Chapter 1 - Introduction to
Child Development
Reasons to Learn About Child
Development
It improves child rearing, promotes adoption of wiser social policies about
children’s welfare, answers basic questions about human nature
Raising Children
Anger
80% of parents of kindergarten children reported spanking their child on
occasion when they fought, name-called and talked back to express their
anger.
This made matters worse no matter the race or culture.
The effects of spanking on the child’s behaviour held above other relevant
factors like parent’s income and education.
Spanking Alternatives
Express Sympathy
This leads to children being better able to cope with the distressing
situation.
Positive Alternatives to Expressing Feelings
Ex. Encourage them to do something they enjoy to cope with hostile
and frustrated feelings.
Use the Turtle Technique
This technique is used to help angry 3- and 4-year-olds.
It also helps children recognize their own and other children’s
emotions (children would “go into their shell” when they were mad
and came back to their peers when they were calm).
Children who did this were better at recognizing and regulating anger, even
after 4-5 years.
Choosing Social Policies
Studies let us make informed decisions about social-policy questions that
affect children.
ex. do violent video games make children and adolescents more
aggressive?
meta-analysis (a statistical technique that combines results from
independent studies) was used to reach conclusions).
It showed that the effect of playing violent video games on
children’s and adolescent’s aggression was minimal & this is
not a major cause of children’s and adolescent’s aggression.
These analyses let us weigh whether the benefits of removing
something that may be harmful outweighs taking away
someone’s freedom of choice.
Understanding Human Nature
nativists → group of contemporary philosophers and psychologists
argue evolution has created many capabilities in early infancy
especially particularly the understanding of basic properties of
physical objects, plants, animals, and other people.
empiricists → infants possess general learning mechanisms but they
do not have the specialized capabilities nativists believe them to.
Romanian Adoption Study
Research examines children whose early lives were spent in horrible
conditions in Romanian orphanages.
The goal of this study was to evaluable the long-term effects of the
children’s deprivation at such a young age (physical, intellectual and social).
When the children left the orphanage, they were below 6 months old. Most
were severely malnourished, showed varying degrees of intellectual
disability, and were socially immature.
At 6 years old, the early experience in the orphanages had prolonged
damaging effects on children’s social development and followed them into
early adulthood. Differences in intellectual development diminished over
time.
The findings showed that the timing of experiences influence their effects,
and the later the age of adoption, the greater the long-term harmful
effects of early deprivation.
Historical Foundations of the Study of
Child Development
Early Philosopher’s Views of Children’s Development
Plato & Aristotle (4th century BC) believed long-term welfare of society
depended on proper raising of children.
Plato thought boys were the most difficult to handle so he emphasized self-
control and discipline.
Aristotle agreed with Plato but he cared more about accommodating to the
different needs of each individual child.
Plato believed children have innate knowledge and Aristotle believe all
knowledge comes from experience.
English philosopher John Locke (1632-1704) & French philosopher Jean-
Jacques Rousseau (1712-1778) focused on how parents and society can
best promote children’s development.
Locke believed children were born as a blank slate (concept of tabula
rasa) & their development was largely influenced by the nurture
provided by parents and society.
He believed parents need to set good examples of honestly,
stability, and gentleness and instill discipline and reason so they
mature.
Rousseau on the other hand believed parents and society should give
children maximum freedom.
He claimed children learn primarily from their own spontaneous
interactions & shouldn’t receive formal education until they are
12 (old enough to judge validity of teachings in his eyes).
Social Reform Movements
Child psychology was important in social reform movements that were
focused on improving children’s lives by changing the conditions in which
they lived.
Children as young as 5-6 years old worked up to 12 hours a day in
factories or mines in dangerous circumstances.
Child psychology investigated the adverse effects harsh environments
can have on children.
Darwin’s Theory of Evolution
This theory focuses on variation, natural selection, and inheritance.
It influenced the thinking of modern scientists in the field of child
development (developmentalists) on wide range of topics.
ex. Infant attachment to maternal care, innate fear of natural dangers,
sex differences, aggression and altruism, and learning mechanisms.
Enduring Themes in Child
Development
Nature and Nurture: How Do Nature and Nurture
Together Shape Development
Nature → genetics
Influence everything; physical appearance, personality, intellect, mental
health & specific preferences.
