International Review of Research in Mental Retardation, Volume 5

International Review of RESEARCH IN MENTAL RETARDATION VOLUME 5

Consulting Editors for This Volume Peter Mittler

Ivar Arnljot Bjorgen

HESTER ADRIAN RESEARCH CENTRE UNIVERSITY OF MANCHESTER MANCHESTER, ENGLAND

UNIVERSITY OF OSLO OSLO. NORWAY

Neil O'Connor

A. R. Luria MOSCOW, U.S.S.R.

THE MAUDSLEY HOSPITAL LONDON, ENGLAND

Philip Roos

Murray Sidman

UNIVERSITY OF MOSCOW

NATIONAL ASSOCIATION FOR RETARDED CHILDREN DALLAS, TEXAS

THE MASSACHUSETE GENERAL HOSPITAL BOSTON, MASSACHUSE7TS

Paul Siege1 UNIVERSITY OF ALABAMA UNIVERSITY. ALABAMA

Contributors to This Volume

PAUL B. BALTES

GEORGE KELLAS

ALFRED A. BAUMEISTER

LOTHAR R. SCHMIDT

JOHN M. BELMONT

KEITH G. SCOTT

FREDERIC L. GIRARDEAU

ROBERT L. SPRAGUE

EDWARD A. HOLDEN, JR.

PAUL WEISBERG

JOHN S. WERRY

International Review of

RESEARCH IN JkENTAL RETARDATION

EDITED BY

NORMAN R. ELLIS DEPARTMENT OF PSYCHOI.OGY UNIVERSITY OF A L A B A M A UNIVERSITY, ALABAMA

VOLUME 5

1971

ACADEMIC PRESS New York and London

COPYRIGHT 0 1971, BY ACADEMIC PRESS, INC. ALL RIGHTS RESERVED NO PART OF THIS BOOK MAY BE REPRODUCED IN ANY FORM, BY PHOTOSTAT, MICROFILM, RETRIEVAL SYSTEM, OR ANY OTHER MEANS, WITHOUT WRITTEN PERMISSION FROM THE PUBLISHERS.

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PRINTED IN THE UNITED STATES OF AMERICA

Contents

...............................................................

ix

preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

xi

List of Contribuhrs

Contents of Previous Volumes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medical-Behaviora JOHN

I. Introduction..

...

xlu

I Research in Retardation

M. BELMONT

.........................................................

11. Origins and Philosophies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

111. Problems of Method ..................................................... IV. Behavioral Studies in Mongolism ......................................... References .............................................................

1

4 9 33 75

Recognition Memory: A Research Strategy and a Summary of Initial Findings

KEITH G. SCOTT I. Statement of the Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

84

11. A Research Strategy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

111. IV. V. V1. VII.

Experimental Designs. . . . ,............................................... Early Experiments. ..................................................... Method.. . . . . . . . . . . .............................................. Empirical Findings. . . ............................................ ............................................ Summary and Discussi References .............................................................

87 89 91

94 106 109

Operant Procedures with the Retardate: An Overview of Laboratory Research

PAULWEISBERC I. Introduction

...........................................................

11. Reinforcement ......................................................... 111. Punishment ............................................................

IV. Schedules of Reinforcement

.............................................. V

113 114

122 132

vi

Contents

V. Dependent Variables .................................................... VI . Concluding Remarks .................................................... References .............................................................

135 141 142

Methodology of Psychopharmacological Studies with the Retarded

ROBERTL. SPRAGUE AND JOHN S. WERRY I . Introduction ............................................................ 148 149 I1. Survey of Literature ..................................................... 111. Methodology of Drug Studies ............................................. 169 1V. A Brief Survey of Our Recent Psychopharmacological Research . . . . . . . . . . . .180 References

........................................................

208

Process Variables in the Paired-Associate Learning of Retardates

ALFREDA . BAUMEISTER AND GEORGE KELLAS I . Introduction ........................................................... I1. Some Methodological Considerations ..................................... I11. Constituent Analysis of Paired-Associate Learning .......................... IV . Acquisition Strategies and Stages of Learning .............................. V. An Acquisition Strategy Model ........................................... VI . Overview .............................................................. References .............................................................

221 225 229 257 259 264 266

Sequential Dot Presentation Measures of Stimulus Trace in Retardates and Normals

EDWARD A . HOLDEN. JR. I . Introduction ........................................................... I1. The Concept of Stimulus Trace and Its Relevance to Research in Mental Deficiency ............................................................. I11. Sequential Integration Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV . Illusory Displacement Studies ............................................ V. Discussion .............................................................. References .............................................................

271 272 273 281 297 300

Cultural-Familial Retardation

FREDERIC L. GIRARDEAU I . Introduction ........................................................... I1. Descriptive, Correlational, Nonmanipulated Group Comparison and Experimental Research .................................................. 111. A Systematic Approach to Cultural-Familial Retardation .................... IV . Concluding Comments .................................................. References .............................................................

304 307 327 340 342

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CONTENTS

German Theory and Research on Mental Retardation: Emphasis on Structure

LOTHARR. SCHMIDT AND PAULB. BALTES I. Introduction

...........................................................

549

11. Theoretical Orientation 111. Specific Research Emph

IV. Education and Rehabilitation . . . . . . . . . . . . . V. Comparative Evaluation ...................................... References . . . . . . . . . .

................................................................ Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Author Index

379

393 405

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List of Contributors Numbers in parantheses indicate the pages on which the authors’ contributions begin.

PAULB. BALTES,West Virginia University,Morguntown, West Virginia (349) ALFREDA. BAUMEISTER, University of Alabama, University, Alabama (221 ) JOHNM. BELMONT, Yale University,New Haven, Connecticut ( 1 ) FREDERIC L. GIRARDEAU, Kansas Center.for Mentul Retardation and Human Development, Kansas City, Kansas (303) EDWARDA. HOLDEN,JR., E. R . Johnstone Training and Research Center, Bordentown, N m Jersey (271) GEORGE KELLAS,University of Kansas,Lawrence, Kansas (221) LOTHARR. SCHMIDT,University of Saarland, Saarbrucken,Germany (349)* KEITH G. SCOTT, Children’s Research Center, University of Illinois, Urbana-Champaign, Illinois (83) ROBERTL. SPRAGUE,Children’s Research Center, University of Illinois, Urbam-Champaign, Illinois ( 147) PAULWEISBERG, University of Alabama, University,Alabama (1 13) S. WERRY,Institute fm Juvenile Research, and University of Illinois, Collegeof Medicine, Chicago,Illinois ( 147)

JOHN

*On research leave at Department of Psychology, University of Illinois, Urbana-Champaign, Illinois.

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Preface The purpose of this yearly volume is to review and interpret current behavioral research in mental retardation. It also provides a forum for theories and new approaches. T h e publication strives to be international in scope, though it is evident that the United States is the major producer in this field. Although previous volumes have consisted mainly of psychological research and theory, “behavioral research” is defined more broadly by the editorial staff and includes research in sociology, social work, education, anthropology and biological studies which have molar behavioral aspects. Future volumes will attempt to represent this broader area. In the main, the contents of these volumes indicate that most research still focuses on institutionalized retardates who fall into the “educable” range. An inordinately small amount of research is conducted on the retardate living at home and attending special classes in public schools. Perhaps, they are much less available as subjects for research. At the same time the behavior of the profoundly and severely retarded receives little attention. And, large numbers of these are found in institutions. Other neglected research areas include sensory and motor disorders existing from an early age which often result in intellectual retardation -deafness and blindness, cerebral palsy, epilepsy, and emotional disorders. These have not come under careful scrutiny by research psychologists in particular. Finally, many hold that approximately 85% of those retarded fall into the cultural-familial diagnostic category. Generally, only the small number of these found in institutions become subjects for research, and they are, perhaps, atypical. Some 30 million persons in the United States have IQs of 85 or less on standard intelligence tests. Large numbers of these would be judged “intellectually” retarded. Our intensive study of the college sophomore, institutionalized retarded, and normal preschoolers leaves this group neglected.

NORMAN R. ELLIS University of Alabama February, 1971

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Contents of Previous Volumes Volume 1

A Functional Analysis of Retarded Development SIDNEY W. BIJOIJ Classical Conditioning and Discrimination Learning Research with the Mentally Retarded E. Ross LEONARD The Structure of Intellect in the Mental Retardate AND C. EDWARDMEYERS HARVEY F. DINCMAN Research on Personality Structure in the Retardate EDWARD ZICLER Experience and the Development of Adaptive Behavior H. CARLHAYWOOD AND JACK T. TAPP A Research Program on the Psychological Effects of Brain Lesions in Human Beings RALPHM. REITAN Long-Term Memory in Mental Retardation M. BELMONT

JOHN

The Behavior of Moderately and Severly Retarded Persons E. SPRADLIN AND FREDERIC L. GIRARDEAU

JOSEPH

Author Index-Subject Index

Volume 2

A Theoretical Analysis and Its Application to Training the Mentally Retarded M. RAY DENNY The Role of Input Organization in the Learning and Memory of Mental Retardates HERMAN H. SPITZ xiii

xiv

Contents of Previous Volumes

Autonomic Nervous System Functions and Behavior: A Review of Experimental Studies with Mental Defectives RATHE KARRER Learning and Transfer of Mediating Responses in Discriminative Learning BRYANE. SHEPPAND FRANKD. TURRISI A Review of Research on Learning Sets and Transfer of Training in Mental Defectives MELVINE. KAUFMANAND HERBERT J. PREHM

Programming Perception and Learning for Retarded Children MURRAY SIDMAN AND LAWRENCE T. STODDARD Programmed Instruction Techniques for the Mentally Retarded FRANCES M. GREENE Some Aspects of the Research on Mental Retardation in Norway ~ V A RARNLJOT BJORGEN Research on Mental Deficiency During the Last Decade in France R. LAFONAND J . CHABANIER Psychotherapeutic Procedures with the Retarded MANNYSTERNLICHT Author Index- Subject Index

Volume 3

Incentive Motivation in the Mental Retardate PAULS. SIEGEL Development of Lateral and Choice-Sequence Preferences IRMA R. GERJUOY AND JOHNJ. WINTERS, JR. Studies in the Experimental Development of Left-Right Concepts in Retarded Children Using Fading Techniques SIDNEY W. BIJOU Verbal Learning and Memory Research with Retardates: An Attempt to Assess Developmental Trends L. R. GOULET Research and Theory in Short-Term Memory KEITH G. SCOTTAND MARCIASTRONGScorn

CONTENTS OF PREVIOUS VOLUMES

xv

Reaction Time and Mental Retardation ALFRED A. BAUMEISTER AND GEORGE KELLAS Mental Retardation in India: A Review of Care, Training, Research, and Rehabilitation Programs J. P. DAS Educational Research in Mental Retardation SAMUEL L. GUSKINAND HOWARD H. SPICKER Author Index -Subject Index

Volume 4

Memory Processes in Retardates and Normals NORMANR. ELLIS A Theory of Primary and Secondary Familial Mental Retardation ARTHURR. JENSEN Inhibition Deficits in Retardate Learning and Attention LAIRDW. HEALAND JOHN T. JOHNSON, JR. Growth and Decline of Retardate Intelligence MARY ANNFISHERAND DAVIDZEAMAN The Measurement of Intelligence A. B. SILVERSTEIN Social Psychology and Mental Retardation WARNER WILSON Mental Retardation in Animals GILBERTW. MEIER Audiologic Aspects of Mental Retardation LYLEL. LLOYD Author Index - Subject Index

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Medical-Behavioral Research in Retardation JOHN M. BELMONT YA1.E U N I V E R S I T Y , NEW H A V E N . C O N N E C T I C U T '

I.

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................

11. Origins and Philosophies . . . . . . . . . 111. Problems of Method . . . . . . . . . . . .

........................

Medical-Behavioral Causation . . . . . . . . . . . . . . . . . . . . B. Characteristics of Research Designs and Medical-Behavioral Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV. Behavioral Studies in Mongolism . . . . . . . . . . . . . . . . . . . . . A. T h e Clinical Picture ...................................... B. T h e Research Picture ...................................... C. A Summary of the Literature ................................. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I 4 9

A.

23 33 33 44

65 75

I. INTRODUCTION

Mental retardation is not a practical problem (any more than the human condition is a practical problem), but is rather a conventional academic rubric which subsumes a great many areas of scholarly enquiry. A recently graduated specialist in retardation is likely to have taken advanced courses entitled Psychological Aspects, Medical Aspects, Educational Aspects, etc., in order to learn the research techniques and current practices with which psychologists, physicians, educators, and others have tried to deal with mentally retarded people. T h e student will inevitably realize, however, that the Aspects are little more than illusory; useful perhaps, only as titles for courses or textbooks in which the tremendous complexity of retardation is neatly lost in the analysis of its parts. But it is of course this very analysis that permits workable research, and despite the unresolved debates that beset all of the disciplines concerned with retardation, there are occa'Address: 163 York Street, New Haven, Connecticut

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John M . Belmont

sional moments of discovery that recharge our research efforts and quicken our hopes that solutions to retardation are closer at hand. The elucidation of phenylketonuria was such a moment. The observation that mongoloids have excess genetic material was another. It is no surprise that research based on these and allied discoveries should account for a large proportion of the recent medical literature in the field. But it is astonishing how much influence this work has had outside the medical literature, particularly on those who have no special interest in medicine but who are very much dedicated to fostering the cause of the mentally retarded. Consider, for example, the symposia attending the Joseph P. Kennedy, Jr. Foundation international awards for research, leadership, and service in retardation (Jervis, 1967). Eleven of the 14 papers included in the volume are medically oriented, while the remaining three are the products of behavioral or psychophysiological research. According to Jervis “this apparent bias is simply a reflection of the extraordinary contributions that the study of chromosomal aberrations and of inborn errors of metabolism has made to our present knowledge of mental retardation. It is not surprising in this respect that the recipients of the scientific Kennedy awards in 1962-63 were biochemists and geneticists [p. vi].” In view of this encouraging introduction, scrutiny of the papers selected to illustrate these extraordinary contributions is disappointing. Retardation is a behavioral deficiency, yet the majority of the papers had little or nothing to say about retarded behavior. Penrose, and Soltan, Sergovich, and Barr were concerned with mongolism, but purely as a cytogenetic and somatic disorder. Carr’s interest was focused on the cytogenetics of abortuses, cases in which mental retardation is of course irrelevant. Lejeune presented a new, extremely rare cytogenetic disease whose behavioral characteristics were simply and uncritically severe retardation and an odd-sounding cry. And Waisman and Gerritsen gave a complete metabolic picture of another rare condition, but their behavioral note was that “the child is usually mentally retarded.” In view of these works’ relatively weak emphasis on retardation per se, one suspects that the sociology of scientific achievement is here operating disproportionately to the practicalities of the situation. It is not surprising that nonmedical professionals have reacted in kind. The American Psychological Association ( 1970) has denounced medicine’s traditional role as the chiefly responsible agent in matters pertaining to retardation, arguing on the ground that in some 85% of all cases, there is no demonstrable neurological or somatic dysfunction, that the cause is polygenetic inheritance or an adverse environment, and that the pre-

MEDICAL-BEHAVIORAL RESEARCH

3

senting symptoms are not medical, but rather psychosocial and psychoeducational. On these bases, the APA recommended that “it is inappropriate that the main thrust of funding and research, as well as of custodial care, should be the responsibility of the medical sciences [p. 2681.’’ (See also Kety, 1967,on this point.) One cannot escape the impression that an intractable leviathan with strong historical roots is being attacked on rational grounds by a group of hopeful hiers to the problems (and the remunerations) of primary responsibility for the mentally retarded. This unhappy reminder of the rift between the behavioral and medical professions will not likely influence the level of research funding enjoyed by either, but the APA’s simplistic view neatly compliments the provincialisms of the medical researchers represented in the Kennedy Symposium, and together they suggest that neither camp has seriously considered at least a partial detente being reached through joint studies of medical-behavioral aspects of retardation. There is, however, a large literature on interrelations of medical and behavioral characteristics of retardates, and certainly no harm will come to a psychologist, a physician, or any other professional who bothers to examine this research - its underlying philosophies, its methods, and its results. The present paper provides such an overview. Its three goals are to trace the origins of interest in medical-behavioral research, to explore some theoretical and methodological problems inherent in the research designs, and, in the case of mongolism, to give a fairly complete evaluation of the results. N o attempt has been made to cover all forms of medical-behavioral research literature. Especially in the review of the research on mongolism, selection was made principally on the assumption that the richly variable behavior problems of mentally retarded people cannot begin to be seen in the results of common clinical psychometrics. The focus is therefore upon studies which have considered specifically defined perceptual, cognitive, motivational, or personality variables on which retardates might be expected to sort themselves out by virtue of their medical classifications. Of the classifications themselves, the general discussion is directed toward ones that have clear medical indices. Cultural-familial retardation, explicitly defined as having no medical signs (Heber, 1961), is thus understandably deemphasized. Before proceeding, it will be well to note that the medical, psychological, and educational researchers who have chosen to cross interdisciplinary lines have done so for numerous reasons, have come equipped with differing conceptions of the theoretical and practical roles of medical and behavioral labels, and have variously appreciated the problems

John M.Belmmt

4

of using these labels for research purposes. Thus, there is evidently no unified field of medical-behavioral aspects of retardation, and the following discussion is neither intended to impose order where none exists, nor to judge the merits of one philosophical approach over another. It is intended only to provide some bases for evaluating medical-behavioral research designs by focusing on common methodological problems, and thereby, hopefully, to aid the planning and execution of future studies. The first step is to explore the diversity of the field. Then some problems of method will be studied as they apply generally and in respect to research on particular medical classifications. Finally, there will be a review of behavioral research. Although focused upon mongolism, this literature provides a model of diversified interest that could well be applied to other medical classifications. II. ORIGINS AND PHILOSOPHIES

Although retardation has always been defined as a substandard adjustment to roughly age-graded behavioral demands upon the child, it happens that the earlier he fails to meet these demands, and the more severe his deviation, the greater the likelihood that it will be accompanied by biological abnormalities. Since the family’s and the community’s ability or willingness to deal with retardation decreasesjust as the probability of biological aberrations increases, it is not surprising that it fell to the physician to make therapeutic recommendations. And as the physician is always inclined to the very practical device of diagnostic classification, so does the history of the care of mental retardates closely parallel attempts to enumerate and classify its biological dimensions. 1. STEREOTYPES

In the last 100 years, however, there has never been a moment when medicine’s nosological enterprise stopped at the boundary of its traditional concerns. It has always been evident in descriptions of mongolism, and recently in other classifications,that physicians are determined to elaborate specific behavioral anomalies, distinct from any global retardation, with which biologically classified retardates can be identified. Although it cannot possibly convey the enormous variety of similar ascriptions easily found elsewhere in the literature, this example may give the flavor of what is meant here: A word should be said about a very characteristic behavior pattern of mongoloid patients; their stubbornness . Contrasted with the lack of attention and the distractibility of many subnormal patients, I venture to suggest that the stubbornnessof mongoloids is a

.. .

MEDICAL-BEHAVIORAL RESEARCH

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psychological manifestation of the peculiar discrepancy in the development of the nervous system, in which the central subcortical areas serving emotional responses are fairly well developed, while the “long-circuiting” system of the cortex, serving the evaluation of sensory stimuli and responses and serving, therefore, intelligent interaction with the environment, remains immature and underdeveloped [Benda, 1946, p. 621.

In many cases, the reasons for providing clinical behavioral observations are unclear and the observations themselves are often quite stereotypic, being untempered by the caution ordinarily expected in scientific writing. They nevertheless constitute regular appendices to the clinical typing of the retarded, and a good deal of recent research has been designed explicitly to test their validity. Because of the fairytale quality of many of the original stereotypes, some researchers have justified their work as attempts to debunk medical-behavioral myths. Others, seemingly motivated by their own informal observations, or their confidence in the acumen of the clinical work, have quite frankly attempted to support the stereotypes, and presumably to bolster their credibility by using objective behavioral measures. These two kinds of studies formulate their hypotheses in much the same way, tending to emphasize improvements in the measurement of behavior and hence the quality of inference, while paying little attention to possible weaknesses in the medical classifications. They may be viewed simply as attempts (and often not very dispassionate attempts) to clarify the possibility that a retarded person, given a medical label, will be found to exhibit some more or less pathognostic behavioral quality, such as the alleged stubbornness of mongoloids. But turn the coin. Physicians whose zealous behavioral observations prompted these tests have at least one notable counterpart in the behavioral sciences. As frequently used by psychologists and educators, “brain injury” is in fact no more than a misnomer for an ill-defined collection of behavioral dysfunctions with presumed biological origins (Stevens & Birch, 1957). There are tests of this medical stereotype, quite analogous to those of the behavioral stereotypes. And just as the latter tend to emphasize their behavioral measures while ignoring the medical classifications, so do the tests of “brain injury” largely ignore behavioral measures while focusing upon medical labels of a much higher quality than “braindamage,” presumably in hopes of specifying the biological referents to which it must surely apply.

2. PRAGMATICS A second group of medical-behavioral studies has taken a distinctly pragmatic approach. Again, there are some which emphasize behav-

John M . Belmont

6

ioral measures, while others are especially tuned to the problems of medical classification. The philosophy and methods of those with a behavioral orientation may be illustrated by Knights, Hyman, and Wozny’s ( 1965) study on “psychomotor abilities of familial, brain-injured and mongoloid retarded children.” These authors justified their choice of measures, which involved a tactile discrimination procedure, by noting that organization of abilities among groups of retardatescarries implications for the planning of beneficial training programs . the assessment of differences in tactual, spatial and kinaestheticskills in children with poor learning abilities is considered an important step for the development of appropriate rehabilitationtechniques [p. 4541.

..

(For variations on this, see Bilovski 8c Share, 1965; Garrard 8c Richmond, 1965a; Halpin, 1958; Hunt, 1960.) On this premise, the pragmatic studies generally choose fairly precise behavioral criteria on which to judge likely differences in educational needs among medical subgroups. In Knights, Hyman and Wozny’s study, groups of retardates were chosen both for their different labels and for the probable times at which their difficulties arose. By this choice, differences between non-brain-damaged and brain-damaged groups could be compared with differences found by Matthews and Reitan (1962) for nonbrain-damaged vs. brain-damaged people who had acquired their lesions as adults. Together, it was hoped, the two studies would shed light on the relative importance of the damage and the time that it occurred. Studies along these lines have been quite popular, and their appeal is readily understandable. One need only assume that biological difficulties upon which medical classifications are based can determine intellectual problems of educational importance. The medical labels are readily available through medical records and can easily be understood, thanks to their carefully edited collected publication by Heber (1961). The burden on the researcher is thus limited to choosing appropriate behavioral measures, and this becomes the major emphasis of the research design. A sharp shift in focus to the etiologies specified in various classifications, while never forgetting their debilitating intellectual concomitants, introduces another practical application for medical-behavioral research: preventive family counseling. Knowing that some biological condition associated with retardation is directly inherited, or at least has a strong familial affinity, it is not unreasonable to tell the patient’s parents that the chances are very high of their bearing another, similarly afflicted child. Phenylketonuria is the classic example, being inher-

MEDICAL-BEHAVIORAL RESEARCH

7

ited approximately as a single recessive characteristic, and there are many other similar metabolic diseases (Hsia, 1967; Paine, 1960). Although the inheritance of many instances of mongolism is still unsure, it too has been studied with a view toward family planning (e.g., see Lenz, 1968; Penrose, 1967; Polani, 1968). Since there is nowadays nothing of chronic importance in the mongoloid’s medical condition, his retardation is the principal concern (Kugel, Fedge, Trembath, 8c Hein, 1964; Mallet, 1964; Mallet & Labrune, 1964). Therefore, strictly speaking, Penrose’s, Lenz’s and Polani’s work must ultimately be viewed as medical-behavioral. The same may be said of the very practical studies concerned with dietary controls and hormonal and other replacements for metabolic and endocrine disturbances which are thought to be rather direct causes of retarded behavior. Steps in metabolic research have been (a) to isolate an abnormal metabolite which might be toxic to the central nervous system, and (b) to develop a diet which will maintain the metabolite at normal levels. T h e first step is exactly the procedure by which the medical classification is made, except that the metabolite’s presence is sufficient for a diagnosis, whereas its toxicity is less a matter of fact than it is a hypothesis for, among other things, behavioral rek h (cf. Fishler, Koch, Donnell, & Graliker, 1966; Fuller, 1967).

3. BASICTHEORY A few medical-behavioral studies have been done, not because of what others have observed at the clinical level, nor because of any practical implications, but simply because the medical condition presents an occasion on which to build theories of cytogenetic and biochemical contributions to human behavior. Shaffer (1962) reported factor scores derived from intelligence tests on Turner’s Syndrome patients simply because “psychological information concerning these persons is relatively scant, owing, in part, to the rarity of the disorder. Nonetheless, such information would be important since a weII-documented chromosomal abnormality is implicated and thus any findings may be of relevance to the growing body of knowledge linking genetics with behavior [p. 4031.’’In this same spirit, Gibson and Pozsonyi (1965) observed that an “opportunity for comparative study of human morphology, behavior and demographic variations, related to position, independence, and size of the chromosomal fragment exists uniquely within classical mongolism [p. Sol],” and Anderson and Siege1 (1968) saw the inherited metabolic disorders as offering “a set of Ss defined on objective laboratory criteria not related to behavior, and the potential

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John M .Belmont

opportunity to relate changes in behavior with concurrent biochemical findings [p. 71.’’ Such positions derive from a basic science tradition which holds that the discipline will mature commensurate with improvements in the quality of known relations between nosological and behavioral variables. The mandate to researchers is not only to elaborate, but also to account for these relations using the clearest possible nosology and the widest possible catalog of clearly defined behavioral variables. On the medical side, the studies’ principal objective is to discover, by minute clinical observations or by definitive experimental manipulations, what characteristic of a particular classification might explain concurrent behavioral disorders.

4. EXPERIMENTAL CONTROL It is generally true that an investigator who groups his subjects according to medical labels is interested in discovering something about the classifications’ behavioral correlates. In some cases, however, grouping by classification is done for the very special reason of guarding against unwanted variability in behavioral data on retardates. Thus, McConnell ( 1967) chose to study personality in cultural-familial retardates because “they seemed most likely to represent the lower end of the normal distribution of intelligence without showing the contaminating effects of brain damage [p. 471,” while Girardeau (1959) used mongoloids in research on discrimination learning partly because of their “relative homogeneity from the standpoint of physical and intellectual characteristics . . . [p. 5661.’’ Similarly, Ross, Headrick, and MacKay (1967) chose mongoloids for a study of classical eyelid conditioning simply “to ensure an etiologically homogeneous population [p. 211.” The titles of each of the two latter studies include the classification of their subjects, and their readers therefore deserve to expect a word or two concerning the classification per se, but neither study contained any such discussion. On the other hand, since these works included only one classification, they could not legitimately conclude anything as regards its behavioral peculiarities. Moreover, their reasons for using mongoloids, and McConnell’s reason for excluding brain-damaged subjects from his study, relied on undocumented assumptions about relations of medical conditions to particular classes of behavior. Thus, brain damage was assumed to have peculiar relations to personality, and mongolism was assumed to be somehow specially related to discrimination learning and to eyelid conditioning, but no data were offered to support these assumptions. The decisions to examine only one classification were thus certainly premature, and possibly unjustifiable.

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5. SUMMARY

A brief excursion into the justifications offered by investigators who looked simultaneously at the behavior and the medical classifications of retardates reveals at least four reasonably distinct philosophies and several variations on each. The first, and largest group of studies is intended to put clinically derived stereotypes to rigorous test. Second, and hopefully most immediately applicable, are those designed to discover particular behavioral or biological qualities of specific classifications around which special training, rehabilitation, or preventive measures might be designed. The third philosophy of research, which is very rare, is the basic science approach meant to support or to give rise to medical-behavioral theory, without regard to application. In contrast, the fourth type of research seems bent on improving experimental designs, without regard to theory or practice.

111. PROBLEMS OF METHOD

As the term is to be used here, a problem of method is anything that interferes with clear interpretation of a research report. The obstruction may occur in the choice of subjects or measures, the actual conduct of the research, the analysis of data, or the reasoning by which the results are treated. People who plan to pursue this line of research would do well to reflect upon some of the difficulties their predecessors may not have acknowledged, but most certainly and unhappily encountered. The first discussion will comprise notes on problems of medicalbehavioral causality. Although the pragmatic studies and the tests of stereotypes might seek none but empirical justification, with no recourse to theory, their findings nevertheless frequently convey clear causal implications. In fact, many investigators who manage to find behavioral differences among subtypes of retardates respond to their discoveries in a theoretical frame of mind, whether or not the purposes of the study justify the effort. For those who are disinclined to speculate on probable causes, it will be well to note, in addition, that the very act of looking for distinctive behaviors associated with particular classifications can sometimes inadvertently bind the investigator to a theoretical position. For example, anybody wishing to test Benda’s (1946, p. 62)clinical observations on mongoloids’ stubbornness will be hard put to disregard the implications the test will have for Benda’s developmental neuroanatomical explanation for the stubbornness. The second discussion deals with problems of experimental design,

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and the use of medical labels as independent variables in medical-behavioral research. A.

Med ica I-Behaviora I Causation

Ask a physician or a psychologist (or anybody else, for that matter) what behaviors might be expected from a young child who incurs a mild head injury. T h e response might be that the child will cry and put a hand to his head. If pressed to say how long he would cry, and how he came to know that rubbing his head would hlep, the best guess would be that he cried until somebody came to soothe him, and he rubbed his head because, at least in part, he had learned to, either by precept or by luck. There would here be little disagreement that significant behavioral reactions to a medical condition can depend upon previous learning and concurrent social conditions. The question for medical-behavioral theory in retardation is whether or not professionals are inclined to make similar assumptions about medical conditions which involve, for example, a cerebral viral infection, an erythrocyte galactose-l-phosphate concentration of 6 mg%, or an additional chromosome in approximately 80% of the child’s G-group karyotypes. In fact, encephalitis, galactosemia, mongolism, and other diseases are frequently assumed to bear a rather uncomplicated, directly causal relation to mental retardation, and there is a widespread failure to maintain some notion of long-term personal-environment effects upon the child’s behavior. Some writers have viewed this reluctance as a serious obstruction to theories of medical-behavioral causation. 1. THECHILD’SWORLD

T h e quintessence of the social-interaction argument is Bijou’s (1966) highly theoretical psychological analysis of retarded behavior. The position holds that at every moment in the child’s development the relations of his behavior to “environmental events are changing continuously by virtue of the unremittent interchanges between them . . . the amount of so-called innate mental ability at birth . . . can be known . . . only by an analysis of behavior . . . [p. 51.” So much for the simplistic genetic model which predicts specific behavioral concomitants to demonstrable chromosomal variations. Toxic, infectious, traumatic, chromosomal, or single recessive genetic conditions may give rise to inherently inappropriate structural or physiological properties, but the behavioral implications of these biological limitations can be realized only in view of the vastly complicated, continuously ongoing cycle of behavioral reflections characteristic of a reactive child in a reactive

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world. One of the more poignantly depressing aspects of this cycle for any humanistic appreciation of the problem emerges when one considers the social fate of a child who, like many retarded children, looks peculiar: “His physical appearance could well be . . . aversive . . . to others, causing them to avoid him, to leave him as quickly as possible, or to behave toward him in an altogether indifferent manner [Bijou, 1966, p. 81.” This “social maltreatment . , . avoidance, scornful discrimination, exclusion from school, segregation in the home . . .” has been noted specifically in the case of epilepsy (Wallin, 1949, p. 366), and Karlin and Strazzulla (1952) suggested disruptive effects of retardation on interactions with parents in the context of speech problems. In a rare experimental study relevant to this point, G. Siege1 and Harkins ( I 963) have shown that in structured and in unstructured settings, disinterested adults react differently to institutionalized retardates of relatively high and low verbal ability. The distinctive responses “may be reflective of linguistic deprivation which the retarded child suffered earlier at home [p. 451.” Whether or not this is true, the study is sufficient for showing that adults do distinguish by their own verbal responses between high and low level children even within the retarded population. It is a small but important step in the direction of establishing indices for assessing the influence of‘what Garrard and Richmond (1965b) call “secondary” etiological factors which hold a “compounding or perpetuating relationship” to “primary or initiating relationships” between biological and experiential etiological factors and mental retardation (p. 35). A noteworthy sociological analysis of the compounding and perpetuating property of the child’s interpersonal relationships has been made by Dexter (1960), who with Bender (1949), Bijou (1966), and Sarason and Doris (1969) widely cover the more extreme social-interaction view of retardates’ enormous problems of adaptation. A pediatrician’s similar view of the function of organic difficulties in determining abnormal behavior may be found in Hawke’s (1952) short but detailed analysis. He saw the relationship as functioning on three levels: direct effects of the medical condition on the central nervous system; emotional reactions of the child to his symptoms; emotional reactions of the child’s parents, siblings, and community. Hawke’s breakdown of these three avenues included notes on possible complicating effects of medications. In the following discussion of social-interaction arguments, it will be clear that the behavioral effects of the disease and those of its treatment are sometimes very difficult to separate. a. Toxic Conditions in Infancy. Jeune, Kohler, and Guidicelli (1961)

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have studied the development of 100 children who suffered extreme toxic states (dehydration, coma, etc.) as very young infants. T w o to four years after the disease had been cured, it was found that roughly 25% were mentally retarded. Of these about 25% had apparently not been primarily affected by the toxic state, but rather had developed abnormal intellectual, social, or personality conditions resulting from secondary factors, including early hospitalization and subsequent parental overprotection. One cannot help wondering how much these factors influenced the degree of retardation suffered by the 75% whose deficits were attributed primarily to the toxic state. b. Phmylketonuria (PKU). PKU is a popular model for the medical presence in the field of retardation, having an ideally biological form and a treatment predicated on sound biochemical principles. As in the case of possible secondary complications of early toxic conditions, several writers have speculated on secondary effects of simply placing the PKU child on a highly controlled diet over which close parental surveillance is required for many years. Early reports of dramatic intelligence and personality improvements in three cases of treated PKU were made by Clader (1957), but she tempered her enthusiasm somewhat by raising the general question of the degree to which successful treatment is related to a close mother-child association during the extended treatment. Similarly, F. Siegel, Balow, Fisch, and Anderson (1968), noting that hyperactivity is the only behavior or personality problem consistently ascribed to PKU children, found in their own evaluations of 13 cases an inclination toward talkativeness and hypersensitivity which “might result from family influence, or the biochemical changes in phenylketonuria, or both. . . . Nearly all the , . .Ss were aware of their condition, and some were constantly reminded of it by virtue of their special diet. The effect of special attention and treatment might foster a hypersensitivity to failure or criticism from family and peers [p. 9421.” One infers that much the same mechanism would prevail in other diseases, such as galactosemia, to the extent that dietary management interacts with other aspects of the afflicted child’s social attachments. c. Sex-Chromosome Aberrations. Sometimes at the fringe of interest for specialists in retardation, sometimes at its very heart, are the numerous medical conditions associated with anomalous intracellular and intercellular distributions of chromosomes. Those appearing as additions or deletions of sex chromosomes [e.g., Turner’s (XO) Syndrome and Klinefelter’s (XXY) disease] can be found over the entire range of psychometric intelligence, even though their frequency among retardates

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is much higher than for the general population (Money, 1964). T h e diagnostic signs, other than the cytological evidence, are found primarily in the development of sex organs and in other, even more obvious chronic visual characteristics. Sabbath, Morris, Menzer-Benaron, and Sturgis (1961) have reviewed cases of ovarian dysgenesis, who are stunted and fail to mature sexually, finding that psychological reactions to the physical condition were much more dependent upon idiosyncratic parent-child relations than upon hormone imbalances o r other results of the condition per se. They thus viewed the numerous psychological problems as secondary, socially determined effects, not attributable to the physiological processes responsible for failures of maturation. For theories of genetic causation of behavior, the sex-chromosome aberrations provide sobering suggestions that something as intuitively gene-linked as sexual behavior is nevertheless crucially dependent upon the patient’s social relations. Hampson, Hampson, and Money (1955) concluded that “a person’s conviction of himself as a man or herself as a woman -the gender role and erotic orientation - is a variable quite independent of genes and chromosomes [p. 2241,” while Money (1963) quite seriously noted that “it is a marked, though not obligatory asset, if the genital morphology and the body image it generates agree with, or at least do not grossly contradict the sex of assignment [p.8201.” d. Mongolism? Perhaps because of their frequency in retarded populations, and certainly because of their distinctive looks (which are after all their prime diagnostic signs), mongoloids are the most popular subject of medical-behavioral research and clinical speculations. There are at least four ways in which their looks or behavior might initiate or reinforce treatment of various kinds which could reciprocate as contributions to secondary behavioral effects of the disease. First are the routes to and through institutionalization. Nagler (1967) observed that in several syndromes, including mongolism, “some visual aspects of the patient may lead us to suspect brain damage, and, thus, possible impairment of intellectual development. . . . Although one has the right to expect that these persons are retarded, many of these visually perceptible clinical entities may mislead us [p. 4981.” This implies [as Hormuth (1953) and Kugel et al. (1964) contend] that physicians sometimes respond to a neonate mongoloid’s looks as a behavioral prognostic, and make recommendations, including early institution*Repugnant as this label may be to some people, it is nevertheless fashionable in America, and it will at least be agreeable to die-hard racialists of Crookshank’s (1924) stamp.

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alization, despite the fact that the first behavioral signs of retardation may not appear for months or years after birth. Besides its questionable propriety, such a practice would irretrievably obscure any primary relationship between the mongoloid’s organic or cytologic condition and his subsequent behavioral development. Once he is institutionalized, moreover, there is a further possibility of secondary effects developing. According to Silverstein (1964), “the treatment of mongoloids by ward personnel and the behavior that they exhibit in response to this treatment are probably determined in part by the personnel’s belief that mongoloids are better adjusted than other retardates, whatever the basis of this belief [p. 4971.’’ In such cases the stereotypes would seem to operate to the mongoloid child’s benefit, if one assumes (a) that the “better adjustment” is a correct view of the behavior in question and (b) that the cycle is self-perpetuating and increases to a satisfactory level. But, from Menolascino’s ( 1967) outraged analysis of the incarcerated mongoloid’s plight, it appears that neither assumption is tenable: Though they tend to swarm around the visitor to their wards, one soon notes that their quality of relating has many of the features of the child with a symbiotic psychosis. . . . How much of this “titrated over-affectionateness”stems from precipitates of delayed or unsuccessful resolution of early personality developmental stages, unresolved anxiety with substitute authority figures, the superimposed programming of expected behavior from the institutional staff, or admixtures of any or all of these dimensions is unclear at this time [p. 731.

If the child manages to escape early incarceration, he still faces different, but powerful secondary complications at home. As an example of such a process, consider Hallenbeck (1960). In explanation of the docile-affective personality seen in some mongoloids, and the aggressive-hostile personality of others, he hypothesized that there are two different body types in mongolism, presumably resulting from variations in thyroid metabolism. One such variation conduces to a wiry, strong child who would be overactive, leading parents to overreact, which in turn would elicit an aggressive response in the child. The x h e r child, who is born and remains a “good baby,” would evoke a tender parental response which in turn would nurture docility and affection in the child. Each of these cycles would, presumably, be selfperpetuating. A fourth possibility arises when these children enter school, for they will likely “disconcert the schools by their physical appearance, and therefore, regardless of 19, [be] placed in classes for the ‘trainable’ [Connor 8c Goldberg, 1960, p. 6601,” with the possible consequence that neither the teaching materials nor the classroom atmosphere will facilitate their potential development.

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Concerning these examples of social-interaction arguments against simplistic theories of medical-behavioral causation, it should be noted that precious little research has been directed toward delineating the crucial social-interaction parameters. The strong statements about sexrole identity being independent of genetic sex, Menolascino’s (1967) diatribes against a tender-hearted view of mongoloids’ affectionatelooking behavior, and Hawke’s ( 1952) detailed analysis of generalized behavioral effects of organic conditions are largely speculative; probably none of them could muster empirical support sufficient to squelch simplistic theorists. The general argument, as presented here, is hence a theoretical proposition, not a strictly formulated set of interlocking empirical observations, but such is the nature of interactional positions. They grasp intuitive complexities far beyond the reach of present-day instrumentation and procedures. Yet they can greatly fortify practical experimental designs by indicating possibly illuminating experimental controls, of which the following are representative: 1. G. Siege1 and Harkins (1963) were interested in the effects of a retardate’s verbal ability upon verbal responses in adults. On the theory that the child’s looks might also influence the adult’s reactions, they were correct in having their potential subjects judged for deviance in “physical appearance, posture, or gait,” and then homogenizing the samples on this control variable. 2. Research on behavioral correlates of galactosemia, PKU, or other conditions requiring perennial dietary management would estimate the quality of the parent-child relationship during treatment, and hence either exclude particularly unfortunate cases, or use the judgements as a leveling variable to increase analytical precision. 3. Studies of mongolism might attempt to judge the degree to which behavioral stereotypes are held by people charged with the child’s management or education, and to use the results as a control or leveling device.

2. THEEXPERIMENTER’S WORLD “It is not surprising that one takes out of a bag what one has put into it [Alstrom, 1950, p. 441.” Twenty years ago, which is a very long time

in the history of medical-behavioral research, Alstrom was writing of a fallacy inherent in the widely held belief that epileptics have a distinctive personality somehow uniquely conditioned by their epilepsy. His criticism pivoted on the counterassertion that authoritative studies had been largely biased by looking only at institutionalized cases. In its general form this argument is applicable in several areas of retardation research and suggests that experimenters are just as confined by

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working in institutions as are their subjects who are committed to live there. The institutional effect on research has two sides. The first is consistent with Alstrom’s metaphor, and it specifies that the results of studying institutionalized retardates will be biased to the extent that the variables of research interest also contribute to the retardate’s incarceration in the first place. The second point (an interactionist’s nightmare) is that the institution’s atmosphere will combine with the retardate’s previously acquired characteristics to yield a specially hybridized picture of adaptation, and probably not one consistent with extrainstitutional existence. This point is obviously misdirected if the researcher intends to draw conclusions only about retarded people as they function in restrictive environments specially constructed to tolerate a wide range of behavioral aberrations. Even such a study would be affected by the first point, however, which is that prior to institutionalization, these people are not representative of the retarded population at large. Conclusions about the effects of institutionalization on mental retardates as a group would therefore be unwarranted. Hence, it is concluded that the two-pronged bias affects all institutional research, irrespective of its aims. For an idea of how deeply this problem has plagued medical-behavioral research designs, one need only look at the variety of criticisms which have been predicated on one or both of its two points. a. Outpatient Clinics. The specter of overlooked biases, which promise imminent collapse for some cherished theoretical construction, is sometimes (but not nearly often enough) sufficiently threatening to induce a salutary obsessional quality in an author’s search for alternative causes to explain his main findings. A notable example of this neglected form of analysis is Menolascino’s (1965b)discussion of a research sample in one outpatient clinic in Nebraska, to which he attributed three sources of bias: (a) The Institute is a public diagnostic facility, to which referrals from economically privileged families should be rare. Menolascino noted that 70% of his sample in fact fell into the two lowest Social Position categories of Hollingshead’s Index. (b) With 97.4% of Nebraska’s population being Caucasian, the sample would underrepresent nonwhite populations. (c) Because “the community takes care of many borderline or mildly retarded children,” there should be an overrepresentation of more seriously retarded cases at the clinic, and this also may explain the high percentage of “brain-damaged” ~ h i l d r e n Not .~ T h i s concentration of severe disorders, if not otherwise biased, however, would facilitate medical-behavioral research by virtue of the sheer numbers and variety of medically interestingconditions obtainable through a single community clearinghouse.

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knowing the clinic’s administrative structure, we cannot be sure why it concentrated on children younger than age 8 years, but for some reason, perhaps selective age sampling, or the selective sampling of severe disorders (which appear early in life), older children are also underrepresented in Menolascino’s sample. As he eagerly observed, these biases severely limit the generality of his findings. It is yet to be seen whether his readers will be inclined to heed the warnings. But, at least in the context of methodological discussions, his carefully documented effort is fully warranted and deserves close attention, for it illustrates a realistic self-consciousness necessary for researchers to maintain as they penetrate the many presently underexploited outpatient settings. b. Znstitz~tions.Certainly before the era of widespread PKU screening programs, and always in the history of mongolism, studies done in institutions have strongly dominated the medical-behavioral literature. This is not surprising, since institutionalization has traditionally been the treatment of choice for children diagnosed as mentally retarded with associated medical classifications. The institutions therefore have relatively large concentrations of some medical conditions which begin as obstetrical and pediatric rarities. For example, mongoloids compose 10% or more of an institution’s clientele, but they occur in perhaps 0.15% of live births (Lenz, 1968). The practical economics of research must therefore largely account for its being done in institutions, however methodologically undesirable this may be. Starting with Penrose and Smith’s (1966) clinical assessment that institutional rearing is destructive to mongoloids, one may look back to Birch and Belmont’s (1961) critique of Centerwall and Centerwall’s (1960) study of differential effects of home vs. foster-home rearing. T h e criticism focused on the argument that the reasons for placing the infant outside the home may contribute to subsequent maldevelopment, and unless the selective placement is controlled, the maldevelopment cannot be attributed to the environment in which the child was reared. Cornwell and Birch (1969) have reviewed this argument, adding several empirical observations in its support. In addition, Shipe, Reisman, Chung, Darnell, and Kelly (1968) have raised the selective placement criticism in studies of relations between intellectual performance and various clinical indices of mongolism, while Lyle (1959) has cited it as an obstacle to studies of institutional effects on language learning. Kugel and Reque (1961) were sensitive to the issue in their design for comparing institutionalized vs. home-reared mongoloids. They chose the institution sample from among children who had been incarcerated before their first birthday, on the assumption that “institu-

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tionalization was chiefly because the diagnosis had been made early and there was no question about severity of condition or greater difficulty anticipated in managing a retarded child at home [p. 9593.” Even this selection was probably insufficient, however, because the parents of home-reared children had sought multiple diagnoses, and hence their resistant attitudes were clearly different from those of parents who had very early abandoned their offspring to the institution. Moreover, the institution sample had been diagnosed within the first week of life, while the home-reared had not. If the severity of somatic symptoms of mongolism reflect physiological processes which also directly influence intellectual potential, the bias of early diagnosis in the institution sample cannot be ignored. c. Ethics. In concluding this discussion of factors which operate against the experimenter in his traditional settings, it must be stressed that the selective placement and selective effects arguments against examining institutional samples are by no means independent of each other. One reason is that selective placement interferes with a clear determination of the effects of institutionalization, but procedures by which the former would normally be controlled - random sampling of children who are to receive a particular institutional treatment, or, better yet, some matched-pairs technique - are generally not open to the experimenter. This denial of optional methods is only part of a much wider and more fundamental problem, which is strikingly obvious, yet has received little attention from the same writers who so freely evoked the selective placement arguments, viz., research ethics. By their nearly unanimous silence on this problem, one may infer that practicing methodologists in medical-behavioral areas are agreed that either nothing can be done o r nothing should be done by way of randomly sampling candidates for institutionalization. This is in spite of the fact that the widespread use of institutions clearly violates any criterion one would wish to use for judging the effects and hence the propriety of any kind of medical treatment. Yet it is surely much less ethical to prescribe an untested treatment, than it would be to suggest something as scientifically defensible and desirable as random sampling or more sophisticated procedures to establish the treatment’s efficacy. Those who would dismiss institutionalization as an inappropriate model for this argument will hopefully respond to the observation that prescriptions of low phenylalanine diets to treat PKU are no more justified than institutionalization from the practical medical standpoint visP-vis mental retardation. According to some authors (Bessman, 1968; Birch & Tizard, 1967; Fuller & Shuman, 1969), the diet has no demon-

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strated benefit for the child’s intellectual progno~is.~ It therefore appears that institutionalization and this more clearly medical treatment are used (indeed, sometimes in combination) not because they prevent or ameliorate retardation, but rather because they have been justified on compelling theoretical grounds and have been made readily available, the institutions by governmental establishment and support, the diet by Mead-Johnson (Lofenolac) and Merck, Sharp and Dohme (Ketonil). The ethics of promulgating the use of low phenylalanine diets without first clearly establishing their benefits to the child’s intellectual growth were clearly not foremost in the minds of those who inspired the “laymen who have been carrying on the amazing campaign that saw to the passage of 25 state laws in 18 months [Bessman, 1968, p. 11771.” These concerned citizens were undoubtedly laboring under the misguided spirit, if not the explicit promise, of what Wolfensberger and Menolascino (1968) called the “magic bullet” view of potential cures for mental retardation. Granted it might seem difficult for medical-behavioral research to cope with ethical problems like random assignment to treatments, controls for placebo effects, and outright withholding of proposed treatments. It would seem preferable, however, to acknowledge these difficulties and to maintain a realistic, if not guarded, view, than to offer optimistic but shallow hope to the parents of retarded o r potentially retarded children. Primum non nocere. In the case of diets for PKU, incidentally, it appears that the premature claims for their benefits have, exactly through the process of widespread unquestioning acceptance, made it extremely difficult to do appropriately controlled research (Fuller & Shuman, 1969). After all, it seems ethically reprehensible to withhold a proven medical treatment, however poor the proof (Hill, 1951).

3. PROSPECTIVE STUDIES “If a male infant survives congenital damage or structural damage at birth, or postnatal infection, he is less likely to be verbal and understandable and to be enrolled in the school department (of the institution) . . . than is a female who has survived the same conditions [Blanchard, 1964, p. 6161.” It is implicit in this observation that Blanchard followed males and females for some years after their births, noting the deaths of some, and recording the speech and other developments of the survivors. In fact, Blanchard’s was not such a prospective study, but rather a simple review of the present status of institu4Nevertheless, in some of the United States the diet is written into statutes along with provisions for mass screening procedures (Bessman, 1968).

John M . Belmont

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tionalized retardates, many of whom had probably been given the various medical labels as part of their admissions evaluations. In view of the biases inherent in such procedures, and especially considering the consequences that such unreasonable conclusions might have as stimulants to inappropriate treatment, it is crucial to establish intellectual prognostics, not by looking at mental retardates, but by looking at the fates of children who incur medical conditions which are sometimes found associated with mental retardation. In some cases, like mongolism and PKU, professional inclinations to treat the afflicted children as though they were mentally retarded at birth are so strong that it would be difficult to gather statistics on random samples of untreated patients. This in itself warrants studies into the inevitability of gross retardation and other psychological characteristics attributed to these medical labels. Prospective studies which have been done on other conditions show that retardation is certainly not an inevitable outcome. For example, Jeune et al. (1961) found that about 75% of infants who suffered severe toxic states nevertheless developed into normal children. Corrigan, Berger, Dienstbier, and Strok (1967) could draw similar conclusions about premature infants (even those with birth weights below 1500 grams, which is a conventional sign of risk). Finally, Shimmel (1960) found that viral encephalitis contracted during the school years left only very mild effects on IQand school achievement 2-4 years after the infection. Shimmel concluded that such results should be widely disseminated “to prevent differential treatment which could result in a selffulfilling hypothesis [p. 1521.” Whether or not such differential treatment had been given to the diseased group is unsure. This study faces a difficulty common to all passive prospective research which does not maintain control over the subjects’ treatments. One cannot know how much of the retardation which is observed in the disease group is caused by the disease, how much by unknown conditions acquired later in life, and how much by secondary factors associated with either of these. Similarly, it is unknown to what degree the normal performance of many diseased children can be attributed to early medical or other rehabilitative treatments. Thus, the prospective studies can render a valuable service in strongly suggesting that mental retardation is not simply caused by several diseases which are frequently found associated with it, but these studies are far from providing clear statistics on untreated cases, and far from showing the effects of specific treatments. 4.

EXPERIMENTAL STUDIES

The most sensible procedure for any medical-behavioral study interested in primary causes would be to induce the disease and hence mon-

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itor intellectual, personality, or whatever other behavioral variables might be expected to respond to it. Berkson (1967) has discussed such research in animals, including studies of X radiation, anoxia, and phenylalanine, pointing out that the treatments themselves have been carefully and reasonably applied, but that the behavioral measures, which were understandably nonverbal, were also usually quite crude. The results tend to be widely variable within treatment conditions, and nothing unique seems to result from any specific agent. Berkson speculated that the timing or maturational stage at which the damaging agent was applied is probably far more important than the type of agent in determining behavioral effects. Although such research with humans is largely proscribed by ethical considerations, there are some practical experimental procedures open to researchers under certain circumstances. Anderson and Siegel’s ( 1968) list of criteria for studies of metabolic diseases comprised the following: First, there must already be a means of treating the disease, and the biochemical pathways responsible for it must also be known. These conditions facilitate reversible experimentation, in which the child’s level of the presumed toxic agent is altered in both directions, with a view toward clearly establishing its relation to b e h a ~ i o rNext, .~ the children must be sufficiently numerous to permit assessment of individual variability, and sufficiently viable to permit longitudinal investigations. There is potentially great theoretical understanding obtainable from research growing out of this approach. I t is not unreasonable to expect, therefore, that researchers would use the highest quality medical and behavioral techniques available, to insure that the effort does not falter for want of reliable and well-understood instrumentation, and they would be especially concerned with the ethical implications of conducting reversibility experiments. In addition, because of an apparent lack of sound theory concerning where in the behavioral realm the classifications might express themselves, it seems imperative that a large range of likely behaviors be sampled. To this point Anderson and Siege1 spoke quite clearly, noting that many studies are content to emphasize global retardation, to the exclusion of specific signs not individually observable on intelligence tests (but sometimes mentioned in the clinical literature) such as “attention span, hyperactivity, irritability or emotional instability [p. 71,” which might respond to biochemical interventions. Although Gibson and Pozsonyi ( 1 965) were not explicit concerning 5 0 f course the toxic effects of abnormal metabolites need not be reversible, and, it‘ permanent or at least systematically progressive, they would not readily respond to experimentally induced variations in metabolite concentrations.

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the conditions required to study behavioral effects of cytogenetic variation within mongolism, it is clear that the power of their approach is much diminished because there is currently no cure for the mongoloid’s chromosomal aberrations, much less a means of systematically altering their type or frequency, and there is no known pathway by which the somatic or chromosomal conditions affect intellectual functioning Thus, when Lejeune (1964) remarked that the proportion of trisomic cells in a mosaic mongoloid should bear a direct relation to the gravity of the clinical syndrome (including, one supposes, the mongoloid’s mental abilities), he could have been implying at best only a correlational model, which would encounter many of the methodologial difficulties so far discussed. 5 . SUMMARY

Several problems of method have been raised in order to illustrate the gross difficulty of assigning causal meaning to medical-behavioral correlations. It was seen first that theories of simple causality would be incomplete, and probably of extremely limited use, because the presumed medical causes of retardation or more specific behavioral effects do not operate in nitro, but instead must act within a web of theoretically potent social interactions. These so-called secondary factors apparently operate both within and without custodial or rehabilitative institutions. They include, among other things, the responses of the afflicted child’s society to the possible primary physical and behavioral attributes of particular diseases, the counterresponses of the child to these reactions, etc. The purpose to that point was not to deny the possibility of accurately ascribing primary behavioral consequences to the diseases. Rather, it was to develop a warning against hasty conclusions. In addition to the secondary factors argument, it was noted that medical-behavioral researchers are severely constrained by the condition in which they find their subjects in the places where subjects can be found. Both in outpatient clinics and in institutions there are a number of biases, some general, some specific to particular medical conditions, which preclude fair appraisals of the primary behavioral effects. In all such settings, one must work with children who were referred or placed there because they had shown behavioral abnormalities with which the child’s family and community evidently could not cope. Selective placement is only the beginning of the biasing process. Once the child is placed, his reactions to his environment, and his caretakers’ reactions to him, will create a special type of retardate, one who has first of all demonstrated his inability to satisfy society’s demands and who is now developing according to the particular institution’s demands. To the degree that institutions degrade general intellectual

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performance and maintain different intellectual and social standards for different medical classifications, the researcher will be limited in his study of primary medical-behavioral relations unless he maintains extremely elaborate experimental controls. T h e problem of research ethics was then raised as yet another obstacle to clearly interpretable research. Unquestioned use of special diets for PKU was cited as an example of a possibly unethical practice, and to illustrate how research can unwittingly contribute to its own ethical constraints. Two research plans, the prospective technique and the experimental technique, were briefly discussed as alternatives to the correlational model to which medical-behavioral researchers have traditionally subscribed. Although the application of these alternatives might currently be limited to particular areas of research interest, the underlying philosophies stand as important considerations for research design because of the possibility of combatting various biases inherent in more tradition a1 approaches. B.

Characteristics of Research Designs and Medical-Behavioral Variables

In addition to looking at possible sources of bias or neglected theoretical considerations, one must weigh research data according to the experimental design by which they were collected, and the characteristics of the variables represented in the design. The author’s effort to acquire a wide sample of the medical-behavioral literature netted a core of 193 titles, 66 of which were reviews, textbooks, or other sources which made no orderly attempt to report original research findings. Most of the remaining 127 studies seem to have proceeded on the theory that somatic, biochemical, or cytogenetic conditions (to which the medical labels apply) can determine behavioral abnormalities. Hence the general form of the large majority of experimental questions: Are there peculiar qualities of’ behavior to be,found associated with particular medical labels? These studies are done by establishing medical conditions or labels as the independent, treatment, or predictor variables. Likely behaviors are taken as the dependent, affected, or predictable variables. There is nothing impractical about reversing these roles, but it alters the study’s focus, turning it into a retrospective design, with important consequences for the kind of question being asked, and fascinating implications for medical-behavioral theory. The retrospective analog to the question posed by the other studies is: Are there particular medical labels found attached to people who have peculiar qualities o j behavior? Anybody who considers a peculiar behavior or pattern of behaviors as pathognostic of a particular medical classification will want to have based his conclusion upon a study which posed such a retrospective question. Except where IQitself is taken as the predictor variable al-

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John M . Belmont

most no such research has been reported. Only seven of the 127 original studies captured in the present review could be considered to be retrospective. The remaining 120 represent four broad subclassifications of research design, here to be termed manipulative (N = 2 l ) , metric ( N = 59), survey ( N = 18), and clinical ( N = 22). 1.

MANIPULATIVE DESIGNS

A study has been termed manipulative if the investigator made a deliberate attempt to experimentally alter some independent variable and reported the results in view of this attempt. Thus, if a group of mongoloids were subdivided, half of them then being treated with thyroid extract while the other half were not, and the two groups were hence compared for mental alertness, the study would satisfy the manipulation requirement. If a group of mongoloids and a group of nonmongoloids were tested for learning ability under two kinds of reward, and the performances for each group were reported for each of the reward conditions, this would also qualify as a manipulative study. This design is particularly important for medical-behavioral research because the introduction of experimental variables permits a high quality of control over extraneous, biasing variables which may otherwise seriously interfere with the research. The only assumption critical to accepting the theory of this control is that whatever the biases, they will be acting equally at each level of the experimentally varied treatment. In the illustrations given above, it would be assumed (a) that all influences acting upon mental alertness over the treatment period (other than the thyroid extract itself) would act equally on both the treated and the nontreated mongoloids; (b) that whatever extraneous factors which might account for learning performance differences between the mongoloids and the nonmongoloids would act equally under both reward conditions. Any interaction of groups by reward conditions would then have theoretical importance far beyond the simple observation that mongoloids and nonmongoloids differ in learning performance, a finding which might arise for any number of reasons. Indeed, this interaction model seems to be the most powerful methodology applicable to the study of retardates, and under some conditions of probable bias it is the only acceptable analytical technique (Baumeister, 1967). Its main limitation is that systematic manipulations are practical only under rather narrowly defined conditions. Generality of interpretation is thus sacrificed in the name of analytical precision. On the other hand, one may be safely assured that generality will always be limited to the degree that such precision is needed to offset extraneous variables, whether or not a sufficiently precise design is used. The influ-

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25

ence of these variables does not evaporate simply because we choose to ignore them.

2. NONMANIPULATIVE DESIGNS T h e nonmanipulative designs are distinguished by their failure to control extraneous variables experimentally or to report the results of using such controls. In the example of thyroid treatments for mongoloids, the study might have been done by locating a group of mongoloids who had been receiving a treatment, and some who had not, and then testing them for mental alertness. This procedure is weak, at least because (a) there is no direct control over possibly critical dimensions of the treatment, such as its length, dosage, time-dosage regulation, etc., and (b) there is no control exerted over the selection of treatment subjects. In the thyroid study, for example, one cannot be sure that they were not chosen to receive the treatment because their unusual dullness seemed to make them promising trial cases, or perhaps resulted in their being placed in an institution or on a particular ward in an institution where the treatment happened to be applied. Many such potentially biasing factors are easily controlled by making an unbiased sampling of the treatment subjects from a common pool of candidates before the treatment is administered. For present purposes the nonmanipulative designs, which compose the majority (82.5%) of the present sample of medical-behavioral studies, have been subclassified roughly according to the quality of their most emphasized dependent variables. T h e metric studies include standardized psychometric or achievement tests or more highly qualified techniques such as controlled aural comprehension tests or batteries of psychomotor performance tests. For several reasons these metrics provide more reliable, precise data than the survey techniques, such as questionnaires, parental interviews, hospital or clinical social history records, or impromptu behavior-rating scales. People who are sent questionnaires may not return them, and it is hard to control biases which determine these partial returns. Interviews frequently rely upon the accuracy and objectivity of parental memory. Moreover, these factors may be influenced in uncertain ways by the form in which questions are asked. Rating scales similarly reflect numerous subjective influences which reduce the accuracy and possibly the reliability of the measures. Such problems do not arise in the metrics, which explicitly control the testing situation, are applied with fairly equal accuracy to all members of the sample, and yield reasonably objective quantitative results. Because of their quantification, the metrics can respond to parametric inferential statistics like analysis of variance or Pearsonian

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correlation. In contrast, surveys generally use qualitative measures for which relatively weak descriptive frequency tabulations and nonparametric statistics are the principal analytical tools. However weak their measures, the surveys nevertheless provide orderly descriptive data obtained from instruments which are at least explicit and hence transferable from one setting to another. The clinical reports do not explicate their criteria for gathering data, and therefore their measurements cannot be systematically confirmed by other investigators. In this very important regard the clinical reports are not research at all, no matter how carefully they might summarize or analyze their data: T h e results are purely subjective so long as the methods remain obscure. This in no way impugns the correctness of clinical observations, but it necessarily relegates them to the status of unproven hypotheses which require research support for admission to the body of medical-behavioral knowledge. According to this discussion of experimental design, it is roughly possible to forecast the precision of a particular piece of research by considering the ways in which it deals with biasing or confounding variables, the quality of its measures, and the objectivity of its methods. It should be noted, moreover, that these are not wholly independent concerns. Experimental control is assessable only if the methods are explicit, and quantification of the measures tends to be accompanied by objectivity and reliability. It is important to bear in mind, however, that the ultimate reproducibility of a study (which is surely a prime criterion of success), is not solely dependent upon these design considerations. N o matter how carefully the dependent behavioral criterion tasks are constructed and administered, and no matter how precisely the results are summarized or how conservative their analysis, the study is bound for ultimate obscurity unless the medical labels are also clearly defined and accurately applied to the subjects of research.

3. MEDICALLABELS The behavioral variables of medical-behavioral research range widely in their relative uniformity across laboratories. I Q i s perhaps the most standard measure, but it is fairly rare that a distribution of IQs is reported without specifying the intelligence test from which they were obtained. Such a practice would require the same quality of universally accepted standards as apply, for example, to the use of degrees Celsius, yet such standards simply do not exist for IQ. Similarly, no researcher who is at all sensitive to the mechanics of collecting, analyzing, and interpreting behavioral data would deem it appropriate to report the proportion of errors made on a verbal-learning task without first care-

MEDICAL-BEHAVIORAL RESEARCH

27

fully describing the task. Yet it is perfectly admissible for this compulsive objectivity to dissolve away when it comes to constructing, justifying, and most particularly applying diagnostic criteria which establish the subject’s medical classification. Thus, Scheffelin ( 1968) used about 330 words to describe and justify her procedures, but from the medical standpoint her sample was simply “twenty-four Down’s Syndrome children”; Byck (1968) used about 950 words to say what he had done with “20 retarded children, 10 Mongoloids and 10 Familials, diagnosed by the hospital staff [pa981.” These are but two recent examples of a widespread tacit agreement that medical labels (unlike behavioral data) are fixed, unquestionable, highly standardized qualities. This assumption that medical classification, as done by physicians for their inhouse use, is sufficient for research purposes is clearly seen in Byck’s explicit dependence on hospital staff, and Martin and Blum’s (1961) insistence that their 44 familials and 22 mongoloids had received an “unequivocal diagnosis by institutional staff [p. 281.” In fact, it seems very unwise for an investigator to base his diagnostic effort-which is, after all, fundamental to constructing a major independent variable-upon existing hospital records, or even upon informal assurances from hospital staff. He should either (a) do as Prysiazniuk and Wicijowski (1964) have done, viz., admit that “. . . so few Ss were unequivocally diagnosed as familial [p. 761” that the group was extended to include anybody in Heber’s (1959) eighth classification (such a practice will at least prevent an unreasonable expectation of homogeneity within the group) or much better (b) follow Rollin’s (1946) example and specify the diagnostics which are used to establish a clinical grouping. For Rollin, “proven mongolism” meant that a prospective subject had to have had at least four out of seven “characters common in mongols” such as IQless than 30, epicanthal fold, fissured tongue, etc. Although the particular signs may not be the most reliable ones available, or even the most widely accepted, it is far better to specify than to ignore them entirely. This is especially important in the case of mongolism, both because mongoloids are the favorite subject of medicalbehavioral research and because the clinical definition of the disease is anything but standard. a. Mongolism. There was a time when mongolism was conceptualized (like mental retardation itself) as a diagnostic classification whose ultimate establishment rests partially upon failure to respond to some form of treatment. Sutherland’s apparent concern with differential diagnostics for mongolism and cretinism (hypothyroidism) led him to remark that “if a patient improved under (thyroid) treatment it was probably not an instance of Mongolism [Garrod, 1909, p. 11211.” How-

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John M . Belmont

ever, until quite recently, the principal focus of diagnostic concern has been on somatic signs, some of which have occasionally been taken as pathognostic. For example, Yannet ( 1953) cited “the peculiar maldevelopment of the skull, particularly of the basilar bones as expressed by the typical facies and orbital slant [p. 1311.’’ Failing such conviction, Rollin (1946) chose a minimum of four out of seven specific cardinal signs to prove mongolism because only six out of 350 unselected defectives had shown more than two of these signs. Dunsdon, Carter, and Huntley (1960) implied that dermatoglyphs (in this case palm prints) are pathognostic, using their absence as an argument against diagnosing mongolism in a person whose JQwas well over 100. In opposition it may be noted that Penrose (1967) has presented several cases of average or above-average intelligence, associated with mongoloid signs including suggestive dermatoglyphs. The contemporary medical consensus seems to be that no somatic sign is either common to all mongoloids or unique to mongolism (Menolascino, 1965a). Thus, when Soltan, Sergovich, and Barr (1967) wrote of “the dominating clinical impression of mongolism,” they were not speaking loosely, but were rather conveying a realistically hazy picture of this highly subjective, probabilistic constellation of perhaps 20 statistically independent, sometimes qualitative and sometimes quantitative diagnostic indices (Gibson, Pozsonyi, & Zarfas, 1964; also see West 8c Ansberry’s, 1968, description of the diagnostician’s dependence upon subjective criteria). Any definition of mongolism predicated upon somatic signs will therefore necessarily be arbitrary, and this is precisely why the definition must be explicit in any medical-behavioral research report. There is an alternative to somatic definition, however, and research on mongolism seems to be in the throws of a challenging transition to this alternative. It is based on the discovery that the cells of the vast majority (perhaps 95%, according to Polani, 1968) of somatically defined mongoloids are afflicted with a chromosome surplus called “primary trisomy 21.” An additional 3.5% are “translocation” or “interchange” types; 1.O% are “chromosomal mosaics” (having some proportion of normal cells), and the few remaining are “double trisomies,” with both an additional G-group chromosome and an XXY sexchromosome condition. With a high proportion of clinical mongoloids sharing a common type of chromosome surplus, it seems reasonable to use karyotype as a leveling device, in hopes of explaining some of the mongoloids’ disturbing heterogeneity of somatic and behavioral signs. Lejeune (1964) thus posited that the proportion of abnormal cells would correspond to the severity of a mosaic’s somatic signs. And indeed, Penrose (1967) has

MEDICAL-BEHAVIORAL RESEARCH

29

adduced evidence to show that at least the average dermatoglyphic deviation among mosaics falls somewhere between the normal and the full trisomy deviation. Along the same lines, Soltan et ul. (1967) noted that translocation dermatoglyphs are on the normal side of standard trisomic deviations. In Gibson and Pozsonyi (1965), Finley, Finley, Rosecrans, and Tucker (1966), Shipe et al. (1968), Rosecrans (1968), and others it can be seen that research relating trisomy, translocation, and mosaicism to other somatic variables is progressing quite slowly, however. The principal reason seems to be that there are simply too few mosaics and translocations to permit meaningful correlational studies. There are other difficulties, however, which argue against a quick acceptance of the general philosophy of using karyotypes in medicalbehavioral work. One of these is that sampling biases are currently severe. In view of the large expense of doing chromosome counts, it is understandable that they have been done primarily in doubtful cases of mongolism (Menolascino, 1965ay, or for cytogenetic studies of clinically normal relatives of known mongoloids (Penrose, 1967; Rosecrans, 1968). In the Western Interstate Commission for Higher Education’s (WICHE) population of 2606 institutionalized mongoloids, there were 296 (1 1 %) karyotyped cases, of whom 86% were trisomy 2 1 , 7 % translocation, 6% mosaics, and 1 % mixed (Johnson & Abelson, 1969a). The sampling route by which many of these 296 came to be karyotyped is unknown, but it is quite possible that here, as in noninstitiitionalized samples, the clinical diagnosis was unclear, and karyotype was hence used as a confirmation. T h e author knows of no study in which a large random sample of mongoloids has been karyotyped for the purpose of relating cytogenetic variation to other somatic or behavioral variables. It is nonetheless clear that karyotype is not absolutely pathognostic of clinical mongolism. There are cases of clinical mongoloids in whom no abnormal cells can be found (Soltan et al., 1967), as well as mosaic trisomies in whom clinical signs are marginal, if present at all. As in the case of somatic diagnostics, karyotypy thus confronts us with a probabilistic quality (which has a clearly quantitative aspect in mosaicism), and researchers may again be fairly cautioned to specify both the nature of cytogenetic conditions and the circumstances surrounding the use of cytogenetic diagnosis in cases chosen for medical-behavioral research. b. Phenylketonuria. The name means a disease defined by abnormally 6Dunsdon, Carter, and Huntley (1960) recommended, for example, that if a patient with suggestive mongoloid features achieves an IQ much higher than 70, the diagnosis should be confirmed karyotypically.

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John M . Belmont

high urine concentrations of phenylpyruvic acid and other products of phenylalanine metabolism. It also happens that high serum phenylalanine concentrations are found in people diagnosed as PKU. Although the serum analysis is costly, it is also an accurate and reliable index of the severity of this metabolic disease. For purposes of medical-behavioral research, the phenylalanine assay in PKU may be likened to the cytogenetic study of mongolism. Each is grounded in a more or less standardized bioanalytical technique, each reveals an abnormality associated with mental retardation, and in many cases, each is performed only when there is some doubt regarding a mental retardate’s diagnosis, or else when there is some interest in close relatives of known cases. People diagnosed as PKU, like those diagnosed as trisomy 2 1, probably have therefore already shown signs of behavioral disturbances, or they are related to people with such distrubances. This need not be true of PKU, since there is an inexpensive screening test. But early screening programs for this disease have not permitted prospective behavioral studies of untreated cases because of the compulsive concomitant use of special diets. As it stands now, therefore, the medical-behavioral researcher is faced with studying either untreated or late-treated mentally retarded cases, or else young, possibly false-positive cases who were treated since 1963, when mass screening programs were first initiated in newborn nurseries and clinics. In fact, almost all of the few behavioral studies of PKU have been done with retardates who were not captured in mass screening programs, and they are hence confronted with the bias of institutionalization. Moreover, unless PKU screening were practiced throughout the institution, there is the additional bias of examining people who have suggested the possibility of PKU by some particular set of looks or behaviors (or the absence of signs diagnostic of some other disorder which rationalizes the person’s retardation). As for somatic indices, Kratter (1959) claimed that “the physiognomy . . . is fairly constant and of remarkable likeness in colour [p. 4211,” and Sutherland, Berry, and Shirkey (1960, p. 522) noted two cases of PKU in whom “diagnosis was made by one of us whose previous observation of [PKU] patients led to a feeling that these 2 children ‘looked and acted’ as if they had [PKU].” One cannot tell from this report how many false-positives were discarded along the way, but it is interesting that Sutherland, Berry and Shirkey’s description is exactly analogous to the traditional intuitive approach to diagnosing mongolism (in which false-positives are of course impossible to identify without karyotypic examination). It appears, however, that there is in fact wide variability in the somatic signs of PKU, suggesting that they are no more reliably pathognostic of this

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disease than are the cardinal signs of mongolism. Blond hair, blue eyes, and light skin with eczema are common, but are neither unique to nor universal in PKU (Carver & Wittson, 1960; Diedrich & Poser, 1960; Garfield & Carver, 1960). It seems reasonable to conclude, therefore, that although phenylalanine assay in PKU and karyotypy in mongolism are relatively objective and reliable, they are administered only to people who have already been screened on a series of largely unknown criteria, some of which may be behavioral. For this reason the medicalbehavioral investigator runs the risk of contaminating his diagnoses with variables more appropriately studied as dependent behavioral measures, and he is thus liable to make unjustifiable generalizations about these diseases.

4. SUMMARY AND DISCUSSION In addition to problems arising from secondary etiological factors, institutional biases, and ethical considerations, all of which militate against clear causal theorizing, there are problems of research design and application of medical labels which may greatly reduce the importance of medical-behavioral studies. In general, precision and interpretability of results varies directly with (a) the degree of control exerted over sampling, (b) the emphasis on systematic variation of conditions which might interact with medical factors, (c) the objectivity and reliability of the dependent, behavioral measures, and (d) the objectivity and reliability of the medical labels themselves. T h e last point means, in effect, that there must be objective, reliable observation of diagnostic signs, and there must be a high agreement among diagnosticians as to the pathognostic constellation of signs. In mongolism there is no such consensus unless the chromosomal condition is taken as the diagnostic sign. The difficulty here is that karyotypy is a laborious procedure which is used in a small minority of cases, and the factors which determine whether or not it is used may well reflect personality, motivational or intellectual variables which an investigator might then incorrectly generalize to a larger population of mongoloids. Unless a behavioral research sample is deliberately chosen for karyotypy from among a somatically defined population, it would seem reasonable to adhere to and carefully detail a somatic definition. In any case, it is insufficient to simply name the label. The factors which determine whether phenylketonuria is detected may be as inane as a universal screening of an institution’s population, or they may reflect complex and ill-defined somatic and behavioral variables. Therefore, it is equally important in PKU, as in mongolism to understand and report the circumstances surrounding the diagnostic

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effort. Since serum phenylalanine concentration is a theoretically important variable, this also should be reported in the description of PKU samples. In view of the multiplicity of methodological difficulties raised in this discussion, it seems that no manageable research design can be expected to yield an answer to the general question of whether there are peculiar behaviors found in people with particular medical labels. The experimental question must be qualified, and the following points are suggested as a guide for making such qualifications: 1. The idea of particular medical labels implies firm control over the definition and application of labels. The more explicitly a person’s behavior is shown to be independent of the process which led to his being given a particular label, the more important will be subsequent observations of peculiar behaviors associated with that label. 2. The idea of peculiar or unique behaviors implies a contrast among medical labels. For example, the assertion that mongoloids are peculiarly stubborn requires that they be compared with nonmongoloid people. The greater the number of different contrast groups, the greater the specificity of the assertion. 3. The composition of control or contrast groups largely determines the precision of the experimental question. The ideal for ascribing primary relations between medical conditions and behavioral outcomes would be to form contrast groups which are identical to the focal group in all ways, including place of residence, family history, educational experience, etc. This ideal is strictly attainable only when the medical condition is systematically varied within a single group of subjects. Any other experimental design will be more or less inadequate, and the precision of its conclusions may be judged accordingly. 4. To the degree that a design interferes with the free expression of behavioral variability within or between the various focal and contrast groups, the study will have limited generality. Thus, if a group of mongoloids were matched on mental age with a group of phenylketonurics, and the range of mental ages were narrowly confined, then the study’s conclusions about behavioral differences between the two groups must correspondingly be qualified.

It is hoped that these, and the other design criteria discussed thus far will help at least in understanding the following review of behavioral research in mongolism. The mongoloid literature is substantial, it is many times larger than its closest neighbor - the work on PKU - and it stands, therefore, as the most complete model available to guide further medical-behavioral research efforts.

:3 3

MEDICAL-BEHAVIORAL RESEARCH

IV. BEHAVIORAL STUDIES IN MONGOLISM

This review is arranged according to whether the study’s principal design is clinical, survey, or metric, with a final subdivision devoted to manipulative designs. Coverage of the clinical literature has been restricted to reports which fairly typify the area, and no attempt was made to exhaust these sources. They are numerous, frequently repetitive, and, by nature, of uncertain validity. It is hoped that the large majority of the research studies have been located, however, for the wish is to convey the full breadth of behavioral research in mongolism. Other than the use of both mongoloid subjects and behavioral variables, there were no systematic criteria for inclusion in this review; however, the review tends to ignore studies in which the principal dependent behavioral measure is IQ. This exclusion is based on the proposition that IQs “mark the beginning, not the end . . . When a child fails to master a set of items, the question before us is ‘why’ [Eisenherg, 1967, p. 5121.” Thus. in a global sense this review asks whether there is anything interesting in the behavior of mongoloids in addition to their gross deficiency of psychometric intelligence. Phrased in this way, the question cannot receive much of an answer from studies which examine only mongoloids, or compare mongoloids only with normal people, for such designs make no provision for determining how specific the findings are to mongolism per se. A few studies of this kind have therefore been excluded from the review.

.

A.

The Clinical Picture

He does not resent his condition any more than the family dog resents being a d o g He does not expect the same treatment that is accorded his sibs, any more than the dog expects kisses at bed-time [West & Ansberry, 1968, p. 641.’ It is this achievement, a capacity for joy and courage, that makes this mongol’s life a comfort and inspiration and it is this that makes Nigel unique not among mongols but among men [Sarason & Doris, 1969, p. 3711.

