PSY 4600

1. PSY 4600 Schedule: Tuesday and Thursday: Lecture Tuesday: Exam Unit 8: Credentialing in Behavior Analysis Ethics

2. End of semester schedule • Thursday, 12/08 • Return of E8 • Special grade sheet • Can you benefit from taking ME2? • If so, how many points do you need for the next highest grade? • ME2 study objectives • No lecture • Tuesday, 12/13: Instructional Assistance • Hours • Wednesday, 12/14: Make-up Exam 2, Units 5-8 • Room 1728 • Be here at 12:30 • Remember you cannot start the exam after a student has left the room with the answers: you will receive a zero

3. Unit materials • Credentialing in behavior analysis • Dickinson article (2016) • Ethics • Martin & Pear (2015), Chapter 30, Ethics • Van Houten et al. (1988), Right to effective behavioral treatment • Skinner (1978), The ethics of helping people • Hanley et al. (2005), On the effectiveness of and preference for punishment and extinction components of function-based interventions • OPTIONAL: Wolf, Risley, & Mees (1964), Application of operant conditioning procedures to the behavior problems of an autistic child

4. Credentialing in BA, intro • Purpose of Credentialing • Protect the public from individuals representing themselves as competent in a field, when they are not • Two Types of Credentialing in Behavior Analysis • Certification • Licensing • Who is covered by certification and licensing • Applied behavior analysts who work with at-risk populations • If you work in human services, you need to be certified and, if relevant for the state you work in, licensed • In a few states, all behavior analysts who work in applied settings with humans are required to be licensed (at this point in time, 26 states have license laws, in a moment, laws do vary from state to state; not EAB regardless of whether your work involves humans or nonhumans)

5. SO1: Two differences: Certification vs. Licensing • Organizations that oversee credentialing (NFE) • Certification: Behavior Analysis Certification Board (BACB) • Nonprofit international organization (separate from ABAI) • Licensing: Individual states • Two differences between certification and licensing • Certification is voluntary, licensing is legally required • Requirements for certification are the same from state to state and globally, requirements for licensing vary from state to state

6. NFE, but WHY Requirements for certification and licensing are similar • Certification predated licensing • National certification began ~1998, licensing began ~2009/2010 • BACB anticipated licensing and developed and posted a “model” license law on its web site to assist states • States: why re-invent the wheel when a professional organization had already developed standards and an exam? • Certified behavior analysts were typically the ones who advocated for license laws and spearheaded their adoption, thus brought the model license law to the attention of the legislators (In almost all states, the requirements for licensing are the same or similar to requirements for certification; some states, identical; in a few you must be certified to be licensed; any event, similar. )

7. NFE: Four levels of Certification • Registered Behavior Technician (new 2014) • Front-line staff who implement behavior plans • Because it is new, most human service agencies do not yet require staff to be certified • I anticipate that in the future, they may require staff to become certified, probably within a certain time period after hire • Board Certified Assistant Behavior Analyst: BCaBA • Board Certified Behavior Analyst: BCBA • Board Certified Behavior Analyst-Doctoral: BCBA-D (Talk a bit about certification: MA vs. Ph.D: program accredited/approved by ABAI; not really a separate credential – extension Independent practitioners who provide BA services; most relevant to you at this point, BCaBA and BCBA, but before I do, I Will just touch on the requirements for the RBT, you could become an RBT at this point in your careers – anyone in class?)

8. NFE: Requirements for RBT • Age requirement: at least 18 years old • Degree requirement: high school diploma • Training: complete a 40-hour training program based on the RBT task list developed by the BACB and be evaluated by a BCaBA or BCBA • Pass the RBT certification exam

9. SO2: Four categories of requirements for BCaBA & BCBA • 1. Educational degree from an accredited university • BCaBA: BA degree • BCBA: MA degree • 2. Specific number of course hours in behavior analysis • BCaBA: 180 course credit hours • BCBA: 270 course credit hours • 3. Specific number of supervised hours by a BCBA • BCaBA: 1000 hours independent fieldwork • BCBA: 1500 hours independent fieldwork • 4. Passage of the relevant certification exam (Different hours supv depending upon intensiveness of supervision; details change rather frequently as BACB upgrades requirements: so no details, visit web site)