Nurture → environments
Physical & social factors that influence our development.
ex. womb, homes, schools, communities, people we interact with
Developmentalists ask how nature and nurture work together to shape
development.
Example: Schizophrenia
Children who have a schizophrenic parent are much more likely of
developing it later in life.
However, children who grow up in troubled homes are more likely to
become schizophrenic than children raised in a normal household.
A study of adopted children showed those with substantial likelihood of
developing schizophrenia had a parent with the illness and were adopted
into a troubled family.
Nurture influencing nature & vice versa
Studies show that the genome - each person’s complete set of hereditary
info - influences behaviour and experiences and vice versa.
Genomes contain proteins that regulate gene expression by turning
activity on and off.
The proteins change in response to experience, and can create
long-lasting changes in cognition, emotion, and behaviour.
This led to new field called epigenetics, which is the study of stable
changes in gene expression influenced by environment.
Methylation is a biochemical process that influences behaviour by
suppressing gene activity.
It is also involved in regulating reactions to stress.
Studies show the amount of stress mothers reported during child
infancy is related to the amount of methylation in children’s genomes
15 years later.
The Active Child: How Do Children Shape Their Own
Development
Children shape their own development through direction of attention,
language use, and play.
Direction of attention
Children pay more attention to things that move which helps them learn
about important parts of world, like people, animals, and vehicles.
They are particularly drawn to faces, especially their mothers’.
This preference leads to social interactions that strengthen the
mother-infant bond.
Language
Usually between 9-15 months of age, toddlers start to speak.
Toddlers 1-2 years old talk when they are alone.
This is an internal motivation to learn language.
It is called “crib speech”.
Play
Play teaches babies about reactions.
ex. sounds of objects clashing, speed of objects falling & even limits of
parent’s patients (pushing and learning about boundaries).
At around 2 years, children play pretend.
Activities vary across cultures, but it does happen, even in cultures
that actively discourage it.
Play teaches children how to cope with fears, resolve disputes, and interact
with others.
Older children play is more organized
It promotes self-control through turn-taking.
It includes following rules.
It also includes controlling emotions.
Continuity/Discontinuity: In What Ways Is
Development Continuous, and in What Ways Is It
Discontinuous?
Continuous development → the idea that changes with age occur
gradually, in small increments, like that of a pine tree growing taller and
taller.
Discontinuous development → the idea that changes with age include
occasional large shifts, like the transition from caterpillar to cocoon to
butterfly.
Researchers who view development as discontinuous start with the fact that
children of different ages are different in terms of how they think and what
they know.
4 year old - 6 year old Piaget’s Conservation of Liquid Task
In this experiment, a 4-year-old watched her mother pour all the
water from a typical drinking glass into a taller narrower one and
then back to the normal one.
The 4-year-old thought there was more water in the second glass
because the water was higher.
However, when she was 6, she said there was the same amount of
water in both glasses.
letters to Mr. Rogers
In this experiment, a 4-year-old asks how Mr. Rogers “got inside
the TV” and a 5-year-old asked if he could “step out of the TV
and into his house” so he could play with him.
These findings beg the question “what is it about 4- and 5-year-olds
that lead them to form such improbable beliefs, and what changes
occur that make such notions laughable to 6- and 7-year-olds?”
Stage theories - approaches proposing development involves a
series of large, discontinuous, age-related phases
These theories propose that entry into new stage affects the
child’s way of thinking and behaviour.
Jean Piaget’s theory of cognitive development - development of
thinking and reasoning.
This theory says that between birth & adolescence, children go
through 4 stages of cognitive growth.
2- to 5-year-olds can only focus on one aspect of an event
at a time.
By age 7, children can simultaneously focus on & coordinate
2 or more aspects of an event.
With this view, the conservation of liquid scenario shows that 4-
to 5- year-olds focus on the single dimension of height, but 7- to
8-year-olds can look at height and volume at the same time
(second glass taller, but also narrower so they cancel each other
out).
Many researchers have concluded that most developmental changes
are gradual rather than sudden & and development occurs skill by skill.
Evidence: a child will often act in accordance with one stage in
some tasks, but in accordance with others in a different task, so
the child isn’t in either-or stage, it’s just a gradual process.
However, there are some discrepancies, like when height spikes at
certain ages. So, we must ask, “is development fundamentally
continuous, or fundamentally discontinuous?”
