I reported earlier on the Rom Houben case that made international headlines when it turned out that he had been misdiagnosed by his physicians as unconscious for 26 years. New diagnostic techniques showed near normal brain function. And, it appeared, he could communicate with the help of a speech therapist using a press keyboard.
That was where the controversy began. The bioethicist Art Caplan said that video tapes of Houben so communicating looked like “facilitated communication,” which he called “Ouija Board.” (Caplan never contended Houbens wasn’t conscious.) Now, he sends me a translated excerpt from Der Spiegel that reports Dr. Laureys could not get Houben to answer questions correctly. From the story (German link only):
The staff at the nursing home had tried it first with an onscreen keyboard, which he used with his right, not completely paralyzed finger. For a while it looked like a good idea: With a little practice Houben succeeded , typing rapidly. And, while he made many mistakes, his messages could be understood.
A speech therapist had, however, stood behind him and supported his hand. The neurologist Laureys said that he was previously convinced speech therapist was not doing the writing. However, Laureys now realizes that the examination was not thorough enough. To obtain valid results, the patient must undergo a lengthy procedure. People with severe traumatic brain injury are not always willing to follow complex instructions, they frequently fall asleep, and sometimes they sink into prolonged delirium. To avoid invalid results, repeated testing over several weeks is needed.
Laureys has now carried out these tests. Result: Houben probably not even have enough strength and muscle control in his right arm to accurately type. The speech therapist, in an effort to help the man type, unconsciously took the lead – such illusions occur in the method again and again. Additionally, the information that Houben gave to the SPIEGEL last year, therefore, did not come from him.
In the current test series, Houben saw or heard 15 items,, while the speech therapist was absent. Then, the man would each write down the correct word – succeeding not once. The method of “assisted writing” itself is thus discredited, but not necessarily. Laureys also investigated the control questions with another paralyzed respondent with a similar brain diagnosis, obtaining 15 correct answers: “It means you have to really examine each individual case.”
In other words, Houben couldn’t answer correctly, but a different patient did using a similar technique???
If I learn more, I will present it here.
February 15th, 2010 | 12:55 pm
Mr. Smith:
The last question in the blog above is indeed an important one. A supposedly real case of facilitated communication just happens to show up during a test of false FC? Readers should note that as I typed the previous sentence, my facial expression was one of deep, but insincere, puzzlement.
Another important question: Why was the modest test reported this month in Der Spiegel not done sooner, before Mr. Houben was used as media bait last November? Similar affect applies here.
More on this, including some additional context for the translated section quoted above, can be found near the bottom of this page:
http://tinyurl.com/yal738a
James T. Todd, Ph.D.
February 16th, 2010 | 1:35 pm
Smith, Smith, Smith…
We have been here too many times before, son.
I warned you last fall that Laureys’ research methods are suspect and I pointed out the obvious flaws in Laureys’ approach and methodologies.
I was able to do this because I actually looked at Laureys’ research and read his papers (they aren’t very impressive). As a physician, he seems decent enough; though I am not as familiar with his branch of medicine, I do question his diagnoses, yet as they did not physically harm the patient, I am inclined to let them pass and yield to his expertise in such areas. As a scientist, he leaves much to be desired.
Anyways, despite my warnings, based on logic, evidence, and data, you derided me for having “conspiracy theories” that had “hit a brick wall”.
We don’t know if Houben is conscious and/or to what extent that consciousness may be. Laureys’ poor scholarship ought to be obvious to everyone, though.
You sure jumped on the Laureys bandwagon mighty quickly, presumably because the “conclusions” fit your desires.
Much to learn, and a long way to go.
Wesley J. Smith Reply:
February 16th, 2010 at 1:54 pm
David. David. David. Nobody faults Laurys. What is being faulted is the speech therapist. Nuance, please.
February 19th, 2010 | 5:44 pm
Mr. Smith:
Dr. Laureys has considerable culpability in this.
He did not fall for cleverly done facilitated communication–with influence and misdirection more resembling a magic trick. He was taken in by facilitator control so obvious that we did not even see the usual FC advocates rise up to defend him.
It is actually worse than that.
