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Is This Man Fully Alert and Communicating - or Not?

YouTube link.

The story of Rom Houben was posted earlier today on Neatorama, and is being carried on every major online news site - a Belgian man paralyzed for 23 years and diagnosed as being in a vegetative state has been found through new technology to be alert but "locked in."  With an assistant helping him communicate by means of a keyboard, he is now reportedly describing what this experience has been like.  The case adds fuel to the fiery controversy regarding end-of-life planning and the right to die.

Every site that I have encountered has taken the story at face value.  The one exception has come from the James Randi, who has written an essay entitled "This Cruel Farce Has to Stop!"  He notes that the communications from the subject all occur via a "facilitator" who "supports" the patient's hand as it traverses the keyboard...
The "facilitated communication" process consists of the "facilitator" actually holding the hand of the subject over the keyboard, moving the hand to the key, then drawing the hand back from the keyboard! This very intimate participatory action lends itself very easily to transferring the intended information to the computer screen. In the video you have just viewed, it is very evident that (a) the "facilitator" is looking directly at the keyboard and the screen, and (b) is moving the subject's hand. The video editing is also biased, giving angles that line up the head of the subject with the screen, as if the subject were watching the screen.

At the essay, Randi states that he has previously investigated "facilitated communication" when it was used to communicate with severely autistic children;  he found the technique to be faulty and subject to observer bias in the manner of the "clever Hans" effect.

This patient is clearly severely impaired but is clearly not brain dead.  Brain imaging studies have shown evidence of consciousness and awareness, which is fully compatible with his impairment.  The controversy is whether the communications are valid representations of his thoughts, or whether they are (consciously or subconsciously) creations of the facilitator.

The video embedded above is a brief excerpt from the MSNBC video.  Several other videos are available at the BBC, Telegraph, and other news sites.

Link, via Reddit.

Addendum:  Subsequent controlled trials failed to show any validity for "facilitated communication."

That's pretty interesting. I didn't know that there was someone actually holding and moving his hand. I don't see how that's actually him. It sure didn't look like HE was the one moving the hand where he wanted. More like she was moving his hand to where she wanted.
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this is a sad case of well-meaning care-givers operating under the ideomotor effect. randi is totally correct in both his skepticism and his conclusions.

however, there are folks who have been "locked-in" and there was one (disturbing) research investigation into awareness levels of vegetative patients that showed brain activity consistent with awareness -- here's the pubmed entry:

"We used functional magnetic resonance imaging to demonstrate preserved conscious awareness in a patient fulfilling the criteria for a diagnosis of vegetative state. When asked to imagine playing tennis or moving around her home, the patient activated predicted cortical areas in a manner indistinguishable from that of healthy volunteers."

note that the researcher's findings have not been verified or replicated, but the study and research is probably still very solid science.
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Look up "Facilitated Communication" and the ideomotor effect.

Also, Frontline did a very good documentary in '93 on FC.
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Here's a video link to "Prisoners of Silence" that Randi referenced. I agree with Randi, this is a farce.
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Wow. Maybe he needs a different "facilitator".

Thank goodness James Randi is still out there. It sounds like a human Ouija board.
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Oh. Yeah, facilitated communication is always bunk. It never seems to be able to work if the "facilitator" can't see the keyboard, for some reason....
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Not communicating. Watching the how quickly the "facilitator" uses the poor fellow's splinted finger to tap the keyboard, I'm convinced it's her doing the communicating, not him.

What's really sad is that the experts and the so-called doctor journalist just take this at face value. And I have to consider that this story is being promoted cynically right now just to inflame anti health care reform sentiment.

Just how long has this particular "facilitation" gone on? Who initiated it and why? How long did it take for the "facilitator" to produce communication and what's the supposed process (feeling micro muscle twitches or is there a psychic claim?) and who does the "facilitator" work for?
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A number of studies on "facilitated communication" back when it was in vogue for autistic children showed that the children frequently did not need to be able to see the screen or the keyboard, whereas the facilitator appeared to (try typing with one finger without looking at the keyboard--it's quite impossible, even if you can touch-type).

Further experiments (e.g. in which the child was shown an image not shown to the facilitator and asked to describe it) showed the communication to be entirely that of the facilitator.

These experiments are easily implemented and would quickly set the record straight for this subject, as well, were the patient's family (and doctors?) not wedded to the false hope provided by what is almost certainly a farce.
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There's a Wikipedia entry for Rom Houben. The story is old (2006) but Houben's doctor Steven Laureys has just published a paper regarding misdiagnosis of coma:

The paper doesn't mention facilitation. Nor does it mention communication, except as one measure in assessing vegetative state.
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Um...I can't get to the the actual link on the site as it seems to be locked up but....James Randi is dead, how could he be commenting on this case? Granted, this essay may be old and does indeed comment on this type of thing, but you should e clear in your post that James Randi is not commenting on this man in particular.
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Yyyyeah... James Randi is very much alive. Every skeptical blog on the internet would light up immediately if Randi died. He's undergoing treatment for cancer, I believe, but just last month he made a live appearance by teleconference and did an interview with Skeptic's Guide to the Universe. By his account, treatment is going well and he's working on a new book.

If Randi is dead, then there's been a cover-up of epic proportions :)
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But I think that misses the point here. The patient may well be conscious; that doesn't imply anything about whether he's communicating.
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Novanglus is correct, Randi is dead. He is communicating via a full-body facilitator. There is some doubt that the opinions Randi is expressing are indeed his own or merely the opinions of the facilitator.
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My mother was in a coma and I could tell by her eyes that she was getting what I was talking about. If you know your love one you will be able to tell even the slightest eye movements or facial ticks. This fellows mother says he was conscious, I believe her! Been there myself. ps the nurses and doc, also did not get the on target facial expressions, but I know how her face moves and her opinions, so there was no doubt she was aware.
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I agree that this looks a bit sketchy, but I would be hesitant to call all facilitation fraudulent. I think some facilitators are actually the ones communicating, wether they mean to or not, but I don't think this is always the case.

I've seen facilitators facilitate while only touching an elbow or shoulder. Where are you all getting your information that facilitation "doesnt work" if the facilitator isn't looking at the keyboard.

(facilitation while only touching the elbow)
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I'm not hesitant to call it fraudulent. This was shown to be bogus years ago. Check out the link to James Randi's site, Michelle.

How would they get the information to transmit while only touching a person's elbow or shoulder? How could a paralyzed person transmit any instructions through that elbow or shoulder as specific as "press A on the keyboard"?

Why doesn't Stephen Hawkings use s facilitator? Because he would disprove what they're doing. Strange how the only people that this supposedly wosks with are people who can not confirm the facilitator's accuracy.
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