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This paper explores the authorship of the written production of children with autism who need to be physically and emotionally supported by a competent interlocutor in order to communicate. Facilitated Communication is a technique developed for this purpose. However, a significant part of the scientific community considers it a controversial technique because of the difficulty in determining the authentic author of the message. The aim of this study is to examine the written communication of six autistic boys in order to investigate and determine direct or indirect evidence of authorship. In particular, the focus is on the process of communication itself, to find behaviours or written expressions that could disprove the hypothesis of a direct influence of the facilitator. Six secondary school students diagnosed with autism participated in this study. Each student participated in 8 sessions of facilitated communication, 4 with one parent at home, 4 with an educator at school, both parent and educator assuming the role of facilitator. According to our data, evidence of authorship was represented in all categories supporting our hypothesis that facilitated communication can be authentically based both on authentic interactions and messages between both partners. © 2012 Associazione Oasi Maria SS. - IRCCS / Città Aperta Edizioni.
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Abstract
This paper explores the authorship of the written production of children with
autism who need to be physically and emotionally supported by a competent
interlocutor in order to communicate. Facilitated Communication is a techni-
que developed for this purpose. However, a significant part of the scientific
community considers it a controversial technique because of the difficulty in
determining the authentic author of the message. The aim of this study is to
examine the written communication of six autistic boys in order to investigate
and determine direct or indirect evidence of authorship. In particular, the
focus is on the process of communication itself, to find behaviours or written
expressions that could disprove the hypothesis of a direct influence of the fa-
cilitator. Six secondary school students diagnosed with autism participated
in this study. Each student participated in 8 sessions of facilitated communi-
cation, 4 with one parent at home, 4 with an educator at school, both parent
and educator assuming the role of facilitator. According to our data, evidence
of authorship was represented in all categories supporting our hypothesis
that facilitated communication can be authentically based both on authentic
interactions and messages between both partners.
Keywords: Autism, Facilitated communication, Authorship.
Received: : September 06, 2012, Accepted: December 03, 2012
© 2012 Associazione Oasi Maria SS. - IRCCS / Città Aperta Edizioni
1Department of Psychology, University of Firenze. E-mail: lbigozzi@unifi.it
2Department of Formation, DISFOR, University of Genova. E-mail: Mirella.Zanobini@unige.it
3Department of Psychology, University of Firenze. E-mail: christian.tarchi@gmail.com
4Department of Formation, DISFOR, University of Genova. E-mail: robertacamba@tiscali.it
5Department of Formation, DISFOR, University of Genova. E-mail: fliuba@yahoo.it
Correspondence to: Telephone number: +390552055843; Fax number: +390556236047
E-mail address: lbigozzi@unifi.it
55
Life Span and Disability XV, 2 (2012), 55-74
Facilitated communication and autistic children:
the problem of authorship
Lucia Bigozzi1, Mirella Zanobini2, Christian Tarchi3,
Francesca Cozzani4 & Roberta Camba5
1. Introduction
This paper explores the authorship of written production for children with
autism who need to be physically and emotionally supported by a competent
interlocutor in order to facilitate written communication. This type of technique
has been called Facilitated Communication (FC). It was created in the 1970s
by Rosemary Crossley for individuals with limited or non-existent access to
oral language, and it was then, subsequently, applied to individuals with autism
(Biklen, 1990).
This technique is considered controversial by many in the scientific com
munity, and it is not an approved technique for the communication-impaired
(Mostert, 2001).
As Duchan (1993) pointed out, this method has become controversial for
a number of reasons, above all, for a lack of consensus about its success. As a
matter of fact, children and adolescents using FC can be considered in a certain
sense both competent and incompetent communicators. Through this techni-
que they can spell messages that otherwise they could not express. But these
persons need much more support than most communicators do, and they are
more susceptible to external influence.
A primary factor in determining whether FC is effective or not relates to
message authorship, namely assessing the authentic author of each message.
