-Lin (2002) are evidence that Tuomas produced these communications. In every case there are more simple, alternative explanations for the observations. The authors end their article with an admonition to presume competence: Science cannot do so. Only through double-blind, controlled procedures will we know who the author of these writings are. I hope it is Tuomas.
Author: Peter Sturmey, PhD, Assistant Professor, Queens College, The City University of New York, Flushing, NY 11367-1597. PSTURMEY@aol.com.