Can Jaswal’s “LetterBoxes” substitute for letterboards?

Can Jaswal’s “LetterBoxes” substitute for letterboards?

Over the past couple of years, S2C proponent Vikram Jaswal, Professor of Psychology at the University of Virginia and the father of an S2C user, and Diwakar Krishnamurthy, Professor of Electrical and Computer Engineering at the University of Calgary and the father of an RPM user have co-authored several papers on the development of virtual tools that enable S2C users to virtually select virtual letters rather than pointing to letters on letterboards. Like Jaswal’s other recent papers, each of these begins with purported justifications for S2C as a valid communication method, and each reports instances of allegedly independent communication by S2C users. Like Jaswal’s other papers, therefore, these papers are worth reviewing in detail. In my last two posts, I discussed Alabood et al. (2024), a study involving a virtual letterboard, or HoloBoard. In this post, I turn to Alabood et al. (2025), a study involving the use of virtual letter cubes to spell words, in which Jaswal is listed, respectively, as the fifth and sixth authors.

The LetterBox study is supposed to address one of the concerns that purportedly arose during the HoloBoard study. I say “purportedly” because this concern was based, in part on the S2C-generated output of the participants, which most likely was controlled by their facilitators, or, to use the authors’ sneaky terminology, their “caregivers.” (In the HoloBoard paper, the authors used the terms “communication and regulations partner,” or CRP). The concern in question was that “accidental swiping on virtual letterboards” resulted in unintended letter selections. For “who may engage in impulsive or repetitive tapping patterns, or users who experience more motor control challenges,” the authors implemented the LetterBox, a “grab-and-release interaction paradigm... designed to promote more deliberate selections of letters, thereby reducing errors.”

This claim about motor control challenges in selecting letters is based on the notion, popular with FC/RPM/S2C-proponents like Jaswal, that pointing is a motor-control challenge in non-speaking autism (see my post on their earlier paper). In particular, the authors claim that

·       “developing the motor and attentional skills required for typing is an arduous process, often taking years of practice and intensive caregiver support”

·       “some nonspeakers experience motor control challenges so significant that they may not develop the skills required for typing or letter-pointing.” Tellingly, their sources for this include FC-promoter Elizabeth Torres, a book attributed to someone who has been subjected to FC (Higashida, 2013), and a meta-analysis of 41 studies on motor coordination in autism, none of which examined pointing (Fournier, 2010).

·       “the grab-snap-release method offers a promising alternative to tapping”

·       “grab-and-release requires less fine motor coordination.”

As I noted earlier, however, pointing doesn’t appear on any of the checklists in standard motor skills evaluations. This indicates that it simply isn’t a specific motor issue for anyone—any more than other simple gestures like waving your hand. Manipulating objects, on the other hand, is more motorically complicated and appears regularly on such checklists. In other words, the authors have it precisely backwards.

The objects to be grabbed and manipulated in the LetterBox experiment involved “virtual cubes (8 cm on each side), each with a letter of the alphabet printed on it; and a spelling area where users arrange selected cubes in the correct order on a set of spelling bases to form words.” These virtual cubes are presented in three different virtual environments: augmented reality (AR); mixed reality (MR); and virtual reality (VR).

Despite its shift from virtual HoloBoards to virtual letter cubes, the LetterBox study largely resembles the HoloBoard study.

First, there’s its use of FC/RPM/S2C-generated information as sources for some of its claims. The paper cites Naoki Higashida, Elizabeth Bonker, Hari Srinivasan, and Edlyn Peña’s compendium of FC/RPM/S2C-generated testimonials. On the purported motor issues in non-speaking autism, it also cites FC-promoter Elizabeth Torres.

FC/RPM/S2C-generated information is also the basis for the input they get from their participants. The authors tell us that

·       “LetterBox was designed in collaboration with the nonspeaking autistic community (nonspeakers, educators, and therapists),” the latter group consisting of “three nonspeaking autistic individuals who use letterboards or keyboards.”