1.

HISTORICAL BACKGROUND

Since Down (1866) first described the mongoloid as an imitative, humorous idiot, there has been a wide proliferation of behavioral stereotypy, sometimes so repetitious, sometimes so baldly inconsistent, as to cast upon mongolism a genuinely mythical character. A brief history of ’Clinicians are divided as to which species is best suited for comparisons with mongoloid children. Crookshank (1924) favored simian allusions, while Benda (1946) preferred the image of a puppy. West and Ansberry (1968) explicitly considered mongoloids to be sub-human, finding chimpanzees, dogs, and parrots to have illustrative value, while Engler (1949) was sometimes content merely LO call them “creature.”

John M . Belmont

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TABLE I A BRIEFHISTORYOF CLINICAL PICTURESOF MONGOLOIDS ~~

Year

Authors

1866

Down

I876 1887

Fraser & MitchellR Down

1895 1909 191 1

Shuttleworth* GuthrieC Sherlock

1914

Tredgold

1916 1924

Shuttleworth & Potts Brushfield“

1928

Brousseau

1942

Berry & Eisenson

1946

Benda

1949

Engler

~

Observations Imitation (mimicry) an asset to training; humorous; considerable manipulative power with training; speech thick and indistinct Musical Imitation; humorous; “strong sense of the ridiculous”; obstinacy; always amiable to companions and animals; not passionate or strongly affectionate Mimicry; love of music and rhythm “Extraordinary powers of imitation” If sufficiently intelligent: imitative, rhythmic; sometimes lively, talkative, restless As infants: placid, good tempered, amusable; as children: happy, very affectionate, readily pleased, jealous, amiable; mimicry; rhythm; love of music; good at drill and dancing Musical (good in time and tune); mimicry; very promising, but rarely does well Cheerful, lively, restless and very happy; seldom show temper; all are supersensitive to musical sounds, irrespective of IQ, and can hum tunes in correct pitch and rhythm Music and rhythm good; as he matures: not given to rage; rarely destructive; good-natured, cheerful, affectionate, easily amused, shy with strangers; docile, easily managed, but occasionally obstinate; mimicry; curiosity; low sex drive, but may masturbate sometimes Mimicry; happy: “seems content with his limited role in life”; voice hoarse, no pitch or intensity modulation; poor speech prognosis, so do not waste time on him unless he responds to medical treatment (suggest removing pressure on pituitary) Stubborn; as infants: quiet, sleepy, no vigorous crying; as children: mimicry; rhythmic (but not reactive to tunes); affectionate (always hugging and kissing one another); insensitive to pain Musicality, but only in higher level children; never mendacious like other defectives; imitation “unsurpassed by any other form of feeble-mindedness”; affectionate; mimicry; happy, gentle, goodnatured, but there are really three groups: I,

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MEDICAL-BEHAVIORAL RESEARCH TABLE 1 (Continued) Year

Authors

1957

Kanner

1963

Penrose

1964

Launay & Bayen

1964

Mallet; Mallet & Labrune

1966

Penrose & Smith

Observations the majority, as described above; 11, a small group of dull and listless children; 111, a small group of wild and pugnacious children; Group I looses all of its charm upon maturing “Secret source of joy”; temper tantrums rare; seldom masturbate: not destructive: love of music; know no fear, caution, or excitement Cheerful, friendly, imitative: memory for people, music and other “complex situations” ranges well beyond other abilities; no abstract reasoning; mental state “very characteristic” Fearful, reactive (particularly to surprises); inhibited, obstinate; adolescent aggressive, less interested than other retardates in activities; quickly lose interest; passive and unstable; good memory; social debilities rather than low IQaccount for difficulties; tend to masturbate unflinchingly; adults: leisure time gives them trouble; listen to records and write home; “correspondence with the family is dear to them” Not hostile, noisy, destructive, violent or cruel like other retardates; completely normal in sensory discrimination, reflexes, etc., sympathetic, soft, gentle, affectionate, pleasable, looking for caresses and kisses; regression after age 7 or 8 years; little interest in sex Still cites mimicry, musicality, etc., but picks up research contradicting these generalizations; differential sensory abilities; absent Moro reflex; personality generally pleasant, but there are exceptions; cytogenetic composition probably not predictive of behavior

“See Blacketer-Simmonds (1953) bSee Penrose and Smith (1966). Garrod (1 909).

this movement appears in Table I , where it may be seen that several themes have developed and been nurtured over the years. A certain familiarity with these ideas is needed in order to understand the research which has sought, from time to time, to debunk or to vindicate the mongoloid mystique. One popular theme is the mongoloid’s musicality. By some inex-

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John M.Belmont

plicable oversight, Down (1866, 1887) missed this trait which was, according to Blacketer-Simmonds ( 1953), first observed by Fraser and Mitchell in 1876. It has been widely corroborated, with systematic embellishments ever since. Shuttleworth (1895) mentioned the mongoloid’s love of music and rhythm, and Sherlock (191 1) reaffirmed the “appreciation of rhythm.” Tredgold (1914) noted “a remarkable sense of rhythm and love for music . . . . Many of these children are adept at drill and dancing.” Tredgolds failure to note this characteristic in the other clinical types suggests that he considered it to be rather peculiar to mongoloids. In contrast, Shuttleworth and Potts (1916) found “a love of music which is common with the feeble-minded.” However, the mongoloid’s particular “love of music is great; their idea of time as well as tune remarkable, so that they are apt at drill and dancing” T h e zenith of appreciation for this musicality came in 1928, when Brushfield (see Blacketer-Simmonds, 1953) studied 177 mongoloids and reported that all of them were “supersensitive to musical sounds.” Irrespective of mental level, they could all hum tunes with correct pitch and rhythm, and the brighter ones could easily learn songs. All were “generally good at drill and exercises.” Brousseau’s (1928) interest in the mongoloid’s “unusual fondness for music and rhythmical sounds” was in its value as evidence for the absence of any “sensorial deficit,” and as an exception to the mongoloid’s otherwise “exceedingly distractible” nature. Regarding the latter, it is interesting that Benda ( 1946) considered these children to “enjoy music more than anything else. It is, however, apparently the rhythm which carries them away; they do not care so much about the melody.” As against Brushfield’s extravagent claims, Wallin ( 1949) noted that although “often exhibiting a strong fondness for music and possessing a fairly good sense of rhythm, they make poor singers and clumsy dancers.” At the same time Engler (1949) exempted “the idiots who usually show little interest” from the group of mongoloids who “listen to any kind of music . . . and usually join in singing, often quite correctly. It is by no means rare to find an otherwise . . . apathetic patient become vivacious and gay on hearing a familiar melody.” One gathers, however, that the undiscriminating tastes of Engler’s more intelligent mongoloids can be overcome. Launay and Bayen (1964) reported on Brauner, Cospen and Brauner’s case who “passed the stage of simple airs and began listening to melodious classical music, while rejecting both the popular and the overly intellectual modern styles. He liked Chopin, Beethoven, Mozart, Tchaikovsky.” The clinical literature thus

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provides a wide assortment of views regarding both the specificity of musical interest in mongoloids as compared with other retarded groups, and the particular ways in which it is expressed within the mongoloid populations. There is here a fertile field of hypotheses for objective research: (a) their musicality may be purely receptive, or it may be expressive as well; (b) it may vary with the gross intelligence of the mongoloid, or it may be a universal trait; (c) it may be limited to an appreciation of rhythm, or it may extend in other rather sophisticated forms to include the total musical experience; (d) it may be unique to mongoloids. Besides musicality, the mongoloid’s other remarkable intellectual capacity is for mimicry or imitation. Down (1866) originally noted simply that “they have considerable power of imitation” which may be channeled and cultivated to education ends. In 1887 he related mimicry to the child’s “sense of the ridiculous” and illustrated it with amusing examples from the institutional setting. Guthrie (see Garrod, 1909) reported “extraordinary powers of imitation,” which Sherlock (191 1) confirmed as “rather striking,” but only in mongoloids who are “sufficiently intelligent to be capable of such manifestations.” In view of Tredgold (1914), these children have a “very considerable power of mimicry,” but he clearly did not consider this to be peculiar, for in microcephalics the “power of mimicry is often very marked.” From Tredgold onward, opinion became divided between increasingly elaborate stereotypes and other variously qualified versions. T h e former are found in the observations of Shuttleworth and Potts (1916), Engler (1949), and Penrose ( 1963). In opposition to these views, Brousseau (1928) concluded that imitation is a purely rote process, which conspires with the mongoloid’s other outgoing traits to make him appear more intelligent.s This argument corresponds to Wallin’s ( 1949) idea that although mongoloids are imitative, they lack initiative in its exploitation. As for its specificity, Benda (1946) observed that mimicry is a conspicuous trait, but that it is also found in normal children between the ages of 2 and 4 years. “The faculty of mimicry . . . is, therefore, not a character trait of this condition, but a manifestation of his protracted infancy.” Moreover, Kanner (1957) observed the “tendency to imitate other people’s gestures,” but, like Tredgold, he also ascribed the trait to microcephalics. It is thus unclear whether in their imitativeness mongoloids are unique among the medical types, or, indeed, BThis deception is now a standard to be expected of the mongoloid, according to Hinsie and Campbell’s ( 1970) definitive Psychiatric Dictionary.

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whether this mimicry harbors any potential creativity (as opposed to being, for example, an uncomplicated philomimesia). In any case, it is widely agreed that mongoloids are outstanding in their mimicry, which therefore becomes an excellent research hypothesis backed by a century of clinical observation. That nobody has put it to a very rigorous test is astonishing in view of its widespread acceptance. Perhaps the reason for this neglect is that mimicry is but one facet of the mongoloid personality, other generally delightful features of which have captured the clinical limelight. As seen in Table I, the literature speaks almost as one voice in praise of Trisomy 2 1’sjoie de vivre. Down ( 1866, 1887) portrayed mongoloids as being humorous, with a strong and lively sense of the ridiculous, and “always amiable both to their companions and to animals.” But as for emotionality, “they are not passionate nor strongly affectionate.” By 1911, Sherlock distinguished between age groups, finding that mongoloid infants are “subject to storms of passion,” while the older children “are good tempered as a rule,” showing interest in their surroundinp, submissive to authority, and sometimes “lively, talkative and restless.” These particularly desirable qualities were seen as specific to mongoloids, at least when compared with cretins. Tredgold (1914) also considered the developmental progression, but, in opposition to Sherlock, he found that “from the beginning, the Mongolian infant is placid, good-tempered and readily amused.” Later on he “retains his happy disposition; he is very affectionate, readily pleased . . . and is usually a great favorite with all around him.” Down’s assertion of weak affection is here also contradicted. Furthermore, Tredgold found that the majority of microcephalics are also “affectionate and well-behaved,’’ although “many of them, before training, . . . are apt to be quarrelsome and difficult to manage.” We are thereby impressed that in childhood the mongoloid’s fine disposition is not unique to his type, but that it is a spontaneous, innate quality, which at least in microcephalics, is obtainable only by training. In Mme. Brousseau’s (1928) monograph are found the beginnings of an allegiance to the psychometric tradition, with its emphasis on objectivity and guarded skepticism, but this evolution hardly touched discussions of the mongoloid’s personality: “In our own 140 cases we have found but 1 Mongol who was bad-tempered and in reports from various authors we have noted but 2 such cases. Good humor and affectionate disposition appear to be characteristic of Mongolism.” Brousseau struck a compromise position between Tredgold’s and Sherlock’s when she observed that “as the Mongol child grows older . . . he be-

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comes lively and restless, exhibiting none of the immobility of the earlier months, thus differing from the cretin who remains apathetic . . , . Unlike infants of other types, Mongols are not given to fits of rage, are not ill-tempered, and are rarely destructive. They are usually goodnatured, cheerful, affectionate, easily amused.” Brousseau’s catalog might seem to have exhausted the fund of possible superlatives, but even as late as 1946, Benda managed a refreshing twist in his note that, as child-playmates, “they are always hugging and kissing one another with vague but genuine smiles of affection.” By mid-century, however, the crescendo of repetitive refrains was ending Engler ( 1949) and Wallin ( 1949) simultaneously and similarly divided the stereotype into three subgroups. Engler began with the good-natured children of “gay and pleasing mood,” who seek attention, eagerlyjoin into singing and games, and are, in short, “amusing, merry, pleasant, and affectionate creatures.” His second group was “a minority of mongolian idiots (who) remain dull and listless throughout life,” while the third group “are exceedingly pugnacious and spiteful . . . they hit out wildly and can scarcely be held down . . . they are the exact opposite of the first group of pleasant individuals.” Wallin submitted that mongoloids are “good-natured, easily amused, and exhibit a smiling countenance. They are affectionate, amiable, docile, and cheerful when intelligently handled . . . . A certain proportion of them are shy, reticent, apathetic and negativistic, and some are restless, noisy, uncontrollable, mischievous, destructive, and subject to bouts of temper or excitement.” Neither Kanner (1957) nor Penrose (1963) entertained such distinctions, but neither did they indulge in the exuberance of their earlier colleagues. Formal research reports were emergng in the early 1960s, and by 1966 Penrose and Smith confined themselves to a long quote from Down, followed by a nonevaluative survey of personality research in mongolism. In addition to the relatively recent assertions of widely variable difficult behavior to be found in a minority of mongoloids, there is at least one seemingly negative behavioral reaction which has been cited by some authors as characteristic of the mongoloid personality, namely, his aggressive obstinancy vis-a-vis authoritarian management. Down (1887) observed that “they can only be guided by consummate tact.” They cannot be coerced against their very strong will, and “in fact, go through a play in which the patient, doctor, governess, and nurses are the Dramatis Personae-a play in which the patient is represented as defying and contravening the wishes of those in authority . . . discretion will often be the better part of valour, by not giving orders which

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will run counter to the intended disobedience, and thus maintaining the appearance of authority while being virtually beaten.” Sherlock (191 1) clearly contradicted this opinion, saying that mongoloids are “willing and submissive to authority,” whereas Brousseau ( 1 928) partially concurred with Down in her note that “occasionally we find children who possess traits of obstinancy that require tactful management.” In an unusual dynamic reversal, Wallin ( 1949) viewed “stubborn spells” as the result of tactless management. He thereby clearly disagreed with Benda’s ( 1 946) neurophysiological pronouncements (see above, p. 4) which leave no doubt that mongoloids are constitutionally stubborn in a sense which is exactly opposite to the “lack of attention and distractability of many subnormal patients.” Also in disagreement with Benda’s theory, Brousseau (1928) was adamant in asserting that “deficient attention is a noticeable peculiarity of the mongo1 child,” and Launay and Bayen (1964) found that “attention is always very labile and the efforts of these easily tired children never promise great success.” Stubbornness, inflexibility, lack of attention, and distractability are thus highly debatable characteristics of the mongoloid and should provide interesting subjects for formal behavioral research. Many authors have observed that the mongoloid’s longevity has increased dramatically over the years, commensurate with increasingly reliable pharmacological and surgical practice. It is likely that the mongoloids once-frequent childhood demise accounts for a failure in the early literature to discuss changes which might be expected as he matures through adolescence and into adulthood. Although Penrose (1963) claimed somewhat cryptically that “in children and adults the mental state is very characteristic,” other relatively recent works (Engler, 1949; Launay & Bayen, 1964) suggest that the delightful characteristics of the child do not persist into adolescence, and indeed that he becomes quite difficult to manage. One problem, which becomes increasingly apparent with the age of the child (and, by the way, with the date of the publication) is his sexuality. In 1928 Brushfield asserted that the mongoloid has no erotic tendency, and Brousseau (1928) concurred that “sex sensations are evidently very much diminished” but “these sensations are possibly present since we have a number of Mongols reported to us who are given to the practice of masturbation. We have, however, no definite data on this subject.” Kanner (1957) was somewhat more positive, asserting that “masturbation is practiced rarely,” and this may be consistent with the clinical observations of Stearns, Droulard, and Sahhar (1960). These people were interested in semen volume and sperm counts in samples obtained by automasturbation

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from 21 mongoloids older than 15 years. “As the project was under way, it became evident that a number of subjects, though able to have an erection, were unable to maintain it: others who were able to maintain an erection were unable to produce an ejaculation despite numerous attempts. There was no question that any of these patients failed to understand the process: they tried repeatedly but were unable to perform the act.” Perhaps French mongoloids are more sexually inclined than American mongoloids, or perhaps the French are simply more accepting of sexual behavior. In either case Launay and Bayen (1964) observed that between the ages of 15 and 18 years, “mongoloids have a tendency towards unbridled and very frequent masturbation . . . around age 20 or 25 years the problem diminishes.” But even in France, clinical opinion can be divided. Eighteen pages prior to Launay and Bayen’s observation, Mallet (1 964) noted that in the mongoloid’s puberty “the sexual instinct is little or not at all developed.”

2. DISCUSSION This brief review touched on five aspects of behavior - musicality, imitativeness, joie de vivre, obstinancy, and sexuality - which together have captured the historical literature, giving rise to a spate of enthusiastic but frequently contradictory pictures of the infant, the child, and the grown mongoloid. In each of the areas, observations were strongly affirmed, yet were often markedly different in details which would ordinarily be expected to coincide, or at least to be reconciled in any orderly accumulation of knowledge. There is thus nothing like a widely accepted stereotype of mongoloid behavior, for there is no consensus as to (a) whether an attribute is unique to mongolism or is shared by other retardates, (b) whether it develops in time o r occurs full-blown at the youngest age, or (c) whether it is universal in mongoloids or pertains only to some special intellectually or temperamentally homogeneous subgroup. Yet out of this inconsistent, sometimes irrational, always obscure picture of mongoloid behavior have come the hypotheses of many recent behavioral studies. What is astounding about these recent works is not that they are based upon old-time observations of highly questionable validity, but rather that in their designs and discussions many researchers are clearly unaware of the contradictions and inconsistencies, or of the few reasonable lines of enquiry which are already suggested in a review of the old literature. They have homogenized and hence destroyed the subtleties of interpretation, and the variety of subjective impressions which color and enliven the historical picture. By referring to a unitary stereotype of mongolism modern

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writers thus do injustice to the efforts of their predecessors, effectively ignoring the complexities of the hundred years evolution in clinical descriptions.

3. CLINICAL STUDIES There is considerable evidence from clinical research which confirms the mongoloid’s capacity for widely variable personality and other behavior patterns. Earl (1934) and Neville (1959) have spoken to the issue of psychotic reactions in mongoloids. Neville reported a case of fullblown paranoia in a noninstitutionalized male, noting that the diagnosis was possible only because this mongoloid had had a home-bound lifetime experience with television, radio, and movies from which he could draw content for his delusions. The difficulty with making sound psychiatric diagnoses in mental retardates arises, according to Neville, because they generally have very little experience of the sort that underlies classical syndromes. Nevertheless, Earl reported 38 cases of psychoses among 135 institutionalized male retardates. Two (5%) of the psychotics were mongoloids, while eight (21%) were classified as having primary postnatal lesions (meningitis or epilepsy). Not knowing the institution’s overall proportion of mongoloids it is impossible to say whether the retrospective 2% is less than would be expected, but Earl noted that the mongoloids’ psychoses were among the least severe. Other clinical studies give highly variable estimates of disturbance. In an institutional sample of 73 mongoloids, Rollin (1946) found 60% to have had gross behavior disorders either before or after admission. He found that 44% of his sample were extraverted (or hyperkinetic), but a third of these had severe behavior disorders, leaving only 29% of the total as well-behaved, out-going types. I t is time, said Rollin, for the mongo1 to be “debunked” and brought into reasonable perspective. An institutional study by Menolascino (1967) confirmed 37% emotional disturbance in 95 mongoloids, and it is in this report that Menolascino made the literature’s most powerfully analytic statement against the mongoloid “Prince Charming” stereotype. In the first of two outpatient clinic reports, Menolascino ( 1965a) was also concerned with the stereotype, but his findings were much less antagonistic than his institutional results. Thirteen per cent of 86 mongoloids vs. 33% of the nonmongoloids presented severe behavior problems. In a second report on the same population, Menolascino ( 1965b) showed a symptomological breakdown for disturbed children of various AAMD clinical types. Of the 17 111s (trauma) and 20 VIs (mostly mongoloids?), 82% and 85% respectively were classed as Chronic Brain Syndrome with associated

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Behavioral Reaction, while about 20% of each group showed Adjustment Reactions. In a very crude sense this analysis of Menolascino’s data suggests that the distribution of behavioral problems among disturbed mongoloids is at least not different from that of a very different classification of known etiologies. A very close agreement with Menolascino’s estimated 13% outpatient disturbance is found in Wunsch’s (1957) often-cited response to Brousseau’s (1928) notes on the mongoloid’s docile, cheerful disposition. Wunsch concluded that 51% of his home-living mongoloids had a “docile-affective” temperament, while 14 % showed aggressive-hostile behavior. In fact, his data show 51/77 = 66% of the sample to be docile-affective. Age and sex breakdowns led him to observe that “the docile-affective type were concentrated in the 5- 13 year age group” and that the aggressive-hostile group contained “a much larger proportion of boys.’’ Neither of these observations is statistically reliable and, since Wunsch did not contrast his group with a nonmongoloid sample, nothing may be concluded about the specificity of his 66% vs. 14%, docile vs. aggressive outcome. However, Menolascino’s estimated 30% disturbance in nonmongoloid outpatients is evidence that mongoloids are less frequently disturbed. It is of course indeterminate whether this difference represents a sampling bias by which nonmongoloids would tend to be referred to outpatient clinics when they are disturbed, while mongoloids would be referred simply because they are mongoloids. Several other clinical studies have touched on the mongoloid personality indirectly in the process of establishing various types of therapeutic approaches. Murphy ( 1 958) reported a music therapy program for low and middle grade institutionalized retardates, noting that, as the sessions proceeded, many of the patients spontaneously arose to sing and dance. “One Mongolian played a harmonica and another boy played a comb [p. 2701.” Evidently musicality is not specific to mongolism, but the implication is that the mongoloid is more instrumentally sophisticated than others. It is unknown whether this trait aided the music therapy program, but other stereotyped traits have evidently facilitated speech-therapy programs for severly retarded mongoloids: Lubman ( 1 955; cf. Strazzula, 1953) found that the 48 mongoloids in a group of 150 trainees “showed more rapid and permanent improvement than the brain-damaged child with comparable intelligence. Being generally more placid, it was not so difficult to retain his attention during the lessons [p. 2991.” Although attention span is one of the most debatable of the mongoloid’s characteristics, it could not have been deficient in the 5/9 institu-

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tionalized mongoloids whom McCord ( 1956) reported to be easily hypnotizable. Yet two of the children were dropped from the- study “for social reasons,” and two were not hypnotizable because one was moody, negative, and resistant to outer direction, while the other was clownish, self-willed, rebellious, and uncooperative. All together, therefore, 45% of McCord’s sample could not be hypnotized, apparently because of social-behavioral problems. B.

The Research Picture

1. SURVEYS

Thirteen surveys of mongoloid behavior were included in this review. Four of these were essentially analyses of case records, involving both outpatient and institutional samples; two used questionnaires sent out to teachers of classes for trainable retardates; seven used behavior checklists. Of the 13 studies, nine were explicitly concerned with testing the validity of behavioral stereotypes in mongolism. a. Cuse Records, Ellis and Beechley (1950) compared the outpatient records of 40 mongoloids and 40 nonmongoloid controls who were matched for sex, age, and IQ. Statistical analyses were performed on the frequency of emotional disturbance (little or none; moderate; severe), religion, family composition, maternal and paternal age, intelligence, and marital status, and the family’s economic status. The authors found 75% of the mongoloids vs. 40% of the controls falling into the little or no disturbance class, and 20% of the mongoloids vs. 45% of the controls in the moderate disturbance class. This distribution is statistically significant. The other reliable findings were that mongoloids tended to be the last born while the controls tended to be the first, and that mongoloids’ mothers tended to be older than the others’ mothers. Ellis and Beechley sharply observed that these three clear-cut differences are “not readily explicable in terms of unarguable theories [p. 4671,” but they went on to try to explain the difference in emotional disturbance between the groups. Each of their reasons either did not relate to the study’s findings, ran exactly counter to them, or depended upon statistically unreliable results. They then concluded, without enumerating them, that many stereotypes were supported in their work. An institutional case-record examination by Lyle (1960b) showed that only 13% of his 34 mongoloid cases involved a severely disturbed preadmission mother-child relation, while 43% of his 43 nonmongoloids had had such a problem. Decker, Herberg, Haythornthwaite, Rupke, and Smith (1968) reported that among cerebral palsies, convul-

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sive disorders, behavior problems, mongoloids, and hydrocephalics, only the mongoloids were referred to psychiatric services significantly less often than the average for the institution’s children. Not surprisingly, the behavior problems were referred significantly more often than the average. As for their chances for extrainstitutional placement, Tarjan, Dingman, Eyman, and Brown (1960) found that mongoloids “made good family care candidates and placements were probably arranged to give them a preferential opportunity [p. 6121.” It should be added, however, that compared to the familial, undifferentiated, postinfection and posttrauma, and other patient groups, the mongoloids were among the earliest to be reinstitutionalized from family-care placements. Taken together, these reports from case records suggest that at every stage in the institutionalization process, from preadmission to placement, as well as in the outpatient setting, mongoloids as a group are less disturbed and seem to find themselves in a somewhat more pleasant or promising condition than d o other retarded children. The present author is inclined to give the Decker et af. and Tarjan d uI. studies a special place in working out such a conclusion because both of them were retrospective, having established large samples of different institutional behaviors before analyzing the results by clinical subtype. b. Questionlauzres. Blessing (1959) polled 23 teachers in public school classes for trainable retardates. Nineteen questionnaires were returned, and these related to 83 mongoloids out of 225 students. Among other things the poll requested teachers to check any of I 1 “Satisfactory Behavior Aspects” and 19 “Behavioral Aspects of Concern.” According to Blessing’s very rough report, the most often chosen positive aspects were the children’s good nature and cheerfulness; the least often chosen were good communication and special talents in music, art, etc. Most frequently checked of the problem behaviors were short attention span and poor communication, while selfishness and perseveration were noted the least often. Blessing gave no analysis of these relative frequencies of choice, so it is impossible to know whether, for example, “perseveration” was ever checked along with “short attention span” for the same child. The picture of these children was apparently widely inconsistent, however, for Blessing concluded that it ran the gamut of social and emotional responses, and did not conform to a neat stereotype. He therefore called for “separating fact from fiction,” but then oddly enough, he cited mimicry, which was not on the checklist, as a positive aspect of mongolism which is not, however, “capitalized on in training and instructional activities.” Myths die hard. Connor and Goldberg (1960) did a similar, but much more compre-

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hensive, open-ended teacher survey, capturing 350 mongoloids out of

67 1 trainable class children. Teachers’ comments were categorized and judged “satisfactions” or “problems.” Responding to Kanner’s ( 1957) stereotype of the placid, well-behaved mongoloid, Connor and Goldberg noted that 54% of their mongoloid special-class cases were reported to be difficult to manage, with high-frequency adjectives including aggressive, stubborn, fearful, unloving, etc. N o statistics were reported, and no criteria for judging the “satisfactions” and “problems” were discussed. These two studies again leave the impression that behavioral stereotyping is unrealistic in mongolism, but again, without comparative data there is no measure of the specificity of the behaviors described for mongoloids. c. Rating Scales. There are two groups of studies which hold special interest for this review because (a) they are frankly designed to test behavioral stereotypes, (b) they claim to be making important procedural advances, and (c) they share a common technique of having institutionalized mongoloids rated by questionably trained, uncertainly objective, nonprofessional observers. The first group of studies includes Blacketer-Simmonds ( 1953), Silverstein ( 1964), Domino, Goldschmid, and Kaplan (1964), and Domino ( 1965). Blacketer-Simmonds ( 1953) was disappointed with preadmission case histories of his institutionalized mongoloids, and so he gave some ward personnel lists containing names of 60 mongoloids interspersed with those of 300 nonmongoloids, with instructions to check the names of people who were conspicuous as to 5 positive and 7 negative traits. The latter were then taken as proof against their positive antitheses; for lack of such proof, the child was scored positive. With all positive traits reduced to a 10 point scale, the distributions of the numbers of mongoloids and nonmongoloids receiving less than 5, 5,6, 7, and more than 7 points were compared and found to be identical, and symmetrical around 6 points. This gave “no indications for subdividing either group into emotional reaction types [p. 7141,” and hence called into question Engler’s account of the tripartite personality division of mongoloids. The findings of no differences between the two groups also contradicted, in particular, the Tredgoldian stereotype. Silverstein (1964) cited Blacketer-Simmonds’s study as the only empirical work in the area [an honor which Blacketer-Simmonds had already accorded to Rollin (1946)], and he attempted to improve upon Blacketer-Simmonds’s methods of behavior rating and subject matching Thirty pairs of mongoloids and nonmongoloids were matched for ward, age, sex, 1% and length of institutionalization. Senior ward personnel then rated these children on a carefully con-

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structed set of 20 five-point scales, including 10 for General Adjustment and 10 for Introversion-Extraversion. Twelve wards, each containing two or three mongoloid-nonmongoloid pairs, were included as a “between raters” factor in 22 mixed analyses of variance, one each for the 20 variables and the two composite factor scores (computed as the sum of the 10 separate ratings). Subject pairs were taken as the “within” factor in these analyses. N o report was made either of differences between the raters, or of interactions between raters and members of pairs. Over-all, there was a significant main effect for General Adjustment, and the separate analyses showed that four of the ten subscales yielded significant differences, all in favor of the mongoloids: mannerly, responsible, cooperative, and scrupulous. There was no significant main effect for Introversion-Extraversion, but two subscales (cheerful and gregarious) significantly discriminated between the groups, again in favor of the mongoloids. Silverstein noted that these differences could not clearly be ascribed to the subjects of the research because the raters might well have held biased views of mongoloids to begin with. However he observed that such biases might also act to reinforce desirable behavior in mongoloids (the social-interaction argument), and concluded by inviting “objective tests” to corroborate his “partial support for the mongoloid stereotype.” Domino et al. (1964) provided a 210-adjective checklist to professional and ward workers, who rated 21 mongoloid and 35 nonmongoloid girls, all of whom lived in the same ward. Point-biserial correlations were run on diagnosis vs. each of the adjectives, and diagnosis vs. various composite scores, I Q CA, length of institutionalization, etc. None of this second group of comparisons was statistically significant, but 33 of the 2 10 adjectives did correlate with diagnosis. T h e behavioral score for these comparisons was the number out of I2 nonprofessional raters who had checked the particular adjective. At best, therefore, the results indicate the degree of consensus about the applicability of an adjective to a patient. Of the 33 significant correlations 14 were positive with respect to mongolism, and 19 were negative. Except for “stingy,” the 14 positively related adjectives were all positive (e.g., unexcitable, content, relaxed, cheerful, affectionate). Except for “attractive,” all of the 19 negatively related words were negative (e.g., emotional, nervous, excitable, confused, obnoxious). Domino rt a/. concluded that there is a consistent mongoloid personality pattern in agreement with the clinical literature, which had not previously received quantitative support. They noted, however, that Benda’s (1946) assertion of stubbornness in mongoloids had received no support in the zero-order correlations for “stubborn,” “defiant,” “submissive,” etc., nor had the picture of restless-

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ness been supported. Unlike Silverstein, they rejected rater bias, but like him they suggested that their results could arise from differential treatment of mongoloids on the ward. In addition they noted that differential nervous system involvement may be influential. They did not consider the alternative possibility that the occurrence of 2 1 mongoloid girls on a ward of 56 might well reflect a placement systematically biased against difficult behavior problems. In spite of assurances that the ward personnel had not been biased, Domino (1965) repeated the study, using “naive raters” (210 college students) to determine whether “the mongoloid personality represents a stereotypic perception or whether it is a characteristic pattern present in mongoloids [p. 5681.” Each of the 210 students was instructed to “observe carefully” two retardates (a mongoloid and a nonmongoloid, matched like Silverstein’s pairs). T h e observations lasted from 5 to 30 minutes during a university field trip. I n the next class meeting the students (10 per subject-pair) rated their subjects on the 210-adjective checklist, yielding a consensus score from 0 to 10 on each adjective for each subject. Subsequently 210 t tests for average differences between the groups yielded 56 significant comparisons. Considering the short observations, the deferred ratings, the consensual rather than quantitative measurement, and the use of 210 t tests, it is not surprising that exactly half of the significant differences were in line with the classic stereotype, and that there were several directly contradictory results. In spite of all this, Domino finally concluded that “the stereotype has a substantial empirical basis,” which, in view of the mongoloid’s specific chromosomal abnormalities, may be genetically determined. T h e second group of behavior rating studies appears to have arisen directly from the ready availability of computerized census data gathered by the WICHE organization in the manner described by Abelson and Payne (1969). Moore, Thuline, and Capes (1968), and Johnson and Abelson (1969a, 1969b) used the census’s behavioral data, which were submitted by ward personnel, to follow u p the modest work of Silverstein, Domino, Rosecrans, and others. Moore et al. (1968) intended to improve upon earlier works by increasing the N to 536 pairs of mongoloids and matched controls (systematically sampled to include 25 AAMD etiological classifications). For each of 2 1 “maladaptive” behaviors, the number of mongoloids rated “occasionally” or “frequently” was compared statistically with the number of control subjects similarly rated. Thus, 170/536 mongoloids vs. 2391536 controls were occasionally or frequently “hyperactive” (x2= 18.30), 198/536 mongoloids vs. 250/536 controls were “aggressive” (x2

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= 9.97), etc. In all, 14 items were found to have similar statistical significance, and Moore el al. concluded that “individuals with mongolism, as

a group, tend to exhibit less maladaptive behavior than retarded peers without mongolism [p. 4361.” In fact, the results could not suggest such a conclusion. I t is possible (no matter how unlikely) that the group of 198/536 mongoloids (37%) who were “aggressive” also comprised the 170 who were “hyperactive,” the 48 who were “self-destructive” and so on down the list of 14 important variables, while the group of 250 “aggressive” controls contained none of the 239 “hyperactives,” or the 48 “likely to escape,” etc., with the result that only 37% of the mongoloids vs. 100% of the controls contributed at all to the study’s findings. I t is also possible, of course, that 100% of the mongoloids vs. only 250/536 = 47% of the controls contributed these maladaptive behavior data, in which case a very different picture of mongolism emerges. T h e Moore et al. findings are thus largely uninterpretable. Johnson and Abelson (1969b) followed up Moore et al. by looking at the census data on “social competence” items, an odd label for six selfhelp skills (tooth brushing, grooming, etc.), but perhaps appropriate for “communication with others,” “understands others,” “candidate for ward helper,” etc. A total of 11 variables were examined and frequencies shown for 2606 mongoloids and 20,605 nonmongoloids. Since nothing but these frequencies per item was analyzed, the same argument holds for this study as was applied to its predecessor. The third study of WICHE information Uohnson and Abelson, 1969a) responded to Rosecrans’s ( 1968) challenge to search for behavioral differences among cytogenetic subtypes of mongoloids. The investigators located 296 karyotyped people among WICHE’s 2606 mongoloid population. There were 254 simple trisomies, 2 1 translocations, 18 mosaics, and 3 mixed karyotypes. One of the five participating WICHE institutions had karyotyped all of its mongoloids; another was nearly complete. Had Johnson and Abelson concentrated on those two samples they would have had the first unbiased karyotypic study of institutionalized mongoloids; unhappily, they would also probably have lost some of their precious mosaics and translocations. The mean IQfor atranslocations was 38; for 238 trisomies, %= 32; for 18 mosaics, I Q = 28. Three critical ratios computed for the mean differences yielded p < .05 for the comparisons of translocations with the other two groups, between whom there was no significant difference. A more conservative analysis of their data, based on the standard deviations given in the paper, shows FzIzr4= 2.44,p < .lo, suggesting that the three groups in fact did not differ significantly in

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intelligence. Johnson and Abelson’s multiple comparisons therefore appear to be unwarranted. Regarding the behavioral data, each person was given a score of 1, 2, 3 or 4 corresponding to the never, seldom, occasionally, and frequently ratings given for each of 14 maladaptive behavior items taken from a pool of 22, which were the same as those used by Moore et al. with the addition of “requires restraint.” T h e translocations and mosaics were matched for age and I Q with trisomies, and it was found that only 5 subjects, all translocations, received a total score higher than 28 on the 14 items (i.e., higher than an average of “seldom”). Without the matching procedure, however, translocations were “higher” than the trisomies on 12/14 items, and higher than the mosaics on 10113 untied items. Johnson and Abelson did not explain what was meant by “higher” in this context, but they concluded from the combined analyses that “the happy, somewhat passive, and affectionate” type of mongoloid seems to include the trisomies and mosaics, whereas deviations from this picture would appear to occur in translocations. Considering that none of the behavior items examined related to happiness or affectionateness, such a conclusion is simply unjustified. At best it might be concluded that some translocations tend to be more maladaptive than most other mongoloids. However, only 8% of the sample were translocations, so even with all of them behaving poorly, there would still be very little reason for Johnson and Abelson’s observation that “many people in daily contact with the retarded talk about two kinds of Down’s cases: one kind that fits the most common pattern . . . and another kind that is more active and is easily angered [p. 8551.’’ This review of seven studies which used rating scales as their principal tool leads to some fairly disappointing conclusions. Three of the first four of these works which sought to bring quantification and methodological improvements to the study of behavioral stereotypes showed a radical disregard for obvious contradictions in the data and weaknesses in the statistics. As for the second three studies, one cannot but marvel at how easily WICHE’s mountains of behavioral data could be reduced to such trivia. Scores of analyses relating to tens of thousands of subjects resulted in almost zero net gain in knowledge about mongoloid behavior. This, moreover, was true in spite of the use of computers which could, with very little additional trouble, have been brought to bear on interesting retrospective questions, on subtle problems of behavioral variability and behavioral patterning within clinical subtypes, etc. Readers will wonder whether the impersonality of computer technology has not seriously weakened the investigator’s relationship to his subjects, and hence largely diluted his efforts to appreciate their behavior.

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2. METRICS Nineteen metric studies to be reviewed here based their behavioral findings upon standardized tests, or upon special-purpose tests administered in a single form to various groups of subjects. Three studies raised the question of dayerences between social and mental age within mongoloid populations, trying to examine the stereotype that mongoloids in particular mature more rapidly in the social than in the intellectual sphere. Four studies were concerned with patterns of abilities as shown by subtest scatter or relative strengths on test batteries. Eight reports focused upon somatic, metabolic, or cytogenetic variations among mongoloids in hopes of accounting for behaviorul variability Finally, four special-purpose studies ranged from verbal subtest and ad hoc verbal test performance to pitch characteristics of the mongoloid’s voice. a . Social us. Intellectual Maturity. Pototzky and Grigg ( 1942) observed that 21 mongoloids in a special private school had higher IQs than are found in public institutional samples. They also showed that the mongoloids, 16 of whom were older than 16 years, had Vineland social ages (SA) on the average 3 years, 4 months (3-4) higher than their corresponding mental ages (MA), whereas for nomongoloids in the same school the excess was only 2-1. N o data were shown for the contrast group, so it cannot be determined whether they were absolutely lower in S A , or simply closer in SA to their own MAS. But the authors noted that given similar IQs, the mongoloids were found to be more sociable than contrast subjects. In explanation, it was said that the mongoloid’s imitativeness and his likeable qualities may elicit special attention from nurses and teachers. Subscription to these particular stereotypes did not hinder the authors from criticizing other ones, however; they cited data from an introversion-extraversion rating scale and “excerpts from the psychologist’s notebook” in addition to purely anecdotal claims in opposition to “a personality which is stereotyped and typical for all Mongoloids [p. 5051.” Quaytman (1953) amplified on the argument about imitativeness and likability, suggesting that such qualities should provide a sounder basis for social learning than for academic learning. His report on 40 mongoloid outpatients, who were almost all below age 16, showed a mean IQof 44, a mean SA of 4-0, and a mean MA of 3-0. The difference, - MA,is 1-0, and this is certainly far smaller than the 3-4 noted by Pototzky and Grigg. Examining the five cases from the latter study who were below age 16-0, however, it is found that the median IQis 44, median MA is 5-1, and the median SA is 5-9. The difference between these medians is only 0-8, and this

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roughly corresponds to Quaytman’s results. There is thus apparently an age-related process by which SA grows faster than MA in mongoloids. Cornwell and Birch (1969, p. 345) demonstrated this relation quite clearly in their Fig. 2, in which the SA-MA difference was essentially zero at age 4 or 5 years, and thence grew to over 2 years past age 14 or 15. Cornwell and Birch’s very complete discussion of age relations in SA and MA acknowledged the relatively higher social than intellectual maturity of mongoloids, but they questioned whether the relatively low absolute social maturity of these children, as indexed by the Vineland test, is commensurate with the stereotype of a highly social child. What is lacking in all of these studies are explicit comparative data for nonmongoloid children, without which there is still considerable doubt as to the specificity of the MA vs. SA difference in mongoloids. 6. Patterns of Behavior. Bilovski and Share (1 965) studied 24 public school mongoloid children (mean IQ47) under the philosophy that a medical label will have educational implications only to the extent that it may be found to relate to explicit educational prognostics. The children were given the Illinois Test of Psycholinguistic Abilities, which is a battery designed to tap visual, auditory, vocal, and motor coding and associative functions. “Language Age” norms provided the comparative data. Their general finding was that the mongoloids were well above expected maturity in the ability to understand pictures and to express ideas by motor rather than by verbal means (mimicry!?). Their greatest weaknesses were in verbal memory for auditory material, and in the ability to predict a word in a partially completed sentence (again, auditory-vocal channeling). Bilovski and Share concluded that the remedial value of their findings was related to the development of programs appropriate to the children’s evident strengths and weaknesses. It is unsure whether by this the authors meant something like using visual and tactile materials for hard-of-hearing children or whether they meant (by analogy to providing a hearing-aid to hard-of-hearing children) that the remediation should be directed toward the mongoloids’ specific (viz., auditory-vocal) handicaps, Nakamura ( 1965) examined 64 adult institutionalized mongoloids, compared with 64 nonmongoloids matched for age, sex, and StanfordBinet (Form L) I Q (mean IQ 23). Tests of correlated proportions showed that there were no significant differences between the groups on 56/60 subitems on the S-B (L). More mongoloids than controls passed three of the four remaining items, and it is interesting that all three of these involved visuomotor performance, while the single item on which nonmongoloids excelled was “repeating three digits,” an au-

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ditory-vocal problem. These findings thus precisely agree with Bilovski and Share’s report of auditory-vocal weakness and visuomotor strength in mongoloid school children. A study by Clausen (1968) partially disagrees with these findings, however. Twelve mongoloids were compared with 196 other retardates, 24 of whom were also selected as matched sex, age, and MA controls for the mongoloids. Thirty-four tests, which yield 50 variables, were standardized on 112 normal 8- to 10-year-old children, and the retardates where assigned T scores relative to these norms. Comparisons with Nakamura’s and Bilovski and Share’s variables may be summarized as follows: (a) Clausen’s mongoloids performed significantly poorer than the 196 retardates, and nonsignificantly poorer than the matched controls on pegboards and on railwalking; they were significantly poorer than the 196, but nonsignificantly better than the controls on visual reaction time; they were nonsignificantly poorer than the 196 and nonsignificantly better than the controls on mirror-drawing. There is thus no indication of better visuomotor performance in the mongoloid sample. (b) On auditory reaction time, span of apprehension, and threshold for speech, the mongoloids were well below the other groups, suggesting that at least in the auditory input channel they are specially deficient, and this tends to corroborate the previous two studies. T h e over-all support is very weak, however, for there are inconsistencies within the Clausen data (e.g., the controls were very much better on verbal reaction time to pictures than on simple visual reaction time, while the other groups were nearly equal on the two). In the fourth study in this group, Knights, Atkinson, and Hyman (1967) first compared 19 mongoloids with 19 CA- and MA-matched cultural-familial retardates. Four tasks included blindfolded discrimination of texture, size, and weight, plus visuotactile discrimination. The first and most important result was that just under half of the mongoloids failed completely or did not even attempt two or more of the tests, while only one familial was similarly deficient. Comparison of the 10 mongoloids and 18 familials who did perform showed that on all but the visuotactile test, the mongoloids were nonsignificantly poorer than the familials. On the visuotactile task the reverse was true. The hypothesis of relative visuomotor strength in mongoloids is thus once again confirmed. In a second study, Knights et al. compared 12 mongoloids with 12 matched familials on a series of six tasks similar to Clausen’s motor performance items (pegboards, visuomotor reaction time, dynamometer, hand steadiness, and finger and foot tapping). Like Clausen, they found no important differences between the groups on these tests. Because these metric studies by Bilovski and Share, Nakamura, Clau-

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sen, and Knights et al. are formally unrelated, it is remarkable that they should agree so closely in suggesting a reasonable direction for further research. The approximate consensus is that mongoloids will be found to be relatively stronger than other retardates on visuomotor or visuotactile channeling, and that they will be relatively weaker on tactile discrimination and on auditory-vocal (i.e., language-related) functions. c. Variability in Mongoloid Behavior. There is a fairly large and unwieldy literature on relations between psychometric intelligence and the number or types of somatic signs in mongolism. Baumeister and Williams (1967) have published an altogether thorough review of these studies along with a forceful, carefully documented methodological critique. There is one tangentially related report (Tang & Chagnon, 1967) which deserves a review, not for its contribution to knowledge, but rather for its historical interest. It focuses on a recurrent debate which began with Down and reached something of climax in Goldstein’s ( 1956) decidedly irresponsible account of endocrinological distinctions among mongoloids. One group, Goldstein reported, maintains IQs over 50, has short stature, wide facial features, pudgy, short hands, myxedema- in short, the hypothyroids. The other group, having a pituitary deficiency, was said to be taller, to have a more incurved fifth digit, lower IQs, speech problems, and restless, emotionally disturbed behavior. Tang and Chagnon ( 1967) considered Goldstein’s classifications to warrant serious research interest. They therefore constituted two groups of mongoloids, not as one might expect, on the basis of metabolic data, but on the basis of weight/height (w/h) ratio. From a large population of mongoloids, they chose extreme w/h groups containing 61 mongoloids each. There was a significant difference between these groups’ mean IQs; the data were not given in the report. A second, somewhat more conservative analysis involved ranking and cutting the 122 IQs, followed by x2 analysis of the distributions of high and low w/h subjects in the upper and lower IQs groups. This showed a nonsignificant trend in the predicted direction; and, with the splits occurring at 59% and 43% for the two w/h groups, there is, as Tang and Chagnon observed, very little predictability from I Q to w/h ratio, o r the reverse. Why w/h ratio was not simply correlated with I Q by some least-squares regression technique remains a mystery. The logical relationship between these findings and the endocrinological arguments is also obscure. Parallel to the studies of somatic measures vs. intelligence are those of cytogenetic measures vs. intelligence and personality. At least four studies (Finley et al., 1966; Rosecrans, 1968; Shipe et al., 1968; Zell-

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weger & Abbo, 1963) have reported correlations between the number of affected cells and intelligence in mosaic mongoloids. Many of the same cases were examined by the different authors (mosaic mongolism is a very rare condition), and some of these were normal parents or other relatives of known mongoloids. Rosecrans’s discussion of exceptional cases and problems of method leaves the impression that a sound basis for predicting adult I Q from mosaic ratios will be a long time coming. Shipe et al. confirmed that there is a “rough correspondence between per cent of abnormal cells and degree of mental impairment [p. 7951,” added a note on two glaring exceptions, and then observed that in at least one case, the proportion of abnormal cells has been found to vary widely over the years. They concluded, however, that “as further cases of mosaicism are reported, together with (hopefully) I Q data, one may expect to settle the question [p. 7971.” This faith in large numbers seems unrealistic, for if in a small sample one finds a very weak relationship, he should expect the extended sample at best to illuminate the complexities rather than to settle an already obviously naive question. There will always be a rough correlation between degree of mosaicism and degree of intellectual impairment. What is required is a sound theory from which reasonably testable hypotheses can be derived to explain the unaccounted variability. Relevant to Johnson and Abelson’s ( 1 969a) WICHE survey of trisomics, mosaics, and translocations, Gibson and Pozsonyi (1965), Pozsonyi and Gibson (1965), and Shipe et (11. (1968) have looked directly at intellectual and personality variables associated with these cytogenetic subtypes. Gibson and Pozsonyi contrasted 10 trisomies and 10 “reliably diagnosed cases of translocation mongolism [p. 80 11,” whose ages were matched at about 8 years. Out of the clinical, psychological, psychiatric, neurological, and dermatoglyphic data which were available prior to the karyotypic information, it was found that these groups’ average IQs were very close but significantly different (Trans., 43.5; Trisom., 40. l ) , and that the average ages at which the children first sat (Trans., 1 1 months; Trisom., 16.6 months) were also significantly different. There were no other differences between the groups. Nevertheless, the authors claimed (in what seems to be clear opposition to Johnson and Abelson’s findings) that “while the differences are not dramatic . . . there was a consistent tendency for the trisomy child to be aggressive . . . . Under favorable . . . nurture, the trisomy child was disposed to enthusiasm and mimicry. By contrast the typical translocation mongoloid tended to be passive, cautious and lethargic [p. 8041.” Pozsonyi and

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Gibson (1965) reported biochemical findings, presumably for the same two groups. Again, there were few significant differences, except in 24hour thyroid uptake measures, in view of which the authors suggested (p. 2 16) that Gibson and Pozsonyi’s “previously observed systematic variations of . . . behavioral artifacts” between translocations and trisomies might be mediated by differential thyroid functioning. An analogous but somewhat more refined quality of reasoning is found in Gibbs, Gibbs, and Hirsch’s ( 1964) electroencephalographic study of mongoloids, only 2% of whom showed 6 or 14 cps positive spiking. Gibbs et al. observed, without references or original data, that “mongoloids, in contradistinction to other types . . . are, as a rule, extremely placid and gentle [p. 5831,” and this might be related to the rarity of 6 and 14 cps spiking, since, when overactive, the “system” responsible for this EEG response “commonly produces emotional instability.” Shipe et al. found that 3 mosaic, 3 translocation, and 25 trisomy outpatient children yielded median IQs of 52, 49, 38, respectively. Only one of the 25 trisomies scored above 48, which was the lowest of the three mosaics’ IQs. Here, again, is a clear disagreement with Johnson and Abelson. From the group of studies by Johnson and Abelson, Gibson and Pozsonyi, and Shipe et al., it appears (a) that mosaics have either higher or lower IQs than trisomies, (b) that translocations show either more behavioral problems or are more passive and lethargic than the possibly aggressive trisomies, and (c) that the differences found among these three groups are typically so unreliable, the overlap in distributions so great that it is difficult indeed to maintain hope that behavioral differences among mongoloids will be accountable by cytogenetic analyses, given current levels of sophistication in the assessment of these variables. d. Special Purpose Tests. Lyle (1959) studied 77 institutionalized and 117 community retardates, comprising respectively 34 and 76 mongoloids. With the Minnesota Preschool Scale he found significant MA differences on the verbal, but not on the nonverbal subscales, showing that institutionalized children were more handicapped than community children, and mongoloids more than nonmongoloids, with no interaction between these variables. Lyle (1960a) followed up this study, using specially designed verbal tests for word naming, comprehension, definitions, speech sounds, etc. His general findings were the same as in the previous study. In addition, he observed that the mongoloids were least deficient in comprehension and word naming, and most deficient in definitions and complexity of language. Citing Wunsch (1957), he suggested that the mongoloids’ phlegmatic, self-sufficient tendencies

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might disincline them to communicate with others. Whatever the explanation, this finding of relatively good comprehension but low communication largely agrees with Johnson and Abelson’s (1969b) findings of differences in these two functions among institutionalized mongoloids. One of the difficulties in communication experienced by mongoloids is reputed to be the quality of their voice. Among other things, it has been said to be peculiarly low pitched. Michel and Carney (1964) took u p the challenge of testing Benda’s clinical observations on this phenomenon. They contrasted the vocal pitch levels of eight institutionalized mongoloids against pitch norms for their ages (8-6 to 10-6) and found that there was a precise match. They concluded that the clinical finding may be an illusion based on the fact that mongoloids of this age tend to be about two years retarded in physical growth, making their normally pitched voices appear to be too low. Michel and Carney conceded, however, that other voice qualities or inflection patterns might account for reports of abnormal voice characteristics. A study of possible attention deficits (distractibility) in mongoloids was made by Fisher (1970). He first standardized a battery of tests reflecting impulse control, incidental learning, and other indices of impulsivity and focus of attention on 60 normal preschoolers, validating the scores against teacher ratings. The four most highly predictive tests were then given to 19 noninstitutionalized high-level and to 62 noninstitutionalized low-level retardates (including 3 1 mongoloids and 3 1 nontnongoloids). T h e etiological and ability breakdowns were not intercompared, each group being judged only against the normal children’s performance. It was concluded that high-level retardates were much more normal than the low-level ones, and the mongoloids’ pattern of deficiencies across the four tests was not different from the nonmongoloids’ pattern. However, without direct comparisons of these two groups on the four tests, it is very difficult to assess their relative performances, especially in view of the use of average ranks, rather than raw score reports on the normal-retardate comparisons. 3. MANIPULATIVE STUDIES

T h e last, but prime group of behavioral researches into mongolism are the 14 manipulative studies. Four of these relate to clinically derived stereotypes, while ten are oriented to traditional problem areas of psychology, including motivation, perception, learning, and reaction time. a. Stereotypes. T h e problem of musicality appears to have received its first controlled test in Rollin’s (1946) experiment with 73 institution-

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alized mongoloids (60% of whom, it will be recalled, showed some form of gross misbehavior). He first placed them all together in a recreation hall and played waltzes and fox-trots. Without further instructions none of the patients budged, although some evidently enjoyed the entertainment. Four of them danced upon invitation, and finally 24 (33%) were willing to be coaxed into it, but not one showed appropriate rhythm. Blacketer-Simmonds ( 1953) ran a similar institutional experiment on 42 mongoloids and 42 nonmongoloids. Under the passive-listening condition, only six of each group (14%)showed pleasure with Hugh Branford or Handel, but none moved in time to the music. Next, a drum was beaten rhythmically before each child, who was then permitted to emulate the gesture. Fifty-seven percent of the mongoloids and 67% of the controls revealed no sense of rhythm at all. A statistical analysis showed the difference to be nonsignificant. Additional tests of exercises to music showed the same 57% and 67% failures, and a final attempt to encourage humming or singing nursery rhymes and popular songs resulted in “plenty of noise without any resemblance to tune [p. 7161.’’Nobody individually tried to sing. Contrasted with Rollin’s 33 % success at getting mongoloids to “dance,” Blacketer-Simmonds’s 43% who actually showed some rhythmical sense is impressive, but the control group’s nearly equal performance belies the specificity of rhythmicality in the mongoloids. Cantor and Girardeau (1959) focused the most sophisticated attempt upon rhythm, comparing 12 community mongoloids with 12 normal children of approximately the same MA (-4-6). A metronome was played at two speeds and at two intensities, and the subject’s task was to identify short bursts as “fast” or “slow.” Unfortunately, 68% of the mongoloids and 33% of normals did no better than chance guessing over 60 trials, so the task appears to have been far too difficult for both groups, and thus could yield no clear results. Although these few studies of musical and rhythmic expression provide not a shred of evidence for the myth of mongoloid musicality, it is clear at least in Blacketer-Simmonds’s study that these children are not musically deficient relative to appropriate retarded controls. One wonders whether the myth was not perpetuated for so long and so widely by arm-chair scholars rather than clinical observers. T h e single experimental study of distractibility in mongoloids, by Brown and Clarke (1963), involved an awkward statistical difficulty and far too few subjects to warrant a clear decision about this hkhly debated problem. Within an institution, 12 adult retardates (IQ= 70) were compared with 14 adult mongoloids 27) and 14 other se-

(m=

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verely retarded adults 29) on an object-naming task. These people were first tested without distraction, then under meaningful and nonmeaningful auditory distraction. The trials were scored for errors and for total time to completion. Since all subjects received both meaningful and nonmeaningful distraction, the appropriate statistical design would be a mixed analysis of variance for repeated measures. This is not what was done, however. Furthermore, it appears that most of the subjects made zero or perhaps one out of a total possible 20 errors, yielding severely skewed distributions [which Brown and Clarke handled with a transformation of the form log (X - 1) X 10001. In their tabular data (Brown & Clarke, 1963, p. 3) it appears reasonably certain that the meaningful distraction caused more errors than the nonmeaningful, and that the mongoloids were at least not more distractible than their IQpeers, and maybe less so. In time to complete the task, the 1Q peer groups were very close and far slower than the higher I Q group. Together with the Fisher (1970) study, there is still little basis for a sound conclusion about distractibility in mongoloids, but the evidence currently points to no differences between mongoloids and other, similarly retarded people. b. Perception. Just as the mongoloid personality has captured the clinical literature, the relative strengths of various sensory and modality integrations (here to be called, loosely, perceptual functions) has had a fairly long history in the experimental literature. Following Brousseau’s (1928) account of the difficulty of testing sensory acuity in mongols, Gordon (1944) produced the source document for many more recent studies. He tested six mongoloids and six normals matched for MA = 6 years on a series of tasks which included visual and tactile discrimination of size, pattern, form, and texture. First ranking the 12 children on MA, on visual, and on tactile composite scores, he reported rank correlations of .15 for MA vs. visual, and -.18 for MA vs. tactile discrimination. T w o t tests showed that normals and mongoloids were not significantly different on visual, but the mongoloids were significantly poorer on tactile discrimination. On the basis of the data shown in Gordon’s Table 111 (p. 60),a mixed analysis of variance for repeated measures shows, contrary to his conclusion, that the mongoloids were uniformly inferior to the normals, and that there is nothing important in the observed differences between visual and tactile modalities. OConnor and Hermelin (1961) and Hermelin and OConnor (1961) accepted Gordon’s conclusion that mongoloids are particularly poor in tactile perception, added that in a previous study nonmongoloids had done better than matched normals on tactile discrimination, and there-

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fore hypothesized that mongoloids would do more poorly than matched nonmongoloid retardates. In the first study, 12 adults of each type were given a delayed visual recognition task, the other 12 a delayed tactile recognition task. Recognition was accomplished in the same modality as the original presentation. Consistent with the hypothesis, mongoloids were weaker than nonmongols on touch recognition, but they were stronger on visual recognition. There was no main effect for etiology or for modality in these retarded samples. In the second study the authors ignored the previous finding of a significant difference in visual recognition, and worked under the hypothesis of “differential abilities in normals, mongols and non-mongols in the motor response area, and the absence of such differences in visual perception [Hermelin & OConnor, 1961, p. 671.” Sixteen normal children, ages 4-6 to 5-6, were contrasted with 16 mongoloids and 16 nonmongoloids, @= 36, ?%= 18. The task required visual matching vs. delayed recognition, and copying vs. delayed reproduction of several line drawings. There were no details of experimental design, no summary analysis tables, and no indications, therefore, of how the data in their Table I (p. 69) came to be, or on what basis analyses of variance were run. One must take on faith that each of 48 subjects tested on eight designs under “any of the four conditions” could reach for a maximal score of 28. It is also on faith, therefore, that one accepts the conclusions, which exactly confirm the original hypothesis: no group differences on the matching or recognition; mongoloids poorer on copying and on reproduction. Knights et al. (1965) were concerned only with the tactile mode in a study of 10 cultural-familial, 9 brain-damaged, and 18 mongoloid retardates. All subjects were blindfolded and then given a form-board test, first with the dominant, then the nondominant, and then both hands. As in their 1967 test, Knights et al. found that the mongoloids were extremely deficient, only 4/18 being able to perform the task at all. They concurred with Gordon (1944) that the tactile modality is specifically weak in mongoloids. The Knights et al. studies produced the most striking evidence for tactile deficiencies in mongoloids, yet they were also the only ones which used blindfolds. If there is any merit to OConnor and Berkson’s (1963) observation that “mongols . . . clinically speaking, showed disturbance when asked to remain alone in the dark [p. 881,” Knight’s use of blindfolds might reasonably be held responsible for at least part of his mongoloids’ failures to perform the tasks. Weak tactile discrimination might therefore best be viewed as a possible contribution rather than a clearly demonstrated cause of the performance deficiencies.

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The final study of perceptual channeling belongs to Scheffelin (1968), who, in one tightly designed experiment, touched on many ol‘the questions raised by earlier researches. Her purpose was to test the relative strength of visuomotor, visuovocal, auditory-motor, and auditory-vocal processes within a mongoloid population. She sampled 24 noninstitutionalized mongoloid children ( F A = 1 1-0; IQ=43). Their task was to learn, by a modified paired-associates anticipation method, four successive eight-pair lists. The stimulus items were 32 common objects, eight for each list. The response items were eight body parts, the same eight being used on all lists. In a carefully counterbalanced design, all subjects learned one list by seeing the object and pointing to the body part (visuomotor), another by seeing the object and saying the part (visuovocal), a third by hearing the object’s name and pointing to the part (auditory-motor), and a fourth by hearing the object’s name and saying the body part (auditory-vocal). The error rate for the auditory-vocal was just twice that for the other three, among which there were no significant differences. By Scheffelin’s analysis, the auditory-vocal channeling deficiency may have resulted from the use of 16 words to complete the S-R cycle, as against a maximum of eight words in the other conditions; alternatively, she noted that the combination of similarity (word-word) and abstractness (names) in the auditory-vocal S-R items might have produced greater interference than the combination of similarity (picture-pointing) and concreteness (actual images) of the visuomotor items. It is indeed regrettable that Scheffelin tested no nonmongoloids in this research, for its results are among the most reliable, and its interpretations among the most reasonably straightforward to be found in the medicalbehavioral literature. Are mongoloids any more or less influenced by Scheffelin’s variables than other retardates? c. Learning. Martin and Blum (1 96 1) wished to test oddity learning and generalization of the oddity concept in 55 normal children - (MA 80 mos.; 115) and in 44 familials (MA = 80 mos.; IQ- 52) and 22 mongoloids (MA -- 45 mos.; IQ- 30). The implication was that the retardates were randomly drawn from a population (a) less than 17 years old, (b) with “unequivocal” diagnoses, and (c) with no major motor or sensory handicaps. All subjects received six uncorrected trials on each of eight 3-choice oddity problems involving visual presentation. One problem was given for each of the following eight odd dimensions: small, large, form, another form, color, another color, orientation, another orientation. Given eight, 3-choice problems, there were eight possible correct trial-one choices, and chance guessing would thus yield an expected score of 2.66 correct. Mongoloids had a mean of

m=

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2.66, familials a mean of 4.63, and normals a mean of 4.19. There was no significant sex or sex-by-groups interaction. Only the groups main effect was significant, and this vanished under covariance analysis with MA used as the equalizer variable. Over eight, S-choice problems, trials 2 to 6 would yield a total of 40 possible correct choices, with 13.33 expected of chance guessing. Mongoloids averaged 18.06, familials 28.62, and normals 29.89. Again, the groups effect was the only significant finding, but unlike the covariance analysis of trial one (intertest generalization), covariance analysis of trials 2 to 6 (learning) did not wash out the mongoloids’ inferiority. T h e authors concluded that in learning, but not in generalization, the mongoloids are deficient in ways which cannot be “fully attributed” to their lower mental age. Three questions arise in view of this study. First, were Martin and Blum justified in using covariance analysis? According to Winer (1962) covariance analysis is appropriate only (a) when there is a good deal of overlap among the groups on the equalizer variable, and (b) when the correlations between that variable and the criterion score are equal across groups. Martin and Blum probably violated both criteria. Their mongoloids’ MA distribution was well below their normals’ and familial retardates’ MA distributions, and there was a significant correlation between MA and total oddity learning score for familials and for normals, but not for mongoloids. The lack of such a relationship in the mongoloids may have resulted from the large concentration of scores around chance, a floor effect which would largely reduce their criterion variance. The second question is whether any observed behavioral differences among the groups could be “fully attributed” to variability in mental age. Behavioral variation is strictly explicable only in terms of processes which mediate behavior. Age, which is nothing more than the ticking of a clock, is certainly not such a process. Even if mental age were an age, it would still, therefore, have no explanatory power. In reality, not only is mental age not an age, it is no more than a set of behaviors, and as such, far from explaining another set of behaviors, it is itself in deep need of explanation. T h e third question is whether Martin and Blum could possibly have sampled mongoloid and familial retardates whose diagnoses were “unequivocal.” It has already been noted that in theory the diagnosis of mongolism is at best a probabilistic decision. It may be added that the diagnosis of familial retardation, according to the AAMD scheme, pivots on the exclusion of other causes. Proof of the null hypothesis being impossible, so must an unequivocal diagnosis of familial retarda-

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tion be impossible. It is not surprising, therefore, that Prysiazniuk and Wicijowski (1964), whose goal it was to make a refined duplication of the Martin and Blum study, finally included several cases of “uncertain cause” in their nonmongoloid group because “so few Ss were unequivocally diagnosed as familial [p. 761.” Regarding the duplication, when the two groups were matched at MA = 40 months, it was found that mongoloids were significantly better than nonmongoloids on trial one, and nonsignificantly better on trials 2 to 6. These results are diametrically opposed to Martin and Blum’s. d. Motivution. Eisenberg (1967) and others have noted that intelligence cannot be understood without appreciating the complexity of cognitive, motivational, and attitudinal factors which ultimately contribute to complex behavioral test performance. A simple example of the intricacy of interactions which influence behavior that would normally be considered strictly cognitive is found in Byck’s (1968) study of concept switching. The first two tasks given to 10 mongoloids and 10 familial institutionalized retardates (matched for age at 13 years and I Q at 40) included sorting a deck of 25 cards, each of which contained one of five forms, and another deck of 25, each with one of five colors. These tasks were counterbalanced across subjects. T h e third task required sorting a deck of 25 cards, each of which contained both a color and a form. The subject made a sorting into five piles, the cards were shuffled, and he was then asked to sort them again i n a different way. Eight trials were given for this second sorting. Although the text is unclear as to when the change occurred, it is clear that half of each group began the experiment under the promise of receiving a toy if they did well, while the other subjects began with the only reward being praise, encouragement, etc. This reward condition was changed, possibly just prior to the third task, such that subjects who were given the unidimensional sortings under tangible reward were now given praise and encouragement, while the originally intangiblereward subjects were now laboring under the promise of a toy. The criterion variable was the number of trials out of the eight maximum that the subject needed o n the third task to shift from his original basis of sorting (color or form) to the alternative basis. Since only one eight-trial opportunity to make this shift was given to each subject, it is unclear how Byck came up with an analysis of variance in which type of reward was taken as a repeated measure (within subject) variable. Nonetheless, his Table 111 shows that the familials were nearly incapable of making a second sort under the intangible reward condition, while the mongoloids were nearly incapable under the tangible-reward condition. Most

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subjects managed to make an appropriate second sorting, however, when they were working under the other rewards and there was no difference between their mean trials-to-second-sort. Byck concluded that each group had its own “optimal” reward condition, and that this represented a cognitive difference between the two types of subjects. Since both groups were near the ceiling under their nonpreferred reward, one cannot tell whether they might have differed, but, with means of 5.2 and 5.3 trials to second sorting under their preferred reward, it appeared to Byck that there was no evidence to indicate a proficiency difference. The basis for this conclusion is obscure, however, because differential proficiency implies that motivation really is optimal. Since both groups were at the ceiling under one reward condition, and they were equal under the other, it is indeterminate whether one group improved more than the other with the change of reward. It is conceivable that the reward change represented a very large difference for one group and a very small difference for the other, and one might then wonder whether the choice of another reward condition might have had yet a greater differential effect. T h e word “optimal” was thus unreasonably attached to the reward conditions under which each group fell below the ceiling in this study, and a clear demonstration of equal proficiencies therefore awaits further research. Hopefully the next study will specify the procedures and statistical design to the point where a much clearer evaluation will be possible. c. Reaction Time. Berkson (1960) studied five groups of adults in= cluding normals and four levels of institutionalized retardates 70, 60, 40 and 30 for workers, subnormals, severely subnormals, and mongoloids, respectively). Four visuomotor reaction-time tasks were (a) lift hand when light #3 of a five-light array comes on, (b) lift hand and turn knob when #3 comes on, (c) lift hand and press button next to light #3 when it comes on, and (d) lift hand and press button next to the one of five lights which appears (choice reaction time). T h e subjects worked for a tangible reward, but the experimenter also said “good” and “fine,” in random order, independent of the subject’s response. O n all tasks, the mongoloids responded significantly slower than the other subjects, and this was true even when mongoloids were matched for I Q with other retardates. From a theoretical standpoint, however, it is far more impressive that there was a significant interaction of groups by tasks resulting from the mongoloid’s being especially slow on the task which required a complex motor response (lift hand and turn knob). Far from indicating a visuomotor performance advantage over equally retarded nonmon-

(m

MEDICAL-BEHAVIORAL RESEARCH

65

goloids, these results suggest that mongoloids are relatively deficient in this channel, and the deficiency increases with increasing motortask complexity. Hermelin and Venables (1964) have confirmed and extended to auditory-motor channeling the finding of generally slower reaction time in adult mongoloids compared with matched nonmongoloids. C.

A SUMMARY OF THE LITERATURE

Table I1 presents a synopsis of 54 studies which provide the data base for this summary evaluation of hypotheses concerning mongoloid behavior. The hypotheses are derived from the wide variety of clinical pictures sketched out in Table I and from some questions posed only in the experimental literature. HYPOTHESIS 1: Mongoloid mid norimongoloid returddes m e equally likely to de7Jekopagreeable or disugreecrble personulit? ti-& The institutional studies of Decker et rrl. and Domino ~t ul. provisionally disagree with this hypothesis in showing that mongoloids tend to be referred less often for psychiatric services and that they appear to ward personnel as less disturbed and less disturbing than other retardates. The institutional studies of Tarjan et al., Silverstein, and Domino ut ul. have also found mongoloids to exhibit more favorable behavior than nonmongoloids, but Blacketer-Simmonds dissented with a finding of no differences between the .groups. In noninstitutional settings, Menolascino, and Ellis and Beechley found fewer cases of severe disturbance among mongoloids. There were no noninstitutional studies of positive traits. The weight of evidence thus points to generally less disturbance among mongoloids, but there is some question as to whether they are any more pleasant than nonmongoloids. Obviously the one does not necessarily imply the other. HYPOTHESIS 2: Mongoloids tend to exhibit (I uniformity oj personality The evidence is unequivocally opposed to this hypothesis. In institutions Rollin, McCord, and Menolascino found from 37% to 60% of mongoloid samples with social behavior problems, while only 29% to 55% showed explicitly positive personalities. Outside the institution, Wunsch, Blessing, and Connor and Goldberg reported wide variability in the numbers and types of maladaptive traits, with somewhere between 14% and 54% of the children showing distinctly negative dispositions, and no more than 66% showing positive ones. HYPOTHESIS 3: Mongoloids and rionrnorigoS-olr,id.Tare pqual(v musical Rollin’s and Blacketer-Simmonds’s sparse evidence on this point shows that institutional samples of mongoloids and nonmongoloids are se-

TABLE I1

SYNOPSISOF 54 BEHAVIORAL STUDIESOF MONGOLISM Studya

Focus

Methods

Subjectsb

Results

NotesC

CLINICAL EVALUATIONS

Earl ( 1934)

1 Psychosis

Clinical observation

Unspec. number of M and N M M R types 73 low-level Ms

Rollin ( 1946)

I Behavior disorders

Clinical observation

McCord ( 1956)

1 Hypnotizability I Languagetherapy response

Clinical trial

9 Ms

Casual observations

48 Ms vs. 102 N M low-level MRs Unspec. number of low-level MRs 95 Ms

86 Ms vs. 530 NM MRs or emotionally disturbed

Lubman ( 1 955)

Murphy (1958) Menolasano (1967) Wunsch (1957)

I Music therapy response 1 Emotional disturbance NI Temperament

Neville ( 1959)

NI Psychosis

Casual observations Clinical observation Clinical observation Case study

Mendasano (1965a, 1965b)

NI Behavior disorders

Clinical observations

77 Ms

1M

SURVEYS Ellis and Beechley (1950)

N1 Emotional disturbance

Case records

40 Ms vs. 40 NMs

matched on age sex, and I Q

2 % of psychotics were M;

M's symptoms less severe 60% with behavior disorders: 29% well-behaved, out-going etc. 4/9 not hypnotizable because of social-behavior disorders Ms respond better because more placid, so more attentive One M played harmonica 37 % emotional disturbance 66% docile-affective: 14% aggressive-hostile Symptoms dependent upon relatively rich background 13%0f Ms vs. 33% of NMs severely disturbed: approx. equal distributions of types of disorders for AAMD classif. I11 and VI 75% M vs. 40% NM in least disturbed category

No info. on pop., so cannot tell if 2% is more or less than expected NCG, author disagrees with stereotype NCC Personality observations not documented lmplies more musical expertise in mongoloids Author extremely hostile to stereotypes: NCG NCC Theoretical note Author charitable to stereotype: sampling bias toward NMs with problems? Possible evidence for similar types of disorders among Ms and NMs Authors claim support for stereotype, but ignore or misread own data

3" is 2 P 0 E

Lyle (1960b)

Tarjan el d. ( 1960) Decker el al. (1968)

I Motherchild relations

Preadmission case records

34 Ms vs. 43 N M

I Prognosis for placement 1 Use of psychiatry and other services

Institutional records Institutional records

Inst. pop. analyzed by subtype Inst. pop. analyzed by subtype

Teacher questionnaires Teacher questionnaires

83 Ms

Ward personnel rate Ss on pos. and neg. traits

60 Ms vs. 300 N Y MRb

Ward personnel rate Ss for Gen. Adiustment and Introv.-Extrav. Ward personnel rate Ss on 2 10 adjective checklist

30 Ms YS. 30 NMs matched on age. sex, I Q-, l e n-a h of institutionalization 21 Ms vs. 35 NMs matched as per Silverstein

MRS

13% M vs. 43% N M had disturbed relations with mother Ms more likely to get homecare placement Ms less likely to go for psychiatric treat men t

Possible bias against NMs with good home environments Retrospective evidence for easier managability Retrospective evidence for fewer emotional disturbances

QUESTIONNAIRES Blessing ( 1959) Connor and Goldberg ( 1960)

NI Behavior in school I& Behavior in NI school

350 Ms

Widely variable pattern of pos. and neg. traits reported 54% have management problems: high % w/ I Q > 5 0 s u g gest biased placement in T M R classes

Author ambivalent about stereotype: NCG Authors question stereotype regarding absence of n e g behaviors: NCG

Very similar distributions of traits for two groups; no basis for emotional subtyping M s higher than NMs on genera1 adjustment: equal on introversion-ext raversion

Author critical of stereotypes; good review of literature

RATINGSCALES BlacketerSimmonds ( 1953)

I Personality

Silverstein ( 1964)

I Personality traits

Domino el al. ( 1964)

I Personality traits

traits

'1: institutional setting: h'l: noninstitutional setting: PI: private institution. bM: mongoloid: NM: nonmongoloid; MR: mental retardate.

'NCC: no control group.

Most signif. correlations of adjective and label favor stereotype, but many rontradictions

Author claims partial support for stereotype: suggem raters might have been biased '. Authors claim support for constant M personality type: reject rater bias: ignore antistereotype findings (Continued)

TABLE I1 (Continued) Studp Domino ( 1965)

Moore el al. ( 1968)

Focus

Methods

I Personality traits

2 10 college students rate Ss as

I Behavior disorders

before WlCHE census data on maladaptive behavior traits

Subjects*

Note6

Author claims “substantial” support for stereotype: extremely weak statistics Frequency data provided cannot be interpreted as evidence for overall fewer maladapt. traits; authors claim support for stereotype Frequency data provided canHigher %of Ms than NMs on not be interpreted as evi7 out of 11 items. Fewer Ms than NMs on “communication“ dence for overall more a d a p tive traits in Ms Authors claim translocation Trans. IQ> others; Trans. > M may be responsible for others on gross behavior stereotype variability disorders

Exactly half of signif. differences are consistent with stereotype 536 Ms vs. 536 NMs Smaller %of Ms than NMs on 14 out of 2 I rated traits; matched for sex. Ms never greater than NMs age, and social quotient

21 Ms vs. 21 NMs

closely matched

Johnson and Abelson (1969b)

1 Social competance

WlCHE census data on socialcompetance traits

2606 Ms vs. 20605

Johnson and Abelson ( 1969a)

I Behavior dis-

WICHE census data on maladaptive behavior traits

254 trisomy; 21

Study of psychometric intelligence vs. Vineland social mat. urity

2 1 M adults vs.

Ill. Test of Psycholinguistic Abilities vs. age norms

24 Ms

orders among cytol. subgroups

Results

NM MRs

translocation; 18mosaic

MlXRIC.9

Pototzky and Grigg ( 1942) Quaytman (1953) Cornwell and Birch ( 1969)

PI Social vs. intellectual deN1 velopment

Bilovski and Share (1965)

NI Psycholinguistic test pattern

NI

unspec. number of NM MR adults 40 M children 44 M children

M s social age 3 yr > mental age; NMs social age 2 yr > mental age Social age I yr > mental age Social age increasingly exceeds mental age with increasing chronological age

Authors conclude that Ms are socially accelerated. Private inst. may be biased toward higher social maturity. Public inst. data have NCG, but suggest that M s absolute social competence not high enough tojustify stereotype

Visual > auditory input; Visual-motor > auditoryvocal association; motor > vocal output

Authors suggest findings have educational importance No MR control group

’ %

b

% 0

2

Nakamura (1965)

I Intelligence test pattern

Stan ford-Binet intelligence test

64 Ms vs. 64 N M MRs matched for sex, age, I Q

Clausen ( 1968)

1 Test pattern

Psychological test battery

12 Ms vs. 196 NM MRs

Knights et al.

1 Visualvs.

( 1967)

Tang and Chagnon ( 1967)

Zellweger and Abbo ( 1 963); Finley ct al. ( 1966); Rosecrans ( 1968); S h i m et al.

Blindfold discrim. of texture, size, weight, shape vs. visual-tactile shape discrim. Compared IQs of 2 1 Body build vs. intelligence p u p s established for high vs. low w/h ratio Cytogenetic comp- Review of published osition vs. n case reports on mostelligence aic mongolism tactile discrimination

19 Ms vs. 19 familia1 MRs

4 out of 60 items distinguish groups: 3 visoornotor in favor of' Ms; I auditoryvocal favoring NMs Inconsistent differences between groups

M < NM except on visual-tactile, but only 1 O/ I9 Ms performed at all

122 Ms

Signif. diff. in 1% but almost no predictability from w/h ratio to IQor the reverse Mosaic Ms. inWeak correlation between cluding nonclinical proportion of affected normal mosaic cells and I Q trisomy 2 I

Expect 3/60 signif. difls. by chance; requires reliability check Internal contradictions suggest no regular pattern for Ms vs. other MRs Blindfold a confounding var. iable. Authors claim also that instructions too difficult for Ms Obscure inferences about presumed diffs. in thyroid functioning between groups Extremely small groups: failures to distinguish between tissue types: correlations not outstanding; authors note problems of methodology

( 1968)

Gibson and Pozsonyi ( 1 965)

N I Cytogenetic composition vs. personality

1% neurol., developmental history, etc.

