Facilitated communication advocated in CNN-funded documentary
May 22, 2005; updated August 18, 2005; April 10, 2006; November 30, 2006; October 30, 2007; November 9, 2007; February 23, 2008
The CNN documentary, "Autism is a World, " is intended to show the successful use of facilitated communication (FC) by a woman who has autism and can otherwise speak at only a two- to three-year-old level. Sue Rubin is not only the subject of this movie, she is credited with writing its script using FC. It appears that everyone involved in this movie believes FC is genuine. Not one word of doubt is expressed. No one thinks to verify that any of the communications actually come from Rubin and not from her facilitators. In the end, the movie fails in multiple ways. It does not demonstrate that Ms. Rubin actually has autism. It does not show a single instance of independent communication by Ms. Rubin. It does not demonstrate that she understands anything she hears or types. These failures are by design. Had anyone involved in the production made a serious attempt to validate Ms. Rubin's communications, she would have been shown to be incapable of doing the things the movie pretends she can do.
Facilitated communication is a technique that creates the illusion of communication by having a "facilitator" guide the hand or arm of another person typing on a keyboard or using a pointing device. Some FC users become so sensitive to subtle cues of that the facililator may not appear to be physically influencing the communications. The question then becomes why the facilitator needs to be there at all. A variation of this technique has the facilitator hold the typing device rather than the person's arm or hand. In "Autism is a World," a tiny keyboard is moved beneath Ms. Rubin's finger as she presses the keys. Nearly invisible cues are given to her to create the illusion that she is producing the typed words. Ms. Rubin is never shown using a keyboard she holds herself. She never uses a keyboard placed on a table to prevent its movement by the facilitator. In some scenes, the facilitator reads whole words and phrases after just a few letters are typed. Close-ups, edited in after the fact, always show carefully guided perfect typing. The real typing is not so precise. For some scenes, entire statements were preprogrammed into Rubin's communication devices.
The proponents of FC claim that their technique reveals that autism and some other disorders are physical rather than mental--that people with autism in particular have "good minds trapped in bad bodies." Indeed, the movie indulges the sentimental misconception that inside every person with autism exists a wise philosopher-poet.Yet after over two decades of promoting FC, its advocates have not produced a single properly controlled scientific demonstration of independent communication using the technique. Dozens of empirical studies, along with tests of independent communication required by courts, invariably show that the facilitator is the author of the typing (Wheeler). The few empirical studies that claim to have "authenticated" FC cannot reproduce the FC performance seen in the movie. Indeed, the best outcomes of these studies--highly unreliable responses coming only after weeks or months of guided practice--suggest accumulating expectancy and observer biases rather than valid communication. Facilitated communication has been the source of numerous false accusations of sexual abuse. Unsurprisingly, the movie says absolutely nothing about lack of empirical support for FC. It offers no independent evidence that Ms. Rubin is herself the author of the words attributed to her. It entirely ignores the dangers FC poses when facilitators consciously or unconsciously make false accusations of abuse.
Ms. Rubin has attended classes at Whittier College in California with the support of its upper administration (press release). She has the endorsement of Whittier's student psychological organization, PSI CHI (newsletter). This endorsement has been made despite the fact that PSY CHI is affiliated with the American Psychological Association (APA), and the APA policy questions the validity of FC (resolution). The movie shows no evidence that anyone at Whittier has questioned the authenticity of Ms. Rubin's communications. That is, no one at Whittier seems concerned that a woman who can supposedly pass college-level courses and write a movie script cannot navigate a hallway without assistance.
"Autism is a World" credits Ms. Rubin with an IQ of 133, well in to the genius range. Yet, the movie also shows that Ms. Rubin is unable to perform even the simplest self-care skills without prompting and assistance. She requires 24-hour custodial care and is guided wherever she goes by an attendant or facilitator. She communicates vocally at a 2-3 year-old level, and her other behavior seems correspondingly infantile. Untreated compulsive mannerisms interfere with her few functional behaviors. Despite the reported IQ of 133, and the repeated claims that Ms. Rubin writes articles and speeches via facilitation, the movie reveals that she is unable to dial 911 on the telephone by herself. Although the movie attributes Ms. Rubin's behavior problems to "autism," that attribution is inaccurate and misleading. Ms. Rubin has been reportedly diagnosed with a deletion of chromosome 2q37, a known condition that produces a wide range of congenital defects, including skeletal malformations and severe developmental disabilities (NLM/NIH). The "autism" label is hardly a surprise. Nowadays, it seems that almost every type of developmental disability with cognitive impairment is labeled "autism" even when it does not meet the DSM criteria for autism.
"Autism is a World" was co-produced by CNN (a Time/Warner Company), State of the Art Productions, and Douglas Biklen, Dean of the Syracuse University College of Education and founder of the Facilitated Communication Institute (criticism of Biklen appointment). "Autism is a World" had its national television premier on CNN on May 22, 2005, and was given multiple showings over the Memorial Day weekend in 2005 (press release). It was rebroadcast on CNN during prime time over the weekend of November 25-26, 2006 and on other occasions. CNN ("The Most Trusted Name in News") and other organizations such as Newsweek, Time Magazine, People Magazine, the Nancy Lurie Marks Foundation, and the Autism Society of America have become heavily involved in the promotion of "Autism is a World" and facilitated communication generally. The Autism Society of America gave "Autism is a World" its "Media Excellence Award" (press release). The Nancy Lurie Marks Foundation, a supporter of Biklen's Facilitated Communication Institute, funded the distribution of 16,000 free copies of the movie to pubic libraries. CNN has also made arrangements for "Autism is a World" to be shown commercial-free in schools as a classroom activity. An accompanying CNN-produced study guide for children has been made available on the CNN web site (CNN Student News) Like the movie, CNN's study materials take the effectiveness of facilitated communication for granted. The study materials say nothing about FC's history of producing false accusations of sexual abuse and its lack of scientific credibility. By doing these things, CNN, a highly respected news organization, and its parent company, Time Warner, have become the world's largest and most active promoters of a pseudoscientific intervention for autism.
1. To date (2-23-08), there have been no scientifically verifiable demonstrations that Ms. Rubin can or has has communicated independently.