Social Constructivism, Positivism, and Facilitated Communication

Grover J. Whitehurst & Deanne A. Crone

State University of New York at Stony Brook

Running head: Social Constructivism, Positivism, and Facilitated Communication

Published in The Journal of the Association of Persons with Severe

Handicaps, 1994, 19, 191-195.

Preparation of this article was supported by grants to G. J. Whitehurst from the Pew Charitable

Trusts (91-01249-000), and the U.S. Administration for Children and Families (90CD095701 &

90CD096201). Views expressed herein are the authors and have not been cleared by the grantors.

Requests for reprints and inquiries can be addressed to G. J. Whitehurst, Department of Psychology,

SUNY, Stony Brook, NY 11794-2500 (e-mail russ@psych1.psy.sunysb.edu) .

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Social Constructivism, Positivism, and Facilitated Communication

Abstract

Facilitated communication, a technique that is said to enhance the communicative abilities of

individuals with severe language impairments, has engendered much controversy. Biklen and

Duchan (1994) and Green and Shane (1994) present two sides of this controversy. Biklen and

Duchan argue that from a constructivist's perspective, the primary issue is the underlying cultural

presuppositions regarding mental retardation and science rather than the efficacy of facilitated

communication. Green and Shane present research evidence challenging the efficacy of facilitated

communication within a positivist's framework. We present a brief review of science as viewed

through positivists' and constructivists' lenses. Using the framework of social constructivism

adopted by Biklen and Duchan, we disagree with them on three points: 1) even though the process of

constructing scientific knowledge is strongly affected by human social, emotional, and cognitive

processes, it also involves matters of fact that cannot be ignored; 2) social constructivists' accounts

of science can be accepted as descriptive without being prescriptive; 3) while we cannot prove that

belief systems, including positivism and social constructivism, are true or false in the larger sense,

belief systems have differential consequences for technological changes of the type that are valued by

persons with severe impairments of communication.

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Facilitated communication is a procedure that is said to enhance the communicative abilities of

persons with severe impairments in typical modes of oral or written language, particularly individuals

diagnosed with autism or intellectual retardation. Typically, a communicatively normal adult, the

facilitator, supports the wrist or arm of the person with the communicative deficiency as that person

generates messages by selecting letters from a letter board or special typewriter. Advocates of

facilitated communication have attributed remarkable improvements in the ability to communicate by

people with severe communicative impairments to this procedure (e.g., Biklen, 1993; Crossley,

1992).

In a characteristic case report (Biklen, 1990), Jonothan, a 7-year-old described as autistic,

incontinent, and without any history of expressive language, reportedly began typing messages in the

first few minutes of exposure to facilitated communication: "Crossley managed to settle Jonothan on

her sofa .... She typed 'JONOTHAN,' followed by 'MUM,' and then asked him for 'Dad.' He went

straight to the D .... She typed 'JONATHAN,' whereupon he [with Crossley holding his hand] typed

'JONOTHAN.' Crossley later checked the spelling with his mother. Jonothan had been correct" (p.

294). In a later interaction, Jonothan reportedly typed a message about someone having sat on him

and was asked by Biklen whether he meant that literally or metaphorically. "Jonothan [with

Crossley holding his hand] responded by typing 'MET'" (p. 292).

That literacy would emerge spontaneously in anyone and then be applied to abstract semantic

distinctions such as "metaphorical" is remarkable. It is even more remarkable that such a

phenomenon would occur with an otherwise low functioning 7-year-old. In normally developing

children, the ability to understand grapheme-phoneme correspondences (e.g., that the word "Dad"

starts with the /d/ sound which corresponds to the letter D) and the ability to translate that

knowledge into print typically requires instruction at home and/or at school and proceeds along a
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regular and gradual course (Adams, 1990). The sudden emergence of these abilities in people

labeled autistic or retarded would represent a critically important therapeutic breakthrough as well as

a significant challenge to theories of autism, retardation, and literacy acquisition.