1 0 trisomy vs. 10 translocation, M A matched

'1: institutional setting; NI: noninstitutional setting; PI: private institution. bM: mongoloid; NM: nonmongoloid; MR: mental retardate.
No diffs. except trans. > trisom. on I Q , and earlier age at sitting

Authors make unjustified assertions of behavior diffs.; samples too small for frequency comparisons (Contiruedj

TABLE I1 (Continued) Study" Pozsonyi and Gibson ( 1965)

Gibbs d al. ( 1964)

Lyle ( 1959, 196Oa)

Michel and Carney ( 1964)

Fisher (1970)

Focus

NI Endocrinolog) vs. personality I EEG vs. personality I& Language test N1 patterns

1 Qualityof voice

N I Distractibility

Methods Metabolic study

Subjectsb 10 trisomy vs.

LO translocation age matches

Results No diffs. except in thyroid uptake

Little 6-or 14spiking

pos.

EEG study

Ms

Studied Minn. Preschool scale and various ad hoc verbal tests

Institutionalization and Ms vs. 43 mongolism both reduce verinst. NMs; 76 noninst. Ms vs. 41 non- bal performance: no interaction. M particularly deinst. NMs ficient on complex language 8 Ms M pitch exactly matches age normals

Analysis of voice frequency from recorded samples vs. age norms Scale of impulse control and other measures of distractibility

NotesC Authors claim differential thyroid functioning might account for (unreliable) behavioral diffs. noted above Authors claim results might account for (undocumented) docile personality in Ms; NCG

34 inst.

31 Ms vs. 31 NMIQ matches vs. 19

high-level MRs vs. 60 normals

Compared with normals, M and N M IQmatches not diff. on attention deficits. High level MRs less distractible

Authors suggest that deep pitch is an illusion resulting from small body size; no MR control group N o direct comparisons between MR groups

MANIPULATIVE STUDIES Rollin (1946)

BlacketerSimmonds ( 1953)

1 Musicality

1 Musicality

Graduated efforts to elicit musical responses

73 Ms

Graduated efforts to elicit musical responses

42 Ms vs. 42 "corn-

parable" NMs

Author suggestswe "debunk" No spontaneous dancing; 4/73 danced on invitation; mongolism: NCG 24/73 finally coaxed into dancing, but none had rhythm No spontaneous dancing; This study and Rollin (1946) give no evidence to support 57% of Ms vs. 67% of NMs myth of musicality had no rhythmic sense; no clear singing from either

3

is b

g

3,

N1 Sense of rhythm Cantor and Girardeau ( 1959)

Rroww and Clarke ( 1963)

Coi-don ( 1944)

I Distractibility

PI Visual vs. tactile discrimination

OConnor and Hei-melin (1961)

I Visual vs. tactile recognition

Hernielin and O C o n n o r ( 196 I)

I Visuo-motor

Knights d o /

I Tactile discrimination

( 1965)

Scheffelin (1968)

processes

Nl Visualvs. auditory, and vocal vs. motor stim.response learning

Sjudged as Cast or slow 60 bursts of metronome at 2 speeds and ? intensities Object naming under meaningful vs. nonmeaningful auditory distraction Battery of-tests for size, shape, and texture under vis. vs. tact. conditions Recognition ofabstract rutouts after vis. or tact. exposure Copying ~. vs. reproduction: matching vs. recognition

12 MRs vs. I2 NM normals

14 MS vs, 1 2 sub. normals vs. 12 severely subnormals ti Ms vs. 6 N M normals inatched for mental age

Task too difficult: no M R control group

Meaningful more distracting than nonmeaningful: group differences

Severe statistical problems; Ms probably more distractible than subnormals, less than

Ms poorer than normals on visual and on tactile; no interaction

24 M s v s . ?4 NS1 SIRS M and normal vis. berter than tact.; NM MR vis. worse vs. 24 normals than tact.: M < N M o n tact.: M > NM on vis. 1 I; 51s vs. I (iN hf hlKs M poorer than others on matched lor age copying and reproduction: all groups equal on matching and 1Q 16 normals and recognitinn 18 M s vs. I9 Nhl MRs Many Ms could not perform

Blindfolded Ss did form-board with doni., then nondom., then both hands 24 Ms Four paired-associa t e problems, o n e each for vis.-motor, vis.-vocal, aud.-motor and aud.-vocal channeling

“I: institiitional setting. NI: noniiisiiliitional setting; 1’1: private insti~ution. b M : mongoloid: N X1: non~i~ong~~lcrid: M R : mental retardate. ‘‘%(:G: 110 control group.

5

Many Ss failed completely: normals > Ms when performance greater than chance

Auditory-vocal learning poorer than other three types

E D >

z

PI

severely subnormals No MRcontrol group. Author concluded that M = normals o n visual. but reanalysis shows no signif. interaction One-rnin. memory interval confuses interpret. of “recognition.” Did all Ss have eq. good memory? Sparse details of methods, analyses, etc.

Blindfolding confounded with tactile perception requirement Methodologically very sophisticated: NCC

T

0

P

r

E 0

G

TABLE I1 (Continued) Studf

Focus

Methods

Subjectsb

Results

I Oddity learning Eight oddity proband generalizalems, 6 trials tion of the oddon each ity concept

22 M vs. 44 famil-

Byck ( 1968)

I Motivators

Tested for concept switching under tangible or intangible reward

10 M vs. 10 familia1 MRs matched for age and IQ

Familial perform better under tangible, M perform better under intangible reward

Berkson (1960)

I Visualreaction time

Several types of RT tasks include simple and complex motor response and simple vs. choice RT; visual stim. Auditory RT after variable length visual warning interval

12 Ms vs. other

MR and normal groups

M slower than other MRs particularly on complex motor tasks

6 M vs. 6 NM MRs

M slower than other MRs

Martin and Blum (1961);

Prysiazniukand Wiajowski (1964)

Hermelin and Venables (1964)

I Auditory reaction time

ial MRs vs. 55 normals; 24 M vs. 24 familial MRs matched on MA

vs. 6 normals

N1: noninstitutional setting; PI: private institution. ,M: mongoloid; NM: nonmongoloid; M R mental retardate. CNCG:no control group. O1: institutional setting:

Ms = others on generalization when MA is statistically controlled M < others on learning: M C others on generalization when matched for MA; M =others on learning

Notesc Martin and Blum claim “unequivocal” diagnoses of mongolism and familial MR; covariance analysis ignores heterogeneous correlations and distributions of covariate; P 8c W counterclaim that “unequivocal” familials very difficult to find; their results exactly contradict M & B’s Methods unclear; author claims evidence for different types of “optimal” rewards for two classifications; statistical problems prevent clear interpretation Suggest that Ms are deficient in both auditory-motor and visual-motor channeling

MEDICAL-BEHAVIORAL RESEARCH

73

verely impoverished, having almost no musical inclinations of any kind. Regarding rhymicality, Rollin found none in his sample, while Blacketer-Simmonds reported 43% of the mongoloids vs. 33% of the nonmongoloids showed some rhymical sense. This difference is not statistically reliable. N o noninstitutional research tested this hypothesis. The available data are thus strongly opposed to the clinical tradition of extraordinary musicality and rhythm in mongoloids. HYPOTHESIS 4: Morigoloids are US dntructable as notrmongoloztls Brown and Clarke’s very difficult study seems to show mongoloids to be somewhat less distractible than nonmongoloids of equal psychometric intelligence, but Fisher found n o differences in their relative distractibility. There are no data on variability within these subgroups. This hypothesis must stand for want of sufficient contradiction. HYPOTHESIS 5: Mongoloids are more socially than itrtellectiiullj1 mature Pototzki and Grigg, Quaytman, and Cornwell and Birch are well agreed in support of this hypothesis, adding that social and intellectual maturity continue to diverge at least up to age 16 years. There are no comparative data on nonmongoloids, however, so the implied specificity of this differential social growth remains untested, and there is some suggestion that despite the disparity, social growth remains too low to account for the clinical tradition. Only the Vineland Social Maturity Scale has been used; perhaps other instruments will yeild different views of the mongoloid’s socialization. There are no data for institutional samples. 6: Variubzlztv of behavior zoithirr the mongoloid Pofiulat2oti iJ HYPOTHESIS firedictcible from iinriabzlzty 271 cytogenetit rotistihition The very existence of tests of this hypothesis signals an important shift away from the romantic simplicity of Hypothesis 2. T h e implication is that variability in psychometric intelligence and other traits relates to distinctive karyotypic differences among mongoloids, but those whose optimism has led to direct tests of this hypothesis are evidently unaware of their burden. For example, if the results of research under Hypothesis 2 are taken as accurate estimates of variability in mongoloid personality, the cytogeneticists are faced with accounting for almost even numbers of mongoloids having predominantly positive and negative personality types. Yet estimates of the incidence among mongoloids of chromosome anomalies other than simple trisomy 21 range from 5 % to 15%, and this includes all cases of translocation, mosaicism, and double trisomies. Hypothesis 6 is therefore doomed from the outset because (a) present cytological classifications other than trysomy 21 can account for only a small minority of mongoloids and, because of their scarcity, (b) these exceptional cases will always constitute samples

74

John M . Belmont

too small for contemporary personality research designs. It will be extremely useful for the cytogeneticists and the personality researchers to improve their technical precision. Comparing trisomies, translocations, and mosaics, Johnson and Abelson found that the translocations were slightly more intelligent than trisomies, while mosaics were slightly less intelligent. Translocations were also reported to have more gross behavior disorders. In contrast, Shipe et al. found the mosaics to be somewhat more intelligent than trisomics, and Gibson and Pozonyi reported that translocations were, if anything, more passive and lethargic than trisomics. None of these findings was clear enough to permit actual prediction of either intelligence or personality functioning from knowledge of cytogenetic subtype. The closest such predictability is of intelligence within the mosaic group, and several reports by Rosecrans, Shipe et al., Finley et al., and Zellweger and Abbo suggest that even here the prediction of intelligence from a knowledge of the proportion of affected cells is very poor. It may be concluded that the hypothesis is untenable on theoretical grounds, and receives no research support, either. HYPOTHESIS 7: Perceptual and associative processing vuries within the mongoloid population, and mongoloids are more or less capable than other retardates, depending upon which input-output chanmls are being considered This final hypothesis is the unique contribution of experimental psychology to the area of mongoloid behavior, being quite uncontaminated by clinical tradition. At the input stage, Bilovski and Share showed that mongoloids are better at visual than at auditory channeling, and OConnor and Hermelin found visual input to be better than tactile input. No direct comparison of the auditory and tactile channels has been reported. Clausen, Knights et ul., Gordon, and O’Connor and Hermelin have compared mongoloids and other retardates on auditory, visual, and tactile input, and the consensus is that mongoloids are relatively poor in tactile discrimination. There is a suggestion that their auditory input is also relatively deficient, but there is no clear agreement about the visual mode. Regarding the clearly integrative processes, Scheffelin, and Bilovski and Share agree that the auditory-vocal system is poorer than the visuomotor, the visuovocal, and the auditory-motor. On the comparative side, Nakamura, Lyle, Clausen, Berkson, and Hermelin and VenabIes well agree that mongoloids are poorer than nonmongoloids in auditory-vocal integration, and there is a suggestion that auditorymotor integration is also weaker in mongoloids than in other retardates. There is again no agreement regarding the visuomotor system.

MEDICAL-BEHAVIORAL RESEARCH

75

At the output stage, Bilovski and Share point to better motor than vocal performance within the mongoloid population, while Hermelin and OConnor, and Lyle seem to show that mongoloids are weaker than others on both motor and vocal output. There is obviously much work to be done, both by way of comparing modalities and modal integration processes within mongoloids, and comparing their strength relative to other retardates. From the presently available research, it is firmly concluded that mongoloids are deficient in auditory-vocal processing, relative both to their own alternative channels and to the auditory-vocal processing of other retardates. There is, moreover, an indication that their visuomotor system is their strongest, and it may be stronger than that of' other retardates.

The preparation of this nianuscript was supported by NICHHD grant HI)-03008. T h e author is greatly indebted to Mrs. Kathleen Bayer lor her very helpful bibliographic work, and to Mrs. Moira Ma, who typed its several drafts.

REFERENCES Abelson, R., Ilr Payne, D. Regional data collected in state institutions for the retarded: Meft/u/ Deficiency, 1969, 73, Reliability of attendant ratings. A?ne?-imu,Jnuruu/ 739-744. Alstrom, C. A study of epilepsy in its clinical, social and genetic aspects. Act0 Psyrchznt,ira rt Neurologica, Supplementurn, 1950, No. 63. American Psychological Association. Psychology and mental retardation. Arnericrcrr PsycliolfJh$, 1970, 25, 267-268. Anderson, V., & Siegel. F. Studies o f behavior in genetically defined syndromes in man. 1 1 1 S. Vandenberg (Ed.), Progress in humnn b r h d ~ tgenetics. . Baltimore: Johns Hopkins Press, 1968, Pp. 7-17. Baumeister, A. Problems in comparative studies ot' mental retardates and normals. American Journal @Mental Deficiency, 1967, 71, 869-875. Baumeister, A., k Williams, J. Relationship of physical stigmata to intellectual functioning in mongolism. ArnmiccirrJou?.rrulofdlttrtul Lkficiencj, 1967, 71, 586-592. Bentla, c. Mofrgohin cmd cretinism. New York: Grune & Stratton, 1946. Bender, L. Psychological problems of children with organic brain disease. Atnrrirutt Jo.unrci/ oJ'O1.t/tc)~s~ckiutr)i, 1949, 19, 404-4 15. Berkson, C. An analysis of reaction time in normal and mentally deficient young men. 111: Variation of stiniulus and response complexity. JourttuI (If iMeula/ h f i c i e n q Rrsecircti, 1960,4, 69-77. Berkson, G . Aspects of a comparative psychology of mental deficiency. American Jorct-rial oJM&u/ Deficiencv, 1967, 74, 10- 15. Berry, M., k Eisenson, J. The ck/Pctzve i n .sjlrerh. New York: Appleton-(:elltury-C:r-ofts, 1942.

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Bessman, S. PKU-Some skepticism. New England ,Journal of Medicine, 1968, 278, 1176-1 177. Bijou, S. A functional analysis of retarded development. In N. Ellis (Ed.), International reuiew of'research in mental retardation. Vol. 1. New York: Academic, 1966. Pp. 1-19. Bilovski, D., & Share, J. The ITPA and Down's Syndrome: An exploratory study. American Journal of Mental Deficiency, 1965, 70, 78-82. Birch, H., & Belmont, L. The problem of comparing home rearing versus foster-home rearing in defective children. Pediatrics, 1961, 28, 956-96 1. Birch, H., & Tizard, J. The dietary treatment of phenylketonuria: Not proven? Dt~ielopniental Medicine and Child Neurology, 1967, 9 , 9-12. Blacketer-Simmonds, D. An investigation into the supposed differences existing between mongols and other mentally defective subjects with regard to certain psychological traits. Journal ofMental Science, 1953.99, 702-719. Blanchard, I. Speech pattern and etiology in mental retardation. Americati Jounial o j Mental Deficiency, 1964, 68, 6 12-6 17. Blessing, K. The middle range mongoloid in trainable classes. American Journal of Mental Deficiency, 1959,63, 8 12-82 1. Brousseau, K. Mongolism: A study ( f t h e physical and mmrtal characteristics of mongolian imbeciles. Baltimore: Williams & Wilkins, 1928. Brown, R., & Clarke, A. The effects of auditory distraction on institutionalised subnormal and severely subnormal persons. Journul of'Mental DeJiciencyResearch, 1963, 7, 1-8. Byck, M. Cognitive differences among diagnostic groups of retardates. American Journal of Men.tal DeJiciency, 1968, 73, 97- 101. Cantor, G . , & Girardeau, F. Rhythmic discrimination ability in mongoloid and normal children. American Journal of Mental Dejiciency, 1959, 63, 621-625. Carver, M., & Wittson, C. Phenylketonuria: An inborn error of metabolism. Nebrcrska State Medical Journal, 1960,45, 101-105. Centerwall, S., & Centerwall, W. A study of children with mongolism reared in the home compared to those reared away from the home. Pediatrics, 1960,25,678-685. Clader, D. Accelerated intellectual growth and personality development as seen in phenylketonuria subjects during medical treatment. American Journal of Mental Deficiency, 1957,62,538-542. Clausen, J. Behavioral characteristics of Down Syndrome subjects. American Journal of Mental Deficiency, 1968, 73, 1 18- 126. Connor, F., & Goldberg, I. Opinions of some teachers regarding their work with trainable children: Implications for teacher education. American Journal of Merital Deficiency, 1960,64,658-670. Cornwell, A., & Birch, H. Psychological and social development in home-reared children with Down's Syndrome (Mongolism). Americun Journal of Mental 0ef;ciemy. 1969, 74, 34 1-350. Corrigan, F., Berger, S., Dienstbier, R., & Strok, E. The influence of prematurity on school performance. American Journal of Mental Deficiency, 1967, 71, 533-535. Crookshank, F. The mongo1 in our midst. London: Kegan Paul, 1924. Decker, H.,Herberg, E., Haythornthwaite, M., Rupke, L., & Smith, D. Provision of health care for institutionalized retarded children. American Journal of Mental Deficiency, 1968,73, 285-293. Dexter, L. Research on problems of mental subnormality. AmericanJournal $Mental D @ ciency, 1960,64,835-838. Diedrich, W., & Poser, C. Language and mentation of two phenylketonuric children. Journal of Speech and Hearing Disorders, 1960,25, 124- 154.

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Domino, G. Personality traits in institutionalized mongoloids. American Jourira/ (4~\.lenla/ D
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Gordon, A. Some aspects of sensory discrimination in mongolism. A m c a n Journal of Mental Deficiency. 1944,49,55-63. Hallenbeck, P. A survey of recent research in mongolism. American Journal of Mental Deficiency, 1960,64,827-834. Halpin, V. Basic issues concerning the education of children with cerebral defects. American Journal of Mentnl Deficiency, 1958,63, 3 1-37. Hampson, J., Hampson, J., & Money, J . The syndrome of gonadal agenesis (ovarian agenesis) and male chromosomal pattern in girls and women: psychologic studies. Bulletin ofthe Johw Napkins Hospital, 1955.97, 207-226. Hawke, W. Organic factors in behavior disorders. Pediatrics, 1952,9,783-784. Heber, R. A manual of terminology and classification in mental retardation. Americun Journal ofMental Deficiency. Monograph Supplement, 1959, 64, (2nd ed., 1961, 65). Hermelin, B., & OConnor, N. Shape perception and reproduction in normal children and mongo1 and non-mongo1 imbeciles. Journal of Mental Deficiency Research, 1961,5, 67-7 1. Hermelin, B., & Venables, P. Reaction time and alpha blocking in normal and subnormal subjects.Journal of Experimental Psycholagy, 1964, 67, 365-372. Hill, A. The clinical trial. British Medual Bulletin, 1951,7, 278-282. Hinsie, L., & Campbell, R. Psychiutn’c Dictionary. (4th ed.) New York: Oxford University Press, 1970. Hormuth, R. Home problems and family care of the mongoloid child. Quarterly Review uf Pediatrics, 1953,8,274-280. Hsia, D. Biochemical factors in mental retardation. In J. Zubin & G. Jervis (Eds.), Psychopatholorn of mental development. New York: Grune & Stratton, 1967. Pp. 28-44. Hunt, B. Differential responses of mentally deficient brain-injured children and mentally deficient familial children to meaningful auditory material. American Journal of Mental Dejicienq, 1960, 64, 747-753. Jervis, G. (Ed.) Mental retardntion: A symposium. Springfield, Ill.: Thomas, 1967. Jeune, H., Kohler, C., & Guidicelli, G . Neuropsychological findings in 100 infants treated for an cured of a “toxic state”. Annales Medico-Psychologigues, 1961, July, 264-284. Johnson, R., & Abelson, R. Intellectual, behavioral and physical characteristics associated with trisomy, translocation and niosiac types of Down’s Syndrome. Americnn Journa/ of Mental DeJiciency, 1969, 73, 852-855. (a) Johnson, R., & Abelson, R. The behavioral competence of mongoloid and non-mongoloid retardates. American Journal of’Mental Deficiency, 1969,73, 856-857. (b) Kanner, L. Child pgchintry. (3rd ed.) Springfield, Ill.: Thomas, 1957. Karlin, I., & Strazzulla, M. Speech and language problems of mentally deficient children. Journal of Speech and Henring Disorders, 1952, 17, 286-294. Kety, S. Intelligence, biology and social responsibility. In J. Zubin & G. Jervis (Eds.), Psychopalhology of mentnl development. New York: Grune & Stratton, 1967. Pp. 193-201. Knights, R., Atkinson, B., & Hyman, J. Tactual discrimination and motor skills in mongoloid and non-mongoloid retardates and normal children. Amricun J i ~ i m dof Mental Defiiemy, 1967,71,894-900. Knights, R., Hyman, J., & Wozny, M. Psychomotor abilities of familial, brain-injured and mongoloid retarded children. Amen’can Journd 4 Mental Deficiency, 1965, 70, 454-457. Kratter, F. The physiognomic, psychometric, behavioral and neurological aspects of phenylketonuria. Journal of Mental Science, 1959, 105,421-427.

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Kugel, R., Fedge. A.. Trembath, J., 8c Hein, H. An analysis of reasons for institutionalizing childreti with Mongolism. Journcll nj’Pediiitrics, 1964, 64, 68-74. Kugel. R., 8c Reque, I). A comparison of mongoloid children. Journal of’the Arnericair Medicul Associritioii, 196 I , 175, 959-96 1. Launay, C . , & Bayen, Mme. Mental development in mongoloids. Revue rlu Prmticieu, 1964, 14, 2 1-3 1. (Textual translations, J , Belmont.) Lejeune, J. T h e karyotypes of trisoiny 21. Revue chi f’ruficieir, 1964, 14, 57-67. Lenz, W. Prospects in prevention of trisomic conditions based on maternal age. In G. Jervis (Ed.), Exf~andingconcepts in rnprrlal retardufiorr. Springfield, Ill.: Thomas, 1968. Pp. 9- 12. Lubman, C. Speech program for severely retarded children. Ainm‘cccn Journal o j Mentul Ueficieircy, 1955, 60, 297-300. Lyle, J. T h e effect of an institution environment upon the verbal development of imbecile children: I. Verbal intelligence. JourtrciI o/- Mental De&:iettcjf Reseurcti, 1959, 3. 122-1 28. Lyle, J. T h e effect o f an institution environment upon the verbal development of iinbecile children: 11. Speech and language. Joururil O J / ~ l ~ u n t&$ciurcy a/ Resecrrrli, 1960, 4, 1-13. (a) Lyle, J . Some factors affecting the speech development o f imbecile children in an institution.Jouruul oJ’Chili1 P . ~ ~ r / ~and u / o/’syc/rkityy, ~ 1960, 1, I2 1-129. (b) Mallet. R. Avant-propos. Rvvue ilu fhtirierr, 1964, 14, 5-6. Mallet, R., 8c Labrune, B. Clinical and diagnostic aspects of mongolism. Revue cfu Proti&rr, 1964, 14. 7-18. Martin, W., & Blum. A. Intertest generalization and learning in mentally normal and subnormal children. J o r u - i r d if Cornpriwtiiw U J K / P/rjsiu/ogircil P.Y~c/~(J/(JQ, 1961. 54, 28-32. Matthews, C., & Reitan, R. Psychomotor abilities of retardates and patients with cerebral lesions. Ainerirciri Juurrru/ (4M e i ~ l d&$iieirr?, 1962, 66, 607-61 2. McConnell, 0. Personality correlates of responsiveness to social reinforcement in mental t~i/ f k f i r i e t j r j , 1967, 72, 45-49. retardates. , j J / / r ~ i r r / / / J f ) ~ ~(J/r J AIeirtcd McCord, H. T h e hypnotizability o f the mongoloid-type child. J(iurna/ ( J / ’ C/iriirci/ aud Expriinunld Hypcisis, 1956, 4, 19-20,

Menolascino, F. Psychiatric aspects of niongolisni. Awriccr?i Jounrcil uf’ ,\fenful Ikfirinrry. 196.5, 69, 653-660. (a) Menolascino. F. Emotional disturbance and mental retardation. Aisuricun Jourrrrd of’ Meirttrl Ihfic~irnry. 1965, 70, 248-256. (I)) Menolascino, F. Psychiatric findings in ;I sample of institutionalized mongoloids. J o i i t i i ( i / OJ/ iLfetrt/t/ Sub~rorrncditj,1967, 13, 67-74. Michel, J.. 1L Carney, R. Pitch characteristics of mongoloid boys. , / o u r r i d vj’ S/Jrrrh ( i i i d HraritrgDisorder.\. 1964. 29, 121-125. Money, J. Cytogenetic arid psychosexual incongruities with a note on space-form hlindness. .JrrzericciirJoiirircil ufl’.sjr./iid?>, 1963, 119, 82O-x’27. Money, J . T w o cytogenetic syndromes: psycliologic comparisons: 1. Intelligence and specific-factor quotients. j o u i - r r r i l u/~P.syc/iici/rir. Kiwiin-lr, 1964, 2, 223-23 I . Moore. B., Thuline, H.. Ils Capes, L. Mongoloid and non-niongoloicl retardates: A behavioral comparison, , 4 ~ ~ i e t J~i i rii vi i r o / oJj’i\Jeutcil l h + i u r q , 1968. 73, 433-436. Murphy, M. A large scale music therapy program for institutionalized low grade and ri/rt/ DrJirie77cy. 1958, 63, 268-273. middle grade defectives. A i i ~ e , . Z r ~ ~ t , l ~ ~ uof’hlmto/

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Shuttleworth, G., & Potts, W. MPntally dtficiort children. (4th ed.) Philadelphia: Blakiston’s Son, 1916. Siegel, F., Balow, B., Fisch, R., & Anderson, E. School behavior profile ratings of phenylketonuric children. Americati Journal oJ’Mental I)efiriencj. 1968.72, 937-943. Siegel, G., & Harkins, J. Verbal behavior of adults in two conditions with institutional retarded children. In R. Schiefelbusch (Ed.), Language studies o j mentally retarded children.Journal of Speech and Hearing Disorders Monograph Supplement, 1963, No. 10. Silverstein, A. An empirical test of the mongoloid personality. Americun J o u r d ofiLfei~h1 Dejicitncy, 1964, 68, 493-497. Soltan, H., Sergovich, F., & Barr, M. Studies of the genetics of mongolism. In G. Jervis (Ed.), Meritol retardution: A symloszum. Springfield, Ill.: Thomas, 1967. Pp. 19-34. Stearns, P., Droulard, K., & Sahhar, F. Studies bearing on fertility of male and female mongoloids. Americun Journnl vf Mentnl Drfieirncy, 1960, 65, 37-4 1. Stevens, G., & Birch, J. A proposal for clarification of‘ the terminology used to describe brain injured children. Exceptional Children, 1957, 23, 346-347. Strazzulla, M. Speech problems of the mongoloid child. Quarterly Kevieicl ./‘ Pediatrics, 1953,8,268-273. Sutherland, B., Berry, H., & Shirkey, H. A syndrome of phenylketonuria with normal intelligence and behavior disturbances. Jourirul of Pedirrtrics, 1960.57, 521-525. Tang, F., & Chagnon, M. Body build and intelligence in Down’s Syndrome. Americun Journal cfMentul DeJlrieircy, 1967, 72, 381-383. Tarjan, G., Dingman, H., Eyman, R., & Brown, S. Effectiveness of hospital release programs. American Jouriinl of Mentul Dejciency, 1960, 64, 609-6 17. Tredgold, A. Meniddeficiency. (2nd ed.) New York: William Wood, 1914. Wallin, J. ChiUrm u d h mental and physicti/ handicups. New York: Prentice-Hall, 1949. West, R., & Ansberry, M. The rehubilitntion of speech. (4th ed.) New York: Harper & Row, I 968. Winer, B. Statisticul pinciples in experimental design. New York: McGraw-Hill, 1962. Wolfensberger, W., & Menolascino, F. Basic considerations in evaluating ability of drugs to stimulate cognitive development in retardates. American Journnl oJMental Deficiency, 1968,73,414-423. Wunsch, W. Some characteristics of mongoloids evaluated in a clinic for children with retarded mental development. Americnn Journal of Mental DeJiciPncy, 1957, 62, 122- 130. Yannet, H. Pediatric management of the mongolian child. Quurledy Rmim of Pediatrics, 1953, 8, 131. Zellweger, H., & Abbo, G. Chromosomal mosaicism and mongolism. Lancet, 1963, 1, 827.

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Recognition Memorg: A Research Strategy and a Summaxy of Initial Findings' KEITH G. scon2.3 CHILDREN'S RESEARCH CENTER, UNIVERSITY

OF

ILLINOIS, URBANA-CHAMPAIGN, ILLINOIS

I. Statement of the Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 11. A Research Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 111. Experimental Designs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 ....................... 89

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Number of Stimuli and Memory Performance

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F. Retention Interval . . . . . . . . . . . . . . . . . . . . . . . . . . G. Within Session Effects . . ....................................

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'The present research was supported by the U S . National Institutes of Health, Public Health Service, through grants MH 07346 and HD 02898. *Two students have made heavy collaborative contribution to the present project, Laraine Masters Glidden and Richard Urbano. Prior to Mrs. Glidden's marriage a number of papers in a Progress Report were accredited to Scott and Masters. Thanks are also due to Mrs. Carol Sohn for the preparation of figures and stimuli and to Mrs.Lois Barham for typing and correcting the manuscript. 3We are indebted to Dr. Louis Belinson, Superintendent, and Mr. William Chambers, Chief Psychologist of the Lincoln State School for their help, cooperation, and support. Special thanks are also due to Mr. G. William Overton for supervising the day-to-day laboratory work.

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84 1. STATEMENT OF THE PROBLEM

In planning a programmatic study of the development of memory in the retarded, a basic consideration is the particular research strategy that might prove most useful. Experimental research in mental retardation can be aimed at providing the answer to a number of different questions. Two common and important questions are “What are the differences in behavior between normals and retardates?” and “What are the laws of retardate behavior?” The problem of discovering differences between the behavior of normals and retardates has resulted in a model experiment where normals and retardates are matched on MA or IQ. Such experiments, while related to other research in the area by literature discussions, are commonly disconnected in that they do not belong to any programmatic attack on a process o r area. The result has been largely piecemeal information that neither clearly describes intellectual variation nor writes the laws of retardate psychology. A need for very programmatic research is clear. One important variation on the comparative method is to compare normals and retardates of similar chronological age. Ellis ( 1970) has programmatically used this approach in combination with some behavioral process studies and has been able to identify some important differences in memory between normals and retardates. He has justified this strategy in detail (Ellis, 1969). The question of what laws control retardate behavior has received attention from Zeaman and House ( 1963). Zeaman (1 965) has justified the approach in detail. T h e argument is that if one wished to modify retardate behavior searching for differences between normals and retardates is neither necessary nor efficient. What is needed is a description of the laws that will allow engineering of the retarded behavior regardless of the applicability or nonapplicability of the same laws to normals. Zeaman and House, in applying this strategy, have developed an impressive set of findings combining a strong empirical base with a well-developed theory. T h e role of intellectual variation, however, is not entirely absent in their work where constructs like the probability of attending to the correct response are loosely related to intelligence (Zeaman & House, 1967). It may be argued that programmatic research using the approaches exemplified by the work of Ellis and Zeaman and House might best be combined. T h e origin of the split in these approaches historically has its basis in the separation of experimental and correlational disciplines in psychology (Cattell, 1966; Cronbach, 1957). This has led to retarda-

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tion being defined in terms largely of an intelligence test score. The experimental psychologist, attacking the problem of retardate psychology many years after the differential psychologist, often tended to accept I Q a n d MA as defining the relevant criterion groups despite a not altogether encouraging literature on the relationship between intelligence and learning (Scott, 1971). Also, there is some evidence that systematic individual differences beyond those accounted for by MA exist in retardate performance (Urban0 8c Scott, 1969a). While experimental psychologists have been concerned with rather general laws of retardate behavior or the identification of differences between normals and retardates there have been major efforts in psychoeducational research to provide differential diagnosis of “learning disabilities.” The recent tests of learning disability have been quite uninfluenced by basic research in retardation and have weak empirical and theoretical foundations. This in part is due to the slow development of retardate psychology but perhaps even more stems from the traditional methods of test construction. In differential psychology, tests are identified typically in terms of content based on face validity. Recent attempts to measure learning disabilities have followed this route. An example is provided by one of the most widely regarded tests in educational circles, the Illinois Test of Psycholinguistic Abilities (Kirk AC McCarthy, 196 1). Here, based on the largely speculative theoretical ideas of Osgood, a pool of test items was compiled on the basis of face validity as measuring “encoding,” “decoding,” and so on. Items were then selected from the pool using conventional item selection techniques with the proportion passing as a function of age, and the item whole subtest correlations as criteria. Diagnostic interpretation for remediation is based on the same face validity as item selection. To summarize, research on retardate psychology has not provided a systematic development of the pattern of individual differences and the related behavioral laws underlying the performance of retarded individuals. The reasons for this are historical and lie in the deep division between correlational and experimental traditions in general psychology. Recent applied approaches in the area of learning disabilities have lacked adequate empirical and theoretical foundations but do focus on the concern of the clinician and practitioner. It is the present contention that there are two basic issues in retardate psychology that need programmatic attention. One is the need for differential diagnosis leading to the question: What dimensions of ability underlie performance on learning and problem-solving tasks? The second issue is concerned with the issue of behavioral engineering

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and leads to the question: Given a differential diagnosis, what are the behavioral laws that are applicable to the problems of management and treatment? II. A RESEARCH STRATEGY

The essential method of the present approach is the combined use of experimental and correlational procedures. The program aims to use techniques both from experimental psychology and psychometrics. Thus inferential statistics are planned to test theoretical predictions and uncover the variables controlling performance. Correlational measures would be used to explore the relationships among individual differences in performance with different dependent measures at various levels and combinations of the independent measures. Not every study can reasonably combine correlational analyses and analysis of variance techniques since unreasonable amounts of data may be needed to meet the requirements of both simultaneously. At present it seems that the combination of experimental and differential psychology might best be achieved in a number of steps. These are roughly sequential where applied to a restricted set of processes and parameters. The plan for the present research program provides an example. First w e wish to experimentally delineate the variables that control retardates’ recognition memory. This is a phase of the research which has occupied our time up to the present. Second, we wish to relate the experimental findings both to theory of memory in general and to other work by researchers in retardation in particular. Third, based on our findings and those that are available to us from general psychology, the aim is to formulate an empirically based theory of recognition memory. Programmatically these three aims are similar to the method of attack employed by Zeaman and House. At present our pretheoretical ideas are borrowed from recent computer-type cognitive models exemplified by the work of Sternberg (1969a), Neisser (1966), and others. The fourth aim is to relate both ability and development to theoretical constructs and related empirical manipulations using a combination of experimental and multivariate procedures. The fifth, and applied step of the project, would be to develop a psychometric device to measure individual differences in memory with subtests identified by known theoretical constructs. Such a psychometric device should provide an individual difference profile interpretable in terms of known behavioral processes. This program could be unsuccessful if no significant individual dif-

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ferences exist in the range of behaviors to be studied. The risk seems small compared with the more common procedure of making more or less hit and miss comparisons between populations manipulating only a few task parameters. At least the failure would restrict the range of behaviors that need to be explored subsequently. 111. EXPERIMENTAL DESIGNS

The proposal to perform both correlational and inferential analyses on the same data places restrictions on the type of experimental design that can be employed. Essentially we wish to achieve a reliable estimate of performance under a number of levels of the experimental condition for each subject. Thus we might wish to consider the performance of our subjects under a number of different memory loads and perhaps extend our questions to include the interactive effects of memory load and recall interval. Such a design is sketched in Fig. 1 . A more common experimental procedure is to run a group of subjects representing each cell in Fig. 1. Other possibilities are to run a group of subjects, with appropriate balancing of order, on either a row or a column. In most of the experiments reported here each subject enters all cells or conditions of an experiment many times to achieve the desired number of observations, House and Zeaman (1963) have explained their development of such designs in detail, and this information is not repeated here. However, some cautions and comments are in order. First it should be noted that the type of design can completely conMemory load (number of pictures)

1

2

3

4

5

I

3 Retent ion 6 interval (seconds) 12

24

FIG. 1. Diagram of a design to examine the interactive effects of memory load and retention interval. Data from the study are shown in Figs. 15 and 16 and are described in Section F of the empirical results.

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found the experimental outcome. That is, in some instances comparisons between subjects and comparisons within subjects may lead to different empirical results. Obvious examples are provided by carry-over effects in a repeated measures design, inadequate pretraining or instructions in a randomized blocks design, or the adoption by subjects of one very systematic strategy induced by one condition in memory experiments. In these cases different designs can lead to very different empirical results. Fortunately, Grice and Hunter (1964) devised an experimental procedure that allows a comparison of effects when the data are obtained from a within or between subjects procedure. An experiment which employed this design is described later. Repeated measures designs have one other characteristic which presents some problems. Baumeister ( 1967) has adequately diagrammed and described the problems associated with the interpretations of interactions when floor and ceiling effects are present. In a repeated measures design the best estimate of error available to test the main effects is the subjects by conditions interaction. This interaction is grossly inflated by subjects who perform perfectly, or at chance, under all experimental conditions. The interaction is inflated when the task difficulty is such that some subjects perform identically under all conditions of the experiment, whereas other subjects, in the middle of the performance range, show a systematic variation in their performance. The result is an unreasonable and conservative test of the main experimental effects unless these subjects are eliminated. The careful researcher can include a range of task difficulty,eliminate failure subjects by using pretraining and entry criteria, or discard those subjects whose grand performance mean does not differ from chance or perfect performance by some specified or acceptable margin. This can be done for chance performers by setting a criterion in terms of the standard error of the mean. Such a criterion is not available for ceiling effects which are best avoided by careful choice of the experimental task. Among the advantages of the repeated measures design is the ability to consider individual as well as group functions, and thus provide checks that averaging artifacts are not occurring. Since individual functions contain fewer data points than the group function they are less stable. Unless huge amounts of data are available individual functions may not therefore represent the clearest method of presenting the data. This fact underlies the general observation that N, that is, number of subjects, is not an adequate statistic to describe the stability of data in the experiments reported later. The more descriptive statistic is the number of experimental observations contributing to each data point in a comparison, the number of observations at a point being a

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product of the number of subjects and the number of times each subject enters a particular experimental condition. For this reason the number of observations contributing to each mean is given in the figure legends and in the text of our reports. Experiments where both correlational and inferential statistics are to be employed need to be specially designed. A randomized blocks design, with a single observation per subject, is perfectly acceptable for inferential statistics. For a correlational approach it is usually quite useless. I t is necessary to concentrate a sufficient number of experimental observations at each combination of the levels of the experimental variables and for each subject, so that statistical reliability is achieved. In one experiment (McCarthy, Scott, & Urbano, 1969) these considerations were met. Use was made of inferential statistics to show the effects of the independent variables. Reliability was established by correlational procedures and a multivariate analysis applied to investigate the relationship of the various levels of the independent variables and the dependent variables as well as the pattern of individual differences. Other studies (Scott & Glidden, 1969) which superficially appear as candidates for a correlational treatment, are in fact unsuitable since there are too few measures per subject to give adequate reliability. It should be noted that the basic procedure of the miniature experiment is to make repeated measures under all conditions for all subjects. Thus, it is very much like a psychometric test with all testees taking all subtests so that a subtest score can be obtained for each subject. A result is that the procedures of the miniature experiment are particularly amenable to the systematic consideration of individual differences and for the application of multivariate procedures. This type of design may therefore be of key importance in affecting a rapprochement between experimental and psychometric psychology. IV. EARLY EXPERIMENTS

A series of experiments, using a procedure borrowed from simple two-choice discrimination learning, was abandoned after certain problems and limitations were encountered. A brief discussion of these experiments is in order as other workers may encounter the same practical problems. The procedure originally used followed from the fruitful discrimination learning technique adapted by House and Zeaman ( 1963) from a miniature experiment design of Estes (1960). In our studies we attempted to assess the within session decline of performance that we thought was due to the effects of proactive inhibition and that had been previously demonstrated (Scott 8c Scott, 1968). A procedure consisted of presenting a twochoice discrimination display

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of two pictures or stimuli and requiring the subject to guess which was correct by touching one directly, in an automatic apparatus, for a candy reward. After a period of seconds the same two stimuli were again presented and now the child’s recognition of which stimulus was correct was tested when he made his choice. With this procedure there was a rapid decline in performance within a session that appears similar to the proactive interference functions obtained by many experimenters using adult subjects and verbal stimuli in a recall paradigm. T h e literature is summarized by Melton (1963). It was proposed to investigate proactive inhibition by manipulating some of the parameters which proved to be important in the verbal literature. A central idea was the importance of proactive inhibition as a determinant of adult forgetting (Underwood, 1957). Among the parameters manipulated in a series of experiments were the following: recall interval, stimulus familiarity, interpolated rest periods, rate of presentation, and meaningfulness of the graphic stimuli. In no study did we find any variable interacting with the order of presentation in a session. Indeed some of the parameters that we expected to be important from our understanding of interference theory failed to produce effects. For instance, a comparison of a “maximum” interference condition where the same four stimuli were constantly reused in all combinations, with a “minimum” condition where the same picture was never reused, produced no stimulus type by order interaction. Similarly, recall interval proved to be a weak variable even with a 30-second delay. These unexpected results were difficult to understand if indeed proactive inhibition was the process we were investigating. One possible explanation was that the binary choice we were using represented too low an information load to show proactive inhibition. Melton (1963) summarized data showing that a single item or chunk recalled by adults does not produce marked proactive inhibition effects. We therefore decided to change the procedure in order to increase the amount to be remembered or the information load. Two concurrent lines of experimentation were begun where the load could be manipulated. They were a recognition series stimulated by the work of Sternberg (1966) which is reported in this chapter, and some studies of dichotic listening that are reported elsewhere (Urban0 & Scott, 1969a, 1969b). T h e recognition series has been more extensively researched. It was quickly evident from pilot work that the proactive inhibition effect was not the powerful variable that we had originally expected. Our data do not support the position that interference, in recognition memory, is the major cause of forgetting in the retardate.

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V. METHOD A.

Experimental Procedure

In choosing a new procedure we took into account some carefully planned considerations. First, we wanted a procedure that would allow the presentation of pictorial as well as auditory verbal stimuli so that results of comparative studies would not be confounded with reading ability. Second, we wished to manipulate information both within an individual frame o r picture as well as the number of such frames. This would enable us eventually to study chunking and organization. Such data would allow us to develop theoretical and empirical bridges with discrimination learning, theory of attention (Zeaman & House, 1963), and the study of cue redundancy effects (Zeaman, 1968). Third, we required a method of partial report, or memory probe technique, so that independent estimates could be made of how much material is stored, lost during the recall interval, and lost through the process of retrieval. Fourth, we needed a technique in which the subject’s response did not rely on his verbal ability. Fifth, we wished to use both latency and accuracy as dependent measures. Sixth and finally, the technique was to be convenient for use with young children. T h e task was piloted with normal 3-year-old children. At the time we were planning our experimental procedure a key article on recognition memory appeared (Sternberg, 1966). T h e procedure we were working on was to present a matrix of pictures and then probe with two pictures, one which was from the matrix and one which was not. We adopted the procedure similar to Sternberg’s as it presented fewer problems due to interference and novelty effects during a probe. T h e general procedure we adopted is to show a child, either simultaneously or successively, a set of one or more to be remembered pictures. This is followed by a memory probe where a single picture is presented, identified by a bell ring. T h e child responds to this single memory probe picture, by pushing one lever to indicate if the picture came from the set to be remembered, or by pushing the other lever if the probe did not. The sequence is illustrated in Fig. 2. T h e daily sessions include a series of such problems consisting of the acquisition of one or more pictures followed by a single picture on the test or memory probe trial. Typically the children are carefully pretrained to play the game over a period of 4 days. Testing is then carried out during 10 to 20 brief experimental sessions on succeeding days. T h e pictures that we use are drawn from a small pool with which the chil-

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dren are thoroughly familiarized during a pretraining period. The pool consisted of from 10 to 40 pictures in various experiments. 6.

Stimuli

Initially we were faced with a large number of parameters that could be manipulated. For a first series of experiments it was decided to manipulate presentation order and temporal parameters while using a very restricted set of clearly discriminable and simple stimuli. Our decision as to what was a simple and discriminable stimulus warrants some brief comment. W e chose pictures cut from children’s Little Golden Books pasted on black 4 X 4 inch posterboard cards, photographed, and

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projected full size using color slides. The pictures were chosen from a pool of several hundred, to make sets that appeared to a number of judges, to contain no pairs that might be readily confused in appearance or subject matter. We have used several different subsets of 10 to 40 pictures for different experiments. Several visitors to the laboratory have suggested that color-form or letter stimuli are simpler. This is not a defensible position to the extent that both are more difficult than pictures for children in learning a discrimination. Further color-form stimuli are particularly complex in that they may be perceived in a number of ways following complex rules of cue combination (Egeth, 1966; Scott & Patterson, 1969; Watson & Scott, 1969; Zeaman, 1968). T h e supposed simplicity of color-forms is deceptive and derived from the ability of the experimenters to count attributes and arrive at a simple numerical result. While pictures do not possess this feature they are perhaps more certain to form familiar “chunks” that a child may encode as a unit. This question of the nature of a unit in memory or “word” is a basic one we plan to investigate systematically. It is certain that stimulus variables must interact with the parameters we have studied to date and they will become a major area of our investigation during the next few years. C.

Apparatus

The apparatus is described in detail elsewhere (Scott, 1970). A suite consisting of an experimental and control room is used. T h e control room contains programming equipment and a Kodak Carrousel projector to display the stimuli. A digital printout clock is used to automatically record accuracy, position, and latency of response. As can be seen in Fig. 3 the subject sits in full side view of a one-way window that separates the control and experimental rooms. T h e stimuli are projected via a front silvered mirror onto an 18 X 12 inch Polacoat rear projection screen mounted on a black panel. Below the screen and 7 inches apart are two response levers inclined slightly to the subject’s view. Centered between the levers is a candy receptacle into which an M & M is delivered automatically following a correct response. T h e response panel with a subject responding is shown in Fig. 4. The two response levers are activated only during a test trial. For a random half of our subjects the left lever is used to indicate that the probe picture is from a set that has just been displayed and the right lever is used to indicate that the picture is not from that set. T h e function of the levers is reversed for the remaining subjects.

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FIG. 3. Diagram of the apparatus from Scott (1970). VI. EMPIRICAL FINDINGS

In the following sections some results of the application of the experimental procedures just described are presented. Most of the results have been replicated in successive experiments and some have been obtained repeatedly. The details of each experiment are left for more extensive presentation in the journals, and here only those details necessary to understand the major effects and some interpretations are presented. Also details of inferential statistics are omitted. All results discussed have reached the 5% level of significance on one or more occasions. Results are also limited to those regularly found in experiments with similar conditions. The results are presented in an order intended to clarify the exposition rather than represent any sequence of experimental findings. A.

Simultaneous or Successive Presentation of Stimuli

Sternberg ( 1966) has demonstrated the time-dependent nature of

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memory for pictures presented successively, that is one after another, followed by a memory probe. One possible reason that the information in memory is scanned in some serial fashion is that it is read into the memory store in a serial order. If a subject is allowed to store the material following the free scan, will a similar increase in latency be found? In an initial experiment a comparison was made between groups given pictures either successively or simultaneously. This experiment produced equivocal results. T h e outcome was of concern since restriction

FIG. 4. A subject responding to the single probe stimulus on a memory test.

96

Keith G . Scott

on the generality of memory search models is implied if a presentation procedure is so critical. The results of a more elaborate experiment can be seen in Figs. 5 and 6. Here we use four groups of subjects. One group of subjects viewed the pictures in a serial order as in previous work. Another group viewed the pictures simultaneously, that is presented all at once as a matrix. Two other groups viewed the pictures on different trials either simultaneously or successively, the order of conditions being random and unpredictable. The data are presented for both speed and latency separately since both are commonly used measures, The speed data (the reciprocal of latency) shown in Fig 5 result in an insignificant interaction of groups and matrix size (F = 0.87, df 6,40). In our original report of this data we chose speed as our dependent measure due to the well-known skew that our latency scores displayed. Subsequently, stimulated by recent discussion (Sternberg, 1969a, 1969b), the data were reanalyzed with latency as the dependent measure (Fig. 6). Using latency the interaction of groups and matrix size is significant (F = 2.53, df 6,40, p < .05) though marginally in an analysis that produces 15 separate F tests? This illustrates the general problem in choice of temporal dependent measures. Is the significant interaction an artifact of the latency measurement scale and therefore to be disregarded? Alternatively should the possible additive nature (Sternberg, 1969a) of real time latency measures, with their potential for theoretical analyses, lead to acceptance of the untransformed laSim-wc e-0 Sim Suc-sim A-A

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tency scores? It should be noted that both measures have been widely used in the psychological literature and that they are not linearly related. Initially all our analyses were conducted with speed. However, in this paper, influenced by the theoretical work in memory and by the use of latency measures in the work of Baumeister and Kellas (1968) in retardation, we have chosen to present latency data as being theoretically more interesting. Some caution is needed, however, in interpreting any interaction that can be induced o r removed by the use of simple transformations. In making the important group comparisons between normals and retardates as advocated by Baumeister (1967), the use of transformations must remain a very serious concern both in general and for subsequent studies in the present program. The research strategy outlined here includes a theoretical component, namely some understanding of the processes involved, as this is considered to provide the strongest guide in making decisions about the appropriate choice of dependent measures. We have used the simultaneous presentation procedure for subsequent experiments. The data in Figs. 5 and 6 show a general linear change for all groups related to the number of pictures displayed limited probably by sampling restrictions, with only 6 subjects per group, and our early mis-estimate of retardates' memory capacity. This led to restricting the set size to just 5 pictures. T h e data in the following sections further justify the decision to use a simultaneous presentation (originally made from a consideration of speed data) since it produces rather similar functions to those obtained with a successive presentation of digits to adult Ss.

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Our subjects had a mean MA of 6.8 (range 4.7-7.7), a mean I Q o f 58.4, (range 46-68) and a mean CA of 14.9 (range 12.1-19.3). 8.

Number of Stimuli and Memory Performance

In Fig. 7 can be seen the result from one of our experiments showing a similar function to that described above with as many as 15 pictures. In Fig. 8 can be seen the decline in accuracy as the amount to be remembered increases. The subjects in the study had a mean I Q o f 56.2 (range 45-74), a mean MA of 6.3 (range 5.2-7.1) and a mean CA of 14.8 (range 11.2-19.5). The latency function is very similar when only the latencies of correct choices are plotted. At this time we are not certain if the decline in accuracy is entirely due to a failure to store, limited storage capacity, to loss during retrieval, or some combination of these effects.

C.

Effects of Stimulus Duration and Pacing

Our stimuli have in most experiments been exposed for 2 seconds per item. That is a matrix of 1 picture would be exposed for 2 seconds, 3 pictures for 6 seconds, 15 pictures for 30 seconds, and so on. The advantage of this procedure is that the available study time per picture is held constant. However, it is also possible that if the exposure was in excess of the optimal time to store then additional exposure may result in forgetting due to trace decay or interference.

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T h e constant exposure per item could also produce a pacing effect. That is, as the number of stimuli to be stored increases so does the total study time. A result is that the S has longer to wait until the probe stimulus appears, and he paces himself accordingly and takes longer to make his decision. To check these possibilities we manipulated display time using the factorial design diagrammed in Fig. 9. If the stimuli Display time (sec)

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Keith G.Scott

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were being exposed beyond the optimal time then any increase in exposure would result in a decline in performance. The Ss in this study had a mean MA of 7.0 years (range 6.2-7.8), a mean CA of 11.5 (range 10.0-14.4), and a mean IQof 62.2 (range 49-79). The performance of the S s as a function of the number of stimuli can be seen in Fig. 10. As can be seen performance increases regardless of the number of stimuli as a function of total display times. The display time per item can more readily be interpreted when the data are plotted as a function of the number of stimuli (Fig. 1 l), and the exposure per item is read from Fig. 9. Possibly with 5 or 9 stimuli and only 2 seconds’ total exposure time the Ss had simply insufficient time to scan the stimuli. A marked decrement is apparent. Display time and the number of stimuli did not significantly interact with latency as a dependent measure. The result of this experiment allows us to rule out a pacing effect as an explanation of increasing latency with increasing memory load. It also shows that from 1 to 2 seconds per item exposure is a reasonable exposure duration and in general suggests that exposure in such experiments should be decided on a per item basis rather than using a common exposure regardless of the number of stimuli. This later procedure would confound the number of stimuli with the study time per item.

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D. The Effect of Type

of Probe

A repeated finding is that the response to a probe picture that is the same as one of the to-be-remembered pictures is made more rapidly than to a probe picture that is different. That is, the response to same (the positive probe) is made more rapidly than to different (the negative probe). This effect is shown in Fig. 12 and the subjects are described in Section F.

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One interpretation is that to make a decision that something is the same the subject need only make comparisons between the memory store and the probe until a match is achieved. However, the decision that the probe is different requires that the probe be compared with each and every item that is stored before the decision can be given. This theoretical interpretation has been put forward by Nickerson (1965, 1967) who obtained the result with normal adult subjects. The critical test of this interpretation is provided by a comparison of same and different with only a single item in the store. Here both same and different require the comparison of the probe with a single item and identical response latencies are implied. Our data do not support this position. We obtain substantial differences between same and different latencies at all matrix sizes. Further research is needed to examine the distribution of latencies and their variances before a theoretical interpretation can be attempted. Since distributional analyses need a very large number of observations, at any given combination of levels of the dependent variables, the present data are insufficient. For the present, it is clear that an exhaustive scan of the memory store occurs regardless of the type of probe. E.

The Effects of Practice

In the series of experiments we have regularly pretrained our Ss for from 3 to 4 days before entering the experimental conditions. This procedure is consistent with the rationale of the miniature experiment as described by House and Zeaman (1963). A result is that the accuracy scores have asymptoted and remain stable across the experimental sessions. However, w e have regularly found a gradual decline in latency that persists across the experimental sessions. Figure 13 shows such a

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function. T h e data are from the subjects and experiment described in the first section. We are presently testing two interpretations of this finding. One that it is a slowly asymptoting motor habit. Second that it results from the gradual encoding of the stimuli in an experiment into long-term storage.

F.

Retention Interval

A further concern of the experimenter in memory is the effects of the interval between storing material and retrieval. We have manipulated retention interval parametrically and examined the interaction with the number of pictures to be remembered. The Ss had a mean I Q o f 58.2 (range 48-65), a mean MAof 6.5 years (range 5.2-7.01, and a mean CA of 14.0 years (range 13.1-19.1). Figure 1 is a diagram of the design. First, the response latency shows an increase as a function of recall interval as can be seen in Fig. 14. This function did not interact with the number of pictures. T h e accuracy functions (Figs. 15 and 16) show that retention intervals of up to 12 seconds did not product a performance decrement but that at 24 seconds there appears to be a general ranking of performance as a function of the memory load. We are presently extending this study with a large number of measures concentrated at fewer and more extreme parameter values. The theoretical interest of the retention interval manipulation lies in the independence of the stored items. If associative interference is operating in the present experiments then with large memory loads

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and long retention intervals forgetting should be maximal. To some extent our accuracy data support such an interpretation. The latency data, on the other hand, do not show the marked increase one might expect under conditions of marked stimulus or response interference. The question in general is, How independent are highly distinct items when in short-term storage?

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G.

Within Session Effects

One variable, both of concern in the design of experiments and of theoretical interest, is the change in performance that occurs as a function of successive problems within a session. At least two opposing effects might be expected: a warm-up effect producing an improvement in performance as a session progresses or a decline caused by the proactive interference of early problems with later problems. Both these effects are expected to be greater with more difficult or with higher memory loads. In Fig 17 the relation of memory load to accuracy of performance is shown. Figure 18 shows the corresponding data for latency of response. It seems that there is some evidence of a decline in performance associated with high memory loads as the session progresses, but we do not observe a similar effect on latency. These data are from the same experiment as the data described in Section B. While present, the proaction is not of the massive sort. Interference does not seem to be a major source of forgetting with the present task.

H. The

Relation of latency and Accuracy of Response

At this juncture the results in the previous sections may be reviewed to note the effects of our two dependent measures. A summary is contained in Table I. As can be seen effects of both latency and accuracy are not always observed. In some cases we have repeatedly found latency effects without any comparable accuracy changes. T h e striking examples of this are type of probe, where same responses are assoI X I

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ciated with short latencies, but no differential accuracy effects, and the practice across sessions where latency steadily decreases (Fig. 13) while accuracy remains stable. It is also clear that individual differences in temporal measures are not highly correlated. Table I1 gives the intercorrelation of speed and accuracy at several memory loads for 10 moderately retarded subjects. Table 111 presents the varimax factor rotation for the same data with just two factors extracted in view of the relative size of the roots (Fig 19)and the small matrix of intercorrelations. It is clear that two rather distinct factors emerge associated respectively with latency and accuracy. VII. SUMMARY AND DISCUSSION

The experiments and data reported here have been concerned with the exploration of the variables controlling recognition using a memory probe task. They represent the first stage of an ambitious program to study the development of memory in the retarded. This first series of experiments is currently being extended in a number of ways. In particular we have experiments in progress that concentrate more observations at parameter values of key theoretical interest to allow for more detailed analyses of latency distributions including those for individual subjects.

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TABLE I TABULATION OF OBSERVED EFFECTSWITH LATENCY AND ACCURACY AS DEPENDENT

MEASURES Variable or process

Effect on latency

Successive or simultaneous presentation Number of stimuli

Both show similar effects Increase in latency as a function of the number of stimuli Little effect

Exposure duration

Pacing of task Type of probe (same or different)

Effect on accuracy Both show similar effects Decrease in accuracy as a function of the number of stimuli Increase in accuracy as a function of increasing exposure No effect N o effect on accuracy in any experiment

No effect Longer latency for different than for same Decreasing latency

Practice across sessions

Stable performance across sessions after pretraining Interaction of retention interval and memory load with lowest accuracy at largest memory load and longest interval Interaction of' memory load and order in a session suggesting some onset of proactive inhibition at high memory loads

N o interaction of memory load with retention interval, increase in latency as a function of retention interval No systematic shift in latency within a session at any memory load

Retention interval

Session proaction

TABLE 11 INTERCORRELATIONS OF LATENCV A N D ACCURACV SCORES Latency Matrix size

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A further development will be an increased focus on theoretical matters. The aim here is not necessarily to be original but rather to be faithful to the overall program. While this chapter was in an advanced state of preparation, two papers of theoretical importance appeared (Sternberg, 1969a, 1969b). They will lead to further research and some more detailed analyses of some of our present data. Sternberg's data (1969a, p. 447) also shows that recognition memory of the type studied here may be fundamentally different from the memory for position studied by Ellis (1970) and his associates. Ross and Youniss (1969) have also suggested an independence of item and order information. Potentially such differences are of great interest in exploring the role of different processes and the role of primary and secondary memory in an attempt to describe the pattern of memory disability that seems to afflict our retarded subjects.

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Certain clear theoretical observations become possible from our data. It seems clear that our Ss scan the to-be-remembered items exhaustively regardless of the use of same or different probes. T h e Ss seem able to erase the stored items at will after they have been probed, as indicated by the fact that successive problems do not show substantial interference with each other. Further, some preliminary analyses of a recent experiment show that the subjects are able to achieve a high degree of accuracy across three successive probes of a given matrix of pictures. Marked interference produced by probing the store, suggested by Sperling’s (1960) data, does not seem to occur. This is possibly due to his use of much shorter exposures which probably tap a perceptual store. Latency and accuracy show a pattern of intercorrelations which suggest that they are measuring separate processes. This part of our data lends support to Sternberg’s (1969a) observation that errors result “from faults in learning and retention, rather than in retrieval [p. 4521.” It should be noted that this lack of correspondence in latency and accuracy might not hold with other tasks as Ellis’s data (personal communication) show. For the present the marked difference in the dependent measures with the present task is of considerable psychometric interest. T h e data on exposure duration suggest that the subjects are able to benefit from quite long exposures. What use is made of this time? Is it simply rehearsal? Here the data of Ellis (1970) suggest that this is quite unlikely with retarded subjects. This agrees with subjective reports of adults who report scanning the stimuli but not rehearsing. We plan both studies of scanning patterns and some comparative studies of normal and retarded subjects to clarify this issue. These observations, coupled with the importance of rehearsal suggested by Ellis, raise the question of what is stored. That is, does the subject learn a verbal label for the stimuli, store a visual representation, or is the storage independent of modality? This and much further work remains to be done over a number of years in an attempt to complete the planned program. REFERENCES

Raumeister, A. A. Problems in comparative studies of mental retardates and normals. Amt.ric.a~rJourrral of‘Mental Deficiency, 1967,71. 869-875. Baumeister, A. A.. 8c Kellas, G. Reaction time and mental retardation. In N . R. Ellis (Ed.), Iit&ernrtlioirrilreiiiew ofresearrh in mental retardotion. Vol. 3. New York: Academic Press, 1968. Pp. 163-193.

110 Cattell, R. B. (Ed.) Handbook of multivariate +‘mentalpsychobgy.

Keith G.Scott Chicago: Rand McNdly.

1966.

Cronbach, L. J. The two disciplines of scientific psychology. American Psychologist, 1957, 12,671-681.

Egeth, H. E. Parallel versus serial processes in multidimensional stimulus discrimination. Perception t3 Psychophysics, 1966. 1, 245-252. Ellis, N. R. A behavior research strategy in mental retardation: defense and critique. American Journal of Mental D e j k e n ~ y 1969,73,557-566. , Ellis, N. R. Memory processes in retardates and normals. In N. R. Ellis (Ed.), International review of research in mental retardation. Vol. 4. 1970. Pp. 1-32. Estes, W. K.Learning theory and the new “mental chemistry.” Psychological Review, 1960, 67,207-223.

Grice, G. R., & Hunter, J. J. Stimulus intensity effects and experimental design. P y h o l o g iculReview, 1964,71,247-256. House, B. J., & Zeaman, D. Miniature experiments in the discrimination learning of retardates. In L. P. Lipsitt & C. C. Spiker (Eds.), Advances in child development and behavior. Vol. 1. New York: Academic Press, 1963. Pp. 313-376. Kirk, S. A,, & McCarthy, J. The Illinois test of psycholinguistic abilities-an approach to differential diagnosis. AmericanJournal of Mental Definemy, 1961,66,399-412. McCarthy, K.,Scott, K. G., & Urbano, R. C. Recognition memory: the relationship of accuracy and speed of response under different memory loads. Progress Report No. 1, 1969, Grant No. USPH HD 02898, Children’s Research Center, University of Illinois. Melton, A. W. Implications of short-term memory for a general theory of memory. Journal of Verbal Leum’ng and Verbal Behavior, 1963,2, 1-21. Neisser, R. C o g d i v e psychology. New York: Appleton-Century-Crofts, 1966. Nickerson, R. S. Response times for “same”-“different” judgments. Perceptual and Motor Skills, 1965, 20, 15-18. Nickerson, R. S. “Same”-“different” response times with multi-attribute stimulus differences. Perceptual and Motor Skills, 1967,24, 543-554. Ross, B. M., & Youniss, J. Ordering of nonverbal items in children’s recognition memory. Journal of Expenmental Child Psychology, 1969,8,20-32. Scott, K. G. A multiple-choice audio-visual discrimination apparatus with quick interchange display and response panels. Journal of Experimental Child Psychology, 1970, 9, 43-50.

Scott, K. G. Intelligence and learning. In C. Haywood (Ed.), Psychometric intelligence. New York: Appleton-Century-Crofts, 197 1. Scott, K. G., & Glidden, L. Recognition memory: proactive inhibition in retardates’ recall at different memory loads. Progress Report No. 1, 1969, Grant No. USPH HD 02898, Children’s Research Center, University of Illinois. Scott, K. G., & Patterson, F. Recognition memory: central versus peripheral color and form cues in preschool children’s performance. Progress Report No. 1, 1969, Grant No. USPH HD 02898, Children’s Research Center, University of Illinois. Scott, K. G., & Scott, M. S. Research and theory in short-term memory. In N. R. Ellis (Ed.), International review of research in mental retardation. Vol. 3. New York: Academic Press, 1968. Pp. 135-157. Sperling, G. The information available in brief visual presentations. Psychological Monographs, 1960,74, 11 (Whole No. 498). Sternberg, S. High speed scanning in human memory. Science, 1966, 153,652-654.

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Sternberg, S. The discovery of processing stages: extensions of Donders’ method. Actu Psychologica, 1969,SO. 276-3 15. (a) Sternberg, S. Memory-scanning: mental processing revealed by reaction-time experiments. American Scientist, 1969, 57, 421-457.(b) Underwood, B. J. Interference and forgetting. Psychologzcal Review, 1957,64,49-57. Urbano, R. C., & Scott, K. G. Digit span, practice and dichotic listening performance in the mentally retarded. Journal ofExperirnenta1 Chtld Psychology, 1969, 8, 432-442. (a) Urbano, R. C., & Scott, K. G. Performance of retarded subjects on a two channel auditory-visual memory task. Progress Report No. 1 , 1969, Grant No. USPH HD 02898, Children’s Research Center, University of Illinois. (b) Watson, L. H., & Scott, K. G. Recognition memory: central versus peripheral cues in incidental learning of retardates. Progress Report No. 1, 1969, Grant No. USPH HD 02898, Children’s Research Center, University of Illinois. Zeaman, D. Learning processes of the mentally retarded. In S. F. Osier & R. E. Cooke (Eds.), The biusocial 6asis of mental retardation. Baltimore: Johns Hopkins Press, 1965. Pp. 107-127. Zeaman, D. T h e law of redundancy. Paper presented at the Gatlinburg Conference of Mental Retardation, March 1968. Zeaman, D., & House, B. J. The role of attention in retardate discrimination learning. In N . R. Ellis (Ed.), Handbook uf mental defrctency, New York: McGraw-Hill, 1963. Pp. 159-223. Zeaman, D., 8c House, B. J. Mental retardation and individual differences in learning. In R. M. Gagne (Ed.), Learning and zndzvtdual dtflerences. Columbus: Merrill Books, 1967. Pp. 192-212.

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Operant Procedures with the Retardate: An Overview of Laboratory Research PAUL WEISBERG’ UNIVERSITY OF ALABAMA, UNIVERSITY, ALABAMA

I. Introduction . . . . . . . . . . . . . . .................................... 113 11. Reinforcement .................... .......................... 114 A. Recent Trends . . . . . . . . . . . . . . . . .......................... 114 B. Perceptual Reinforcers and Control ems . . . . . . . . . . . . . . . . . ( 2 . Conditioned Positive Reinforcement . . . . . . . . . . . . . . . . . . . . . . . . . D. Conditioned Neg-ative Reinforcers . . . . . . . . . . . . . . . . . . . 111. Punishment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 IV. Schedules of Reinforcement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. Schedules as Formal Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 B. Naturally Developing ............................. 134 V. Dependent Variables ............................................. -135 A. Rate: T h e Primary Measure ................................... .I 35 R. Refinement of Rate . . C. Temporal Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 37 D. Spatial Dimensions ..................... . . . . . . . . . . . . .137 E. Topography and Collateral Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 39 F. Rate: A Multicontrolled Measure . . . . . . . . . . . .I40 V1. Concluding Remarks ............................................. . I 41 References ...................................................... 142

1. INTRODUCTION

There recently has been a tremendous swell of activity in operant research with retardates. Many operant conditioners have “moved in” with the retardate, claiming that the apparatus of the “laboratory” should rightly include equipment indigenous to the schoolroom, workshop, cafeteria, playground, lavatory, and wherever the retardate finds himself. Such a redefinition of the traditional experimental setting has certainly enlarged the range and richness of operant phenomena studied and has provided a thicket of data not always easy to untangle in the assorted journals where it is reported. ‘My appreciation to Richard H . Passman and Roberta S. Weisberg for their critical comments on various sections of this chapter. 113

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The legitimacy and relevancy of operant research in natural settings is recognized, and this review even suggests some meaningful instances of its extension. Certainly, a broad and objective appraisal of behavior modification procedures with the retardate is needed, and such a product is bound to come soon. Until that time, this review is intended to serve as a methodological bridge between laboratory-tested operant procedures which concern the management of the retardate and control procedures now in use in many applied settings but not always receiving thorough assessment. The review dwells upon studies carried out under traditional experimental settings, although it does not necessarily deal with mere traditional issues. Familiar subject matter, such as schedules of reinforcement, will be briefly touched upon since a well documented review already exists (Spradlin & Girardeau, 1966), although subtle issues not always aired, most notably the analysis of dependent variables in laboratory work, will receive more critical and extensive coverage. Procedures likely to be used by individuals having custody of the retardate in a number of situations are scrutinized for their effectiveness under laboratory conditions. Thus, contemporary research in social engineering which utilizes positive and aversive consequences is reported in detail as are issues and empirical outcomes of shock punishment. II. REINFORCEMENT A.

Recent Trends

There is a definite shift in the kinds of items falling from the dispensers and feeders of most operant laboratories nowadays. Consumables and manipulatables, long the mainstay (Bijou 8c Sturges, 1959), are giving way to the use of generalized conditioned reinforcers in the form of money and tokens (e.g., Gates & Fixen, 1968; Morris, 1968; Spradlin, Girardeau, 8c Hom, 1966). Since “token economies” have also become fashionable in the wards of many institutions (J. M. Gardner 8c Selinger, 1970), this trend toward the exclusive use of tokens should promote a fair amount of dialogue between those giving tokens in the laboratory and those in the ward. Hopefully, this interchange will produce mutual understanding of each other’s research and set into motion the machinery for the coordination of laboratory-ward policies. It is obvious that durable token reinforcers will suffer in value and the behavior they are chosen to regulate will become more variable if, after each session, they are rarely exchanged for the commodities they are

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purported to buy or if a large supply of laboratory-earned tokens are intermittently withdrawn by some naive attendant for petty undesirable acts done in the ward. Another trend is to request retardates to deposit dispensed edibles in some receptable provided for this purpose, thus transferring and postponing ingestion of the food item to a time and place outside the laboratory (Sidman & Stoddard, 1967). Presumed advantages of this strategy for operant-type investigations are the attenuation of the debilitating behavioral effects of food satiation, greater standardization in the length of the reinforcement period, reduction of extraneous and interfering behaviors sometimes associated with bizarre eating patterns, and a more tidy, inhabitable laboratory space. Notwithstanding Siegel’s 1968) point that consummatory activity consists of a chain of behaviors and is not simply synonymous with the act which marks its endpoint, namely ingestion, the practice of bypassing the terminal link can nevertheless backfire. Like the token reinforcement situation, highly variable intersession behavior may be produced when extralaboratory policies with respect to the stored reinforcers are inconsistent and nonequitable. 8.

Perceptual Reinforcers and Control Problems

In the ever-diligent search for reinforcing stimuli that will instigate and maintain more adaptive behaviors in multihandicapped, crib-confined retardates than the self-stimulatory, self-destructive behaviors these sensory-isolated children often display, two recently investigated stimuli offer promising leads. Bailey and Meyerson ( 1969) found that delivery of a vibratory stimulus for lever pressing sustained this response in a sensory handicapped 7-year-old child for 3 successive weeks. Using dual audio consequences (single chime sound or continuous tone as feedback), Friedlander, McCarthy, and Soforenko (1967) found marked differences in response duration associated with each kind of stimulation in two profoundly retarded children, each younger than 40 months. In both studies all manipulanda and feedback sources were mounted onto the child’s crib or playpen and the responses were recorded for 24 hours daily in the Bailey and Meyerson study and for only a single 15- to 36-minute session in the Friedlander et al. demonstration. However, Friedlander has successfully applied the same audio feedback system over a number of sessions with a blind retarded child (Friedlander, 1967) and home reared, normal infants (Leuba & Friedlander, 1968). Provocative as these studies are for the evaluation and rehabilitation

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of basic sensory and learning processes of crib-bound individuals, they are considered by the very workers in this field to be exploratory in nature and in need of experimental refinement and substantiation. In many ways the state of the art is chronologically at a point where infant conditioning research was less than 10 years ago (Lipsitt, 1963). Like infant research, the job of finding nonbiological maintaining stimuli will undoubtedly prove arduous and frustrating, and the reinforcing effectiveness of many stimuli can be expected to be a transient, highly idiosyncratic affair, as Meyerson, Kerr, and Michael (1967) have already discovered with their vibratory stimulus. Moreover, control procedures will need to be instituted to gauge the functional properties of the presumed reinforcers. In all the studies listed above, the stimuli were presented following every response and, since it is well known that attractive sensory and perceptual events can themselves have motivational aspects (Berlyne, 1960), the arousing or eliciting properties of a stimulus were unavoidably confounded with its reinforcing-strengthening characteristics. Previous control procedures, aimed at isolating these stimulus functions, have utilized some form of between groups design (e.g., Weisberg, 1963) wherein comparison is made between the acquisition performance of two groups receiving response-dependent and response-independent events, respectively; however, with some adjustment, this procedure can accommodate single organism research designs. One variation is to split response-contingent and noncontingent stimulus events into separate components of equal duration within the same session. If distinctive exteroceptive cues are correlated with each component, w e have the case of a multiple schedule of reinforcement, and the prototypic control procedure is reported in Sheppard's (1969) study of infant vocal behavior. Here the same stimulus events, flashing lights and the playback of a mother's voice, were programmed in successive fashion, first dependent upon vocalizing (on a small fixed ratio schedule) then in the independence of this response (on a purely temporal basis). More responses or lower latency scores associated with the contingent reinforcement component would document the stimulus complex as a reinforcer and indicate operant control. Alternatively, the absence of performance differences between the noncontingent and contingent reinforcement components would suggest stimulus eliciting properties and possibly respondent control. Worth emphasizing is that an equivocal result will be obtained if the frequency of reinforcement in one component does not match that given in the other. The multiple schedule offers a special bonus in that it also enables assessment of the

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subject’s ability to distinguish between the set of discriminative stimuli paired with the contingent and noncontingent events. Stimulus control may be easily assessed during a series of extinction probe periods when only the discriminative stimuli are programmed. Manipulation of the reinforcement contingency may also be made between sessions as Hart, Reynolds, Baer, Brawley, and Harris (1968) did in order to determine the nature of adult social interaction with respect to cooperative play behaviors and proximity responses in a nursery school child. A number of sessions given to contingent versus randomly presented noncontingent social consequences for cooperative behavior were alternated with each other, and the proportion of responses in each condition was compared. In Hart et d., explicitly programmed discriminative stimuli did not accompany either contingency condition, although there may be justification to include these cues in future studies. T h e rationale and method for determining the functional nature of the suspected reinforcer is identical to the within-session multiple schedule paradigm, except that assessment of control by the never presented discriminative stimuli is, of course, not possible. C.

Conditioned Positive Reinforcement

Because for many retarded individuals, social, in contrast to material, reinforcers exercise poor behavioral control, a methodological and practical problem of immediate interest concerns the establishment of a functional class of social reinforcers. One reinforcement-strengthening procedure proven effective with rats (D. W. Zimmerman, 1959) recommends a two-stage process: (1) for a stimulus to become a reinforcer, it must first develop discriminative properties (Dinsmoor, 1950), and (2) for the attainment of stable and durable properties, the pairings between it and a known reinforcer should gradually diminish over blocks of training trials. However, application of Zimmerman’s prescriptions to retardates and other populations has met with varying degrees of success. Steinman ( 1968) attempted to enhance the reinforcing effectiveness of a verbal stimulus (the saying of “good over an intercom) in its relation to much stronger material reinforcers (e.g, M8cM’s) in the control of lever pressing in five retardates (IQs from 37 to 77). Despite indications that the verbal stimulus had become discriminative for material reinforcement in four subjects, lever pressing was only moderately and temporarily elevated. In contrast, Lovaas, Gilbert, Kinder, Rubenstein, Schaeffer, and Simmons ( 1966), working with autistic twins, paired food with a previously inert social stimulus (the saying of

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“good sometimes simultaneous with patting the subject) and were able to turn it into a functional and durable conditioned reinforcer which effectively strengthened and sustained lever-pressing behavior. Undoubtedly, innumerable experimental and organismic variables peculiar to each study are related to the dual outcomes, but only the vastly different methods of testing reinforcement efficacy will be emphasized here. To measure and evaluate social control during pre- and posttest phases, Steinman utilized a successive choice situation wherein the weaker social reinforcer was always pitted against the stronger material reinforcer. Thus, as Steinman admits, since the conditions for social and material consequences during pre- and posttesting were mutually exclusive, the subject could readily discriminate which reinforcement condition was in force so that whatever gains accrued to the social stimulus as a result of training were probably drastically diminished during the critical posttest phase. The likelihood that the seed for a well-fortified discrimination, resistant to subsequent change, had been planted inadvertently during pretesting is indicated by the diverging rates of responding between the two reinforcers over the pretest sessions of four of the five subjects. One aspect of the Lovaas et al. (1966) posttest procedure involved a learning test, but, unlike the classical paradigm which demands the removal of the unconditioned reinforcer altogether during the test condition, intermittent food reinforcement and an always available discriminative social stimulus followed behaviors in one component while behaviors in a second component produced the conditioned social reinforcer only. Concisely stated, “the social stimulus was tested (in the second component) while acquisition of its discriminative properties was continued (in the first component) [Lovaas et al., 1966, p. 1151.” Under this arrangement, the social consequences engendered and maintained performances in the second component as long as concurrent food reinforcement was given in the first component; withdrawal of food extinguished conditioned reinforced behaviors in the second component. The Lovaas et al. (1966) procedure has much to recommend its use in further studies of social engineering with retardates. Anyone interested in discovering what parameters have already been investigated with a procedure closely related to Lovaas et al. (1966) should consult J. Zimmerman’s technique for sustaining a pigeon’s behavior indefinitely with conditioned reinforcement as the only response consequence. He will find that the pattern and level of responding in the second component is a function of the schedule of conditioned reinforcement (J. Zimmerman, 1963), that primary rein-

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forcement in the first component need not be response contingent in order for conditioned reinforced behavior in the second component to be maintained (J. Zimmerman & Hanford, 1966), and that the rate of conditioned reinforced responding is related to the frequency of noncontingent primary reinforcement Zimmerman, Hanford, & Brown, 1967). He might also detect some control conditions missing from the Steinman and Lovaas et al. (1966) studies, such as the substitution of a Zimmerman & Hannovel stimulus for the conditioned reinforcer ford, 1967) to evaluate whether conditioned reinforced behavior was specific to a particular stimulus. Translated to the Steinman and Lovaas et al. ( 1966) situation, would conditioned reinforced behavior have been maintained to the same extent had the experimenter occasionally muttered “mux” instead of “good”?

u.

u.