·       “Our consultants indicated that being able to see a familiar individual in these more immersive environments [AR, MR, and VR] the virtual could prevent anxiety.”

·       All participants tolerated the device throughout their session, with only one requesting a brief break midway through.

·       Several participants expressed interest in continuing to use the device even after their session had concluded, suggesting a positive user experience.”

·       One purportedly stated: "It felt good to have this available to me... Can you give me more info on how I can get started at home? Really excited to be part of this, thanks." 

As I noted in my discussion of the HoloBoard paper, proclaiming this kind of participatory research allows the researchers to check off that box that so many in disability studies fields now prioritize, i.e., making sure your research is “inclusive” or ”participatory;” in other words, mindful of the “nothing about us without us” mantra of the disability rights movement. One of the perverse effects of this new priority is that it’s incentivized those who do research on minimally-speaking autism to include non-speaking autistics in the only way that seems (to the more deluded or denialist of these researchers, anyway) to work: namely, through FC/RPM/S2C-generated output. And what this means, more broadly, for any research on non-speaking autistics is that a specific subset of non-speakers, namely those subjected to FC/RPM/S2C, will be the ones recruited to provide “feedback” on everything from experimental design to future directions for research—feedback that is most likely coming, ironically, from their non-autistic, non-clinically-trained CRPs.

As in the HoloBoard study, the authors play up the motor and cognitive demands of their virtual interface, suggesting that spelling words through the novel medium of grabbing and releasing virtual letter cubes involves an “interplay between cognitive and motor demands.” This, they say, explains “the slower reaction times for incorrect selections and the effect of increasing [the number of letter cube] options.” As I noted earlier, anecdotes of hyperlexic autistic kids report no difficulties at all transferring spelling skills to novel contexts: such kids have been observed spelling words in all sorts of media, and without any explicit instruction: from refrigerator letters to sidewalk chalk, to letters they form out of playdough.

As Jaswal does in all of his papers, he also makes false claims about standard AAC devices falling short in the communicative options they offer non-speakers:

While useful for requesting items, such systems fall short of enabling fully expressive communication, as users are constrained by preselected images and words.

As I noted earlier, Jaswal appears to be persistently unaware that most AAC devices allow customization of images to reflect users’ needs and interests and have keyboard options that allow typing. Used in typing mode, an AAC device is just like a letterboard: the only difference is that no one is holding it up in front of the user and prompting and cueing their letter selections.  The authors’ implication that standard AAC devices are only useful for requesting items, meanwhile, is a warping of the empirical evidence. Empirical studies do find that minimal speakers with autism mostly use AAC devices to make requests. But Jaswal et al. are assuming here, as they did in their HoloBoard paper, that this is the fault of the device rather than a consequence of the well-known socio-communicative challenges that have defined autism since it was first identified eight decades ago by Leo Kanner. Non-autistic users of AAC tools—deaf children with sign language, individuals with mobility impairments—regularly advance beyond the requesting stages to a whole range of communicative acts.

Finally, as in their HoloBoard paper, the authors state that “Some nonspeakers have learned to communicate by typing on a keyboard or tablet, a process that took many years and required consistent opportunities to practice the necessary motor skills.” And while there are occasional reports of non-speakers who truly do type independently, and while, like all of us who learned to type, years of consistent practice are needed to acquire “the necessary motor skills,” truly independent typing in truly minimally-speaking autism (i.e., not people who can/could speak well enough to hold a conversation), appears to be extremely rare. Furthermore, none of these few truly minimally speaking autistic individuals who type completely independently are people who started out using FC/RPM/S2C. However, the authors suggest otherwise: their sources for the claim that “some nonspeakers have learned to communicate by typing on a keyboard or tablet” come from two individuals who have been subjected to RPM. One citation is of Elizabeth Bonker’s pre-recorded Rollins College valedictory speech, in which you can see Bonker standing at the podium while a pre-recorded speech, attributed to her, is broadcast. The other is of a piece attributed to Hari Srinavasa in Psychology Today entitled Dignity Remains Elusive for Many Disabled People A Personal Perspective: I often feel like a charity case.