The authorship issue is rooted in the method’s very nature, as FC is a shared
communication method. As pointed out by Bebko, Perry and Bryson (1996),
the contribution of the adult communicator in this process is twofold: they con-
sciously supports the communication process; but on the other hand, the com-
municators can unconsciously influence the content of the messages by
providing, for example, some subtle cues to the disabled communicator about
an acceptable response through increased or decreased resistance to the inter-
locutor’s movements. Clearly the first contribution approach type is necessary
– at least for a certain period – to allow the individual to communicate freely
without hindrance; however, the second methodology type would represent a
confounding variable. For this reason, the authors stressed how this kind of
support can take many different forms: it could be present and continuous, or
present but intermittent, or it may not be present at all.
The purpose of this study is to contribute to the debate around FC and messages
authorship. The aim of this contribution is not to show that FC has a positive
effect for all individuals, but to analyze under what circumstances this type
of communication might prove of greatest benefit. In the past decades, the in-
discriminate use of interlocutor facilitation has led to the suspicion that it is
often the facilitator who writes rather than the autistic person.
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Life Span and Disability Bigozzi L. et al.
On the other hand, the almost complete interruption in scientific debate on this
topic in the last decade is unfortunate for two reasons:
1. Despite the fact that most of the available literature concludes that in-
tellectually disabled FC users’ communication is the result of inadver-
tent facilitator influence, the technique continues to be used and the
scarcity of studies means that there are many unanswered questions
(Grayson, Emerson, Howard-Jones, & O’Neill, 2011);
2. there is some evidence deriving from naturalistic studies as well as from
controlled research that FC users have been the authors of some written
information unknown to the facilitator (Cardinal, Hanson, & Wakeham,
1996; Sheenan & Matuozzi, 1996; Weiss, Wagner, & Bauman, 1996);
in particular, Weiss and colleagues (1996) observed an autistic child in
a message passing situation, but concluded just the same that there are
at least some individuals for whom FC appears to be a valid method of
communication.
For all these reasons, it makes sense to further explore the issue of authorship
in FC settings.
First, what does “evidence of authorship” mean?
Most of the literature supporting FC has attempted to find evidence validating
the method, analyzing spontaneous productions emerging from “natural” set-
tings. In descriptive studies, the main evidence for authorship considered were:
consistent misspelling, unexpected words, the unusual content of some mes-
sages and evidence of word-finding difficulties. Moreover, communications
occurring in spontaneous settings and containing information unknown to the
interlocutor were considered as strong evidence of authorship.
Sceptics are likely to require more stringent evidence: such as the com-
municator’s ability to type messages that contains information not known to
the facilitator in controlled settings, or the ability to type messages with no
physical support. In experimental situations, researchers have used message-
passing tasks. Most results collected with this method have shown that the
communicator is not able to write when the facilitator does not know the topic.
However, there are some exceptions. For example, Cardinal et al. (1996) adop-
ted a research design considering three conditions (baseline 1, facilitated con-
dition and baseline 2) and a total of 110 trials to test the main hypothesis: namely
that facilitated communication users could type words which were unknown to
the facilitator, randomly from a 100-word set. The results showed that:
− In the controlled condition some FC users could pass information to a fa-
cilitator even though they were not aware of that information;
− The number of words accurately written in this message, increased when
there was the opportunity for further practice;
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Authorship in facilitated communication in autism
− The participant’s performance in the non-facilitated baseline 2 condition
was better than in baseline 1, a fact which suggests the subject was learning
how to type without physical support.
This study emphasized the importance of avoiding over-controlled situations,
where not only the facilitator is unaware of the words being typed, but where
he/she is given misleading information and wears ear-phones. As we pointed
out before, the study also stressed the importance of practicing on the basis of
the test situation. Researchers have suggested many ways in which findings
can be better investigated. Certainly, it is important to understand why some
of the participants failed to pass-on any information during the test trials.