Dr. Laureys is claiming to be in the business of detecting very subtle and significant neurological events–events that require delicate measures and sophisticated scientific techniques. Yet, when faced with someone literally pushing around an unconscious and paralyzed man’s hand–claiming that the man could, by this method, communicate and even write books–Laureys was oblivious to the need to make a genuine scientific determination about who was doing the typing. Instead, Laureys instigated and participated in a multilingual world-wide media blitz using Mr. Houben’s supposedly amazing abilities as a hook. Only now, after considerable public embarrassment to Dr. Laureys, but not apparently because the question deserved it or that Mr. Houben should have been treated better in the first place, has a minimal and methodologically insufficient controlled test been done.
We might want to think charitably, concluding that Dr. Laureys was fooled by something he did not understand. Perhaps he was taken in by a clever charlatan. However, Dr. Laureys, with all his advanced degrees and sophisticated knowledge of the brain, does not have the luxury of being obtuse. He has, as John Erskine would say, a “moral obligation to be intelligent.”
Facilitated communication has been around in its current form for almost three decades now. It is neither obscure nor does it remain unsettled. It does not take much of review to see that the scientific literature does not contain a single methodologically sound demonstration of reliable FC in even one individual. It is hardly difficult to find the many experiments that demonstrate that the main operative principle in FC is facilitator control. Several major organizations in North America and Europe see FC as so scientifically vacuous and actually dangerous that they have taken explicit positions against it. This is old news.
If we changed the world and erased FC, would anything be different? No.
Had FC never existed before its use with Mr. Houben, Laureys would have still had at his disposal a vast legacy of research on observer bias, expectancy effects, talking horses, ESP, Ouija boards, ape language training, the ideo-motor effect, table-tipping, and other things obviously and directly relevant to what he is trying to accomplish with his research. Robert Rosenthal, Martin Gardner, Thomas Sebeok, John Stuart Mill, James Randi, Harry Houdini, Joseph Jastrow, Michel-Eugene Chevreul, Oskar Pfungst, Milbourn Christopher, John Wilkins, Daniel Wegner, Michael Faraday, and many others going back centuries have written detailed accounts of how those things come to seem real, and how to show they are not. They suffered the apparently vain hope that thus educated and forewarned no one need fall victim to hopeful biases and parlor tricks. We cannot say that knowing about these things is beyond Dr. Laurey’s scope; that such issues are just for skeptics to ponder for their own amusement. The sources cited above encompass and define the very basics of scientific method, contacting the most fundamental aspects of experimental verification. They are thus exactly and precisely the things Laureys has the obligation to know.
Dabbling in the lives of others only makes it more so.
James T. Todd, Ph.D.
February 21st, 2010 | 11:32 am
“… it appeared, he could communicate with the help of a speech therapist using a press keyboard.
That was where the controversy began.” – Wesley Smith
Not true at all.
When researchers like Dr Laureys make amazing leaps to “newsworthy” conclusions they are embroiled in controversy among their peers- even if the controversy isn’t deemed newsworthy or made part of the November news story.
It is a very amazing leap of logic for Dr Laureys to conclude that the form of medical imaging he relies on can reveal hidden “consciousness”. It would be one thing for Dr Laureys to declare that his medical imaging revealed unexpected “activity” in damaged brains.
It is quite another for him to declare that any form of currently existing medical imaging can reveal “consciousness”.
There are many forms of neurologically useful medical functional imaging and each looks at a different aspect of biologic function of the cells:
FMRI is used to “see” a reduction of oxygen in the blood. In order for a cell to function, it has to — at the very least — be able to burn biofuel to produce energy. Oxygen is used in this process.
PET scans look at glucose uptake and metabolism — the ability of cells to turn fuel into energy. In order for a cell to function, it has to — at the very least — be able to burn biofuel to produce energy. This is what a PET scan looks at.
SPECT is a bit more specific. It looks at cells’ abilty to power a specific cell membrane pump that maintains polarization. It doesn’t just look at glucose metabolism, therefore. It looks at the capacity of cells to harness the energy to do work. Being able to power this cell membrane pump is crucial for cell survival and function.
EEG isn’t a form of “medical imaging” but as far as neurological testing EEG testing looks at a neuron’s ability to generate electrical signals via depolarization and repolarization of the cell membrane. This is how neurons communicate with one another, and it is essential for the proper functioning of neurons.
Clearly these tests reveal useful information about various biologic functions but NONE of them “reveal” or “image” or “measure” consciousness.
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