The authors do note that:

In some cases, nonspeakers learned to type with assistance from another person, a teaching method that has generated controversy because of the potential that the assistant could influence what the nonspeaker types.

But rather than citing any of the many studies that show just how powerful such influence is, and how it goes far beyond what most people might think of as influence to actual message control, they simply cite the American Speech-Language-Hearing Association’s Position Statement on Rapid Prompting Method—and then repurpose it into a segue way to the virtual LetterBox:

If it were possible to provide automated support to a nonspeaker as they learned the motor skills required to type, this concern would no longer apply.”

As with the HoloBoard study, the results of the LetterBox study might initially seem impressive:

·       Participants only got support from their “caregivers” and feedback from the virtual environment in the training stages, where they were asked to unscramble words. Caregiver support included verbal prompts and what the authors call “mirroring”: indicating the correct letter with a physical letterboard. Virtual feedback after incorrect letter placement involved not providing a new slot for the next letter, thus prompting the user to “return the cube to the picking platform and select a different one.”

·       Even in the training stages, “[s]everal participants... demonstrated strong independence,” with no verbal prompts or mirroring, with no incorrect responses, and “with [one participant] completing 45 [of their] correct interactions entirely independently,” Several additional participants “performed well, completing most interactions independently, though they occasionally required prompts or cues.”

·       Caregivers were present but limited in what prompts and cues they could provide. While the caregivers “remain[] visible to the user[s] via a dynamic passthrough window,” unlike in the HoloBoard study: they “see the letters on the picking platform in a different order than the user.” In addition, “when the participant grabs and moves a letter, this movement is not synchronized for the caregiver.”  Presumably, then, the caregivers, however much they  prompted and mirrored, would be more limited than typical CRPs are in their ability to guide participants to specific letters. Furthermore, the authors suggest that the caregivers were only allowed to use generic prompts like “‘Keep going,’ ‘What’s your next letter?’ or ‘Remember to open your hand when grabbing.’”

·       In the experiment’s test phase, participants faced the more challenging spelling task of spelling words with the entire alphabet, as opposed to unscrambling scrambled letters into words.

·       In the testing phase, “[p]articipants achieved a mean spelling accuracy of  90.91%. In the open-spelling task, 14 participants provided answers, often independently and with minimal support.”

·       The 19 participants “completed spelling tasks with a mean accuracy of 90.91%. Most increased interaction speed across immersion levels, and 14 participants provided one-word answers to open-ended questions using LetterBox, often independently.”

·       “6 participants... achieved perfect accuracy across all three immersion levels”

But as with the HoloBoard study, the results, on closer inspection, are much less impressive—particularly as evidence for authentic message authorship. First, while some participants were highly successful during training, “[o]ther participants required multiple attempts to be successful” and “showed a greater reliance on assistance.” One had “11 mirrored interactions and 8 prompted responses;” another “required 5 mirrored and 8 prompted responses;” several “recorded a few incorrect responses (between 3 − 5 per participant).

Given that all the training involved was spelling common 3-6 letter word like BED, FISH, HOUSE, and GARDEN after the researcher said the word by unscrambling the 3-6 virtual letter boxes that spell the word, this is arguably somewhat surprising. The participants, furthermore, were all S2C users, and so had many months, or years, of practice pointing to letter sequences that spell common words. As the authors disclose, the participants had “at least one year of experience using a letterboard or keyboard to ensure they had sufficient spelling proficiency to complete the study tasks.” Of the 19 participants, 1 had just under one years’ experience; most had at least three; one had been at it for 10 years.

Furthermore, the tasks were primarily spelling tasks--even in the test condition, where they were no longer unscrambling letters, but choosing from a full alphabet of letter cubes. In that phase, they had to answer five specific questions. Besides “Can you spell your name,” the questions were randomly selected from the following

·       “What is your favourite colour?"