The use of facilitated communication with communicatively impaired populations has

burgeoned in the United States, perhaps due to the presentation of dramatic case histories by Biklen

(1990), Crossley (1992) and others. Controversy over its meaning and effectiveness has gone hand

in hand with its increased implementation. In an effort to present both sides of this controversy, the

editors of this journal asked Biklen and Duchan (1994) and Green and Shane (1994) to respond to

10 questions concerning facilitated communication, such as "Under what conditions ... might

facilitated communication work and what evidence is available?" These authors were apt choices as

Biklen has been the major advocate for facilitated communication in the United States, and Green

has generated the largest body of research questioning its efficacy. We considered ourselves

reasonable choices as commentators on their papers. Our basic research on the development of

children's communication skills (e.g., Sonnenschein & Whitehurst, 1984) and our applied research on

interventions for language delay (e.g., Whitehurst, et al., 1991; Whitehurst et al., 1994; Whitehurst &

Fischel, 1994) is similar enough to the subject matter of facilitated communication to allow us a basis

for evaluating competing claims. At the same time our work has never involved the severely

impaired, nor do we know or have any connection with the principals in the controversy. Thus we

looked forward to sorting through the answers to the questions posed by the editors with what we

hoped would be both an absence of interfering bias and the perception of neutrality.

As it turned out, Green and Shane hued closely to the task set by the editors, while Biklen and

Duchan chose instead to argue that the editors' questions were invalid: "the controversy ... is not just

about whether particular individuals are authoring their own messages, nor is it about whether the
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method is successful or not. It is not about what percentage of people can be proven competent, or

about the percentage who have achieved or will achieve independent typing" (Biklen & Duchan,

1994, p. 34-35). Questions such as these are said by Biklen and Duchan to reflect "a positivist

perspective, implying that there are objective truths about facilitated communication that can be

discovered through research studies" (p. 22). Biklen and Duchan take the position that they are

practicing a different type of science, one incommensurate with questions concerning objective truths

about facilitated communication. This type of science, called social constructivism (and conflated by

Biklen and Duchan with other descriptors such as competence-based, phenomenological,

experiential, ethnographic, and interpretivist), is said to lead to questions, methods, and answers that

are different from those of positivists' science, and equally valid, e.g., "Our aim in this article is to

provide convincing evidence to show that mental retardation does not exist as fact separate from

interpretation ...." (p.2).

Before detailing our disagreement with Biklen and Duchan's interpretation of social

constructivism and its relevance for basic issues concerning facilitated communication, we note

several points on which they and we are of like minds: 1) People with mental retardation should be

treated with respect as individuals. 2) It is important to consider individuals' competencies as well as

their deficiencies. 3) Labeling a person as retarded has repercussions on that person's life

circumstances. 4) If an individual has the cognitive ability to communicate, but does not possess the

necessary motoric skills, that person should be assisted by any valid means to express his/her

thoughts and feelings. 5) Individuals involved in a discourse influence each other. 6) Data should be

collected across time and under different circumstances for the same individual in order to produce

an accurate assessment of that person's abilities and deficits. 7) It is interesting and important to

determine how people with severe communicative impairments interpret their experience. 8) Data
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collected in natural circumstances can present a different view than data collected in highly controlled

circumstances. 9) Ethnographic, qualitative research can be extremely useful in allowing scientists to

formulate the intuitions and hypotheses that are a critical prerequisite to the most creative controlled

research. 10) People without advanced degrees or special credentials can be trained to provide

effective services for people with special needs.

We have no particular bias regarding the efficacy or importance of facilitated communication.

The research reviewed by Green and Shane seems to us to present a strong negative case for the

general efficacy of the procedure, but we think the possibility of facilitated communication being

useful in occasional specific cases is not entirely foreclosed and should be the topic of continued

research. We do however have strong views about philosophy and research on social constructivism

and its relevance to the evaluation of claims that are said to be scientific. Biklen and Duchan have

used tenets of social constructivism to legitimize their claim that the utility and validity of facilitated

communication need not be evaluated. They have attempted to refocus debate on the issue of the

cultural presuppositions underlying mental retardation. We will attempt to place social

constructivism in the context of the scientific enterprise and explain why Biklen and Duchan have

misused it. In doing so we have been influenced by the work of our colleague, Stephen Cole

(1992), who views the larger philosophical issue, of which social constructivism is one variant, as

being able to account for consensus in science. That is, why do scientists come to agree that certain

theories or claims of fact are justified and others are not?

