Rapid Prompting Method: On Understanding and Respect
Updated: Feb 10, 2022
During a client's recent visit to their pediatrician's office, the pediatrician explained to my client's child what he expected from the child and what the child could expect during the exam. When the child's mother told the physician that her child didn't understand what he said, he responded by saying, "Children on the spectrum really understand everything that is said to them". The belief that 'children on the spectrum understand everything' seems to have permeated throughout the professional community.
What does it mean to hold such beliefs? "What do we mean by understanding" Why is this question important? These questions are important because misuse of the term distorts the phenomenon of 'understanding' (Hacker, 2013) and renders it meaningless. Its misuse leads to well intention-ed but misguided intervention and uncertainty.
What we mean by understanding
To 'understand' something is akin to an ability. Thus, to say that I understand calculus, means that I will be able to solve differential equations. My understanding is manifest in what I do/ my ability to do it. If I pass my calculus exam, my teacher will be able to say that I "understand" calculus. Similarly, if it is to be said that a child understands what their teacher tells them to do, e.g., 'get the ball on the chair', the child will be able to do it when directed.
One's ability to do calculus or retrieve a ball remains whether or not they perform the tasks at a given moment. Thus, understanding is not behavior. Even when sleeping, abilities - understanding remain. Additionally, understanding does not reside in the brain... for if it did...where would it be found... for it has no substance. Nor does it reside in the mind...for the mind is simply an array of abilities and does not consist of anything.
Understanding is not a "mental state". States have levels of intensity. Thus, it makes no sense to say that my understanding is more intense today than it was yesterday. States can be interrupted but it makes no sense to say that my understanding was interrupted. States lend themselves to the form of the words "in a state of"... (Hacker 2013) but it makes no sense to say "I was in a state of understanding". Understanding is not a process either, since a process has duration, a process is 'clockable' and can be interrupted and resumed. Thus, if understanding were a process, we'd be able to say "my understanding of calculus was interrupted, but it picked it up later".
'Understanding' and language
In language, to say that someone understands a word or phrase is manifest in their ability to use it in certain ways for a certain purpose just as knowing how to play chess is knowing how to move the pieces within the rules of chess in pursuit of the goal of winning; in both cases, a technique is mastered." (L. Wittgenstein, unpublished, cited in Wittgenstein's Nachlass). To ascribe the term "understanding", absent anything manifest violates the conventions for the use of the term and strips the term of all meaning. Doing so is just confused and confuses.
What happens when the term "understands" is misapplied?
It's this kind of confusion concerning 'understanding' that drives the Rapid Prompting Method (RPM) and its cousin, Spelling to Communicate - S2C and other members of that family and which drove the Facilitated Communication (FC) calamity. Within these systems, it is believed that persons with autism understand everything, but simply can't express themselves and thus need the assistance of others in order to unleash otherwise hidden abilities residing somewhere in the brain. While Facilitated Communication was fully debunked, its iteration, RPM and cousins are wildly popular.
RPM requires that an adult hold a letter board while a child/adult "types" fully formed sentences-prose. The reason given that adults need to hold the board is that persons with autism don't have the motor control to type 'independently'. Yet, in promotional videos, the same 'motorically challenged' persons are seen painting elaborately detailed pictures and skiing moguls. Moreover, one doesn't need to type in order to follow a simple direction...to show understanding of what is being said.
The question that brought down FC needs to be raised concerning RPM, i.e., "Is inadvertent manipulation of the board occurring in the same way that studies revealed inadvertent manipulation of children's arms during FC?" Another way to ask this question is, "Whose understanding is manifest, the person holding the board or the child's?" Although this question goes unanswered, the practice persists largely because it is believed that 'understanding' exists sans expression... that understanding is 'just in there waiting to get out'. Certainly, a child's ability to respond appropriately to language as evidenced by being able following directions (e.g., go to my room and get me Mommy's pillow) would point to language abilities/understanding. Yet somehow, simply asking for children to demonstrate such receptive abilities is overlooked. Why is that?
Respect for our students demands certainty
Our job as (language) instructors is to help children so that we can say, without equivocation, they "understand". This simply means to ensure that children are able to respond to and to do things with words and gestures appropriately, on their own. Let's at the very least not misuse the term 'understanding'. To hold the belief that children with autism understand everything that is said to them helps no one. Concerning RPM, the fact that we can't know whose 'understanding' is manifest is troubling. Such a question would not be difficult to answer. Research methods similar to those used in the FC studies would work equally well for investigating RPM.
Vigilance should be key in our teaching practice. Practical and critical assessment of abilities is of utmost importance. If motor abilities are a factor in limiting a person's ability to communicate, there are technologies that can be employed which would unequivocally allow for the ascription of the term 'understands'. For example, no one questions the understanding / language abilities of persons with 'locked-in syndrome who have access to technologies which allow them to communicate independently. If uncertainty exists, who benefits? No one likes when others put words in our mouths. What could be more disrespectful? Alternatively, what could be more respectful than to be certain that the words uttered by the children we care for are their own.