Autism is a childhood disease where the child is in a private world of their own. A
description of an autistic child by her mother is:
We start with an image---a tiny, golden child on hands and knees,
circling round and round a spot on the floor in mysterious
self-
absorbed delight. She does not look up, though she is smiling
and laughing; she does not call our attention to the
mysterious
object of her pleasure. She does not see us at all. She and the spot are all
there is, and though she is eighteen months old, an age for touching, tasting,
pointing, pushing, exploring, she is doing none of these. (Groden 2)
This is the most important trait in an autistic child: They don't interact or socialize
with other people. Other characteristics in autistic children are language retardation
and ritualistic or compulsive behaviors. It used to be thought that children became
autistic because of "poor parenting" and that the only solution was that the parents
should be removed from the child (Baron-Cohen 26). Now it is known that autism is caused
by biological factors due to: neurological symptoms, mental handicap, genetic causes,
infections, and even difficulties in pregnancy.
Even though autism is thought of as a disease or disorder, autistic
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children can demonstrate special skills. These skills are referred to as "isolated
islets of intelligence" (Baron-Cohen 53). Some examples of these are found in an
autistic child's ability to draw, play music, or recall a certain date. Nadia, an
autistic child, has the ability to draw in an "almost photographic way" (Baron-Cohen 54).
Autistic children can also play instruments, accurately sing songs, recognize structures
of music, etc. A problem that arises when autistic children are going through therapy
is that they start to lose their remarkable skills.
For parents to find out that their child is autistic can be very shocking. They go
from having a bouncy, livey baby to a having a total stranger as their child. Many
therapies have been devised to help autistic children. Some of these therapies are:
behavior therapy, speech and language therapy, holding therapy, music therapy, and the
newest one, facilitation therapy.
Since most autistic children are different and their behaviors are different, one therapy
may be more effective than another one. Facilitation therapy is catching on, but is
already becoming a controversy. Although facilitation therapy is one of the most popular
used methods in communicating with autistic children, it is being downgraded because of
the controversies where the children are being manipulated by the facilitators.
A child with autism can be detected by the age of three. "If treament is started right
away, the child may gain their normal functioning. This is a critical factor in
reversing the disorder" (McEachin 105). Other elements in autistic therapy that are
important factors in helping with the child are "observations, establishing
relationships, and changing behaviors" (Simons 27). Once autistic children have made a
relationship, they are brought closer to the outside world. That is why facilitation
therapy is so popular. This kind of therapy helps the
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outside world to communicate with the lost child. The autistic child is supported by a
facilitator who holds the arm, the wrist, or the hand. This support helps the
child to control his/her movements in order for the child to point to words, pictures,
etc. In this way autistic children can express feelings or thoughts that no one thought
they had.
So why is there controversy over facilitation therapy ? The autistic child is being
observed, a relationship is formed between the child and the facilitator, and the gap is
being closed. The problem with facilitation therapy is expressed by Dr. Green from the
New York Times, "Facilitated communication seems tantamount to a miracle, but it's more
like a self-fulfulling prophecy - you see what you want to see" (C11). There is always
the chance that the child is not the one expressing the thoughts. Scientists in the New
York Times "are likening it to a Ouija board" (C1), because as people subconsciously
move the message indicator to get an answer to their question, facilitators can move the
autistic child's hand to what they want. Another argument against facilitation therapy
was in an article, the "Harvard Educational Review," where three concerns were mentioned:
1) facilitated communication manipulated the handicapped, 2) facilitation has never
been proven valid, and 3) facilitation contradicts "50 years of research in autism and
developmental disabilities" (Biklen 110). It seems impossible that an autistic child who
can not speak can suddenly communicate with words. The autistic child can answer
questions when asked by a facilitator, but normally would just ignore a person that asked
a question. Even though facilitation therapy is a gateway into the autistic child's
mind, it causes much skepticism.
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"One of the greatest barriers to success with facilitation is the tendency to
underestimate people's abilities based on prevailing paradigms or definitions of
disability" (Biklen 193). When assumptions are made about people with a
handicap, others don't put too much faith in their ability to spell, write, or
communicate. People that are retarded are assumed that they have no
intelligence, so others do everything for them. Another example is that people talk
loud around the elderly because they are assumed to have lost their hearing. Many
assumptions related to autism are: "receptive problems, processing problems, global
cognitive failure, specific cognitive failure, levels of deficit, and the inability to
use pronouns, verb tenses, and other forms of language" (Biklen 193). These assumptions
would lead a facilitator to think that an autistic child, who has always had to depend on
others, would have no skill of their own. Biklen suggests instead of facilitators making
wrong assumptions about the child's ability, that they should encourage the child in a
"natural manner," and "treat the person being facilitated as competent" (193). This
would be hard to do knowing the limitations of the person. It is also hard to think of
someone as being competent when that person starts to scream or starts hitting
themselves.
