Coma recovery case attracts doubters

November 26, 2009 By RAF CASERT , Associated Press Writer

(AP) -- Rom Houben's mother remembers her son's amazement when he finally started communicating again after spending 23 years locked in a paralyzed body that was misdiagnosed as vegetative.

"Early on, he was surprised that the words came out of his finger," Fina Nicolaes said. "Now, he is busy writing a book."

However, his communication, with the help of a speech therapist holding his hand punching a touch screen, is stirring controversy only days after the story of his comeback as a fully conscious man entombed in an immobile body captured the world's imagination.

It has scholars questioning the technique of facilitated communication, bloggers denouncing it as a cruel farce, and millions asking as they watch the video of Houben's hand being held as it quickly types into the screen - who is really doing the punching here?

Dr. Steven Laureys understands the questions and said he might ask the same if he did not know the patient. And he said there is only one way to address the doubters - science.

"For me, there are two questions: Is he conscious? Can he communicate? That is 'yes' twice," he said in a telephone interview with The Associated Press.

Doctors point out that it has been three years since Houben was discovered to be conscious and he has had much time to improve his communication skills. In the early stages they were basic and through practice he has been able to communicate as fluidly as he does now, they say.

One of the checks Laureys applied to verify Houben was really communicating was to send the speech therapist away before showing his patient different objects. When the aide came back and Houben was asked to say what he saw, that same hand held by the aide punched in the right information, he said.

He said there are many more tests he and his team conducted that he won't divulge because they are covered by medical secrecy and patients rights. "How would you like me discussing your IQ on the Internet?" he asked.

Laureys of the University of Liege has plenty of credentials.

He has published papers on patients in comatose or vegetative states, including one in the prestigious medical journal, The Lancet Neurology, with colleagues from Cornell University and Cambridge University. Dr. James Bernat of Dartmouth Medical School calls him "one of the world's leaders" in the field of brain imaging in people with consciousness disorders.

Still, when news of Houben's recovery and the video hit the world this week, some people immediately began raising doubts.

Bioethics professor Arthur Caplan of the University of Pennsylvania was among the first - calling the practice of facilitated communication "Ouija board stuff."

"When people look at it, it's usually the person doing the pointing who's doing the messages, not the person they claim they are helping."

The British Psychological Society, through clinical neurologist Dr. Graham Powell echoed that view, arguing there is nothing in scientific literature to support using facilitated communication as it's been used with Houben.

"The person (doing the facilitated communication) says they're being guided by the patient, but we really don't know if that's the case," Powell said.

Powell said a much more simple yes-no button device would reduce the potential of error: "He may not use it perfectly and his movement control may not be great, but with a system like this, there is no danger of a third party introducing mistakes."

The 't Weyerke care institute in eastern Belgium where Houben is residing knows the practice "is open to controversy. We realize that," said spokesman Lode Vanbriel.

He said Houben started out with a yes-no system before moving to the touch screen, and returning to it would be extremely limiting. He added it would be strange for Houben's mother not to have noticed anything wrong over the three years he has been communicating again.

Nicolaes said she is convinced her son speaks to her and appreciates the jokes and "black humor" that lace his sentences.

Laureys's team is in the process of producing a scientific study validating the controversial practice. He refused to discuss it in the media, saying he will follow the classical route of scientific peer reviews and publication in specialized journals before making it public to the world at large.

He hopes it will be ready "in the not too distant future."

The next challenge for Houben is to continue improving his movement by tiny steps so that one day, he might even write without an aide, said Laureys.

"We talk about small movements, a tiny control of the finger. But it can mean a lot for him. He might control his wheelchair or his computer," he said.

©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Related Stories

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

frajo
Nov 26, 2009
This comment has been removed by a moderator.
bfast
not rated yet Nov 27, 2009
Just because a guy's body isn't working worth a hill of beans, doesn't mean he isn't capable of making his own decisions. Let the doctor hook him up to the yes/no, and ask him if he is satisfied with the accuracy of the assisted writing. Let his opinion be the final answer.

I bet bones his answer will be YES!

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.