10. SO3: Educational Requirements for BCABA and BCBA • 1. BCaBA: Bachelor’s degree • Specifically, bachelor’s degree from an accredited university - does not have to be in behavior analysis or psychology • 2. BCBA: Master’s degree • Specifically, master’s degree from an accredited university (a) in behavior analysis, psychology, or education, or (b) from a program with an approved BACB course sequence (Only BA or MA is required for the SO)

11. NFE: requirements for BcaBA and BCBA at WMU • 1. BCaBA • Our undergraduate behavioral science major curriculum has been approved by the BACB to fulfill all course requirements • To complete the supervised hour requirement, students must take PSY 2517 as an elective and complete the required number of hours • See Dr. Jon Baker in our department • 2. BCBA • Our BA graduate curriculum has also been approved by the BACB to fulfill all course requirements for the BCBA • Like the undergraduates, to complete the supervised hour requirement, students must take electives and complete the required number of hours (sometimes do this by working in a HSS) (As I indicated earlier, a certain number of course credit hours in behavior analysis is required for both the BCaBA and the BCBA – 180 or 270 ; ABA in Austim & DD; so the good news is that both our undergrads and graduate students can be eligible to take the relevant certification exam after completing our programs –many of our graduate students get their BCBA while they are still in the graduate training program; QUESTIONS?)

12. NFE: Why license laws? • 1. To protect at risk-individuals seeking behavior analytic clinical services • 2. To accompany autism insurance laws that have recently been passed, specifying and regulating the individuals who could receive insurance reimbursement • 3. Some behavior analysts believe license laws should protect all consumers, not just at-risk individuals (also protecting the field in general) • 4. Some believe that we will not achieve the same status as other professionals (doctors, licensed clinical psychologists) unless we are licensed (I am now moving onto licensing: certification is voluntary; licensing is legally required – more teeth first two are the main ones; Employees, athletes, college students, etc.; because of these differing views, two broad category of laws; license laws typically have two levels of licensing that correspond to the BCaBA and BCBA)

13. SO4: Two types of laws • 1. Restrictive laws (relates to first 2 reasons) • Only behavior analysts who provide clinical services to individuals need to be licensed, for example • Those who work with children diagnosed with autism • Those who work with individuals with developmental and intellectual disabilities • Those who work with seniors with dementia • 2. Broad title and practice laws (relates to all 4 reasons) • You cannot call yourself a behavior analyst (title) or practice behavior analysis (practice) unless you are licensed (in general, two types of laws, although one state has a “title” law; first type relates to the first 2 reasons on the previous slide, the last type relates to all four reasons – last two; most laws include mental health parity for other relevant professionals who are credentialed in their specialization – see the article)

14. States that have each type (according to Dr. D) • Restrictive laws: 19 states • Alabama, Alaska, Hawaii, Kansas, Louisiana, Maryland, Mississippi, Nevada, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, Virginia, Washington • Michigan has a restrictive law pending (it is in the legislature) • Broad title and practice laws: 6 states • Arizona, Kentucky, Massachusetts, Missouri, Vermont, Wisconsin • Sixteen laws were passed within the last two years: all were restrictive, but one • Due to revision of the BACB model license law in 2012, including wording for the potential exclusion of applied behavior analysts who provide non-clinical services, and explicitly OBM practitioners and applied animal trainers • Seems to be the trend (although again I could be wrong) (I could very well be wrong; it is hard to interpret the laws; talk more about this in the article)

15. Implications for you • If you are planning on a career in human services • You need to be certified • You need to be licensed in states that have license laws • If you are planning on a career in other applied behavior analysis areas • You do not need to be certified • If you work/move to a state that has broad title and practice law, you need to check with the licensing board and behavioar analysis association in that state to determine if you need to be licensed (Right now, for example, most OBM professionals are not certified; don’t deal with a vulnerable population and task list and exam really are focused on clinical work/methodology. Two issues emerge: need and relevancy. Questions?)