Many parents doubt the effectiveness of facilitation therapy with their child. How can
their brain damaged child know anything? Dr. Schneiderman, a pediatrician at the State
University of New York Health Sciences Center in Syracuse, uses facilitation therapy with
his autistic son, David. In a New York Times article he exclaims his concern over
whether or not he is the one cuing the responses, "I worry a lot about whether what I'm
doing is real when I facilitate. If I'm doing this unconsciously, I'm unconsciously
producing an autistic
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personality" (C11). Another father expressed his doubts about facilitation therapy over
his daughter:
My child is severly handicapped. This breaks my heart; but I have learned
to live with that and make it part of my joy. I cannot in good conscience allow that
to be erased by the denial of other; that [she] . . . is reading and comprehending .
. . is incredibly ludicrous, not to mention serious fabrication . . . . The onus of
responsibility to prove whether or not this so-called method is effective should
rest on the practitioner. (Biklen 119)
The father had also done facilitated communication with his daughter and nothing
happened. If encouragement, love, and support is given by the facilitator to the
autistic child, and these elements are supposed to help the child communicate, then a
parent should be able to get a response from their child.
Facilitation therapy is controversial in that manipulation is thought to be involved.
Biklen uses an argument by Cummins and Priors:
The success of assisted communications has very little to do with
emotional support, . . . and very much to do with physical control
by the assistant; either in the form of overt control of the client's
movement's or by supplying covert cues which are used by the
client to control his or her movements. (112).
Biklen noticed in his first studies of facilitation, an autistic child would only
communicate with one facilitator, and could not independently communicate even though he
wrote, "Let me show them what I can really do" (112). Physical manipulation is also
evident if the child being facilitated is not old enough to spell, but is communicating
on the keyboard. Other signs of physical manipulation are: if the child types without
any problems of pronoun reversals,
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incorrect verb tenses, not normal "autistic" language, and if the child says things that
others would not want to know or that aren't true about family and friends (Biklen 128).
The most recent controversial subject with facilitation therapy is the reports of sexual
abuse to the autistic child. Dr. Bernard Rimland, director of the
Autism Research Institute in San Diego, states, "I know of about 25 cases through
facilitated communication of sexually abusing their kids" (Goleman C11).
The result of the cases is that the facilitator was sexually abused and expresses the
event through the autistic child. When these cases go through the court it is up to the
judge to determine the reliability of the facilitator (Lambert B10). It's sad to think
that facilitators would use the autistic child in revealing their sexual abuse.
Facilitation is not the only answer in helping with autism. Behavior therapy is making
progress with its effects in treating autism. In the New York Times, it explains how a
team of psychologists have reported that the progress of "19 children with autism who at
age 2 or 3 had recieved 40 hours a week of behavioral treatment . . . By age 11 . . .
nine of those autistic children were going to regular schools" (C10) This kind of
therapy is used to award good behavior and discourage bad behavior. It is less
controversial and seems to working more than facilitated communication. Also with
behavioral therapy, it not only communicates with the child, but obviously can bring some
children back into the real world. Facilitation therapy only helps the child to "talk,"
if it is even the child speaking.
Another treatment for autism is an effective medication called clomipramine. It was
reported in the Archives of General Psychiatry that it
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"reduced a range of symptoms in three-quarters of autistic children tested" (Goleman
C11). The improvements in the children were that they were able to make eye contact and
begin interactions. Also compulsive behaviors were reduced. In facilitation therapy
many of the compulsive behaviors are still observed, plus when the child is given
medication there is no doubt that it is the autistic child doing the communicating.
For some autistic children facilitation therapy may be the key to reaching out. For the
majority of autistic people, to close the gap between the real world and the world they
live in, takes intensive therapy. It takes more then a hand supporting a wrist or an arm
to communicate. Facilitation therapy is proving to be too controversial to really know if
it's the autistic person's own thoughts. Yes, there is a hidden person inside that mute
creature. Hopefully with love and support from family and other outside contacts, that
unique individual will emerge.
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