D.

Conditioned Negative Reinforcers

Adult verbal and social events, when they are rarely responded to, may also be converted into controlling stimuli through the use of aversive stimulation. Three classical training paradigms -escape, avoidance, and conditioned punishment - suggest themselves and, indeed, all three were implemented by Lovaas, Schaeffer, and Simmons (1965) to make a set of autistic twins more receptive to the commands, gestures, and threats of people in the laboratory environment. T o inculcate approach to and physical contact with adults via escape training, the autistic child was placed barefoot on an electrified grid floor and, upon experiencing shock, was asked by one of two nearby adults to fall into their outstretched arms at the command, “come here.” Shock terminated when the child complied, although he was sometimes pushed forward. Avoidance training naturally came next and here shock was preventable contingent upon approach to the inviting and commanding adult. Consistent with shaping principles, the adults gradually moved farther away, while simultaneously deleting hand signals. T h e results were striking. From a nonshock baseline of no approach or physical contact whatsoever, three avoidance training sessions quickly established these target behaviors to an 80 to 90% level of occurrence. This level was maintained throughout nine sessions of shock removal (extinction of avoidance behavior) distributed over 10 months. Two months after the ninth session, two additional extinction sessions were run but, unfortunately, the adult’s command suddenly lost hold and both children seldom came nor made contact. Before concluding that the adult’s commands had developed long-lasting but not perma-

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nent discriminative properties and that the adults had become conditioned positive reinforcers through their association with the reduction of pain, certain aspects of the experimental situation need examination. The experimental space was quite small (12 foot square room), and it worked to Lovaas’ et al. (1965) advantage during escape training since shock most likely activated vigorous movement, so that falling into the adult’s safe arms became a highly probable event. But does this mean the command, “come here,” provided the specific cue for approach during the avoidance component or even during avoidance extinction? In the absence of a discriminated avoidance procedure (e.g., no physical pacification offered for approach to erroneous commands), no definitive answer is possible. It seems not far-fetched to believe that the general situation in which a noxious event occurred both activated exploratory behaviors and sensitized the child to gravitate toward any stimulus and that the children eventually stopped coming to the adult as a result of adaptation to the stimulus complex which was marked by a reduction of generalized activity. This notion receives some support from the fact that following the last avoidance extinction session, one noncontingent shock sufficed to return the proportion of approach and contact behavior to its former high level, a phenomenon perhaps accompanied by the dishabituation of activity. One comment regarding the criteria for approach is necessary. Shock was avoided if the child began to move toward the commanding adult within 5 seconds or was one foot away within 7 seconds. The only dependent measure provided was whether the subject came during the prescribed time. Some might consider the temporal demands not very stringent within the small confines of the laboratory space. Also, the collection of latency scores and the number of false starts would have contributed important data concerning the nature of the controlling stimuli. Establishment of an ineffectual stimulus as a conditioned punisher for the twins was carried out in parallel with the escape-avoidance procedure. Whenever self-stirnulatory and tantrum behaviors were evidenced, the child received a foot shock and, upon its onset, the adult said, “no.” The ability of the verbal threat to thwart self-stimulation and tantrums was not attempted; instead, the suppressing power of “no” was tested for some other behavior in another situation. Specifically, following conditioned punishment training, “no” was superimposed upon a trained lever-pressing activity maintained by a fixed ratio of candy reinforcement. Lovaas et al. (1965) reported that whenever issued for lever pressing, “no” immediately eliminated the prevailing high fixed ratio rate of both twins and that this phenomenon was repli-

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cated in each of three sessions. Suppression ratios, changes in fixed ratio reinforcement density, response recovery latencies, changes in the nonpunished fixed ratio pattern, and other indexes of conditioned punisher facilitation are not presented. T h e only data offered is a segment of a sample cumulative record of one child in which the single suppression trial provided clearly indicates that “no” suppressed behavior both during the time of its delivery and for a long time afterward. The available literature points to the use of three evaluative procedures to test the power of adults as controlling agents after they have been associated with noxious events. One procedure assesses the social agent as a conditioned positive reinforcer, a role the adult assumes during escape training. In this capacity, the opportunity to view or somehow interact with an adult who once alleviated pain should facilitate the development of a new performance or, at least, maintain the level of performance engendered by another reinforcer. Lovaas et a/. ( 1965) utilized the behavior-maintenance paradigm and found that the opportunity to view an adult who was periodically associated with shock removal could indeed function to sustain behavior. However, the positive reinforcing properties of the once-attractive adult wore off, and he could no longer rely upon shock-escape training sessions to revitalize these properties. The second method gauges a characteristic of an adult, usually his verbal reproval, as a conditioned punisher. (For lack of consistent nomenclature, stimuli which derive suppressive functions after repeated pairings with known punishers are called conditioned punishers.) Such stimuli usually bring about immediate suppression, although there is some doubt regarding the punishing status of adults not correlated with punishment. In the Lovaas et al. (1965) study already reported, the reprimand, “no,” quelled a positively reinforced behavior, but the potentially suppressive effects of other adults issuing the same reproof were not examined. Lovaas and Simmons (1969) presented the word “no” following its correlation with shock for self-injurious behavior and discovered the reproof sufficient to keep the behavior at a low level both in the punishment situation as well as in the nonshock situation, Of special significance was that the suppressive attributes of the conditioned punisher also generalized to adults never delivering shock. Birnbrauer ( 1968) did not replicate the generalization phenomenon. Negativistic behavior was not quelled by verbal admonishments emitted by adults who were both correlated and uncorrelated with shock punishment in another setting. However, when shock

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“backed up” the admonishments in the same setting that the oppositional act appeared, oppositions promptly disappeared. The ability of a social agent to impart compliance for various requests encompasses the third means of estimating control. Here, the vigorous urgings and commands of the adult are intended to serve as discriminative stimuli for desired performances. Bucher and Lovaas (1968) have implied a three-prong attack to instill compliance with obstinate and seemingly oblivious autistic and retarded individuals: ( 1) negativistic or noncompliant behaviors to verbal requests are punished with shock or slaps; (2) appropriate performance removes the punishment; and (3) the request is readministered and, if carried out, food reinforcement ensues. If unsuccessful, the punishment and escape sequences are repeated. Requests presented to three retardates were quickly fulfilled without concurrent interfering acts if noxious events served as punishers. Removal of punishment in step one combined with the substitution of adult social attention for food in step two initially caused a breakdown of compliant behavior, but, with additional training, the transition from noxious to social control was perfected. Tate and Baroff (1 966) and Risley (1968) utilized essentially the same steps to get retarded individuals to obey the profferings of an adult (e.g., swallow liquids, sit in a time-out chair). Both studies showed that unless the commands were fortified with noxious agents, oppositional behaviors were not overcome. The ability of conditioned verbal and social stimuli to exercise behavioral control can be no better than the terminal consequences from which these stimuli derived their function. An analysis of underlying aversive consequences will include time-out periods of various lengths, different modes of corporal punishment, and the amperage of shock delivered from any one of several commercially available shock prods. Examination of the severest of these forms - electric shock-seems next in order, if only because of its recent interest and cause of concern. Readers wishing to learn of the features of time-out procedures should consult the Leitenberg (1965) and W. I. Gardner (1969) reviews. 111. PUNISHMENT

Studies of punishment with retardates, once eschewed on obvious ethical grounds and stifled as a scientific enterprise because of unwarranted generalizations, have of late proliferated. Of 60 references cited in a recent review of the subject (W. I. Gardner, 1969), 90% were dated after 1960 and, of these, almost three-quarters appeared after 1965.

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Part of the upsurge of interest in punishment stems from a failure of techniques predicated on the sole manipulation of positive reinforcement contingencies to ameliorate extremely deviant behavior. T h e very deployment of strong shock as a punisher of “last resort” is testimony to the failure of these techniques. Extinction (adult inattention) has been found to curtail self-injurious behavior very slowly (Bucher & Lovaas, 1968; Lovaas & Simmons, 1969) or not at all (Risley, 1968; Tate & Baroff, 1966), both circumstances magnifying the risk to the performer’s safety and bringing repugnance and concern to most onlookers. Variations of the time-out from positive reinforcement procedure (W. I. Gardner, 1969) have yielded inconsistent results. Sometimes the inappropriate behavior can be eliminated both when the causal agents can be identified (Tate & Baroff, 1966) and sometimes when the maintaining conditions are unclear (Hamilton, Stephens, & Allen, 1967). At other times removal of social attention for a disruptive act has left its frequency unchanged both when social reinforcement of similar acts is clearly vindicated (Birnbrauer, 1968) as well as when any social conditions sustaining the act are unknown (Risley, 1968). Combining procedures of extinction and positive reinforcement for incompatible behaviors has also failed with some retardates who exhibit extremely disruptive acts (Hamilton & Standahl, 1969; Risley, 1968). Resort to electric shock gains support from other considerations as well. Bucher and Lovaas (1968) and Birnbrauer (1968) report cases in which adult reprimands and harsh slaps for negativistic performances brought little or only temporary change. This finding led Bucher and Lovaas to surmise that the “adult’s anger and corporal punishment served, paradoxically, as positive reinforcers [p. 1041.’’ In both studies, when shock became the main ingredient of the punishment contingency, the child’s defiance stopped almost immediately. To the naive observer of self-injurious behavior, the claim that the performer will endure considerable pain to gain attention is puzzling, even though the operant qualities of the act have been documented (Bucher & Lovaas, 1968; Lovaas & Simmons, 1969; Schaefer, 1970). Additionally, not always evident are the long periods during which a great deal of response habituation has been allowed to occur. Strong electric shock may then be effective because its novel and aversive characteristics preclude habituation and provide no chance for it to become discriminative for positive reinforcement (Lovaas 8c Simmons, 1969). T h e delivery of shock, in common with all aversive events, also possesses motivational advantages. Unlike edibles and consumables which are limited as durable reinforcers by deprivation-satiation operations, shock is insulated against motivational infringement since it is blind to

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momentary and dispositional states of the organism. Furthermore, distinctive cue properties may adhere to the shock stimulus since their delivery underscores a just-completed inappropriate act while their continuation or offset may come to signal what behavior is required. Lastly, the argument that application of shock is inhumane and forever to be shunned as a form of treatment, even after exhaustive and wellplanned attempts to eliminate the deviant performance have failed, is contraindicated by another form of severe punishment many institutionalized retardates receive for their self-injurious and equally bizarre behavior, that of a life of physical restraint combined with social isolation or one of a medicated semistupor (Baer, 1970). So much for some presumed and real behavioral advantages of shock. For some limitations, we need only examine the research conducted with retardates. Table I presents, in summary form, the results of seven recent investigations and comments on several performance issues of shock punishment. Almost all of the subjects studied were nonverbal institutionalized retardates having long-standing behavioral problems that either endangered themselves (head banging, climbing) or others (biting or hitting other children). All were employed in a within-subject research design, and most were studied rather extensively, sometimes for as long as 60 sessions in the laboratory and 125 sessions in the home (Risley, 1968). With respect to the first performance outcome, immediacy of suppression, the normally high baseline rate of the unwanted behavior most often has been sharply diminished or virtually eliminated within the first session following several applications of response-contingent shock. Where immediate behavioral diminution was not achieved (Hamilton & Standahl, 1969; Luckey, Watson, & Musick, 1968), apparently because of the nonaversive nature of shock intensity, a stronger level of shock sufficed. Replications of the relatively instantaneous effects of strong shock were also obtained in several cases where the frequency of the target behavior returned to nontolerable levels after the shock was removed or when it was delivered for secondary, unwanted behaviors. It is difficult to evaluate precisely the permanency of suppression since not all studies provided specific provisions to examine behavioral recovery under conditions of extinction, i.e., removal of shock and nonuse of conditioned punishers or conditioned aversive instructions. This methodological deficiency is to be expected inasmuch as the treatment procedures under these mitigating circumstances dictated that conditioned aversive stimuli and conditioned punishers rapidly sup-

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plant the shock wherever possible. Moreover, generalizations about long-term laboratory effects must be couched in terms of the time allotted to assess recovery of the punished act; as Table I reveals, session length varied greatly. On the basis of three studies which provide quantitative data on recovery and where confounding variables are not in evidence (Birnbrauer, 1968; Lovaas et al., 1965; Risley, 1968), it appears that the punished act will remain close to a zero rate in the punishment setting over a protracted time, but it could return to full prepunishment strength should the subject be enticed to perform the act. More specifically, on this last point, Risley (1968) found that a footstool placed next to a bookcase on which punished climbing had been eliminated reinstated frequent climbing on the bookcase. Correspondingly, Birnbrauer ( 1968) discovered marked recovery of punished behavior when light offset signalled response-contingent shock and light onset a no-shock period. An overwhelmingly higher incidence of the prohibited act occurred during the “safe” period. Once a punished response is allowed to recover, it takes far fewer shocks to reinstate a zero rate relative to when the punishment procedure was first enforced. All that may be necessary for quick and sustained suppression is a single shock at the time of recovery (Lovaas & Simmons, 1969; Risley, 1968), which could even be delivered on a noncontingent basis (Lovaas et al., 1965). These findings suggest that with continued punishment training the shock stimulus assumes discriminative properties, informing the subject of what not to do as well as what class of behaviors are desirable. Indeed, this very function could have provided Birnbrauer’s subject the basis for responding differentially between “unsafe” (shock) and “safe” (no shock) sessions. It is difficult to pinpoint when cue properties develop, although Tate and Baroffs (1966) data suggest it may occur very early in punishment training. In the first punishment session, they delivered shocks immediately after the target behavior, but in the next two sessions the majority of shocks were presented some 30 to 35 seconds after display of the behavior. Nearly identical suppressant effects were produced by immediate and delayed (behaviorally cued?) shocks. The claim by Bucher and Lovaas (1968), that the effectiveness of noncontingent shock will depend upon whether the performer “knows” what is required, gains support from the Tate and Baroff study in that their subject was reputed to pay increasingly more attention to requests as a result of shock. Similar observations were noticed by Lovaas et a.1. (1965). On the other hand, response-independent aversive events, milder than shock, can have opposite effects. Perloff and Lovaas (1967) slapped a child noncontin-

c

TABLE I

Jw

SUMMARY OF SHOCKPUNISHMENT STUDIES

Q,

Performance variables ~

Investigator@), subject designation, and characteristics

Punished response, punishment schedule and length of session

Immediicy of suppression (number of shocks to eliminate behavior)

Lovaas et al. (1965), autistic twins (CA = 5 yr, neither had verbal or social behaviors)

Self-stimulation or tantrums, 100%: session length unspecified

0 rate within

Tate and Baroff (1966), Sam (CA = 9 yr, 20 word vocabulary, blind)

Self-injury (face slapping, hand banging). 1OO%, session length increased over days from 11h hr to most of day

Low rate with-

1st session (shock freq. unspecified); one replication of suppression achieved in lab

in 1st session (30 shocks over 4 sessions)

Was response

Was stimulus specificity obtained?

Permanency of suppression

specificity obtained?

Slight recovery after 10 sessions (over 9-month period) of 0 rate; subsequent suppression via one noncontingent shock