The answer is, it depends on how you look at it. It is gradual in
some cases, and sudden in others.
Mechanisms of Change: How Does Change Occur?
Developmental mechanisms can be behavioural, neural or genetic.
The roles of brain activity, genes, and learning experiences in development
of effortful attention:
Control of one’s emotions and thoughts: Inhibiting impulses,
controlling emotions, and focusing attention.
Difficulty in exerting effortful attention is associated with behavioural
problems, weak math and reading skills, and mental illness.
To specify the physiological mechanisms under this, researches examined
brain activity of people who performed tasks that require these types of
control.
The findings showed when people are controlling thoughts and
emotions, brain activity is intense between the limbic area (the part of
brain that plays a role in emotional reactions), and the anterior
cingulate and prefrontal cortex (brain structures involved in setting
and attending goals).
Connections among these areas develop during childhood primarily
through nature and nurture.
Ex. if one grew up in poverty, there is a negative effect on the
brain activity that suppresses negative emotions.
Brain activity and parenting:
Variations of genes that influence the production of key
neurotransmitters (chemicals involved in communication among brain
cells) are associated with variations in quality of performance on tasks
that require effortful attention.
Ex. Infants with a specific variance of a gene are impacted by the
quality of parenting they receive. (Lower-quality parenting →
lower ability to regulate attention. Higher-quality parenting,
higher ability to regulate attention).
However, for children who do not have the variance of the gene,
the quality of parenting has less of an effect on effortful attention.
Learning and Effortful attention:
Learning can impact effortful attention.
In a study, 6-year-olds were presented with a 5-day training program
that used exercises to improve capacity for effortful attention.
The result was that those who completed the exercises showed
improved effortful attention.
These children also showed improved performance on
intelligence tests.
The role of sleep in promoting learning and generalization:
Infants spend a lot of time sleeping, which is important in promoting
learning.
The type of learning sleep encourages changes with the
maturation of the hippocampus (brain structure that is important
for learning & remembering).
In the first 18 months of birth, sleep promotes learning of
frequently encountered patterns.
After 24 months, children often remember the specifics after a
nap better than those who did not take a nap, but memory of
general patterns is no better than those who did not nap.
How?
Active Systems Consolidation Theory
This theory suggests the hippocampus and cortex encode
new information during learning at the same time.
The hippocampus learns details after one or two
experiences, and the cortex produces abstraction of
general patterns over many experiences.
This theory also suggests that in older children and adults,
hippocampal memories (specifics) are replayed during sleep,
which allows the cortex to take the general, frequently
encountered patterns and, vice versa, to improve retention
of the content.
These findings showed that before 18-24 months of age, the
hippocampus is not mature enough to handle the rapid
details of specific experiences, so sleep doesn’t help with
retention of information, but after 24 months, it does.
The Sociocultural Context: How Does the
Sociocultural Context Influence Development?
Sociocultural context - physical, social, cultural, economic, and historical
circumstances that make up any child’s environment.
Uri Bronfenbrenner’s bioecological model:
This model includes:
People with whom children interact with (parents, grandparents,
siblings, day-care providers, teachers, friends, peers)
The physical environment (house, day-care center, school,
neighbourhood...)
Institutions (education systems, religious institutions, sports
leagues, social organizations)
Society (economic & technological advancement, values,
attitudes, beliefs, traditions, laws, political structure...)
ex. Most toddlers in america go to childcare outside their homes, and
this reflects the historical era, economic structure, cultural beliefs and
cultural values held.
What happens in day care determines who the children meet and
the activities in which they engage in as well.
A method used to understand influence of sociocultural context is to
compare the lives of children who grew up in different cultures (cross-
cultural comparisons).
This reveals practices that are rare in one culture and very common in
another and vice versa.
Ex. sleeping arrangements
In America, infants sleep in a crib or in the parent’s bed, but when
they are 2-6 months old, they move to another bedroom and
sleep alone there.
However, in other nations such as Italy, Japan, and South Korea,
young children always sleep in the same bed as their mother and
somewhat older children also sleep in the same room or bed.
How do these arrangements affect children?
Morelli and colleagues interviewed mothers in middle-
classed families in Utah and in rural Mayan families in
Guatemala
This study revealed that by 6 months, children in
America sleep in their own bedroom and as they
grow older, they have a bedtime ritual to comfort
the child (children also took comfort objects with
them to bed, like teddy bears).
