Tuesday, November 24, 2009

Facilitated Communication for 23-Year Coma Man?

In the newspaper yesterday, it was a heart-rending story. A man lies in a coma for 23 years, until a brain scan reveals he is actually conscious after all, and has been all that time. He is given a keyboard, and wow! He can tell us all about his thoughts and feelings, and how he coped throughout his long imprisonment, trapped inside his own body.


On TV last night, it looked like something else. Rom Houben was not exactly typing out his own messages. They were being typed by a "helper" who was holding his hand and carefully aiming his index finger at a flat touchscreen. He did not appear to be even looking at the screen (as you can clearly see in these pictures from the BBC & Guardian), yet he typed with amazing speed and accuracy. Now read this extract from the Facilitated Communication (FC) page at the Skeptic's Dictionary:

FC clients routinely use a flat board or keyboard, over which the facilitator holds their pointing finger. Even the most expert typist could not routinely hit correct letters without some reference as a starting point. (Try looking away from your keyboard and typing a sentence using just one finger held in the air above the keyboard.) Facilitators routinely look at the keyboard; clients do not. The messages' basic coherence indicates that they most probably are produced by someone who is looking at the keyboard.
The resemblance is uncanny, is it not? Needless to say, FC is complete bollocks. It is easy to test: show the patient some stimulus or other with the facilitator absent, then bring them back in and ask what it was. If they can only "see" what the facilitator has seen, it is not communication. Has this been done for Coma Man? None of the stories I have read seem to have mentioned this possibility. Are we being taken for a ride?

I will expand this post later if I have time to find the full article...

UPDATE: I have found the journal article mentioned in the news stories above. It's open access and can be read here. It's an interesting study of 103 patients, comparing different diagnosis methods. It doesn't include any details of individual cases but it does say that the main indicator of consciousness was "purposeful eye movements" rather than the foot tapping mentioned in the Grauniad article. This paper clearly isn't the source of the story. More digging needed...

UPDATE 2: Now the mighty Randi is on the case. He seems pretty sure it's a cruel farce. PZ Myers is sceptical too, but it also looks like the story is proving popular with right-wing yanks keen to restart the Terri Schiavo debate. I smell a rat. I smell a giant rat...

UPDATE 3 (Wednesday): Now it's getting ridiculous. The Grauniad today has a full page on the case, again without a single sceptical word. There is more detail of the foot movements mentioned in the earlier article, but it stinks!
Nicolaes (Rom's mother) recalled: "We needed to make him press the mouse. But how? He was lying down. He's very spastic. He can't control his movements. The doctor saw that he was moving his right foot. We put the mouse under the foot and were shouting, 'Push, Rom, push, Rom, push.' And he pushed. The computer said 'I am Rom'."
This is just plain daft. He goes in one second from barely being able to move, to being able to type a coherent sentence with one "spastic" foot? Clearly the computer must have been pre-programmed to say "I am Rom" on a single click. I could shove a mouse under my dog's paw and get the same effect!

6 comments:

CoralBloom said...

I saw that too and didn't like what I saw - she was doing it for him and I couldn't tell how she knew which letters to aim at!

I've never heard of FC. So when you blog further, I'll learn something today.

I do hope we are not being taken in.

Rob A said...

How sad for that guy.

Anonymous said...

This is disgusting. She is clearly typing for him. What kind of pathetic reporting is this? I'd be typing asking for cyanide.

epark14 said...

I'm a speech pathologist in the US and first saw the story on CNN. As I watched the woman holding his R arm, I said aloud to my husband, "Facilitated Communication, anyone?!"

onegeekspeaks said...

This was so awful. Clearly this is FC, but last I heard there was some debate over him actually being locked in. Can you imagine desperately trying to communicate with the outside world, and then finally thinking you had broken through only to have your hopes dashed by some moron and their FC wiji nonsense!

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