No. Correlated decrease in avoidance of adult physical contact

Equivocal

Slight recovery after 6 mo

No data

Apparently

~~~~

Nature of emotional and other "side &em"

S reputed to be more socially responsive

so

S reputed to listen to adults more and whine less

P

r,

Risley (1 968). Girl (CA = 6 yr, variously diagnosed, almost no verbal behavior)

Climbing, 100% for most responses, 20-30-min sessions

0 rate within 4 sessions (6 shocks), 2 replications of suppression in home of climbing and other behaviors

Strong recovery after 12 sessions of 0 rate; subsequent long term suppression via 1 shock

Yes. Climbing on other furniture correlated

Luckey el al. (l968), Boy (CA = 6 yr. 1Q= 26)

Vomiting and rumination, 100% for most responses, I2hr sessions

0 rate within 6 sessions (52 mild shocks)

Slight, occasional recovery during 27 sessions of low rate

N o data

Birnbrauer (1968), Mike (CA = 14 yr. profoundly retarded)

Button pressing (arbitrary designated as incorrect), VR 6 shock schedule, 6090-min sessions

Low rate within 2 sessions ( 1 1 shocks for 43 responses), replication of suppression of other acts in lab, ward, and dining room

Slight, occasional recovery during 25 sessions of low rate, then strong recovery when cue signalled absence of shock, also full recovery on ward after I20 days of a gradual decline

Yes. N o generalized suppression to home setting negatiiiely in absence of E , and to nonwith punished climbing punishing adult

Yes. No correlated decreases in destructive acts and wetting

N o data

Yes. No generalized suppression during meals and to nonpunishing E

Frequency and duration of food reinforced eye contact increased

Increase of affectionate and play behavior, plus decrease of tantrums and excessive motor behaviors

el

6

Frequency of food reinforced correct button pressing increased nonsystematically

L

M ._

4 (continued)

TABLE I (Continued) Performance variables Investigator(s), subject designation, and characteristics

Punished response. punishment schedule and length of session

Immediacy of suppression (number of shocks to eliminate behavior)

Permanency of suppression

Was response specificity obtained?

Was stimulus specificity obtained?

Nature of emotional and other “side effects”

Hamilton and Standahl (1969), Pat (CA = 24 yr. profoundly retarded)

Sterotyped screaming (growling), loo%, 15-min sessions extended to waking hours

High rate for Slight re8 sessions covery after with “medium” 4 sessions shock, low rate within 1st session with “strong” shock (shock freq. unspecified)

Yes. No correlated decreases in other vocalizations

Yes. No generalized suppression in ward and to nonpunishing E

No undesirable side effects noticed in lab or ward

Lovaas and Simmons (1969), John (CA = 8 yr,

Head banging, 100%. 5-10min sessions

0 rate with-

No. Correlated

Yes. No.generalized suppression in different setting and to nonpunishing E

Showed more “rambunctious” and exploratory behaviors

IQ=

24)

in 1st session (12 shocks over 30 sessions), replication of original effect in another setting

No recovery for more than 24 sessions

decreases in avoidance of adults and whining

*cl a t

h

No. Correlated decreases in avoidance of adults and whining

Yes. N o genNo additional data eralized suppression in different settings, generalized suppression to different Es via conditioned punisher

Strong recovery in presence of nonpunishing Es

No. Correlated decrease in whining

Yes. N o generalized suppression to nonpunishing Es

No additional data

N o data

N o data

Apparently so

Belief that aggression against children increased in ward

Linda (CA = 8 yr, I Q = 33)

Self-stimulation, loo%, 5-min sessions

0 rate within N o recovery for 31 ses1st session sions (4 shocks over 32 sessions), replication of original effect via conditioned punisher in another setting

Greg (CA = 8 yr, I Q = 24)

Self-destruction (unspecified), loo%, 2.5-min session

0 rate within 4 sessions but not sustained ( 1 5 shocks over 35 session)

Marilyn (CA = 16 yr, moderately retarded)

Self-rnutilation (hand banging, biting), data from one 2-hr session reported

0 rate half way into 1st session (5 shocks)

OlOO% refers to the delivery of shock for every response.

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gently during several sessions in which an imitative repertoire was being taught and maintained. Whereas noncontingent aversive stimulation at first served to restore a diminishing proportion of nonreinforced correct imitative responding back to the same high level that food reinforcement was able to engender, this “boostering” phenomenon at one point backfired and correct behavior greatly suffered under noncontingent stimulation. Undoubtedly, the interactive effects of reinforcement history and the intensity of noncontingent events deserve thorough examination. The subject who reports to the punishment setting usually comes equipped with a barrage of aberrant behaviors in addition to the one slated to receive shock. If punished and nonpunished performances belong to the same class of deviant responses, then some diminution of the nonpunished members should be expected to accompany cessation of the punished one. Response spec$city refers to the absence of generalized suppression wherein only the designated behavior is systematically inhibited by shock. The punishment studies are not consistent on this issue. Intuitively, repertoires topographically similar to the shocked response should enjoy maximal suppression, but this logic is unsupported by available data. Delivery of shock for low pitched, loud screams failed to change nonpunished vocalizations (Hamilton & Standahl, 1969), and, on the same note, punished climbing did not curtail nonpunished chair climbing; in fact, the latter response increased following alleviation of the former (Risley, 1968). If anything, it is the nature of the punished response which qualifies the extent of generalized suppression. Only punishment of self-injurious behavior by Lovaas and co-workers (Bucher & Lovaas, 1968; Lovaas & Simmons, 1969; Lovaas et al., 1965) has uniformly yielded a correlated decrement in physically compatible, nonpunished disruptive acts. Punishments of both laboratory-acquired and nonlaboratory-acquired improper behaviors have not always transferred their inhibitory features to other behaviors (Birnbrauer, 1968). Unfortunately, many findings which are related to response generalization have been rather arbitrarily stated and of an impressionistic type. Investigators would do well to collect systematic and reliable quantitative data on as many disturbing behaviors as possible, since the subject who displays generalized response suppression would then be spared of much needless pain. Then, too, the investigator would be freed from a heavy investment of time and manpower. A significant drawback of shock is the nontransferability of its effective inhibitory impact beyond the confines of the punishment setting

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and to individuals never-before dispensing shock. Most likely, stimulus specific results are obtained because the subject can differentiate the time and location of shock delivery. Bucher and Lovaas (1968) recommend the formation of a functional stimulus identity stemming from the laboratory to other settings where the disruptive behavior is likely to arise and be perpetuated. Implementation of this strategy has invariably involved authorization to use the shock prod by either the mother in the home (Risley, 1968) or by ward attendants in an institution (e.g., Birnbrauer, 1968). Hamilton and Standahl(l969) are quick to point out some undesirable by-products of this approach. Attendants may develop such defeatist attitudes as: “Shock is cheap, easy to apply and does the job well, so why bother to spend time learning other techniques that demand ingenuity and finesse.” From the socially minded public, denouncements and harassment are bound to mount as it learns of attendants armed with shock prods on a 24-hour vigil. Hamilton and Standahl endorse shock only with residents who inflict serious harm to themselves or others and whose violent behaviors do not permit experimentation with positive reinforcement. To the charge that punishment will work if the subject has alternative responses, one needs to consider the range of options a resident has in an institution guided by orders, exhortations, and the like. Is a retardate to be castigated for not obeying a command when he instead engages in a spontaneous alternative behavior which would otherwise be deemed appropriate? In a similar vein, Ferster (1967) has decried the application of such aversive stimuli as shock since its removal specifies a narrowly defined and arbitrary response repertoire and one which does not bear a direct physical or natural relationship to the aversive stimulus. In short, the use of shock often benefits the controller more than the controllee. Contrary to psychodynamic prophesy that recurring emotional side effects and behavioral disorganization will spring from severe aversive events, the research literature with retardates insists that this is not so. Pain-induced aggression (Ulrich & Azrin, 1962) has not been seen, nor has the adult who dispenses shock been actively avoided in the punishment setting. Quite the opposite. An increase in attentional, exploratory, and play behaviors has usually been noted. To be sure, the presentation of food and attention for these prosocial displays partly accounts for their continuance. Nevertheless, the reason for the occurrence of prosocial activity in the face of shock with subjects marked by a past history devoid of explicit social activity is difficult to formulate at this juncture.

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Paul Weisberg IV. SCHEDULES OF REINF OR C E ME N T

A.

Schedule, as Formal Rules

A schedule of reinforcement “is the rule that specifies when an operant response is to be reinforced [Blough 8c Millward, 1965, p. 631.” Such a rule may be explicitly stated in terms of the numerical order that reinforced responses bear to past nonreinforced responses (ratio schedules), or the temporal distance of reinforced responses with respect to a clock (temporal schedules) or to a nonreinforced response (differential reinforcement of low rate or DRL schedule). Separate rule statements are alternately called single or simple schedules, while a combination of rule statements are called complex schedules, any number of which are referenced in Honig (1966). Detailed performance characteristics of retardates and other individuals within the four classic, simple schedules can be found in several sources (Bijou 8c Baer, 1966, Spradlin 8c Girardeau, 1966), and these efforts will not be duplicated here. In general, better initial and long-lasting control is achieved with fixed ratio and variable ratio schedules than with fixed interval and variable interval ones. High and relatively uniform rates of responding are usually associated with the ratio regimes, with performance appearing to suffer (long interresponse pausing) under poor motivational conditions and occasionally when the size of the ratio is too high. With interval schedules, variable performance, both within and across sessions, has been found, especially with the fixed interval schedule. Not many data are available on the variable interval to generate steady state performance, but the nonuse of this schedule in free operant discrimination work with retardates (Bijou 8c Orlando, 1961; Bricker 8c Bricker, 1969; Orlando, 1965), where constant response rates in S+ components are highly desirable, suggests that the variable interval has not lived up to this assignment. Whereas the variable interval is ubiquitous in animal discrimination studies (e.g., Honig, 1966), ratio schedules have received favor with retardates, infants (Weisberg, 1969), and children (Long, 1962). Probably the simple schedule receiving the greatest scrutiny is the fixed interval, which is a story unto itself. Welldeveloped, fixed interval (FI) behavior in infrahumans reveals a “scalloped” pattern: a pause after reinforcement followed by a smooth positive acceleration persisting until the time of the next reinforcement. There are no a priori grounds for predicting this temporal pattern. Such a prediction could not be made on the basis of the schedule

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rule which simply states that the first response to occur after a fixed period since the last reinforcement will be reinforced. T h e schedule requires only one response per interval for the organism to earn the maximum number of programmed reinforcements. Nonetheless, scalloped FI patterns do develop with infrahumans and, because of the predominance of this form and its relevance for exploring temporal processes, investigators working with retardates and other human subjects have often been inspired to search for this “characteristic” FI performance. In general, two common patterns can be identified in the FI performance of retardates: low rates of responding with postreinforcement pausing (Spradlin, Girardeau, & Corte, 1965) and higher uniform rates without pausing (Ellis, Barnett, & Pryer, 1960; Orlando & Bijou, 1960). Similar descriptions of these two FI patterns have been reported with children (cf. Bijou & Baer, 1966) and adults (Weiner, 1969). (Although the low rate-pause pattern and scallops are not necessarily synonymous phenomena, they are often incorrectly described or implied as identical patterns. To properly examine curvature, one should utilize Gollub‘s (1964) quarter life index.) The factors which produce and sustain the divergent patterns are not readily understood. Studies differ widely in instructional procedures and the nature and extent of pre-FI reinforcement schedule histories, two conditions already shown to affect FI performance (Headrick, 1963; Lippman 8c Meyer, 1967; Weiner, 1969). A third factor capable of producing dual FI response patterns is the “cost” involved in FI responding (Weiner, 1962). In most FI studies, responses occurring between reinforcements are simply unrewarded, and, under these conditions, the two described FI response forms are discernible. However, when each FI response results in a penalty (e.g, a point loss from an accumulated total) and there are no special conditioning histories, low rate-pause behavior usually develops in human subjects. Weiner’s ( 1969) recent penetrating analysis of human FI performance has shown it to be a joint function of reinforcement history and cost conditions. Providing ratio schedule experience establishes high rate-no pause FI behavior which cannot be overcome by FI cost conditions. Thus the ratio schedule history persists during the FI. In contrast, a DRL history (one which produces low rate, spaced responding) generates the low rate-pause pattern during the FI and the likelihood of obtaining this pattern is increased by FI cost. When both DRL and ratio schedules precede the FI, low rate-pause behavior still occurs even though the DRL may be in the remote past of the organism.

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As far as is now known, the retardate’s FI behavior has not been analyzed in terms of response cost. It may be that “scalloped FI behavior occurs in natural settings which are governed by temporal events and where mild punishment or threat of punishment follows some responses (e.g., fixed interval body rocking may occur while a retardate waits in a cafeteria line that is supervised by a stern attendant). Weiner’s results also suggest that by appropriate manipulation of conditioning histories, a high degree of control of intersubject variability can be attained and that this control can persist despite intervening schedule histories. B.

Naturally Developing Schedules

By programming the availability of reinforcing events on punched tapes or similar storage systems, it is possible to specify precisely the temporal and response characteristics that dictate the delivery of reinforcers even before the subject steps foot into the laboratory. The “prepackaging” of reinforcers may also be done in natural settings by deliberately forewarning social agents when to dispense reinforcers and for what behaviors. There may be times, however, when one does not wish to state formal rules a p ~ o m and ’ look at the resulting behavioral development and stabilization. Instead, one may wish to “write” the schedule as it naturally evolves from the unique interactions which take place between responses and reinforcers in a specified environment. Bijou (1970) has called for the examination of reinforcement schedules in the natural ecology of the developing organism. An analysis of the frequency and interspacing of appetitive and social consequences with respect to several concurrent behaviors could be performed in the major living quarters of a number of individuals. Relationships among the dominant concurrent schedules and the growth, length, and decay of sustained sequences of behavior would provide useful and direct indexes of developmental comparison. The range and richness of the ensuing schedules of reinforcement are bound to be a function of ecological factors and the individual’s physical condition. Commenting on what characteristic schedules may be generated by different child rearing practices in the home setting, Bijou (1970) has provided several examples. A mother who keeps the child nearby as she works is likely to dispense social reinforcement on a small variable interval or ratio schedule. Location of the crib more distal from the work area, perhaps in a larger home, will probably provide reinforcement of the baby’s behavior on a larger variable interval or ratio schedule. These simple examples could be compounded at will and generalized to the institutional living settings of the retardate.

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Behaviors strongly suggested for long-term developmental analysis with retardates are head banging, stereotypic rocking, hand gesturing, and other rhythmic patterns for which the etiology has not been clearly established. It would be particularly relevant to choose young institutionalized individuals, not yet displaying these practices with any intensity or frequency, and chart their possible growth, change in topography and magnitude, and descent in concert with the set of reinforcement contingencies prevailing at each stage. The fact that some nonretarded infants and children also manifest these behaviors (e.g., body rocking and head banging), but at some point give them up, makes the discovery of the concurrent schedules of reinforcement associated with their decline an extremely important matter. V. DEPENDENT VARIABLES A.

Rate: The Primary Measure

Of all the attributes of behavior serviceable for the assessment of operant performance, frequency measures, either in the form of total number of responses or the ubiquitous conversion to rate of responding, have and continue to receive the greatest attention. The obsession with response frequency is not difficult to understand. Taking as their model the recording procedures provided by infrahuman operant studies of the 1950s, early investigators engaged in laboratory studies with the retardate (Ellis et al., 1960; Orlando & Bijou, 1960) found the recording of a response event against some time base a relatively simple affair to instrument, to monitor or plot on a cumulative record, to analyze, and one which was more than occasionally sensitive to experimental manipulation. After a decade of research it is time to take stock of response rate, to consider whether it has lived up to its earlier claims, and, whenever relevant, to suggest newer and different methods of behavioral evaluation. As in the case of response rate, the rationale and motivation behind the deployment of the newer forms of measurement are often dictated by those not directly involved in laboratory research with retardates. B.

Refinement of Rate

For one thing, response rate is a gross measure and, as such, it is apt to obscure subtle details about behavior. Skinner (1938) very early showed that the flow of behavior could be segmented into temporal intervals and counts could be taken both of the time between successive responses, known technically as interresponse times (IRTs), and in the

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case where a response followed a reinforcement of the time between the end of a reinforcing event and the emission of the first response. When there is an exclusive concentration of very short IRTs in a distribution which plots their occurrence, the overall response rate will be “high”; and, alternatively, when very long IRTs predominate, the rate will be “low.” Of course, not all I R T distributions will naturally assume one of these extreme shapes, although it is not hard to produce either one through the selective reinforcement of short or long IRTs. Since discrepancies in the shape of I R T distributions of different subjects will be the rule and the modal I R T will usually lie somewhere in the middle zone, a question immediately rises: Will overall response rate provide a convenient and useful measure to express the various shapes? This is really not a fair question, for overall response rate cannot be expected to describe the shape of the subdivisions upon which it is based; yet the question is intentionally asked to remind operant conditioners who work with retardates of the unitary and global character of their major dependent measure. Blough (1963) has presented some provocative pigeon data which suggest that two measurable components are buried in response rate, one possibly controlled by internal (proprioceptive) stimuli and the other by external stimulus sources. Short IRTs (from .3 to .5 second) were seemingly governed by respnse-dependent factors and were insensitive to exteroceptive stimulus changes, whereas longer IRTs were influenced by values along an external stimulus continuum. Although the limits of the I R T distribution that might pinpoint the source of stimulus control will no doubt vary from organism to organism and with the response requirements under examination, the utilization of I R T analysis for similar classification among retardates, nevertheless, seems a worthwhile venture. Following discrimination training, values on a stimulus dimension could be presented during generalization tests and separate gradients could be plotted based on the proportion of extremely “short,” “moderate,” or “long” IRTs. Steep I R T gradients around the reinforced stimulus would be indicative of exteroceptive stimulus control, whereas relatively flat gradients, presumably obtained with short IRTs, would signify lack of control by the manipulated stimulus dimension and possibly point to response-dependent or internal influences. Besides enabling one to disentangle sources of stimulus control, the I R T analysis has also been shown to be an increasingly important tool in animal research for assessing schedule changes, extinction effects, and temporal discrimination phenomena. Save for some few modest attempts (Locke & Strayer, 1970), analysis of behavior by I R T

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distributions or indexes which compensate for the greater number of opportunities for short IRTs (Anger, 1956), have not found their way into the evaluations of the retardate’s behavior. C.

Temporal Dimensions

Gilbert ( 1958) has presented a rather convincing argument for breaking down gross rate into more elemental units, in this case into temporal dimensions of latency (time between the opportunity for an operant and its first occurrence), tempo (slope of local rate detected on a cumulative record), perseveration (the proportion of time operants are in force), and duration (time between initiation of the first operant and completion of the last). When rat data relating response frequency to percent concentration of sucrose were separately plotted in terms of these four dimensions, each yielded a functional relationship remarkably different from the original frequency-concentration curve. Thus, we see again that total output (or overall rate) is far from representative of the various temporal dimensions of an operant, and, taken by itself, rate may give a one-sided picture of the effect of the experimental variable. As far as can be determined, systematic comparison of the four temporal dimensions has not been uniformly extended to any single set of retardate data although incidental contrast of intrasubject differences is frequently made with respect to tempo (Orlando & Bijou, 1960) and latency (Orlando, 1965). D.

Spatial Dimensions

The spatial dimensions of an operant have received formal, in-depth analysis. Morris (1968) reinforced the second lowest of four force requirements during the lever-pressing acquisition and reconditioning sessions of three retardates. Changes in force emission (intension, as defined by Gilbert 1958) above or below the reinforced requirement were also scrutinized during periods of extinction which varied in degree of stimulus similarity to the reinforcement conditions. In general, extinction relative to reinforcement sessions produced a shift in the response-force distribution toward more forceful responding, and the magnitude of the increment was greatest when the extinction and reinforcement settings were most dissimilar. Rate of responding was also recorded, and extinction rates varied inversely with changes in response force only when the stimuli in extinction were different from those presented during reinforcement. When nonreinforcement and reinforcement conditions had some common features, the extinction

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rates remained high and showed no sensitivity to the contingency manipulation, whereas predicted variations in response force were easily detected. Obviously, contentions positing the inability of certain retardates to discriminate changes in the reinforcement contingency had better question the nature and sensitivity of the dependent variable in use. Morris speculated that force emission is directly affected by contingency variables whereas the response rate measure is controlled by indirect, extraneous factors (viz., an instructional set). Another spatial dimension, measurable by the direction a movement takes with respect to a fixed reference source and appropriately designated as direction by Gilbert (1958), has been examined by Gates and Fixen (1968) with eight retarded teenagers. An eight response panel console was utilized, and despite the equalization of reinforcement probability on all panels, spatial location preferences or “directional sterotypes” developed during the continuous reinforcement (CRF) baseline sessions of four subjects. Retardates with strong preferences evidenced low overall response rates, whereas the median CRF rates of the four other subjects with low or no preference scores were conversely high. Moreover, this negative relationship between rate and preference appeared to be preserved and sometimes intensified when variable interval (VI) reinforcement, extinction, and noncontingent reinforcement were subsequently programmed. Closer scrutiny, however, suggests that the discovered relationship under these conditions may have been spurious and its generality limited. All three changes in the reinforcement contingency, but especially the last two, served to reduce the initial CRF response rate to low levels so that attempts to assess the factors which maintain preference while the overall behavioral level is simultaneously decelerating is bound to produce equivocation in interpretation. In fairness to Gates and Fixen, the rate-preference relationship was not of major interest to them, though their analysis of the higher preference scores during the VI schedule as due to an increased response differentiation implicates a test of the relationship with other intermittent schedules. Gates and Fixen assume that dominant response repertoires occurring during the CRF should receive additional contrast from less preferred repertoires because the VI permits both the opportunity for the partial extinction of all repertoires as well as the strengthening of the already dominant one. If dominant responses are becoming more dominant, then the nature of the relationship should be determined under ratio schedules which generate a high overall output, thereby surmounting the “basement effect” caused by the VI, extinction, and noncontingent conditions. The

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intermittent reinforcement feature of ratio schedules should, at least theoretically, allow the same response contrast phenomenon to develop as that proposed under the VI regime. Additionally the burst-pause pattern often seen with ratio-type performance permits one to assess Gates and Fixen’s observations that the CRF pattern of retardates with spatial preferences was one of an irregular single response on several manipulanda and occasional bursts on the dominant one, while nonpreference subjects distributed responses evenly across all manipulanda in a rapid and sequential manner. E.

Topography and Collateral Behavior

Primary focus on a discrete measure such as the frequency of an event often ignores or fails to uncover interesting patterns of continuous behaviors and unusual topographies not obtainable from counter readings. A variety of functional topographies have been detected by animal investigators interested in the nature of collateral activity correlated with temporal performances (Laties, Weiss, Clark, 8c Reynolds, 1965; Segal 8c Holloway, 1963), attentional processes (Blough, 1959). and changes in schedule requirements (Boren, 1953). These studies serve as excellent reminders of the kinds of intriguing behavioral interactions which can be discovered when we closely monitor the organism’s behavior in the experimental chamber. Obviously, we cannot nor should we survey all of the retardate’s behavior in an endless descriptive fashion; at some point in time, surveillance must become selective with the chosen class of behaviors quantified and subjected to experimental manipulation. Hollis’ (1968) study of the relationship between changes in a collateral behavior, namely sterotypic rocking, and a mechanically compatible but different activity nicely illustrates how the dynamics of behavioral covariation may be utilized with retardates. Unlike the animal observations mentioned above where the collateral behavior is discovered as it naturally develops in the operant setting, Hollis intentionally chose rocking because the single retarded subject studied freely rocked prior to the experiment. Additionally, when recorded as a single operant, a high and continuous rate of rocking developed under a fixed ratio schedule but noncontingent reinforcement failed to alter the rate. However, when rocking and another activity, ball-pulling, were recorded simultaneously and periods of fixed ratio reinforcement and extinction were programmed only for ball-pulling, collateral rocking became modifiable, its rate now decreasing and increasing in step with changes in the reinforcement con-

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tingency for ball-pulling. Rocking was also susceptible to extralaboratory manipulations: the high rate of collateral rocking during the extinction of ball-pulling virtually vanished following preexperimental administration of chlorpromazine but was unaffected following preadministration of seconal. Hollis’ work suggests that those primarily interested in the analysis of single operants also be on the lookout for the development of secondary collateral behaviors whose life may be dependent upon change in the primary recorded response. Should the collateral patterns contain elements of high incident socially undesirable ward behaviors, grounds for their study as multiple operants would be more than justified. F.

Rate: A Multicontrolled Measure

Consider the traditional operant paradigm. A stable response rate of desired magnitude is produced by some schedule during baseline, some aspect of the environment is added to or removed from the situation, baseline conditions are reinstated, and the rate is scrutinized for its susceptibility to the change. Very often the rate is found to vary with the experimental manipulation in an orderly and informative manner. Sometimes, however, the baseline rate departs drastically from the typical schedule pattern and a fixed, supposedly unalterable rate develops which precludes the assessment of the independent variable. The subject with this “locked rate” is either dropped from the experiment or the investigator (e.g., Orlando, 1965), seeking to confront this nemesis head on, turns to remedial procedures. The “locked rate” may establish itself when a particular momentary rate gains favor because the probability of reinforcement was high at one time; thereafter the rate is perpetuated as a superstition. Nonschedule variables may also contribute to stereotyped and unwanted patterns of behavior. Bijou and Baer (1 966) have cautioned the unsuspecting investigator to be aware of implanting preexperimental response sets through special instructions, nonverbal demonstrations, and the like. In this regard, Headrick (1963) has documented how the presence or absence of simple instructions can markedly affect the fixed interval performance of retardates. It is also possible that delivery of reinforcement and attendant conditioned reinforcing stimuli may serve as discriminative occasions for unique response sequences. Hollis (1968) found a resumption of high rate responding in a retardate during extinction when a free reinforcer was given and emphasized its stimulus function. Spradlin et al. (1966) directly tested this function and found retardates to differ widely in the effectiveness of reinforcing stimuli to evoke immediate responding

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when, in fact, reinforcement was given for nonresponding. Most assuredly, other nonschedule variables share or compete for the control of response rate and the anguish plus the befuddlement they have caused in the persistent attempts to isolate and remove them is, perhaps, more than one would care to admit. But the point to be made is that response rate is potentially controllable by a multitude of sources, many of which will be elusive and unrelated to deliberately manipulated schedule variables. T h e investigator wishing to analyze the rate of a freely repeatable response would do well to recognize this fact of life and not suppose that primary dependence on rate measures necessarily avoids the swell of confounding factors. VI. CONCLUDING REMARKS

There appears to be a shift of emphasis by many operant conditioners which, if not seen in actual research, is at least implied as a distant goal. T h e early preoccupation with the direct manipulation of the retardate’s behavior, as such, is giving way to an examination of those critical environmental events which will control his behavior in the long run. Since the development and stabilization of stimulus functions hinge upon the effectiveness of techniques which directly regulate behavior, the two approaches can never be mutually exclusive, and proof that behavior can be altered must necessarily precede the learning of stimulus events as discriminative stimuli and conditioned reinforcers. Punishment research, indeed, indicates the long-term removal of behavior by noxious events, but whether social stimuli associated with punishers will also assume this role is another question, the answer to which, in the case of the severely and profoundly retarded, does not seem to be affirmative. Durable behavioral control by stimuli associated with positive reinforcement contingencies is less easy to answer because of limited research on this score. Undoubtedly, getting certain retardates to give a modicum of consideration to the most pronounced social overtures of a person will represent a significant gain, while for other retardates, whose every behavior is predicated on the slightest attention given by social agents, the focus will be on gaining inhibitory control. The race to establish stimulus control on the basis of either positive or negative events need not be a race at all since there is increasing concensus that the two forms of control could complement each other. Increasingly, schedules of reinforcement are scrutinized less for their ability to generate a profusion of unique patterns of behavior in the retardate and are exploited more as necessary accompaniments for the

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development and assessment of stimulus functions and as control procedures. Perhaps the investigation of new parameters, such as response cost in combination with reinforcement history of the individual, will sustain the study of schedules as the laboratory stronghold. Finally, the laboratory-ward traffic should move in both directions at a greater pace. Schedules of reinforcement and other operant armaments should be applied with greater frequency toward the analysis and prevention of disturbing ward practices under controlled laboratory settings, and the retardate's natural ecology should be examined for possible development of many stimulus and response properties.

REFERENCES Anger, D. The dependence of interresponse times upon the relative reinforcement of different interresponse times. Journal ofExfierimenta1 Psychology, 1956.54, 145- 16 1. Baer, D. M. A case for the selective reinforcement of punishment. In C. Neuringer & J. L. Michael (Eds.), Behavim m d j i c a t w n in clinical psychology. New York: AppletonCentury-Crofts, 1970. Bailey, J., & Meyerson, L. Vibration as a reinforcer with a profoundly retarded child. Journal OJ'Applied Behavior Analysis, 1969, 4, 135- 137. Berlyne, D. E. Conflict, arousal, and curiosity. New York: McGraw-Hill, 1960. Bijou, S . W. Reinforcement history and socialization. In R. A. Hoppe & G. A. Milton (Eds.), Early experiences and the procmes of socialdullion. New York: Academic Press, 1970. Pp, 121-143. Bijou, S. W., & Baer, D. M. Operant procedures and child behavior and development. In W. K. Honig (Ed.), Operant behavior: Areas of'research and application. New York: Appleton-Century-Crofts, 1966. Pp. 7 18-789. Bijou, S . W., & Orlando, R. Rapid development of multiple schedule performances with retarded children. Journal of'the Exfierimental Analysis ofBehavior, 1961,4,7- 16. Bijou, S. W., & Sturges, T. P. Positive reinforcers for experimental studies with children -consumables and manipulatables. Child Development, 1959,30, 15 l- 170. Birnbrauer, J. S. Generalization of punishment effects-a case study. Journal o j Applied Behavior Analysis, 1968, 1, 20 1-2 I 1. Blough, D. S. Delayed matching in the pigeon.Jo.urnal of'the Experimental Analysis of Behavior, 1959, 2, 151-160. Blough, D. S . Interresponse time as a function of continuous variables: A new method and some data. Journal of the Experimental Analysis ojBehavior, 1963,6, 237-246. Blough, D. S., & Millward, R. B. Learning: Operant conditioning and verbal learning. Annual Review of Psychology, 1965.16.63-94. Boren, J. J. Response rate and resistance to extinction as functions of the fixed ratio. Unpublished doctoral dissertation, Columbia University, 1953. Bricker, W.B., & Bricker, D. Four operant procedures for establishing auditory stimulus control with low-functioning children. American Journal of Mental Deficiency, 1969, 73, 981-987.

Bucher, B., & Lovaas, 0.1. Use of aversive stimulation in behavior modification. In M.R. Jones (Ed.), Miami symposium on the prediction of behavior, 1967: Aversive stimulation. Coral Gables, Fla: University of Miami Press, 1968. Pp. 77-145.

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Dinsmoor, J . A. A quantitative comparison of the discriminative and reinforcing function of a stimulus. Journal oj’Kx~nvinirtito1f’syrhology, 1950, 40, 458-472. Ellis, R., Barnett, C. D., & Pryer, M. W. Operant behavior in mental defectives: Exploratory studies. Journal of the Experinkentd Anulysis $Behavior, 1960, 3 , 63-69. Ferster, C. B. Artibrary and natural reinforcement. Psyrhological Record, 1967, 17,34 1-347. Friedlander, B. Z. Development of selective play for audio reinforcement in a profoundly retarded blind infant. Paper presented at the meeting of the Midwestern Psychological Association, Chicago, May 1967. Friedlander, B. Z., McCarthy, J. J., & Soforenko, A. Z. Automated psychological evaluation with severely retarded institutionalized infants. Amrricnn Journnl n/ M a n h l rienry, 1967, 71, 909-919. Gardner, J . M., lk Selinger, S. Trends in learning research with the mentally retarded. Amrriruit , ] ~ J U ~oIj IMental U/ L)?firJicirnry, 1970, in press. Cardner, W. I. Use of punishment procedures with the severely retarded: A review. Amerirati Jouninl q/,fMenlalDeficiency, 1969, 74, 86- 103. Gates, J. J., & Fixen, D. L. Response variability in retarded children. Jounud oJ E x p r i mrnlal Child P.yc/iolog, 1968, 6. 306-320. Gilbert, T. F. Fundamental dimensional properties of the operant. f’syrhologicol KYIWUI, 1958,65, 272-282.

Gollub, L. R. T h e relations among measures of performance on fixed-interval schedules. Journul qjllrp Experimental Analysis ($Behavior, 1964, 7 , 337-343. Hamilton, J., & Standahl, J. Suppression of stereotyped screaming behavior in a profoundly retarded institutionalized female. Jouninl oJ Exjwrimpntal Child I’syr/tology, 1969,7, 114-121.

Hamilton, J., Stephens, B. A., & Allen, P. Controlling aggressive and destructive behavior in severely retarded institutionalized residents. Amrriran Jouriiul oJ’ Menlal Dpficirnry, 1967,71,852-856.

Hart, B. M.,Reynolds, N. J., Baer, D. M.,Brawley, E. R..& Harris, F. R. Effect of contingent and noncontingent social reinforcement on the cooperative play of a preschool child.Journul rfApplied Behavior Ancdysis, 1968, 1, 73-76. Headrick, M. W. Effects of instructions and initial reinforcement on fixed-interval behavior in retardates. American Journul oJ Mental Drfirieiicy, 1963, 68, 425-432. Hollis, J. Chlorpromazine: Direct measurement on differential behavioral effect. Scirncr, 1968,159, 1487-1489.

Honig, W. K. Operant behavior: Areus of researrh and application. New York: Appleton-Century-Crofts. 1966. Laties, V. G., Weiss, B., Clark, R. C., & Reynolds, M. D. Overt “mediating” behavior during temporally spaced responding. ,Journal ($thu Experimentul Ana!vsis (!/ Beharior, 1965,8, 107-1 16.

Leitenberg, H. Is time out from positive reinforcement an aversive event? A review. f’sycholog-ical Bullelin, 1965,64,428-44 I . Leuba, C., & Friedlander, B. 2. Effects of controlled audiovisual reinforcement on infant’s manipulative play in the home. Journul of~Exfterirnenta1Child I’.sychoIogy, 1968, 6, 87-99.

Lippman, L. G., & Meyer, M. E. Fixed-interval performance as related to instructions and to subject’s verbalizations of the contingency. I’sychotiomic Srietice, 1967, 8, 135- 136.

Lipsitt, L. P. Learning in the first year of life. In L. P. Lipsitt & C. C. Spiker (Eds.), Advances in chiM development and behavior. Vol. 1. New York: Academic Press, 1963. Pp. 147-195.

Locke, B. J., & Strayer, D. W. Experimental modification of vocalization rate among re-

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tarded participants in a three-person conversation. American Journal o j Mental Dejciency, 1970, in press. Long, E. R. Additional techniques for producing multiple schedule controi in children. Journal of the Experimental Analysis of Behavior, 1962,5,443-455. Lovaas, 0. I., Gilbert, F., Kinder, M. I., Rubenstein, B. D., Schaeffer, B., & Simmons, J. Q Establishment of social reinforcers in two schizophrenic children o n the basis of food. Journal ofExpetimental Child Pqchology, 1966,4, 109- 125. Lovaas, 0. I., Schaeffer, B., & Simmons, J. Q. Experimental studies in childhood schizophrenia: Building social behavior in autistic children by use of electric shock. Journal of Experimental Research in Personality, 1965,1,99-109. Lovaas, 0. I., & Simmons, J . Q Manipulation of self-destructive in three retarded children. Journal ofApplied Behavior Analysk, 1969,.2, 143- 157. Luckey, R. E., Watson, C. M.,& Musick, J. K. Aversive conditioning as a means of inhibiting vomiting and rumination. American Journal of Mental-Deficwncy, 1968, 7 3 , 139-142. Meyerson, L., Kerr, N., & Michael, J. L. Behavior modification in rehabilitation. In S. Bijou & D. Baer (Eds.), Child development: Headings in experimental analysis. New York: Appleton-Century-Crofts, 1967. Pp. 2 14-239. Morris, J. P. Changes in response force during acquisition and extinction in retarded children. AmericanJournal ofMenta1 Deficiency, 1968,73,384-390. Orlando, R. Shaping multiple schedule performances in retardates: Establishment of baselines by systematic and special procedures. Journal of Experimental Psychology, 1965,4, 135-1 53. Orlando, R., & Bijou, S. W. Single and multiple schedules of reinforcement in developmentally retarded children. Journal of Experimental Analysis oj' Behavior, 1960, 3, 339-348. Perloff, B., & Lovaas, 0. I. Effect of non-contingent aversive stimulation on learned behaviors in an autistic child. Unpublished manuscript, 1967. See B. Bucher, & 0. I. Lovaas, 1968, p. 105. Risley, T. R. The effects and side effects of punishing the autistic behaviors of a deviant child. Journal ofApplied Behavior Analysis, 1968, 1, 21-34. Schaefer, H. H. Self-injurious behavior: Shaping "head-banging'' in monkeys. Journal oJ Applied Behavior Analysis, 1970, 3, 1 1 1- 1 16. Segal, E. F., & Holloway, S. M. Timing behavior in rats with water drinking as a mediator. Science, 1963, 140, 888-889. Sheppard, W. C. Operant control of infant vocal and motor behavior. Journal OfExFrimental Child Psychology, 1969, 7 , 36-5 1. Sidman, M., & Stoddard, L. The effectiveness of fading in programming a simultaneous form discrimination for retarded children. Journal of the Experimental Analysis of Behavdor, 1967,10,3-15. Siegel, P. S. Incentive motivation in the mental retardate. In N.R. Ellis (Ed.), International review of research in mental retardation. Vol. 3. New York: Academic Press, 1968. Pp. 1-30. Skinner, B. F. The behavior oforganism. New York: Appleton-Century-Crofts, 1938. Spradlin, J. E., & Girardeau, F. L. The behavior of moderately and severely retarded persons. In N. R. Ellis (Ed.), In.kmarional review of research in mahl retardation. VO~.1. New York: Academic Press, 1966. Spradlin, J. E., Girardeau, F. L., & Corte, E. Fixed ratio and fixed interval behavior of severely and profoundly retarded subjects. Journal of Experimental Child Pgchology, 1965,4,340-353. Spradlin, J. E., Girardeau, F. L., & Hom, G. L. Stimulus properties of reinforcement

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Zirnmerman, J., & Hanford, P. V. Sustaining behavior with conditioned reinforcement as Re,bor/s, 1966, 19, 39 1-40 I . the only response-produced consequence. /-'.sy/ro/ogi:'c~iI Zimmerman, J . , lk Hanford, P. V. Differential eRects of extinction on behaviors maintained by concurrent schedules of primary and conditioned reinforcement. /'.\yr.lroI I O ~ Scirncu. ~ C 1967, 8, 105-104. Zimmerman, J.. Hanford, P. V., & Brown, W. Effects of conditioned reinforcemenl frequency in an intermittent free-feeding situation. Journal of'llic Exprrimrntnl Atra!v.~i.so/ & / t n 7 ~ h ' , 1967, 10, 33 1-340.

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Methodology of Psychopha,rmaeologica,l Studies with the Retarded’ ROBERT 1. SPRAGUE2 CHILDREN’S

RESEARCH CENTER, UNIVERSITY OF ILLINOIS, URBANA-CHAMPAIGN, ILLINOIS

AND

JOHN S. WERRY

INSTITUTE

FOR

JUVENILE

RESEARCH,

AND

UNIVERSITY

OF

ILLINOIS,

COLLEGE

OF

MEDICINE, CHICAGO, ILLINOIS

I. 11.

Introduction ..................................................... 148 Survey of the Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 A. Previous Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 B. Classifications of Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I5 1 151 C. Minimum Requirements for a Drug Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 D. Limitations of This Review . . . . . . . 155 E. Major Tranquilizers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..................... 162 F. Minor Tranquilizers ............. G. Stimulants ..................... . . . . . . . . . . . . . . 163 . . . . . . . . . . . . . . . . 167 H. Monoamine Oxidase Inhibitors . . . . . . . . . . . . . . 168 I. Miscellaneous ................................................ J. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I68

‘Preparation of this paper was supported in part by PHS Grant No. MH-07346 from the National Institute of Mental Health and by PHS Grant No. HD-03598 from the National Institute of Child Health and Human Development. Also, a research trailer was utilized to conduct some of the studies which was supplied by Grant No. OEG-3-6062063-1559 to Dr. Herbert C. Quay, who was director of the Children’s Research Center when the trailer was purchased. 2For all of our studies in which institutionalized retardates were the subject population, we thank Dr. William Sloan, Director, Division of Mental Retardation Services, State of Illinois; Dr. Louis Belinson, Superintendent, Lincoln State School, Lincoln, Illinois; Mr. William R. Chambers. Psychologist, Lincoln State School; and Mr. William Overton, Psychologist, Lincoln State School. For all of our studies in which emotionally disturbed, special education children were the subject population, we thank Mr. Eugene Rankin, Principal of Lincoln School, Urbana, Illinois; Mrs. Alice von Neumann, Social Worker; and Mrs. Miye Cohen, Research Associate; and the teachers of the Lincoln School Project. 147

R . L. S p a p andJ. S. Werry

148

....................................... .........................................

111. Methodology of Drug Studies

169 169 B. Design of Studies ............................................. 170 C. Measurement of Drug Effects ................................... 175 180 IV. A Brief Survey of Our Recent PsychopharmacologicalResearch A. Methylphenidate and Thioridazine Effects on Marble Dropping 180 B. Methylphenidate and Thioridazine Effects on Learning and Retention . 181 C. Methylphenidate and Thioridazine Effects on Stereotypy . . . . . . . . . . . . . 184 D. Effect of Methylphenidate and Thioridazine on Stereotypy and Nonstereotyped Operant Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184 E. Methylphenidate and Thioridazine Effects on Learning and Activity . . . 186 F. Methylphenidate Dosage Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 A. Ethical Considerations

........... ....... .

1. INTRODUCTION

“The first law of psychopharmacology might be formulated to state: The certainty with which convictions are held tends to vary inversely with the depth of knowledge on which they are based [Eisenberg, 1964, p. 1671.” Often it seems that the amount of scientific talent, time, and funds expended in areas of human endeavor is inversely proportional to their impact upon the welfare and progress of society, leaving glaring gaps in our knowledge. The area of psychopharmacology of the retarded is one of such gaps. For the past 30 years or more, psychologists have expended thousands of scientific man-hours attempting to develop methodologies and theories pertinent to animal behavior (usually the rat), presumably in the hope ultimately of extrapolating their findings to human behavior. Much of this methodology is quite sophisticated and useful, but it is strange that such methodologies have seldom been utilized in areas where there are obvious needs, such as the psychopharmacology of children. The dearth of soundly derived empirical information in the context of widespread use of psychotropic drugs presents a particularly serious situation for institutionalized retardates. In an excellent review, Lipman (1967) reports his questionnaire survey of all public institutions for the mentally retarded in the United States, concerning the administration of drugs to children in these institutions. Approximately 68% of the institutions returned usable data for his survey, the results of which survey were startling, to say the least. Lipman reported that “two of the sedative-type phenothiazines thioridazine (Mellaril) and chlorpromazine (Thorazine)-account for roughly 58% of all drug usage [pp. 2-31.’’ It is not uncommon to find a patient in an institution for the mentally retarded who is receiving a

-

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very high dose, such as 2000 mg/day for chlorpromazine or about 800 mg/day for thioridazine. In addition to these findings, Lipman also stated that those patients for whom medication was prescribed tended to be given heavy dosages of medication for long periods of timeabout “25% of patients typically receive these drugs for four or more years [p. 41.” Since practically nothing is known about the effects of these drugs on development in children, more particularly upon critical stages of development (Ross, 1959), this would seem to be a very serious problem indeed. In addition, it should be noted that these retarded patients are in an institutional environment of minimal meaningful stimulation which almost certainly restricts cognitive growth enough without whatever limitations might be added by chemical constraints. The extensive use of drugs for children, particularly exceptional children, is certainly not limited to institutions for the retarded. In another study Lipman (1 968) and Greenberg and Lipman (personal communication, 1969) reported that 91.2% of 157 pediatricians, child psychiatrists, and neurologists surveyed in the Washington, D.C., area were using psychotropic drugs with children whom they considered to be hyperactive. As we have pointed out previously (Werry, 1968a, 1968c; Werry & Sprague, 1970), hyperactivity is among the most common presenting complaints in children brought to some type of mental health facility for treatment. The above statements about prevalent use and lack of proven usefulness and of safety of drugs are disturbing in their implications but will be adequately documented throughout this chapter in a review of the psychopharmacology literature. II. SURVEY OF THE LITERATURE

A.

Previous Reviews

Currently, this nation is in the midst of profound changes in the use of drugs for behavioral effects, not only the use of hallucinogenic drugs which have attracted so much public attention but also in the use of prescribed drugs (Lasagna, 1969). The changes Lasagna describes involve expanding knowledge of diseases, which lead to processes permitting pharmacological attack, expanding knowledge of drug action, and increasing facilities for drug research, production, and distribution. T h e influence can be seen in the area of the mentally retarded. Recently, Freeman, whose previous outstanding review on the effects of drugs on learning is well known (Freeman, 1966), has written two ex-

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R . L. S f l a p and J . S . Werry

cellent chapters dealing with psychopharmacology of the mentally retarded. In the first entitled “Psychopharmacology and the Retarded Child” (Freeman, 1970a), he gives a thorough survey of the literature covering, particularly, clinical usage and medical aspects of psychotropic drugs with the retarded rather than methodological aspects of research studies discussed in this chapter. In a shorter, more succinct summation, Freeman (1970b) has briefly reviewed the literature on the psychopharmacology of the retarded and made clinical recommendations for drug use. Learning, which is an area of prime interest to those working with the retarded, has received some coverage from a psychopharmacological viewpoint. Two chapters on the effects of psychotropic drugs on the learning of children have appeared recently (Conners 8c Rothschild, 1968; Freeman, 1966). Because of the increasing interest in the area, the Psychopharmacology Research Branch of the National Institute of Mental Health has appointed a Task Force in Pediatric Psychopharmacology to set guidelines for future research in this area, and learning is one of the topics of interest. The behavioral effects of drugs have attracted scientific interest for a number of years. Important articles, from a historical sense, are those of Meyer (1922) and Darrow (1929) which set the pattern for some of the subsequent reviews by strongly emphasizing behavioral aspects of drugs. Other previous reviews of importance, although not dealing exclusively with exceptional children, or even children, are as follows: A recent book edited by Efron, Cole, Levine, and Wittenborn (1968) is an excellent reference text in this area; an earlier volume edited by Uhr and Miller (1960) is still quite useful, although some of its contents are now out of date since considerable advancements have been made in the last decade, A recent provocative article by Pauling (1968) is mentioned because it raises once more some basic questions about the nutritional and enzymatic aspects of mental health and mental retardation. In the past decade a number of reviews concerned with the psychopharmacology of children appeared. For convenience, the following listing is in alphabetical order. Eisenberg, one of the foremost authorities in this area, has summarized his experience and research in two interesting articles: one on the use of drugs in treating disturbed children (Eisenberg, 1964) and the other on the use of drugs in the management of hyperactive children (Eisenberg, 1966). Eveloff’s (1966) review is primarily aimed at psychiatricts, particularly child psychiatrists, and is rather incomplete. Fish, who is well known for her psychotropic drug work with emotionally disturbed children, has written a useful article on methodology (B. Fish, 1968). Two books have appeared: s.

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Fisher (1959) deals with the early research in the area and Freed (1962), in a most uncritical book, discusses the clinical and applied aspects of child psychopharmacology. Grant (1962), in one of the better earlier efforts, and Grossman (1966) produced general reviews about psychopharmacology of disturbed children, while Himwich ( 1965) and Kugelmass ( 1956) have addressed themselves to the use of the drugs for the medical practitioner. Lourie (1964) published an interesting review for pediatricians, while Lucas (1 966) wrote about psychopharmacology with a psychiatric viewpoint. In the area of the brain-damaged child, Millichap has two informative reviews (Millichap, 1968; Millichap & Fowler, 1967). Discussion of methodology has appeared in our earlier papers: Sprague and Werry ( 1 968) and Sprague, Werry, and Davis (1969a); however, some of our work has had a definite applied aspect: Werry (1967); Werry (1968a); Werry (1968~);and Werry, Sprague, Weiss, and Minde (1970). In addition to the two chapters by Freeman (1970a, 1970b) which deal exclusively with the mentally retarded, there have been other reviews relevant to general pediatric psychopharmacology. Craft (1959) gave a good review of the area to 1959, Copeland (1965) and Kugelmass (1956) covered psychotropic drugs in the retarded, and Mautner (1957) reviewed the relevant literature in the area of cerebral palsy which overlaps greatly with mental retardation. Two bibliographic listings of articles are available: those by Jones (1966) which are incomplete and occasionally inaccurate and by Lipman (1969) which is an exhaustive listing of articles in the area of psychopharmacology of the retarded. B.

Classification of Drugs

In order to make some sense out of the voluminous literature which cites large numbers of drugs using both proprietary and generic names, some type of classificatory system is necessary. A number of such systems have been proposed, but none is completely satisfactory. In this review, the essential elements of the classification scheme suggested by Berger (1960) and by Thompson and Schuster (1968) have been used along with those suggested by Freeman (1970a). The final authority for the proper generic name, spelling, and classification of a drug was the fine, comprehensive work of Usdin and Efron (1967). C.

Minimum Requirements for a Drug Study

Listed below are six criteria which we consider to be the minimum criteria for a valid scientific study of the behavioral effects of psycho-

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tropic drugs. Certainly, the six criteria of themselves do not ensure that a particular study is scientifically without fault, but it seems unlikely that progress could be made unless studies meet this minimum. More important than meeting the minimum requirements is the fruitful use of innovative, sophisticated designs with sensitive and valid measurements. This aspect will be discussed more thoroughly later in the chapter. 1. PLACEBO CONTROL

Until more valid, empirical evidence on at least a few standard drugs can be accumulated, it seems necessary to include a placebo condition in each drug study. If one wishes to estimate the placebo effects of a certain type of administration on a certain type of population, then it follows logically that a no-drug (ND) condition should also be used. Since the magnitude of the placebo effect is largely unknown, it would seem preferable to have both placebo and ND conditions. Other psychotropic drugs should be removed during the time of the experiment, for there is no logical way of ascertaining the behavioral effect of a given drug if its administration is confounded with that of other drugs. This obvious fact is often ignored, and seldom is information given about either continuation or discontinuation of other drugs.

2. RANDOM ASSIGNMENT OF SUBJECTS Assignment of the subjects to experimental conditions should not depend upon the hunches or other idiosyncratic procedures of a particular investigator for this may seriously bias the sample. If, as is true in many cases in this review, some type of matched-pair design is used, then the members of the pairs should be assigned at random to the conditions. If some type of crossover design (a common term in psychopharmacology that indicates a design in which each subject receives each experimental condition) is utilized, then the subjects should be randomly assigned to the sequences of treatment used in the experiment. Furthermore, random assignment is necessary to meet the minimum assumptions of the statistical tests which should be used to evaluate the findings. 3. DOUBLEBLIND(DB)

This term simply means that neither the subject taking the medication nor the person evaluating the subject’s behavior is aware of

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153

which is the placebo condition and which is the active medication condition. This procedure attempts to prevent the investigator’s expectations from influencing his assessment of the subject’s behavior, as well as the subject’s expectations.

4. STANDARDIZED DOSAGES Unless the dosage of a drug is standardized in some manner for some period of time, it is impossible to obtain any worthwhile information from the study about the effects of dosage. Since dosage is always assumed to be a very important variable, it seems absolutely necessary to use some kind of standardized dosage procedure. If each individual subject is given a different dose at different times throughout the experiment, it is impossible to evaluate dosage effects; nevertheless this seems to be the standard procedure in most studies. While a few investigators standardize their dosage on a mg/kg (milligram of drug per kilogram of body weight) basis, and such a technique would appear to be highly desirable, it is seldom followed and vigorously opposed by some investigators on the grounds that individual variation is so great. The solution to the controversy probably could be answered by dosage studies (see Section IV, F).

5. STANDARDIZED EVALUATIONS By the term “standardized evaluation,” it is meant that the measurement device has been used before and some empirical information on basic reliability (does the instrument give the same finding when repeated across testers and/or time) and validity (some independent evidence that the instrument is actually measuring what it purports to measure) is available. In addition, it is obvious that more rapidiadvance can be made if the measuring instrument is anchored in some good theory.

6. APPROPRIATE STATISTICAL ANALYSIS It is not sufficient simply to list percentage figures about the degree of improvement in a drug study. Such data are next to impossible to interpret operationally and are seldom subject to scientifically valid tests of replicability. The most acceptable manner of data evaluation is to use some kind of inferential statistical analysis. Mere use of statistics is, however, not sufficient, for they can be and are often grossly abused. An appropriate statistical analysis which does not violate the assumptions of the test used is necessary. Throughout the review the word

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"significant" refers to statistical significance, i.e., probability of occurring at or less than 5 times in 100 by chance alone. In Table V at the end of the chapter is listed in summary form the results of evaluating the studies reviewed herein in the light of the above criteria. Due to lack of space, there are several restrictions in the table. One, if sufficient information was not given in the study, it is assumed that the criterion was not met; e.g., if there is no information about whether the study was DB, it is assumed that it was not. Two, if the authors developed some type of rating scale and if there is no information about the reliability and/or validity of the scale, the symbol (?) is used to indicate no information is available. Three, only one or two psychological tests are mentioned if psychological tests were used in the evaluation, and the names of the tests are abbreviated. Four, unless otherwise noted, the dosages are oral and are per day. D.

Limitations of This Review

This survey of the literature is not exhaustive for several reasons. First, only studies published in English are cited in this review. Second, some studies were unobtainable, for example those published in highly limited circulation journals issued by a state mental hospital. Third, some very good papers have been presented at conventions but have not been published. Fourth, in a somewhat arbitrary fashion, certain areas related but peripheral to psychopharmacology have not been included. For example, though there is considerable research on the efJ fects of nutritional supplements, such as glutamic acid which has been adequately reviewed (Arbitman, 1952; Astin 8c Ross, 1960; Vogel, Broverman, & Draguns, 1966), this research has not been included. Likewise, though a vast body of literature dealing with the control of convulsive disorders in children exists, this literature has not been surveyed. The following review by its extensive criticisms of statistical analysis may seem implicitly to emphasize statistical evaluation as the most important of the six criteria. This is certainly not the intention. The aim is to counteract forcefully the notion abroad in the area of psychopharmacological research that mere statistical treatment alone sanctifies a study. Generic names of the drugs have been used throughout the chapter, but the trade name is included at the time the agent is first mentioned. This critical review will be divided into two parts for each drug: the first discusses the few studies which come close to meeting the minimum methodological requirements and the second section lists briefly the other studies.

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E. Major Tranquilizers

1.

PHENOTHIAZINES

a. Chlorpomuzine (Thorazine@). Chlorpromazine is the most thoroughly studied drug, at least in the mentally retarded, and it is also probably the most widely used (Lipman, 1967). Adamson, Nellis, Runge, Cleland, and Killian (1958) studied 40 mentally retarded patients. T w o drugs, chlorpromazine and reserpine and a combination of these two, were studied using a DB procedure. They developed their own behavior checklist on which the interjudge reliability coefficient varied from .75 to .85 for three judges. Their basic criterion was percentage improvement, but how this score was obtained is not defined. A x2 on the percentage improvement for the first 8 weeks of the study indicated a significant difference from baseline conditions for all groups including placebo. Their repeated use of the x2 on the same subjects violates the assumptions of independence (Lewis 8c Burke, 1949), and, thus, their results must be interpreted cautiously. In one of a series of his studies, Craft (1957a) investigated the effects of chlorpromazine on mental retardates. He selected 16 of the most difficult patients. The study utilized a placebo control and a standardized evaluation-a rating scale which he had previously developed. It is interesting to note that the placebo condition was an active placebo, namely sodium amytal, rather than an inert substance. A baseline was taken before either the placebo or drug was administered, then the drug conditions were reversed at midpoint. Analyses of variance were used to evaluate the data, and there was significantly less hyperactivity under chlorpromazine than placebo and more social behavior under chlorpromazine. Hunter and Stephenson (1963) divided their 18 subjects into two groups which received different orders of administration of chlorpromazine, trifluoperazine, placebo, and ND conditions. The ND condition always was first, and placebo was in the middle of each order. No information about DB procedures was given. They developed a rating scale containing 48 items arranged in four areas. The mean correlation over 40 pairs was .70. They apparently calculated 32 Wilcoxon T tests to evaluate the data, and such repeated use of a test on a set of data is not good statistical usage (Siegel, 1956). Both drugs were significantly better than the placebo condition but did not significantly differ from each other. Throughout this survey, it will be seen that often an intelligence test is used as a measure of drug effectiveness. In comparison with other

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measures of drug effectiveness,such as behavior rating scales, it will be seen that the intelligence test is seldom a sensitive measure. Ison (1957) used one of the Wechsler tests [either Weschler Adult Intelligence Scale (WAIS) or Wechsler Intelligence Scale for Children (WISC)] before and after the experiment; the tests were administered by students who were blind as to the drug conditions. The 64 subjects were “divided” into matched groups. Fourteen t tests were calculated, and two were significant. In the best of the series of studies on chlorpromazine, Wardell, Rubin, and Ross (1958) investigated the effects of the drug on 82 institutionalized retardates using a DB procedure in which the subjects were randomly assigned to four groups: chlorpromazine and its placebo; reserpine and its placebo. Six weeks of baseline data were taken before 3 months of drug administration, and 2 months after drug discontinuation a followup was given. The authors devised a rating scale in five areas, and the reliability correlation of 82 pairs of ratings was -85. They planned to use a three-way analysis of variance for Rating ( 5 ) by Drug (5) by Testings (3), but incomplete data prevented this analysis; consequently, they computed five analyses of variance. Bathing was significantly worse on posttest after chlorpromazine. They asked their ward attendants to guess the drug conditions. Combining their data, it was found that when the subject was on a drug, the attendants’ guesses were 61.6% accurate and for placebo 75.7% accurate. In a much different type of study, Hollis (1968) investigated the effects of chlorpromazine and secobarbital on the stereotyped rocking behavior of a single institutionalized female mental retardate. The subject was trained to pull a ball 100 times or rock 100 times for candy reinforcement (FR 100). The ball pulling developed into a very high rate response at 225 to 325 responses per minute, whereas rocking remained at the rate of 80 responses per minute. Although no statistical evaluation was undertaken on the single subject, it is quite apparent from figures presented in the article that chlorpromazine stopped the rocking but did not interfere with the ball-pulling response. A number of other less well-designed studies (see Table V) will be simply enumerated: Bair and Herold (1955); Bonafede (1955); Carter (1966); Charatan (1954); Davies (1954); Denhoff and Holden (1955); Durling, Esen, and Mautner (1956); Esen and Durling ( 1956); Garrison (1956); Horenstein (1 957); Ilem and Osterheld (1960); Johnston and Martin (1957); MacColl (1956); Moore (1960); Rettig (1955, 1956); Robb (1959, 1960); Rowley, Kaplitz, and Schwartz (1959); Rudy, Him-

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wich, and Rinaldi (1958b); Schiller (1959); Sprogis, Lezdins, White, Ming, Lanning, Drake, and Wyckoff ( 1957); Tarjan, Lowery, and Wright (1957); Ucer (1968); Weir, Kernohan, and MacKay (1968); and Wolfson (1957). b. Fluphenuzine (Prolixin@).There are five poorly controlled studies on the effects of fluphenazine: Arnold and Maginn (1967); Burness (1968); LaVeck and Buckley (1961); LaVeck, Cruz, and Simundson (1960); and Waites and Keele (1963). c. Mepazine (PacutuP). There are two studies, neither of which used any standardized evaluation but rather percentage improvement (Gillie, 1957; Rudy et d.,(1958b). d. Perphenuzine (Trilafon@).In a study which departs from the typical manner of evaluating psychopharmacological agents, Jaquith, Nail, Smith, and Taylor (1967) studied the number of months patients stayed out of the hospital after discharge as a function of using perphenazine (18 were mentally retarded). T h e data indicate a much higher percentage of return and a lower percentage of employment in the group that did not use the drug. Kaplitz (1966) and Sprogis, Babcock, and Segall (1958) reported the percentage of improvement with perphenazine. e. Prochlorperurine (Cornpurine@).In this critical review of the literature, it will be noted that certain investigators typically produce studies which are methodologically much sounder than the majority. Such a group is Rosenblum, Buoniconto, and Graham (1960) who investigated the effects of prochlorperazine in 36 institutionalized patients. The patients were randomly assigned to three groups: ND, placebo, and drug. A DB procedure was used throughout, and the patients were given a standard dose of 20 mg/day . Several standardized evaluation procedures were used, including the Gardner-Thompson Rating Scale. Unfortunately, they calculated 33 t tests to evaluate their data when an analysis of variance would have been the appropriate test. Four t tests were significant on the change scores: 2 for ND, 1 for placebo, and 1 for drug conditions. In an article which reports on investigations with a number of drugs, Craft ( 1959) evaluated prochlorperazine with 18 subjects. All of the 18 subjects received a number of different drugs according to a Latin Square design, all of the studies were DB, used placebo, had daily observation on a standardized rating scale, and used a fixed dosage. Although the test is not specified, the drug produced a significant reduction in activity. Mitchell, Hargis, McCarry, and Powers (1959) report the effects of this drug on 50 retardates in a study which involved pla-

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cebo, DB techniques, standardized evaluations, and statistical evaluation. There was no significant effect of the drug on I Q , rating scale, or academic achievement. Poorly controlled studies are those by Bowman and Blumberg (1958), Carter (1959), Pilkingtan (1959), Robb (1960), and Stearns and Sahhar (1959). f: Promazine (Sparhe@).Schulman and Clarinda (1964) used an objective measuring instrument, an actometer which is a modified selfwinding watch sensitive to movement, to measure the amount of activity of the wrist and ankle of six retardates. Placebo and DB conditions were used, and the placebo and drug were randomly assigned for 2-week periods. Fixed dosages of 40 mg, 80 mg, 120 mg, and 160 mg were administered for 2 weeks each. However, dosage and time are confounded in that dosage was given in an ascending order over time which means that practice effects, if any, cannot be separated from dosage effects. Sixteen t tests were calculated, 12 of which were one-tail tests. There was significantly lower activity measures obtained at night when the subjects were on the drug. Craft (1959) reported no significant effects (test not specified) of a daily dose of 600 mg of promazine with 18 retarded subjects. The methodologically weak studies in the area are those by Baird (1959); Benda (1958); Bergin and Bergin (1958); Esen and Durling (1957); Ilem and Osterheld (1960); Rudy et al. (1958b). g. Promethazine (Phenergan@).Craft ( 1959) used a crossover design with a placebo condition and DB procedures to investigate the influence of promethazine. The results were not statistically significant; the test was not specified. h. Properickine (Bayer 14099).In a study of 45 institutionalized retardates, Weir et d.(1968) reported no significant effect of the drug using 12 Wilcoxon tests on data obtained from the Hunter and Stephenson Scale in a study which was not DB. i. Thiorihzine (MellariP)). One of the best psychopharmacological studies with mentally retarded subjects, from the standpoint of methodology, is that by Alexandris and Lundell (1968), who investigated the effects of amphetamine and thioridazine. From an institution for the mentally retarded, they selected 2 1 patients and randomly assigned them to three different groups. One of the groups received amphetamine (dosage from 7.5 mg to 75 mg for individual subjects), another group received thioridazine (30 mg to 150 mg), and the third received placebo (9 to 30 capsules). A DB procedure was used. They developed their own rating scale, a 5-point rating scale of 14 items. Unfortunately,

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they give no reliability information about the scale, but they indicate that there was training of the observers which should increase interjudge reliability. Other standardized evaluations were the WISC, the Draw-A-Person Test, and the Bender-Gestalt. The data were in the form of change scores, apparently the difference between the pre- and posttest scores. Forty-two, one-tail t tests (14 for each drug condition) were calculated to evaluate the change scores. An analysis of variance of Drug (3) by Items (14) was found to be significant, and subsequent Duncan Range Tests were computed. In the review of the literature up to this point, they are the first authors to correctly analyze a multivariant design, although they did calculate repeated t tests which was not statistically legitimate and superfluous considering the appropriate analysis of variance. The Duncan Range Tests showed significant differences with thioridazine superior to amphetamine on concentration, aggressiveness, sociability, interpersonal relationships, comprehension, work interest, and work capacity with thioridazine superior to placebo on all the aforementioned items plus four others and with amphetamine superior to placebo on comprehension and work interest. There were no significant differences on psychological test change scores. Although the study did not use a DB procedure nor a random assignment of the subjects, Badham, Bardon, Reeves, and Young (1963) reported a study on the effects of thioridazine in 143 subjects. A rating assessment was developed, but no reliability information is given on the instrument. The results were cast into a table indicating percentage of improvement subdivided by male, female, and children. Three sign tests indicated significantly more of the subjects fell in the improved categories. Thioridazine and placebo were used in a crossover DB study conducted on 30 retardates by Allen, Shannon, and Rose (1963). A rating scale that was developed by Wardell et al. (1958) was used with some modifications. Of the five t tests computed, the one significant test indicated that girls were significantly worse than boys, and a significant x2 showed that the mildly retarded improved significantly more than the severely retarded. Ucer and Kreger (1969) studied 50 retardates in a study which had random assignment of subjects, DB conditions, evaluations based upon play interviews, and had both thioridazine and haloperidol administered. It was reported that there was significantly less (test not specified) reduction in severity in the thioridazine group on impulsiveness, anxiety, and aggressiveness. The other studies are those by Abdou (1967); Abbott, Blake, and Vincze (1965); Blue, Lytton, and Miller (1960); Leger (1966); LeVann (1961); Pregelj and Barkauskas (1967); and Ucer (1968).

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j . Tnjuoperatine (Stelatine@’). Beaudry and Gibson (1960) studied 32 emotionally disturbed children of whom 6 were retarded. Although they did not use random assignment nor a DB technique, good evaluations were used in the form of the Venables Scale with an interrater correlation of .79and a scale which the authors developed that produced an interrater correlation of .86 for 11 categories. To evaluate their data, they calculated 16 sign tests of which 10 were significant in favor of the drug condition. The Hunter and Stephenson (1963) study has been described previously in the discussion of chlorpromazine, and 11 of the 16 Wilcoxon Tests computed on the drug condition were significantly different from placebo. Sharpe ( 1962) investigated the effects of trifluoperazine on 30 subjects in a DB study with a placebo condition. The Claridge Excitability Rating Scale was utilized to evaluate behavioral changes. Of the four Wilcoxon Tests on change scores, one was significant for the drug group indicating improvement, and of the three Mann-Whitney U Tests computed to compare drug and placebo groups, two were significant in favor of the drug group. The other studies are by Fine (1964); Himwich, Costa, Rinaldi, and Rudy (1960); Lawlis (1958); LeVann (1959); Lowther (1960); Rettig, Caldwell, and Josephs (1958); Rudy, Himwich, Costa, and Rinaldi ( 1958a); and Vasconcellos ( 1960). k. Trijupromazine (Vespm’n@’).Only one poorly controlled study has been reported (Himwich et al. 1960). AKALOIDS 2. RAUWOLFIA Reserpine (SerjxzsiP). Reserpine was one of the first psychotropic drugs to be marketed. Scanning the dates of the studies in Table V, it can be seen that all of the studies were completed by the middle or late 1950s. There are several studies which come close to meeting the methodological minimum and will be described in some detail. The work by Adamson et al. (1958), which was discussed under chlorpromazine, indicated that reserpine improved behavior significantly more than placebo. Graham, Rosenblum, and Callahan ( 1958) studied 30 institutionalized retardates using DB procedures, placebo conditions, and standardized evaluations in the form of the Gardner Behavior Rating Scale, the Binet Q t e s t , the Children’s Manifest Anxiety Scale, and the Children’s Anxiety Pictures. Three different orders of drugs for 2 months each were utilized with one order receiving reserpine-reserpine, another receiving placebo-placebo, and another receiving reser-

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pine-placebo. Of the 50 analyses of variance computed, three were significant: two of these are difficult to interpret since they indicate differences between aggression at the end of 2 months on the two orders receiving reserpine for that period, while the second result shows a change of mood after the order was switched from drug to placebo. In another of their studies, Rosenblum, Callahan, Buoniconto, Graham, and Deatrick (1958) studied the effects of 1 mg of reserpine on 30 institutionalized retardates using the same design. Again, the pattern of results from the 50 analyses of variance was almost identical to those just described above. Wardell el al. (1958) studied the effects of reserpine and chlorpromazine (discussed previously). Only one significant difference was obtained in the five analyses of variance and that showed reserpine significantly improved toileting. Zimmerman and Burgemeister (1958) utilized a number of performance tests taken from I Q tests to study the effects of reserpine and methylphenidate. T h e methylphenidate group and the reserpine group were matched; DB conditions were not used. Although there was very little difference between the pre- and post-IQ, test scores, the data curves for number of seconds reduced from pre- to posttest on the timed performance subtests look very interesting, but, unfortunately, they calculated no statistical tests. It appears, solely from the data curves, that reserpine did not effect the time measure but methylphenidate did reduce the time required. The less well controlled studies are by Baird (1959); Carter (1956); Dice, Bagchi, and Waggoner (1955); Fischer (1956); Garrison (1956); Horenstein (1957); Jensen (1957); Johnston and Martin (1957); Kirk and Bauer ( 1 956); Noce, Williams, and Rapaport (1954); Pallister and Stevens (1957); Rudy et al. (1958b); Schiller (1959); Sprogis et al. (1957); Timberlake, Belmont, and Ogonik (1957); and Wolfson (1957). 3. BUTYROPHENONES

Haloperidol (HaloPoidol@).Burk and Menolascino ( 1968) studied 50 retardates in a DB, placebo control, and random assignment of subjects experiment in which they developed their own evaluation scale but presented no reliability data on it. The results were cast into a 5-category percent of improvement table, and a significant x2 was obtained on the differences between the drug and placebo groups with the drug group showing a greater number of subjects in the improved categories. Ucer and Kreger (1969), which has been previously discussed under thioridazine, reported that haloperidol significantly reduced impulsiveness, anxiety, and aggressiveness more than thioridazine.

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Kivalo and Amnell (1961) and LeVann (1969) are two weak studies of this drug. F.

Minor Tranquilizers

1. DIPHENYLMETHANE DERIVATIVES

a. Azacyclonal (FrenqueP). Azacyclonal was one of the six drugs used by Rudy et al. (1958b) in their study of 25 retardates. Although the DB procedure was not used, a type of crossover design was used in which all subjects were administered each of the six drugs in one sequence followed by 2 weeks of placebo after drug administration. There is no information on the form of evaluation given, and the data are reported in terms of percent improvement. The fewest patients improved under azacyclonal. Wright ( 1958) studied azacyclonal in 8 mental retardates, and in the author’s own terms, the data “was evaluated” by case histories which showed that 7 subjects benefited by the drug. b. Benactyrine (SuavitiP). Craft (1959) studied seven drugs using a Latin Square design for sequence of drug administration. No significant effects were noted using the Malamud Scale. c. Hydroxyzine (Atarm?. T h e effects of hydroxyzine was studied in 23 retardates by Craft (1957b). He developed his own rating scale and gives some details on how the scale was scored. Subjects received baseline conditions for 17 days then either placebo or drug for 30 days. Statistical analyses were used (the test was not specified), but no significant results were obtained. Segal and Tansley (1957) report percent improvement under the drug on a scale they developed. They asked teachers to guess the drug o r placebo condition, and they were correct in 26 of 30 guesses for 87% accuracy.

2. SUBSTITUTED PROPANEDIOLS Meprobamate (EquaniP, Miltown@).One methodologically sound study has been reported in the literature which investigated the efficacy of meprobamate in the mentally retarded. Craft (1958) studied 19 institutionalized retardates using the rating scale he developed for attendants in a DB study with a placebo condition in a crossover design. From the four analyses of variance, it was found that meprobamate significantly reduced male aggressiveness, significantly reduced hyperactivity, and significantly increased social behavior. Four other studies can be grouped together: Baird (1959); HeatonWard and Jancar ( 1958);Rudy et ul. ( 1958b); and Sterling (1960).

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3. MISCELLANEOUS a. Chlordiarepoxide (Libtiurn@'). LaVeck and Buckley (1961)reported on five drugs, one of them chlordiazepoxide. Twenty-eight mental retardates were divided into two groups, one of which was given the d r u g and the other placebo. T h e evaluation took the form of a checklist, about which there is no information, and a structured interview. There was no significant effect on behavior, but the authors failed to mention what statistical test was utilized. The other experiments are by Pilkington ( 1961) and Zrull, Westman, Arthur, and Bell (1963). b. Diazepam (Valium@).Engle (1966) studied 20 cerebral palsy children, some of whom were mentally retarded, using motion pictures of walking as the form of evaluation. The nonparametric sign test was misused as if it were a parametric test. Patients were categorized as very good (+), fair (0), etc. T h e author then simply counted the good (tt), number of PLUS signs for the sign test rather than correctly counting the number of patients in a category. Galambos ( 1965) also investigated the effects of diazepam. G.

Stimulants

1. AMPHETAMINE (BENZEDRINE@) The use of amphetamine as a psychotropic agent dates back to at least 1937 when Bradley (1937) reported his success with this drug on a group of emotionally disturbed children. Perhaps this longer history of use has had a beneficial effect upon the experimental methodology, for studies on this drug are notably superior. In a study which was described under thioridazine, Alexandris and Lundell (1968) studied 2 1 retardates using amphetamine, thioridazine, and placebo. After the significant analysis of variance, the Duncan Range Tests showed six significant differences (see review under thioridazine) between amphetamine and thioridazine and two differences between amphetamine and placebo. Craft ( 1959) reported no significant differences between placebo and amphetamine in 18 retardates. There are two other methodologically sound studies dealing with amphetamine that used other indices of behavior rather than the typical rating scale or IQtest. Lobb (1968), in a DB study with random assignment of the subjects and placebo controls, administered amphetamine on a 2 mg/lO kg ratio using classical conditioning of GSR

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(galvanic skin response) as the dependent measure. Quite a variety of significant effects was observed in this welldesigned, well-executed study. In summary, the effects shown in the appropriate analyses of variance are that the drug led to significantly slower acquisition and to significantly less retention, measured 24 hours after acquisition. These findings led the author to conclude that “taken together these properties of the data support the proposition that the drug interfered with learning [p. 2451.” Morris, MacGillivray, and Mathieson ( 1955) used two matched groups of retardates to study the effect of amphetamine and placebo. Dosage was systematically varied, but dosage level was confounded with sequence: 5 mg the first week, 10 mg the second week, 15 mg the third and fourth weeks. Besides the Binet I Q tests, several other measures were taken including paired associate learning, attention as measured by cancellation tests, memory as measured by ability to recall designs, and level of aspiration tests. In the 24 t tests which were calculated between the drug gain scores and the placebagain scores, only two were significant. The other studies are by Cutler, Little, and Strauss (1940); Molitch and Eccles (1937); Molitch and Sullivan (1937); and Moskowitz (1941).

2. &Amphetamine (Dexedrine@) As was the case with amphetamine, there are quite a number of methodologically sound studies of d-amphetamine with retarded subjects. Bell and Zubek (1961) reported the effects of d-amphetamine, deanol, an active placebo, and an inert placebo using the Fergus Falls Behavior Rating Sheets for attendants in a DB study. Of the 18 t tests which were apparently done, three showed that the amphetamine group gained significantly less than the placebo group on the three derived IQscores of the WISC. Berkson (1965) investigated the effects of d-amphetamine upon stereotyped rocking in four retarded men using a stereotypy scale which he had developed previously. A DB procedure in a crossover design with a placebo was used. Although the test was not specified, he reported that d-amphetamine had no significant effect. McConnell, Cromwell, Bialer, and Son (1964) in a placebo controlled crossover design studied the effect of d-amphetamine on the activity level of 57 institutionalized retardates. The DB procedure was used, and both ratings and objective measures (as taken by the ballistographic chair) of activity were obtained. There was no significant effects of the drugs on either measure. Sprague, Werry, and Scott ( 1 967) reported

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on the effects of 10 mg of d-amphetamine on the learning and activity of eight institutionalized retarded males. A two-choice discrimination learning task was utilized, and activity scores were taken with a stabilimetric cushion. The design was a crossover study which confounded drug administration with practice effects as has been previously pointed out (Conners & Rothschild, 1968). T h e drug was administered only on the third day after ND on the first day and placebo on the second. Although the analysis of variance for latency of responding indicated that the drug significantly reduced latency and the analysis of variance for activity indicated the drug significantly reduced activity, the significant findings cannot be interpreted unambiguously since they also could be attributed to practice. T h e remaining studies are by Anton and Greer (1969); C. H. Fish and Bowling ( 1962);and Zrull et al. ( 1963).

3. DEANOL (DEANER~) Deanol caught the attention of several investigators in the 1960s as a possible drug to increase intelligence in the mentally retarded. As reported above, Bell and Zubek (1961) found that of the 18 t tests computed deanol gains were significantly less than placebo on two derived IQscores. Clausen, Fineman, Henry, and Wohl (1960) studied deanol and placebo in a DB study using IQtests and a rating scale. There were no significant effects. Fleming and Orlando (1962) randomly assigned 32 mentally retarded subjects to deanol and placebo conditions in a DB study. Reaction time to a green light with an occasional orange light and buzzer as distractors was the task used to evaluate the drug. There was no significant difference between drug and placebo conditions. In an interesting study from a statistical standpoint, Jacobs (1965) studied the effects of deanol on 60 retardates. A DB procedure, placebo condition, and ND condition were incorporated into two sequences of drug administration to which subjects were randomly assigned, T h e author developed a rating scale of nine items. In evaluating the data, the experimenter calculated 384 t tests; 26 of them were significant at the .05 level which is about 6.7% of the total calculated. One would expect 5 % of the t tests to be significant on the basis of chance. T h e other studies are by Bostock and Schackleton (1961); Fields (1961); Huddleston, Staiger, Frye, Musgrave, and Stritch (1961); and LaVeck and Buckley (1961).

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166 4.

METHYLPHENIDATE (RITALIN@)

Levy, Jones, and Crowley (1957) studied 61 retardates. They randomly assigned the subjects to two groups, which consisted of different orders of placebo and 30 mg and 60 mg of the drug, in a study that used DB procedures and a rating scale, developed by the authors, on which they gave no information. The experimenters reported that the rating scales indicated the patients were significantly more alert under the drug condition, but they failed to indicate what test they utilized. Using five $'s, they reported that the drug significantly reduced activity in comparison with placebo during sleep. Zimmerman and Burgemeister (1958), as discussed under reserpine, presented data curves from which it appears that methylphenidate appreciably reduced the amount of time spent in performing motor tests. The remaining experiments are by Blue et al. (1960); Carter (1956); and Carter and Maley ( 1957). 5 . PENTYLENETETRAZOL (METRAZOL@)

From a group of 30 institutionalized retardates, half the subjects were randomly assigned to a drug condition and half to a placebo condition by Barnett and Lampert (1957), but DB conditions were not used. The WISC was given before and after the drug study. Apparently, the authors computed a total of nine t tests between pre- and posttest scores on the three derived scores on the WISC for the drug and placebo groups and for the difference scores between the groups. None of the tests was significant. Berman, Lazar, Noe, and Schiller (1957) is the second study which used pentylenetetrazol.

6. DIBENZAZEPINE a. Zmipamine (TofraniP). G. W. Fisher, Murray, Walley, and Kiloh (1963) investigated the effects of imipramine on 34 enuretic institutionalized retardates in a study which included placebo and DB procedures. The evaluation was in the form of an objective measure-the number of wet beds per night. Though the drug reduced the number of wet beds in comparison with placebo, this was not significant (test'was not specified). Drew (1967), as reported under amitriptyline, found\ no difference in amount of incontinence between imipramine and placebo. The other study was done by Pilkington (1962). 6. Nortriptylzne (hen$@). Using an intramuscular form of administration, Carter ( 1966) studied the effect of nortriptyline, pentobarbital,

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and chlorpromazine on 49 mental retardates. The subjects were assigned to the drug conditions by a Latin Square design, DB conditions were used, and more than one drug was administered which reduced the need for a placebo condition. The evaluation was whether the patient was quiet or asleep at various points after the administration of the drug. Using a Friedman two-way analysis of variance, he reported no significant effect of the d r u g E. H. Smith and Gonzalez (1967) investigated the effect of the drug on 34 retardates using DB conditions and placebo control in a crossover study. The evaluation was the number of wet beds; there were significant differences between drug and placebo groups. c. Amitriptyline ( E l a d @ ) .After 6 weeks of study with imipramine, Drew (1967) selected 16 patients and randomly assigned them to amitriptyline and imipramine groups. Although the test was not specified, no significant differences were reported on frequency of incontinence. H.

Monoamine Oxidase Inhibitors

1.

ISOCARBOXAZIDE (MARPLAN'@)

In a poorly controlled study, Carter ( 1 960) reported on the percent improvement of 116 retardates who were given isocarboxazide.

2. NIALAMIDE( N I A M I D E ~ ) Heaton-Ward (1962) used 5 1 mongoloids in a study which contained DB conditions, placebo control, and an evaluation which contained seven items that the author developed (no further information is available). This experimenter interpreted the requirements of the DB procedure quite literally and very rigidly in that he apparently kept his statistical consultant blind as to the nature of the experiment after the data were collected and were made available to the consultant. Such rigidity of some aspects of experimentation only betrays a lack of appreciation for the basic concepts of sound experimental design particularly in view of the fact that this experimenter planned to switch the drug and placebo conditions after 13 weeks, but the coded labels were switched, as planned, at the same time the drug and placebo tablets were incorrectly switched which kept the conditions, in fact, the same for the second 13 weeks. There were significant differences (test not specified) in favor of the drug after the second 13 weeks; however, the author suggests not drawing any conclusions from this finding. Davies (1961) and Pakszys (1967) conducted the other studies with this drug.

R . L. SFague and J . S . Werry I. Miscellaneous

1. CELASTRUS PANICULATA

In two studies of the Indian shrub Celastrus paniculata, Morris, MacGillivray, and Mathieson (1953, 1954) used matched drug and placebo groups and extensive psychological tests such as the Binet, Porteus Mazes, picture completion, and form boards. Of the 17 t tests computed on the change scores in each experiment, only two were significant; the drug showed a significant gain on mental arithmetic in the first study but placebo showed the gain on bead stringing in the second study.

2. CENTROPHENOXINE (LUCIDRIL~) Kirman (1961) studied the effects of this drug and placebo in a DB study which utilized ratings that the author developed. The data were classified into a dichotomous table (improved or not improved), and a significant x2 was obtained in favor of the drug.

3. Z-EPHEDRINE (EPHEDROSAN~) Mautner (1 955) conducted a poorly controlled experiment with this drug. 4.

COMBINATIONS OF DRUGS

Combinations of two drugs have been studied in four poorly controlled studies. Lindholm ( 1967) investigated the effects of hydroxyzine and promazine, Schiller ( 1959) studied chlorpromazine and reserpine, and Faretra ( 1964) and Ilem and Osterheld ( 1960) experimented with meprobamate and promazine. J.

Summary

It is quite clear from this review that very few empirically verified generalizations can be made about psychotropic drugs with the mentally retarded, yet it is just as clear that this series of methodologically weak, experimentally poor, and statistically inept studies have not provided a fair, sensitive measure of the behavioral effects of the drugs, effects which are routinely assumed to be present considering the widespread use of these prescribed drugs. In the face of this obvious dilemma, some tentative summary statements will be attempted. There is evidence to suggest that some of the major tranquilizers are quite beneficial in reducing the severe symptoms of disturbed retardates. In regard to the minor tranquilizers, the overall picture is so un-

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dear that it appears doubtful this class of drugs has any consistent therapeutic effect. T h e stimulants may have some beneficial effect on performance, but this tendency is by no means always present. T h e remaining classes of drugs (monoamine oxidase inhibitors, combinations, and miscellaneous) have failed to produce any clear therapeutic results. 111. METHODOLOGY OF DRUG STUDIES

A.

Ethical Considerations

From an ethical standpoint, there is less of a chasm between the clinical use of drugs and the research use of drugs than many people realize. Even in the clinical use of psychotropic drugs by a physician, there is some experimentation involved, for the physician usually is not completely certain as to what drug should be administered, its safety, and even less certain as to the dosage level. It is quite typical that the doctor will experiment somewhat with each individual patient to find the drug which seems to give the best results and to ascertain the proper dosage. The case can be made that research on psychotropic drugs simply involves the systematic investigation of some of these applied clinical problems with more than one subject at a time. Certainly, this case for the ethical use of human subjects in research with psychotropic drugs becomes even stronger if the experimenter uses something which approaches a single subject design enabling the investigator to give precise, scientific information about a particular drug at particular dosages for a particular patient (Chassan, 1960, 1961, 1967; Holtzman, 1963; Shapiro, 1966; Svenson & Chassan, 1967). With a single subject design, the line of demarcation between research and good clinical practice is completely blurred. Everyone is familiar with the rapid advances in medical treatment as important new drugs have been introduced (Lasagna, 1969). Since there are problems and dangers involved, the new drugs must be tested in a valid, scientific manner on limited populations of human subjects before they can be made available to the general market regardless of their therapeutic potential. For this reason, research is absolutely necessary. Research is also necessary because it is not uncommon to find new uses for old drugs. Iproniazid, the first effective antidepressant drug discovered, was introduced as a chemotherapeutic agent in the treatment of tuberculosis. An astute physician noted that it appeared to improve the mood of some patients. T h e discovery of the antipsychotic

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phenothiazines has a similar serendipidous history arising out of a search for better antihistamines. There has been considerable interest shown in the last few years concerning the ethics and legality of using human subjects in experiments. This has been reflected in the requirements of the Public Health Service in that the agency now demands Committees of Associates to evaluate the use of human subjects in any project which is funded by public monies appropriated by that agency. Professional associations have also become interested in the area as exemplified by a publication (Graubard, 1969) sponsored by the American Academy of Arts and Sciences. Beecher (1969) and Wolfensberger (1967a) have both reviewed the ethical and legal aspects of research with human subjects. In another article, Wolfensberger ( 1967b) reviews this issue for the institutionalized mentally retarded. T h e ethical and legal problems associated with psychopharmacological research with human subjects are a bit more complex. Cavers (1969) has written an excellent chapter broadly covering the legal aspects of drug investigations. He summarizes the regulations of the Federal Drug Administration in this area. Part of the problem is reflected in his estimate that about 300,000 people a year in this country are exposed to experimental drugs that will never develop into a New Drug Application for possible marketing subsequently. 8.

Design of Studies

1. TYPES OF DESIGNS AND THEIR MERITS As can be seen by this review, the design of the drug study is an extremely important factor in determining experimental outcome. Much has been written about design and strategy in the area of drug research (Greiner, 1959; Kety, 1959; Mandell, 1967; Mandell & Spooner, 1968). In a chapter reviewing psychopharmacology, Russell ( 1964) warned about very poor designs. He prefers a battery of tests on independent groups of subjects rather than repeated tests on the same subjects (crossover design). Hartlage (1965), in his review of chlorpromazine on learning, suggested that it was difficult to meet the statistical assumptions implicit in the crossover design. In his review of the design of drug studies, Nash (1960) suggested that the analysis of covariance is an appropriate procedure for removing sources of error that are uncontrolled. Both B. Fish (1968) and Lipman (1968) in their papers on method-

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ology of drug studies in children warn about the difficulty of using a crossover design. T h e emphasis on the disadvantages of the crossover design are in contrast to the recommendations for a crossover design by other authors (Chassan, 1960, 1961, 1967; Sprague et al., 1969a). Three very basic and simple designs will be discussed. T h e first is the simple randomized group design (Lindquist, 1953; Winer, 1962). In this design the subjects are assigned at random to the treatment conditions which means that there are independent groups of subjects for each treatment. Whether this design or the crossover design is used should depend upon the nature of the question under investigation as has been cogently explained by Grice (1966) in another context. For example, if one were investigating the effectiveness of a drug on etiological classifications, it would be necessary to use the independent group design, for it is obvious that a subject could not be more than one member of mutually exclusive diagnostic categories. Thus, even if one wanted to use the crossover design in this situation, it would not be logically possible. Another basic design used is the crossover design. In this design, each subject serves in every experimental drug control condition. T h e advantages of the design are (1) the between subjects variance, which is usually the largest source of variance in a study and not the error term (the quantity that is used as the divisor in the final equation to calculate the quotient which is an index of statistical significance); thus, the design should often prove a more sensitive measure of drug effects, (2) one does not need to worry about initial differences between the groups due to sampling, (3) the design requires a relatively small number of subjects, and (4) the design seems most appropriate for certain problems in the area of psychopharmacology, e . g , dosage studies. Utilization of the miniature experiment procedure developed by House and Zeaman (1963) which permits sophisticated manipulation of a number of variables gives the research worker a powerful tool for studying drug effects suitable for this kind of design. Although this design is less frequently used in psychopharmacological studies, nevertheless there are good examples of the appropriate use of this design which are given in the final section of this chapter. There are disadvantages to this design: (1) it assumes that there is no carry-over or unique sequence effects of drug administration; (2) it requires the subjects be tested on a number of different occasions which sometimes is logistically difficult; and (3) one often cannot give all possible treatments to the same set of subjects. Although the authors feel that the warnings about pharmacological carry-over effects violating the assumptions of

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this design have been overstated from the practical point of view in that sufficient washout times can be given to overcome this difficulty, nevertheless carry-over effects are sometimes observed (Lipman, 1968). At any rate, with the correct experimental design carry-over effects can be statistically evaluated. As Chassan (1967) and his colleagues (Bellak 8c Chassan, 1964) have forcefully indicated, it would be highly desirable to have available a research design which would utilize a very small number of subjects, even one subject, to investigate the effects of various drugs and/or various dosages. Chassan has argued for using time-series analysis with a single subjects design, but the authors believe that a variant of the crossover design can be appropriately utilized with a single subject. If one can safely assume that replications of experimental sessions or that blocks of trials within experimental sessions is a random variable, it is then possible to use the variance associated with this random variable as an appropriate error term for the drug effects or the subject by drug interaction. In more technical terms, the drug effect within a crossover design is the subject by treatment interaction (Winer, 1962). A technique to investigate the subject by treatment interaction (as suggested above) in a drug study is quite important because, theoretically, the subject by treatment interaction is due, primarily, to the individual difference factor which could probably be attributable to physiological and/or biochemical factors such as different uptake rates of the drug, different detoxification rates of the drug, etc. It is just such factors as these that should be investigated in relation to the behavioral effects of the drug in order to increase the precision of drug administration and to increase knowledge about drug use. 2.

DB PROCEDURES

The DB technique is considered very important in psychopharmacological research. “Almost all investigators regard the double-blind, placebo-controlled method as virtually a sine qua non of clinical drug research . . . [Glick & Margolis, 1962, p. 10871.” In a very interesting paper which deals with the methodology of studying antidepressant drugs, A. Smith, Traganza, and Harrison (1969) give strong empirical support for the use of DB condition^.^ They surveyed 918 studies which used antidepressant drugs. In Table I is listed the results of their thank Dr. Aaron Smith, Elizabeth Traganza, and Grace Harrison for permission tables.

to reproduce their

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TABLE I MEAN IMPROVEMENT RATES FOR STUDIESOF ANTIDEPRESSANT DRUGWITH DIFFERENT TYPES OF DESIGNS Controlled not blind

No control

Controlled and hlind

Basis for conclusions

YO

N

%

N

YO

N

Statistical tests Global judgments

57.2 71.7

6 208

59.3 66.4

8 98

63.0 60.2

24

70

ANALYSISOF VARIANCE O F IMPROVEMENT RATES

Source

DF

Basis for conclusions (B) Type design (T)

1

2 2 408

B X T

Error

MS

F

P

18.36 3 I .69 10.97 3.19

5.76 9.93 3.44

<.05 C.01

Table 34 which shows that the improvement rates are significantly influenced by DB conditions. In fact, they have data that indicate the type of design is more important than the type of drug used-see Table I1 which is taken from their Table 37. MEAN IMPROVEMENT

TABLE I 1 TYPES OF ANTIDEPRESSANT DRUGS

R A T E S FOR T W O

N o control

Controlled not blind

Controlled and blind

Type of drug

%

N

LTO

N

%

N

Monoamine oxidase inhibitors Tricyclic antidepressants

70.9 70.4

59 86

65.1 64.8

45 30

55.5 63.9

29 49

ANALYSIS OF VARIANCE OF IMPROVEMENT RATES Source

DF

Drug type (D) Type design (T) DXT Error

2 2 292

I

MS

F

P

4.24 26.77 4.3 I 3.23

1.31 8.29 I .33

<.0 1

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However, there is accumulating evidence that the DB condition can be broken by physicians and sensitive observers. In a pertinent article, Rickels, Lipman, Fisher, Park, and Uhlenhuth (1970) report that physicians are significantly better than chance at guessing when subjects are on drugs. Bufford (1968) wrote that psychiatrists were about 90% accurate in guessing a drug condition in a study by Werry, Weiss, Douglas, and Martin (1 966), which involved emotionally disturbed children. At several points in the review in this article, it was pointed out that sensitive observers can often be very accurate in guessing whether the mentally retarded child is on drug or placebo (Denhoff & Holden, 1955; Segal & Tansley, 1957; Wardell et al., 1958). Thus, it is apparent that the DB procedure influences the improvement rates that are obtained in an experimental study, but yet it is also obvious that physicians and observers can often break the DB code. Unless the experimenter moves into the area of highly automated data acquisition systems in which the human observer has much less influence, we feel that the DB condition should be maintained in drug studies even though observers can sometimes break the code. Nothing could be gained in experimental rigor by dropping DB conditions but something might be lost by dropping it. 3. DOSAGE A strange paradox exists in the drug literature on the topic of dosage effects. Every physician who uses psychotropic drugs and almost all researchers who investigate their effects in humans readily acknowledge that dosage is a very important variable, but not one study in the above review adequately manipulated dosage experimentally as a variable. Russell (1964) has admonished researchers on this topic, “Among the worst offenders was the experiment which studied the effects of only one dose level of a drug at only one time interval following its administration [pp. 94-95].” Two basic designs have been used with regard to the manipulation of dosage. In the first, the dose is individually adjusted for each subject; the largest percentage of the studies utilized this method. In the second, a fixed dosage is established, and everyone regardless of weight, age, or susceptibility to the drug is given the same dose. Occasionally, more than one dose level has been administered, but in every case it was confounded with some other variable which made interpretation impossible, e.g., a fixed dosage of several levels administered in an ascending order over time which completely confounded it with any practice effects which may have occurred (see Morris et al., 1955, under amphetamine). There is another serious ex-

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perimental error involved with individual adjusted dosage, besides the fact that it gives no reliable dosage information. Those researchers who use dosages which vary from subject to subject in an experiment are confounding dosage with between subject variance which is the appropriate error term for the randomized group design, a design which almost all researchers use. With such confounding, it is impossible to separate out after the experiment is finished the effects due to individual dosage and the effects due to random error between subjects. Moreover, if there is a dosage effect, such confounding probably inflates the error term and, thus, statistically makes the obtaining of significant drug effect less probable unless, of course, it is true that individual sensitivity is highly variable, a fact which remains to be determined. If dosage is an important variable as everyone agrees, then it should be systematically investigated. T h e experiment entitled “Methylphenidate Dosage Effects” in the last part of the chapter is a design which could be used to systematically study dosage effects. C.

Measurement of Drug Effects

1.

THEIQTESTIs INSENSITIVE

A brief survey of the data in Table V will quickly show that a number of experiments have used IQtests as the criterion but few have shown any significant results. More important, the very few well-controlled studies which have used IQtests as an index of drug effect have shown no significant effects (Alexandris & Lundell, 1968). T h e issue of psychotropic drug effects on the intelligence of mental retardates has been discussed before, and investigators have repeatedly warned about not searching for any “magic bullets” in the form of drugs that could miraculously cure the deficient intelligence of retardates (Louttit, 1965; Wolfensberger & Menolascino, 1968). Louttit commented, “. . . no clear benefit to the intellectual ability of the general population of mental defectives has been shown through the use of any chemical treatment [p. 4991.” In spite of the fact that the overall IQscore seems insensitive to drug effects, certain subtests within standard I Q tests appear to be quite sensitive to drugs. It should also be noted that the data curves of Zimmerman and Burgemeister (1958) based upon the reaction time measures taken from IQ subtests seem to show an effect of methylphenidate. Conners, Eisenberg, and Sharpe ( 1964) have shown a

