Ethical research issues: going beyond the Declaration of Helsinki.

La Vaque and Rossiter made a strong, supported argument that it is unethical to use a "no treatment" control group in a research study if a known, effective treatment is available. Their argument is based on the supposition that the Declaration of Helsinki is the ethical world standard for research with humans. Their argument appears to be straightforward, but is not simple to apply. The issues are very complex, include issues not discussed in their argument, and can lead to a different conclusion as pointed out in this paper. The World Medical Association developed the Declaration of Helsinki as one of their official policies. The Declaration of Helsinki, however, is not accepted as the world ethical standard, as demonstrated by its lack of adoption by many professional associations or even by the United States Federal Government. Perhaps it is not mentioned because its ethical provisions are aspirational rather than mandatory as implied by La Vaque and Rossiter. Researchers and clinicians should also be aware of other ethical issues not directly discussed in the La Vaque and Rossiter paper. The Belmont Report is the basis for the ethical protection of human research subjects for at least 17 federal agencies and does not mention the Declaration of Helsinki. The Belmont Report mentions several ethical principles that form the basis for informed consent, risk/benefit assessment, confidentiality of data, subject selection, Institutional Review Boards, and other protections needed when doing research with human subjects. At least 2 of these core principles have direct implications to the discussion related to the use of placebo controls. The ethical principle of fidelity is also important in guiding research activities with human subjects. Researchers should be familiar with the La Vaque and Rossiter argument, the Belmont Report, and the federal policies developed to implement the provisions of that report, for example, Regulation 45 CFR 46.

Is the working definition of applied psychophysiology proposed by Schwartz too narrow/restrictive?

This paper raises issues in further refining the working definition of "applied psychophysiology" proposed by Schwartz (1999). Issues to be addressed include defining what the word "psycho" means within the definition of applied psychophysiology and the implications of this word in practice. Other issues discussed include the meaning of the word "applied," and how incorporating the acquisition of self-regulatory skills or behaviors as one aspect of the definition of applied psychophysiology would help differentiate applied psychophysiology from other specialty areas. Finally, a revised definition is proposed to stimulate further discussion.

Limitations of the American Academy of Neurology and American Clinical Neurophysiology Society paper on QEEG.

The AAN/ACNS report is misleadingly negative regarding the current status of quantitative EEG and tends to discourage its development and use with other related clinical problems. There have been many excellent studies showing that QEEG can be useful for the evaluation and understanding of mild traumatic brain injury, learning disabilities, attention deficit disorders, alcoholism, depression, and other types of substance abuse. In fact, Hughes and John recently provided in this Journal an extensive and detailed review of the use of QEEG in psychiatric disorders. The bias of the AAN/ACNS report is also evident when contrasted to the outstanding review of the clinical utility of QEEG by the American Medical EEG Association, which clearly articulates the opposite points in many cases and concludes that QEEG has reached maturity. At present, the most one can say is that there are legitimate scientific debate and differences of opinion concerning the utility of QEEG, as there are in many other areas of medicine. The AAN/ACNS article should not be considered the definitive opinion. Too many implications for health care are at stake. The debate and research may continue without withholding valuable help from the public. We hope that revised guidelines will be drafted in such a way as to encourage the development of quantitative EEG and brain mapping rather than discourage future research support and use of QEEG with patients. Furthermore, we strongly feel that this technology should be available to, and be explored and used by, nonphysicians who are properly trained and certified.

Creating the future of applied psychophysiology and biofeedback: from fantasy to reality.

AAPB and its membership are faced with a number of giant challenges, including but not limited to: (1) the cost savings efforts of third-party payors and managed care organizations; (2) the lack of public awareness of biofeedback and its usefulness; and (3) the lack of sufficient research data on both the effectiveness and efficacy of biofeedback. In spite of these challenges, there are windows of opportunity that have been or which could be created to move biofeedback further into the realm of conventional treatment. We must focus our efforts on working together to: (1) create strategic plans for creating the future of applied psychophysiology and biofeedback; (2) educate all decision makers, including the general public; (3) establish better relationships with other professionals with common interest; (4) conduct more efficacy and effectiveness research; and (5) create a demand for our services so that the public will be more willing to pay for our services "out of their own pocket." In order for this to happen, we must stop fighting with each other and direct our energies to productive activities that can change fantasies into realities.

A revised blocked-trial procedure for establishing arbitrary matching in children.

The present study evaluated a modified blocked-trial procedure in the learning of arbitrary matching tasks (A1-B1, A2-B2) by children. The procedure consisted of five steps. In Step 1, the comparisons (B1 and B2) were presented simultaneously with the samples (A1 and A2). The comparisons were presented at fixed locations (B1 left and B2 right), and the samples, A1 and A2, were randomly presented in successive trials. Subjects were reinforced for placing A1 on B1 and A2 on B2. Step 2 was the same except that the locations of B1 and B2 were reversed. Step 3 was the same as Steps 1 and 2 but with reversed B1-B2 locations after every fourth trial. Step 4 was the same as Step 3 except that the B1-B2 locations randomly changed over trials. Step 5 was the same as Step 4 except that subjects were required to point to the B stimuli. The procedure was highly effective--far more so than the traditional blocked-trial procedure.

