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(The following, placed here with the agreement and consent of the person about whose situation it was written, is a summary of the work I did in connection with my graduate degree – Master of Education – at the University of Birmingham. I was awarded the degree ‘with distinction’, on 13th December 2006. Because of my prior training in education and applicable psychology, this qualifies me to act as a psycho-educational consultant.)

Reasonable accommodation is that which overcomes structural discrimination, or which compensates for aspects of the teaching/learning environment and/or methods that would ordinarily leave the student at a substantial disadvantage (because, in my capacity as a psycho-educational consultant, I have to define things in terms of educational settings). That is as far as I can come up with a definition without having to rely on specifics.

My thesis deals with the case of a young chap who applied to study for a B. Eng. degree in Energy Technology, hoping to specialise in Environmental Engineering. He is (from the investigative work we have done over the past 18 months) clearly Asperger-autistic (having fulfilled the criteria as operationalised by Gillberg in 1989). In addition, when his responses to the ASDI were cross-referenced to the criteria developed purely for adult diagnosis by Tantam, they matched there also; it was concluded from this – and other psychological testing – that the chap is Asperger-autistic: F84.5 as opposed to F84.

At no point in his application process did this chap get any counselling – either at high-school or at the polytechnic – regarding his rather naive choice of degree for which to study. His leaving certificate profile from high-school did not contain enough background studies in mathematics or physics (8 courses out of something like 50-odd for the ‘lukion päättötodistus’). A reasonably competent educational/occupational psychologist, psycho-educational consultant, careers counsellor or admissions officer would have spotted that.

He passed an entrance examination, which – in Finland – has about as much reliability as a Lappish summer night has darkness. So, the polytechnic let him in, without calling him for an interview. His grades were monitored (as they are required to be when someone is on state student support payments), and yet it took the polytechnic three years to intervene. The intervention: stopping his payments, despite the fact that he was talking to a psycho-educational consultant well-acquainted with educational issues for autistic persons in higher educational settings.

On examination, this chap was found to experience difficulties learning mathematical and physical concepts. He was also found to have difficulties using language (although his colleague in the Green Party, a Communications major with a post teaching academic Finnish at another branch of the polytechnic, had been in a position to help him to improve his academic-linguistic skills to the level where anything he submits to the local newspaper is immediately published). Even so, his mathematical skills let him down, and he has definite dyspraxic issues going on (measured using DTVP-A); his verbal IQ in Finnish is at least 115 but his PIQ suffers from the problems he has either with movement or with planning courses of action and computing consequences of actions.

It was also clear that this chap has a working memory problem: his ability to do mental arithmetic tasks was severely compromised, and – given the emotional sensitivity element to his make-up, coming up in the next paragraph – was severely jeoparised in high-stress situations (even the testing situations proved nerve-wracking for him). A personality assessment showed him to be highly sensitive to his own emotional state and quite adversely influenced by it, as well as not being a very socially-oriented person. His social circles are few and have very subject or topic specific foci, which are centred on his special interests.

There were three points at which interventions should have been conducted during his academic career at the polytechnic. Firstly, his study counsellor at high-school messed up: this person should have questioned him on his choice of course, on the basis of his background studies. Secondly, the admissions officer at the polytechnic should have called him in for interview to ask why he’d chosen that course with the background he had. At any point where it became doubtful that the chap would succeed, the admissions officer should have rejected the application.

Thirdly, the polytechnic – after monitoring his grades for three years – failed to intervene even after the second year’s poor performance, let alone the first year’s. Had there been a study support network in place at the polytechnic, this chap could have been directed there at the end of his first year’s studies to get remedial support for his mathematics skills (during the three years, his failed courses almost entirely were in the fields of mathematics, physics and engineering technology – all highly mathematical courses). The polytechnic’s approach was essentially a way-too-little-way-too-late approach. The polytechnic, in order to get money for having this guy’s bottom on one of its seats, had wasted three years of his life and wasted three years of his study support entitlement… just for him to fail as expected (there is no evidence that the expected – or even wanted – him to succeed).

In his case, reasonable accommodation would have been something like:

1) additional time in examinations (and/or – for maths/science/technology exams – the requisite formulae on a card);

2) printed lecture notes given a few days beforehand, so that he could have built up some idea of what was going to be dealt with… lectures being conducted too fast came up a lot in interview with this chap;

3) separate examination facility, with opportunity to take a break when necessary;

4) opportunity to undertake project-based assignments instead of examinations (or at least to do occasional simulated project-based assignments) as a means by which to provide corrective information about his actual abilities, rather than his abilities under conditions that prove way too stressful for him;

5) other recommendations to be determined after further interview and testing.

I would not expect the polytechnic to allow someone else to do his work for him, and nor would I expect the academic standards to be lowered. But, given the clear discrepancy between what this chap is capable of (in a suitably sympathetic study environment) and how he has performed (in a completely negligent one), it is clear that accommodations at least commensurate with my recommendations above were necessary.