However, Mayan mothers said their children sleep
in the same bed until they are 3, and sleep in the
same room after with no rituals.
Why is it the way it is?
Mayan culture values interdependence,
and they believe this method is
important for developing a good
parent-child relationship.
In America, independence and self-
reliance are valued, and this method
allows for that, and also allows for
intimacy between couples.
(Basically, these normal practices reveal the
deeper values we hold.)
In multicultural societies, contextual differences are related to ethnicity, race
& socioeconomic status (SES) - the measure of social class based on
income and education.
Virtually all aspects of children’s lives (food, parental discipline, toys...)
vary with these factors.
SES plays a large part in children’s lives
In America, most children grow up in reasonably comfortable
circumstances, but millions of other children do not.
Poverty rates are high in Black and Hispanic families &
single-mother families.
Poverty rates also high in the 25% of immigrant children or
children with immigrant parents (twice as high as among
children of native-born parents).
Children from impoverished families tend to do less well than
other children because of difficulties they face (dangerous
neighbourhoods, inferior day-care centers and schools, exposure
to high levels of air and water pollution, less parental involvement
in schooling), which boils down to cumulative risk (which is the
accumulation of disadvantages over years of development).
By infancy, they are more likely to have serious health
problems.
Their brains, on average, have less surface area in areas that
support spoken language, reading, and spatial skills.
They tend to have more emotional problems, small
vocabulary, lower IQs, and lower math and reading scores on
standardized tests.
In adolescence, they are more likely to have a baby or drop
out of school too.
However, many children do overcome the obstacles of poverty through:
1. Positive personal qualities
2. A close relationship with at least one parent
3. A close relationship with at least one adult other than parents
These factors show that children’s resilience are not just about
their personal qualities, but their interactions too.
Individual Differences: How Do Children Become So
Different from One Another?
Children differ in physical appearance, activity level, temperament to intelligence,
persistence, and emotionality.
Four factors that lead children to turn out very different from one another are:
1. Genetic differences
2. Differences in treatment by parents and others
3. Differences in reactions to similar experiences
4. Different choices of environments
5. Genetic differences
Every child is genetically unique, even identical & fraternal twins.
1. Differences in treatment by parents and others
Parents are more caring towards easygoing infants than difficult ones (by
second year, parents of difficult children are generally angry at them even if
they didn’t do something wrong in the moment).
Teachers provide more positive attention and encouragement towards well-
behaved students and are openly critical with disruptive students. They even
deny requests for special help from disruptive students.
There are subjective interpretations of treatment that are also influential.
ex. A sibling feels that parents favour the other child over them.
1. Differences in reactions to similar experiences.
Ex. A parent is fired? One sibling might be very concerned, but the other
might believe everything will be okay.
2. Different choices of environment
As children grow older, they choose their activities and friends for
themselves and thus influence their subsequent development.
They might choose niches (the smart one, the popular one, the
naughty one, the nice one...)
If labeled by family members, they might try to live up to their
label, whether it is good or bad (the nice one vs the
troublemaker).
Research and Children’s Welfare: How Can Research
Promote Children’s Well-Being?
Research helps children deal with anger, helps understand whether
eyewitness testimonies from young children are valid or not, and so on.
Educational innovations
Some believe intelligence is fixed, but some believe it increases with
learning.
People who believe intelligence is fixed tend to give up when they fail,
but people who believe it increases with learning often persist and
work hard until they accomplish their goals.
Building on this, an effective educational program for middle school
students was developed.
In this program, some students were given findings about how
learning alters the brain in ways that improves subsequent
learning.
Others were given info about how memory works.
Investigators predicted students who were taught about how
learning affects the brain would change their beliefs about
intelligence, and expected their math skills to improve primarily
as most students expect initial failure in math (they were right).
Children who initially believed intelligence was fixed but
came to believe that it can be improved showed especially
large improvements.
Therefore, providing children with information about how learning changes
the brain increases their motivation to learn, but struggle stories of famous
people are also motivating.
Methods for Studying Child
Development
The Scientific Method
The approach to testing beliefs that involves choosing a question,
formulating a hypothesis, testing the hypothesis, and drawing a conclusion
is called the scientific method.
hypotheses are testable predictions of the presence of absence of
phenomena or relations.