In the traditional positivists' view that is held by nearly all working scientists, science consists of

claims about matters of fact. Scientists who wish to contribute to the body of knowledge that

represents their discipline submit the results of their work to a process of peer review in which

agreed upon criteria for publication are applied. These criteria consist of a set of clear rules for
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judging the procedural adequacy of the research and more fuzzy judgments regarding the work's

importance. Given that the application of these criteria is subject to ordinary human frailties,

mistakes are expected to occur. These include false claims of fact that are published, true claims of

fact that are rejected, and the publication of work that is trivial. Mistakes at the level of publication

are corrected by a second and more stringent evaluation occurring at the level of the audience of

scientists to whom the published work should be relevant. The massive volume of published

research in almost all fields of science is winnowed by the process of selective citation in subsequent

research efforts. The net effect is cumulative science: The false or trivial research falls by the

wayside, while the valid and important claims of fact become part of the enduring core.

The last 50 years have witnessed a sustained attack on the positivists' view of science by

philosophers and other critics. Though the arguments against positivism may vary, at the core of

each is an appreciation of the degree to which science is a product of human cognitive, social, and

emotional processes. The net effect is an acknowledgment that scientists, unlike Spock, are not

perfectly rational beings. Instead they are involved and invested in a process of making meaning

from their data and successes of their careers. At the least, this means that scientific theories and the

degree of allegiance they engender are not completely dependent on observationally reliable facts.

For instance, Lakatos (1970, p. 70) argued that observations (i.e., facts) in science are always theory

laden:

Galileo claimed that he could "observe" mountains on the moon and spots on the sun and
that these "observations" refuted the time-honoured theory that celestial bodies are
faultless crystal balls. But his "observations" were not "observational" in the sense of
being observed by the -- unaided -- senses: Their reliability depended on the reliability of
his telescope -- and of the optical theory of the telescope -- which was violently questioned
by his contemporaries.
In a similar vein, Kuhn (1962) held that science is not cumulative. New approaches are simply
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different rather than better than the ones they replace. In fact, according to Kuhn, objective truth

plays no role in the evaluation of theories or paradigms. He notes that when Newton first published

the inverse square law and his calculation from it of the predicted motion of the moon at perigee, the

motion that could be observed with available methods was only half that predicted. Yet the theory

was generally accepted during the 60 years that passed until the observational data caught up to it.

In addition to philosophical writings, there is research that demonstrates the extent of

irrationality in the scientific process. For example, a large and consistent body of work shows that

consensus among reviewers of manuscripts submitted to prestigious journals or the National Science

Foundation is relatively low (e.g., Whitehurst, 1984, Cole, Cole, & Simon, 1981). In one

particularly revealing study, 12 already published research articles were resubmitted to the original

journals a year or so later with fictitious authors and institutions, but otherwise unaltered (Peters &

Ceci, 1982). Of the nine articles that were not detected as resubmissions by journal editors, eight

were eventually rejected. In many cases the grounds given for rejection were described as "serious

methodological flaws." As the argument goes, if science were a rational enterprise, firmly grounded

in matters of fact, results such as these would be impossible.

A final research and theoretical influence that has played a key role in the development of social

constructivism is the theory of Piaget (1976, p. 13), who holds that objective knowledge structures

"are the result of a construction and are not given in the objects, since they are dependent on action,

nor in the subject, since the subject must learn how to coordinate his actions ..." This is the principal

hypothesis of social constructivism, that learners construct their knowledge of the external world and

this knowledge depends as much on learners' physical and mental actions as on the external world.

Evidence supporting Piaget's position takes the form of demonstrating that individuals will fail to

acquire certain specific concepts despite adequate teaching or exposure unless their general state of
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cognitive development allows those specific concepts to be assimilated. For instance, Lawson et al.

(1991) demonstrated that skill at hypothetic-deductive reasoning rather than age predicted whether

high school students could learn particular classification tasks that involved systematically testing

alternative hypotheses about class membership.