16. NFE: Two Assumptions of systematic applications of behavioral principles • 1. Behavior can be controlled • Science of behavior can be used to help humanity • Science of behavior can be used to harm humanity • 2. It is desirable to control behavior to achieve certain objectives (Moving onto ethics; Martin & Pear; what are ethics from a behavioral perspective and why we need ethical guidelines and monitoring of the use of this very powerful science and technology of behavior)

17. SO7: Define ethics from a behavioral perspective • Certain standards of behavior that a culture develops to promote the survival of that culture • Example In most cultures, respect for the possessions of others is reinforced, and stealing is punished • Why? In prehistoric cultures, stealing may have resulted in so much in-fighting, members of a culture became vulnerable to invasions by other cultures Members may have killed each other off or defected to other groups so that the culture did not survive. On the other hand, cultures that reinforced respect for the possessions of others survived. (Skinner, 1953, 1971, Science & Human Behavior & Beyond Freedom and Dignity; sometimes codified Into legal contingencies, sometimes religious principles, back up a bit and explain)

18. NFE: cultural selection of ethics and values • Variation and natural selection operate at three levels • Biological evolution – morphological features and “innate” behavioral tendencies • Shaping of operant behavior -reinforcement and punishment • Selection of cultural practices —some increase the survival of that culture and are transmitted culturally • Ethics and values

19. NFE: How are Ethics and values acquired? • Direct instruction (parents, schools) • Modeling (media) • Religious and secular rules and laws

20. RELigious codification • Jewish and Christian, Ten Commandments: • Thou shalt not kill • Thou shalt not commit adultery • Thou shalt not steal • Thou shalt not bear false witness • Thou shalt not covet neighbor’s wife, house, animals, etc. • Buddhism, Five Precepts (basic morality): • Refrain from taking life • Refrain from taking that which is not given (not stealing) • Refrain from sensual (including sexual) misconduct • Refrain from lying • Refrain from intoxicants which lead to loss of mindfulness (not a coincidence that many of these resemble each other – no matter what the culture, violation leads to problems in the culture/group that can decrease its survival; cultural anthropology – Marvin Harris)

21. NFE: Why do we need ethical guidelines? • Behavior can be controlled • Immediate reinforcers can influence a person to behave in ways that lead to aversive simuli for others or harm to others e.g., Stealing is reinforced by possession of the goods, loss of the goods is aversive to the victim • Ethical guidelines help to offset immediate reinforcers for behavior that is harmful to others and help to control the behavior of controllers e.g., Study objective 5: Constitutions, bills of rights, and other such political documents can be viewed as formal specifications of contingencies designed to control the behavior of those who control the behavior of others

22. SO8: Is all control unethical? • It is sometimes argued that all control is unethical. Why, upon a little reflection, doesn’t this argument make sense? • The goal of any social help professional can only be achieved by exerting control over behavior • Teachers can only teach children to read by changing their behavior • Drug addiction counselors can only get addicts clean by changing their behavior • Behavior analysts can only get autistic children to successfully interact with the world and learn new skills by changing their behavior • Sports psychologists can only get athletes to improve their skills by changing their behavior • OBM practitioners can only get mangers to be better managers by changing their behavior (Because of abuse power and personal experience with people who have abused power, some argue that all attempts to control behavior is unethical…common criticism of our field; behavior modification; go on to make the point that control is ubiquitous, and when left to chance sometimes things go horribly wrong – look at all the problems in our society, even with our legal system)

23. SO10: What is Countercontrol • From a behavioral perspective, countercontrol is the most fundamental and effective safeguard to ensure individuals and groups are treated ethically. • Countercontrol is the reciprocal of control; it is the influence the controllee has on the controller by having access to suitable reinforcers (and punishers) • Citizens vote politicians out of office • Workers unionize • A client stops seeing a therapist

24. NFE: Countercontrol and Ethical Guidelines • When individuals lack meaningful forms of countercontrol, the culture/group creates safeguards (arranges contingencies) to ensure ethical treatment • Ethical guidelines for behavior analysts working with at-risk individuals (monitored by the BACB and profession) • Loss/suspension of certification • Loss/suspension of license • Ombudsman and Office of Student Conduct at WMU • Students can complain to the ombudsman about a faculty member without retaliation • Students can only be charged with academic dishonesty after a hearing with an unbiased panel overseen by the OSC (What ethics are, when and why they are necessary; I am going to move on to the Van Houten article – any questions on this material?)