There are four basic steps to the scientific method:
1. Choosing a question to be answered.
2. Formulating a hypothesis.
3. Developing a method for testing the hypothesis.
4. Using the resulting data to draw a conclusion regarding the
hypothesis.
Importance of Appropriate Measurement
Researchers must use measures that are directly relevant to the
hypotheses.
To determine whether a measure is good or not, it must
possess reliability and validity.
Reliability
The degree of which independent measurements of given
behaviour are consistent.
Interrater reliability is the amount of agreement in the
observations of different raters who witness the same behaviour.
The rater’s evaluations must be in close agreement to have
confidence in research findings.
Used in qualitative & quantitative observations.
Test-retest reliability is the degree of similarity of a participant’s
performance on two or more occasions.
This is attained when child’s performance of the same test
administered under the same conditions are similar on two
or more conditions.
In this situation, to accurately reflect each child’s status, the
test needs to be reliable, and we know it is if the outcomes
are similar when done multiple times.
Validity
The degree to which a test measures what it is intended to measure.
Internal validity is the degree to which effects observed within experiments
can be attributed to the factor that the researcher is testing.
external validity - The degree to which results can be generalized beyond
the particulars of the research.
Additional studies with participants from different backgrounds are
needed to establish external validity of general findings.
KEY PROPERTIES OF BEHAVIOURAL MEASURES
relevance of interrater test-retest internal external
hypotheses reliability reliability validity validity
Do the Do different Do children Can effects How widely
hypotheses raters who who score within the can the
predict in a observe the higher on a experiment findings be
straightforwa same measure at be attributed generalized
rd way what behaviour one time to the to different
should classify or also score variables that children in
happen on score it the higher on the different
these same way? the measure researcher places at
measures? at other intentionally different
times? manipulated times?
?
Contexts for Gathering Data About
Children
Interviews and Questionnaires
Structured interview - a research procedure in which all participants are asked to
answer the same questions.
Questionnaires - a method that allows researchers to gather information from a
large number of participants simultaneously by presenting them a uniform set of
printed questions.
Questionnaries are often used for young children orally, but are printed for
children of reading age.
clinical interview - a procedure in which questions are adjusted in accord
with the answers in the interviewee provides.
ex. 10-year-old child Bobby who was assessed for symptoms of
depression
Bobby was asked what he would wish for if 3 wishes could be
granted.
His answers were instrumental in understanding his experience
and his depression.
This would have been impossible if the interviewer did not
tailor the questions to him specifically.
Interviews can get a lot of data quickly, but they can also be biased.
Naturalistic observation - examination of ongoing behaviour in an
environment not controlled by the researcher.
ex. troubled and typical families
To observe the frequency at which members engaged in negative
behaviours, assistants observed dinnertime interactions of troubled
and typical families silently.
troubled households typical households
Parents are more self-absorbed and Parents are less self-absorbed and
less responsive to children than more responsive to children than
parents in typical households. parents in troubled households.
Parents are more self-absorbed and Children responded to punishment
less responsive to children than by becoming less aggressive.
parents in typical households.
Interactions were in a cycle where the Typical households did not fall into
child acted hostile, the parent reacted this cycle.
angrily, the child became more
hostile, the parent became more
angry, and so on.
It is hard to know what influenced the behaviour specifically with naturalistic
observation.
Many behaviours only occur occasionally which makes limits the
researcher’s opportunities to observe them.
structured observation - a method that involves presenting an identical situation
to each participant and recording participant’s behaviour
data-gathering features advantages disadvantages
situation
interview/questio Children can 1. can reveal 1. reports are
nnaire answer questions children’s often biased to
asked either in subjective reflect favorably
person or on a experience 2. on the
questionnaire. structured interviewed
interviews are subject 2.
cheap ways to memories of
collect thorough interviewees are
data about often inaccurate
people 3. clinical and incomplete
interviews allow 3. prediction of
for following up future
on comments behaviours often
is inaccurate
naturalistic children’s 1. useful for 1. difficult to
observation activities in one describing know which
or more behaviour in aspects of
everyday settings everyday settings situation are
are observed 2. helps most influential
illuminate social 2. limited value
interaction for studying
processes infrequent
behaviours
structured children are 1. ensures that all 1. reveals less
observation brought to labs children’s about subjective
and presented behaviours are experience than
prearranged observed in interviews
tasks same context 2.
allows controlled
comparison of
children’s
behaviour in
different
situations
Variables - attributes that vary across individuals and situations, such as age, sex,
and popularity.