There are many problems with the types of evidence that have been presented in support of the

contructivists' view. For instance, the low reliability in peer review may be an artifact of the

statistical procedures that are applied to measure it (Whitehurst, 1984), and the claims of close links

between Piagetian stages of development and the learning of specific tasks have been seriously

challenged (Brainerd, 1978). However, suppose we accept the claims or implications of social

constructivism that flow from the material we have briefly reviewed: 1) the history of science

includes many instances in which ideas and theories have had far more influence on generating

scientific consensus than have observable facts; 2) the history of science can as often be characterized

as due to the theoretical equivalent of fad and fancy as to the relentless forward march of cumulative

knowledge; 3) the procedures for judging the worth of contemporary research at the level of peer

review are filled with caprice; and 4) the construction of human knowledge depends as much on

actions of the learner as on the external world. Even so, does it follow that Biklen and Duchan, or

indeed anybody who wishes to cloak their work in the mantle of science, can reasonably take the

position that they need not address matters of fact because there are no objective truths that can be

discovered through research? We think the answer is clearly no, for three reasons.

First, the only thing that the empirical, philosophical, and historical analyses of social

constructivists demonstrate, if taken at face value, is that human processes that are not grounded in

matters of fact or the formal rules of science have a very significant impact on the products of

science. However, such a demonstration does not exclude a separate or interacting role for reality,
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nature, or objective truth in the production of scientific consensus, either logically or empirically.

Certainly in Piaget's theory, which is a touchstone of constructivists' thinking, knowledge emerges as

a joint product of the learner and the object. Cole (1992, p. 25) describes the necessary role of

empirical facts in science as follows:

Even though in some 'ultimate' sense there may be no way to determine whether one
paradigm is a better approximation to the 'real' laws of nature than another, the exclusion
of nature and the empirical world from our model of how scientific knowledge grows
makes it difficult to understand why some knowledge enters the core and most does not....
[Consider HIV and AIDS.] If a vaccine is developed and all people who are given it do
not become HIV positive, then we know that the vaccine works ..... If we consider the
scientific goal the development of a vaccine for the virus that leads to AIDS, it becomes
clear that a successful solution to that problem could not be socially constructed
independent of the external world, that is, independent of the nature of the virus.
Second, social constructivists' accounts of science can be accepted as descriptively accurate

without being accepted as prescriptions for optimal science. Suppose an enterprising reporter

uncovers evidence of widespread graft and corruption among local politicians. Do we then accept

graft and corruption as part of the formal definition of local politics, or do we view these activities as

inconsistent with the ideal of politics and attempt to reduce them? Likewise, if scientists are shown

to make decisions based on an attempt to curry favor, advance their careers, and be associated with

what is "hot," often in disregard of matters of fact, should we then make these behaviors criterial for

science, perhaps replacing courses in research methodology for graduate students with courses on

how to be obsequious to the big names in one's field?

Third, though the rules of knowing that define positivists' science are clearly socially

constructed (and in that sense are no different from the rites of a religious community or the

principles of astrology), systems of belief are not without differential consequences. Hopi Indians
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performing a rain dance, communication facilitators supporting an impaired child's hand, and

scientists with a p < .05 effect all believe they are effecting change and all possess an interpretive

framework in which their behavior has meaning. We may not be able to determine which of these

and other belief systems is true and which is false, and indeed, such questions may be meaningless.

We can, however, conclude that the system of belief and practice that Biklen and Duchan label as

positivists' science, much as it frequently diverges from its idealization, is differentially likely to

produce technological progress. This includes the domain of communicative impairments. We can

also conclude that people who call what they are doing science but who do not comport themselves

in a manner that conforms to that system of belief and practice should expect to be treated like any

infidel in the temple.

Thus when Biklen and Duchan (1994, p. 34) say that the controversy is not "about whether the

method is successful" in the face of a substantial body of evidence that it is not (Green & Shane,

1994), and simultaneously describe what they are doing as science, they are at best misleading the

consumers of facilitated communication, who we venture to guess are not spending the huge amount

of time and effort they invest in facilitated communication based on their commitment to social

constructivism, and who would certainly be surprised to learn that the world has no objective truths.
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