Duchan (1993) suggested innovative ways of conducting video-analysis
or video-microanalysis of natural and spontaneous communication. Indeed, it
is difficult to understand the authorship of a message without analyzing the
context of the communication. A careful study of the communication process
allows the observer to collect evidence on how the communicator constructs
their message (Duchan, Calculator, Sonnenmeier, Diehl, & Cumley, 2001).
First of all, it is possible to study the degree and type of physical support
required. This is a very important question, since most of the criticisms of FC
authorship are based on cases in which the communication facilitator supported
the hand or the wrist of the disabled person, making it difficult to visually deter-
mine the origins of the movement, as the facilitator’s hands and the FC user’s
move together. Bara, Bucciarelli and Colle (2001) avoided involvement in the
controversy by selecting only subjects that showed a good level of autonomy in
using FC. According to these authors, a hand on the shoulder or the thigh excludes
the possibility that the facilitator affects the answer of autistic participants.
Furthermore, it is possible to video-record when and how often FC users
look at the keyboard, and to analyze the direction of their gaze. This suggestion
is very important because the possibility of connecting looking and typing or
pointing actions could confirm the authorship of the written productions.
For the author, video-microanalysis also allows the observer to examine
participants facial expressions and the content of affective messages. The po-
tential connection between the two events should make it difficult to attribute
the content of the message to other persons.
Duchan and collaborators (Duchan, 1993; Janzen-Wilde, Duchan, & Hig-
ginbotham, 1995) also proposed a psycholinguistic analysis of facilitated wri-
tings in order to come to some pertinent conclusions about the consistency of
communicative ability over time and in different contexts, thereby indirectly
contributing to the debate about the authenticity of facilitated production.
These authors identified six characteristics that, in contexts of natural interac-
tion, might be indicative of the authorship of the message by FC users: unex-
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Life Span and Disability Bigozzi L. et al.
Authorship in facilitated communication in autism
pected content, unconventional spelling, writing of entire sentences without
physical support, giving information unknown to the facilitator, oral spelling
and self-corrections.
These suggestions have been almost completely ignored by the international
scientific community. The qualitative nature of most data in favour of author-
ship and the repetition of the same results in experimental studies have made
this topic practically “taboo” and, in the last ten years, there has been an almost
complete absence of scholarly publications on the topic.
Rare exceptions were some studies directed on the linguistic features of FC.
A few studies on individual cases (Zanobini & Scopesi, 2001; Niemi & Karna-
Lin, 2002; Scopesi, Zanobini, & Cresci, 2003; Zanobini, Camba, & Scopesi,
2008; Zanobini, Camba, Cozzani, & Scopesi, 2011) documented the specific
characteristics of facilitated language: rich in rare words, and forms and gram-
matical constructions typically not used by adults. Also, one textual analysis
study (Bernardi, 2008) conducted with thirty-seven Italian autistic persons re-
vealed that the lexicon of the autistic persons was richer in uncommon expres-
sions than either the facilitators’ lexicon or the control group’s (six persons
with typical development).
Grayson et al.’s study (2011) offers a valid starting point for encouraging
renewed interest in this field. The authors suggested that a systematic obser-
vational inquiry could add useful knowledge to this topic. The principal aim
of their study was to precisely and reliably describe the relationship between
an FC user’s looking and pointing behaviour by employing specialist eye-trac-
king equipment and through video analysis. The main research hypothesis was
that if the FC user involved in this case study was really the author of the texts
that were constructed during the data collection sessions, then one would ex-
pect to see a systematic relationship between looking and pointing. Supporters
of the facilitator-influence hypothesis would interpret Grayson et al.’s findings
by affirming that any existing relationship is ‘caused’ by pointing, which, in
turn, is influenced by the facilitator. In other words, the FC user is simply fol-
lowing the trajectory of their (guided) finger with their eyes. However, beyond
just finding a correlation, Grayson et al. showed how simply the action of loo-
king systematically preceded that of pointing.