David N. Andrews M. Ed., C. P. S. E.

Psychologist (Teaching, Learning & Development) and Psycho-educational Consultant,
Kotka, Finland

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A recent development in Finnish services for autistic people has been the uptake of Facilitated Communication as a primary means of eliciting information from non-verbal autistic people that will be used in making diagnostic and treatment decisions regarding the person whose communication is being facilitated. In this method, the client is supported by physical contact at the hand/wrist, or the arm or the shoulder. This contact enables, so the proponents say, the autistic person to overcome the psycho-motor inertia that is (according to the proponents of this method) the cause of autism. As a person on the autism spectrum myself, I am sure that most people would think that I would be solidly behind this method. But I am in fact solidly against it.

Why?

Many studies have been done on this method, focussing on the issue of authorship: the problem of determining who actually came up with what has been written. There are also many studies that belie the notion held be the people who promote the method that autistic communication difficulties arise from a psycho-motor inertia problem. In this article, I shall attempt to deal with these two issues in a relatively easy-to-understand way.

The first issue that I mentioned here is authorship: who is actually coming up with what gets said in Facilitated Communication sessions? And how can you tell for sure who it is?

One of the first proper studies into this matter was conducted by staff at the O. D. Heck Developmental Center in Schenectady, New York. The staff were sure amongst themselves that their adoption of Facilitated Communication was helping their clients to express themselves. They had been trained by the people at Syracuse University, under Douglas Biklen (a major proponent of the method). In the study, which lasted three months, hundreds of trials were conducted with twelve students and nine facilitators. The results were presented at a staff meeting, and these results were astounding.

What did these results tell about Facilitated Communication that was so astounding? Did they support the idea that Facilitated Communication was a good method for use with autistic or other communication-handicapped people?

No. They did not.

This study, now known to be the first objective study of Facilitated Communication ever conducted, demonstrated that the typed output under facilitation was not the work of the clients/students but, rather, was the output of the facilitators themselves. How did they know this?

The study involved an experiment, with the participants being “the most competent producers of facilitated communication in the program(me)”. These participants were shown pictures of familiar objects and asked to name them by typing the name of the object. To control for as many confounding issues as possible, the experimenters used three conditions in the experiment. One was that the facilitators did not know the content of the stimulus picture. The second was that there was no facilitator present to assist with typing. The third was that both client/student and facilitator were shown pictures at the same time but, in this condition, the pictures shown would be the same for both partners in the facilitation session some of the time and different some of the time. In the first and second conditions, there was no sensible output from the clients/students; and, in the third condition, the only correct answers given were typed when the facilitator and client/student saw the same picture.

The team at O. D. Heck D. C. concluded that the facilitators were unwittingly influencing the typed output of the clients/students. But is this possible? Can people influence the typed output of a client/student without even realising it? The answer is, in fact, yes.

A social psychologist at the University of Virginia, Daniel Wegner, proposed a way in with this might happen. According to the theory of ironic processes, the very imperative to not act on thoughts can lead to the person actually acting – entirely unconsciously – on those thoughts. It is known that the training of facilitators includes instructions that urge the facilitator to refrain from acting on thoughts they might have about what the client is trying to type. Under this theory, such an exhortation is in fact a means of setting up the facilitator to fall prey to the effects of ironic processes.

Other experimental studies have demonstrated similar results to those obtained by the O. D. Heck D. C. staff. And the effects of ironic processes, as described by Daniel Wegner, seem to be at the heart of why Facilitated Communication seems to work, but actually doesn’t.

Regarding the basis of autistic communication difficulties being a psycho-motor inertia, similar to that seen in some people diagnosed with cerebral palsy, it has to be said that such a theory flies in the face of the best scientific research conducted into autism over the past fifty years. The difficulties experienced by autistic people are indeed mediated biologically, but not in the psycho-motor domain. These problems arise, rather, in the cognitive domain… the domain of thought, language use, memory formation, working memory use, and understanding of social linguistic conventions. The autistic brain develops differently from the so-called typical person’s brain’s development. Because of differences in development, many autistic people do not join in with many others socially: so an idiosyncratic use of language can arise from this phenomenon. There is a demonstrated propensity for autistic people to be slower than typical people at integrating sensory input from different sources. And, whilst there is indeed research that confirms the existence of motor problems in many autistic people, none of this research demonstrates the effects claimed by the proponents of Facilitated Communication as being the basis for the communication difficulties we see in autism.

So, when I see the hoo-haa about Facilitated Communication, and the promise of being able to unlock “hidden literacy” skills and of “giving voice” to the disabled person by means of this method, I find myself reacting in two ways: one cognitive and one visceral. The cognitive response is that I cannot support a belief in Facilitated Communication as producing output that is in fact authored by the client. The visceral response is that I feel sick.