25. SO13: Right to effective treatment and restrictiveness • An individual is entitled to effective and scientifically validated treatment • Selection of treatment should be consistent with the philosophy of the least restrictive but effective treatment (both italicized terms are critical) • It is unacceptable to expose an individual to a restrictive procedure unless it can be shown that such a procedure is necessary to produce safe and clinically significant behavior • It is equally unacceptable to expose an individual to a nonrestrictive procedure if assessment results or research indicate that other procedures would be more effective (one of the first set of ethical guidelines for behavior analysts; generated by controversy surrounding the use of punishment; one of the most important things in this article, statement with respect to what determines the overall restrictiveness of a procedure)

26. NFE, but consider Slow-acting nonrestrictive procedures • Slow-acting nonrestrictive procedures could be considered highly restrictive if prolonged treatment: • Increases risk • An autistic child’s head banging can lead to very serious injury • A child with pica can swallow a life-threatening object/liquid • A child that bites can hurt himself, his siblings, his parents For samples of severe self-injurious behaviors, see youtube.com The videos are very disturbing and emotionally distressing. (may not have thought about this, but you must consider all of the effects of alternatives; SR may Be more restrictive than SP; the ethical nature of a decision/treatment cannot be judged in isolation; increased physical risk is the one that people think of most often, but there are others…next slide)

27. NFE, but Slow-acting nonrestrictive procedures, Con’t • Slow-acting nonrestrictive procedures could be considered highly restrictive if prolonged treatment not only increases risks, but: • Inhibits or prevents participation in needed training programs (because of aggressive behaviors toward others) • Delays entry into a more optimal social or living environment (hospitalization vs. a group home or living at home) • Leads to a adaptation to the treatment and eventual use of a more restrictive procedure Conclusion: In some cases, a client’s right to effective treatment may dictate the immediate use of quicker acting, but temporarily more restrictive procedures.

28. SO15: What determines overall restrictiveness? • 1. Absolute level of restrictiveness • Antecedents vs. consequences, reinforcement vs. extinction vs. punishment, restraints, medication • 2. Amount of time required to produce an acceptable outcome • 3. Consequences associated with interventions that have delayed effects • Note carefully for this one: it is NOT the intervention that is delayed (the intervention is implemented); rather it is the fact that the intervention does take a while to produce clinically significant effects, and those delayed effects have consequences for the individual like the ones presented on the two preceding slides (to summarize; questions, comments, on to Skinner)

29. SO16: What is the problem of giving too much help? • Skinner: • By giving too much help, (a) we postpone the acquisition of effective behavior and (b) perpetuate the need for help. • In the words of a well known proverb: • Give a man a fish and you feed him for the day. Teach a man to fish and you feed him for a lifetime. • By giving the man a fish, the reinforcer for the behavior of fishing, we have postponed his learning how to fish • He continues to need our help (Skinner’s basic point throughout the article: Make what people need, fish/food, contingent upon appropriate behaviors; instead of giving people things, we should teach them the appropriate/functional behaviors that will be reinforced by the things they need. Not only does this really help the individual, but it also improves the quality of his/her life.)

30. So17: Reasons why behavior may not be reinforced • Three reasons why the behavior of some individuals is not sufficiently reinforced • Others do things for them • They have not learned to do things for themselves • They are given things their behavior would otherwise be reinforced by (Then Skinner considers why the behavior of some individuals is not sufficiently reinforced – three reasons: he is basically saying that we are not helping individuals –in fact we are not really being ethical when we do things for others, when we don’t teach them to do things for themselves, or when we given things to people that would, in fact, reinforce appropriate/functional behavior.

31. So18: A Nice Behavioral Translation • When we refer to people as lacking initiative, having weak wills, suffering from apathy and boredom, what are they actually suffering from? • A world in which their behavior is not positively reinforced (Skinner is making this translation to build up to his point that a good quality of life – a happy life, an active live, a “passionate” life/career depend upon people having functional/appropriate behaviors that result in positive reinforcement – and thus, we contribute to individuals having a lack of initiative, or to individuals being apathetic and bored when we give things to them or do things for them rather than teaching them the skills/behaviors that will result in positive reinforcement – this leads into SO20)

32. SO20: How does behavior modification help people? Behavior modification helps people by arranging conditions under which they get things rather than by giving them things. Again, in other words, we teach people the functional behaviors that will result in valued/powerful reinforcers (getting things, “earning things”) rather than by noncontingently giving them those things. (this is a rather simple objective, but again, I want to stress the point Skinner is making here)