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number of effects of methylphenidate on learning and Porteus Maze Tests in emotionally disturbed children. 2. RATINGSCALES It has been previously well documented that a reliable, sensitive rating scale for drug effects is not available for a population of children (Doty, 1968; Lipman, 1968). This survey of the literature documents this lack also for the mentally retarded. However, several investigators have developed rating scales for populations of retarded subjects and have given some reliability information on them, and these scales seem to be likely prospects for further refinement and investigation. The scales are: Patient Evaluation Form, a 5-point scale with 14 items (Alexandris & Lundell, 1968); Berkson Stereotypy Scale, an 8-item observation scale (Berkson, 1965; Berkson 8c Davenport, 1962); Craft Rating Scale, a 3-point scale of 5 items (Craft, 1957a); Stereotypy Rating Scale, 11 items for observation (Davis, Sprague, 8c Werry, 1969); HeatonWard Scale, 6 items (Heaton-Ward, 1962; Heaton-Ward & Jancar, 1958); Hunter and Stephenson Scale, 48 items in 4 areas (Hunter & Stephenson, 1963; Weir et al., 1968); Levy, Jones, and Crowley Scale, 22 items in 5 areas (Levy et al., 1957); Child Rating Scale, 10 items (McConnell et al., 1964); Wardell, Rubin, and Ross Scale, 5-point scale of 5 items (Wardell et al., 1958). Scales devised for other types of subjects have been used with some success to evaluate psychopharmacological effects in the retarded; Venables Short Scale for Rating Activity (Beaudry & Gibson, 1960); Fergus Falls Behavior Rating Sheets (Bell & Zubek, 1961); King Rating Scale (Clausen et al., 1960); Gardner-Thompson Rating Scale (Graham et al., 1958); and Claridge Excitability Rating Scale (McKenzie & Rosewell-Harris, 1966).

3. LEARNING MEASURES Because mental retardation is usually defined with some reference to slow learning or inadequate learning, it is surprising that there has been very little investigation of the effects of psychotropic agents upon learning in the mentally retarded. This lack of empirical evidence on the effects of drugs on learning is a more general problem, for Freeman (1966) clearly showed that there are very few sound studies on the effects of drugs on learning of children, although this is obviously a very important activity of children. In his general review on the effects of chlorpromazine on learning, Hartlage (1965) concluded

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that in spite of the number of experiments, there is such a paucity of methodologically sound studies that no generalizations could be made. T h e dearth of information for mentally retarded subjects is even more depressing, for there is less than a handful of adequate studies. As described under amphetamine, Lobb ( 1968) conducted a methodologically good study on the effects of this drug on GSR. In summary, his findings were that the drug slowed acquisition of the response and reduced the amount of retention. Although there are statistical inadequacies in their study, it is interesting to note that the only significant effect found by Morris et al. (1955) was improvement in the number of prompts needed on the visual paired association task under amphetamine. Other than the studies we have conducted, which are cited at the end of the chapter, this is the extent of the investigations of the effects of psychotropic drugs on learning in the mentally retarded.

4. DISSOCIATION OF LEARNING Dissociation of learning refers to the reduction of or failure to transfer a habit learned under a drug state to a nondrug state, or vice versa. This phenomenon has been adequately documented and replicated many times in animals (Overton, 1966, 1968). I n spite of the fact that this phenomenon is well known, it is again surprising that no one has investigated the phenomenon in children considering that children who take psychotropic drugs are usually actively engaged in some kind of school situation. Other than Lobb's (1968) finding that there was a reduction in retention when the GSR was conditioned under amphetamine, there has been no previous study of this phenomenon with retarded subjects. However, there is some pertinent literature dealing with children. Young and Turner (1965) studied enuresis in children using three treatment groups: conditioning with the buzzer-blanket, conditioning under d-amphetamine, and conditioning under methamphetamine. The two drug groups conditioned significantly faster than the blanket-buzzer group, but the relapse rate was significantly greater when conditioning was carried out under d-amphetamine. In a long term followup of the above study, Turner and Young (1966) sent questionnaires to the former patients quizzing them about their enuretic condition. T h e time elapsed since termination of the conditioning varied from 9 to 63 months for the three groups. Using a x2 test, the authors found significant differences between the relapse percentages of the three groups: conditioning alone 32%, conditioning under damphetamine 77%, and conditioning under methamphetamine 43%.

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R . L. Sprague and J. S. Werry

Kennedy and Sloop (1968) attempted to replicate Young and Turner’s data using 8 mentally retarded and 10 normal subjects. Unfortunately, they did not use any statistical evaluations but only presented a graph of the data. Although they state that methamphetamine did not lead to faster conditioning, it should be noted that 3 of the 3 mentally retarded subjects in the methamphetamine group conditioned but only 1 of the 5 mentally retarded subjects in the ND group conditioned. In view of the fact that dissociation has been so adequately shown in animals, it is amazing that the phenomenon has not been more substantially investigated with mentally retarded subjects, since learning and retention are extremely important factors in the treatment of the mentally retarded. Hopefully, this review will stimulate other investigators to think about these problems and conduct research in the area.

5. BEHAVIORMODIFICATIONAND DRUGINTERACTION A great barrier to communication exists between the physicians who prescribe psychotropic drugs for behavioral change with the mentally retarded and the people, primarily psychologists, who attempt to alter deviant behavior using behavior modification techniques. It is not uncommon to find physicians who are not conversant with behavior modification techniques, nor is it uncommon to find psychologists utilizing behavior modification procedures who are quite unaware of the therapeutic effects of drugs. Keeping in mind the significantly faster conditioning which Young and Turner (1965) reported as discussed above, we believe there is a great potential for interaction between these two techniques of treatment. It seems quite probable that psychopharmacological agents could reduce deviant behavior and set the stage for the beginning of operant conditioning (Davis et al., 1969). If drugs could make the organism more amenable to behavior modification, then they should be used (Bandura, 1969; Brady, 1968). If the two treatment techniques were to be combined, it is likely that both the therapeutic effects of drugs would be enhanced in the sense that the behavior change would probably be more permanent and the therapeutic effects of behavioral modification would probably be increased in the sense that acquisition could be hastened, but dissociation of learning may vitiate any advantage. Certainly, this interrelationship should be investigated. As we have previously indicated (Werry & Sprague, 1970), hyperactivity is the most common presenting complaint in regard to children’s deviant behavior, and it is one of the most common reasons that psy-

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chopharmacological agents are prescribed and also a common reason that behavior modification procedures are undertaken. Using a stabilimetric cushion to monitor activity with candy as reinforcement, Edelson and Sprague ( 1969) reported a significant analysis of variance which showed that seat activity of institutionalized retarded boys could be significantly increased or significantly decreased, depending upon the contingency of reinforcement, in a classroom-like situation. The question immediately arises as to whether the acquisition would even be more rapid if drugs were administered to reduce the initial hyperactivity of the subjects. This discussion of drug and behavior modification interaction brings u p the issue of the almost complete lack of theory in psychopharmacology (Russell, 1960). Commenting on this issue, Rosenblum ( 1962) stated, “What is missing from most experiments that involve the use of tranquilizers with children, and also adults for that matter, is a theoretical explanation of how or even where these drugs do what they are purported to do. The staunch advocate of tranquilizing medication is very much akin to the head of the house who fixes the family radio by shaking it vigorously [p. 65 11.” Experiments in psychopharmacology should be anchored in well-developed theory. Behavior modification would offer such theoretical anchoring for some psychopharmacological investigations. Theoretical anchoring could also be found in other learning theory and psychophysiological theory (Fehr 8c Sprague, 1969). It seems quite apparent that the most rapid progress would be made when studies are based upon theoretical formulations rather than a shotgun empirical approach. 6. SIDEEFFECTS

The problem of side effects was not discussed in the review of the literature, not because it was felt to be an unimportant problem but because it is felt that an empirical baseline of drug effectiveness based upon methodologically sound studies should be obtained against which side effects can be logically and sensibly evaluated. In other words, if a minor side effect, such as drowsiness, is noted, what are its implications if it is not known whether the drug producing that side effect, in fact, actually alters deviant behavior. In the absence of such empirical information, it is difficult or impossible to evaluate the importance of a minor side effect. Given that a psychotropic drug had a known, profound effect upon some deviant behavior, let us say hyperactivity, then it would seem that drowsiness might be tolerable in subjects who displayed severe hyperac-

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R . L. S p r a p and J. S. Werry

tivity. It might not be tolerated in subjects who displayed only mild amounts of overactivity. The same methodological issues raised in this chapter (particularly in the context of systematic dosage manipulations) can be applied to the investigation of side effects and should be applied to their assessment. IV. A BRIEF SURVEY OF OUR RECENT PSYCHOPHARMACOLOGICAL RESEARCH

The previous psychopharmacological research with the retarded has been critically reviewed. But criticism alone is not sufficient to alter research practice. Some models which avoid the earlier mistakes are needed. Hopefully, the following studies can serve as models for much improved research designs. In addition to the studies discussed herein, a list of our other studies related to drugs is Fehr and Sprague (1969); Sprague and Werry (1968); Sprague et ad. (1967, 1969); Weiss, Werry, Minde, Douglas, and Sykes (1968); Werry (1967, 1968a, 1968b, 196%); Werry and Sprague (1970); Werry et al. (1966, 1970); Werry, Weiss, Douglas, and Martin (1964); Werry, Weiss, Minde, Dogan, Guzman, and Hoy (1 969); and Werry and Wollersheim (1 967). A.

Methylphenidate and Thioridazine Effects on Marble Dropping

A student at the University of Illinois (Schickedanz, 1967) studied the effects of administering thioridazine (1.3 mg/kg) and methylphenidate (0.44 mg/kg) upon the well-known marble dropping task which is usually used to investigate social reinforcement effects. The subjects were 24 institutionalized mentally retarded boys who were randomly assigned to the drug treatments with DB conditions. During the experimental sessions, their activity was measured with a stabilimetric cushion (Sprague & Toppe, 1966). The number of marbles dropped per minute for 8 minutes was automatically recorded by the apparatus. A mixed (between and within subjects) analysis of variance was computed on the number of marbles dropped for the three drug groups, and it was found (F= 27.19, df = 2,336) that thioridazine significantly lowered the mean number of marbles dropped (29/minute) in comparison with the placebo (31/minute), and methylphenidate significantly increased (33/minute) performance in comparison with the placebo. The drug did not significantly alter seat activity, but this is, perhaps, not surprising since the subjects tended to lean their elbows on the marble dropping apparatus, thus stabilizing themselves while performing the task.

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

B.

181

Methylphenidate and Thioridazine Effects on Learning and Retention

Breitmeyer (1969),another student at the University of Illinois, decided to preclassify groups of institutionalized retarded boys on activity level, then enter these groups into an experiment on an activity level factor. Boys were brought into the laboratory for several weeks of pretraining. Two indices of activity were taken from two devices: the stabilimetric cushion and a motion transducer transmitter. This early model of the motion transducer transmitter was built similar to the device described by Stattelman and Cook (1966). Basically, this is a one-transistor circuit in which a capacitor modulates the oscillation of a transistor in a tank circuit. The capacitor is a plastic container about the size of a quarter with half-circle copper plates glued to the outside. It is half filled with oil, and as the child moves in space, the oil rotates around and changes the capacitance which modulates the oscillator. T h e FM signal from the motion transducer transmitter is broadcast to an FM radio where the signal is taken from the detector of the radio and fed into a DC amplifier. The output of the amplifier operates a recorder which produces an analog record of the movement of the child. The whole motion transducer transmitter weighs only a few ounces; in fact a supportive hockey helmet and transmitter totally weighs only 14 ounces. Not only does this device give a continuous record of the amount of movement of the child, but it also gives information about where the child’s head is located in space at any given time. For example, if the child’s chin is resting on his chest, a different record will be produced than if he is holding his head upright. Since this experiment, a more accurate, modified version of the transmitter has been developed. A total of 16 boys participated in this DB experiment. They were classified on the basis of both activity measures into a high activity group, a medium activity group, and a low activity group. A two-choice discrimination task was utilized with 10 trials per problem, 5 problems per day. From previous (Keely & Sprague, 1969) data, it was known that delayed reinforcement makes such a discrimination task much more difficult. Consequently, a delay of reinforcement was introduced to make the task difficulty level very near the 75% level of accuracy which is optimum for detecting any upward or downward change in accuracy level in a two-choice task. Actual delay was 2 seconds between the response and subsequent reinforcement with M8cM candy. The preclassification activity data and the data from the telemetry device obtained during the experiment proper agreed quite well as can be seen in Fig. 1, which shows that the high activity group produced many more head

R . L.Spague and J. S. Werry

182

High activitygmup -4 Medium activity group )--*-e Low activity group I

I

I

I

I

2

3

4

I 5

Blocks

FIG. 1 . Frequency of head movements during the experiment by groups according to preexperiment classifications.

movements as measured by the telemetry device than did the other groups. All the subjects received all 3 drug treatments (DB) which were placebo, methylphenidate (0.4 mg/kg), and thioridazine ( 1 . 1 mg/kg). T h e subjects learned the problem on one day under drug conditions and were subsequently tested 48 hours later under ND conditions. An Activity (3) by Day (2) by Drug (3) by Problem (5) analysis of variance for head movement showed significantly more movement (F= 10.06, df = 1,13) on retention days (53.2) than acquisition days (45.4). There was also a significant Activity by Problem interaction (F = 2.15, df = 8,52) with the high activity group moving more over blocks. To our surprise, an Activity (3) by Day (2) by Drug (3) by Problem (5) analysis of variance showed the high active group had significantly longer latencies (Fig. 2). To measure retention, the mean percentage correct on the last trial of the five problems was compared with the mean percentage correct 48 hours later on the first trial of the same problems. A Drug (3) by Day (2) analysis of variance (F= 13.98, df = 1,15) showed that the mean of the acquisition day was higher than the mean of the retention day (Fig. 3). T h e effect of Drug closely approached significance (F = 3.24, df = 2,30). Although the placebo condition appears to show less forgetting, the Drug by Day interaction was not significant ( F = 1.08, df

1.2

I .I

1.0

-

-2 0

.9

a c c

0 I

.8

.7

'-& ."........*. -.**

.6

,

. .... I

....

**

High activity group +--a Medium activity group e...-* Low octivity group U J

I

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2

3

4

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FIG. 2. Latency curves o f the activity groups. IOC

90 Methylphenidate

--f

80

L

0

'\

70

b

0

' '\

60

'\ '\

Thioridozine \

50

1

Acquisition

I Retention

FIG. 3. Percent correct on last trial of acquisition compared with first trial of retention for drug conditions.

184

R . L. Spague and J . S. Wewy

= 2,30);however, this is not a crucial test of dissociation since each of

the data points in Fig 3 represents the mean of only 15 binary choices. C.

Methylphenidate and Thioridazine Effects on Stereotypy

Davis (Davis et al., 1969),in a masters thesis, investigated the effects of drugs on stereotypy, i.e., the repetitive, often bizarre, movement pattern that one typically sees in the most severe wards of an institution for the retarded. Theoretically, the question is open as to whether retarded children engage in stereotypy because their arousal level is lowered by environmental deprivation and consequently they engage in self-initiated behavior to increase the level of stimulation, or alternately, because their arousal level is high, and the stereotypy in some way reduces arousal. The administration of methylphenidate (0.4 mg/kg) and thioridazine (1.3 mg/kg) in a DB fashion to nine retardates seemed to be one good way of approaching manipulation of arousal level. The subjects were randomly assigned to orders of the four drug conditions, including two drugs, placebo, and ND. The stereotypy scale of Berkson and Davenport (1962) was modified so that it would be suitable with profoundly and severely retarded patients. Two composite scores were formed from the various scales on the stereotypy ratings: total stereotypy which includes body rocking, complex hand movements, head movements, and self-manipulation; and total other behavior which includes helmet manipulation (the telemetry helmet was used), manipulation of the environment, and locomotion. In a Drug (4) by Time (2) by Block (4) analysis of variance, it was shown that thioridazine (F = 7.56, df= 3,24) significantly reduced the total stereotypy score but did not alter the total other behavior score. This is a very desirable result in that thioridazine reduces the stereotypy which one typically wishes to eliminate, but it does not interfere with other behavior, such as manipulation of the environment, which one might wish to increase. Another interpretation is that thioridazine reduces high probability behavior such as total stereotypy but does not alter low probability behavior. Whatever the interpretation, the empirical fact with implications for treating stereotypy remains as the important point of this experiment. D.

Effect of Methylphenidote and Thioridazine on Stereotypy and Nonrtereotyped Operant Behaviors

In another study of stereotypy, Davis (1970) studied the effects of methylphenidate (0.5 mg/kg) and thioridazine (1.4 mg/kg) on five severely retarded and five moderately retarded institutionalized boys in a

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

185

DB study. Their task consisted of obtaining candy reinforcement on an FR '15 schedule of reinforcement by bar pressing or rocking in the presence of discriminative lights in the bar and room. The telemetry helmet accurately monitored rocking (Fig. 4).

FIG. 4. Excerpt from actual telemetry record for S3 on Day 5 illustrating rocking and bar pressing segments.

R . L. Sprague and J . S . Werry

186

The subjects were randomly assigned to orders of drug conditions, and all the subjects received all the drug conditions. Pause time was the latency of the first correct response from the onset of the discriminative stimulus. In an IQ(2) by Drug (4) by Behavior (2) analysis of variance, the severely retarded have significantly longer latencies (F = 8.33, df = 1,8), bar latencies were significantly longer for the severely retarded (F = 4.13, df = 1,8), and methylphenidate significantly increased latencies for bar pressing (F= 3.49, df = 3,24) as can be seen in Fig. 5. E.

Methylphenidate a n d Thioridarine Effects o n Learning a n d Activity

Many of the methodological problems mentioned in this chapter associated with investigating the effects of drugs on learning appear to be

lot

1

0

Bar pressing

. 2

I

No

I

I

Placebo

drug

Thioridazine

1

Methylphenidote

Drugs

FIG.5. The effects of drug conditions on pause time for bar pressing and rocking in the two groups.

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

187

on the road to being solved in a paper based upon an undergraduate thesis (Barnes, 1968; Sprague, Barnes, & Werry, 1970) using a recognition task previously described by Sternberg (1966) and later used with the mentally retarded by Scott (197 1). T h e effects of drugs on learning and activity level were studied in 12 emotionally disturbed children from special education classes in the local community. Pictures of animals and other objects commonly seen in children’s books were presented as stimuli simultaneously. They were presented as a matrix of stimuli containing either 1, 2, or 3 pictures. T w o seconds of exposure were given for each stimulus, i.e., a I stimulus matrix was exposed for 2 seconds, 2 stimuli for 4 seconds, and 3 stimuli for 6 seconds. Then the projection screen was turned blank for 4 seconds after which a single test stimulus appeared. T h e child had a binary task; he pressed the “same” response panel if he thought the picture had been presented in the previous stimulus matrix o r pressed the “different” response panel if he thought the picture had not been presented in the prior matrix. Accuracy of responding, reaction time, and activity level on the stabilimetric cushion were recorded. The subjects were randomly assigned to all six orders of the three drug conditions (placebo, methylphenidate, thioridazine) which were given in a DB condition. High and low dosages were also administered: methylphenidate 0.25 mg/kg and 0.35 mg/kg; thioridazine 0.75 mg/kg and 1.00 mgikg. In a one-way analysis of variance for the six different orders, no significant sequence effect was found, neither was any practice effect found. The main results of the study are presented in Fig 6. I n an analysis of variance for Drug (3) by Dosage (2) by Number of stimuli (3) on the number of correct responses, it was found that methylphenidate significantly (F = 9.08, df = 2,22) increased accuracy of responding while at the same time thioridazine significantly decreased accuracy. In an analysis of variance for Drug (3) by Dosage (2) by Number (3) for latency, it was found that methylphenidate significantly (F = 29.14, df = 2,22)decreased latencies whereas thioridazine significantly increased latencies. The Number in the matrix had very similar effects as Drug had, i.e., the accuracy was the highest and the latency the lowest for one stimulus while the reverse was true for three stimuli. In an analysis of variance for Drug (3) by Dosage (2) by Number (3) for seat activity, it was shown that methylphenidate significantly ( F = 5.95, df = 2,22) reduced activity (Fig. 7). A classroom-observation scale which measures several categories of behavior pertinent to social behavior and academic performance has been refined by one of us (Werry & Quay, 1969). Fifteen minutes prior

R . L. Sprague and J . S. Werry

188 91

ij

t!

z

- Accuracy

90

-

89

-

88

-

87

-

86

-

Latency

- 2 24 -

---

2 20

2 16

- 2 12 -

-

-204

;

-208

x

- 2.00 $ z - I96 - I92 +.

0

85

-

84

-

z

83 82

-

81

--

I

I

-

/

- 1.88 -

1 I

Methyl-

- I84 I

I

Placebo

Thiori-

FIG. 6. Accuracy and latency curves for the three drug conditions. 24

20 22 2,

t -

B

18

5 E a

14 12 10

\

b E

.b-

&

n

g

16

8 -

Methylphenidate

Placebo

T hioridarine

FIG. 7. Seat activity as a function of drug condition.

189

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

TABLE 111 EFFECTS OF DRUGSON CLASSROOM BEHAVIOR I N PERCENTAGE OF OCCURRENCE DURING OBSERVED INTERVAL.^ Methylphenidate . I I and .I6 mg/lb

Placebo

Deviant behaviors No deviant Out of seat Physical contact Noise Turns Vocalization Isolations Other

68.9 9.0 0.6 4.3 5.3 17.7 1.1 6.0

59.4

Attention On task

Behavior

Teacher contact Teacher initiated Pupil initiated Pupil initiated -

+

+

Teacher’s observations Quality of day Times out No. Times out (minutes)

Thioridazine .35 and .45 mg/lb

F

P

(DF 2/’22)

I .2 8.0 4.3 21.7 8.0 9.7

59.3 11.7 2.4 7.7 4.7 22.0 3.1 15.0

I .82 1.12 2.14 2.22 0.16 1.18 4.43 3.01

NS NS NS NS NS NS .05 .I0

92.2

83.9

82.6

3.92

.05

56.9 14.0 1.8

43.3 7.0 3.3

39.6 9.0 4.3

3.73 3.76 3.00

.05 .05 .I0

4.00

3.46 I .8n 6.10

3.54 I .40 3.40

3.88 1.78 1.26

.05 NS NS

1.10

2.80

7.7

to the laboratory study of the children, they were observed by a member of our staff who was blind as to drug conditions in the classroom. The results of the observations are listed in Table 111, and in Table IV is given the Newman-Keuls Test of the significance of the difference for pairs of means of observations found significant in Table 111. Corroborating the laboratory findings of improved performance, methylphenidate significantly reduced Isolations (time out room), significantly increased attention on the Task, significantly increased the amount of both Teacher Initiated Positive Contact and Pupil Initiated Positive Contact, and significantly increased the Quality of the Day for that child as rated by the teacher (under blind conditions). F.

Methylphenidate Dosage Effects

Sprague, Werry, Greenwold, and Jones ( 1 969b) studied the effects of dosage (ND, placebo, 0.10 mg/kg, 0.20 mg/kg, 0.30 mg/kg, 0.40 mg/kg)

R . L.S w a p and J. S . Werry TABLE IV DIFFERENCES BETWEEN PAIRSOF MEANS Isolation Methylphenidate Methylphenidate Thioridazine

Thioridazine 2.0

Placebo 6.9" 4.9

On task Thioridazine Thioridazine Placebo

Placebo 1.3

Methylphenidate 9.6" 8.3"

Teacher initiated Thioridazine Thioridazine Placebo

Placebo 3.7 Pupil initiated

Placebo Placebo Thioridazine

+ Methylphenidate 17.3" 13.6

+

Thioridazine 2.0

Methylphenidate 7.0" 5.0

Quality of day Placebo Placebo Thioridazine

Thioridazine .O

Methylphenidate .5" .5"

"P < .05

of methylphenidate upon accuracy and latency on a task identical to the task described above. Sixteen emotionally disturbed children from special education classes received all drug conditions in a DB study. Subjects were randomly assigned to four orders of drug administration. An analysis of variance for Dosage (6) by Number (3) for accuracy showed a significant (F = 2.19, df = 5,75) effect of Dosage by Number interaction (Fig. 8). This interaction can be seen more clearly in Fig. 9 in which only the accuracy curve for three stimuli is significant (F = 3.20,df = 5,75) in analyses of variance for Dosage for each of the stimulus conditions. This last finding can be interpreted to mean that the task must be relatively difficult (three stimuli) before dosage effects can

191

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

92r

- 2.0

\ Latency

- 1.9

-t 0

ZI

- 1.8 2 c 0 c

- 1.7

No drug

-10

Placebo

20

mg/kg

mg/kg

.30 mg/kg

r"

.40 mg/kg

Dosage level

FIG. 8. Mean accuracy and latencies for the dosage levels.

be detected. None of the children showed side effects. The decrement in performance seen on accuracy (Fig. 8) may mean that behavioral toxicity (Cole, 1960) can be detected with a sensitive learning measure well before drug dosages are reached which will produce physiological side effects.

loot

?! L

E

z c

I Stimulus

90-

P,'\

/

85-

//

/

I"

\

/' \'

//

V'

\.

3 Stimuli

/

80

-

i I

1

I

I

1

1

Dosage level

FIG. 9. Mean accuracy for the three matrices of stimuli.

R . L. Sprague and J . S . Werry

192

TABLE V

SUMMARYOF PSYCHOPHARMACOLOGICAL Random assignment

Double blind

Drug

Date

N

Amphetamine (Benzedrine? 1, Alexandris and Lundell

I 968

21

Yes

Yes

Yes

2. Craft

1959

18

Yes

Yes

3. Cutler et a1.

I940

(?)

ND

Yes, Latin Square “Matched”

4.Lobb

1968 1937 1937 1955

160

1941

93 96 50 23

Yes Yes Yes Yes No

Yes No No No No

Yes Yes Yes No No

1969 1961

6 75

No,ND Yes

No “Matched’

No Yes

3. Berkson

I965

4

Yes

Yes

4.C. H. Fish and Bowling

1962

106

5. McConnel et al.

1964

57

Yes Yes

6. Sprague rt al.

1967

8

Yes

7. Zrull el al.

1963

16

Yes

Yes, crossover No Yes, crossover No, crossover No, crossover

Amitriptyline (Elavil? I . Drew

I967

16

No

Yes, crossover

Yes

Azacyclonal (Frenquel3 1. Rudy el al.

1958b

25

Yes

No, crossover No

No

5 . Molitch and Eccles 6. Molitch and Sullivan 7. Morris ut al. 8. Moskowitz d-Amphetamine (Dexedrine@’) 1. Anton and Greer 2. Bell and Zubek

Placebo

No

Yes Yes Yes Yes

2. Wright Benactyzine (Suavitil? 1. Craft

1958

8

No

No

1959

16

Yes

Yes, Latin Square

Yes

Celastrus paniculate I . Morris el al. 2. Morris et al.

1953 I954

32 56

Yes Yes

No, matched No, matched

No Yes

Centrophenoxine (Lucidril? 1. Kirman

1961

40

Yes

“Paired’

Yes

193

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

STUDIESWITH

THE

RETARDED Standardized evaluations

Dosage

Statistics and interpretations

7.5-75 n1g

Developed scale (?) WISC

30 mg

Malamud Scale

5-7.5 mg

10,20,30 mg I0 mg 5,10.15 mg Varied

Developed questionnaire (?) Binet Galvanic skin response Kent EGY, formboards Stanford Achievement Paired associates, Binet No

10 mg 10 mg

Urine samples for catechols Fergus Falls Scale, WAIS

F test, significant

10 mg/100 Ib, 15 mg/IO0 Ib

Berkson Scale

15 mg 7.5, 15 mg 10 mg

No Developed scale r = .86, activity Learning and activity

Test not specified, not significant YOImprovement Test not specified, not significant 3 F tests, 2 significant

10 mg

Developed checklist (?)WISC

70Improvement

100 nig

Incontinence

Test not specified, not significant

60- 1 'LO mg

No

% Improvement

120 nig

No

Case histories

Malamud

Test not specified, 3 significant

10-30 gm

Binet, Porteus Mazes, etc. Binet, Porteus Mazes, etc.

17 1 tests, 1 significant 17 I tests, I significant in favor of drug, 1 significant in favor of placebo

100-500 mg

Developed scale (?)

$Significant on % improvement

2 mg/kg

6-21 gm

42 one-tail t tests, F tests, significant F test Test not specified, not significant Summary data, some gains on form boards F tests, significant Change scores Gain scores 24 t tests, 2 significant Case histories

18 1 tests on gains, 3 significant

(Continued)

R . L. Sprague and J . S. Werry TABLE V Random assignment

Double blind

“Divided’ crossover No No, crossover

Yes

Yes

4 Matched, crossover

Yes

Date

N

Placebo

1961

28

Yes

1961 1963

21 16

No Yes

Chlorpromazine (Thorazine@) I . Adamson el al. 1958

40

Drug Chlordiazepoxide (Librium@) 1. LaVeck and Buckley 2. Pilkington 3. Zrull el al.

No Yes

2. Bair and Herold

1955

20

No, ND

No

No

3. Bonafede

1955

75

No

No

No

4. Carter

1966

49

Yes

Yes

5. Charatan

1954

3

No

Yes, Latin Square No

6. Craft

1957

16

Yes

Yes

7. DaviesD 8. Denhoff and Holden

1954 1955

32

No Yes

9. Durling el al.

I956 1956

No, crossover No Yes, crossover No No

No No

10. Esen and Durling

1 1. Garrison

10 14

25

No No

No

No Yes No No

1956 1968

25

12. Hollis

1

No No

13. Horenstein

I957

36

Yes

14. Hunter and Stephenson

1963

18

Yes

15. Ilem and Osterheld 16. Ison

1960 I957

12 64

No Yes

No Single subject crossover No, crossover Yes, crossover No “Matched”

17. Johnston and Martin 18. MacColl 19. Moore“

1957 1956 I960

87 53 90

No No Yes

Yes No Yes

No

20. Rettig 2 1. Rettig

1955 I956

27

No No, ND

No Yes

No

50

No No No

Yes

No No

NO

195

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

(Conlinued)

Standardized evaluations

Dosage

<50 Ib 30 mg >50 Ib 75 mg 40-60 mg 20 mg

Checklist (?) EEG

50 mg; chlorpromazine 25 mg and reserpine combination 75 mg

Developed checklist r =

No Developed checklist (?)

.75 to .85

CMMS

Varied 200-300 mg, some I.M.

No

25 mg 1.M.

Quiet and sleep

Varied 75-300 mg, 1.M. 50 mg Varied 50-800 mg

No

75-400 mg <5 yr 30 mg, >5 yr 60 mg

? Varied and increased 25- I00 mg Varied 10-550 mg 150 m g

Varied 50-75 mg, some 1.M. Varied 75-750 mg Varied 100-300 mg 100 mg

Statistics and interpretations

Test not specified, not significant % Improvement % Improvement

Inappropriate significant x2. significant Significant IQgain, test not specified 96 Improvement, increase in seizures as anticonvulsant reduced Friedman analysis, not significant Case history

Craft Rating Scale, 5 item (?) No Developed scale (?) Motor tests WISC WISC

F tests, significant % Improvement Significant improvement, test not specified Summary statement IQ-ain, case history

No Ball pulling, rocking

% Improvement Data curves

Developed scale (?)

% Improvement

Hunter & Stephenson Scale

32 Wilcoxon tests, sig-

r = .70 No WlSC or WAlS

% In~provement 14 I tests, 2 were

nificant change scores

significant Developed scale (?) No Binet, Haggarty-Olson? Wickman Behavior Rating Scale 25-50 m g I.M., 100-200 m g N o Varied 100-800 mg Number of seizures Varied 100-500 mg Varied 50-300 m g

% Improvement

5% Improvement Test not specified, significant loss

in achievement % Improvement

Significant change, test not specified (Continued)

R . L. Spragw and J. S. Wemy TABLE V Random assignment

Double blind

Date

N

22. Robb

1959

42

No

No

No

23. Robb 24. Rowley el al. 25. Rudy et al.

1960 1959 I958b

23 54 25

No No Yes

No No No

26. Schiller 27. Sprogis et al. 28. Tarjan et al. 29. Ucer

1959 1957 1957 1968

66 71 278 80

No No No No

No No No, crossover No "Divided' No No

30. Wardell et al.

1958

41

Yes

Yes

Yes

3 1. Weir et al.

1968

45

Yes

No, crossover

No

1957

63

No

No

No

1961

21

No

No

No

I967

10

Yes

No, crossover

No

1961

25

Yes

No

Yes

2. Bostock and Shackleton

1961

6

No

No

No

3. Clausen et ai.

1960

40

Yes

Yes

Yes

4. Fields 5 . Fleming and Orlando

1961 1962

41 32

No Yes

No Yes

No Yes

6. Huddleston et al. 7. Jacobs

1961 1965

120 60

Yes Yes, ND

No, matched Yes

No Yes

8. LaVeck and Buckley

1961

50

Yes

No

Yes

1966

Yes

No

Yes

1965

CP 20 42

No

No

No

I967 1968 1961 1960

8 9 48 48

No No Yes Yes

No No No No

No No Yes Yes

Drug

32. Wolfson Chlorprothixene (Taractan? 1. Pilkington Cypenamine 1. Kurland, Dorf, Michaux, and Goldberg Deanol (Deaner? I . Bell and Zubek

Diazepam (Valium? 1. Engle 2. Galambos Fluphenazine (Prolixin? 1. Arnold and Maginn 2. Burness" 3. LaVeck and Buckley 4. LaVeck el (11.

Placebo

No No No No

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

197

(Continued)

Standardized evaluations

Dosage

Statistics and interpretations

Varied male 150-300 mg, female 300-600 mg 300 mg Varied 30-800 mg 100 mg

No

Yo Improvement

No

% Improvement

No No

70Improvement YOImprovement

Varied 100-600 mg Varied 75-150 mg Varied 25-600 mg

No Developed scale (?) No Developed scale (?)

Varied 300-600 mg ?

Wardell, Rubin, & Ross Scale r = .85 Hunter & Stephenson

Yo Improvement % Improvement % Improvement 54 tests (t tests?), 25 significant 5 F tests, I significant

Varied 100-300 mg

No

12 Wilcoxon tests, 2 significant for drug effect % Improvement

30-60 mg

No

% Improvement

50-400 mg

No

U/o Improvement

100 mg

Fergus Falls Scale; WAlS

75 mg

Mother's Report on Behavior (?) Vigotsky WISC, EEG

18 t tests on gains: 2 significant % Improvement

75 mg 4 wk; 50 mg 4 wk 25-100 mg 75 mg 55 days; 150 mg 37 days I50 mg

3 got WISC or Binet

Reaction time

N o significant effects % Improvement N o significant difference

75 mg 55 days; 150 mg 37 days

Developed checklist (?)

4 F tests, I significant 384 1 tests, 6.7% significant N o effects

4-20 mg

No

Inappropriate sign test

2-105 mg

No

% Improvement

0.4- I .25 mg 1-2 ml weekly l.M. 0.5-30 mg 0.5-30 m "e

No No No No

Case histories Case histories % Improvement Yo Improvement (Continued)

?

Gates Reading test Developed scale (?)

R . L.Sprague and J. S. Werry

198

TABLE V Random assignment

Double blind

Drug

Date

N

5. Waites and Keele Haloperidol (Haldol? 1. Burk and Menolascino

1963

28

No

No

No

1968

50

Yes

Yes

Yes

2. Kivalo and Amnell 3. LeVann

1961 1969

40 54

No No

No No

No

4. Ucer and Kreger

1969

50

No

Yes

Yes

195713

23

Yes

No

Yes

Hydroxyzine (Atarax? I . Craft

Placebo

No

2. Segal and Tansley lmipramine (Tofranil? I . Drew

1957

32

Yes

No, matched

Yes

1967

28

Yes

Yes

Yes

2. G. W. Fisher et al.

1963

34

Yes

Yes

3. Pilkington Isocarboxazide (Marplan? 1. Carter 1-Ephedrine (Ephedrosan? 1. Mautner

1962

39

No

No, crossover No

1960

116

No

No

No

1955

86

No

No

No

Mepazine (Pacatal9 1. Gillie

1957

30

Yes

No, cross-

Yes

Yes

over No, crossover

No

No

No

No, crossover "Allocated" No, crossover No

Yes

?

? Yes

2. Rudy el al. Meprobamate (EquaniP, Miltown@) 1. Baird 2. Craft

1958b

25

1959

No CP 210 19 Yes

1958

3. Heaton-Ward and Jancar 1958 4. Rudy et al. 1958b

16 25

Yes Yes

5. Sterling

1960

CP5

Yes

1960 1969

60 16

Yes Yes

1956

49

No

Methylphenidate (Ritalin? 1. Blue ef a1.O 2. Breitmeyer 3. Carter

Yes, crossover No

No

Yes No

No

No

199

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

(Confinurrl)

Standardized evaluations

Dosage

Statistics and interpretations

0.5- 15 mg

No

VOImprovement

0.2-7.8 mg

Developed scale (?)

x2, significant on%

0.01-0.13 kg 2-12 mg

N0 No

% Improvement

0.75-5.75 mg

Developed scale (?)

Up to 500 mg

Craft Rating Scale

20 mg

Developed scale (?)

50, 100 mg

Incontinence

25-50 mg

Number wet beds

Up to 200 nig

No

‘Test not specified, not significant Test not specified, not significant % Improvement

10-30 mg

No

% Improvement

<5 yr. 25 mg >5 yr. 75 mg

No

Summary statements

< I2 yr. 36- I50 mg

NO

YOlmprovement

100- 10.50 mg

No

70 Improvement

400 mg

N0

o/o

800-4800 mg

Craft Rating Scale

4 F tests, 3 significant

400-600 nig 1200 mg

Developed questionnaire (?) No

Summary statement VOImprovement

100-600 mg

Motor tasks

Test not specified, not significant

? 0.4 mgikg

CTM M Learning, activity

Summary statement F tests, significant

10-30 mg

No

% Improvement

improvement Improvement, test n o t specified significant 6 unspecified tests, 4 significant o/o

Test not specified, not significant % Improvement

> 12 yr. 7.5-300 mg

Improvement

(Continued)

R . L. Sprague and J. S. Wemy TABLE V

Drug

Date

N

Placebo

4. Carter and Maley 5. Davis

I957 1970

130

10

No Yes

6. Davis el al.

1969

9

Yes

7. Fehr and Sprague

1969

8

Yes

8. Levy et ul.

1957

61

Yes

9. Schickedanz

1967

24

Yes

10. Sprague et a/.

I970

12

Yes

1 1. Sprague et al.

1969b

16

Yes

12. Zimmerman and Burgemeister Nialamide (Niamid@) 1. Davies

1958

108

No

1961

127

1962

Random assignment

Double blind

No Yes, crossover Yes, crossover

No Yes

Yes, crossover Yes

Yes

Yes

Yes

Yes, crossover Yes, crossover Yes, crossover “Matched”

Yes

No

No

51

Sometimes Yes

No

Yes

I967

16

No

No

No

1966

49

Yes

Yes

2. E. H. Smith and Gonzalez 1967

34

Yes

Yes, Latin Square “Divided” crossover

1957 1957

30 111

Yes No

Yes No

No No

1967

18

No

No

No

1966 1958

28 25

No No

No

No

No

No

1958 I959

52 82

No No

No No

No

2. Heaton-Ward

3. Pakszys Nortriptyline (Aventyl? 1. Carter

Pentylenetetrazol (Metrazol7 1. Barnett and Lampert 2. Berman et al. Perphenazine (TrilafonQ) 1. Jaquith et ul. 2. Kaplitz

3. Sprogis el al.

Prochlorperazine (Compazine? 1. Bowman and Blumberg 2. Carter

Yes Yes No

Yes

No

20 1

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

(Continued)

Standardized evaluations

Dosage

Statistics and interpretations

20-55 mg I.M. 0.5 mg/kg

No Learning, activity

Summary statement F tests, significant

0.4 mg/kg

F tests, significant

0.3 mg/kg

Berkson & Davenport modified r = .6 I to.88, activity Flicker fusion, GSR

30-60 mg

Developed scale (?)

5 inappropriate x2,5 sig-

0.44 mg/kg

Marble dropping

nificant, I significant not specified test I.' test, significant

0.25 mgikg, 0.35 mgikg

Learning, activity

F tests, significant

0.10,0.20,0.30,0.40 mg/

Learning, activity

F tests, significant

10-40 mg

WAlS

N o statistics, data curves

30-300 rng

No

76 Improvement

50 Nlg

Developed questionnaire (?)

Test not specified, significant differences which balance out % lmprovement

20 mg I.M.

Quiet and sleep

25 mg

Number of wet beds

Friedman analysis, not significant 8 Wilcoxon one-tail tests, 4 significant

200 mg 32-390 nig

WlSC Developed scale (?)

9 t tests, not significant Summary statement

Varied

Months since discharge. employment No Szondi Test, nurses' reports

Number of months

No

% Improvement

No

% Improvement

kg

I .5 mg/ k g

3-16 mg 8-36 mg

15- 100 mg 30- I50 mg

28 1 tests, 16 significant

% Improvement 70Improvement

(Continued)

R . L. Sprague andJ. S. Werry

202

TABLE V ~~

Drug

N

Date

Placebo

3. Craft

1959

18

Yes

4. Mitchell et 01.

1959

50

1959 I960 I960 1959

88 23 36 42

1959

5. Pilkington 6. Robb 7. Rosenblum et al. 8. Steams and Sahhar Promazine (Sparine3 I . Baird

Random assignment

Double blind

Yes

Yes, Latin Square Yes

Yes Yes

No No Yes, N D No

No No Yes No

No No Yes No

No

No

No Yes, crossover Yes, Latin Square No No No, crossover Yes

No Yes

2. Benda 3. Bergin and Bergin

I958 1958

CP No 210 76 No 34 Yes

4. Craft

1959

18

Yes

5 . Esen and Durling 6. llem and Osterheld 7. Rudy et al.

1957 1960 I958b

14 25

No No Yes

8. Schulman and Clarinda

1964

6

Yes

Promethazine (Phenergan? I . Craft

1959

18

Yes

Yes. Latin Square

Yes

Propericiazine (Bayer 14099 1. Weir et nl.

1968

45

Yes

No, crossover

No

1966

40

Yes

Yes

Yes

I958

40

Yes

Yes

2. Baird

1959

CP

3. Carter 4. Dice et al. 5. Fischer

1956 1955 1956

No 210 223 No 20 No,ND 22 Yes

No, crossover No

No No No, cross-

No Partial Yes

6. Garrison 7. Graham et al. 8. Horenstein

1956 1958 1957

25 30 36

No Yes Yes

9. Jensen

1957

97

No

Prothipendyl (Dominal? I. McKenzie and RoswellHarris Reserpine (Serpasil") 1. Adamson el al.

12

Yes No No No Yes

No

over

No Yes No, crossover No

No Yes No

No

203

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

(Continued) ~

Standardized evaluations

Dosage

Statistics and interpretations

150 mg

Malamud Scale

30-75 mg

VSMS, Arthur

37.5-75 mg 100 mg 20 nig 30-1.50 mg

Developed scale (?) No Gardner Scale, Columbia I Q Developed scale (?)

Test not specified, significant Test not specified, not significant % Improvement % Improvement 33 / tests, 4 significant Yo Improvement

50-400 mg

No

96 Improvement

150-600 mg < I2 yr. 75-300 mg > 12 yr, 150-600 mg 600 mg

No

% Improvement 70Improvement

2.5-400 mg 150-400 mg 450-2000 mg

WlSC No No

Test not specified, not significant % Improvement 70Improvement YO Improvement

For 2 wk each, 40, 80, 120, 160 rng

Actometer

16 1 tests, 2 significant

Up to 15 mg

Malamud Scale

Test not specified, not significant

Hunter & Stephenson Scale

I2 Wilcoxon tests, not significant for drug

80-I280 mg

Claridge Scale, DAP

x',

0.5 mg

Developed checklist (?)

6-16 mg

No

Inappropriate x', significant % Improvement

1-30 rng 1.5-2.5mg I.V. 75 mg

No WISC No

% Improvement Summary statement Yo Improvement

0.1-8 mg 1 mg 1-6 mg

No Gardner Scale, Binet Developed scale (?)

70Improvement 50 F tests, 3 significant % Improvement

0.3-8mg

No

% Improvement

NO

Malamud Scale

significant

2 04

R . L. S p a p e and J. S. Werry TABLE V

Drug

N

Date

Placebo

Random assignment

Double blind

10. Johnston and Martin 11. Kirk and Bauer 12. Noce et al. 13. Pallister and Stevens

1957 1956 1954 1957

87

No

60 13 300

Yes No Yes

14. Rosenblum ei al. 15. Rudy et al.

1958 1958b

30 25

Yes Yes

16. Schiller 17. sprogis el a[. 18. Timberlake et al.

1959 1957 1957

55 77 188

No Yes

1958 I957 1958

41

Yes

71

No

108

No No

Matched

Yes No No

1965 1967 1968

141 50 21

No No Yes

No No Yes

No No Yes

1963 1963 1960 1969

30

Yes

143

60 16

No Yes

Yes No ? Yes

1970

10

No No ? Yes, crossover Yes, cross-

19. Wardell el al. 20. Wolfson 21. Zimmerman and Burgemeister Thioridazine (MellariP) I . Abbott et al. 2. Abdou 3. Alexandris and Lundell 4. 5. 6. 7.

Allen et al. Badham et al. Blue et al? Breitmeyer

8. Davis

No

Yes

Yes

I969

9

Yes

10. Leger 11. LeVann 12. Pregelj and Barkauskas

1966

1961 1967

210 89

304

No With 12Ss No

13. Schickedanz

1967

24

Yes

14. Sprague et al.

1970

12

Yes

15. Ucer

1968

80

16. Ucer and Kreger

1969

1960

9. Davis et al.

Trifluoperazine (Stelazine? 1. Beaudry and Gibson

Yes Matched No Matched

No Yes No Yes

Yes No, crossover No “Divided No, crossover Yes

Yes No

over Yes, crossover

No No Yes

Yes Yes

No

Yes

No

No No By diagnosis Yes, crossover Yes, crossover No

50

No

Yes

Yes

6

No

No

No

No No

Yes No

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

205

(Continued)

Standardized evaluations

Statistics and interpretations

Developed scale (?) Developed scale (?), Binet No Developed scale (?), Binet Gardner Scale, Binet No

% Improvement % Improvement Summary statement 1Qnot significant, did not test rating data 50 F tests, 3 significant % Improvement

No Developed scale (?) Developed scale (?), Binet

% Improvement % Improvement % Improvement

Developed scale r = .85 No WAIS & other tests

5 F tests, 1 significant

30-150 mg

Developed scale (?) Developed scale (?) Developed scale (?) WISC

50-250 mg 50-400 mg ? 0.4 mg/kg

Wardell et al. Scale Developed scale (?) CTMM Learning, activity

% Improvement % Improvement 42 one-tail 1 tests, F test, significant x' significant, 6 t tests 3 sign tests, significant Summary statement F tests, significant

1.4 mg/kg

Learning, activity

F tests, significant

1.3 mg/kg

Berkson & Davenport modified r = .61 to .88, activity No

F tests, significant

Dosage 1-3 mg 0.5- I .5 mg 1 mg 0.1 mg

2-3 mg 0.5-1 mg 1 mg

4-6 mg 2-6 mg

Average 0.75 mg

50-300 mg

Varied

% Improvement N o statistics, data curves

50-800 mg 20-800 mg 10-800 mg

Developed scale (?)

1.3 mg/kg

Marble dropping

% Improvement % Improvement Test not specified, not significant F tests, significant

0.75 mg/kg and

Learning, activity

F tests, significant

25-800 mg

Developed scale (?)

54 tests (t tests?), 25

15-75 mg

Developed scale (?)

significant 6 unspecified tests, 4 significant

2-15 mg

Developed scale r = .82 Venables Scale

I6 sign tests, 10 significant

No

1.OO mg/kg

206

R . L. Spague and J . S. Wemy TABLE V

Date

N

2. Fine 3. Himwich et 01. 4. Hunter and Stephenson

1964 1960 1963

38 23

5 . Lawlis 6. LeVann 7. Lowther 8. Rettig el ~ l . 9. Sharpe

1958 1959 1960 1958 1962

24 33

Drug

Placebo

No No Yes

Random assignment

Double blind

57 11 30

No No No Yes

No No Yes, crossover No No No No Yes

No No No No Yes

1960

21

No

No

No

1960

23

No

No

No

Dixyrazine (Esucosq (H ydroxyzine & Promazine) 1. Lindholm

1967

35

Yes

No, crossover

Yes

Chlorpromazine & Reserpine 1. Schiller

1959

18

No

No

No

Meprobamate & Promazine 1. Faretra and Gozun 2. Ilem and Osterheld

1964 1960

49 12

No No

No No

No No

10. Vasconcellos Triflupromazine (VesprinS 1. Himwich et al.

18

No

No No No

COMBINATIONS

"In abstract form, some details missing

METHODOLOGY OF PSYCHOPHARMACOLOGICAL STUDIES

207

(Continued)

Standardized evahations

Dosage

Statistics and interpretations

15-60 mg, I.M. 2-4 mg 2 mg I.M., 1-3 mg 5-30 mg

No No Hunter & Stephenson Scale, r = .70 Developed scale (?) No No Developed scale (?) Claridge Scale

15,90,60 mg

No

% Improvement Yo Improvement 32 Wilcoxon tests, significant change scores % Improvement % Improvement % Improvement % Improvement 4 Wilcoxon tests, 3 U tests, significant % Improvement

200- 1200 mg

No

% Improvement

Average = 25 mg

No

% Improvement

Chlorpromazine 50800 mg Reserpine 2-8 mg

No

% Improvement

4- I2 capsules Meprobamate 200 mg Promazine 25 rng

No No

% Improvement % Improvement

4-80 mg 20- 120 mg

3-24 mg 1-15 nig

1-15 mg

R . L. Sprague and J. S . Werry

208 REFERENCES

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Process Variables in the Paired-Associate Learning of Retardates’ ALFRED A. BAUMEISTER UNIVERSITY OF

ALABAMA,

UNIVERSITY. ALABAMA

AND

GEORGE KELLAS UNIVERSITY OF KANSAS,

LAWRENCE,

KANSAS

1. Introduction . . . . . ............. .......... 11. Some Methodological Considerations . . . . . . . . . . . . . . . .

111. Constituent Analysis of Paired-Associate Learning ..................... -2%) A. Response Learning ........................................... . 2 3 1 8. Response Stage for Retardates and Normal Children ............... .233 C. Associative Learning Stage . . . . . . . . . . . . . . . . . . . . . ...... .237 IV. Acquisition Strategies and Stages of Learning . . . . . . . . . . . . . . . ..257 V. An Acquisition Strategy Model . . . . . . . . . . . . . . . . . . . . . . . . ,259 V1. Overview . . . . . . . . .................. . . . . . . . . . . . . . . . . .264 References ...............................................

1. INTRODUCTION

If one were to poll those working with mental retardates he undoubtedly would find that the inability to learn verbal materials is widely regarded as their most obvious and critical area of behavioral deficiency. Indeed, formal definitions of mental retardation almost always refer to “learning disabilities.” A general impression gained from the available ‘The first author’s research reported here was supported by PHS Grant HD 02588. The second author was supported by PHS Grant HD00870 of the Bureau of‘Child Research, the University of Kansas General Research Fund, the Biomedical Sciences Support Grant No. FR-07037. 22 1

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research literature indicates that retardate abilities are more depressed in verbal than in performance areas (Baumeister, 1967a). It is not surprising, therefore, that recently, considerable experimental effort has been directed toward gaining a better understanding of learning impairments, particularly with regard to verbal behaviors. Two major goals are implicit in this research: first, to develop a more definitive and valid conceptualization of retarded behavior and, second, to devise effective remedial educational procedures. AS a consequence, the psychometric tradition that has dominated the field of mental retardation for 50 years is being strongly challenged by the experimentalist working within broader behavior theory. Nevertheless, it is probably fair to characterize the experimental psychology of mental deficiency as conceptually, if not methodologically, primitive. Even granted the disjointed and incomplete nature of general behavior theories, the experimental analysis of retarded behavior suffers from a considerable conceptual gap. The problem is that an experimental psychology of mental retardation has grown along side, not within, current concepts of experimental and developmental psychology. Much of the learning research with mental retardates can be described as “deficit oriented.” That is to say, we have focused more on the dissimilarities of behaviors than on their commonalities. The typical experiment consists of a normal-retardate comparison involving the manipulation of some independent variable. If an interaction is observed, the experimenter is usually pleased because he has identified a variable which differentially affects the performance of his two intelligence level groups-a deficit has been found and, in turn, related to the operation of some task or experimental variable. A skeptic, perhaps, many wonder what artifact operated to produce such a result. Eventually this procedure supposedly will produce a complete list of deficits that describe the learning impairments of mentally retarded subjects. But what of the study which fails to turn u p an interaction? In such an instance, the two intelligence level groups are similarly affected by the operation of the independent variable. Again, considering what excites experimenters, this result would probably be regarded as a source of disappointment, for the two intelligence level groups have shown the same behavioral adjustment to environmental or task demands. For deficit hunters, little of theoretical significance is produced in the absence of a significant interaction. However, from the point of view of general behavior theory and, more particularly, developmental psychology, the absence of the inter-

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action demonstrates generality of function. In other words, the commonality of behavior indicates the presence of a basic law, a continuity of learning, that applies across different developmental levels. T h e attitude adopted here is that ultimately the identification of commonality of functions and the growth of these processes across developmental levels will be more productive for our understanding of developmental retardation than the consistent demonstration of discontinuities. T h e similarities appear to be more important than the differences. Many researchers and writers in the field of mental retardation evidently assume that a new psychology of learning will have to be written to account for the mental retardate. This assumption does not square with the data, fortunately. Most intelligence level group differences w e have observed are quantitative, not qualitative. The assumption made here is that whatever processes control the learning of mature, normal adults (i.e., the college sophomore) are also present in the behaviors of mental retardates, albeit sometimes in very rudimentary forms. This conceptualization places the problem of mental retardation squarely within the province of developmental rather than pathological psychology. Growth rather than deviancy becomes the focus of experimental concern. We advocate that researchers working within mental retardation should generate developmentally oriented hypothesis within a nomological system that anchors process variables to both independent and dependent variables. We assume that the processes that subserve the learning of normal adults represent the criteria1 level and, further, that these processes follow an orderly progression of development. Hypotheses concerning the learning of retarded individuals should be couched in developmental terms and derived from well-established functional relations among independent processes and dependent variables inferred from and observed in the behaviors of normal adults. At an intuitive and perhaps even an empirical level, the area of learning of greatest relevance to an understanding of developmental retardation is that subsummed under the rubric of verbal learning. As noted earlier, the ability to acquire verbal associations is one of the major identifying characteristics of intelligent behavior. Underwood ( 1964) has argued that verbal learning is central to all human learning. Of the various methods generally included within verbal learning, the one that has demonstrated the greatest analytical power is the paired-associate (PA) paradigm. The major advantage usually cited in favor of the paired-associate methodology is that the experimenter can specify the stimulus term with greater precision than he can when using any other verbal learning procedure. However, it should be

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added that this advantage probably is more apparent than real, for the functional stimulus may be quite different from that which the experimenter has nominally designated as the stimulus. For the purposes of a general research program as outlined above, the attractiveness of the paired-associate technique stems not so much from the operational precision of its stimulus term, but rather from the array of generic processes that can be functionally identified in the course of learning. An older conception of paired-associate learning, derived from a mechanistic kind of associationism, viewed the learner as a somewhat passive participant in a process by which single S-R connections were stamped into his memory, one at a time. Within this stereotyped model, presumably habits were acquired by contiguous presentation of the stimulus element and the response term, reinforced by feedback. Each presentation of the S-R pair added an increment of habit strength until the connection was brought above some threshold value. The association was then said to be ‘‘learned.” The major goal of verbal learning research was the functional specification of independent variables. Except for those S-R learning principles developed with simpler types of conditioning tasks, there was little concern with formulation of theoretical models that apply expressly to verbal learning. Not uncommonly, paired-associate learning was regarded as a “rote” process. Some contemporary theorists (e.g., Jensen, 1970) still hold such a view. Given this lingering conceptualization it is not remarkable that more “cognitive” oriented psychologists often have failed to attribute much significance to paired-associate learning, at least insofar as an understanding of higher order processes is concerned. Nevertheless, it has become clear that paired-associate learning involves much more than the mechanical “hook up” of stimuli and responses. The learner comes to the laboratory with a complex language system, a variety of learning strategies, and a potent motivational system, not to mention a certain distrust of the experimenter. The notion that the paired-associate learning task consists entirely of pure associationistic learning is antiquated. Moreover, the direction of contemporary research in paired-associate learning is changing from a functionalistic to a theoretical orientation. Phenomena which previously were ignored, because they were not readily amenable to S-R analysis, now often assume a prominent position within verbal learner’s concern. We have come to recognize that paired-associate learning has a complex, multiprocess character. No simplistic conceptualization of S-R conditioning is adequate to describe the phenomena which can be observed when subjects learn lists of verbal pairs.

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It is not the purpose here to offer a complete review of paired-associate learning studies with mental retardates. A fairly substantial literature has accumulated which involves normal retardate comparisons on verbal learning tasks. Current reviews of this literature are available (Goulet, 1968b; Lipman, 1963; Mordock, 1968; Prehm, 1968). Most verbal learning research conducted with retarded individuals has been derived from conceptualizations that are only tangentially related to verbal learning theory. Because much of this research is deficit oriented, the methodology is usually inadequate to allow tests of hypotheses originating within a developmental verbal learning framework. The focus of this chapter is primarily on certain process variables that are developmentally reflected in the learning of paired associates, including such factors as response learning, associative learning, backward learning, and stimulus selection. I t is our intention to deal with some of those process variables that have been reliably implicated in the verbal paired-associate learning of normal adults. Studies dealing with these processes in retardates and children are relatively few in number. In some areas it will be apparent that we have more hypotheses to suggest than data to report. II. SOME METHODOLOGICAL CONSIDERATIONS

Recently, considerable discussion has appeared in the literature concerning the selection of intelligence groups for study. One school of thought advocates comparing normal and retarded subjects matched on mental age (e.g, Zigler, 1969). Others have found that CA match more theoretically meaningful (e.g., Ellis, i 969). Some recommend a three-group design where both M A and CA matches are employed (e.g., Denny, 1964). And, to complete the array of possibilities, Baumeister (1967b) has questioned whether it is at all necessary to compare normal and retarded groups directly. The view generally taken, whether an M A and/or CA match is employed, seems to be that these variables have some explanatory function, at least insofar as a broad conceptualization of retarded behavior is concerned. After all, these variables do provide the major formal defining operation of mental retardation, the IQ. I t is not the purpose of the present discussion to reiterate the various conceptual and methodological arguments concerning matching procedures. The view taken here is that CA and MA measures simply provide a means of grouping subjects within gross levels of development. We regard the MA and CA as the basis for sampling and grouping subjects who have achieved a fairly homogeneous level of verbal development. These var-

A . A . Baumeister and G.Kellas iables merely provide a starting point for the purpose of examining the development of process functions in paired-associate learning. T h e variables of CA and MA are, according to our intuition and to considerable data, sufficiently correlated with rate of learning to warrant grouping subjects on the basis of either or both variables. We are concerned with the way in which people-some normal and mature, some normal and immature, and some mentally retardedlearn to associate verbal materials. Within any MA-CA category we can find sufficient inter- and intrasubject variability to occupy our experimental attention. The questions of whether to match and how to match are determined by the experimental issue, rather than by some compelling commitment to a matching strategy. Whenever intelligence groups are compared, whether matched on MA, CA, or both, a myriad of methodological problems are encountered (Baumeister, 1967b; Prehm, 1966). Many of these are task-related; that is, does the task provide equally meaningful measures for all groups of subjects? If it does not, we may have confounded our developmental variable with some other factor. Unfortunately, verbal learning experiments seem to be especially susceptible to task confounding. Differential ceiling and floor effects are common grievances, for the verbal material must be gauged to the ability level of the subject. The list of pairs that provides a sensitive measure of learning for retardates o r young subjects often will be too easy for older normals. One could employ lists composed of different items o r of different lengths for the various ability groups, but then lists are confounded with subject classification. On the other hand, it may be that these variables are confounded when identical lists are used across different developmental levels. For our purposes, it is not the stimuli per se that are important, but rather, certain characteristics that these stimuli possess, e . g , pronounciability, meaningfulness, or associative strength. Without data concerning these attributes, we cannot say with great confidence that a particular list of paired associates is comparable across different developmental levels. If, in turn, the materials are not comparable across developmental levels being compared, then performance may reflect the operation of different learning processes. This problem becomes particularly acute when the lists are varied in an effort to manipulate a variable that is directly dependent upon the verbal materials, e.g., pronounciability. Suppose, for example, that we wish to compare the PA learning of Japanese and American children as a function of conceptual similarity among the response terms of pairs of English words. N o doubt we would observe an interaction. T h e

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American children would find one list easier than the other. As far as the Japanese children are concerned, however, both lists are functionally nonsense materials and performance would be comparable under the two conditions. T h e point is that the independent variable was effectively varied to a greater extent for one group than another. A meaningful comparison of learning processes was not possible under these conditions. A more reasonable procedure, of course, would have been to administer lists of equivalent Japanese words to the Japanese children. While this little example may seem absurdly simple-minded and the principle self-evident, it is only rarely that the equivalence of verbal materials presented to subjects at different developmental levels receives attention. When groups of subjects representing different developmental stages are being compared on their ability to learn verbal materials, data on association frequencies should be obtained or, at the very least, well controlled. Perhaps the greatest technical problem facing workers who are interested in the verbal learning behaviors of retarded individuals is the lack of suitable normative data. Typically the assumption is made that such relevant factors as free association strength, meaningfulness, and pronounciability are comparable for normal and retarded groups matched on mental age. Flamer (1969) has concluded that retardates have essentially the same associative hierarchies as normal children, and further, that it may be assumed that word-association norms collected from normal children are equally applicable to MA-matched retardates. As it turns out, that may be both a good or a bad assumption depending upon the particular MA levels involved, the verbal materials, and the way in which the stimuli are presented. Where an attempt is made to specify the materials more precisely, reference may be made to either the Palermo and Jenkins (1964) o r Entwisle ( 1966) norms established with reference to normal children. When nonsense words are employed, the Underwood and Schulz ( 1 960), Archer (1960), or Noble (1961) norms, all obtained with normal adults, are sometimes cited. The assumption made in this case is that the words retain their relative status from adults, to children, to retardates. Not everyone doing research with mental retardates, of course, is unaware of the need to describe his verbal stimuli more adequately. Occasionally an experimenter will obtain pilot data from retarded subjects in order to develop the materials he plans to employ (e.g., Berry, 1969). There have been a few systematic attempts to collect word association norms from mentally retarded subjects. The earliest efforts were made by Eastman and Rosanoff ( 1 912) and Otis (1915) who selected words from the well-known Kent-Rosanoff list. These norms

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probably would not be applicable today. More recently, Horan (1956) obtained normative data for educable mental retardates in New York City. Silverstein and McLain (1961, 1964),expressing an interest in the diagnostic implications of word associations, gathered data from residents at Pacific State Hospital. Preliminary norms for CVC trigrams and 100 words from the Palermo-Jenkins list were obtained on a few subjects by Prehm and Hom (1967). Until very recently, perhaps the most useful study was conducted by Gerjouy and Gerjouy (1965) who obtained normative data on 100 words from the Kent-Rosanoff list. Their subjects were 102 institutionalized retardates. These particular norms were utilized by Gallagher (1969a, 196913) in two free association strength studies, leading him to conclude that it is critical to have normative associative data when investigating mediational and learning processes in retarded subjects. The most comprehensive normative study with retarded subjects is one recently completed by Gerjouy and Winters (1969). Data were obtained from 1000 institutional subjects, half males and half females, ranging in age from 11 to 19 years and in I Q from 40 to 80. The stimuli consisted of the 200 words used by Palermo and Jenkins. The words were orally presented and the subject was requested to give a one-word response. The responses given by the retardates were compared with those of normal children from the Palermo and Jenkins study. This comparison should be viewed cautiously because there are some significant procedural differences between the two studies, e.g., oral vs. visual presentation. Nevertheless, association values for the children and retardates were significantly correlated. A general decline in these correlations was observed with increasing chronological age of the normal children. The correspondence in association values between the two groups matched on mental age was fairly high. However, it was also evident that the best correspondence was between low MA normals and high MA retardates. In other words, the "association age" of institutionalized retardates was lower than that implied by their mental age. This is not an entirely unexpected finding, at least for retardates living in institutions. Another normative study, which at the time of this writing is in the final stages of analysis, has been conducted by Joseph Gallagher in collaboration with the first author? Free association data were collected for 70 nouns and 30 adjectives selected from the Palermo and Jenkins

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( 1964) norms. T h e study employed 400 institutional retardates (100 from each of four institutions), 100 noninstitutional retardates (all in special education classes), and 100 normal children selected from grades 3, 4, and 5. Mean IQs and CAs and their standard deviations were equated across all retardate groups. The distribution of MAS of the normals approximated the distribution of CAs of the retardates. All groups were equated for parental occupational level. Norms were collected using an oral procedure. The analysis consisted of frequency counts of the responses to each stimulus, commonality of the first five responses, amount and type of syntactic responding, number of responses per word, the number of primaries, and the number of contrast responses. Comparisons were made by various levels of I Q a n d CA across the different groups. In general, this study revealed considerable equivalence of norms. However, there were some significant differences as well, including differences between institutions. Normative associative data are not completely interchangeable between these various groups. Clearly, basic data are beginning to accumulate that will be of use to experimenters interested in verbal learning processes of retardates. These data will be of considerable value in furthering research concerned with learning strategies, especially in relation to mediational processes. On the other hand, it should be noted that more refined normative data concerning such word characteristics as meaningfulness and pronounciability still are not available for use with retarded populations. 111. CONSTITUENT ANALYSIS OF PAIRED-ASSOCIATE LEARNING

As noted previously, researchers have begun to turn away from the examination of gross PA performance and are focusing on “breaking down” PA learning into subphenomena, or constituent processes. By isolating and independently examining component processes it may be possible to predict and comprehend associative learning more accurately. The primary impetus for the experimental analysis of PA learning may be attributed to Underwood and his associates (Underwood, Runquist, 8c Schulz, 1959; Underwood 8c Schulz, 1960). According to them, PA learning involves two distinct processes, response learning and associative learning. That is, normal adults first learn the response members of the S-R pairs (response stage) and then associate the available responses with their appropriate stimuli (associative stage).

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Evidence for the validity of the two-stage model comes from a variety of direct and indirect sources. T h e most typical approach for investigating the response stage is to provide pretraining on the response terms of a PA task while including controls for nonspecific learning factors (e.g., warm u p and learning to learn). Because response learning logically precedes associative learning, relevant pretraining should benefit subsequent PA performance as compared to irrelevant and no-pretraining controls. This specific prediction has been upheld in numerous experiments (e.g., Blanchard, 1967; Jung, 1968; Underwood et al., 1959). Only a few studies have failed to obtain the expected results (e.g., Nelson, 1967). Similar attempts to produce PA facilitation by pretraining with the stimulus terms have been generally unsuccessful using standard PA procedures (Schulz & Martin, 1964; Schulz & Tucker, 1962a; Underwood & Schulz, 1960). In some instances, stimulus familiarization has even inhibited subsequent PA performance (Schulz & Tucker, 1962b). T h e failure of stimulus pretraining to benefit subsequent PA learning suggests that stimulus learning per se, independent of its association with the response term, plays only a small role in associative learning. Empirical examination of the associative stage may be accomplished in two ways. (1) The experimenter may provide pretraining with the response terms, thereby experimentally eliminating this requirement during PA learning. The independent variable may then be varied within the stimulus items. (2) An associative matching task may be used in which the responses are made available without pretraining (e.g., Horowitz, 1962; Underwood, Ekstrand, & Keppel, 1965). The advantage of the latter method is that an independent variable may then be examined for either the stimulus or response terms. Such an approach is essential for assessing the influence of a response term variable on the associative phase. Experimentation has demonstrated the validity of the two-phase conceptualization of paired-associate learning. Now it should be feasible to determine the experimental variables which differentially affect the response and associative learning stages. A stage analysis of PA learning offers a potentially powerful technique for evaluating the processes involved in the verbal learning abilities of retarded individuals. There seems to be little doubt that retardates generally learn PAS more slowly than normals (Goulet, 1969). If it can be shown that impaired learning arises within a particular process, then pretraining and/or instruction variables may alleviate the source of this disadvantage. A gross statement of a PA learning deficit does

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little to indicate what training techniques might successfully improve retardate performance. The present discussion should not be construed as advocating the uncritical use of a two-stage model. Rather, the intent is to emphasize the need for an experimental analysis of PA learning in which the twophase conceptualization may provide the beginning point for the eventual development of a workable associative learning model. Battig (1968) has reported numerous models of associative learning which include many stages of learning not present in the Underwood formulation. It may be that a more elaborate framework will be required to describe adequately the paired-associate performance of retardates. A.

Response Learning

The function of the response learning stage of paired-associate learning is to make the response terms more readily available for recall as single functional units. In the case of low meaningful material, this would first include integrating the response items which, in turn, may require a subphenomenon of associative learning. For example, if the response members are CCC trigrams (e.g., KPZ), associations would have to be developed among the respective letters so that one letter would elicit the remaining letters. Following response-term integration, the subject must learn to delimit his recall performance to those items which are actually in the test list. With high meaningful material where the verbal units are already well integrated, the role of response learning would be only to delimit recall performance (Underwood & Schulz, 1960). Underwood and his associates have developed criteria1 measures which allow the assessment of the relative length of the response and associative learning phases. The response learning stage is measured by tallying the number of PA trials required before a response item is first given (FG), without regard for the appropriateness of the stimulus term with which it is paired. When the measure is averaged across all response terms the experimenter is provided with a gross estimate of the number of trials which were required to complete the response stage. T h e relative length of the associative stage is obtained by determining the average number of trials required for the responses to be successfully paired with their respective stimuli after they were first recalled. It is apparent that these two measures are not independent because both rely on the point at which the response was first given. Ekstrand (196613) has presented a cogent criticism of these measures. He demonstrated that stage analysis leads to an overestimate of the

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length of the response learning stage and, consequently, an underestimate of the duration of the associative stage. Ekstrand reported a transfer-of-training study by Postman (1 962) which included a stage analysis of the four basic transfer paradigms (A-C, C-D, C-B, and ABr). The length of the response learning stage should be similar for CB and A-Br since the response terms are identical to those in original learning. The C-D control group, however, should manifest a longer response stage than the C-B and A-Br groups. Contrary to expectation, the results of the analyses indicated a shorter response stage for the CD control group. These findings suggested that associative interference arising from first list learning was influencing the measured length of response learning. Further evidence offered by Ekstrand showed that, in certain experimental situations, more responses are available when free recall is the response measure than when the “first given” is used. In agreement with Postman, Ekstrand suggested that the FG measure reflects something other than response learning In particular, he indicates that the measure reflects the subject’s readiness to attempt an associative response. Whether the subject is ready to respond will be determined by (1) “Ss’ confidence in the correctness of the response to be attempted’ and (2) “the amount of interference present in the learning task [Ekstrand, 1966b, pp. 345-3461.’’ As a result of Ekstrand’s critique, stage analysis has fallen into general disuse in research on normal adults. However, to reject stage analysis out of hand for research with normal children and retardates seems premature. The subjects’ readiness to respond will depend on the presence or absence of competing responses. In the absence of associative interference, Ekstrand admits that stage analysis may be sufficient if only gross relative measures are of interest. For comparative investigations (normal children and retardates) of PA acquisition, stage analysis may illuminate the source of retardate’s learning disability. However, it is necessary to provide some evidence that retardates and normal children do not differ in their readiness to respond. Also, it is clear that stage analysis should never serve as the major analysis in an investigation; nor should it be used in transfer-of-training experiments or in other experiments in which high associative interference is present . There are two alternatives to stage analysis which are recommended by Ekstrand. The first is to use paced free recall as the measure of response learning. Free recall is considered to be an analogue to the type of learning required during the response stage. Yet, it should be emphasized that free recall reflects response availability in the absence of ongoing associative learning. In such a case, free recall may underestimate the time required for response learning. The final alternative is to

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stop PA learning after varying numbers of trials and request paced free recall of the response terms. This approach seems to be the most acceptable, but it is also the most inefficient. With this procedure, the researcher must use independent groups for the different trials he wishes to examine.

B.

Response Stage for Retardates and Normal Children

As an initial attempt to examine experimentally the PA learning processes of retardates, Kellas and Baumeister (1969) evaluated the applicability of the two-stage model to retardate performance. Three groups of institutionalized retardates were given either relevant, irrelevant, o r no pretraining with the response terms. It was hypothesized that if response learning played an important role, then relevant pretraining should benefit subsequent performance independently of nonspecific learning factors. T h e analyses confirmed this prediction. T h e results are graphically displayed in Fig. 1. Relevant pretraining reliably improved retardate performance above any facilitation that could be attributed to learning to learn o r warmup. Both average performance and variability of performance was beneficially affected.

Paired -associate trials

FIG. I . Paired-associate learning curves as a function of trials for groups receiving relevant (RL), irrelevant (IRL), or no pretraining (NRL) with the response terms of the PA list. (From Kellas & Baumeister, 1969.)

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According to Underwood and Schulz (1960) the major part of response learning is comprised of response term integration. Research with normal adults has indicated that response pretraining does not facilitate PA performance when the response terms are highly integrated (Schulz & Martin, 1964). Even though meaningful two-letter words were used as responses in the Kellas and Baumeister study, the possibility remains that the response items may not have been fully integrated for the retardates. To examine this alternative, we classified each subject’s errors as misplaced responses, omissions, partial responses, importations, and intrusions. If integration of the responses were required, the retardates in the irrelevant and no-pretraining groups should evidence a high frequency of partial responses. If response learning, in the present instance, required mainly the delimiting of recall performance, then one should expect a high frequency of intrusion and importation errors in these same groups. T h e results of the error analysis showed that 96.7% of all errors committed were either omission or misplacements. Evidently the retardates had little trouble integrating the responses, or delimiting their recall to the list items. There are two possible interpretations of these findings: (1) integration of the response terms was necessary and the retardates failed to respond until the items were fully integrated, or (2) the retardates did not spontaneously have an acquisition strategy for learning the response terms, and that nonspecific practice allowed the development of a learning strategy. The latter interpretation is partially supported by the type of errors committed by the irrelevant trained group. On early trials they made reliably more omission errors than the group receiving no pretraining, whereas the no-pretraining group committed about equal percentages of misplaced and omission errors. A distribution of errors such as that made by the irrelevant pretrained group would be expected if they were attempting to learn the list of response terms prior to an associative recall attempt. In the second study of the series, Kellas and Baumeister tested a specific prediction from Underwood‘s Model. Because response learning logically precedes associative learning, it was predicted that on early PA trials more responses would be available for free recall than could be successfully paired with appropriate stimuli. In addition, the superiority of free recall over PA recall should diminish with increased practice. Once again the prediction was upheld. A stage analysis was conducted on the data from Experiment 1 in this series. The results indicated that relevant pretraining significantly reduced the length of the response learning stage. However, there were no reliable differences in the length of the associative learning stage among the three

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groups. These findings are in agreement with the two-phase model proposed by Underwood. The combined results of these investigations demonstrates that at least two stages are involved in the PA performance of retardates. T h e major difference between these findings and the results from normal adult research is that, with apparently integrated response terms, retardates benefit from relevant pretraining. Following the overall test of the two-stage model, Kellas and Butterfield (1970a) questioned whether the typical PA inferiority of retardates could be related to a deficiency in the response learning stage. As before, a pretraining paradigm was employed with the appropriate controls for nonspecific facilitation. Noninstitutionalized retardates and an equal number of normal MA matched children were compared on PA performance. Pretraining on the response terms was continued to a criterion of three successive errorless trials. T o control for possible differential meaningfulness of the response terms, empirical association values were gathered prior to the experiment. In order to test directly for a response learning deficit, specific and nonspecific transfer effects were examined separately. The results showed that only the retardates benefited from relevant response training. For normal children, no significant difference was found between relevant and irrelevant pretraining, and normal children and retardates were equally facilitated by nonspecific factors. T h e average results are presented in Fig. 2. Under both irrelevant and no-pretraining conditions, normal children were superior to retardates. However, with relevant pretraining, the difference between intelligence groups was virtually eliminated. These results were confirmed by analyses of the pretraining data and by evaluating the relative lengths of the response learning stages for the two samples. Stage analysis indicated that t.he number of trials to complete response learning was reliably longer for retardates than for normal children. Examination of free learning of the response terms indicated a superiority for normal children. This agreement between stage analysis and free learning suggests the validity of both measures for evaluating the first phase of paired-associate learning with normal children and retardates. Apparently irrelevant pretraining does not give rise to competing responses during PA learning, which would tend to lengthen the relative duration of the response stage. In view of the fact that normal children were not benefited by relevant pretraining, Kellas and Butterfield (1 970b) conducted one final study in this series. T h e degree of integration of the response terms was systematically varied within lists, for a sample of normal children

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236 RRF

IRF

NRF

Paired -associate trials

FIG. 2. Paired-associate learning curves describing the effects of relevant response familiarization (RRF),irrelevant response familiarization (IRF), and no response familiarization (NRF) for normal children and retardates. (From Kellas & Butterfield, 1970a.)

obtained from the same population as in the previous investigation (Kellas & Butterfield, 1970a). As before, relevant, irrelevant, or nopretraining was provided prior to PA learning. The index of integration was rated pronounciability obtained from normal adults (Underwood & Schulz, 1960).As with college students, the magnitude of the facilitation arising from relevant pretraining was related directly to the index of integration. As the response terms became increasingly difficult to pronounce, the facilitation from pretraining increased. Under conditions of high pronounciability there was no benefit from relevant pretraining. Rate of free learning was also related to rated pronounciability. The slope of the free-learning curve decreased as the response terms became more difficult to pronounce. A previously unreported stage analysis of these data revealed that the relative length of the response learning stage (as measured by the first given technique) increased in this order: easy, intermediate, and hard to pronounce. In summary, the investigations reported here indicate the utility of a constituent analysis of retardates’ PA learning. It should be emphasized that the research described thus far has been primarily concerned with

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the response learning phase of paired-associate learning T h e findings indicate that the overall inferiority reported for retardates on PA tasks may be related, at least partly, to the response learning process. However, this should not be construed to mean that retardates are comparable to MA matched normals in the associative stage. The verbal materials employed in these studies were of relatively low difficulty. As difficulty increases, the retardate may become more disadvantaged in both stages of learning. Finally, the two stage model does seem to represent the PA learning processes of retardates. Yet, clearly the model provides only a partial description of PA learning. For example, there is some evidence suggesting that a stimulus learning stage may need to be added. Girardeau (1966) conducted a PA study in which the formal similarity of the stimulus terms were varied. Because pretraining of the response items was provided prior to the experiment, the results may be related to the associative stage. The low similarity lists were learned at a faster rate than those of high similarity. The retardates may have had difficulty in integrating o r differentiating the stimulus terms. If such were the case, pretraining with the stimuli may prove to be beneficial to PA performance, and a stimulus learning stage would be a useful addition to the model. C.

Associative Learning Stage

When college students are asked, either directly or experimentally, how they learned to associate pairs of verbal items, it is clear that a variety of strategies are employed. It is safe to assume that the learner will actively impose some type of organization on the to-be-learned materials. Strategies verbalized by these subjects range from complex syntactical connections of elements of the stimulus and response terms to simple repetition of the pairs. T h e strategies adopted depend, in part, upon the characteristics of the verbal materials, the “set” of the subject, and the demands of the task. Moreover, an individual may utilize different strategies at various stages of learning and different strategies for particular items. From the point of view of developmental psychology it is important to gain an understanding of the nature and range of learning strategies employed by children and developmentally retarded individuals. One possibility is that strategies of increasing sophistication are emergent at particular developmental levels. Another possibility is that strategies observed in normal adults are also present, in rudimentary forms, in the behaviors of children and retardates. In the latter case, growth in learning ability is the result of the increasingly efficient application of these strategies.

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One approach is to catalog the various strategies that normal adults employ and then determine whether these processes characterize the learning of normal children and retardates as well. This procedure has been employed by C. J. Martin (1967) and his associates. Their first step was to develop a classification scheme of associative strategies reported by college students. Subjects learned eight pairs of low meaningfulness paralogs and, subsequently, were asked how they attempted to form each of the associations. Seven categories of associative strategies, assumed to be ordered along an underlying continuum of cue complexity, were developed from the introspective data. At one end of the continuum the subject was unable to describe the manner in which he formed the association; at the highest level, a syntactical mechanism was employed in which the subject selected elements from each of the paralogs and expressed these elements in a meaningful word relationship. A substantial correlation was observed between the ordinal complexity of the strategy and the quality of overall performance. In spite of some obvious methodological problems, and the introspective nature of the classification system notwithstanding, it does appear that a reliable and apparently heuristic scheme was developed by Martin and his colleagues. Applying their system to educable mental retardates, they found that less intelligent subjects were more likely to rely on low level strategies. Moreover, retardates could be taught to employ more effective strategies. T h e procedure developed by Martin represent, in a sense, a “shotgun” approach to the assessment of PA learning strategies employed by mental retardates and children. This is a fairly general description of the variety of strategies that may occur. However, a much more refined and detailed experimental analysis of each of these processes is required in order to delineate their functional role in PA learning. 1. CUESELECTION

Of seven categories of associative strategies identified by C. J . Martin (1 967), four involve some type of cue selection. That is, the functional stimulus for eliciting the response was some fractional part of the nominal stimulus. This phenomenon has been observed frequently in PA learning and currently is the focus of a great deal of experimental attention. Given a stimulus term consisting of a number of discrete components, any one or combination of these elements may become functional for response evocation. For example, if the subject is asked to learn the trigram-digit pair T U K : 6 it may be that all characteristics of T U K serve as the functional stimulus. On the other hand, the letter

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“T” may be the effective stimulus for recall of “6,” in which case the other elements of the trigram become quite superfluous. Only recently has the problem of cue selection received any substantial attention from verbal learning researchers. This issue has, of course, long been of interest to those working in other areas of learning, especially in regard to discrimination learning. With particular reference to mental retardation, the well-known “attention” theory of Zeaman and House (1963), for example, could be construed as a problem in cue selection. It is now widely recognized that stimulus selection behavior also influences the acquisition of verbal material. Although there is some disagreement regarding certain theoretical aspects of cue selection, there can be no doubt that this process constitutes one of the fundamental strategies in paired-associate learning. The first author and his colleagues have recently initiated a series of studies designed to explore the conditions under which normal children and retardates decompose stimulus compounds and select certain cues to become the functional stimuli for response recall. Not surprisingly, there is a correlation between methodological sophistication of these studies and their ordinal position in the series of investigations. T h e first study in the series (Baumeister & Berry, 1968) was designed to determine whether stimulus term compounding of primary verbal unit and a secondary color cue would facilitate original learning of paired-associates by normal children and retardates. “Primary” refers to that aspect of the stimulus term that the subject is explicitly instructed to associate with the response. No mention of the “secondary” cues is made in the instructions. The results of similar studies with adults are equivocal in that some investigators have reported facilitation of learning (Saltz, 1963; W. Weiss & Margolius, 1954) while others (Sundland & Wickens, 1962) have not observed such an effect. This apparent discrepancy may be related to the nature of the primary stimulus. When cues from two distinct dimensions are used as a compound, the functional stimulus will probably be the one with the higher meaningfulness. When the primary stimuli are relatively low in meaningfulness (CVCs) then one might expect greater reliance on secondary cues (colors). Consequently, the study by Baumeister and Berry (1968), in addition to bearing upon the developmental issue, was intended as a test of the hypothesis that greater facilitation of learning due to the secondary cues would occur when the primary stimuli were difficult to associate with their responses. Five PA lists, each consisting of five pairs, were constructed. The stimulus terms in these lists were (a) high association three-letter words, (b) low association CVC trigrams, (c) solid colors, (d) combinations of

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words and colors, and (e) combinations of trigrams and colors. The words and trigrams were selected from Noble’s (1961) lists. The responses consisted of single digits. The response learning stage should be minimized when digits are used. These materials were photographed and presented with a slide projector. Each list was learned by a different subgroup of normal children and retardates. The retardate subgroups performed about equally across the various conditions. The normal children, on the other hand, found the trigrams alone more difficult to learn than either the colors or the words alone. Compounding the stimulus did not affect the childrens’ performance when the primary stimuli were words; but, given CVCs as primary stimuli, learning by the compound group was superior to that of the trigram-only group. These results suggested, in short, that the normal children benefited from the presence of redundant secondary cues when the primary stimuli were relatively meaningless. Although the less intelligent subjects were not similarly affected, certain methodological problems render conclusions concerning the retardate groups more equivocal. The interaction of intelligence groups by stimulus conditions was confounded by the failure of the retarded subjects to show any differential learning across the three single stimulus conditions. That is, the colors and words, presented alone, were as difficult for the retardates to associate with the digits as the trigrams. Additional data gathered on the verbal units indicated that meaningfulness had not been varied to the same extent for the two intelligence groups. The Noble (1961) norms evidently were not as applicable to the retardates as to the normal children. In order to provide a fairer test of the difficulty hypothesis with retarded subjects, a similar study (Baumeister, Berry, & Forehand, 1969, Study I) was conducted in which list difficulty was established preexperimentally with retarded subjects. Two lists of six CCC:digit pairs were thus constructed. Two additional lists were formed with colors and trigrams as compound stimulus terms. Again, three variables were combined factorially: list difficulty (easy vs. hard), stimulus redundancy (six colors vs. no colors), and intelligence group. The results of this study are graphically displayed in Figs. 3 and 4. It can be concluded from Fig. 4 that the secondary color cues markedly facilitated learning performance of the normal children given the more difficult list of primary CCCs. This corroborates the results of the first study. In both cases, compound facilitation began to develop at about the fifth trial. As in the earlier study, when the primary verbal units were relatively easy to associate with the digits, the presence of the colors made little difference for the normal children. The retardates,

24 1

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0

5.0 -

\

\

FIG. 3. Paired-associate learning curves for normals and retardates for the no-colors (NC) and six colors (6C) context condition on the easy (E) list. (From Baumeister el al., 1969.)

Normals

-

Retardates

HNC 0 - - 4 H6C O---C

5.0

W

4.0 E

3.0 r L

0"

5

2.0

C

P

I. 0

b-0-W1

1

1

I

I

I

I

1

I

2

3

4

5

6

7

8

I

I

I

9 10 II

1

I

I

I

12 13 14 15

I

16 17

Q 18 19

Trials

FIG. 4. Paired-associate learning curves for normals and retardates for the no-colors (NC) and six-colors (6C) context condition on the hard (H) list. (From Baumeister el al., 1969.)

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on the other hand, were not affected by the background colors under either condition, a result observed in the earlier investigation as well. T h e results of these two studies, taken together, suggest that the retardates did not cue select as effectively as the normal children. It should be stressed that in these two studies the instructions explicitly directed attention of the subject to the verbal element of the compound. No mention was made of the colors. One explanation of the apparent failure of the retardates to benefit from the addition of distinctively colored backgrounds to the trigrams is that they followed instructions more faithfully. T h e normal children may have been less instruction-bound and more inclined to shift their attention to the color dimension when they found the verbal elements difficult to associate with the digits. Although the behavior of the retardates suggested that they did not spontaneously cue-select, this does not necessarily mean that cue-selection strategies are unavailable to them. Would they cue select if all relevant elements of the stimulus compound were brought to their attention? Another study in the series (Baumeister et al., 1969, Study 111) was designed to examine the effects of various instructional sets on cueselection behaviors of retardates. Six groups of subjects were employed. One group learned to associate CVC trigrams with digits, another colors with digits, and four groups were given compound stimuli consisting of trigrams and colors paired with digits. Four different sets of instructions were administered to the four compound groups: (a) instructions to associate digits with trigrams (the same instructions as in the earlier studies), (b) instructions to associate digits with colors, (c) instructions to associate digits with colors and trigrams, and (d) instructions that did not explicitly identify either cue. Following original learning, the four compound groups were given a transfer test to ascertain which set of cues had become functional in original learning. The results of the transfer test revealed that when a single cue was identified in the instructions, that cue became functional for the retardates. In a similar study with normal adults, Houston (1967) found that his subjects utilized the colors, regardless of instructions. From the experimenter’s point of view, retardates are evidently more trustworthy. However, when the instructions either explicitly identified both sets of cues or were ambiguous in this respect, the retardates tended to select colors. This finding does indicate the operation of a cue-selection strategy among the retardates. Nevertheless, even though the retardates did select the colors under some instruction conditions, it is interesting to note that the colors were no easier to learn for the retardates than the trigrams under single cue learning.

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We have established that for normal children, at least, PAS with compound stimuli consisting of nonsense syllables and colored backgrounds are easier to learn than pairs where the nonsense syllable is presented by itself. However, the mechanism through which such facilitation occurs is unclear. It should be stressed that this facilitation is observed when the child has been instructed to form the trigram: response association with no explicit reference to the background colors. One possibility is that a mediational chain is formed consisting of trigram + color + response. In other words, the subject may have completed the criteria1 trigram:response association by employing the color as a mediator. A second possibility is that each combination of colors and trigrams was responded to as a dictinct configuration and that the observed facilitation of learning is attributable to enhanced stimulus differentiation (Saltz, 1963). Another experiment, involving normal children and retardates, was undertaken to determine, by transfer tests, which cues had become functional in learning and whether intercomponent associations had been formed (Baumeister et af., 1969, Study 11). An additional purpose of this experiment was to assess cue-selection behaviors of public school retardates. The retarded subjects in all the previously described cueselection experiments were residents of a large public institution. All subjects learned a list of CVC co1or:numeral pairs in which the trigram was the primary stimulus. After reaching a learning criterion of one perfect recitation of the entire list, each subject was given one of five transfer tests as follows: (a) trigram color:numeral, (b) color: numeral, (c) trigram:numeral, (d) trigram:color (appropriate pairing), and (e) trigram:color (new pairing of components). T h e first transfer condition (a) was a control for postcriterion drop. Transfer conditions (b) and (c) permitted a determination of the degree to which the individual cues had become functional. In conditions (d) and (e) the compound was fractionated and a pair formed such that the trigram became the stimulus term and the color the response term. In one case (d) the trigrams and colors were paired in the same relationship as in original learning. The other component transfer condition (e) involved a new pairing of the components, anaIagous to an A-Br transfer paradigm. Again, the pattern of results indicated that the background colors were more likely to be functional for the normal children than the retardates. The normal children displayed comparable transfer under all three conditions involving the digits, i.e., color trigram:digit, color: digit, and a trigram:digit. T h e retardates, on the other hand, showed relatively poor transfer when given the colors alone as stimuli.

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An additional finding that could have some theoretical implications with respect to cue utilization is that the normals may have adopted a mediation strategy. For the normal children, a fairly substantial amount of intercomponent learning had occurred. The children made roughly half the errors in transferring to a list of pairs composed of the original trigram and color components as they did to a list made up of trigram and colors that had not been combined in original learning. Thus, the necessary steps for a mediational process, word --* color + digit, were all present for the normal children. The retarded subjects demonstrated little or no intercomponent learning. It is not likely, therefore, that many of their correct responses to the trigrams were mediated by the colors. A configuration hypothesis concerning the effects of stimulus compounding did not receive a great deal of support from this study. The normal children performed as well, in transfer, to the single stimuli as they did to the compound. While this result is not entirely compatible with the configuration explanation it is consistent with, indeed suggested by, the mediation hypothesis. Finally, one other aspect of this study should be stressed. The retarded subjects who participated in this particular investigation were not institutionalized. It does appear that the failure to utilize secondary cues effectively and spontaneously is related to measured intelligence, independently of the factor of institutionalization. All of the studies described so far have shown that normal children will spontaneously utilize the secondary color cues of a compound stimulus while the retardates are more inclined to learn the pairs on the basis of the primary verbal element, at least when the instructions emphasize the verbal cues. There are, however, some assumptions inherent in this conclusion. One is that the colors and the verbal elements retain their relative meaningfulness for both intelligence groups. It will be recalled that the learning of the normal children was facilitated only when the verbal units were low in meaningfulness. Presumably, the colors became functional when they were the more meaningful stimuli. In order to conclude that the retardates experience a failure to apply effective cue-selection strategies one must also assume that the disparity in meaningfulness existed for the less intelligent subjects as well. Actually, color meaningfulness has never been assessed directly in cueselection studies involving adults, children or retardates. One disconcerting finding, in this regard, that ran through our earlier experiments was that the retardates were unable to learn co1or:digit pairs any faster than trigram:digit pairs. Another assumption implicit in these studies is that the response

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learning phase of PA acquisition does not differentially influence cue selection for the two intelligence groups. However, there are two relevant precautions that should be borne in mind. One, as noted earlier, is that retarded subjects often do display a response learning inferiority, even with digits as responses (Baumeister & Berry, 1970). Second, certain variations among response terms apparently do influence cue selection (Davis, Brown, & Ritchie, 1968). A series of studies related to these issues was recently carried out by Berry (1969) in collaboration with the first author. The main intent was to examine, further, cue selection in normal children and retardates given trigram color compounds as stimuli in PA learning. In this case, however, a series of pilot studies was conducted to measure color meaningfulness and trigram meaningfulness with both populations. On the basis of this work, compound lists were constructed in which the color cues were known to be more meaningful than the trigrams for both populations. Moreover, both groups were able to associate responses more readily with the colors as stimuli than with trigram as stimuli. A number of additional procedural refinements were incorporated in Berry’s study. T h e effect of the response learning phase on PA acquisition was minimized by response pretraining. A recognition procedure was employed in transfer, and transfer was measured in both forward and backward directions for each element of the compound. Intercomponent transfer was also measured bidirectionally. The results of this study indicated that, given (a) complete response availability, (b) stimulus components that are clearly unequal in meaningfulness, and (c) instructions that direct attention to both stimulus dimensions, both normal children and retardates will select the more meaningful cues as their functional stimuli. In this case, the colors were completely effective cues for response recognition. Very few of the correct responses, in either intelligence group, could have been acquired through mediational chaining involving the two stimulus elements. In short, given the proper circumstances, the strategy of simple cue selection is operative in the performance of both normal children and retardates. Cue selection seems to be a very fundamental learning strategy that extends over a wide range of developmental levels. It is, of course, possible to argue that more than meaningfulness had been varied in Berry’s study. Can “meaningfulness” of colors be compared to “meaningfulness” of verbal stimuli? Do these two cases refer to essentially the same psychological events? Moreover, it is conceivable that when the response terms (in this case, bigrams) are in the same class of materials as one element (trigrams) of the stimulus compound the subject, in order to reduce interference, will rely on the other stim-

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ulus dimension (colors). It is possible that the high degree of color selection observed by Berry could have resulted from more than a difference in stimulus meaningfulness. Another study was therefore conducted in which retarded subjects learned PA lists with the stimulus consisting of a meaningful threeletter word and a trigram paired with a numeral response (Berry & Baumeister, 1970). The transfer results indicated that the retardates consistently used the word for their functional stimuli. In almost all of those cases where the correct response was given to the trigram the subject could also reproduce the word, suggesting that these correct associations might have been the result of a mediational process. In brief, this study provides fairly clear evidence for cue selection, among retardates, as a function of relative meaningfulness of the stimulus elements. This relationship appears to hold for either the verbal element and color procedure or the two-verbal element paradigm. However, it should be added that the relationship between component meaningfulness (M) and cue selection apparently is not as general among retardates as among either normal children or normal adults. Retardates only appear to cue select on the basis of component M when all potential cues are made relevant by the instructions. In most of the studies so far discussed, a multiple-cue paradigm was used in which two distinct stimulus dimensions, namely colors and three-letter verbal units, were combined. An even more complex cue selection process can obviously occur in this context. That is, the subject may select one of the letters as his functional stimulus for response recall or recognition. In fact, it is clear that even without the colors present, given a verbal unit as a stimulus term, the learner has ample opportunity to cue select among the letters. (In some of the experiments previously described, this possibility was reduced by using trigrams with high formal similarity.) Several studies with college students indicate that these subjects do indeed “fractionate” the stimulus term at least when it is difficult to pronounce as a unit (e.g., Jenkins, 1963; Postman 8c Greenbloom, 1967; Rabinowitz & Witte, 1967). Moreover, when letter selection does occur, it is generally to the first letter. Although children and, under some conditions, retardates cue-select when presented compounds composed of two distinct stimulus dimensions, it is not certain whether these subjects would utilize such a strategy when components making u p the stimulus term are less disparate in the dimensional sense. That is, will children and retardates “fractionate” verbal stimuli when learning a list of PAS? Unlike the color-word paradigm, the letter-selection procedure may be sensitive to reading habits.

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Baumeister and Berry (1970) have attempted to assess the amount and locus of letter selection in normal children and retardates. Subjects were asked to learn a five-item PA list with hard to pronounce trigrams (WNP, FTH, KSB, CGR, and DLY) as stimuli and digits as responses. All subjects were response pretrained. Following acquisition of the pairs, a transfer test was given in which the stimuli were either the first, second, or third letters on the entire trigram. Subjects in the singleletter transfer conditions were also asked to reproduce the missing letters. We have concluded that this latter procedure, or one like it, is necessary in order to make unequivocal inferences concerning the amount and locus of cue selection. Unless it can be shown (as in Berry, 1969) that intercomponent associations have not been formed to a substantial degree, then what appears to be cue selection in the transfer task may be the result of a mediational process. A subject may be able to recall the correct response to a particular element of a stimulus term, but this does not necessarily mean that he selected that element as his functional stimulus. Intercomponent associations may have occurred during learning, in which case the overt cue presented during transfer may have evoked an implicit response to some other element of the stimulus term, and, in turn, enabled the subject to produce the correct response. In order to state unequivocally that single cue selection has occurred on a particular item it is necessary that two conditions hold: (1) the response to a stimulus must be the correct one and (2) n.0 other element of the original stimulus compound can be reproduced. This “double criterion” typically has not been used in cue-selection studies. T o the extent that a mediational process has occurred, the role of cue selection in PA learning is exaggerated. Postman and Greenbloom (1967), the first to apply this control for mediation, found that letter selection does occur among college students, but only when the trigram is difficult to pronounce. Moreover, single-letter selection occurs almost exclusively to the first letter. Applying this double criterion analysis to the digit recall and letter reproduction scores of normal children and retardates, Baumeister and Berry found that the two intelligence groups performed almost identically in the transfer phase of their experiment. Even given the stringent criteria for definition of letter selection, both intelligence groups showed a substantial amount of first-letter selection. When a letterselection strategy was employed by the subject, normal or retardate, most frequently the first letter was functional. T h e conditional probabilities of correct digit recall, combined for the two intelligence groups are shown in Table I. T h e probability of a correct response is very high

A . A. Baumeister and G.Kellas

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TABLE I CONDITIONED PROBABILITIES OF RESPONSERECALL GIVEN DIFFERENT NUMBERS OF LETTERS REPRODUCED~

Number of letters reproduced 0 1 2

Single letter (First)*

Transfer (Second)*

Subgroup (Third)b

N 38 25

P .74 .80

N

P

N

53

.40

25

P .30 .83

57

.93

42

.76 .88

80 23

17

.88

“Baumeisterand Berry (1970). bN is the number of cases in which a given number of letters were successfully reproduced; P is the conditional probability of correct recall.