In order to show that the FC-user was the author of the typed text, they hy-
pothesized that the FC user was making visually guided and intended move-
ments towards letters, and therefore needed to look before pointing to them.
Two principal hypotheses were tested:
1) There would be a systematic relationship between looking and pointing,
which cannot be attributed to only “chance”.
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Life Span and Disability Bigozzi L. et al.
2) Fixation durations on to-be-typed letters would be on average longer than
fixation durations on not-to-be-typed letters.
The results showed a strong relationship between the actions of looking
and pointing. Furthermore, fixations on the to-be typed letters were on average
longer than fixations on irrelevant areas of the keyboard.
Taking into consideration the strong evidence supporting this technique,
included in Grayson et al.’s work (2011), along with Duchan et al.’s sugge-
stions (Duchan, 1993; Janzen-Wildeet et al., 1995), the aim of this study was
to examine the written communication of six autistic boys. The examination
aimed to see if it were possible to find direct or indirect evidence of authorship.
In particular, the focus was on the process of communication in order to seek
out behaviour or written expressions that could disprove the hypothesis of di-
rect influence from the facilitator.
The six subjects were expected:
− to write comments in disagreement with the adult;
− to anticipate some written language with congruent behaviour or oral
language when that was present;
− to write information not known to the adult.
The adult communicator, meanwhile, was expected:
− at times to “wrongly” anticipate the subjects’ written text;
− to need occasional clarification from the six participants in order to un-
derstand their language.
In synthesis, if evidence is found supporting the idea that on some occasions
some autistic people can write without the direct influence of another person,
then this form of communication is valid and authentic. Most importantly, it
means that autistic people are able to express their own thoughts through FC.
2. Method
2.1 Participants
Six secondary school students participated in this study (table 1). Five of
them were diagnosed with autism with absence of spoken language, whereas one
of them was diagnosed with fragile-X syndrome with some linguistic production.
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Authorship in facilitated communication in autism
Table 1 - Description of participants: age, school, diagnosis
and experience with FC
Age School ICD 10
Diagnosis
Experience
with FC
P1 14 years and
3 months old
Grade 9,
Scientific Studies Infantile autism 4 years
P2 16 years Grade 10,
Classic Studies Infantile autism 10 years
P3 16 years and
3 months
Grade 10,
Classic Studies
Fragile X,
autistic syndrome 10 years
P4 14 years and
6 months old Grade 8 Infantile autism 9 years
P5 15 years and
3 months old Grade 9 Infantile autism 8 years
P6 16 years and
1 months old
Grade 10
Artistic Studies Infantile autism 9 years
Participants were selected according to the following criteria:
- each student had been using FC for at least 5 years
- they had a certain autonomy in writing, that is they only needed a contact
on their shoulders or another part of their body not directly involved in
the process of writing (see table 2).
Table 2 - Type of facilitation
61
2.2 Procedure
For the diagnosis of autism, existent evaluations were used. The diagnostic
documentation for each participant was screened in agreement with parents and
educators. Where the documentation was incomplete, participants were assessed
through CARS (Schopler, Reichler, & Renner, 1988), in collaboration with the
professionals who represented the clinical point of reference for the families.
During a preliminary meeting the aims of the research were explained and
the consent forms for the overall evaluation and the videotapes of the sessions
were filled-out by parents and educators.
Each student participated in 8 sessions of facilitated communication in natural
settings, 4 with one parent, 4 with an educator, both of them assuming the role
of facilitator. Each session lasted at least 40 minutes. Each time the participant
was not feeling comfortable with the procedure, the session was suspended
and re-scheduled. Facilitated communication sessions were video and audio-
recorded and transcribed. Furthermore, two independent observers were pre-
sent during the sessions and their observations were integrated into the
transcripts. The observers carefully took notes on the essential context: start
and finish times, pauses, type of support and situation.