33. Hanley et al. Intro • I included this article because of what it indicates about (a) restrictiveness of interventions and (b) that the selection of treatments should not be based on “personal conviction” about what is “good” or “bad” • We should not be using the Golden Rule to select treatments, but the Platinum Rule • Golden Rule: Treat others as we would like to be treated • Platinum Rule: Treat others as they would like to be treated (I am quoting Van Houten et al. here again)

34. Hanley et al. summary • Participants: Two children • Jay • 5 years old, moderate retardation, autism, seizure disorder • Self-injurious behaviors: hitting and slapping head with hands, hitting head with objects, biting arms, and eye poking • Aggression: hitting, kicking, pushing, pinching, hair pulling, scratching, and head butting • Disruption: throwing objects, breaking objects, and knocking objects to the floor • Betty • 8 years old, mild to moderate retardation, ADD, and oppositional defiant disorder • Aggression: hitting, kicking, pinching, scratching, biting, pulling hair, and throwing objects at people (behavior targets in the study) • Pica and self-injury (not treated in the current study due to the fact that these were controlled by different variables than her aggression; but did treat these in an intervention that was not described in the current paper)

35. Hanley et al. summary • IV • Functional communication with extinction • Functional communication with punishment • Punishment only for inappropriate behavior (control) • SO23: What is functional communication training? • The reinforcer for the problem behavior is determined • The person is taught to emit an appropriate behavior – technically a mand – such as a gesture, vocal response, or picture card • The appropriate behavior is reinforced by the samereinforcer that was reinforcing the problem behavior • The problem behavior is extinguished, punished, or sometimes noncontingently reinforced (special type of DRA schedule; so you are reinforcing an alternative appropriate response, again with The same reinforcer that was maintaining the problem behavior)

36. Hanley et al. summary • 1. Determined what reinforcer was maintaining problem behaviors of Jay and Betty using a functional analysis • Adult attention • Jay: self-injury, aggression, disruption • Betty: aggression • 2. Functional Communication Training • Taught children to emit appropriate responses that would result in adult attention • Jay: Handing a yellow card that had the word “play” written on it to the therapist • Betty: Taught her to say “attention, please” and “excuse me”

37. So27, 28, 29: Hanley et al. summary • IV • Functional communication with extinction (FCT only) • FCT: Jay: if he handed the card to the therapist, 20 seconds of praise/interaction with the therapist • FCT: Betty: if she said, “attention, please” or “excuse me”, 20 seconds of praise/interaction with the therapist • Extinction for inappropriate behavior • Functional communication with punishment • FCT: same as the above for Jay and Betty • Punishment for inappropriate behavior: Jay: 30 seconds hand-down procedure (therapist stood behind him and held his hands to his sides) • Punishment for inappropriate behavior: Betty: 30 seconds hand-down procedure plus vision screen (therapist stood behind Betty, and placed one arm around Betty’s arms while placing the other hand over Betty’s eyes. • Punishment only for inappropriate behavior (control) • Punishment only, same as above (make sure you read Sos – askyou to learn details of the intervention; what is meant by “punishment” procedure)

38. SO30: Hanley et al. summary • DV: Selection of treatment by Jay and Betty • Pressed one of three different-colored switches, each of which was paired with one of the treatment conditions • After they pressed the switch, they were: • Immediately praised by the E regardless of which switch they pressed • Were exposed to the corresponding treatment for 2 minutes (again, make sure you read the Sos –details)

39. SO31 & 33: Hanley et al. summary • Results • Both children strongly preferred functional communication with punishment, rather than functional communication with extinction • Possible reason • Functional communication with punishment was more effective in decreasing their inappropriate behaviors • Because of that, a higher percentage of their responses were reinforced • They preferred the condition in which they received the highest rate of reinforcement (SO33 reason: can’t just say they preferred the condition..explain that statement – it doesn’t stand on its own)

40. Hanley et al. summary: • Back to Skinner and Van Houten et al. • Skinner: • What they are suffering from is a world in which their behavior is not positively reinforced • The “good life” is not a world in which they have what they need; it is one in which the things they need figure as reinforcers in effective contingencies • Van Houten et al. • In some cases, a client’s right to effective treatment may dictate the immediate use of quicker acting, but temporarily more restrictive, procedures • Selection of a specific treatment is not based on personal conviction. Techniques are not considered either “good” or “bad” according to whether they involve the use of antecedent rather than consequent stimuli or reinforcement versus punishment. (Onto Dicky)