if the subject can reproduce either or both of the missing letters. However, in those instances where no additional letters were reproduced (one of the conditions for inferring cue selection) only those subjects receiving the initial letter of the trigram show a high probability of correct recall. The letter-selection strategy employed by both groups may have been influenced by reading habits. That is, why was the first letter of the trigram selected? Not only was the initial letter the most effective single cue for response recall, but also it was most effective for eliciting the other letters and the one more likely to be reproduced by subjects given letters from either the second or third positions. This pattern of results suggests that the trigram itself was processed in a left-to-right sequence, as would be expected if reading habits were implicated. When mediation is ruled out by the application of the double criterion, it appears that there is a substantial amount of single-letter selection, almost entirely limited to the first letter. There seems to be considerable generality of this strategy across various developmental levels. In all of the previously described studies, the point at which cue selection was assessed was, by and large, the same: after one or two correct recitations of the entire list of PAS. This had generally been true for studies of cue selection in adults as well. Obviously, in order to describe the development of cue-selection strategies during learning, it is necessary to probe at different points. A study by Berry, Joubert, and Baumeister (1971) was designed to tap for cue selection at various stages of learning of PAS by retarded subjects. Learning of a five-item list of trigram-digit pairs was carried to 1, 2, 3, 5 , 7 trials, two perfect or eight overlearning trials for different groups of subjects. Letter selection was evaluated, in transfer, at each of these points. The per-

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centage of the total correct items solved by single-letter, two-letter, and three-letter strategies changed at various degrees of list learning. These data reveal that retardates begin to respond to single letters very early in learning It is only in later trials that two- and three-letter solutions become possible, and, in most of these cases, a mediational strategy cannot be ruled out. In view of these results, one may wonder whether the subject actively adopts a single-letter strategy at all. He may respond on the basis of part of the trigram, not because he purposely selected that portion of the nominal stimulus, but because he has not learned, by the time of the transfer test, to associate completely all elements of the stimulus. The same may be true for normal adults. The general picture conveyed by these studies is that normal children adopt cue selection and/or mediational strategies in much the same way as normal adults. The role of mediation probably is greatest when the subject is specifically instructed to use the less meaningful element of a compound stimulus. Retardates do not appear to make as effective use of a mediational strategy under these conditions. On the other hand, simple cue selection is most likely to occur, for all developmental groups, when there is great disparity in meaningfulness between elements of the compound and when the subject’s attention is actively directed to both relevant dimensions.

2. BACKWARD LEARNING If a person is explicitly asked to learn a list of S-R pairs so that he can recall R given S, he may also be able to produce S when presented with R. In other words, the subject has learned a backward (R-S) association although he has not been expressly asked to do so. For this reason, backward learning has sometimes been conceptualized as a variant of incidental learning. However, simply calling this phenomenon by another name adds little to our understanding of it. Regardless of what we term it, backward learning has some important implications for developmental theory and research regarding verbal learning. In particular, backward associations are probably implicated in some mediation and transfer paradigms (E. Martin, 1965). In certain types of learning situations where there is a high degree of free association strength between stimulus and response or where there is high stimulus-response similarity, the influence of backward learning may be particularly important. It would not be difficult to conceive of a learning situation in which an efficient strategy on the part of the subject would be to “turn-around” the association. Another area in which backward associations may have some explanatory role concerns stimulus selection. Selection of a functional stimulus may be dependent, in

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some measure, upon the strength of the backward association to the respective elements of the compound. Suppose, for instance, that the response “apple” is to be associated with the color and trigram compound RED TUK. A common association to apple is “red,” an association which, in this instance, might lead to backward selection of the color element of the compound. One question immediately raised by the concept of backward learning concerns its strength relative to forward learning. In fact, this consideration is at the center of a controversy over what is learned when the subject acquires a list of associations. In general, studies with normal adults have shown that backward learning is weaker than forward learning. However, there are several procedural considerations that, when ignored, tend to produce an underestimate of R-S learning. Indeed, because of the high susceptibility to methodological confoundings, backward learning is an unusually difficult phenomenon to study with verbal materials. T h e most serious problem is one of insuring that stimulus availability is equated with response availability. The very nature of the typical PA task requires that the subject learn a pool of responses from which he must draw the correct one. He is not ordinarily required to learn the stimuli, in this sense, because they are supplied to him by the experimenter. Thus, stimulus learning may not have taken place to the same extent as response learning Moreover, if the subject is cue selecting during original S-R learning, he may not be able to reproduce the nominal stimulus when presented with the response term. Of course, when learning in the forward direction, the subject is required to recall the complete response. This confounding would tend to exaggerate performance differences with respect to S-R and R-S learning. Ekstrand (1966a) has presented a thoughtful review of these and other factors that need to be considered in interpreting the results of backward learning studies. Perhaps the most important (and controversial) conceptual development regarding backward learning is the principle of associative symmetry. This principle holds that “when an association is formed between two distinct terms, a and b, it is established simultaneously and with equal strength between b and a” (Asch & Ebenholz, 1962). I n this view, R-S learning is not considered to be “incidental” but rather is functionally identical with forward learning and should, therefore, be influenced in the same way and to the same extent by independent variations. Of course, most of the available experimental evidence suggests that backward learning is not as strong as learning in the forward direction, but Asch and Ebenholz attribute this difference to the common failure to equate for stimulus and response availability.

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Despite the obvious theoretical implications of the developmental study of backward learning behaviors, almost all of the research relevant to this issue has been conducted with college students as subjects. Nevertheless, as Goulet (196813) has observed, the optimal subjects for test of associative symmetry are developmentally immature individuals. He meant children, but he could have just as well included retardates. In any case, because of the possible role of backward associations in transfer, applying old learning to new, it is important to assess these behaviors in children and retardates. In the first empirical study of backward and forward learning in children, Palermo (1961) found that not only was there a high degree of asymmetry but that R-S recall was substantially lower (about 57%) than that which would be expected with adult subjects. Although Palermo used pictures of highly meaningful objects as stimuli, a procedure which is often assumed to insure high correspondence between functional and nominal stimuli, he did not present data concerning stimulus and response availability. Moreover, a mixed-lists transfer design was employed, perhaps introducing a confounding contextual variable. A more recent study by Kausler and Gotway (1969) demonstrated a much higher degree of backward learning relative to forward (79% to 87%) for children at two age levels. Again, pictures of highly meaningful objects comprised the PA pairs. Unlike the Palermo study the mixed-lists transfer design was not employed. However, Kausler and Gotway did not control for postcriterion drop by presenting a control group one additional S-R trial. In view of their fairly weak criterion of original learning (one errorless trial), backward learning, relative to forward, was probably underestimated. Furthermore, no data were obtained concerning nominal stimulus availability. In any case, the strength of backward associations reported by Kausler and Gotway is much higher than that found by Palermo, and it is comparable to that typically reported for adults. One study has been reported which provides evidence of perject associative symmetry for both normal and retarded adolescents. Logan, Prehm, and Drew (1968) had subjects learn pairs of words with either high or low associative connections between stimulus and response terms. The high degree of bidirectional learning demonstrated by this study would be significant theoretically if it were not for certain methodological and statistical problems. Among other problems, Logan et al. employed a covariance analysis in which the covariate, first-list learning, was itself affected by the treatments. In an effort to avoid some of the methodological pitfalls commonly encountered in the study of R-S learning, Borkowski, McGrath, and

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Doyle (1969) used the transfer design proposed by E. Weiss (1965) for the identification of backward learning effects. In this design, subjects learn a list of A-B pairs and are then exposed to either a B-A or B-Ar transfer list. To the extent that backward associations have been formed, the B-Ar list should generate a high degree of negative transfer and the B-A high positive transfer relative to the C-D control. The results of the Borkowski et al. study indicated that MA matched normal children and retardates learned about the same amount in the backward direction. Marked retardation of relearning was observed for both intelligence groups transferred to a B-Ar list. Although the design employed by Borkowski and his associates does possess some methodological advantages, it is substantially different from the procedures used by others who have investigated backward learning in children and retardates. Comparisons are difficult to draw. Perhaps the greatest disadvantage of the Weiss technique is that it allows only an indirect assessment of the amount of R-S learning that took place originally. Actually, the problems that are apparent in the more traditional design stem from the failure to apply proper controls rather than from any intrinsic flaw in the design per se. A series of studies have been undertaken by the authors and their collaborators using the more conventional design for comparing R-S and S-R learning. Attention was paid to controls commonly overlooked. In the first study of this series (Baumeister, Kellas, 8c Gordon, 1970), normal children and retardates learned an A-B list of six pairs of pictures of common objects to a criterion of one errorless trial. Subsequent to list I learning, three subgroups of subjects were given six-item transfer lists containing (1) the original items in the forward direction (A-B), (2) the original items in the backward direction (B-A), or (3) a new list of items (C-D). The dependent measures consisted of the number of correct recalls on the first transfer trial (just for A-B and BA lists) and number of trials required to learn the second list (A-B, BA, and C-D). Insofar as original backward learning is concerned the most meaningful measure is performance on thejrst transfer trial. Groups of normals and retardates learned the original A-B list to criterion and then were given a free-recall test in which they were asked to recall stimulus and response pictures. Controls for stimulus and response availability were included. Additional control groups were run to guard against intrinsic differences in A-B and B-A pairing direction. That is, it was necessary to show that the B-A list as an original task was learned as rapidly as the A-B list. These controls-for stimulus and response availability and difficulty of pairing direction -are vital to a clear interpretation of backward versus forward learning differences. Data based on the first transfer trial revealed high, but imperfect,

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backward learning relative to forward for both intelligence groups. Backward association strength, relative to forward, was 80% and 70% for normals and retardates, respectively. Relearning data were consistent with first trial data. T h e A-B list was relearned most quickly, followed by the B-A list with the C-D learning a poor third. An analysis of the availability controls revealed a slight, but nevertheless, statistically significant superiority of response recall over stimulus recall. Both intelligence groups recalled an average of 4.8 response pictures and 4.2 stimulus pictures. Consequently, part of the observed asymmetry, although fairly small, may have been due to differential availability of stimulus and response terms. Inasmuch as data were available with respect to forward and backward learning and for free recall of stimuli and responses, it seemed reasonable that a procedure could be devised for making an adjustment in backward learning scores. The assumption was made that some, but not necessarily all, of the “missing” stimulus terms would have been correctly recalled in backward transfer had they been available to the subject. Accordingly, the following formula was conceived for adjusting backward learning: 1

2

3

4

The first term indicates the superiority of response availability over stimulus availability. The second term is a correction for postcriterion drop (i.e., the difference between the number correct on the last trial of original learning and the number correct on the first A-B transfer trial). Note that this “correction” for postcriterion drop is made only with respect to the unavaila6le stimuli. The third term is a measure of the difference between total possible correct backward associations and those actually observed. Thus, the adjustment is only made with respect to erroneous backward recalls. The final term refers to the number of correct backward associations produced on the first transfer trial. I t is obvious from this formula that if stimulus availability equals response availability (term I ) or if R-S performance is perfect (term 3), then no adjustment at all occurs. The first three terms of this formula assume associative symmetry. The correction proposed here to account for incomplete stimulus learning has general application. It will be most important in those situations where the stimulus terms are difficult to intergrate into functional units. Applying this correction to our first trial transfer data, backward association strength was 83% for normals and 76% for retardates. Apparently, neither intelligence group demonstrated complete associa-

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tive symmetry. These figures are comparable to those reported for normal adults. One may conclude that the ability to learn a PA item bidirectionally is a general phenomenon. There is a contradiction between the results of this study and those reported earlier by Palermo (1961). Using the same types of materials, he observed much weaker backward learning in children. This finding led Palermo to conclude that children (and presumably retardates) d o not learn in the backward direction as readily as normal adults. The most obvious procedural difference between these studies is related to the transfer phase. Palermo employed a mixed-list design whereas in the Baumeister et al. study different groups of subjects were exposed to only one type of item (e.g., A-B, B-A, or C-D) in transfer. In an effort to determine whether design variations were the source of the discrepant results, we repeated Palermo’s experiment, using the controls previously described (Baumeister et al., 1970). Normal and retarded subjects were requested to learn a list of PAS (pictures of common objects) to a criterion of one errorless trial. T h e subject was then presented with a six-item transfer list including two each of A-B, B-A, and C-D items. As in the previous study an analysis was conducted on the initial transfer trial for the A-B and B-A comparison only. In addition, relearning scores were obtained for all three types of items. The results of this second study generally confirmed the earlier finding of high, but incomplete, associative symmetry. Backward learning was considerably greater than that reported by Palermo (1961). In view of these findings, together with those of other investigators, we must conclude that the developmental differences inferred by Palermo are exaggerated. In one respect the results of the second study of this series contradicted the observations made in the first experiment. In the mixed-list study an interaction of learning direction and intelligence group was observed. More specifically, backward association strength was 90% and 66% for normal children and retardates, respectively. This difference is statistically and, perhaps, theoretically significant. Further analyses of the relatively poor backward learning of the retarded subjects revealed that it was related to the order in which the items were presented in the first trial of the mixed list transfer test. Those retarded subjects who were presented the C-D items first showed considerably poorer transfer to the subsequent B-A items. These Ss pulled down the average backward recall performance of the retarded group. Performance of the normal children was not similarly affected. Retarded S s who received either the A-B or B-A items first in transfer did not show a backward learning inferiority.

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Of the studies in which bidirectional learning has been compared for normals and retardates, this is the only one that has produced any evidence for a retardate backward learning deficit. It is the only comparative study, also, in which the mixed-list transfer test was employed. In view of these considerations and taking into account the nature of the mixed-list paradigm, it must be concluded that the backward learning deficiency experienced by the retarded subjects in this experiment is due either to a general shift in expectancies or to specific negative transfer effects arising from the C-D items. One can only wonder how many other retardate “defects” in process variables are due to contextual effects. As we have observed on several occasions, one of the major methodological difficulties encountered in the study of backward learning is that the functional and nominal stimuli may not be identical. If the subject has cue selected and thus learns an association between the response and some element of the stimulus terms, he will obviously experience difficulty when the experimenter turns the task around and, without warning, asks for the nominal stimulus. In order to sidestep this problem most experimenters interested in the backward learning abilities of children and retardates have employed pictures of highly meaningful objects. This procedure, hopefully, maximizes the overlap between functional and nominal stimuli. There is another approach to this problem. Even if the experimenter cannot force the subject to utilize th.e nominal stimulus, he can measure backward learning to various elements of the stimulus compound. As one aspect of his stimulus selection study, Berry (1 969) tested backward associations to the elements of his nominal stimulus term. I t will be recalled that Berry employed compounds of trigranis and colors paired with bigrams. T h e colors were found to be functional for both normal children and retardates. Berry also observed a high degree of backward learning to the colors. That is, when subjects were given the bigrams (response terms) in a transfer test and asked to recognize the corresponding stimulus terms they were able to identify the correct color with about the same accuracy as in picking out the bigratn when given the color. On the other hand, very few correct backward associations were produced to the trigrams, and even in these cases, a mediational process involving the colors was implicated. Backward association strength to the colors was 94% and 89% for the normals and retardates, respectively. When allowance was made for postcriterion drop, these figures became 94% and 99%. These values are higher than those observed in earlier studies. I t seems the more care taken to insure that backward learning

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is measured relative to the functional stimulus, the greater the amount of backward learning that is observed. Typically bidirectional learning is measured after original learning has been carried to some criterion, usually one errorless trial. It is one thing to show a high degree of associative symmetry for highly practiced items and quite another to demonstrate that backward associations are being formed simultaneously with the forward. Possibly, backward learning does not occur until after the subject has learned an item sufficiently well in the forward direction. Baumeister and Campbell (1970) have attempted to examine this possibility by measuring backward learning after varying amounts of learning in the forward direction. Eight pairs of pictures representing familiar common objects were constructed. Subjects were noninstitutionalized retardates and normal children matched with regard to mental age. Different groups of subjects were run for 1, 3, or 5 learning trials or to a criterion of two errorless trials. Transfer tests were imposed at each of these points to assess bidirectional learning. Table I1 presents the percent amount of backward learning for each group relative to forward learning. As in most of the previous studies S-R learning was somewhat superior to R-S learning. But this differential was constant over different amounts of practice. T h e values observed here are well in keeping with those reported earlier. The two intelligence groups displayed approximately equivalent backward learning overall. Although there were slight differences in favor of forward recall, the main result of this study supports the concept of associative symmetry in the PA learning of norma1 children and retardates. That is, backward learning strength remained at a consistently high value for all levels of learning. Backward associations appear to form at the same time and about to the same extent as forward associations. All of the studies reported here lead to the conclusion that bidirectional learning is a general phenomenon that occurs over a wide range of human development. There is little evidence to suggest that college TABLE I1 BACKWARD LEARNING EXPRESSED AS PERCENTAGE OF FORWARD LEARNINGFOR DEGREES OF ORIGINAL LEARNING

VARIOUS

Trials Group

1

3

Normals Retardates

.85 .91

1.oo .94

5 1

.oo .77

2 Errorless .86 .9 1

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students are fundamentally any different with respect to this process from either children or mental retardates. I t is possible, of course, that subjects selected at even lower levels of development would not display bidirectional learning. But from institutional retardates, through children, to normal adults, there is considerable evidence for a broad continuity of this process. Again, developmental differences that exist are more of degree than of kind. IV. ACQUISITION STRATEGIES A N D STAGES OF LEARNING

In previous sections of this paper w e have suggested that retardates may be inferior to children in both stages of PA learning. However, it is by no means clear what the source of slowness may be in either phase. The problem could be related to storage or retrieval processes in response or associative learning. T h e usual PA task does not separate the storage and retrieval aspects of performance (such as the typical anticipation procedure where storage and retrieval opportunities alternate within any one trial). Even when the study-recall method separates storage and retrieval functions, the experimenter typically does not receive any direct information concerning storage. For all practical purposes the subject is “turned off’ during these intervals. Consequently, the experimenter is forced to examine recall (retrieval) performance, and only indirect inferences are possible about acquisition processes. Only recently has there been any concern reported about the learning strategies employed by subjects during the learning period (e.g., C. J. Martin, Boersma, & Cox, 1965). One reason for this dearth of information has been the experimenter’s inability to gather objective data on various types of associative strategies. Nevertheless, as a result of the similarity of certain techniques reported by different subjects during postexperimental interrogation, investigators have succeeded in bringing many strategies under experimental control (e.g., mediation and cue selection). Within the framework of a two-stage model, the problem of acquisition strategies becomes even more complex. There is a distinct possibility that different strategies may be employed during the two stages. This dichotomy would account for the wide variety of techniques reported by a single subject on a PA task. If response learning is adequately described by free learning, then it is apparent that the first stage of PA learning requires a list-learning strategy, whereas the second stage may require an item-learning strategy. In spite of the difficulties involved, there is increasing evidence that retardates suffer from inefficient acquisition strategies. For example,

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current research indicates that retarded individuals do not spontaneously use mediator, or cue-selection strategies (Baumeister & Berry, 1968; Jensen & Rohwer, 1963). Similar evidence is available for freelearning strategies (e.g., Gerjouy & Spitz, 1966). Considering the language deprivation which affects most retardates, it seems unwise to explore the problem of acquisition strategies solely by introspective report procedures. It would be more satisfactory to develop objective techniques which would allow strategies to be monitored during the study period of a learning task. One such method is available which provides direct monitoring capabilities. Rather than using the traditional experimenter paced task, the subject may present the to-be-learned material to himself, thus creating his own presentation rate and interitem intervals. At the same time, the latencies of these events can be recorded. The temporal patterning generated, across item positions, as the subject progresses through the test list reveals systematic latency functions which may be directly related to acquisition strategies. Recently, the second author has collected latency data for approximately 150 normal college students for a variety of tasks, procedures, and materials (Kellas & Butterfield, 1970c, 1971). The tasks employed have been PA learning, free learning, and modified serial learning (ordered recall and forward probe recall). Also, latency data were recorded for a PA task in which relevant, irrelevant, or no pretraining was provided with respect to the response terms. In addition, introspective reports were gathered for all subjects. For all tasks, a nineitem list was employed. T h e materials were single letters, CV bigrams, and CVC trigrams. While all the data analyses are not yet complete, a few pertinent facts are apparent. Regardless of the type of material used for free learning, the acquisition latency functions are similar, differing only in absolute level. These functions are systematic and, in general, increase monotornically across the first five or six positions with a decrease on the terminal positions. Inspection of the individual subject’s temporal patterning, coupled with his verbal reports, suggested that the average curves were a combination of three distinct strategies: (a) grouping, (b) cumulative rehearsal (building), and (c) a strategy in which the subject used cumulative rehearsal for primacy items then progressed rapidly through the terminal items. These latter subjects invariably recalled the last items first, followed by ordered recall of the first items presented. T h e strategies reflected by temporal patterning were later corroborated by postexperimental interrogation and by recording the order of items recalled in the free-learning situation. It should be emphasized that

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these strategies appear to be rote repetition devices. T h e subject’s reports indicated various coding techniques (e.g., visual imagery, mediation, and cue selection), but the products of the coding strategies were then subjected to rote repetition which was obviously organized. In the paired-associate task, similar strategies were apparent during pretraining and, to a lesser extent, during PA learning for the group which was not exposed to pretraining. The configuration of these results indicates that within the rehearsal period two distinct strategy classifications are apparent: coding strategies and rote repetition strategies. Although tempting, there is insufficient data to conclude that coding devices represent associative learning and repetition strategies represent response learning. In all likelihood, both are involved in the two stages of PA performance. One additional finding is important. T h e postexperimental interrogations indicated that approximately 75% of the subjects reported changing strategies during early PA and freelearning trials. Similar phenomena have been reported by Atkinson and Shiffrin (1968). The alteration in strategies suggest that the subjects are engaging in hypothesis testing, or in some way evaluating their own recall performance. I n order to understand the development of response and associative learning, it is necessary to explore systematically both acquisition and retrieval processes. T o the extent that coding strategies are related to acquisition performance (C. J. Martin et al., 1965), we might expect developmentally retarded individuals to be handicapped. T h e majority of strategies available to a subject will depend to a great extent upon his preexperimental associations. Without a sufficient associative history, many mnemonic devices available to normal adults will not be available to retardates and children. However, on the optimistic side, once researchers have gained enough information concerning both acquisition and retrieval strategies in normal individuals, it may be possible through training techniques and instructions to raise markedly the level of retardate’s performance.

V. A N ACQUISITION STRATEGY MODEL3

Throughout the previous sections it has been assumed that free learning is an adequate analogue to response learning. Although there is little empirical data to substantiate this claim, numerous investigators have been willing to accept this assumption (e.g., Ekstrand, 196613; :$Thismodel was developed by the second author (George Kellas).

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Keppel, 1968; Underwood, 1966). In the present section, we shall continue to make such an assumption. Earlier evidence was provided from both stage analysis and free learning that the PA learning slowness attributed to retardates may be partially due to a response learning process. Also, it has been pointed out that even when the response learning requirement was eliminated in the PA task retardates were inferior to MA matched normals. In the normal literature there has been a marked rise in research interest in individual learning strategies. However, there is still very little information available. T h e most commonly employed experimental approach seems to be one of preventing the subject from selecting his own strategy. To accomplish this, the experimenter provides instruction and/or experimental training. This type of research program has yielded data concerning a few specific strategies. However, there have been few attempts to integrate or to suggest directions for research in this area. T h e following model of acquisition strategies is offered as a brief first approximation in order to provide a framework within which developmental research may be synthesized and generated. The model depicted in Fig. 5 is, as far as possible, an empirical and descriptive model based on existing research. There are four main features: a strategy selector mechanism, coding operations, repetition strategies, and a feedback system. 1. STRATEGY SELECTOR When a subject is presented a list of PA items he must first evaluate the material with reference to what the experimenter demands of him. T h e list evaluation would occur during the familiarization trial of the Coding

output

f

jl i

Normals Retardotes

FIG. 5. Model of acquisition strategies.

-

_ I _

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26 1

typical anticipation procedure, or on the first study trial for the studytest method. T h e strategy chosen probably depends on a number of factors. (1) T h e meaningfulness level of the task items will determine the frequency of preexperimental associations available. The more associations available the more likely the involvement of a complex coding strategy such as visual imagery or mediation. The premise is that the subject will attempt to make sense out of the nonsense the experimenter presents him. If the verbal material is low meaningful the probability is higher that the subject will select a more primitive technique (e.g., cue selection, chunking). In the extreme case, the subject will avoid a time-consuming search for associations and will rely on rote repetition. There is ample evidence that visual imagery is enhanced by the use of concrete material and becomes less effective as the material becomes more abstract (Paivio & Yuille, 1969). (2) The amount of material to-be-learned will influence the strategy employed. If the amount exceeds the immediate memory span of the subject, an attempt will be made to reduce the amount to a manageable size via chunking or grouping. Recently, Battig (1966) has demonstrated grouping according to difficulty in a PA task. Other investigators have demonstrated PA grouping by differentially rewarding specific items within the PA list (Harley, 1965a, 1965b). (3) The response required of the subject partly determines the coding operation employed. Under recall conditions an attempt will be made to integrate low meaningfulness response terms, whereas for a recognition requirement the subject would select a portion of the response which would differentiate it from other response items. (4) The rate at which the list is presented might also influence strategy selection. For example, at a fast rate the subject may not have sufficient opportunity to employ certain preexperimental habits involving elaborate organizational schemes. (5) The subject’s preexperimental history will greatly influence the selection of a coding operation. The learning history and preexperimental associations will determine the number of strategies available for him to seiect from. (6) Finally, postexperimental interrogations indicate that subjects evaluate their own output performance, regardless of experimenter feedback, and maintain o r change their strategy as a consequence. 2. CODING The coding operations included in the model are not meant to be exhaustive, but representative of the majority of coding devices. In general, visual imagery and mediation techniques are probably em-

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ployed to increase the meaningfulness of the verbal material. Mediation is defined grossly as any process employed to intervene between stimuli and responses. Mediators may be words, phrases, or sentences and may also be acoustically coded. Cue selection is also included here because research has indicated that all the assoc.iative ingredients are present (bidirectional associations among the stimulus elements and an association of these elements with the response) to describe a mediation process (Baumeister et aE., 1969). Visual imagery includes both the visual image of concrete objects, and also the placing of verbal material within a visual context by the use of images (Norman, 1969). Clustering, chunking, and rhyming are grouped together in the belief that these operations are less complicated strategies used solely to reduce the amount of material to be learned. These sorts of coding devices would be most effectively used for the response learning stage. Clustering has repeatedly been shown to be a powerful strategy for free learning (Tulving, 1968). It should be noted that the use of clustering for the associative stage might produce associative interference through the development of stimulus equivalence. 3. ROTEREPETITION

Evidence cited earlier has indicated that the coding product will, itself, be subjected to rote repetition (Kellas & Butterfield, 1970a). Also, subjects reporting the use of various coding operations have still demonstrated clear-cut temporal patternings which suggest the use of a building or grouping strategy following the coding operations. Another strategy which could be included here is a more passive one, in which the subject repeats each item to himself with approximately equal frequency. However, no normal subject was observed to do this. The function of the grouping strategy is also to reduce the total amount of material to be learned. The building strategy was often noted to be a “first attempt” technique which was quickly altered. A building strategy is the least efficient device for learning low meaningful material and requires tremendous intake effort. 4. FEEDBACK LOOP The feedback system was discussed earlier in relation to the strategy selector. The basis for the inclusion of the loop system was twofold: (1) the large number of subjects reporting a strategy change because they “thought they could do better,” and (2) other areas of verbal learning which employ PA procedures (e.g., concept learning) have also noted a high frequency of hypothesis testing (Jung, 1968). In the discussion of

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the strategy selector, it was pointed out that the subject examines the material then makes a strategy decision on early PA trials. Strategy changes on later trials will occur as a result of the subject’s own evaluation of his output performance. Decoding has not been mentioned because it is essentially a retrieval phenomenon. However, whenever a coding operation is employed which translates the original material into a form which is unacceptable as a correct response, a decoding process is required to convert the items into their original forms. As noted in the model, certain coding operations (e.g., clustering) may not require decoding except to the extent necessary for the subject to emit discrete units during output. 5. RESEARCHIMPLICATIONS

T h e solid lines depicted in the model indicate the numerous ways in which a normal individual may acquire a list of PA items. It is unlikely that any one coding operation will be used to learn an entire test list. Some PA items will elicit one coding technique, whereas others may be learned in a rote fashion. In any case, the normal individual will attack the list on an active manner which will be reflected by acquisition latencies. On the other hand, the immature individual will assume a more passive approach (indicated by the dotted lines) forced on him by his deficient preexperimental learning habits and associations. Belmont and Butterfield ( 1969) have demonstrated recently that the retardate’s latency function is essentially flat when plotted against serial position in an S-paced probe task. T h e study by Kellas and Butterfield, cited earlier, compared free learning with serial learning using a subject-paced technique. The results showed similar latency functions for both tasks. These data suggest that rote repetition acquisition strategies are similar in these experimental situations, and therefore may reflect learning strategies which are relevant to the response learning phase of‘ PA acquisition. A number of predictions are immediately suggested within the model’s framework: (1) Using an acquisition latency procedure, retardates should manifest shorter latencies than normal adults on early PA trials. The coding operations employed by normal adults should consume a large portion of their study time during initial learning. (2) Retardates should show fewer strategy changes during PA learning than normal adults. This prediction may be tested by examining trial-to-trial latency functions, o r by postexperimental interrogation. (3) Finally, any active strategy induced by experimental procedures or instruction should improve the retardate’s performance relative to a control group. If an

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instruction inducement is utilized for an active repetition strategy, the latency technique will allow the monitoring of the extent to which it is used; thereby providing the experimenter with objective feedback concerning the number of subjects who followed the instructions. VI. OVERVIEW

Our attempts to analyze the verbal associative learning of retardates have been couched within two major orientations. First, we assume that verbal learning behaviors of most retarded individuals are best understood in terms of a developmental, rather than a pathological, conceptualization. Performance differences observed between groups of subjects representing different levels of intelligence development, for the most part, seem to be quantitative, not qualitative. Second, we have endeavored to demonstrate that the processes subserving paired-associates learning of normal children and retardates may be productively evaluated in terms of constituent analyses - procedures that have been applied previously to paired-associate learning of adults. T h e two-stage model of paired-associate learning proposed by Underwood and Schulz appears to be valid for describing performance of people at the lower end of the developmental scale. However, it must be emphasized that other processes may also be involved. For example, a stimulus learning stage may be a useful addition to the model. T h e empirical description of an associative learning model, in any case, is merely an initial step. Once the loci of inefficient learning are identified, we must determine the experimental procedures that are necessary to strengthen the abilities involved. T h e word “strengthen” is emphasized in the belief that the requisite process variables are basically similar for normal and retarded individuals. Assuming that a two-phase description of associative learning is valid for developmentally retarded or immature individuals, we suggest research should be conducted to ascertain the variables which differentially affect the stages of learning. Research with college students, for example, has demonstrated that high conceptual similarity of the response terms facilitates completion of the response stage but adversely affects the associative learning stage (Underwood et al., 1959). Additional attention should be directed toward the use of free-learning procedures for evaluating the response stage. We should establish whether free learning can serve as an analogue to response learning. One approach would be to assess whether performance phenomena of free learning can be demonstrated on early PA trials (e.g., clustering of re-

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sponse terms, or a serial position effect). If a free learning process is not involved, the acquisition strategy model proposed here would require revision. The associative stage process of cue selection appears to be a very fundamental one occurring over a wide developmental range. Our findings indicated that cue selection behaviors are similar for normal children and retardates. I t appears that retarded subjects make less sponhneow use of cue-selection strategies. Two factors that govern cueselection behaviors in both normal and less intelligent children are stimulus meuningfulness and attentional set. In certain contexts, a mediational process is probably involved in cue selection. Another associative process that we considered in some detail is the one commonly, but perhaps inaccurately, referred to as backzuurd learning. Backward associations undoubtedly play an important role in associative learning, particularly where transfer operations are involved. We concluded that bidirectional learning is a general phenomenon that occurs over a wide range of human development. Although perfect associative symmetry has not typically been observed, certain methodological problems lead to an underestimate of backward learning It appears that the greater the care taken to insure that backward learning is measured relative to thefunctional stimulus, the higher the degree of backward learning that is observed. Evidence from our studies with retardates and normal children suggests that symmetry rather than asymmetry is the more accurate description of the bidirectional learning process. Throughout this chapter we have frequently referred to the notion of “acquisition strategy.” The view that S-R connections are strengthened through frequency of contiguous exposure simply does not square with the active involvement of subjects in a learning task. The evidence reported here and elsewhere suggests that normal individuals bring their entire preexperimental history to bear on any given task. This active process is reflected by the various devices, both organizational and associative, reported by subjects during postexperimental interrogation and by the temporal patternings which develop across item positions on an S-paced task. Retardates appear to approach a learning task much more passively. This passivity is also revealed by latency patterning and by instruction manipulations which suggest that, in general, retardates are bound by the experimenter’s instructions. In the final sections of the chapter we have presented an acquisition strategy model which incorporates the cognitive aspects of PA learning, suggesting avenues of research which would yield experimental anal-

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Palermo, D. S., 8c Jenkins, J. J. Word association norms: Grade school through college. Minneapolis: University of Minnesota Press, 1964. Postman, L. Transfer of training as a function of experimental paradigm and degree of first-list learning. Journal of Verbal Learning and Verbal Behavior, 1962, 1, 109118. Postman, L., & Greenbloom, R. Conditions of cue selection in the acquisition of pairedassociate lists.Journal qfExperinaenta1 Psychology, 1967,73,91-1 00. Prehm, H. J . Verbal learning research in mental retardation. American Journal o/ Mental Deficiency, 1966,71.44-47. Prehm, H. J . Rote verbal learning and memory in the retarded. In H.J. Prehm, L. A. Hamerlynck, & J. E. Crosson (Eds.), Behaviorul research in mental returdalion. Monogr. No. 1. Eugene, Ore.: Rehabilitation Research and Training Center in Mental Retardation, University of Oregon, 1968.Pp. 3 1-43. Prehm, H. J., & Hom, G. L. Association norms for retarded subjects. Unpublished manuscript, available from HJP, University of Oregon, 1967. Rabinowitz, F. .J., 8c Witte, K. L. Stimulus selection as a function of letter color.Journal q / Verbal Learning and Verbal Behavior, 1967,6,167-168. Saltz, E. Response pretraining differentiation of availability?Journal?/ Experinzttitul Plychology, 1961,61,583-587. Saltz, E. Compound stimuli in verbal learning: cognitive and sensory differentiation versus stimulus selection.Journal i~/ExperimentalI'sycholo~y, 1963,66,1-5. Schulz, R. W., & Martin, E. Aural paired-associate learning: stimulus familiarization. response familiarization, and pronounciability. Journal of Verbal Learning and Verbal Behavior, 1964,3, 139-145. Schulz, R. W., & Tucker, 1. F. Supplementary report: stimulus familiarization in pairedassociate learning. Journal o/Experimentul Psychology, 1962.64,549.(a) Schulz, R. W., & Tucker, 1. F. Stimulus familiarization and length of the anticipation interval in paired-associate learning Psycholog-icd Record, 1962,12, 341-344.(b) Silverstein, A. B., & McLain, R. E. Association processes of the mentally retarded: 1. An exploratory study. American Journnl of Mentd Dejirkncy, I961.65,76 1-765. Silverstein, A. B., & McLain, R. E. Associative processes of the mentally retarded. 11. Effects of selected background variables, Americati ,Journal o/ Mental Deficiencji, 1964, 69,440-445. Sundland, D. M., & Wickens, D. D. Context factors in paired-associate learning and recall.Journal a/ Experimental Psychology, 1962,63,302-306. Tulving, E. Theoretical issues in free recall. In T. R. Dixon & D. 1,. Horton (Eds.), VerOd behavior and general behavior thoty. Englewood Cliffs, N.J.: Prentice-Hall, 1968. Pp. 2-36. Underwood, B. J. The representativeness of rote verbal learning. In A. W. Melton (Ed.), Categories of human learning. New York: Academic Press, 1964.Pp. 47-78. Underwood, B. J. Motor-skills learning and verbal learning: some observations. In E. A. Bilodeau (Ed.), Acquisition o/skill. New York: Academic Press, 1966.Pp. 489-516. Underwood, B. I., Ekstrand, B. R., & Keppel. G. An analysis of intralist similarity in verbal learning with experiments on conceptual similarity. Journal qf Verbal Leuming and Verbal Behavior, 1965,4.447-462. Underwood, B. J., Runquist, W. N., & Schulz, R. W. Response learning in paired-associate lists as a function of intralist similarity. Jourrinl o / Experimentul Psychology, 1959, 58, 70-78. Underwood, B. J., & Schulz, R. W. Meaning/ulrms and verbal learning. Philadelphia: Lippincott, 1960.

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Weiss, E. Stimulus availability and backward association: meaning frequency and associative bond strength. Psycholopcul Reports, 1965, 16,427-437. Weiss, W., & Margolius, G. The effects of context stimuli on learning and retention. Journal of'Experiman6ul Psychology, 1954,48, 3 18-322. Zeaman, D., & House, B. J. The role of attention in retardate discrimination learning. In N. R. Ellis (Ed.), Hundbook of'mentul dejciency. New York: McGraw Hill, 1963. Pp. 159-223. Zigler, E. Developmental versus difference theories of mental retardation and the problem of motivation. Americanjournul o/Mentul Dejwency, I969,73,536-556.

Sequential Dot Presentation Measures of Stimulus Trace in Retardates and Normals E D W A R D A. HOLDEN, JR. E. R. JOHNSTONE TRAINING AND RESEARCH CENTER, BORDENTOWN, NEW JERSEY

I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. T h e Concept of Stimulus Trace and Its Relevance to Research

in Mental Deficiency ............................................. A. T h e Stimulus Trace Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Ellis’ I963 Stimulus Trace Theory ........................... C. Ellis’ Modified Formulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111. Sequential Integration Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. Rationale and Relationship to Stimulus Trace Theory .............. B. Experimental Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IV. Illusory Displacement Studies ...................................... A. Rationale and Relationship to Stimulus Trace Theory . . . . . B. Primary Experimental Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. Secondary Experimental Parameters ............................. V. Discussion . . . . . . . . . . . . . . . . . . . . . ......... . References .....................................................

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272 272 272 273 273 274 275 281

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1. INTRODUCTION

Persistence of a poststimulus correlative is necessary if that stimulus is to have unique representation. This has been labeled “stimulus trace,” a transient neural process by which the organism remains temporarily under the control of or has temporary information about a stimulus no longer present. The history and development of stimulus trace theory has been thoroughly reviewed by Gomulicki (1953). It is the purpose of this article to review the stimulus trace concept as an explanatory device for short-term memory deficits in the mental defective, to examine evidence suggesting that such deficits may derive from factors other than inadequate stimulus trace processes, and then to present some relevant experimental findings from the E. R. Johnstone Research Laboratories. 27 1

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Edward A . Holden, Jr. 11. THE CONCEPT OF STIMULUS TRACE A N D ITS RELEVANCE TO RESEARCH IN MENTAL DEFICIENCY

A.

The Stimulus Trace Process

Recent reviews of research and theory in short-term memory (STM) (Scott & Scott, 1968) and of the relations of STM to development and intelligence (Belmont & Butterfield, 1969) have discussed the role of STM functions. Briefly, if the poststimulus trace were abnormally attenuated, abbreviated, or diffused the organism would have difficulty in maintaining an adequate representation of a preceding event. This inadequacy would eventuate in one or both of two deficiencies: (a) no memory for the event; and (b) insufficient representation of the event for integration with traces from subsequent events.

B. Ellis’ 1963 Stimulus Trace Theory A theoretical system relating STM and stimulus trace characteristics in normals and mental defectives has been generated by Ellis (1963) from a rich foundation of experimental evidence. The theory hypothesizes that certain behavioral inadequacies in individuals with subnormal nervous systems are attributable to deficiencies in STM. Shortterm memory, measured in minutes or seconds, is postulated to depend upon transient poststimulus perseveration processes which mediate continuity between events until more permanent changes underlying long-term memory occur. It is the central hypothesis of the theory that in subnormal organisms, for example, those with inferior intelligence, apparent learning deficits reflect the discontinuity between events as a result of diminished poststimulus trace perseveration. More specifically, both amplitude and duration of the stimulus trace are attenuated in the subnormal. Ellis also speculates that ‘‘. . . the young child has a stimulus trace deficit and the establishment of the adult form of the short-term memory function will show a developmental trend [Ellis, 1963, p. 1401.” The theory predicts a difference in STM for low and high IQsubjects of the same CA, as well as increased amplitude and duration of the trace as age increases during the developmental period. It also predicts differential effects of certain stimulus parameters, namely, that increased stimulus intensity, increased stimulus duration, and increased temporal contiguity will be relatively more advantageous for the defective individual.

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C.

273

Ellis’ Modified Formulation

More recently Ellis (1970) has modified his original theory. Although the series of studies to be reported in this chapter were based on the earlier theory, their relationship to certain aspects of the newer theory warrants a summarization of the 1968 modification. T h e modified theory assumes two discontinuous processes operating in retention of supraspan information (sequence of input stimuli exceeding the attention span). Primacy portions of the serial position curve are hypothesized to be influenced by rehearsal strategies (RS) and recency by passage of time. Three systems of memory are postulated -primary memory, secondary memory, and tertiary memory. Storage in primary memory is limited and transient, items being lost either by decay or interference. Transfer of information from primary to secondary and to tertiary memory is mediated by RS. Comparisons of primacy and recency functions for retardates and normals demonstrated normals to be superior to retardates in the former only, leading to the interpretation-that primary memory does not differ in retardates and normals but that retardates are deficient in their ability to rehearse. Thus a “RS deficiency hypothesis” was proposed to explain STM deficits in retardates. This deficiency would be expected to limit the retardates’ memory for items exceeding primary memory capacity, items which normally would be transferred to secondary memory through RS mechanisms. Tertiary memory is assumed not to differ i n normals and retardates (Belmont, 1966) and hence plays no relevant role in the theory. 111. SEQUENTIAL INTEGRATION STUDIES

T h e experimental evidence presented by Ellis in his 1970 theory suggests that the degree of support obtained by various investigators for his 1963 theory depended upon the extent to which measures of simple stimulus trace (primary memory) were confounded by secondary memory, i.e., by qualitative and quantitative differences in the RS utilized by retardates and normals. Although the extent to which RS operated in those studies to differentially facilitate STM in retardates and normals cannot be specified, in most cases it could probably be demonstrated that verbal mediatorial processes obscured the effects of simple trace decay. Even in the case of delayed response measures, which “, , . on the face, would appear to be the ‘purest’ measure of St [Ellis, 1963, p. 1471,” it has been demonstrated (Barnett, Ellis, & Pryer,

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1959) that retardate performance can be facilitated by learning names of the discriminative cues. Belmont summarizes the present problem. “There is no systematic research into the role of verbal labeling, rehearsal, and consolidation in retardate retention, and this prevents anything beyond highly speculative accounts of the source of retardate retention deficits, where they are rarely observable [Belmont & Butterfield, 1969, p. 531.” Ideally, measurement of stimulus trace amplitude and duration should employ a task in which RS contribute negligibly to the STM process. It was toward this objective that the following series of experiments was undertaken. A.

Rationale and Relationship to Stimulus Trace Theory

The studies to be described in this section were based on the assumption that optimal behavioral measurement of stimulus trace amplitude and duration would obtain from an S - S . . . R perceptual task in which verbal mediation or other possible RS do not operate to obscure the traces of individual stimulus events. For this purpose a task was devised in which spatially distributed components (points) of familiar visual patterns are presented sequentially so that recognition depends upon integration of successive traces into a single entity. It was assumed that the necessary integration for pattern recognition would depend upon the simultaneous persistence of traces from all stimulus events, but as the experimental evidence will show, it is more likely that continuity between traces of immediately contiguous stimuli is more critical. From the foregoing it can be predicted that any factor which influences amplitude and duration of the stimulus trace, e.g, central nervous system integrity, maturational level, stimulus intensity, stimulus duration, or time lapse following a stimulus event, will affect trace continuity and, consequently, integration of sequential stimulus components into a recognizable pattern. The experimental task required Ss to identify I0 familiar visual patterns that were presented individually by successively illuminating a sequence of neon lamps defining one of 10 configurations. These configurations are shown in Fig. 1. Arrows indicate the first light and direction of progression for subsequent lamp illuminations within each pattern. The unilluminated lamps were not visible to S, and subdued room illumination resulted in a fairly homogeneous black field against which the patterns were viewed. Essentials of the apparatus are described in

275

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an earlier report (Holden, 1965). S s were tested with this task only after having successfully completed a pretest requiring correct identification of each pattern when its separate components were presented simultaneously. 8.

Experimental Parameters

T h e experiments described here were undertaken to examine several hypotheses from Ellis’ 1963 stimulus trace theory and to investigate the relevance of additional variables suggested by the findings. In the first experiment (Holden, 1965) the following hypotheses were examined. (a) Trace amplitude and duration are attenuated in mental defectives and young children. (b) Trace amplitude diminishes over time following cessation of the stimulus. (c) Increasing temporal separation between stimuli is relatively more disadvantageous for mental defectives and young children compared to equal CA normals. Since trace amplitude and duraticn are considered to be covariant functions, any variable influencing amplitude should also influence duration. 1.

STUDYI

Institutionalized educable retardates (R), equal CA normals (CA) from a public high school, and equal MA normals (MA) from a public elementary school were compared on the pattern identification task. Interstimulus intervals of .05, -10, -20,.50, 1.O, 2.0, 3.0, and 5.0 seconds were employed, and all lights were illuminated for .05 second Ss were tested individually in sessions requiring approximately 35 min. In

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no case was S told whether his response was correct or incorrect, but if he failed to respond or said he did not know E urged him to guess. Essential results of the study are depicted by the curves in Fig. 2. Statistical evaluation of the subject and temporal factors represented by these curves demonstrated significantly fewer correct responses for both the equal MA and retarded groups compared to the equal CA normals, supporting the hypothesis that trace amplitude and duration are attenuated in retardates and young children. T h e hypothesized diminution of trace amplitude with increasing interstimulus intervals was also supported by statistical tests, although the first significant decrease in performance did not occur until 1.0 second in the equal MA group and until 2.0 seconds in groups CA and R. For interstimulus intervals less than 1.0 second, it was reasoned, continuity between stimulus traces remained above a critical threshold. Because failure of the retardate group to show earlier performance deterioration than the equal CA group is critical to the theory, further examination of the

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curves in Fig. 2 was made. Comparisons of performance decrements from 0.5 to 5.0 seconds showed that the equal MA group declined significantly (p < -01) more than the equal CA group and that the difference between decrements in the equal MA and retardate groups was marginally significant ( p < .06). The difference between decrements in the equal CA and equal MA groups is consistent with the hypothesis of relatively greater decrements over longer time intervals for children, but the expected greater decline in retardates compared with equal CA normals was not supported. In view of these results it was speculated that there are two different types of CNS deficits, one for mental defectives and one for immature normals. It was suggested that for future experimental analysis the trace theory might be modified to include two independent processes: (a) initial trace amplitude, which is positively related to I Q and CA; and (b) trace duration, which is positively related to CA. Although the trace theory does not make differential predictions about equal MA normals and retardates, the relative performance of these two groups is important for the defect vs. developmental controversy. Despite their lower maturational level, overall performance of the equal MA group was significantly above that of the retardates. This finding is consistent with a defect interpretation of retardation (discussed by Zigler, 1966, 1967), implying that Ellis’ construct of CNS integrity is represented by IQrather than MA. In view of Ellis’ speculation that “. . . the young child has a stimulus trace deficit . . . [Ellis, 1963, p. 1401,” whether or not this deficit derives from the same deficiency underlying stimulus trace inadequacies in the retardate, it is important to recognize that equal performance for the retardate and equal MA groups would not necessarily support the developmental theorists. Since young children suffer a maturational deficit, which should depress their performance below that of retardates with the same MA, equality between equal MA normals and retardates implies a nondevelopmental defect in the latter group. This fact has been overlooked by some investigators testing Ellis’ trace theory (Butterfield, 1968; Fagan, 1966). Only if equal MA normals and retardates are compared at ages beyond maturational asymptote can such comparisons be valid. Ellis’ omission of differential predictions for retardates and equal MA normals could be construed in one of two ways. (1) Equal MA normals do not differ from retardates, thus providing implicit support for a developmental rather than defect approach to mental retardation. (2) Equal MA normals, by necessity of lower CA, do not differ from

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retardates because their lower maturational level has effects equivalent to the retardates' CNS deficit. Solution of this dilemma could be approached by experimental analyses of trace parameters in normals of differing CA levels so that maturational factors could be eliminated. As an alternative to the stimulus trace interpretation of group differences obtained in Study I it might be argued that performances reflected the relative numbers of pretest patterns available to S's recall during the testing session. This possibility is consistent with the finding that normal adults not shown the pretest patterns identify fewer sequentially constructed configurations than those who are shown the patterns. Evaluation of the recall factor was made by comparing the number of patterns Ss could remember immediately after the pretest. Mean recall scores for the equal CA, retardate, and equal MA groups were 8.91, 8.47, and 7.81, respectively. The equal CA group recalled significantly more patterns than the equal MA group, but no other comparisons were significant. If the overall performance level for each group during the sequential integration task were dependent upon memory of the 10 patterns shown during the pretest, these levels should have the same rank order relationship as the group recall means. Since they do not, it is unlikely that inferior pattern identification for retardates can be explained in terms of their having a smaller population of available guesses to choose from during the sequential integration task.

2. STUDYI1 In this study (Holden, 1966), as in the previous one, educable retardates were compared with equal MA and equal CA normals on a task requiring recognition of visual patterns formed by sequentially illuminated lights. One objective was to determine whether the integration of traces depends upon the temporal separation of spatially adjacent lights or upon the time lapse between the first and last stimuli of each pattern. Since the previous study showed no regular relationship between performance and pattern length (number of dots), it was speculated that simultaneous persistence of traces from all lights is not as critical as continuity between traces of any two consecutive lights. Accordingly, it was hypothesized that integration of a light sequence depends upon some minimal continuity (temporal overlap) between traces from adjacent lights, and that the degree of continuity depends upon the amount of trace decay at the time the q,econd stimulus appears. Assuming that trace decay begins at stimullts termination (although results from the

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previous study suggest at least a 0.5-second plateau before decay begins), it follows that increasing the duration of each stimulus, thereby shortening interstimulus decay time, will increase continuity between traces from adjacent stimuli. According to this hypothesis it was predicted, for all groups, that if the time between onsets of the first and last stimuli in a pattern is held constant the number of correct pattern identifications would be a positive function of stimulus duration. A second objective was to further test Ellis’ 1963 hypothesis that trace amplitude and duration are diminished in retardates and young children. I t was predicted that for all light durations the retardates and equal MA normals would demonstrate fewer correct pattern identifications than would the equal CA normals. Although Ellis does not differentiate between deficits in retardates and young children, evidence from the previous study led to a third hypothesis, viz., that trace amplitude ancl duration in adolescent retardates is lower than in equal MA normals. Accordingly it was predicted that foi- interstimulus intervals less than 1.O second, retardates would demonstrate fewer correct pattern identifications than would the equal MA normals. T h e fourth hypothesis, based upon empirical findings of Study I, is a modification of Ellis’ theory and asserts that trace duration for a given amplitude level is positively related to CA independently of IQ. Frorn this hypothesis it was predicted that the equal MA group would nianifest an earlier ancl greater performance decrement than gtoups (;A and K over decreasing stimulus durations. The patterns used previously were also used in this study, although in some configurations the number of lights was reduced. All Ss received each pattern under six different conditions, which varied with respect to the length of tirne lights in a sequence remained illuminated. Time between onsets of contiguous lights was fixed ;it 3.05 seconds, ancl each light remained on for .0.5, .20, 1.0, 2.0, or 3.0 seconds. Otherwise the testing procedure was identical to that described for Study I. The mean number of correct pattern identifications associated with each stimulus duration in the three groups are presented in Fig. 3. Groups and duration effects were significant, as was the interaction between these variables. Analyses of differences between durations at each S level demonstrated significant decrements for the equal MA and retardate groups, and for group CA the decrement was marginal ( p < .06). Relative performance deterioration among groups was determined by comparing decrements from 3.0 to .05 second durations. The equal MA and retardate groups dropped significantly more than group CA, but they did not differ from each other.

Edward A . Holden, Jr.

280

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The significant duration effects are consistent with the hypothesis that trace continuity varies directly with the duration of each light, and that integration within sequences depends upon the temporal proximity of traces from adjacent stimuli rather than upon simultaneity of traces from all stimulus events. Consequently, it was concluded that as stimulus duration decreased from 3.0 to .05 seconds there was a concomitant greater decay of traces between consecutive lights. T h e possibility that stimulus duration per se may have affected persistence of the poststimulus trace will be considered subsequently. The lower trace amplitude and duration for groups R and MA supports Ellis’ theory of deficient trace processes in retardates and young children. Consistent with the findings in Study I is the demonstrated superiority of group MA compared with the retardate group, which confirms the hypothesis that adolescent retardates suffer a greater trace deficit than do equal MA normals. T h e data fail to support the hypothesis that trace duration is a p s i -

STIMULUS TRACE STUDIES

28 1

tive function of CA independent of I Q but is in complete agreement with Ellis’ concept of amplitude and duration deficits for retardates and young children. Thus, contrary to the findings of Study I, it appears that trace duration is not an independent process but depends upon both I Q a n d CA. An additional analysis suggested by the data was made to determine the relative efficacy of faster flashing rates in Study I as compared with longer stimulus durations in study 11. Comparisons were made between those points in Study I and Study I1 which had identical interstimulus intervals but different stimulus durations. Although suggestive, the comparisons did not demonstrate a consistent- advantage of longer stimulus durations over faster flashing rates. They did demonstrate, however, that the greater difficulty of the 3.0-second compared to the .05-second interstimulus interval in Study I could, in Study 11, be completely negated by increasing stimulus duration so that the time between successive stimuli in the two studies was equal. Comparison of recall scores for the pretest in Study I1 provided results consistent with a similar analysis in Study I, indicating that differences between groups on the sequential integration task cannot be attributed to differences in the number of pretest patterns available to recall. IV. ILLUSORY DISPLACEMENT STUDIES

In Studies I and I1 many Ss reported a “wandering” of individual light stimuli about the display screen, an effect which in some instances apparently interfered with correct recognition of the patterns. Investigation of this phenomenon in a subsequent pilot study demonstrated that if several points of light are illuminated sequentially in a straight line, particularly with the longer interstimulus intervals, Ss experience a compelling illusory displacement of the lights in an erratic manner about their actual progression lines. Unlike autokinetic movement, however, there is no apparent driftingof individual lights while they are illuminated. Rather, the lights are displaced in relation to each other. When, for example, the third light in an horizontal array appears, it might appear to be above or below an imaginary straight line drawn through the first two lights. Since this displacement phenomenon seemed to be sensitive to length of the interstimulus interval, and to involve little or no verbal mediation, it presented an ideal experimental technique for investigating trace parameters within the framework of the trace theory.

282 A.

Edward A . Holden, Jr. Rationale a n d Relationship to Stimulus Trace Theory

It is a fundamental assumption underlying studies in this section that illusory displacement of sequentially illuminated lights reflects dissipation of a locus-defining trace, and that veridical perception of the spatial relationship between immediately successive lights depends upon some minimal continuity between the traces of these lights. Accordingly, any variable which influences amplitude and duration of the stimulus trace, e g . , CNS integrity, maturational level, stimulus intensity, stimulus duration, or temporal interval following a stimulus event will affect trace continuity and, consequently, the perceived relationship between two o r more sequential stimuli. T h e experimental task for the following series of studies required S s to judge the rectilinearity (ie., as straight or crooked) of straight line dot progressions generated by sequentially illuminated lights. T h e 10 light sequences used for the remaining studies in this section are shown by the open circles in Fig 4.Arrows designate the first light and direction of subsequent lamp illuminations for each sequence. Prior to the sequential judgment task, each S was given a pretest to assure that h e could discriminate between rectilinear and nonrectilinear sequences when the four stimuli for each line were presented simultaneously either in a straight line or with one of the stimuli slightly displaced from rectilinearity. B.

Primary Experimental Parameters

Hypotheses and predictions for the first study (Holden, 1967b) in this series were as follows. (a) Stimulus displacement reflects the dissiJ

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pation of a locus-defining trace, and veridical perception of the spatial relationship between immediately successive lights depends upon some minimal continuity between the traces of these lights. If, as concluded in Study 11, continuity between the traces of adjacent stimuli decreases with increasing interstimulus interval, the number of “straight” judgments following lights presented in a straight line would decrease with increasing temporal distance between the lights. (b) T h e relationship between apparent displacement and interstimulus time is independent of stimulus duration. For sequences with a constant interstimulus interval the number of “straight” judgments would not be influenced by duration of the intervening lights. (c) Trace amplitude and duration is highest in equal CA normals, next highest in equal MA normals, and lowest in retardates. Consequently, the relative number of “straight” responses for these groups would follow in the same order. (d) Increasing interstimulus interval effects relatively greater trace discontinuity for retardates and equal MA normals, so that with increasing interstimulus intervals retardates and equal MA normals would demonstrate more rapid decrements in the number of “straight” responses. 1 . STUDYI11 T h e preceding hypotheses were tested in two experiments, both of which compared educable retardates, equal CA normals, and equal MA normals drawn from the same populations used in the previous studies. In the first experiment the duration of each light stimulus was 0.5 second, and Ss received the 10 patterns with interstimulus intervals of -50, 1.0, 2.0, 3.0, and 5.0 seconds. In the second experiment the time between onsets of successive lights was maintained at 3.05 seconds, and interstimulus interval varied by changing stimulus duration. Ss received the 10 patterns with stimulus durations of .05, 1.0, 2.0, and 3.0 seconds, corresponding interstimulus intervals for which were 3.0, 2.05, 1.05, and .05 seconds, respectively. Figure 5 shows the mean number of “straight” responses associated with each interstimulus interval for the three groups in Experiment 1. An analysis of variance of these curves demonstrated a nonsignificant group effect, a highly significant interval effect, and a significant interaction. T h e mean number of “straight” responses over increasing stimulus durations for the three groups in Experiment 2 are depicted in Fig 6. An analysis of variance demonstrated a nonsignificant group effect, a highly significant duration effect, and a nonsignificant interaction. To evaluate the effect of longer stimulus duration independent of interstimulus interval, comparisons were made between those points in

Edward A . Holden, J r .

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Experiments 1 and 2 which had identical interstimulus intervals but different stimulus durations. These comparisons revealed no significant effect of longer stimulus durations. The decreasing number of “straight” responses with longer interstimulus intervals in Experiments 1 and 2 supports the hypothesis that nonveridical perception results from inadequate trace continuity, and that the degree of continuity decreases with increasing temporal separations of the lights. Failure to obtain differences between the number of “straight” responses when the 2.0-second and 1.O-second interstimulus intervals in Experiment 1 were compared with corresponding intervals in Experiment 2, where stimulus durations were, respectively, 20 and 40 times longer, supports the hypothesis that the relationship between illusory displacement and interstimulus interval is independent of stimulus duration. Consequently, it was concluded that temporal summation does not operate to facilitate trace processes within the range of durations and intervals employed in two previous studies (Holden, 1965, 1966) and the present one.

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T h e hypothesized trace deficits for equal MA normals and retardates compared with equal CA normals, and for retardates compared with equal MA normals, was not supported by the results. Since these findings are in direct contradiction to those of Studies I and 11, they suggest that the three groups did not differ in trace amplitude and duration but instead with respect to some characteristic necessary for organizing discrete stimuli into meaningful form. It was conjectured that the present experimental task provided a relatively pure measure of stimulus trace, since the level of required organization is relatively low compared with that required in Studies I and 11. This will be discussed in more detail in Section V. Results relating to the hypothesized greater trace discontinuity for equal MA normals and retardates with increasing interstimulus intervals are equivocal. Evidence contrary to the hypothesis derives from the

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failure to obtain a significant groups X duration interaction in Experiment 2, or for the equal MA normals to decline more rapidly than the equal CA normals in Experiment 1. The only supporting evidence for the hypothesis is the significant groups X interval effect in Experiment 1, which Fig. 5 shows to obtain for the retarded group at the 3.0second and 5.0-second intervals. That this more rapid decline for the retardates may have been a spurious finding is suggested by a replication study reported by Belmont & Butterfield (1969). Retardates and equal CA normals were compared on the illusory displacement task over the same interstimulus intervals employed in Experiment 1. Curves for the normals and retardates did not differ, and it was concluded that the findings in Experiment 1 of the present study were unreliable and hence very weak support for a retardate retention deficit.

2. STUDYIV Although the preceding studies have demonstrated no reliable relationship between trace parameters and stimulus duration per se, they are subject to the criticism of having confounded stimulus duration and interstimulus interval. Since interstimulus interval has proved a potent variable, and stimulus duration is presumed to be one of the parameters affecting trace amplitude and duration, it was considered desirable to investigate the effects of stimulus duration independently of interstimulus interval. Consequently, this study (Holden, 1968) was undertaken to determine the relationship between trace continuity and stimulus duration under conditions in which interstimulus interval remained constant. The experimental task was identical to that employed in the preceding study, requiring Ss to make “straight” or “crooked” judgments of rectilinear dot sequences. I t was hypothesized that if trace amplitude and duration increase with longer stimulus durations, continuity between traces of successive stimuli would also increase as stimulus duration is lengthened. Since Study 111 demonstrated that veridical perception of the spatial relationship between lights depends upon the degree of continuity between their traces, it was predicted that the number of “straight” judgments would increase with longer stimulus durations. It was conversely predicted that if, as suggested by the evidence in Studies I, 11, and 111, trace parameters are independent of stimulus duration, longer durations would not affect the number of “straight” judgments when interstimulus interval remains invariant. Whether or not stimulus duration were found to affect trace continu-

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ity, it was further predicted that the number of “straight” judgments for any stimulus duration would be higher for the shorter of two interstimulus intervals. Only retarded S s were used in this study, since the theory presumes that they would be more sensitive to any hcneficial effects of increased stimulus duration. S s received all possible combinations of the 10 dot sequerices with stimulus durations of .05, 1.0, 2.0, and 3.0 seconds. Half the S s received these combinations with 1 .O second between offsets and onsets of successive stimuli on one experimental session and then with 3.0 seconds between stimuli on a second session approximately 4 weeks later. T h e remaining S s received these sessions in reverse order. The mean number- of responses associated with each stimulus duration in the 1 -0- and 3.0-second (constant interval) interval conditions are depicted by the broken curves in Fig. 7. T h e solid curve (variable interval) represents data from the retardate group in Experiment 2 of 9 -

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the preceding study and is included here for comparison with the effect of increasing stimulus duration when there is an associated decrease in length of the interstimulus interval. An analysis of variance of the constant interval curves demonstrated no significant difference between durations, a significant difference between intervals, and a nonsignificant interaction. Failure to demonstrate more “straight” judgments with increasing stimulus durations in the two constant interval curves is contrary to the hypothesis that trace amplitude and duration are dependent upon stimulus duration. This finding is consistent with evidence from the preceding studies, however, and it can be concluded that the apparent relation between duration and performance in the variable interval curve was attributable only to concomitant changes in the time between stimuli. T h e significant interval effect depicted by the two constant interval curves is consistent with the hypothesized superior performance for the shorter of two constant interstimulus intervals. However, comparison of these curves reveals that their difference is much less than would be predicted from relative performances for corresponding interstimulus intervals, viz., 1.05 and 3.0 seconds, within the variable interval curve. It is apparent that the effect of interstimulus interval on perception of “straight” or “crooked’ is greater when different levels of the variable operate within the same experimental session than when they operate in isolation. In explanation it was conjectured that the .05-second interval in the variable interval condition provided a standard of rectilinearity against which the less proximate sequences were compared. According to the principles of successive contrast these sequential comparisons enhanced the displacement effect of the longer interstimulus intervals.

3. STUDY V T h e final study (Holden, 1969) in this section was undertaken to investigate the relationship between trace continuity and stimulus intensity in normals and retardates. T h e experimental task was identical to that in the two preceding studies. Deficient trace continuity was inferred from illusory displacement of the light stimuli about their actual progression lines. Evidence to the contrary notwithstanding, three hypotheses were derived from the stimulus trace theory for experimental test in this study. (1) Trace amplitude and duration increase with increasing stimulus intensity. Since this should be reflected by increased continuity between traces of successive lights, it was predicted that the number of “straight’’ responses would increase with higher stimulus intensities.

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(2) Trace amplitude and duration in retardates and equal MA normals is lower than in equal CA normals, from which it was predicted that they would demonstrate fewer “straight” responses than the equal CA normals. (3) Increasing stimulus intensity effects relatively greater duration of stimulus control in retardates and equal MA normals. Consequently, there should be a decreasing disparity between the number of “straight” responses for both retardates and equal MA normals compared to the equal CA normals as stimulus intensity increases. It should be noted that hypotheses (2) and (3) are inconsistent with findings from Study 111, which showed no reliable differences between trace characteristics for retardates and normals. Thus comparison of the three groups in this study provided a reliability check on the results obtained in Study 111. Ss judged all possible combinations of the 10 light sequences with brightnesses of 0.22, 1.1, 5.2, and 41 foot candles as measured with a Macbeth Illuminometer at the surface of the display screen. All lamps were pulsed for 0.1 second, with 3.0 seconds between offsets and otisets of successive stimuli. T h e mean number of “straight” judgments for each brightness level in the three groups are depicted by the curves in Fig. 8. Statistical evaluation of these curves demonstrated no significant difference between groups, no significant differences between brightnesses, and a nonsignificant interaction. These results are contrary to all predictions made

-

Equal CA normals

0-0

Equal MA normals

0------0Retardates

.22

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FIG. 8. Mean number of “straight” responses per brightness level for each subject category. Abscissa values are spaced logarithmically (from Holden, 1969).

Edward A . Holden, Jr.

2 90

from the three hypotheses and permitted the conclusions that, under conditions of this study, stimulus trace parameters are independent of stimulus intensity; trace amplitude and duration are not lower in mental defectives and young children; and increasing stimulus intensity does not effect relatively greater trace continuity for defectives and children. Failure to find group differences in this study was especially significant because it further supported the conclusion in Study 111 that retardates and young children have normal trace characteristics and that previous evidence for trace deficits (Holden, 1965, 1966) in these groups reflected differences in an organizational ability not required in the illusory displacement studies. C.

Secondary Experimental Parameters

This series of studies was concerned with parameters indirectly related to stimulus trace theory, but which were considered relevant to the illusory displacement phenomenon. First consideration was given to the possible role of eye movement, since there is experimental evidence (Matin 8c Kibler, 1966; Matin, Pearce, Matin, & Kibler, 1966) that in complete darkness the perceived uniplanar spatial relationship between two sequential light stimuli, S, and Sz, is affected in a predictable manner by the direction and extent of intervening eye movement. Although the Johnstone Laboratory studies were not conducted in complete darkness, the low illumination level and relatively homogeneous visual field conditions suggest that part of the illusory displacement phenomeon may have derived from interstimulus eye movements. If, for example, s’seyes were to drift upward between S1and Sz in one of the horizontal light sequences, Sz would appear displaced below its objective relation to S , . For the following series of studies it was assumed that S’s perception of the relative positions of temporally distributed visual stimuli depends upon information from two sources. (a) T h e first is locus trace, defined by the display screen X,Y coordinates. These coordinate values derive from textural and other invariant stimuli associated with the pattern display screen and function as spatial anchors during the interstimulus interval. (b) T h e second source is retinal signal, which is defined by the retinal position of any stimulus in the sequence relative to that of an immediately preceding stimulus. Retinal signal is assumed to be determined by S , and Sz retinal positions at the onset of Sz.Conjecture with respect to the role of eye movement in illusory displacement presupposed that, as the evidence has suggested, longer interstimulus intervals result in larger retinal signal errors. This source of error was

STIMULUS TRACE STUDIES

29 1

assumed to be compounded with that resulting from dissipation of the

X,Y coordinate trace. 1. STUDYVI It was the purpose of this study (Holden, 1967b) to determine if illusory displacement could be partly attributable to interstimulus eye movements and their resulting effect on the retinal signal. Retinal signal theory would dictate that close proximity between each poststimulus eye fixation and position of the preceding stimulus is critical for veridical perception of the spatial relationship between consecutive stimuli. Accordingly, stabilization of eye positions during the interstimulus interval would minimize retinal signal error and, consequently, illusory displacement of the following stimulus. Stabilization of interstimulus eye positions was inferred from a highly redundant series of light sequences, i.e., where the same sequence of lights was presented on every trial. It was assumed that, according to the principles of contiguity learning, more frequent repetition of the same light sequence effects stronger association between each light stimulus and its defining X,Y coordinate values. Consequently, it was predicted that the number of “straight”judgments would be greater than for a less redundant series of light sequences, i.e., where sequences start at several different points and progress in different directions. Also examined in the present study were three predictions from the stimulus trace theory. (a) Retardates and equal MA normals would demonstrate fewer “straight” responses. (b) With increasing interstimulus intervals all groups would give fewer “straight” responses. (c) With increasing interstimulus intervals retardates and equal M A normals would demonstrate more rapid decrements in the number of “straight” responses. Since the hypotheses from which these predictions were derived had been investigated in one or more of the preceding studies, their function in the present study was replicative. Equal CA normals, equal MA normals, and retardates were compared on the illusory displacement task under two conditions of locus redundancy. Data for the low redundancy condition were obtained from the first experiment in Study 111, where Ss received all possible combinations of the 10 light sequences in Fig. 4 with interstimulus intervals of 0.5, 1.0, 2.0, 3.0, and 5.0 seconds. In the high redundancy condition Ss were given the same sequence of horizontal lights on all trials, 10 each at identical interstimulus intervals. The results are graphed in Fig. 9. An analysis of variance for the complete set of curves demonstrated

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no significant difference between subject (S) classifications, a highly significant difference between locus redundancies (R), and a highly significant difference between interstimulus intervals (4. The R X I and S X R X I interactions were significant, but the S X I interaction was not. An analysis of the high redundancy curves independently of those for the low redundancy condition revealed no significant difference between groups, a highly significant interval effect, and a nonsignificant interaction. The hypothesized more accurate interstimulus eye fixations in the high redundancy condition was clearly supported by the data, indicating that retinal signal does indeed contribute some information concerning the spatial relationship of sequential stimuli under conditions other than absolute darkness. Although confounded by the S X R X I interaction, apparently attributable to the atypical decline in the Low Redundancy retardate curve from 2.0 to 3.0 seconds, the R X I interaction suggests that, under subdued cue conditions, retinal signal contrib-

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Utes relatively more than locus trace as interstimulus interval is lengthened. Relationships between the data and remaining hypotheses were straightforward and consistent with findings from the previous illusory displacement studies, thus providing further support for the conclusions that (a) trace characteristics in retardates and young children do not differ from those in equal CA normals, and (b) continuity between traces of adjacent stimuli decreases with increasing interstimulus intervals.

2. STUDYVII This study (Holden, 19674 further investigated the roles of locus trace and retinal signal in the perception of spatial relationships between sequential stimuli. Conclusions about the contribution of retinal signal in Study VI are subject to the criticism that locus trace and eye movement parameters were confounded within the two redundancy conditions. Specifically, since stabilization of interstimulus eye positions in the high redundancy condition was assumed to have resulted from more definitive locus trace values, i.e., stronger associations between each light stimulus and its corresponding X,Y coordinates, it is more parsimonious to suppose that the higher trace values independently accounted for the greater number of “straight” judgments. Consequently, the present experiment attempted to assess the effect of eye movement independently of changes in stimulus X,Y coordinate values. In this study three different levels of assumed eyemovements were utilized. Differential treatment for the three levels of eye movement was as follows. (a) Minimum Movement Condition: a fixation point was placed on the display screen in the center of the light matrix, around which the 10 sequences in Fig. 4 were presented. Ss were instructed to fixate this point at the ready signal and to maintain fixation until termination of the last stimulus in each sequence. (b) Intermediate Movement Condition: Ss were shown the 10 sequences in Fig. 4 but had no fixation point. (c) High Movement Condition: Ss had no fixation point, and were shown the 10 sequences in Fig. 4 with all interstimulus separations doubled, i.e., 2 inches instead of l. It was predicted that if retinal signal were a contributing factor in the veridical perception of these sequences the number of “straight” responses would vary inversely with the amount of eye movement. T h e hypothetical basis for this prediction is straightforward in the case of the minimum vs. intermediate conditions, since a fixation point would be expected to reduce retinal signal error to a minimum. In the case of the intermediate vs. maximum movement conditions, however, the

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hypothetical basis is more tenuous. It might be supposed that larger anticipatory movements in the latter group would increase retinal signal error by further increasing the distance between each stimulus and its subsequent interstimulus fixation point. Ss in this study were three groups of equal CA normals, each of which was tested with all possible combinations of the 10 sequences with interstimulus intervals of 0.5, 1.0, 2.0, 3.0, and 5.0 seconds. All stimulus durations were .05 second. Curves depicting the mean number of “straight” responses associated with each interstimulus interval for the three eye movement conditions are plotted in Fig 10. Two variance analyses were performed, one including all three of the curves and one including only the minimum and intermediate movement curves. The latter analysis was made because of the highly conjectural basis for assuming increased eye movement in the maximum movement condition. Both analyses demonstrated a nonsignificant group effect, a highly significant interval effect, and a nonsignificant interaction. Failure to demonstrate differences between the three levels of eye movement, or between the minimum and intermediate levels, is inconsistent with the hypothesis that retinal signal information contributes to uniplanar spatial perception when visual background cues are present. It thus appears that the larger number of “straight” responses obtained

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under the high redundancy condition of the preceding study cannot be attributed to decreased interstimulus eye movement, but rather to the stronger associations between each light stimulus and its defining X, Y coordinate values. The facilitation of “straight” responses with shorter interstimulus intervals is consistent with findings from the preceding studies and needs no further elaboration here.

3. STUDYVIII This final study (Holden, 1970) investigated the effect of different display screen cue conditions on the illusory displacement phenomenon. It was hypothesized that if, as the two preceding studies suggest, interstimulus representations of light positions depend upon the associative strength between each light and its defining X, Y parameters, then increasing association potential of the display screen cues should increase their mediative efficacy. Association potential was varied by presenting the 1 0 light sequences in Fig. 4 with four different degrees of peripheral cue proximity, viz., no frame, large frame, medium frame, and small frame of lights surrounding the central lamp matrix. T h e no-frame condition was identical to display screen conditions in the preceding studies and may be assumed to have provided least opportunity for interstimulus anchoring of’ the sequential light positions. In the remaining conditions association potential was progressively increased by illuminating frames in which the sides were, respectively, 3, 2, and 1 inches from the central lamp matrix. Frames were illuminated 3 seconds before onset of the first light in each sequence and remained on until 3 seconds after termination of the last light. Sequence lights were illuminated for 0.1 second and were separated by 3.0-second intervals. Equal CA normals, equal MA iiormals, and retardates were compared in this study t o determine their relative abilities to utilize the different degrees of mediative cues provided by the four frame conditions. On the basis of two previous studies (Holden, 1967b, 1969), which with one minor exception demonstrated no difference between trace continuity in retardates and normals, it was predicted that the three groups would not differ in the number of “straight” responses for dot progressions presented under the no-frame condition. N o predictions were made about relative performances of the three groups under the three increased cue conditions, but it was predicted that within each group the number of “straight”judgments would increase progressively from the no-frame to most proximate (small-frame) condition.

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The mean number of “straight” judgments associated with each frame condition for the three groups are plotted in Fig. 11. An analysis of variance demonstrated a significant group effect, a highly significant frame effect, and a nonsignificant interaction. Multiple range tests of frame effect within each subject category showed the small frame to have produced consistently more “straight” judgments than any of the other frame conditions, but except for the no-frame versus large-frame condition in the equal MA group no other differences were significant. Multiple range tests between subject categories revealed the following results: (a) for combined frame conditions a highly significant difference between the retardate and equal MA groups; (b) within the noframe condition no significant difference between any of the groups; (c) within the large-frame condition a highly significant difference between the retardate and equal MA groups; (d) within the mediumframe condition a significant difference between the equal MA group and both the equal CA and retardate groups; and (e) within the smallframe condition a significant difference between the retardate and equal CA normal groups. These results lend support to the hypothesized greater mediative 9i-

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efficacy obtaining from increased association potential of the display screen cues, although only the small-frame condition effected a significant increase in all groups. As one possible explanation for the weak effects of the large and medium frame conditions, it was conjectured that their proximity was too remote to provide additional associational strength over that available from the no-frame condition. The results also support the hypothesis that the three groups would not differ within the no-frame condition, and are consistent with the previous conclusions of no differences between trace continuity in retardates and normals. Explanation of inferior performance for the retardate group under the remaining frame conditions is highly speculative, suggesting that the retardates were not able to form associations o r otherwise utilize the interstimulus mediation referents as efficiently as the normal group. This less efficient utilization may relate to the deficient organizational ability previously hypothesized to account for inferior performance of the retardates and equal M A normals in the sequential integration studies, although such an interpretation is difFicult to reconcile with the relative positions of the equal MA and equal CA curves for the large and medium frame conditions. V. DISCUSSION

Recapitulation of the experimental evidence presented in this chapter reveals little to support the theory of stimulus trace inadequacies in mental defectives and young children. The experimental findings also failed to demonstrate a relationship between stimulus trace and duration or intensity of the environmental stimulus, both of which the theory hypothesized would be relatively more advantageous for organisms with a stimulus trace deficit. Although ancillary to the primary purpose for which the preceding series of studies was initiated, additional studies provided evidence that illusory displacement of sequentially and spatially distributed lights is not related to eye movement when a peripheral visual field is present. More specifically, it was concluded that illusory displacement is partly attributable to impoverished reference cues and that it can be diminished by enriching the contextural framework. Some additional experimental support for trace equality in normals and retardates has been obtained by Belmont (1967) from a perceptual task in which verbal mediation or other rehearsal strategies apparently did not operate to obscure the traces of individual stimulus events. Normals of 8, 10, 12, and 20 years of age were compared with adult

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retardates (MA approximately 10 years) on a delayed brightness comparisons task with delay intervals of 2.0, 5.0, 9.5, and 14.0 seconds. Except for better performance of the retarded group at the 2.0-second interval, no differences in the STM functions were found. Belmont concluded that perceptual short-term memory (STM) develops before 8 years in normal children and is not deficient in retardates, but that a verbal STM deficit may exist in retardates and normal children over a wide range of ages. These results, in conjunction with those from the illusory displacement experiments reported earlier, necessitate a reinterpretation of findings from the sequential integration studies. The explanation advanced here might be subsumed under Ellis’ 1970 concept of superior rehearsal strategies in normals, although Spitz’s (1963) concept of organization differences may be equally applicable. It is conjectured that in addition to the integration of traces from contiguous stimuli there is a second process, possibly the matching of each successive integral to patterns in permanent memory storage. Assuming that S s cycle through the patterns in memory storage and match to sample after each dot progression, faster sampling rates would result in a higher probability of coincidence between a compatible alternative at any specific moment in the validation process. This might be considered a series of hypothesis testing and elimination, with faster rates providing either a correct solution or fewer remaining hypotheses to select from at the termination of each pattern. A similar hypothesis might also make differential predictions in the illusory displacement task, but this would require that normals and retardates have disparate access to the concepts of straight and crooked. Considering the ubiquity of these concepts in the real world, and that only two binary alternatives need be considered after each trace integral, it would be unreasonable to expect different validation rates to be a relevant factor. Rehearsal strategy or some other verbal mediative process can also be implicated to explain the findings of two recent studies (Gordon & Bush, 1968; KOUW,1968) which have, contrary to evidence from the Johnstone laboratories, found trace parameters to be dependent upon duration and intensity of the stimulus. Kouw compared high and low short-term memory adequacy (STMA) groups of mental defectives (top vs. bottom 44% of a distribution of scores on the Knox Cubes Test as used in the Arthur Point Scale of Performance Tests) on a delayed response task, using two different stimulus intensities, five different delay intervals, and two different stimulus durations. Performance was significantly better for high STMA, high intensity, and shorter delay inter-

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vals, but there was no difference between the two duration groups. The STMA effect can be explained by the selective nature of the Knox Cube Test, whether it separated groups on the basis of different trace characteristics or different RS. Deterioration of performance with longer delay intervals is predictable on a simple trace decay basis, but because of the verbal component involved in this task it is more likely that intrusion of incorrect color names contributed to the phenomenon. Explanation of the intensity effects is more speculative, but two alternative possibilities involving a verbal component seem reasonable. (a) The better spectral quality of the more intense stimulus condition (filament color of incandescent lamps shifts from yellow to white as applied voltage increases) gave less generalization and hence less intrusions by competing color names during the delay intervals; or possibly the increased distinctiveness of the higher intensity stimuli facilitated color naming. As previously mentioned, cue-naming has been demonstrated to facilitate performance in a delayed response task (Barnett et al., 1959). (b) T h e greater attention value of the higher intensity stimuli minimized distractions which would interfere with color name rehearsal during the predelay exposure period. Gordon and Bush also investigated the effects of different stimulus durations in a similar task, arguing that Kouw’s failure to find duration differences (2 vs. 6 seconds) resulted from an asymptotic relationship between “consolidation” and time under 2 seconds. T o test,this hypothesis they used durations of yS, E,and 2% seconds in combination with delay periods of 3 and 30 seconds, with intensity remaining constant. As would be expected from either interference theory or simple trace decay, performance was superior for the shorter delay interval. Performance also improved significantly with longer stimulus durations, which could be explained by the longer opportunity to rehearse the appropriate color name during the predelay exposure period, rather than by a simple increase in amplitude o r duration of the stimulus trace. In view of the alternatives available for explaining many of the experimental phenomena described in this chapter, two questions appear especially relevant. ( 1 ) Do Belmont’s (1967) concept of verbal STM, Spitz’s (1966) concept of input organization, and Ellis’ (1970) concept of RS all include one o r more common specifiable processes which would preclude the “critical” experiment for deciding between theories? (2) If these concepts, as well as others, could be refined to include only mutually exclusive processes, would it be possible to manipulate a variable influencing one of these processes in isolation from the others? These questions are certainly not peculiar to theory construction in

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mental retardation, but they are particularly germane here because one of the principle purposes of research in mental retardation is to specify and define fundamental differences underlying the functions of defectives and normals. ACKNOWLEDGMENTS Reproductions of Figs. I , 2, 3, 6. and 9 published by permission of the editor of the J o u d of Comparative and Physiological Psychology. Reproductions of Figs. 7 and 8 published by permission of the editor of the American Journal of Mental Defiiency. Reproductions of Figs. 4 and 10 published by permission of the editor of Psychonomic Science.

REFERENCES Barnett, C. D., Ellis, N. R., & Pryer, M. W. Stimulus pretraining and the delayed reaction in defectives. Amerkan Journal of Mentnl Deficiency, 1959,63, 104-1 11. Belmont, J. M. Long-term memory in mental retardation. In N. R. Ellis (Ed.), International review of research in mental reiardaiion. Vol. 1. New York: Academic Press, 1966. Pp. 219-255. Belmont, J. M. Perceptual short-term memory in children, retardates, and adults. Journal of Experimental Child Psychology, 1967, 5 , 114-122. Belmont, J. M., & Butterfield, E. C. The relations of short-term memory to development and intelligence. In L. P. Lipsitt & H. Reese (Eds.), Aduances in child development and behavior. Vol. 4.New York: Academic Press, 1969. Pp. 29-82. Butterfield, E. C. Stimulus trace in the mentally retarded: Defect or developmental lag? Journal of Abnormul Psychology, 1968,73,358-362. Ellis, N. R. The stimulus trace and behavioral inadequacy. In N. R. Ellis (Ed.), Handbook of mental deficiency. New York: McCraw-Hill, 1963. Pp. 134-158. Ellis, N. R. Memory processes in retardates and normals: Theoretical and empirical considerations. In N. R. Ellis (Ed.), International review of research in mental retardation. Vol. 4.New York: Academic Press, 1970. Pp. 1-32. Fagan, J. F. Short-term retention in normal and retarded children. Psychonomic Science, 1966,6,303-304. Gomulicki, B. R. T h e development and present status of the trace theory of memory. British Journal of Psychology, 1953,44 (Monogr. Suppl. 29). Gordon, A., & Bush, S. Some effects of stimulus duration upon short-term memory in retardates. American Journal of Mental DeJiciency, 196b. 73, 79-80. Holden, E. A. Temporal factors and subnormality in visual pattern recognition: A test of stimulus trace theory. Journal of Comparative and Physiological Psychology, 1965, 59, 340-344. Holden, E. A. Stimulus duration and subnormality in visual pattern recognition: A further test of stimulus trace theory. Journal of Comparative and Physiological Psychology, 1966.62. 167-170. Holden, E. A. Eye movements and the perception of rectilinear dot progressions. Psychonornit Scimce, 1967,7,219-220. (a)

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Holden. E. A . 1ntei.stiniuIus interval, locus redund~uicy,and mental subnormality iii perception ot' rectilinear dot progressions. Journul o/ Cotiipurali~~ aiid Pliy.siologirc~IPsqrholo w , l%'i, 64, 366-370. (b) Holden, E. A. Stimulus duration and the perception of rectilinear dot progressions in educable retardates. Anirrirm Joirrnd of Meitto/ Deficiency, 1968, 72, 599-602. Holden, E. A. Stimulus intensity and mental subnormality in perception of rectilinear dot progressions. American Journal cfMenlal Deficiency, 1969, 73, 749-752. Holden, E. A. Frame size and mental subnormality in the perception of rectilinear dor progressions. Percepion W Ps?r/iophqsirs, 1970, 7. 291 -293. Kouw, W. A. Effects of stimulus intensity a n d duration upon retardates' short-rerni memory. American Journal of Mental Deftciency, 1968, 72, 734-739. Matin, I.., & Kibler, C . Acuity of visual perception of direction in the dark for various positions o f the eye in orbit. Perceptuul und Motot Skills, 1966, 22, 407-420. Matin, L., Pearce, D., Matin, E., & Kibler, G. Visual perception of direction in the dark: Roles of local sign, eye movements, and ocular propi-ioception. Visiofi Heserrnli, 1966, 6,453-469. Scott, K. G . , & Scott, M. S. Research and theory in short-term memory. In N . R. Ellis (Ed.), futurnationnl review of reseurrh iir meiikd retur&&ti. Vol. 3. N e w York: Academic Press, 1968. Pp. 135-162. Spitz, H. H. Field theory in mental deficiency. In N. R. Ellis (Ed.), Haiidbook 01 mental dejciency: Psqrhological flierny m d research. New York: McGraw-Hill, 1963. Pp. 1 1-40. Spitz, H. H. T h e role of input organization in the learning and memory of mental rei u l ofreseurcli in rneiilul retclrdrttion. Vol. 2. tardates, In N. R. Ellis (Ed.j, l n t e m ~ ~ t i o ~revim New York: Academic Press, 1966. Pp. 29-56. Zigler, E. Mental retardation: Current issues and approaches. In M. L. Hoffman & L. W. Hoffman (Eds.), Review uf child developrnent researrk. Vol. 2 . New York: Russell Sage Foundation, 1966. I'p. 107- 168. Zigler, E. Familial mental retardation: A continuing dilemna. Science. 1967, 155, 292-298.

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KANSAS C I T Y ,

KANSAS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304 A. T h e Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Environment Is a Wo C. Organization of Chapter .......... 306 11. Descriptive, Correlational, Experimental Research . A. Descriptive Research Concerning <.:ulturial-Familial Retardation . . . . . . 309 B. Correlational Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15 C. Nonmanipulated Croup Comparison Research . . . . . . . . . . . . . . . . . . . . 3I7 I). Experimental or Manipulative Research . . . . . . . . . . . . . . . . . . . . . . . . . . $25 E. Concluding Remarks for Section 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 111. A Systematic Approach to Cultural-Familial Retardation . . . . . . . . . . . . . . . . 327 Classes of Variables Involved in the Developnient of Cultural-Familial Retarded Behavior ...................................... $28 IV. Concluding Comments ...................................... 540 .................................. 342 1.

‘The writing of this chapter and some of the research reported herein were partially supported by National Institute of Child Health and Human Development grants HD 00870-04 and H D 00183-01 to the Bureau of Child Research, University of’ Kansas. Appreciation is d u e Pamela Calia for-typing several versions of the manuscript. Synonynis used in the literature for cultural-familial retardation include familial retardation, “garden-variety” retardation, primary retardation, endogenous retardation, and subcultural retardation. *The author was the Field Director of the J u n i p e r Gardens Project, a research and demonstration program of the Bureau of Child Research, for the first 2 years of its development. This project is directed to the study of the behavior of the socioeconomically deprived, urban child. T h e author is now the Associate Director for Research ‘Training of the Bureau of Child Research and Directoi- of Research Training for the Kansas Center for Mental Retardation and Human Development. H e is also a Senior ‘Research Associate, Department of Hearing and Speech, University of Kansas Medical School.