In each session the following procedure was followed. After an initial step
of familiarization in the presence of the observers, participants were given a
general instruction: “What would you like to talk about today?” In this way,
the participant-facilitator dyad was inserted in a working situation similar to
their usual ones.
At the end of each session, the observers asked the facilitator questions about
how typical/atypical the session had been; the presence of unexpected content
and/or unknown information within the participant’s interventions was noted.
2.3 Data analysis and coding system
All video-recordings were transcribed immediately after the FC session by
one of the two observers, and doubtful cases were discussed with the other obser-
ver. Complete transcriptions included: participants’ written productions; facilita-
torsoral production; notes from the observers; notes from the video; changes in
facilitation; physical contacts between the facilitator and the subject; and stereo-
typy, or the subject’s behaviour when it interfered with his writing activity (Camba
& Zanobini, 2010). Transcriptions were integrated with a microanalysis of the vi-
deos, allowing for an accurate report of each participant’s individual behaviour in
terms of the sequence of events. In those cases in which the writing of words and
sentences was interrupted by one of the participant’s oral interventions or some
non-verbal act, these interventions were reported in the correct sequence, distin-
guishing between oral language, written language, and non verbal behaviour.
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Life Span and Disability Bigozzi L. et al.
Authorship in facilitated communication in autism
From an analysis of the participants’ writings and from the relationship between
the writing and the verbal and non-verbal behaviour of the participants, evidence
for authorship was extracted; that is, evidence that texts typed by the children
were authentic. This authorship evidence was derived from either participants’
behaviour or from the facilitators’ behaviour. Evidence could support either phy-
sical motor independence/autonomy (i.e. written production without any facili-
tating contact) or a psychological equivalent (i.e. suggestion and/or exhortation
disregarded by the participant).
The coding system used to collect data on authorship for the written pro-
ductions is presented in table 3.
Table 3 - Coding system for authorship evidence
63
3. Results and discussion
According to our data, all categories of authorship evidence were represented.
The most frequent categories were the ones highlighting a disagreement bet-
ween facilitators and participants. Five participants produced written answers
that resulted in an incongruence with the facilitator’s interventions, 18 times
across the sample. Four participants produced written comments in open disa-
greement with what the facilitator had just said, or in the form (i.e. spelling)
or in the content, 21 times in all. Vice versa, the facilitator openly disagreed
with 4 of the participants, a total of 18 times. Four participants showed an emo-
tional reaction to the working situation and/or the facilitator that congruently
anticipated his written productions (e.g. giggling before writing something
funny), for a total of 10 times. Three participants wrote information that was
unknown to the facilitator, a total of 9 times. Two participants orally anticipated
their written productions a total of 9 times, and the same number was asked by
the facilitator to clarify the meaning of a word or a statement that they had pre-
viously written, for a total of 5 times. Finally, only one student autonomously
wrote two sentences, without any physical and facilitating contact (see Table 4).
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Life Span and Disability Bigozzi L. et al.
Authorship in facilitated communication in autism
Here the data for each category will be discussed in detail.
3.1 Autonomous writing, without facilitation
In the third session between P3 and his parent, while the participant was
writing “We can have a healthy...”, C, the facilitator moved her left hand from
P3’s right shoulder (facilitating contact), and the participant wrote the sentence
without any contact. The situation occurred again in the same session when
P3 began writing a sentence with a facilitating contact, but finished it without
any contact with the facilitator (i.e. the written parts in bold without facilitating
contact “how we all behaved”; “just like real ladies magnificently well “When
are we seeing each other again?”).