41. DickyWolf, Risley & Mees • One of the most famous articles in behavior analysis • First written account of behavior analysts working with an autistic child, 1964 • First use of time out (Before I talk about this, I want to just briefly review some earlier material so that will be fresh)

42. SO 21: Skinner, Behavior analysis vs. traditional views of helping others, the conflict • Why was it inevitable that there would be a conflict between behavior modification and the traditional views of helping others, particularly those in institutional care? • In order to help individuals with complex behavioral problems and provide a reinforcing environment, we need to implement effective contingencies of reinforcement. • The arrangement of effective contingencies of reinforcement involves depriving individuals to some extent of powerful reinforcers; things that have been traditionally viewed as guaranteed rights and withholding them until the habilitative behavior occurs.

43. DickyWolf, Risley & Mees • Dicky was 3.5 years old • Progressed normally until he was 9 months • Cataracts were discovered in both eyes • Severe temper tantrums and sleeping problems developed • When two years old, he had a series of eye operations which made wearing glasses necessary; if he didn’t wear them it would result in permanent loss of macular vision (central as opposed to peripheral vision) • He was seen by a variety of specialists who diagnosed him as: • Mentally retarded, diffuse and locally brain-damaged, psychotic (among other things) • It was recommended that he be placed in an institution for the retarded because his prognosis was so poor

44. DickyWolf, Risley & Mees • Behavioral problems • Did not eat normally, lacked social and verbal repertoires, and engaged in self-injurious behaviors such as head-banging, face-slapping, hair-pulling, and face-scratching • Would not sleep at night, forcing one or both parents to remain by his bed • His mom said that after a severe tantrum • “he was a mess, all black and blue and bleeding.” • Sedatives, tranquilizers, and restraints were tried, without success

45. DickyWolf, Risley & Mees • At three, he was admitted to a children’s hospital with the diagnosis of schizophrenia (subsequently released) • Wolf, Risley, & Mees brought into consult • They did readmit him to the hospital temporarily until they could change his disruptive behaviors • They dealt with • His temper tantrums (using time out), bedtime problems, wearing his glasses, throwing his glasses (which he began to do after he started wearing them), verbal behavior, and eating problems (so that’s where we start: how many would like this case? I am going to focus on his glasses: getting back to the ethical consideration raised by Skinner: the necessity to deprive individuals of powerful reinforcers and conflicts with traditional views of helping and the rights of individuals.)

46. DickyWolf, Risley & Mees • They conducted a session at breakfast, using food as the reinforcer: that didn’t work • They conducted a session at lunch, using food as the reinforcer: that didn’t work • They conducted a session at 2:00 that afternoon: Dicky had received very little to eat all day, just a few pieces of dry cereal, and was most interested in the ice cream we brought to the session. At the beginning of the session it was quite obvious that our reinforcers were much powerful than earlier in the day….After this, progress was rapid and he was soon wearing his glasses continuously during the meal sessions in his room. Started with fruit & candy; modified the glasses a number of times – more “wearable”, less easy to take off; (they were not having much success getting him to wear the glasses 5 weeks – shaping – so the authors decided to get directly involved. Quote from the article.., remember permanent loss of vision – one more slide on this)

47. DickyWolf, Risley & Mees After wearing the glasses was established in these sessions, it could be maintained with other, less manipulable reinforcers. For example, the attendant would tell Dicky, “Put your glasses on and let’s go for a walk.” Dicky was usually required to wear the glasses (during meals, snacks, automobile rides, walks, outdoor play, etc.). If he removed the glasses, the activity was terminated. Fast forward a bit: Dicky was released from the hospital and according to his mom, six months later Dicky had continued to wear his his glasses, did not have any tantrums, had no sleeping problems, was becoming increasingly verbal, and was a new source of joy to the members of his family. (one more slide)

48. DickyWolf, Risley & Mees • So, essentially, the authors: • Food deprived a 3.5 year-old autistic child for, give or take, 7-8 hours (not counting overnight) so food would function as an effective reinforcer and • Punished him for removing his glasses by taking away food and activities he enjoyed Question: Were these procedures and interventions ethical or were Dicky’s rights violated?

49. Questions/Comments/discussion • Exam: 12/06 • Instructional assistance hours: 12/05. 3:30-5:00 • Isaac will be there