Ethical beliefs and practices of AAPB members.

Ethical codes and principles and laws govern the behavior of health-care professionals. Yet, the impact that ethical codes and laws have on the actual moral behaviors of health-care professionals is relatively unknown. A survey on the ethical beliefs and practices of health-care professionals was sent to the United States membership of the Association for Applied Psychophysiology and Biofeedback. AAPB's heterogeneous membership offers a unique opportunity to compare the ethical beliefs and behaviors of professionals across various health-care professions, educational levels, licensure and certification statuses, age, years in practice, and gender. The survey examined the respondents' ethical beliefs and practices in the domains of confidentiality, dual relationships, and professional practice. Five hundred thirty-six surveys were returned completed. The results of the survey indicate that all respondents have substantially the same reported ethical beliefs and practices across the three domains. There were no statistically significant differences between the reported ethical beliefs or practices when compared across disciplines, educational levels, licensure or certification statuses, age, or years in practice. Statistically significant gender differences were found.

Establishing mirror-image discriminations with progressively delayed extra-stimulus prompts.

Progressively delayed extra-stimulus prompts were used to help normal preschool children discriminate left-right mirror-image stimuli. Two issues were addressed, the attention guiding properties of the prompts and the necessity for their gradual elimination. The study consisted of four experiments in which one or multiple prompt conditions were used. Each condition involved three prompts: a reference prompt for indicating the S+ and two superimposed prompts, one on the S+, and one on the S-. The prompts required subjects to respond to the orientation of the S+ (Orientation condition) or to the location of the reference prompt (Location condition); or allowed them to respond to the discriminative shapes of the superimposed prompts (Shape condition). The results showed the following. First, most subjects rapidly learned to respond to the Orientation prompts. Second, delayed orientation prompting was always successful regardless of how the prompts were eliminated. Delay training was never successful in either of the other two conditions. Third, the Orientation condition did not reliably produce learning unless the delayed prompting procedure was used.

Regulating behavioral procedures for individuals with handicaps: review of state department standards.

We reviewed standards (i.e., mandatory policies or recommended guidelines) from 39 state departments of special education and 41 state departments of developmental disabilities/mental retardation (DD/MR) to determine how they addressed the use of behavioral procedures. Results indicated that many standards described procedures to change behaviors of individuals with handicaps and identified ways to regulate usage. Major findings were that (a) standards from state departments of DD/MR addressed behavioral procedures more frequently than standards from special education departments; (b) many standards addressed procedures to decrease, but not increase, behavior; (c) several standards identified safeguards to clients' rights, such as prior approval requirements and periodic review of behavioral procedures' effects; (d) some standards prohibited and/or restricted the use of specific procedures, such as those judged to be aversive; (e) about one-fifth of special education standards and two-thirds of DD/MR standards described staff training requirements for using some procedures; and (f) relatively few standards used decision models to select behavioral procedures. Implications of these findings for policy makers, service providers, and future research efforts are discussed.

Discrimination training of mirror-image stimuli with a delayed-prompt technique: some critical dimensions of extra-stimulus prompts.

Research on fading and delay procedures has shown that extra-stimulus prompts frequently fail to help children learn difficult discriminations. The present study analyzed two delay conditions for an extra-stimulus prompt to help preschoolers discriminate mirror-image stimuli as a function of the configurations and locations of the prompts. All subjects were selected on their ability to discriminate the task stimuli in the presence of a third stimulus, a replica of the S+ and an arrow pointing to that stimulus; and on their inability to do so without these stimuli. Experiments 1 and 2 compared these prompt configurations (S+ replica, arrow) when presented equidistant from the task stimuli. Experiment 3 analyzed the contribution of the replica configuration in terms of its location, in between stimuli or immediately above the S+. Experiment 4 investigated the extent to which the results of the previous experiments could be influenced by the methodology for the assessment of prompt control. The results consistently demonstrated that most subjects did not learn the task unless the extra-stimulus prompt had the same configuration as the S+ and was located equidistant from both task stimuli.

Time-delay discrimination training: replication with different stimuli and different populations.

Two time-delay conditions for teaching complex visual discriminations to normal preschoolers and children with mild and moderate intellectual handicaps were compared. One condition involved spatially separating the distinctive components from the redundant parts of both stimuli (multiple dynamic distinctive-feature prompts). The other condition involved adding a colored field to the correct stimulus (single static nondistinctive-feature prompt). The effect of the latter condition was assessed with unlearned and learned tasks. The study consisted of four experiments. In one experiment, children were also required to use the prompts for self-monitoring responses given before prompting had occurred. The results indicated that for all populations and stimuli (a) time delay of multiple dynamic distinctive-feature prompts consistently produced learning, and (b) time delay of the single static nondistinctive-feature prompt almost never produced learning and frequently led to a complete loss of discriminative performance on previously learned tasks. The resistance to disruption was a function of the training history (i.e., with or without time delay) and IQ level. Self-monitoring increased the efficacy of time delay when multiple dynamic distinctive-feature prompts were used but not when the single static nondistinctive-feature prompt was used.