Correlational designs - studies intended to indicate how two variables are
related to each other.
Correlation - the association between two variables.
Direction-of-causation problem - the concept that a correlation between 2
variables does not indicate which, if either, variable is the cause of the other.
Third-variable problem - the concept that a correlation between two variables
may stem from both being influenced by some third variable.
Experimental designs - a group of approaches that allow inferences about
causes and effects to be drawn.
Random assignment - a procedure in which each participant has an equal
chance of being assigned to each group within an experiment.
Experimental control - the ability of researchers to determine the specific
experiences of participants during the course of an experiment.
Experimental group - the group of participants in an experimental design who
are presented the experience of interest.
Control group - the group of participants in an experimental design who are not
presented the experience of interest but in other ways are treated similarly.
Independent variable - the experience that participants in the experimental
group receive and that those in the control group do not receive.
Dependent variable - a behaviour that is measured to determine whether it is
affected by exposure to the independent variable.
ADVANTAGES AND DISADVANTAGES OF CORRELATIONAL AND
EXPERIMENTAL DESIGNS
types of design features advantages disadvantages
correlational comparison of 1. only way to 1. direct-of-
existing groups compare many causation
of groups of problem
children/examina interest (boys- (correlation does
tion of relations girls, rich-poor) not equal
in each child’s 2. only way to causation) 2.
scores on establish third-variable
different relations among problem
variables many variables
(IQ &
achievement,
popular,
happiness
experimental random 1. allows casual 1. need for
assignment of inferences experimental
children to because design control often
groups & rules out leads to artificial
experimental direction-of- experimental
control of causation and situations 2.
procedures third-variable cannot be used
presented to problems 2. to study many
each group allows differences &
experimental variables of
control over the interest such as
exact age, sex, and
experiences that temperament
children
encounter
Cross-sectional design - a research method in which participants of different
ages are compared on a given behaviour or characteristic over a short period.
Longitudinal design - a method of study in which the same participants are
studied twice or more over a substantial length of time.
Microgenetic design - a method of study in which the same participants are
studied repeatedly over a short period.
ADVANTAGES AND DISADVANTAGES OF DESIGNS FOR STUDYING
DEVELOPMENT
name features advantages disadvantages
cross-sectional children of Yields useful data Uninformative
different ages about differences about stability of
are studied at a among age individual
single time groupsQuick and differences over
easy to timeUninformativ
administer e about
similarities and
differences in
individual
children’s
patterns of
change
longitudinal children are Indiciates the Difficult to keep
examined degree of all participants in
repeatedly over a stability of studyRepeatedly
prolonged individual testing children
period differences over can threaten
long external validity
periodsReveals of study
individual
children’s
patterns of
change over long
periods
microgenetic children are Intensive Does not provide
observed observation of information
intensively over a changes while about typical
relatively short they are occuring patterns of
period while a can clarify change over long
change is process of periodsDoes not
occuring changeReveals yield data
individual regarding
change patterns change patterns
over short over long
periods in periods
considerable
detail
Ethical Issues in Child-Development Research
All research with human beings raises ethical issues, and this is especially
the case when the research involves children.
The Society for Research on Child Development has formulated a code of
ethical conduct for investigators to follow. Some of the most important
ethical principles in the code are:
Be sure that the research does not harm children physically or
psychologically.
Obtain informed consetn for participating in the research.
The experimenter should inform children and relevant adults of all
aspects of the research that might influence their willingness to
participate and should explain that refusing to participate will not
result in any adverse consequences to them.
Preserve individual participants’ anonymity, and do not use
information for purposes other than that for which permission was
given.
Discuss with parents or guardians any information yielded by the
investigation that is important for the child’s welfare.
Try to counteract any unforseen negative consequences that arise
during the research.
Correct any inaccurate impressions that the child may develop in the
course of the study.
Debrief the participants after the research has been completed.
Recognizing the importance of such ethical issues, universities, and
governmental agencies have established institutional review boards made
up of independent scientists. However, the individual investigator is in the
best position to anticipate potential problems and bears the ultimate
responsibility for seeing that their study meets high ethical standards.