This is the most compelling evidence that the author of the written message
is himself the facilitated person. The fact that the subject was able to write wi-
thout any contact, however, in the presence of the facilitator, suggests that the
facilitator plays, at times, only an emotional supportive role. This evidence
clarifies that the contact works as a sign of presence, to reassure the facilitated
boy/girl, and not as a modality to pilot the facilitated person’s movements on
the keyboard. For this reason, when the facilitated person feels confident with
the activity, the presence of the facilitator is enough.
65
Table 4 - Frequencies and participants rates for authorship evidence categories
Life Span and Disability Bigozzi L. et al.
When data were collected, only one subject was writing autonomously.
Currently P3 is able to write without any facilitating physical contact.
3.2 Participant’s comment in disagreement with the facilitator about
form or content
The fourth session between P6 and his parent:
F: “You have to finish this session, it just takes 10 minutes”
P6: “AND I SAY I HAVE HAD ENOUGH OF ALL OF YOU...”
In the first session between P3 and his educator:
F: “I accept it, chatterbox. Now tell me something deeper”
P3: HUMOR IS A HIGH DEMONSTRATION OF INTELLECTUAL ABILITY
In the fourth session between P4 and the educator:
P4: I WAS IMAGINING THAT THE LITTLE FRIEND IN THE SIMPLICITY
OF THE HAPPY EXPRESSION FEELS A LOT OF JOY
F: “You should put the brakes on this sentence or you’ll get lost. I suggest you
put a full stop”
P4: SMALL THOUGHTS I HATE
A disagreement between the facilitated person and the facilitator was often
found in our data in both directions.
The comments made by the facilitated person in disagreement with the fa-
cilitator were the most frequent category of evidence for authorship. If it is
true that facilitators direct the movements of the facilitated person, then SI-
MILARILY SO would all the facilitators who participated in this study have
pushed the students to write sentences in open disagreement with what he/she
had just said or written?
These examples ALSO support too the hypothesis that the communication
taking place between the two individuals (student and educator) is real and au-
thentic. Indeed, it is typically adolescent to continually disagree with a “signi-
ficant” adult and for the adolescent to express his own thoughts.
3.3 Facilitator’s disagreement with the participant about form or content
In the first session between P6 and his parent:
P6: I NEED SOMEONE WHO SPEAKS FRENCH
F: But why? You speak French, plus you had a teacher and you still did not
want to do this. Why do you need someone who speaks French? You know,
it is you who has to write, not the other person.
66
In the first session between P5 and his parent:
F: What do you prefer, pizza or disco?
P5: DISCO
F: I organized a Pizza, you knock me out, P5!”
[…]
F: Do you want to invite the professors too?
P5: NO
F: Noooo, why not?
In the second session between P4 and his parent:
P4: DAD MUST TAKE ME
F: Where?
P4: PLACE SWIMMING-POOL
F: You know that Dad, on Tuesdays, can’t take you because he works. On Satur-
days, when he could be free, you go to school
In the fourth session between P1 and his educator:
P1:IN KINDERGARTEN, NO ONE HAS EVER MADE SOAP BUBBLES
FOR ME
F: Poor guy, no one has ever made soap bubbles for him, poor guy! How many
lies you tell! In primary school I remember how we used to play with soap
bubbles.
In the first session between P3 and his educator:
P3: LEAVE ME ALONE!
F: Only if we talk a little[…] otherwise they will think that we are just playing
In all these examples, just like the preceding category, there is no agreement
on the content of the discussion. Consequently, the two participants had to ne-
gotiate the meanings of the discussed topic, and this represents evidence that
each participant is the author of his/her messages. It is highly unlikely that all
the facilitators artificially created conflicts and interpreted both sides alterna-
tely, theirs and the autistic person’s. Furthermore it must be noted that, though
this research did not aim at proving the efficacy of this method, this category
also represents a proof of effective communication.
3.4 Participant’s answers incongruent with the facilitators interventions
In the third session between P1 and his educator:
P1: I AM NOT ALLOWED TO CHOOSE WHETHER W….
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Authorship in facilitated communication in autism
F: What does “W” mean? (the facilitator cancels the W)...whether, come on!