Time-delay discrimination training with impulsive children: self-monitoring nonwait responses and the dimensions of prompts.

This study investigated whether in time-delay discrimination training, the performance of impulsive children can be improved by requiring self-monitoring of the correctness of nonwait responses, and to what extent these improvements are a function of the dimensions of the prompts. Four experiments, in each of which multiple prompts were used, one for each stimulus (S+, S-), were done. Comparisons between time delay of distinctive- and nondistinctive-feature prompts, with and without self-monitoring, were made across and within subjects. Time delay of distinctive-feature prompts without self-monitoring did not produce learning. The added requirement of self-monitoring nonwait responses led to a dramatic improvement in performance, but only when distinctive-feature cues were used for prompting and self-monitoring.

Response restriction and substitution with autistic children.

Few studies to date have examined time reallocation in naturalistic, multiresponse human repertoires when one or more responses are restricted. For this experiment, free-operant baseline levels of six responses were measured for four autistic children. The high-probability responses were made unavailable, one at a time, such that subjects had access to five, four, three, and two responses in successive restriction conditions. A return to the six-response free-operant baseline condition completed the experiment. Results were compared to predictions made by four time-reallocation models. These results were described accurately only by the selective substitution model. Further analyses examined alternative explanations for the individual reallocation patterns obtained. An expanded selective substitution definition is proposed that may characterize orderly patterns observed in multiresponse repertoires under restriction conditions more accurately than the other existing models.

Stimulus manipulation versus delayed feedback for teaching missing minuend problems to difficult-to-teach students.

The present study evaluated two procedures, Stimulus Manipulation and Delay Feedback Only, for teaching difficult-to-teach students to solve missing minuend problems (i.e., missing number problems starting with a minus sign). The Stimulus Manipulation procedure was directed at establishing the target skill with a minimum of errors. The training consisted of three phases of several steps each. The first phase was designed to establish a nonnumerical response to a prompt, the shape of which was gradually transformed into the final discriminative stimulus. The second phase was designed to extend the control of this stimulus to the numerical operations and to eliminate all supplementary stimuli. The third phase gradually eliminated the originally trained nonnumerical responses. The Delayed Feedback Only procedure included no stimulus manipulation and consisted of the experimenter giving only delayed right.wrong feedback on the solutions. The data indicate that both procedures resulted in all (N = 4) subjects (a) learning to solve the target problems, (b) generalizing this skill to similar, more advanced problems, and (c) maintaining it over multiple intervals of several consecutive weeks. However, systematic differences in error rate and long-term retention across training methods were observed, favoring the Stimulus Manipulation procedure.

Developing generalized instruction-following behavior in severely retarded people.

A sequence of studies used a transfer of stimulus control procedure to train severely and profoundly retarded people to follow verb-noun instructions and to perform correctly when given only a verbal label for an action or object. Procedures were developed and utilized for providing the subjects with strategies for successfully generalizing to untrained instructions. When training was initiated on more complex instructions involving color or size adjectives, all subjects had some difficulty in acquiring the conditional discriminations. Modifications in the training procedures resulted in most of the subjects learning to respond correctly. Many of the variables deemed critical in training instruction-following skills with such a population are discussed in detail based on the data presented. The implications for training expressive skills in such a population are also discussed.

Acquisition and cross modal generalization of receptive and expressive signing skills in a retarded deaf girl.

A transfer of stimulus control procedure was used to teach a retarded deaf girl manual signing skills. Eight manual signs were trained in the receptive modality; eight others in the expressive modality. Acquisition of receptive and expressive signing skills occurred for most signs after they had been trained in multiple baseline order. There was a marked difference in cross modal generalisation between each of the trained signing modalities. With some exception training of receptive sign discrimination had little effect on the expressive usage of these signs. In contrast, training in the expressive usage resulted in a near perfect acquisition of receptive sign discrimination.

The effects of different reinforcement conditions on the test performance of multihandicapped deaf children.

The present study explored the effects of different reinforcement conditions on the number of correct responses on the Rvaen Progressive Matrices. Four groups of 11- to 18-year-old multihandicapped deaf children matched on the basis of mean age and pretest scores were used. The groups were randomly assigned to any of four posttest conditions: end-of-session reinforcement, noncontingent reinforcement, delayed reinforcement, and immediate reinforcement. The mean posttest score of subjects tested under the immediate-reinforcement condition was significantly higher than that of any other group. No significant differences were observed between the mean posttest scores of the three other groups. The practical implications of using reinforcement procedures for testing purposes are discussed.