The claims that Facilitated Communication “unlocks hidden literacy” and “gives a voice” to those with very evident language-based and communication-based disabilities induce nausea in me because these assumptions are wrong entirely (as we have seen earlier, output is basically facilitator-determined) and because – if these assumptions are acted on, and if programmes are modified – the person experiencing serious language/communication disabilities is likely to lose much of his/her existing support without a proper basis in the evidence. And the loss of such supports can only do more damage than would be done if Facilitated Communication were not even tried.

Facilitated Communication has never found validation in rigorous scientific testing, and many professional associations have actually written resolutions against the use of Facilitated Communication. As with any non-validated method of support, Facilitated Communication has no place in the support packages offered to people who cannot express themselves linguistically.

So, as an autistic person who has some documented communication difficulties himself, I am not disposed to accepting Facilitated Communication as a validated method of support for people whose difficulties in communication are worse than mine. And the fact that most professionals in Finland blindly accept this method is indeed very worrying for me: it tells of a total lack of scientific thinking on the part of professionals here (and a corresponding lack of training in scientific thinking in the institutions that train them). Obviously, this situation is not good. For this reason, I became a signatory of the Behaviour Analysis Association of Michigan Resolution on the Use of Facilitated Communication.

In this article, I have left out of the discussion the instances of Facilitated Communication producing output that has lead to the unwarranted splitting up of families on the basis of facilitator-originated accusations of sexual abuse. These matters are for another article I would like to write at a later date, when I deal with forensic aspects of the psychology of teaching, learning and development.

I shall include a comment shortly with a set of references for the points made in this article.

Edit:
Might be worth pointing out that the FCI is now the Institute on Communication and Inclusion, according to the Syracuse University web-pages.

The Institute also refers to FC these days as Supported Typing. It seems that the term ‘facilitated communication’ is a millstone round its neck.

Hello world!

So here I burst out into the world, with some very not-so random thoughts to share.

Regarding who I am, the following tells you plenty:

I am a psycho-educational consultant. I live in Finland. I trained as a remedial mathematics teacher, before continuing to get a B. A.-equivalence in Applicable Psychology, a Master of Education degree in Special Education (Educational Psychology), and a Certificate of Professional Studies in Education covering a rather new field (Educational & Organisational Psycho-Anthropology/Ethno-Psychology). I have worked on internships in the following organisations since graduating (December, 2006): AutSpect Education Tmi, the Finnish Autism & Asperger Syndrome Association and the South-Eastern Finland Social Psychiatry Association. I have also held the post of Visiting Lecturer (Autism Studies – Psychology) at the University of Birmingham, whilst tutoring/supervising a student of that university who lives and works in Finland, and whilst carrying out a revision of the university’s study materials.

What is a psycho-educational consultant?

A psycho-educational consultant is a person who has studied psychology to Master’s degree level, but – rather than going into a full-blown clinical career in psychology – restricts his/her practice to: psycho-educational assessment and intervention; counselling; consultation; teaching/training and the development of teaching/training materials. The idea seems to be a Canadian one, but it is certainly a very transportable idea and fits within the uniquely Finnish notion that people trained in psychology outside of Finland can only work as self-employed/freelance consultants.

What do I mean by a B. A.-equivalence?

Simply the equivalence in study credit to a Bachelor of Arts degree, which is 360 CATS points (or 180 ECTS points). At the time I transferred from the University of Oulu to the University of Birmingham, I had collected equivalent study credit to that undertaken in a first degree, and I matriculated into Birmingham on the basis of equivalency of prior studies.

What is Educational & Organisational Psycho-Anthropology/Ethno-Psychology?

This is the interface between ethnology/anthropology and psychology in relation to understanding phenomena that exist in groups of people where mind and culture interact. The educational and organisational emphases are just those in which I am interested professionally. Ethnology is the study of societal structures and, in this case, anthropology is the study of the cultures carried and supported by those structures. Psychology is – at its most basic definitional level – the scientific study of behaviour and the effects of thoughts and emotions on behaviour.

What is social psychiatry?

Social psychiatry is an interesting development in the promotion of mental well-being: the unit has no patients, just clients. One of the tenets of social psychiatry is that people have worth as individuals, regardless of any diagnosis that might be applicable in their respective situations. The right to a safe place is paramount; the right to be part of a social group is also paramount, as is the right to something meaningful to do during one’s waking hours. When I was working at the SEFSPA units, I never saw the unit psychiatrist anywhere near the units; this is, arguably, a good thing.

What is this blog about?

Well… the shortest answer to that question is that it is about my thoughts on certain matters within my areas of expertise, based on the scientific training that I have had and the things that interest me. It will include articles on things like autism, specific learning difficulties, testing & assessment, teaching & learning, and other miscellaneous topics of interest to me.