P1: WRITING OR DOING SOMETHING ELSE
In the fourth session between P3 and his educator:
P3: IMAGES ASSOCIATED TO THE IMAGO (he cancels the “O”)
F: Ah, I thought you wanted to quote from Latin, eh? [in Latin, imago= image]
P3: E [to complete the word “image”]
In the second session between P2 and his parent:
F: Shall we revise the lesson?
P2: SO (in Italian these are the first to letters for the word “sono”, which is “I
am” in English)
F: “So” is neither yes (“si” in Italian) nor no (“no” in Italian), answer me!
P2: SONO ATTRATTO DALLA TELECAMERA (in English: “I am attracted
to the video-recorder”)
In the third session between P4 and his educator:
P4: CAN I JUST MAKE A SMALL CRI
F: I thought it was a question
P4: TICISM
F: Ah, now I get it!
In the first session between P6 and his parent:
P6: I CERTAINLY WON’T GET GOOD MARKS AT THE END-OF-TERM
ASSESSMENT
F: Why not? Why do you think that that is?
P6: I WANTED TO CRY MY EMOTIONS TO THE WORLD
In this category, the autistic participants followed their own line of thought,
even if incongruent with the facilitator’s input. Again, it is highly unlikely that
such a situation was artificially created by all facilitators.
3.5 Information not known by the facilitator
In the second session between P2 and his educator:
P2: I WAS WORRIED ABOUT YOUR POSSIBLE ABSENCE AT SCHOOL
TO DECIDE STUDYING SUBJECTS
F: ...Come on, I do not understand... I did not know that there would have been
this to decide, who did you hear it from?
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Life Span and Disability Bigozzi L. et al.
In the second session between P6 and his educator :
F: What were you talking about in your group? I have not been with you for a
very long time. I was not with you TODAY, I do not know what you have been
doing, come on
P6: I WILL TELL YOU ABOUT WHAT WE HAVE DONE TODAY WHEN
THERE WAS TOMMASO WITH ME: WE HAVE WATCHED A MOVIE I
DO NOT REMEMBER THE TITLE IT WAS ABOUT A YOUNG UNI-
VERSE OF RENOUNCERS WHO WANTED TO EXPAND THEIR WORLD
OF BIG NATURAL TREASURES. I LIKED IT A LOT, BECAUSE I THINK
THAT I AM TOO PART OF THIS SOCIETY AND THAT I AM NOT A RE-
NOUNCER, BUT TENACIOUS OF LIFE AT ALL COSTS
In the third session between P5 and his educator:
F: Did you get an Easter Egg?
P5: NO
F: why?
P5: BECAUSE I AM ON A DIET
This category represents strong evidence supporting the authorship of messages.
Indeed, this category described situations in which the facilitator asked the au-
tistic student information which was not known to him. Consequently, all the
content of the participant’s subsequent message can be attributed to the parti-
cipants alone.
3.6 The participant orally anticipates his/her written production.
In the first session between P3 and his educator:
P3: IF YOU WANT TO VERIFY MY KNOWLEDGE AND MY LEXICAL
PERTINENCE
P3: [speaking] I said
P3: I SAID…
As already noted, the majority of participants in this study are not able to speak.
Nevertheless, in the case of the single subject who was able to speak fluently,
his verbalization sometimes preceded the corresponding written production,
showing evidence of planning.
3.7 Facilitator’s request to clarify the meaning of words or statements
In the third session between P1 and his parent:
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Authorship in facilitated communication in autism
P1: THE EXTREMELY SECURE AND BRAVE STUDENT PROCEEDS
WITHOUT HESITATION, HAPPY WITH THE CONSTANT AND DILI-
GENT PREPARATION SURE IN HIS BRACES
F: No, P1, what do those braces have to do with it, please? What do the braces
have to do with all this?