·       "What is your favourite meal?"

·       "What is your favourite hobby?"

·       "What is your favourite movie?"

·       "What is your favourite book?"

·       "What is your favourite song?"

And this didn’t go as well as the unscrambling tasks did:

Of the 19 participants, 15 provided at least one valid response to the open-ended questions. Among them, 8 answered all 5 questions, 6 answered 4 questions, and 1 answered only 1 question.

Furthermore, it’s telling that the researchers chose questions whose answers can only be assessed for validity rather than actual correctness. That is, except for “Can you spell your name,” which is question that many minimal speakers with autism learn to do independently of S2C, it’s hard to know whether an answer is correct (how do we verify that “blue” is a participants’ favorite color) as opposed to valid (“blue” is at least a valid answer to a “what color” question). What would have happened if participants had been asked, say, “How many legs does a bird have,” or “Which is heavier, a balloon or a bowling ball?”

As for the 14 who answered all, or nearly all of the 5 questions correctly, I don’t profess to be able explain how they did this. But this experiment, as designed, doesn’t rule out that some or all of them did so simply by having learned, over years of answering questions both inside and outside of S2C contexts, (1) the associations certain key words (“color,” “meal,” “hobby,” etc.) spoken within in a certain common frame (“what is your favorite X”), and (2) certain specific letter sequences. Especially given the rote memorization skills in autism, and the significant comprehension deficits in non-speaking autism, particularly in those with motor impairments (Chen et al., 2024), this would appear to be the more likely route to some of the correct answers that were obtained—as opposed to intentional responding to the semantic content of the questions they were asked.

As an aside, this paper, unlike the HoloBoard, contained some interesting details about the speed of the letter selections. The average selection time during the scrambling activities was nearly 5 ½ seconds per letter, with time increasing “when there were more options to choose from. Participants were fastest when only one letter remained.” This strikes me as extraordinarily slow. The average selection time during the five questions in the test phase was similar, though the authors make much of the fact that it improved from the first question to the fifth question, in what the authors claim “reflect[s] continued improvement in efficiency and comfort with grab-and-release as the session progressed.”

I’m not sure what this extremely slow letter selection process means, but I’m pretty sure it isn’t a reflection of the alleged motor difficulties the authors have asserted without empirical support, and that it isn’t good news for those who wish to make claims about intact language comprehension and literacy in S2C-ed individuals.

REFERENCES

Alabood, L.,  Nazari, A., Dow, T., Alabood, S., Jaswal, V.K., Krishnamurthy, D. Grab-and-Release Spelling in XR: A Feasibility Study for Nonspeaking Autistic People Using Video-Passthrough Devices. DIS '25: Proceedings of the 2025 ACM Designing Interactive Systems Conference. Pages 81 – 102 https://doi.org/10.1145/3715336.3735719

Chen, Y., Siles, B., & Tager-Flusberg, H. (2024). Receptive language and receptive-expressive discrepancy in minimally verbal autistic children and adolescents. Autism research : official journal of the International Society for Autism Research, 17(2), 381–394. https://doi.org/10.1002/aur.3079

Fournier, K. A., Hass, C. J., Naik, S. K., Lodha, N., & Cauraugh, J. H. (2010). Motor coordination in autism spectrum disorders: a synthesis and meta-analysis. Journal of autism and developmental disorders, 40(10), 1227–1240. https://doi.org/10.1007/s10803-010-0981-3

Higashida, N. (2013). The reason I jump: The inner voice of a thirteen-year-old boy with autism. Knopf Canada.

Torres, E. B., Brincker, M., Isenhower, R. W., Yanovich, P., Stigler, K. A., Nurnberger, J. I., Metaxas, D. N., & José, J. V. (2013). Autism: the micro-movement perspective. Frontiers in integrative neuroscience, 7, 32. https://doi.org/10.3389/fnint.2013.00032