P1: SO HE FEELS
F: What does it mean? What does he feel?
P1: NOTHING LESS THAN THE PROUD OCCURRENCE OF THE DUCE
[Benito Mussolini] WHEN HE LOOKED OVER FROM THE BALCONY
OF PIAZZA VENEZIA
In the third session between P4 and the educator:
P4: READY NOW WILL YOU BE ABLE TO TALK TO ME SWEET...
F: Sweet. Ready now you’ll be able to talk to me sweet. Sweet what?
P4: LY
F: Ah, I understand
This category supports the hypothesis that autistic participants are the authors
of their own messages. Indeed, the subject produces a message that is not fully
understood by the facilitator, who, in turn, has to interrupt the communicating
process to explicitly request context clarification. Only the subject, as author
of the message, can disclose the authentic meaning of the message and re-start
the communication process.
3.8 Participant’s emotional behaviour or reactions that congruently
anticipate his/her verbalizations
During a first session between the P4 and his mother
F: “Did you like the ballet?
P4: OK?
F: “Was it OK?”
P4: OK
F: “I am not sure whether this is your answer”,
P4: Makes an expression of disappointment with his face, along with some
grumbling sounds.
F: “Let’s complete the sentence, it is not enough.”
P4: Agitates his feet and writes: HEAVY IS YOUR INSISTENCE
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Life Span and Disability Bigozzi L. et al.
The verbal antecedents, significantly connected to the content of the written
production, are evidence of a genuine intention that precedes and guides the
act of writing. Even if we wanted to support the hypothesis that all facilitators
in our study are able through a distal contact to “magically” communicate with
the autistic subjects, no one would suggest that the facilitator can induce the
subject to show specific non-verbal behaviour, congruous and synchronous to
the corresponding written communication.
4. Conclusions
This study is based on the suggestion that a video analysis of naturally oc-
curring social interactions can shed light on the communicative process that
takes place during facilitated communication. First of all, this method can yield
reliable quantification and accurate descriptions of the behaviour found here
(Duchan, 1993; Grayson et al., 2011). As expected, the study has revealed
some evidence that disproves the hypothesis of direct influence between the
facilitator on the content of the written communication of the autistic subjects.
First of all, the video analysis allowed us to check facilitation and to be sure
that, throughout the registered sessions, no facilitator supported hands or wrists
as they were involved in the written process.
Furthermore, analysis of the sequence of the taking of turns of the two in-
terlocutors has allowed this study to focus on strong evidence of authorship.
Independent writing, for example, even if present only in one participant, our
data shows that the facilitator’s support is not always necessary (Konstantareas
& Gravelle, 1998). Strong evidence of authorship includes the connection bet-
ween non-verbal behaviour, namely, and the content of the written text, on the
one hand, (Duchan, 1993) and on the other, and the oral anticipation of some
part of the written text. Finally, the dialogue sequences often includes requests
for clarification to clear-up misinterpretations and resolve possible conflicts
of character in the reciprocally sensitive roles of the interlocutors.
A problem with this study is the limited quantity of evidence collected. This
fact is explained not only by the small size of the sample and the corpus of
the written texts, but also by the tendency to be conservative in the analysis of
the patients’ behaviour that might be considered factual proof. For example, it
was not always possible to see the expression of the subject on the video. We
codified a certain behaviour or sequence of acts as evidence only when all the
information was available.
Caution is necessary especially where practices are controversial (Duchan,
Calculator, Sonnenmeier, Diehl, & Cumley, 2001).
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Authorship in facilitated communication in autism
This study did not aim at proving the efficacy of Facilitated Communication.
It focused rather on this method’s “authenticity”. Our data strongly supports
the hypothesis that the six boys were the authors of their written messages.
The efficacy of this method in improving the quality of life among the autistic
and their families remains open. We think that further research is justified, taking
into account, naturally, the opinion of autistic persons (Gernsbacher, 2007).
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