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304 I . INTRODUCTION

Retarded development of behavior in the absence of presently demonstrable biological pathology has been frequently observed. Persons who fit these two criteria and have a parent and sibling who are retarded are usually labeled “cultural-familial.” In the AAMD manual (Heber, 1959),cultural-familial retardation is said to be “due to uncertain or presumed psychological cause with the functional reaction alone manifest.” Both genetic and environmental factors are mentioned, but the specific actions or relationships of these variables in the development of cultural-familial retarded behavior were unspecified because of a lack of scientific data. One basic observation which has been made many times is that children who have a retarded parent and sibling and grow up in a socioeconomically limited environment are more likely to exhibit retarded behavior than are children who have nonretarded parents and siblings and grow up in average socioeconomic environments. What are the specific conditions, factors, or variables which are responsible for cultural-familial retardation? How can the retarded behavior be prevented and remediated? It is the purpose of this chapter to review selected studies relating to cultural-familial retardation and then to suggest an approach which holds promise for predicting, preventing, and modifying the lack of appropriate behavior by the cultural-familial retardated person. A.

The Population

I n the United States, it is estimated that there are now at least 5 million retardated persons who score between 50 and 75 1Qon standardized tests (Scheerenberger, 1964). Most of these probably would be classified as “cultural-familial” o r “undifferentiated.” It is difficult to estimate the number of people who would score between 75 and 85 IQ and show “an impairment in adaptive behavior,” but a conservative estimate probably would be 5 million. There are many psychologists and educators who contend that it is inadvisable to label a person “mentally retarded” if he scores above 75 IQ. Independent of labels attached to behavior, the problems presented by persons below 85 I Q a r e numerous, and this chapter will utilize an upper limit of I Q 84 for the cultural-familial category. Whether the precise number is 8 or 15 million persons, it still constitutes a sizeable proportion of the U.S. population. For the purposes of this chapter, the population being discussed will include all those who score between 50 and 85 IQand d o not make an adequate adjustment in the culture in which they live, e.g., drop out of school, have employment problems, and have antisocial behavior. In addition, they meet the criteria that (1) a parent and sibling are re-

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tarded also, and (2) there is no demonstrable biological pathology which has been shown to be highly correlated with retarded intellectual development. B.

Environment Is a Word with Many Referents

T h e word “environment” has been used to refer to many different events and objects, including events occurring during the period from conception to birth (intrauterine environment), chemical substances, housing conditions, social interaction, nursery school curriculum, and amount of money earned by the family. Rnrely, h o w v e r , has thr iuord been tued to rejer to behavioral 1 elatiorwhij).s which hmvr been shown to have N Junctio?inl efect on the behavior o j devolopriig oig-ctviisnu. In the main, it has referred to the stimuli in close geographical proximity to the child (toys, housing conditions, books, social contacts, etc.) with almost no mention of the consequences following the behavior which occurs in the presence of these stimuli. Although psychologists and educators have known for quite some time of the powerful effects of reinforcement, punishment, and extinction, these procedures usually have not been included in discussions of environmental effects. Most investigators of environmental effects are interested in the learning experiences of children, how they can be quantified, and how they are related to development, but they do not discuss the role of consequences (reinforcement and punishment) or the lack of consequences (extinction) in the development of behavior. Many writers who have discussed the effect of environment on behavior give little attention to the consequences which follow behavior (Anastasi, 1958; Hunt, 1961 : Jones, 1954; McCandless, 1964; Sarason & Gladwin, 1958). However, the Hull-Spence approach to the study of behavior (e.g., see Cantor, 1963) has been concerned with consequences, particularly the positive reinforcer type. Within this system, reinforcement variables are considered to have an effect on the intervening variables “incentive motivation” (K) and ‘7construct.” Deprivation conditions (which make the reinforcer more or less effective) are considered to have an effect on the intervening variable “drive” (D). The reinforcement and deprivation variables do not affect the “associative” intervening variable of “habit strength” ( H ) said to be involved in instrumental learning; many investigators have considered the retardated person’s basic problem to be an “associative” one. Hence, there has been a relative neglect of “motivational” variables and their effect on retarded behavior. However, Cantor ( 1 963) stated that the manipulation of reinforcement variables might prove to be one of the most effective means of bringing the retardated performance u p to the highest level possible and that studies in the area of “incentive motivation” may be an important contribution. T o the present writer, this

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would seem to be an especially promising area in the study of cultural-familial retardation, Zigler ( 1966) and Butterfield and Zigler (1965) have been concerned with the role of “motivational” variables (social reinforcement and social deprivation conditions) in the development of behavior. Their work has focused on social “motivation” and its relationship to the behavior of the cultural-familial retardated person. Consequences of behavior - those events which follow behavior play an important role in the approach proposed by Skinner (1938, 1953). Although conducted by investigators with different orientations, there are numerous experiments already completed which demonstrate the effects of type of consequence, time of delivery, amount of consequence, and schedule of delivery, as well as experiments designed to establish conditioned consequences. Keller and Schoenfeld ( 1950) have provided accounts of some of the experiments in their development of a systematic approach to behavior based on Skinner’s suggestions. T h e effects of contingent consequences on behavior, however, represent only part of the system commonly referred to as “experimental analysis of behavior” o r operant conditioning and experimentation in all areas probably will be beneficial in the systematic accumulation of knowledge regarding cultural-familial retardation. C.

Organization of Chapter

The research in cultural-familial retardation, as in many other areas, is difficult to organize or classify. The most useful organization would be one which classifies the results of experiments in terms of the independent variables responsible for the development and maintenance of the unintelligent behavior, e.g., genetics, nutrition, reinforcement, punishment, contingencies, discriminative stimuli, and programming of discriminative stimuli. For the present, however, there does not seem to be enough research in these categories to attempt a review organized along these lines. Therefore, the first part of this chapter (Section 11) is organized in terms of type of research methodology: descriptive, correlational, nonmanipulated group comparison, and experimental or manipulative research. Attention is given to such a classification because what can be said about the present status of knowledge in the field depends on the type of research that has been done. As will be pointed out in more detail, most of the research in cultural-familial retardation belongs in the first three categories and, therefore, very little can be said definitively regarding the causes of the condition. Much more manipulative research is needed. The second part of the chapter (Section 111) is concerned with an attempt to classify the variables in a way which will provide for a meaningful, systematic approach

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to the study of cultural-familial retardation. Also, Section I11 reviews some selected studies as examples of the proposed classes of variables. II. DESCRIPTIVE, CORRELATIONAL, NONMANIPULATED GROUP COMPARISON A N D EXPERIMENTAL RESEARCH

One useful classification of research consists of four categories: (1) descriptive, (2)correlational, (3) nonmanipulative group comparisons, and (4) experimental or manipulative. T h e order in which these are discussed does not imply an order of importance. In some areas it is not acceptable to do experimental or manipulative research with humans (e.g., brain ablation, extreme diet control, and controlled mating). Also, some descriptive research may be more important, as far as its overall contribution to science is concerned, than some experimental o r manipulative research. Furthermore, it is sometimes the case that the invention of an apparatus or the development of a classification system constitutes a substantial contribution. T h e present classification does relate, however, to the conclusions which may be made from research in terms of functional or causal variables which have an effect on behavior. Studies involving the experimental manipulation of variables in a within-subjects design permit more definitive statements. Descriptive research reports some characteristic(s) of a population(s) in a situation where there has been no experimental manipulation of antecedent conditions (or variables). Although it may be speculated that natural manipulation has occurred prior to the experiment, the study still is classified as descriptive unless the manipulation occurs during the course of the study. Examples of descriptive research are a study which reports the amount of time that 2-year-old children spend playing with their peers and a study which reports the EEG patterns of children who have seizures. Another example is a study where the patterns of performance of retardates and nonretardates on an intelligence test are described or reported but no quantitative comparison is made. Descriptive research does not permit conclusions regarding “causal” or functional relationships, although it may provide leads for further study. In correlational research with correlational statistical techniques, one o r more characteristic(s) of a population is related to another characteristic of a population, or one characteristic of a population is related to the same characteristic of a different population. Studies have correlated different characteristics on different populations. T h e events being studied are not experimentally manipulated. In nonmanipulated group comparison research subjects are grouped in terms of scores on some nonmanipulated variable, such as chronological age (CA) or mental age (MA), and then the groups are compared in terms of their performances on some other measure. Also, the

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groups may be compared on some anatomical, physiological, or biochemical characteristics. Developmental norms of child development and much of the research regarding retarded behavior has been of this type. Neither descriptive, correlational nor nonmanipulated group comparison research permits definitive conclusions regarding “causal” or functional relationships between the nonmanipulated variables and the behavior assessed during the study. In experimental or manipulative research a change is made in one event and a subsequent event is observed and recorded. A change in a n event, the independent variable, may be a modification in the internal or external environment of an organism, but the modification must occur during the course of the study for it to be classified experimental. Several events may be modified or manipulated at the same time; in this case the group of events constitute the independent variable, e.g., in educational programs where several conditions are changed at the same time. However, in the latter case any change in the subsequent event may be attributed to any combination of the events which were manipulated. Many studies reported in the literature are not pure cases of a single type but may involve combinations of descriptive, correlational, nonmanipulated group comparisons, and experimental research. An example of this “mixed” type is a study which compares two methods of discrimination training (first trial correct vs. first trial incorrect) for two mental age groups, all Ss receiving both training procedures. T h e former is a manipulated variable and the latter (mental age) is a variable which has not been manipulated. A survey of the literature revealed that most of the research dealing with cultural-familial retardation has been limited to descriptive, correlational, and nonmanipulated group comparison studies, although there have been a few notable exceptions which involved experimental manipulation (Birnbrauer, Bijou, Wolf, 8c Kidder, 1965; Gray & Klaus, 1965; Skeels, Updegraff, Wellman, 8c Williams, 1938; Staats 8c Butterfield, 1965; Weikart, Kamii, 8c Radin, 1964; Wolf, Giles & Hall, 1968). Although the work of Montessori (1965) may not be considered research, it was oriented toward experimental modification of the behavior of slum children. More emphasis should be placed on the type of study which stresses a precise description of specific events considered to be responsible for the retarded behavior. It must be determined which events are functionally related and which events are irrelevant. A good example of a correlated variable, which is not functionally related to behavior, is the frequently reported relationship between place of residence (urban or rural) and scores on intelligence tests (see Sarason & Gladwin, 1958, for examples of these studies). This relation-

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ship held until the 1940’s and now the correlation is changing in the opposite direction. A recent writer (Ginzberg, 1965) has suggested that this change may be due to the fact that many present city dwellers are first and second generation descendants of rural parents! What is sometimes overlooked is that the functional relationships are to be found in the specific behavioral interactions in the child’s environment, which include not only the behavioral interactions with the nonsocial stimuli in the environment but the behavioral interactions between the child and those who respond to his behavior. The present writer speculates that amount of income, number of children in the family, number of books and magazines, racial and ethnic group, and father’s occupation are all examples of correlated, but functionally irrelevant, variables in the development of intelligent behavior. The point being made is that the functional relationships (as far as psychology, education, and sociology are concerned) involve the stimuli presented the child and the consequences he receives following his behavior. Correlations and nonmanipulated group comparisons at times may serve to obscure the important, functional relationships. A.

Descriptive Research Concerning Cultural-Familial Retardation

The early studies, which had an influence on work in the area of cultural-familial retardation, were genealogical. Following these there were studies concerned with descriptions of home conditions and test performances of cultural-familial retardates (A. D. B. Clarke 8c Clarke, 1960; McCandless, 1964; Sarason & Gladwin, 1958). Representative descriptive studies will be discussed and the interested reader referred to other sources for a more complete account of other similar studies. 1.

GENEALOGICAL STUDIES

According to several writers (Boring, 1950; Hunt, 1961; Sarason & Gladwin, 1958), psychological research and the psychological literature regarding “intelligence” was greatly influenced during the first half of this century by four men, Francis Galton, J. McKeen Cattell, G. Stanley Hall, and H. H. Goddard. All four contended that “intelligence” is inherited (fixed at conception ) and that behavior is predetermined. Galton’s early “evidence” (Hereditury ( k n i u s , 1869) was a descriptive report that most of the famous men in Great Britain came from a few families. Cattell studied with Galton and taught the hereditary position to his students, among whom were H. H. Goddard, Lewis Terman, Arnold Gessell, and F. Kuhlmann. Goddard was a prominent figure in the study of mental retardation, and his descriptive report of the Kallikak family “was accepted as confirmation so conclusive that it was scarcely

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questioned for at least 10 years after publication of the book [Sarason & Gladwin, 1958, p. 1961.’’ The evidence reported was that certain classes of behavior occurred more frequently in one branch of the family than in another. This evidence was accepted by most people as proof that all behavior was determined “genetically” and that the environment had very little, if any, effect on the developing organism. These brief comments indicate the predominance of the hereditarian position within psychology during the first half of the 20th century. A more complete account of genealogical studies may be found in Anastasi and Foley ( 1948).

2. ANATOMICAL, PHYSIOLOGICAL, AND BIOCHEMICAL STUDIES By definition, neither the anatomy nor the physiology of the cultural-familial retardate contains conditions which have been shown to be highly correlated with retarded behavior. The diagnosis of “culturalfamilial” is made and the label applied only after medical examination has ruled out the presence of such conditions as extensive brain damage, galactosemia, and mongolism. But what about the presence of anatomical and physiological conditions which are not highly correlated with retarded behavior? Are these typically present? Although not dealing specifically with retarded persons, Pasamanick (1959) has reported that there are many more complications of pregnancy among lower class mothers than among middle or upper class mothers. These complications, even when they do not result in gross biological pathology, may affect the biological functioning of the child. He views these conditions as factors influencing later physiological functioning of the offspring and the occurrence of retarded behavior. Garrard and Richmond ( 1965) discussed mental retardation without biological manifestations and made the statement that very little is known regarding the molecular basis for learning. These writers report that several people are working on studies regarding brain-behavior relationships. The objective is to relate early experience, or the lack of it, to changes in the brain, and then to show that these brain changes limit later behavior. Most of the relationships which have been proposed are based on very little evidence, and Garrard and Richmond regard the proposed relationships as tentative at this time. In addition, they make the important point that etiological factors do not define “mental retardation,” that it is functionally or behaviorally defined. Waisman and Gerritsen ( 1964) reviewed studies that were concerned with relationships between biochemical substances and behavior and stated that one of the directions which research will take is the biochemical investigation of the retarded child. However, they reported no extensive biochemical investigations involving the cultural-familial person.

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Future experimentation by biologcal-behavioral researchers probably will allow us to make statements such as “X amount of substance Y must be present in the organism in order for a red-green discrimination to be learned in 20 trials with Z procedure.” T h e biological conditions are examples of what Bijou and Baer ( 196 1) refer to as “setting conditions” for behavioral procedures. However, the behavioral scientist, as well as the biological scientist, can continue the investigation of procedures which can overcome present limiting biological conditions. In other words, new developments in biological and behavioral science can change the “setting conditions” for behavioral procedures. For example, if phenylalanine is removed from the ‘diet of a child with phenylketonuria, then many behaviors can be acquired by the child with fewer trials involved. Zimmerman ( 1965) has discussed interactions of this type between biological and behavioral variables. Although there has been a great deal of speculation regarding the role of genetics in cultural-familial retardation, the literature is without definitive studies in this area. Anderson (1964) does not report any studies which describe the genetic composition of the cultural-familial retardate but contends that the possibility must be left open that “mild retardation” of presently unspecified origin is due to “polygenic factors.” Gottesman ( 1963) has reported some “theories” of the genetic transmission of “intelligence” and proposed a “five-pair polygenic model.” Recently, Zigler ( 1967) has proposed a “polygenic explanation” of “intelligence.” Such “theories” usually are based on an assumption that “intelligence” is the approximate normal distribution of IQscores forced by the procedures of test construction (Anastasi & Foley, 1948). It is important to remember that the approximate normal curve of I Q scores is not obtained in the same manner as the normal curves for height and weight. In the case of the IQcurve, the measuring instrument (IQ test) is constructed in such a manner that an approximately normal curve will inevitably result. Such is not the case with height, weight, and some other biological characteristics. It should be noted also that, even if a normal distribution were not forced with test construction procedures, the distribution could as well be a function of environmental variables as “polygenes.” Theories of “polygenic transmission of intelligence” are supported by little scientific data. Such premature theorizing, without appropriate data, may result in an undue restriction of the educational opportunities for the culturalfamilial retardate. Such a restriction would then lead to even more retarded behavior and a vicious cycle is perpetuated. T h e area of biochemical genetics is relatively new. When more information is accumulated and better methods of biochemical analysis are developed, it may well be that one will be able to produce, by altering the biochemical substances brought together at conception, a given set

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of biological characteristics, so that in one case behavior will be easy to establish and in another case difficult to establish. For the present, however, it should be realized that most of the genetic studies are familial, not biochemical, in which numerous variables are confounded. It may not be advisable to talk about genetic transmission of behavior from evidence that certain behaviors occur more frequently in some families than in others. Statements regarding functional relationships should be held in abeyance until more experimental research is conducted. Scientific answers are not possible at present because the appropriate data have not yet been collected. One point regarding genetics should be made clearly. There is considerable evidence of a relationship between abnormal genetic material and abnormal anatomy and physiology. Many geneticists stop at this point and do not make the statement that aberrations in anatomy and physiology (of a genetic or nongenetic origin) result in abberations of behavior. These geneticists view the genetic composition of an organism as influencing its structural development, but this influence may be greatly changed by chemical treatment, e.g., in the treatment of phenylketonuria. In other words, the biological conditions within which the behavioral scientist functions may be altered by biochemical changes that may be made at various points in the life cycle, some points possibly being more crucial than others. In summary, it does not appear that there is any evidence at present to support the position of a biochemical (genetic) difference between the cultural-familial and the normal child relevant to the development of intelligent behavior. However, even if such a difference is found, it may be overcome by either biological or behavioral treatment procedures. 3. GENERAL CULTURE STUDIES

Although not dealing strictly with the cultural-familial person, Lewis (1966) has provided narrative reports of the “culture of poverty.” Keller (1963) has described selected aspects of the social world of the urban slum child and compared these for Negro and Caucasian children. Reports of home conditions and verbal “attitude” statements by mothers have been made by Hess and Shipman (1965). Other descriptions may be found in studies by Sears, Maccoby, and Levin (1957), Klatskin (1952), and Kohn ( 1959). A brief description of the linguistic environment may be found in an article by Bernstein (1962). It is reported that the cultural-familial subculture differs a great deal from the middle class subculture. Academic, verbal or intellectual materials are not as prevalent in the cultural-familial home; thus behavior in the

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presence of these materials is not possible. The absence of a parent(s) probably results in fewer adult-child interactions than occur in the middle class home. There is an emphasis on physical safety and quietness (“behaving”) rather than exploratory behavior and question-asking behavior. Nonparental caretakers probably reinforce behavior which makes caretaking easy (e.g., obedient quietness) and punish other behavior. Goshen ( 1963) has reported psychiatric disturbances to be prevalent for a group of mothers of retarded children with no biological abnormality. Social interaction was not normal, including a low frequency of spontaneous verbal communication. C. Clarke and Davis ( 1963) have reported that a disproportionate number of the mothers of 17 “familial” children had disturbed relationships with their parents and little support from their relatives during the first years of their children’s lives. The Fels Scales were developed by Champney ( 194 la, 194 1 b) to describe parental “attitudes” towards children and to relate the “attitudes” to the development of the children. Baldwin, Kalhorn, and Breese (1945) reported the results of a longitudinal study with the Fels Scales which included the finding that parental statements which indicated low democracy and high control in the home were correlated with quiet, nonresistant behaviors, and the children from these homes were low in curiosity and originality. An effort to quantify those aspects of’ the home environment which are relevant to the development of behavior during the first 3 years of life has been made recently by Caldwell, Heider, and Kaplan (1 966). These investigators have assembled a series of 73 items designed to sample certain aspects of the home environment. This Inventory of Home Stimulation (STIM) is divided into eight subsections: (1) Frequency and Stability of Adult Contact; (2) Development and Vocal Stimulation; (3) Need Gratification; (4) Emotional Climate; ( 5 ) Avoidance of Restriction; (6) Breadth of Experience; (7) Aspects of the Physical Environment; and (8) Available Play Materials. According to these investigators, they have avoided general ratings (e.g., “maternal attachment”) in favor of the specifics of what and who the child sees, touches, hears, etc., in his daily environment. T h e scale depends heavily on observations of what happens in the home while the interviewer is present rather than interpretations of such things as “maternal rejection.” Early work with the STIM inventory has led these investigators to say that we are in error to speak of lower class homes as though they were homogenous; actually, the lower class distribution has greater variability than the middle class distribution, and the lower class distribution is definitely bimodal. Further work with the STIM revealed a correlation of

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.87between the average STIM score for the first year of life and a positive change in development score between 6 and 12 months as determined from the Cattell Infant Intelligence Scale. 4.

BEHAVIORAL STUDIES

N o studies were found which described the reflex or conditioned reflex behavior of the cultural-familial retardate. Therefore, all the studies in this section are concerned with instrumental or operant behavior. T h e early behavior (such as vocalizing, walking, playing, responding to pictures) of the cultural-familial retardate has not been described precisely in the literature. T h e lack of such information is understandable, since the label “cultural-familial retardation” is rarely given prior to the age of 6 or 7 years. Almost all of the descriptive information deals with standardized test behavior after 6 years of age. Baroff (1959) analyzed the test performance of 53 familial and undifferentiated retardates and described the patterns of the test scores. I n addition, he compared the pattern for each subject to the group pattern. In terms of group performance, lowest scores were obtained o n the Similarities and Vocabulary subtests and the highest scores on Object Assembly, Block Design, and Picture Completion. Baroff reported that approximately 80% of his subjects had higher Performance IQs than Verbal IQs, a finding which has been reported for this group on numerous occasions. As Baroff points out, though, there is at least one exception (Atchison, 1955) to this finding. Fisher (1960b, 1961) has replicated the test pattern findings of Baroff, but not the Performance-Verbal difference, and also has reported test patterns for other groups of retardates compared to the culturalfamilial group. In addition, Fisher (1960a) has compared the altitude quotient (AQ) and the I Q f o r a group of familials and undifferentiated subjects on the WAIS. Clausen ( I 965) reported subtest scores and analyses of performances on the Primary Mental Abilities test, Porteus Mazes, and Raven’s Progressive Matrices for “familial” and other groups of retardates and normals. He described the subtest patterns and reported that etiological subgroups did not differ in pattern. This investigation is part of a larger project, the Abilities Structure Project, in which an extensive battery of tests was given to retarded and normal subjects. Other descriptive studies in the area of the test behavior may be found in reviews by Miller ( 1960) and Benton ( 1964).

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Correlational Research

1 . TWIN AND FOSTER PARENT STUDIES Studies with identical twins and studies involving placement of children in foster homes are reviewed in most discussions of heredity, environment, and “intelligence” (e.g., Gottesman, 1963; Haywood & Tapp, 1966; Hunt, 1961; McCandless, 1964; Sarason & Gladwin, 1958). T h e studies involving twins generally involve correlations between the IQscores of twins reared apart or correlations of the scores on subtests of the PMA and WISC of twins reared together. T h e studies on foster home placement generally involve a comparison of two correlations, a correlation between the IQscores of a group of children and the IQscores of their biological parents compared with a correlation between the I Q scores of these same children and the I Q scores of their foster parents. Different conclusions are reached by different investigators regarding the relative contributions of “heredity and environment,” but the conclusions which usually are stated are not warranted from the data. Twins, even when reared apart, may be reared in functionally similar environments, and it does not appear appropriate to attribute the common behavior on I Q tests to heredity. Foster children may be placed in all types of homes in terms of the specific behavioral interactions between adults and the child and between siblings and the child. It does not appear appropriate to interpret the correlational data as evidence for the relative contributions of heredity and environment to the IQtest behavior o r other behavior. This point has been made well by Anastasi and Foley (1948) in a review of twin and foster children studies, but this type of data is still being offered as evidence of causal relationships by some (Gottesman, 1963; Illingworth, 1966; Haywood & Tapp, 1966).

2. TEST-SOCIOECONOMIC STATUS STUDIES The correlation between test behavior and socioeconomic status (SES) has been the focus of a large number of studies (e.g., see review by Anastasi & Foley, 1948). An example of a relatively recent study in this area is one by Knief and Stroud ( 1959). Using 344 fourth graders, these investigators correlated the score from the Warner Index of Status Characteristics with the scores from the Lorge-Thorndike Intelligence Tests, the Davis-Eells Games, and the Iowa Tests of Basic Skills. T h e correlations between the Warner Index and the three tests were .30, .32, and .34, respectively. T h e Ravens Progressive Matrices was

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given a year later to 164 of the Ss; the correlation with the Warner Index was .17. In general, the test-SES studies report positive correlations between standardized test scores and socioeconomic status determined in a number of different ways. These studies have concentrated usually on amount of income, occupation of the father, educational level of the parents, books and magazines in the home, and housing conditions as correlates of test behavior. As Anastasi and Foley (1948) have noted, there is a wide range of individual differences within each socioeconomic level, with considerable overlapping between levels. Such evidence should suggest a focus on the study of specific factors which produce this extreme variability within socioeconomic levels. The child of low socioeconomic status may be limited in his opportunities for the development of intelligent behavior (e.g., there may be few trips outside the neighborhood or only a few educational materials in the home), but such a limitation is overcome in the behavioral environments of some children. The specific factors which produce this difference are the functional variables of interest in preventing the development of retarded behavior, and there is probably little to be gained from additional test-socioeconomic status correlations. 3. TEST-TEST STUDIES

Few studies are devoted entirely to correlations between responses on various tests by the cultural-familial retardate. Most studies in this area have dealt with “validating” a short form of a test and have utilized heterogeneous groups of retardates. Other studies have compared one test with another purported to “measure the same thing,” but these studies also usually utilized groups of heterogeneous classifications. Other studies presented group comparisons as well as correlations and are included in the group comparison studies. The following two studies are representative of test-test correlational studies, which have declined in recent years probably because of less emphasis on testing and more on theoryderived research and an experimental analysis of retarded behavior. Bensberg and Sloan ( 1955) administered the Revised Stanford-Binet and the Cattell Culture-Free Intelligence Test (CCFIT) to a group of 60 “familial” retardates. T h e correlation between the two sets of scores was .85. However, the mean MA on the Binet was 6.5 months higher than the CCFIT. These investigators stated that “The CCFIT is felt tu be potentially useful because it is short, interesting, and easy to score [p. 5021.” Ogdon and Allee (1959) gave the Rorschach and Wechsler-Bellevue

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tests to 60 cultural-familial retardates. These investigators reported that “. . . eight purported Rorschach signs of intelligence correlated significantly with IQlp. 8951.” Other scores derived from the Rorschach protocols did not correlate significantly with IQ. References to other studies which related Rorschach scores to I Q scores may be found in the Ogdon and Allee article.

4. TEST-OTHER BEHAVIOR STUDIES Although not dealing entirely with cultural-familial retardates, Cromwell and Palk (1961) did not find a relationship between IQscore and eyelid conditioning rate in a group of 61 subjects (IQrange of 15 to 68). Mental age had a low positive correlation (.29) with eyelid conditioning rate. Activity level recorded by a ballistograph during the conditioning session did not relate to eyelid conditioning rate. As part of a larger study, Bensberg and Cantor (1957) reported correlations between mental age (MA) and reaction time scores for a group of 24 cultural-familial subjects in the MA range of 3.5 to 9.1 years. Significant correlations were found between M A and simple reaction time (-.67) and between MA and a discrimination reaction time task (-.67). Although not directly concerned with cultural-familial retardation, several other studies have reported relationships between “intelligence” test performance and simple reaction time (e.g., Berkson, 1960a; Ellis 8c Sloan, 1957). C.

Nonmanipulated Group Comparison Research

1, SOCIAL CLASSCOMPARISONS

Hess and Shipman (1966) have conducted an extensive study with four groups of mothers and their 4-year-old children. Group A came from college-educated, professional, executive, and managerial occupational levels; Group B came from blue-collar occupational levels with not more than a high school education; Group C came from unskilled or semi-skilled occupational levels with predominantly elementary school education; Group D also came from unskilled or semi-skilled occupational levels with predominantly elementary school education, but with fathers absent and the families supported by public assistance. The groups were equally subdivided by sex of child and, except for Group A, by private and public housing. The mothers were interviewed in their homes about their activities with the child, their daily schedules, the availability of intellectual stimulation and other features of the home environment considered to be related to “cognitive” development. The mother-child pairs were then

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taken to the university for testing and for an interaction session which required the mother to teach the child three simple tasks that she had been taught by a staff member. The lower class mothers, more than the middle class, agreed with questionnaire statements that said that it was futile to use one’s power against the school system, but they agreed, more than middle class mothers, that a good education is an important way to improve one’s status. In an open-ended question regarding what they would do to change the schools, the lower class mothers had many fewer suggestions than the middle class mothers. Lower class mothers said their children should be obedient in school more than middle class mothers. When asked how far in school their child would probably go, there were discrepancies between the groups. In the lower class, 73% wanted their children to go to college but only 38% “expected” their children to go. I n the middle class, the comparable percentages were both 100%.The data on the teaching behavior of the mothers during an Etch-A-Sketch task were reported. These investigators scored the mother’s interactions with her child on three teaching measures, and these were correlated with scores of the joint mother-child performance. The multiple correlation of the three teaching measures with performance was -64; when the three teaching measures were combined with mother’s I Q , child’s I Q , and social class, the multiple correlation obtained was only .67. In general, the lower class mothers did not give specific instructions and did not provide models for the children, although they were free to show the children the 3 X 5 cards on which line drawings of the sketches were made. Also, these investigators report that in this mother-child situation the use of rewards and punishments was different for the middle class and lower class mothers. T h e lower class mothers were more likely to criticize errors than praise success. Although no quantitative data were reported, this latter observation appears extremely important in terms of increasing evidence regarding the effectiveness of reinforcement and punishment procedures on child behavior. These studies and others at the Urban Child Center of the University of Chicago (Hess & Shipman, 1965) are based essentially on the observation that mothers interact with children more than anyone else and that much of the child’s behavior probably is learned within specijic mother-child relationships. Although the children are not classified as cultural-familial retardates (the mean I Q o f the lower class children was approximately 96). the mean I Q o f the lower class mothers was approximately 82; thus, the results seem relevant to the area of cultural-familial retardation. Many other earlier studies comparing social class groups on nu-

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merous measures are reviewed by Bronfenbrenner ( 1 958), Anastasi and Foley (1948), and Caldwell ( 1 964). Most of these studies reported that a greater proportion of one group engaged in some behavior when compared with another group, or that the mean score for one group was higher than the other group on some test or scale. The most consistent finding has been that lower socioeconomic class groups are inferior to middle and upper class groups on verbal or language tests. As with the correlational studies, the fact that there were overlaps between the groups on many of the measures generally has been overlooked. Fortunately, the emphasis is moving in the direction of the study of the effects of specific parental behavior on the behavior of the child ( e g . , Caldwell & Richmond, 1966; Hess 8c Shipman, 1966). Considerable information may be obtained in precise studies in which mothers try different procedures, and the effects of these procedures on the child’s behavior are objectively observed and evaluated, as Harris, Wolf, and Baer (1964) have done with nursery school teachers and normal nursery school children.

2 . COMPARISONS OF CULTUWAL-FAMILIALS WITH NORMALS Berkson (1960a, 1960b) studied the reaction time of a group of cultural-familial (mean I Q = 61) and a group of equal CA normals (mean I Q = 99). In the first experiment there was no evidence for a difference between groups in terms of the length of time a simple stimulus must be exposed in order to be correctly identified (duration threshold). In other words, recognition speed did not differentiate a group of cultural-familial boys from a group of normal boys. In the second study, which utilized the same Ss, there were significant differences between the groups on three more complex reaction time tasks. This second study (Rerkson, 1960b) will be discussed more fully in Section 11, D. Weight judgments of “heavier” or “lighter” than a standard were reported by Hawkins, Baumeister, and Friedrich ( 1 966). These investigators compared the performance of a group of 26 retardates (mean CA = 43 years, mean I Q = 60) with that of’26 normals (mean CA = 33 years, no I Q , given) on a successive weight discrimination task. The conclusion reached by these investigators was “. . . that retardates are markedly inferior to the normal Ss in their sensitivity to weight discrimination .” Cantor and Stacey ( 195 1) compared performances of a group of 175 male familial retardates on the Purdue Pegboard with the performance of 865 industrial men and 456 male veterans, the data on these latter two groups being obtained in other studies. On all the measures used,

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the familials were inferior to the normals. However, Cantor and Stacey point out that there was a marked overlapping of scores, to the extent that many of the defectives obtained scores equal to o r above that of superior normals. These investigators noted that individual Ss did sufficiently well to predict that they could capably perform various manual tasks in industry, providing that the Purdue Pegboard relates to such tasks. Other findings were that the 70-82 I Q g r o u p of familials was significantly better on every measure than the 42-59 group and that on no measure was there a significant difference between the 70-82 and 60-69 IQgroups. Cassel ( 1957) compared the serial verbal learning performances of groups of normals, “familial” retardated, and “non-familial” retardated. The three groups were equated for MA. On two preliminary lists used to introduce the Ss to the task, the normal group learned significantly faster than the familial and nonfamilial groups. However, on learning and relearning an experimental list, as well as an interpolated list, there were no significant differences between groups. About 100 possible retarded Ss were eliminated because of inability to read the experimental materials. Cassel concluded that the retardated do as well as normals of equal MA, once they are adjusted to the task. Zigler, Levine, and Gould (1966) have compared the humor responses of normal children, institutionalized and noninstitutionalized cultural-familial retardated persons. The Children’s Mirth Response Test, composed of 25 cartoons appropriate for children between the ages of 7 and 15, was given to the three groups of 20 S s each. Three scores were obtained; a “yes” or “no” as to whether the cartoon was funny (“appreciation”), a facial mirth score, and a comprehension score. The data were first analyzed for sex differences but none of the analyses revealed any sex differences. Analyses of the scores of the three groups on the three measures revealed no significant differences between the groups on the appreciation measure and the comprehension measure. T h e noninstitutionalized retarded group was less “expressive” (lower scores on mirth responses) than both the institutionalized retarded and the normals. In terms of comprehension the normals were superior to both retarded groups, with no evidence for differences between the retarded groups. Kaufman and Peterson (1965) presented four cultural-familial ( I Q 60-75) and six normal children (IQ90-109) with 96, six-trial conditional discrimination problems. The groups were matched only in terms of mean CA. T h e procedure involved rewarding responses to

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object “A” only when the background of the stimulus tray was white, and rewarding responses to object “B” only when the background was black. Five of the six normals, but no retardates, reached 90% correct Trial 2 performance during the first block of 48 problems. Two retardates and the sixth normal reached the 90% criterion by the end of 96 problems. T h e mean correct responses for Trial 2 and Trial 3 were compared for the two groups for the first 48 problems and the last 48 problems. T h e only significant difference between the groups was on Trial 2 for the first block of 48 problems. An inspection of these scores revealed no overlap between groups. In no case, for the first 48 problems, did the correct Trial 2 responses of a retardate exceed that of a normal. In addition, it was found that the retarded, as a group, made a significantly higher percentage of stimulus perseveration errors than the normals. Balla ( 1966) has provided information regarding the interaction of cultural-familial children with peers and adults and compared these interactions with normal children of two age groups, one equated for MA and the other comparable in CA. T h e institutionalized and noninstitutionalized familial retardates were compared on five measures of environmental interaction with institutionalized and noninstitutionalized younger and older normal children of two social classes. Observations were made in the home and school situation and five measures were taken; number of interactions with peers, supportive interactions with adults, nonsupportive interactions with adults, total interactions with adults, and total interactions with the environment. In the home situation, when the retardate groups were compared with the appropriate normal groups (i.e., institutional or noninstitutional) there was no evidence for group differences on these measures. When institutionalized retardates were compared with noninstitutionalized normals it was found that the retardates came into contact with the environment less frequently. Also, there was no evidence for social class differences in either the home or school situation. Other studies in which one of the main effects in the experimental design was a retardated-normal comparison are reported in Section 11, D, since the studies also involved a manipulated variable.

3. COMPARISONS OF CULTURAL-FAMILIALS AND OTHER RETARDATES Bensberg and Cantor ( 1957) tested “organic” and “familial” groups on a simple reaction time task and a discrimination reaction time task. T h e familial group was significantly faster on both tasks, with the dif-

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ference being greater on the discrimination task than on the simple reaction time task. These investigators point out that there was considerable overlap in the score distributions, a very important point in group comparison studies. Bensberg ( 1 950) compared the performances of 3 1 “familial” and 3 1 “brain-injured” Ss (1Q 35-75) on the marble board test, which Werner designed to differentiate “brain-damaged” from “familial” retardates. The test involves the S copying six designs presented by the E. T h e mean accuracy scores for the groups were 2.3 for the “brain-injured” and 3.3 for the “familial.” A chi-square of those in each group reproducing less than three correctly and more than three correctly was significant at the .01 level. The biserial correlation between MA and accuracy was .82 for the familial group. Bensberg concluded that MA must be taken into consideration before a differential diagnosis regarding etiology can be made. Halpin ( 1 955) tested a group of “familial” retardates and a group of brain-injured retardates in terms of the errors of rotation made on the Bender-Gestalt Test and the Goldstein Scheerer Stick Test. The group of familials made fewer errors than the brain-injured group. In comparing the test performances, Halpin concluded that rotations are not a form of behavior which can be predicted from one visual-motor task to another. Shotwell and Lawrence ( 1 95 1 ) compared the Mosaic Test performance of a group of 30 “familial” and “undifferentiated’ S s with that of 22 brain-injured retardates. The groups were equated for CA and MA. The “familial,” when compared with the brain-injured, used less pieces, had a longer reaction time, had a shorter response time, but did not differ significantly in the shapes or colors used. Cassel and Danehower (1949) studied the MA ranges of Primary Mental Ability (PMA) test scores for 37 “endogenous” and 38 “exogenous” Ss, all under CA 20 years. The “endogenous” MA range was 6.5 to 7.2 years, whereas the “exogenous” range was 4.1 to 6.7 years. The PMA total MA correlated 0.85 with Stanford-Binet (S-B) MA for the “endogenous” group, but only the Verbal MA of the PMA correlated as high with the S-B MA for the “exogenous” group. These investigators interpreted their findings as some corroboration of the general notion of “endogenous mental deficiency” involving general overall retardation, while the exogenous may have more specific deficits. Barnett, Ellis, and Pryer (1959) compared the performances of groups of cultural-familial retardated and brain-injured retardated persons on seven learning tasks (oddity discrimination, object-quality discrimination, mirror drawing, rotary pursuit, maze, serial verbal, and Yerkes double alternation). A covariance analysis was used to adjust

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scores for differences in MAS between the groups. Statistically significant differences (.05 level) favoring the cultural-familials were found on two of the tasks, serial verbal and Yerkes double alternation learning. This article includes quite a few references to other studies which have compared brain-injured and cultural-familial groups.

D.

Experimental or Manipulative Research

The studies in this section could be categorized in terms of the general class of behavior studied (respondent or operant) and further subdivided according to research design (between-subjects group studies, within-subjects group studies, within-subject studies, and replicated within-subject studies). However, there are not enough studies in each of the eight categories to warrant a subdivision in the present review. Perhaps current research will provide enough data for future reviews to include such a categorization. Gardner, Cromwell, and Foshee (1959) studied the activity of a group of 24 organics and a group of 24 familials under reduced and increased distal visual stimulation conditions. Both groups showed significantly less activity under increased stimulation and there was no evidence for a difference in activity between groups. T h e effects of irrelevant visual and auditory stimuli on performance of the Rutgers Drawing Test and the possible differential effects on three groups were investigated by Jones (1964). Both forms of the test were given to three equal MA groups (normal, brain-damaged, familial) under conditions of “distraction” and “nondistraction.” The accuracy of the familial group was significantly reduced under the “distraction” condition, but this effect did not occur for the normal and brain-damaged groups. Overall the normals were more accurate than the retarded groups, and the familials were more accurate than the brain-damaged S s on the more difficult tasks. Baumeister, Smith, and Rose (1965~)investigated the effects of stimulus complexity and retention interval with a group of cultural-familial retardates and normals. The stimuli varied in the number of Chinese characters presented (2, 3, 4, or 5), and the retention interval between exposure and recognition was either 2, 12, or 20 seconds. An analysis of the data revealed an interaction between normal-retardate and complexity, as well as between normal-retardate and retention interval. The differences between the normals and retardates became greater as the complexity increased, with the most pronounced effect occurring with the increase from two to three objects. The normals were superior to the retardates at all retention intervals, but they were significantly more superior with the longest delay interval.

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Variables hypothesized to have an effect on reaction time (RT) have been manipulated in several studies. Berkson (1960b) measured the RT of familial and normal boys (equated for CA only) under three conditions of task complexity. T h e three tasks used required a hand lift, a simple button press, and a choice button press. Poker chips traded in at the end of the session for cents were used as rewards for performing, not according to the speed of response, but in a predetermined random order, except when the reaction time exceeded one-half second. In addition, the E said “good” or “fine” on each rewarded trial. The retardates were slower than the normals in all conditions and there were differences between the three tasks, reaction times being slower for the more complex tasks. However, there was not an interaction between familial-normal and task complexity within the range of task complexity used. Baumeister, Urquhart, Beedle, and Smith (1 964) compared cultural-familial and normal groups on a reaction time task with varying intensities of the signal to respond. A change in the initial illuminance of the reaction time light was used as the signal to respond. The three intensities used involved changes from 0.5, 4.0, and 7.0 foot-candles (fc) to 8.0 fc, i.e., changes of 1.0, 4.0, and 7.5 fc. T h e experimental procedure involved a one second buzzer warning stimulus, a 3-second preparatory interval, onset of reaction time light, and a 10-second intertrial interval. Scores were discarded and a new trial given when there was a false start or when the reaction time exceeded 1 second. The analysis of the results revealed a significant retardate-normal by stimulus intensity interaction. Further analyses of the data revealed that there were differences between performances for the three intensity levels for the retarded group but not for the normal group. Since different subgroups were given the different intensity changes, the intensity comparisons were between-subjects comparisons. As a follow-up to this study, Baumeister, Hawkins, and Kellas (1965a) controlled for threshold differences between groups, since improvement in reaction time as a function of increases in intensity of the reaction stimulus is a function of the distance from threshold. Thirty male cultural-familials and 30 normal men were given audiometric exams to determine thresholds for a 1000 Hz tone, the reaction stimulus. T h e reaction time task was then given in three blocks of 15 trials each. Three preparatory intervals (4,5 , and 6 seconds) and three intensities of reaction stimulus (25, 50, and 75 dB above threshold) were used with all Ss. A light was used for a warning signal. Analysis of the data revealed an interaction between retardate-normal and reaction stimulus intensity, with the retardates improving more with a change from low to higher intensity

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than the normals. T h e performance of the normals differed only .05 second, whereas the retardates differed 10 seconds as a function of a change from 25 to 75 dB in the intensity of the reaction stimulus. This effect, however, was significant only for certain orders of the reaction stimulus intensities, generally those beginning with a low intensity and ending with the highest intensity. These investigators viewed their results as support for the hypothesis that an “arousal mechanism” may be involved in the retardate-normal differences. It should be noted that the normals may have been performing very close to an upper limit at all reaction stimulus intensities and, thus, there was no opportunity for differences as a function of intensity. Such an artifact may have been responsible for the retardate-normal by intensity interaction. Baumeister, Hawkins, and Koenigsknecht ( 1965b) reported two experiments concerned with the possible effects of the complexity of‘ the warning signal and the length of the preparatory interval (PI) on the reaction time of the cultural-familial retardates. In the first experiment, retardates and normals were compared using varying PIS and two types of warning signal. The only significant effect was between normal and cultural-familial groups, with the normals having a faster reaction time. The second experiment, utilizing 48 cultural-familial Ss, was designed with shorter PIS, with the notion that the complexity of the warning signal would be more effective with shorter PIS, resulting in faster reaction time. All S s received the three PI conditions, with half receiving a light only as the warning signal and the other half receiving a light and buzzer. The predicted interaction did not occur, the only significant group difference being that shorter PIS produced faster reaction times. The investigators pointed out that the results do not support the “activation hypothesis,” which states that the inability of the retardate to react quickly stems partly from a generally lower state of “arousal” or “alertness.” Hawkins, Baumeister, and Holland (1965) varied the preparatory interval and the intensity of the warning signal (WS) to evaluate their effects on the reaction time responses of cultural-familial retardates. The PIS used were 2.5, 4.0, and 8.0 seconds; the WS intensities were varied by delivering different voltages (30, 70, 120) of a 1.25-amp current to a 60-watt bulb. All Ss received all combinations of PI and WS intensity. Different orders of WS intensities were given to different subgroups. T h e duration of the WS was 2 seconds with an intertrial interval of 10 seconds. False starts and scores longer than 1 second or two times greater than the mean of the first three trials in a block were discarded and the trial was rerun. An analysis of the results revealed no evidence for an interaction between differing PIS and differing WS in-

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tensities. There were significant main effects for both PI and WS intensity. The longer PIS resulted in slower reaction times, except there was no evidence for a difference between the 2.5- and 4.0-second intervals. T h e most intense WS intensity produced significantly slower reaction times than the other two WS intensities, with no evidence for a difference between the two lower intensities. It was reported that the optimal PI for retardates is around 4 seconds, plus or minus 2. These investigators viewed their results as being contradictory to the “arousal hypothesis” and stated that the controlling variable is probably the relative intensities of the WS and the reaction stimulus rather than the absolute intensity of the WS. Several studies with cultural-familial retardates have been concerned with the effects of “motivational” variables on the performance of various tasks. Hunt and Patterson (1957) found that verbal urging, including the promise of candy for a good drawing, increased the raw scores obtained by 50 familial retardates (mean IQ61) on the Goodenough Draw-A-Man Test. Simply holding the candy sucker in front of the child during the instructions did not increase or decrease the score for that administration of the test. “Motivational” aspects of the behavior of the cultural-familial retardated have been investigated by Zigler and his colleagues (reviewed in Zigler, 1966). Zigler’s position is that the differences in performance between familial retardated and normals of the same MA are not functions of “cognitive structure” but can be attributed to present motivational differences, which are a function of differing social histories of the two groups. Familial retardated, or normals with similar histories, are assumed to have an increased “motivation to interact” with a supportive adult as a function of deprivation. T h e results of several studies (Butterfield & Zigler, 1965; Green & Zigler, 1962; Zigler, 1961; Zigler, Hodgen, & Stevenson, 1958; Zigler & Williams, 1963) are viewed by the investigators as supporting this position. A social deprivation scale has been developed (Zigler, Butterfield, & Goff, 1966) and two studies have been completed on the effectiveness of social reinforcers with familial retardated, one study involving Ss who score differently on the scale and the other study involving Ss from different institutional environments. Butterfield and Zigler (1965) found that children from an institution judged more depriving and punitive were more responsive to social reinforcers than a child from an institution which was judged to be a model institution. In the second study, which utilized two naive Es, there was an interaction between experimenter and institution (two institutions were used) in determining the playing time of the Ss on the marble-in-the-hole game. T h e main effect of institutions also was signif-

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icant. Zigler, Balla, and Butterfield (1968) have found a complex interaction between factorially different aspects of preiristitutional deprivation and three years of institutionalization in determining Ss’ responses to social reinforcers. E.

Concluding Remarks for Section II

There have been no comprehensive, systematic research prqjects concerned with cultural-familial retardation per se, and the scattered research to date has contributed very little empirically to the specification of the variable(s) responsible for cultural-familial retardation. Furthermore, it is unlikely that the necessary experimental work for a dejfnitive answer will ever be done in either the biological or behavioral areas because of the ethical considerations involved in producing the condition. Nevertheless, we can move closer to a determination of the variables by changing those conditions that are correlated and determining their effect on the intelligent behavior. T h e geneticist has yet to show genetic differences but if these are found, then perhaps they can be altered. The following section deals with one approach which the behavioral scientist can take. In contrast to some previous approaches (e.g., gross developmental and environmental), Section 111 will place a great deal of emphasis on an analysis of the specific events in the environment of the cultural-familial retardate. I l l . A SYSTEMATIC APPROACH TO CULTURAL-FAMILIAL RETARDATION

Cultural-familial retardation may be studied systematically, using an experimental analysis approach which focuses on the direct relationships between behavior and its controlling events, without using inferred constructs. This approach to the study of behavior, known as the exprimevital anulysb of behauior or Jutictronal a n n l y k of behavior, was proposed by Skinner (1938, 1953) and systematically presented by Keller and Schoenfeld ( 1 950). Bijou and Baer (1 961, 1965) have extended the system to child development, and Bijou (1966) and Spradlin and Girardeau (1966) have discussed the relevance of the system to the study of retarded behavior. T h e chapter by Bijou ( 1966) was concerned with the entire area of retardation, and the one by Spradlin and Cirardeau (1966) dealt with moderately and severely retarded persons. The present chapter is an attempt to utilize the experimental analysis approach to organize more systematically the problems involved in cultural-familial retardation. This approach seems to offer a great deal in the study of cultural-familial retardation since it focuses directly on the relationships between behavior and its controlling variables. The bal-

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ance of this chapter will be devoted to a discussion of the classes of variables important in the prevention and remediation of cultural-familial retardation from this viewpoint. A.

Classes of Variables Involved in the Development of Cultural-Familial Retarded Behavior

With the small amount of evidence presently available, it is difficult to determine the importance of early respondent behavior (both reflex and conditioned reflex) in the development of what we generally label intelligent behavior. Infant “intelligence” tests sample this category of behavior more than tests designed for older children and adults, but there is little correlation between the sample of behavior taken at 6 months and 6 years. Furthermore, a child who has extremely sluggish reflexes and poor motor behavior may do extremely well on I Q tests and academic tasks; such a person is regarded as intelligent, not retarded. Therefore, the present discussion will focus on intelligent behavior as being primarily, if not entirely, operant or instrumental behavior, although there are interactions between an individual’s respondent and operant behavior (Ferster 8c Perrot, 1967) and sometimes the distinction is not easy to establish. One approach is to examine the variables (or conditions) that are functionally involved and to consider these variables in terms of being necessary for the development of intelligent behavior. In addition, one may consider these variables in terms of their being necessary and su.czent conditions. A certain variable or set of variables may be necessary but not sufficient for a certain behavior to develop. For example, the presence of printed or written material is not necessary and sufficient. If we add a reinforcer to the situation we now have two variables which are necessary conditions for reading behavior. With the addition of one more variable, a contingency between reading behavior and the reinforcer, the set still may not be necessary and sufficient for the development of the behavior. A special program of the reading material may be necessary to make the set of variables sufficient. It is quite possible, it should be noted, to have a set of conditions which are sufficient but which includes some condition(s) that is irrelevant, i.e., unnecessary. From this point of view, the task is to determine the minimal conditions which are both necessary and sufficient for producing the behavior. (For the practitioner, sufficiency alone may be enough, unless he is interested in improving his efficiency.) How may we classify the variables which at this time appear to be necessary and sufficient for the development of intelligent human behav-

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ior, i.e., the elimination of cultural-familial retardation? The variables may be classified into five general categories. ( 1) Antecedent stimulus events (including objects) in the environment which have a relationship to the events that will be present in the future environment. (2) An ordering, or program, of these events that takes into account the child’s present behavioral functioning and has a relationship with the ordering of these events in the future environment. (3) The anatomical and physiological features of the response system. (4) An environment that provides some events which will serve as consequences for behavior, both reinforcing and punishing. (5) Contingencies between behavior and its consequences. Prevention and remediation of cultural-familial retardation may be considered in terms of these necessary and sufficient conditions. In prevention, all of the conditions share equal responsibility in the sense that i f any one is absent to any marked degree unintelligent behavior will be the result. In remediation, however, the retarded behavior may be eliminated by manipulating only one (or more) of these conditions, since the others may already be present. I t may be the case, for example, that much of the remediation in cultural-familial retardation can be accomplished by changing conditions (4) and (5) only. In other words, perhaps, the environment is primarily ineffective in terms of (4) and (5) rather than ( I ) , (2), and (3), whereas most investigators have concentrated on ( l ) , (2), and (3). This is not to say that ( 1 ) and (2) are not deficient, but that probably in remediation programs more could be accomplished by concentrating first on (4) and ( 5 ) and then moving to (1) and (2). Another very crucial point is that ( 1 ) and (2) are not related functionally to behavior unless (4) and ( 5 ) are involved. In other words, events do not function as controlling stimuli for operant behavior unless there are consequences for the behavior in the presence of those stimuli and the consequences are arranged in a contingent manner.

I,

ANTECEDENT STIMUL.US EVENTS I N THE ENVIRONMENT THAT HAVE A RELATIONSHIP T O T H E EVENTS “rHAT W I L L BE PRESENT IN T H E FUTUREENVIRONMENT

There have been writers who have contended that one of the major variables which contributes to cultural-familial retardation is the amount of stimulation in the home and, hence, that the studies of stimulus deprivation with lower animals are relevant to the problem of cultural-familial retardation (e.g., Hunt, 196 l ) . Such deprivation, i.e., low

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total amount of stimulation, may be important in some cases, but it has become increasingIy clear in recent years that simple amount of stimulation, or number of events occurring per minute, probably is not a major contributing variable. In fact, the noise level (i.e., auditory stimulation) in many of these homes is higher than in many other homes, a factor which may be detrimental (e.g., Wachs, 1967). In other words, the extreme noise in some homes may prevent a child from acquiring behavior which would be labeled intelligent in the general community. It may well be that a reduction in the amount of stimulation in some homes, or the provision of a quiet area, would help prevent some cases of cultural-familial retardation. For most cases we should probably look at the type o r clms of events and their relationships to behavior and its consequences that are occurring in these homes, rather than the total frequency of all events. It is the frequency of uf$m@-iute discriminative stimuli which is important. These stimuli must be related to the discriminative stimuli that will be present in the child’s future environment for generalization of appropriate responses to occur. Since the majority of what we consider intelligent behavior for adults could be classified as language or verbal behavior, it seems important that we analyze the verbal environment of the cultural-familial retardate. When this has been done (e.g., Bernstein, 1962), it has been found that the verbal or linguistic environment of the lower class child bears a limited relationship to that which is found in the general verbal community in which he is later expected to function. This is particularly true of the cultural-familial retardate who spends most of his life in a state institution, although descriptive studies of the linguistic environment in state institutions have not been made. If the language stimuli in the cultural-familial retardate’s environment is not appropriate, what can be done? It may be augmented by providing appropriate language stimulation through educational television, nursery school linguistic experiences, o r by changing the linguistic patterns of the parents and siblings, the latter probably being a very difficult and time-consuming procedure. Nevertheless, the child must be provided with language stimuli which approximate the general language culture in which he is later expected to function, and he must be reinforced for responding appropriately. In the early stages, this may involve reinforcement of imitative responses. To some extent, imitation may continue as a means of learning language, and the child is taught what not to imitate. In the area of language events, McReynolds, Petre, Sulzbacher, and Costello (1965) have attempted to develop materials that might be useful with the young cultural-familial retardate. The language materials developed by Dunn and Smith (1965) may be

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quite useful, but they are essentially untested with this population. Evans (1966) has developed a series of experiences which might be beneficial in the prevention of cultural-familial retardation. The essential point is that the language environment, including the grammatical structure (syntax), should be as close as possible to that which the child will encounter in his future environment. Language subcultures may be perpetuated, i.e., two “languages” may be taught, but it must be realized that the cultural-familial retardate within a certain general culture must be prepared to respond appropriately to the language stimuli of that general culture, and must be prepared to provide language stimuli (spoken, written, or gestural) to which the people in the general culture will respond appropriately. Much has been written about the values and attitudes of the lower socioeconomic class (e.g., Gray, 1962), a class into which many cultural-familial retardates would be placed. One may view “values” and “attitudes” primarily as verbal behavior or, in some cases, as other behavior under the control of verbal behavior. When viewed in this manner, the statements by adults in the lower class environments are stimuli which the children imitate and are reinforced for imitating. The verbal statements of the lower class culture may differ from those of the general culture, and the child develops a repertoire of verbal behavior called “attitudes” which impair his development, particularly his academic progress in school. He imitates well, but the stimuli which he imitates are not those of the general culture, and his behavior is not reinforced by the general culture. In summary, one class of variables which may contribute to the development of cultural-familial retardation is the lack of a variety of appropriate events or discriminative stimuli in the environment. This lack of appropriate stimuli prohibits the development of appropriate speech and language behavior. It should be stressed, however, that the eIT. P p o p r i a t e stimuli does not insure that appropriate behavior will occur. “Enj,+ment” often may be necessary, but not su$cases, may not ever) be necessary. Consequences decient and, in livered on a contingent basis must occur in the presence of the Ianp a g e stimuli for the language stimuli to become functional. OR PROGRAM, OF THE DISCRIMINATIVE STIMULI OR 2, AN ORDERING, STIMULUS MATERIALS IN THE CHILD’S ENVIRONMENT

Many of the stimulus events in our environment to which we must respond appropriately to be considered intelligent d o not occur randomly but occur according to some order or program. F~-thermorej educational materials have a specifiable order into which they have

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been arranged. For example, correct counting behavior occurs in a specific order (“one, two, three, etc. . . .”), and the words in our language system usually occur in a specifiable order or program. Specific programs of these and other educational materials may be useful in remediating the behavior of the cultural-familial retardate, but there is no evidence yet that they are necessary. T h e program must be designed such that there are opportunities for reinforcement, regardless of the present behavioral level of the child, and the materials must be programmed in such a manner that the child moves progressively toward the terminal or target behavior as efficiently as possible, without disruptions of an “emotional” nature. Essentially, programming is the ordering of discriminative stimuli so that the control of the behavior may be shifted from one stimulus to another without losing the correct response. Welch (1939) did some early work in programming successive steps of a size discrimination problem and tried his program with some retardates in the 35-50 IQ range. T h e work of Lawrence (1952) with rats, and Terrace’s work on errorless discrimination by the pigeon (1963a, 1963b), are examples of work concerned with transfer or programming procedures. Moore and Goldiamond ( 1964) have utilized fading techniques with humans. In terms of more extensive programs, Homme (1965) has worked on teaching English to preschool Indian children. Some of the work by Birnbrauer et al. (1965) was concerned with the development of programs of educational material for educable retardates. Watson (1967) has reported on some of the experimental efforts in this area with profoundly retarded individuals, and some of the techniques reported may be useful with cultural-familial retardates. Sidman and Stoddard (1966) and Touchette (1968) have programmed tasks for severe and profound retardates, and their techniques may be quite useful with the young cultural-familial retardate. Most of the work in the area of program&ing is relatively recent. Fading, the gradual changing of the discriminative stimuli, may be a very useful programming procedure in developing materials to be used with the cultural-familial retardate, if specially programmed materials are needed. A great deal of work in stimulus programming remains to be done. Readers interested in a more extensive discussion of programming should see Holland (1962), Hively (1962, 1966), and Findley (1966). Work with the retarded has been reported by Greene (1966). 3. ANATOMICAL AND PHYSIOLOGICAL FEATURESOF THE RESPONSE SYSTEM Bgou (1966) has discussed the relevance of this class of variables to retarded behavior in general, stating that abnormal anatomical devel-

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oprnent and physiological functioning may have an effect on behavioral development by impairing the response system which is necessary for adequate behavioral development. Lindsley ( 1964) has suggested that we step u p our search for prosthetic methods (biological, mechanical, and behavioral) to overcome what presently are considered to be limiting, biological conditions, and he has suggested that methods of behavioral prosthesis be considered more frequently. T h e relevance of this particular group of variables to culturalfamilial retardation has been the subject of at least 100 years of debate. To this writer, it seems that proof of the contention that there is a biochemical difference (e.g., genetic) between the cultural-familial retardate and the normally functioning individual must be furnished by those who make such a claim (eg., Anderson, 1964; Gottesman, 1963; Zigler, 1967). Furthermore, any biochemical difference which is demonstrated must be related functionally to behavior in order to contend that the biochemical difference “causes” the retarded behavior. There are, indeed, quite a few cases of retarded behavior which are related to biochemical abnormalities, but such a biochemical relationship has not yet been demonstrated for the cultural-familial retardate. There are certain “setting” conditions which involve biological functioning and are related to behavior. For example, pain stimuli from abscessed teeth, sleep patterns, and nutritional status all may be factors which relate to behavior in a lawful way. Their effect may be to facilitate responsiveness to certain stimuli and/or to lower responsiveness to other stimuli in the environment. These events must be considered in a complete account of cultural-familial retardation and, in certain cases, are factors which must be eliminated before other variables can become effective in the development of intelligent behavior, but these factors are not unique to cultural-familial retardation, 4. AN ENVIRONMENT THAT PROVIDES SOMEEVENTS WHICHWILL SERVEAS CONSEQUENCES FOR BEHAVIOR

One of the major aspects in the deveIopment of operant or instrumental behavior is that there are some consequences which will serve to accelerate or reinforce appropriate behavior and to decelerate or punish inappropriate behavior. Without consequences, appropriate behavior cannot be developed and inappropriate behavior cannot be eliminated. Therefore, it is extremely important that the environment of the cultural-familial retardate include events which may serve as consequences for behavior. I t is probable that the environment of most cultural-familial retardates includes many events which may be used as consequences, both reinforcing and punishing However, the range of available consequences is probably not as great as in the middle class

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home. For example, the middle class parent who has a good income may use money or trips (which require money) as reinforcers for desirable behavior, whereas, the parent of the cultural-familial child usually does not have these reinforcers available to him. Furthermore, there are many other events which middle or upper class parents use to reinforce the behavior of their children which are not used by many parents of cultural-familial children, e.g., the completion of reading a book is reinforced by the middle class parent by his saying that there will be a trip to the library to get another book, and this is backed up by going to the library and getting another book. Consequences may be classified into natural and synthetic3 T h e giving of dessert to a child, contingent on his eating his beans, is an example of the use of a natural consequence, i.e., the dessert is already in the environment and is not added for the purpose of behavioral management. Natural punishment or decelerating consequences also occur, such as shock for placing one’s fingers on both points of an electrical outlet. Many of these occur in such a relationship to behavior that they help develop and maintain behavior. For example, poor driving is punished by an accident in many cases and walking behavior is developed rather rapidly in most cases following a few falls. Synthetic consequences are those added to the environment by the parent, teacher, or experimenter for specific behavioral development purposes. Synthetic consequences may be slowly faded out and natural consequences faded in. For example, tokens may be used in the initial development of some behavior and then gradually faded out as verbal praise is faded in as a reinforcer for the behavior (e.g., Girardeau & Spradlin, 1964). Hence, it is possible, through proper management, to have the child less and less dependent on the token or synthetic positive reinforcer as one progresses in behavior development. Synthetic consequences may be quite useful in the beginning stages. Later, the control may be transferred to other consequences that are already naturally occurring in the environment. Whether synthetic consequences are more effective than natural ones in the early stages is an unanswered experimental question. The primary advantage in certain situations may be that the development of a synthetic reinforcer system is a quick and easy way to establish a reinforcer system without dependency on those that are presently in the environment. Other advantages of token systems are discussed by Girardeau and Spradlin (1970, pp. 5-6). Time out from opportunity to engage in behavior that will result in 3The potential usefulness of distinguishing between natural and synthetic consequences was suggested to the author by Ogden R. Lindsley. Such a distinction might be useful in determining the initial procedures in a prevention or remediation program.

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positive reinforcement is an example of a synthetic punishment consequence that may be added in a particular situation. In some home situations it is a consequence which the parents are already using; hence, time out is a natural consequence in some homes. From this example, it can be seen that there are some consequences which are natural in some homes or classrooms and synthetic in others. T h e distinction between natural and synthetic consequences is a matter of whether they are (or are not) present in the environment when prevention or remediation procedures are started; it is not a functional distinction so they will not be treated separately in the following discussion. A discussion of consequences involved in the development of cultural-familial retarded behavior also involves a discussion of whether or not they are used in a contingent or noncontingent manner and whether the available consequences of a reinforcement nature are used contingent on undesirable behavior, i.e., behavior incompatible with the development of intelligent behavior. Consequences, independent o f the contingency or schedule on which they are administered, may be discussed in terms of the two reinforcement relationships, the two punishment relationships, and the lack of consequences (extinction). a. Procedure3 Which Increase the Frequency of Behavior ( 1) Positive reinjorcement. As mentioned previously, there are many

events or things in the cultural-familial retardate’s environment which can be used as positive reinforcers, although the range of reinforcers is not as great as in the normal child’s environment or, for that matter, in the environment of other types of retardates. The parent of the cultural-familial retardate is less likely to have money (or candy) in his pocket to deliver when desirable behavior occurs. Furthermore, even if the parent has a little money (or candy) for reinforcement of the first few responses, he cannot continue for a large number of correct responses due to his limited income. Of course, such a reinforcer limitation can be overcome by developing a synthetic reinforcer system, e.g., the parent could give bits of colored paper and then back up each 100 with a one-cent piece. Or an extra serving of ice cream could back up each 100 conditioned reinforcers (bits of paper). But the main reinforcer problem may well be that the parents of these children do not know about the effectiveness of positive reinforcers and, even if they did, would not develop effective synthetic systems without the assistance of professional persons. An additional problem is that many professional people still view the systemutzc use of positive reinforcers and other consequences as undesirable but implicitly approve of the haphazard or occasional use of them.

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The lack of use of positive reinforcers following intelligent behavior by the cultural-familial retardate may be viewed as a twofold problem: (1) adding reinforcers to the environment so that they can be used, and (2) educating parents and professional personnel regarding their effectiveness and lack of deleterious side effects. In those situations where they have been used in a contingent manner with the cultural-familial retardate, there has been a considerable increase in intelligent behavior (e.g., Birnbrauer et al., 1965; Staats & Butterfield, 1965; Wolf et d.,1968). Homme, DeBaca, Devine, Steinhorst, and Rickert (1963) have suggested the use of allowing the occurrence of one behavior (a “high probability” behavior) as a reinforcer for another behavior (a “lower probability” behavior), which is an application of the Premack principle to the classroom situation. This principle is used in many homes, e.g., after a child finishes his homework he is allowed to watch “Batman” or after eating spinach he is allowed to eat ice cream. (2) Negative reinforcement. In many situations, the parents of the cultural - familial retardate probably use negative, rather than positive, reinforcers in the development of behavior. In the negative reinforcement situation, an aversive stimulus occurs until a response is made; then the aversive stimulation is terminated. This means that the behavior is escape behavior and in its initial stages occurs only in the presence of the aversive stimulation or stimuli associated with it. Although effective, it may result in behavior which will avoid the situation entirely, in some cases prohibiting an interaction with people in the environment who provide necessary stimuli for learning. For example, the mother may “nag” until the child makes an appropriate intelligent response, e.g., says “green” in the presence of a certain wavelength of light. However, over an extended period of time the child may come to avoid the mother who provides the stimulus, “What color is this?” T h e frequent use of such negative reinforcers (e.g., nagging, spanking, screaming), and the termination of them as consequences for behavior, may be a factor in cultural-familial retardation in that the child will learn to avoid many potentially useful learning situations. b. Procedures Which Reduce the Frequency of’ Behavior (1) Punishment. Punishment is a term used in two situations, for the presentation of a stimulus o r the removal of a stimulus, when either procedure results in a decrease in the rate of the behavior. The presentation of aversive stimuli following behavior is a frequent occurrence in the lives of many cultural-familial retardates, if the descriptions of parental behavior in these homes and teaching situations by mothers are accurate (e.g., Hess & Shipman, 1966; Sears et al., 1957; Wortis, Bardach, Cutler, Rue, & Freedman, 1963). The parent of the cultural-

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familial retardate probably relies much more on punishment as a means o f control than the parents of other children, although this is not always the case. Probably there are many middle and upper class homes where punishment is the major control technique. If the child is punished for most of his behavior, then he emits less and less, not only in the presence of the adult delivering the punisher, but also in the presence of’all adults (including psychological examiner and teacher). Books and other stimuli may become conditioned aversive stimuli or punishers. Furthermore, autonomic respondent behavior may be conditioned to the stimulus situation and “emotional” reactions may be developed in the presence of stimuli associated with the situation. T h e other type of punishment, the removal of positive stirnuli contingent on behavior, probably is not frequently used as a control procedure in many cases. One of the reaons may be that there is a lack of positive stimulation occurring so that it can be used. Also, a procedure such as the “time-out” is not feasible in many homes; because of crowded conditions there is almost no place to put the child where he is removed from social interaction. In summary, the use of physical punishers may be a major factor in the low rate of intelligent behavior by the cultural-familial retardate, not only in specific situations, but because of its possible extensive side effects. T h e extensive use of aversive control in this situation and others may be due to the fact that it frequently serves to negatively reinforce the behavior of the person delivering the punisher, i.e., the cessation of loud screaming by the child following spanking by the parent serves to negatively reinforce the parent’s spanking behavior. In other words, the parent’s spanking serves to terminate an aversive stimulus for the parent. In order to avoid an increase in the rate of spanking by the parent for all types of behavior, the parent must be taught positive reinforcement procedures for controlling the behavior. Otherwise, the child’s behavior may degenerate to a point that it will be classified as retarded. (2) Extinction. When consequences are omitted following some behavior and there is a subsequent decrease in the rate of the behavior, the functional relationship is referred to as extinction. Many culturalfamilial retardate families are composed of a mother and several children. In many cases it may be that certain behavior begins to develop and the mother is too busy to provide any positive consequences, or she may be absent from the home for long periods of time, leaving the younger children in the care of older children or a grandmother. In these cases, certain behavior (e.g., speech) may undergo extinction, i.e., cease to be emitted as a function of absence of positive reinforcers contingent on the behavior. This is one area where stimulus deprivation is

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relevant, but it is stimulus deprivation of reinforcing stimuli, rather than deprivation of discriminative stimuli (which precede operant behavior). 5. CONTINGENCIES OR LACK OF CONTINGENCIES BETWEEN BEHAVIOR AND ITS CONSEQUENCES

Events may occur subsequent to behavior in a number of ways. T h e events may occur unrelated to the preceding behavior and have no effect on the behavior. In such a situation, these events are merely subsequent events and not useful in a functional analysis of behavioral development. However, when certain events are delivered contingent on behavior, these events have an effect and are referred to as consequences. T h e consequences may be delivered in a number of relationships to the behavior, and it is important to know and arrange the consequences in specifiable contingencies, since different contingencies have different effects on behavior. a. Contingencies. A consequence may occur after each response, after a fixed number of responses (fixed-ratio contingency or schedule) or after a variable number of responses (variable-ratio). Furthermore, a consequence may occur following the first response made after a fixed time interval (fixed-interval) or after a variable time interval (variable interval). There are many more complex arrangements of contingencies, and those interested in other contingencies or schedules should see Ferster and Skinner (1957) and theJournal of the Experimental Analysis of Behavior. A consequnce may occur immediately following a response or it may be delayed for varying time intervals. In general, the consequence loses effectiveness as a function of increasing delay intervals. However, complex behavior may be developed by reinforcing the last response in a long chain of responses, thus eliminating the necessity to provide external consequences for each member of the chain. Also, it appears possible to teach or train some children to continue behavior when there is a long delay between the behavior and the consequence, although what may be happening is that we teach the child to provide his own consequences during this interval. In the early stages of the development of a particular behavior, frequent consequences appear necessary. As the behavior begins to occur more and more frequently, the contingency may be shifted to a partial or intermittent schedule. Such “thinning out” or “leaning out” of the contingency may be involved in what is referred to as “persistence” or persistent behavior, i.e., the continuation of behavior when no reinforcer occurs frequently. Gray (1962) has noted that lower class children lack “persistence toward a goal,” which may be due to the specific contingencies under which the behavior was initially developed and

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maintained. In these situations, it may be that there is not an appropriate shift from acquisition (with a relatively continuous schedule of the reinforcer) to maintenance of the behavior (using an intermittent schedule which involves long periods or high ratios before reinforcement). Persistent behavior, then, may be a function of the arrangement of the contingencies by the parent or teacher. Gray (1962) has also noted that there is a disruption of behavior by some lower class children when there is a “delay of gratification.” Such disruption may be related to the possibility that increasing delays between behavior and its consequences were not used during training, or that the child was not taught to provide his own consequences for partial completion of the task. Other situations regarding contingencies involve the use of consequences for behavior, but instead of being contingent on appropriate, intelligent behavior, the consequences are delivered contingent on behavior incompatible with the development of intelligent behavior. As mentioned previously, the parent may attend and talk to the child only when he has engaged in some undesirable behavior, such as fighting. When the child starts looking at pictures in a magazine and asking questions, he is either ignored or punished. In such a situation, the rate of looking at pictures and asking questions goes down and the rate of fighting goes up. Such situations may occur frequently in some cultural-familial homes. Buehler, Patterson, and Furniss ( 1966) have found that many of the reinforcers provided by peers in an institutional environment are for inappropriate behavior. As Bijou (1 966) has noted, the contingent reinforcement of inappropriate behavior has two features: (1) such behavior may be so strong that it becomes the usual way of responding, and (2) such behavior may be so aversive to so many people that social and educational opportunities for the child become limited. This situation, the reinforcement of behavior incompatible with the development of intelligent behavior, may be one of the major factors in the development of retarded behavior by many cultural-familial retardates. Such behavior probably can be eliminated in the school situation but it requires systematic contingency management, with the teacher and principal using effective reinforcers. b. Motivation. T h e lower class child is said to lack “achievement motivation” (e.g, Gray, 1962). We certainly observe that children do not continuously engage in behavior which may be called academic. Furthermore, it has probably been observed on numerous occasions that the cultural-familial retardate does not engage in academic behaviors as much of the time as the average 1Qchild. Within psychology and education it has been traditional to attribute the infrequent “academic” behavior to lack of “achievement motivation.” At least 3 distinct situations or procedures are involved when the word “motivation” is used.

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(1) T h e word “motivation” is used when there is well-defined discriminative stimulus control of behavior, as in verbal “urging” or “encouragement.” Furthermore, it is said that a person is “motivated” by a model which he imitates. In other words, the behavior is under the control of stimulus conditions which occur prior to the behavior, e.g., if the parent sits down and reads a book, the child sits down and reads a book. This use of the word “motivation” can be subsumed under the procedures for discrimination training and relates to the events or discriminative stimuli found in the retardate’s environment. (2) The word “motivation” is used when the organism is riot in a homeostatic state, either natural or imposed. For example, deprivation conditions are frequently referred to as “motivating” conditions. This use of the word “motivation” can be subsumed under the “setting” conditions for behavioral relationships. (3) T h e word “motivation” is used when “incentives” or positive reinforcers are given contingent on behavior, or when negative reinforcers are terminated contingent on behavior. T h e person is said to be “motivated” by these procedures. In the early stages you use reinforcement to get the person more active in general, then you narrow the range of behavior which will be reinforced, and finally you progressively “lean out” or “thin out” the reinforcement schedule. It is in regard to this latter procedure-the contingent use of reinforcers -that the discussion of motivation is included in this section, although all three procedures are relevant, e.g., a parent may not provide an “academic model” and may not positively reinforce academic behavior under appropriate deprivation conditions. In the remediation of cultural-familial retardation it may be difficult and time-consuming to train parents to be a better “academic model.” However, “achievement motivation” behavior can probably be developed rather quickly in most cases by systematically using reinforcers under appropriate deprivation conditions. T h e study by Wolf et al. (1968) demonstrated that this type of behavior can be developed rather rapidly with a token reinforcer system backed u p by a large variety of reinforcers. IV. CONCLUDING COMMENTS

T h e studies regarding cultural-familial retardation present a confusing picture. Much of the data has come from correlational studies and nonmanipulated group comparison studies in which there was considerable overlap between the behavior of the cultural-familial group and the normal group. One should be extremely careful in the interpretation of these data and not attribute “cause” o r functional effectiveness to a variable which has not been manipulated experimentally.

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There are some who contend that the transmission of specific genetic material from parents to offspring is the major ccrcisitiz~efactor in cultural-familial retardation, but there appears to be no scientific evidence at present for such a position; at least this writer could find none. This is no/ to say that a difference in genetic material between the normal person and the cultural-familial retardate will not be found in future investigations, but that such a difference has not yet been reported. Continued research in biochemical genetics should certainly be pursued, but it seems reasonable to the present writer that a behavioral approach to cultural-familial retardation can accomplish its aim without an assumption of genetic differences. For several reasons (e.g., nutrition, inadequate health care), the cultural-familial retarded, as u grout>, may have somewhat inadequate physiological functioning, but these factors probably are not critical ones. They may, however, interfere with the effectiveness of behavioral procedures in certain situations. In other situations, however, these conditions may make a remedial program more effective. For example, if a child is receiving very little food at home, a remedial program which uses food as a positive reinforcer may be extremely effective. Thus, the effective remedial program takes advantage of such natural deficiencies in the environment and, where possible, provides reinforcers which are also discriminative stimuli for other desirable, int.elligent behavior. For example, books or trips to the zoo are perfect reinforcers because they also provide an occasion for the child to emit other intelligent behavior which may be positively reinforced. T h e lack of such reinforcers in the environment o f the cultural-familial retardate and their use, contingent on intelligent behavior, are probably the major problems, although not the only ones. Almost without exception, discussions of cultural-familial retardation involve “heredity versus environment,” as if the two are opposed to each other! Within the past 20 years, however, the question has changed from “Is it one or the other?” to “What are the relative contributions of heredity and environment to certain behavior?” or “How do heredity and environment interact?” According to this writer, the cpestion of the interaction of heredity and environment could be approached more appropriately in terms of specific experimental questions rather than as a gross generalization. If t h e question is ever answered it will be in the form of many answers to many specific questions, with biochemical and physiological functioning viewed as “setting” conditions. These answers, some of’which we now have, will come from a precise experimental analysis of the functional relationships between stimuli, behavior, and consequences of the behavior under conditions of differing biological characteristics or “setting” conditions. T h e behavioral scientist can proceed rapidly by asking specific ques-

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tions within the general question, “Given X set of biological characteristics, what procedures are necessary and sufficient to develop Y behavior, maintain Y behavior, and reduce or eliminate Y behavior?” Likewise, biological scientists interested in behavior can proceed rapidly by asking specific questions within the general question “What procedures are necessary and sufficient to change X set of biological characteristics so that Y behavior may be more difficult or easier to develop, maintain, reduce or eliminate?” From such research a science of human behavior - including retarded behavior -can be developed and remediation procedures can be devised whereby man can solve completely the perplexing problems presented by the lack of appropriate behavior of the cultural-familial retardate. We should not, as some suggest, let the verbal behavior of others control our experimental behavior to the extent that we do not attempt, with naive enthusiasm, to do those things which have not yet been done, including an attempt to completely solve cultural-familial retardation with the methods of behavioral science. N O T E ADDED IN PROOF Since this chapter was written a number of studies have been published which are relevant for improving the behavior of the cultural-familial child. A list of these studies can be obtained by writing to the author (Children’s Rehabilitation Unit, Kansas University Medical Center, 39th St. and Rainbow Blvd., Kansas City, Kansas 66103).

REFERENCES Anastasi, A. Heredity, environment, and the question, “How?”Psychological Review, 1958, 65, 197-208. Anastasi, A., & Foley, J. P.,Jr:A proposed reorientation in one heredity-environment controversy. Psychological Review,1948,55,239-249. Anderson, V. E. Genetics in mental retardation. In R. Heber & H.Stevens (Eds.), Mental retardation. Chicago: University of Chicago Press, 1964. Pp. 348-394. Atchison, C. 0. Use of the Wechsler Intelligence Scale for Children with eighty mentally defective negro children. American Journal of Mental Deficiency, 1955, 60, 378-379. Baldwin, A. L., Kalhorn, J., & Breese, F. H. Patterns of parent behavior. Psychological Monographs, 1945,58,1-75. Balla, D. The verbal action of the environment on institutionalized and non-institutionalized retardates and normal children of two social classes. Unpublished doctoral dissertation, Yale University, 1966. Barnett, C. D., Ellis, N. R., & Pryer, M. W. Stimulus pretraining and the delayed reaction in defectives. American Journal of Mental DejEciency, 1959,64, 104- 1 11. Baroff, G. S. WISC patterning in endogenous mental deficiency. American Journal of Menlal Dejciency. 1959,64,482-485. Baumeister, A. A., Hawkins, W. F., X Kellas, G. T h e interactive effects of stimulus intensity and intelligence upon reaction time. American Journal of Mental Deficiency, 1965, 69, 526-530. (a)

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Baunieister, A. A,, Hawkins, W. F., & Koenigsknecht, K. Effects of variation in corriplexity of the warning signal upon reaction time. Americvn ,Jottrnn/ o/ ,Wen/c// D e / i c i e ~ ~ r 196.5, y, 69, 860-864. (b) Baumeister, A. A., Smith, T. E., & Rose, J . L). ~I'heeffects of stimulus complexity and retention interval upon short-term memory. z ~ m e ? i rJoo ~w ~r r d o/' h f P ? l / / / / Deficierir:y. 1965, 70, 129- 134. (c) Baunieister, A. A., Urquhart, D., Beedle, K., & Smith, T. E. Reaction times of normals and retardates under different stimulus intensity changes. American Journal cfMental Deficiency, 1964, 69, 126- 130. Bensberg, G. J . A test for differentiating endogenous and exogenous mental defectives. Ame~iccrii,Joirrntil o/Menlnl Deficirncy, 19.50, 54, 502-506. Bensherg, C . ,I., & Cantor, G. N. Reaction time in mental defectives with organic and familial etiology. ,4nirrircin,Jorrr~rrr/o/ M e n / n / Defrrirncy, 19.57, 62, 534-537. Bensherg, G. J., & Sloan, W. T h e use of the Cattell Culture Free Test with mental defectives. .4merirun J o u r n d o/ M e i i t d DeJlrirncy, 1955, 59, 499-503. Benton, A. L. Psychological evaluation and differential diagnosis. I n H. A. Stevens & R. Heber (Eds.), Menla/ retardution. Chic;igo: University of Chicago Press, 1964, Pp. I(<-56.

Berkson, G. An analysis of reaction time in normal and mentally deficient young men. 11. Variation of complexity in reaction time tasks. ,]ourna/ of lZlentn/ De/icirncy R e t m r d , 1960.4, 59-67. (a) Berkson, C;. An analysis of reaction time in normal and mentally retarded deficient young men. 111. Variation of stimulus and response complexity. ,]o.urnul o/ M ~ i , t a l Deficiency Resetirrh, 1960, 4, 69-77. (b) Bernstein. B. Social class, linguistic codes and grammatical elements. L(ingi~agecind S ~ J P P ~ , 1962,5, 221-240. Bijou, S. W. A functional analysis of retarded development. In N. R. Ellis (Ed.), Iri/rrncitional review a/ reseurch in mental re/ardutiow Vol. 1. New York: Academic Press, 1966. Pp. 1-19, Bijou, S. W., & Baer, D. M . Child developnien/: A .ry,\/emntic. ccnd enrpirird theory. Vols. I & 11. New York: Appleton-Century-Crofts, I96 I . Biou, S. W., & Baer, D. M. Child developmen/, Vol. 2 01. Injancy: The universal stage of inJ k y . New York: Appletoii-C:entury-~r(~fts, 1965. Birnhrauer, J. S., Bijou, S. W., Wolf, M. M., & Kidder,,]. D. Programmed instruction in the classroom. In L. P. Ullman & L. Krasner (Eds.), Crrw studio in behmrior modificolion. New York: Holt, Rinehart & Winston, 1965. Pp. 358-363. Birnhrauer, J. S., Wolf, M. M., Kidder, J . D., & Taque, C:. E. Classroom behavior of retarded pupils with token reinforcement.,Joirrif[i/ o/ Bx,!Jerznrrir/a/Child P.sycho/ogv, 1965, 2 , 2 19-235. Boring, E. G. A hi3foT qf experimrntal p,yhology. (2nd ed.) New York: Appleton-CenturyCrofts, 1950. Brofenbrenner, U. Socialization and social class through time and space. In E. E. Maccoby, T. H. Newcomb, & E. L. Hartley (Eds.), Hunding.r i n .sorinllisyc/io/oW. New York: Holt, Rinehart & Winston, 1958. Pp. 100-125. Buehler, R. E., Patterson, G. R.. & Furniss, J . M. T h e reinforcement of- behavior in institutional settings. Behaviour Research and Them~iy,1966, 4, 157-167. Butterfield, E. C., & Zigler, E. T h e influence of differing institutional social climates on the effectiveness of social reinforcement in the mentally retarded. American Journal !/ Mental DPficiency, 1965, 70, 48-56. Caldwell, B. M. T h e effects of infant care. In M. L. Hoffman & L. W. Hoffman (Eds.), Review o j child development resenrrh. Vol. I . New York: Russell Sage Foundation, 1964. Pp. 9-87.

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children. October, 1965, Contract No. 14-20-065001506, U. S. Department of lnterior. Homme, L. E., DeBaca, P. C., Devine, J. V., Steinhorst, R., & Rickert. E. J. Use of the Premack principle in controlling the behavior of nursery school children. Journal ./' the Experimntal An.aly.sisof Behavior, 1963,6,544. Hunt, B., & Patterson, R. M. Performance of familial mentally deficient children in response to motivation on the Goodenough Draw-A-Man test. American Journal !/ Mental Dejiriency, 1957,62, 326-329. Hunt, J. McV. Zntelligence and Expprience. New York: Ronald Press, 1961. lllingworth, R. S. Thr denelofmenf o j ' thc illfarit and young child. Baltimore: Willians & Wilkins, 1966. Jones, H. E. T h e environment and mental development. In L. Carmichael (Ed.), Mun,ual of'child psychology. New York: Wiley, 1954. Jones, R. W. Cross-sectional views of visual reproduction and the effects of distraction on visual reproduction by brain-damaged retardates, familial retardates and normal children. Dissertation Abstracts, 1964, 25, 2068. (Abstract) Kaufman, M. E., & Peterson, W. M. Acquisition of a conditional discrimination learningset by normal and mentally retarded children. Americarr Journal o j Mental Zlejirienry, 1965,69,865-870.

Keller, F. S., & Schoenfeld, W. N. IJrincip1es of psychology. New York: Appleton-CenturyCrofts, 1950. Keller, S. T h e social world of the urban slum child: Some early findings. American Journal of Or&hop.qychiatq,1963.33, 823-831. Klatskin, E. H. Shifts in child care practices in three social classes under an infant care program of flexible methodology. AmericanJournal qfOrth+sychiatv, 1952.22, 52-61. Knief, L. M., & Stroud, J . B. Intercorrelations among various intelligence, achievement and social class scores.Journa1 ofEducationa1 Psychology, 1959,40, 1 17-1 20. Kohn, M. L. Social class and parental values. American Journal of' Sociology, 1959, 64, 337-35 1.

Lawrence, D. H. T h e transfer of a discrimination along a continuum.Jourira1 of'Comparative and PhysiologicalP.sychology, 1952,45, 5 1 1-5 16. Lewis, 0.T h e culture of poverty. ScientificAmerican, 1966, 215, 19-25. Lindsley, 0. R. Direct measurement and prothesis of retarded behavior.,/ournal Vf' Education, 1964, 147,62-81. McCandless, B. R. Relation of environmental factors to intellectual functioning In H. A. Stevens & R. Heber (Eds.), Mental retardation: A review oJresearch..Chicago: University of Chicago Press, 1964. Pp. 175-2 13. McReynolds, L., Petre, R. D., Sulzbacher, S. I . , & Costello, J . An experimental language improvement program for preschool culturally deprived children. Bureau of Child Research Laboratory Working Paper No. 7, 1965, University of Kansas Medical Center, Kansas City, Kansas. Miller, M. B. Psychometric and clinical studies in mental deficiency, 1954-59: A selective review and critique. ArnericanJournal of' Mental DPficiency, 1960.65, 182-1 93. Montessori, M. The Montessori method. Translated by Anne George. Cambridge, Engl.: Robert Bently, 1965. Moore, R., & Goldiamond, 1. Errorless establishment of visual discrimination using fading procedures.Journal of'the ExperimentalAnalysis of'Behavim, 1964, 7, 269-272. Ogdon, D. P., & Allee, R. Rorschach relationships with intelligence among familial mental defectives. American Journal of Mental Deficiency, 1959, 63, 889-896. Pasmanick, B. Research on the influence of sociocultural variables upon organic factors in mental retardation. American Journal of'Mental Deficiency, 1959, 64, 316-321.

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Sarason. S. B., & Gladwin, 7'.Psychological and cultural problems in mental subnorPart 11. N e w York: Basic Books, 1958. Pp. 145-392. mality. Meirtd suhriornrrr/i/~~. Scheerenberger, K. C. Mental retardation: definition, classification, and prevalence. MPII/I// Relardutioic A6.strurts. 1964, 1, 432-44 I . Sears, R. K.,Maccoby, E. E., & Levin, H. / J o / / v r r t . ~v/ d i / d ruuririg. Evanston, Ill.: Row & Peterson, 1957. Shotwell, A. M., & Lawrence, E. S. Mosaic patterns of institutionalized mental defectives. American ,lournal of Mrnlrcl Dtjirierrcy, I 95 I ,56, 1 6 1 - 168. Sidman, M.,& Stoddard, L. T. Programming perception and learning for retarded chilr w i e 7 ~i)/ i-cserot-cli in irierrkd rrfiirilution. Vol. 2. dren. I n N. R. Ellis (Ed.), liitertt~i/ior~ul New York: Academic Press, I!)titi. Pp, 152-208. Skeels. H. M., Updegraff, R., Wellman, B. I.., & Williams, H. M. A study of environmental stimulation: An orphanage preschool project. U r i i ~ ~ r r .v/'~ i !070/i / ~ ~ S i d i r r in Clrild IVelfitre, 1938, 15. Skinner, €3. F. The hrliriiior U/ orgmism.v. N e w Y o r k : Appleton, 195H. Skinner, R. F. Sriritre and hurnun /w/tn7,ior. New York: Macmillan, 19.53. Spradlin, J . E., & Girardeau, F. I-. T h e behavior of moderately and severely retarded persons. In N. K. Ellis (Ed.), liilmwi/iomd review IJ/ re.srcirch iri ~ i ~ ~ i ii-e!ardatiow. /a/ Vol. I . New York: Academic Press, 1966. Pp. 257-298. Staats. A. W., & Butterfield, W. H. Treatment of non-reading in a culturally deprivedjuvenile delinquent: An application of reinfa-cernenl principles. (:hi/d ~ k T J f ' / f J / ) ? n P l l / , IYti5,36, 925-942. Terrace, H. s. Discrimination learning with and without "errors." ,/oirrirn/ /J/ flw E x / w J , ~ nirri/ri/ Arin/ysis 01 BeItm~ioi-,1963, 6, 1-27. (a) Terrace, H. S. Errorless transfer of a discriniinarion across t w o continua. , / m i i - t w / o/ /lie Ex/wrirnrnlnl Ana/y.rh v/ Heliirzior, 1963, 6, 293-232. (b) Touchette, P. E. 'The effects of graduated stimulus change on the acquisition of a simple discrimination in severely retarded boys. ,loitnial o/ llw Exprrimmlal Annlysi.~of B e h ior. 1968, 11.39-48. Wachs, T. D. Environmental stimulation and early intellectual development: A broader look at a one-sided problem. Paper presented at the meeting of the Indiana Psycho1967. logical Association, West Lalayette, Incli~iti~~. Waisnian, H. A,, & Gerritsen, T. Biochemical ;ind clinic;tl correlations. I n R. Heber & H. A . Stevens (Eds.), Mental returddon. Chicago: University ot' Chicago Press, 1964. PI). 307-547. Watson, 1.. S. Application of operant conditioning techniques to institutionalized severely and profoundly retarded children. Meti/rr/ Rctardnlion A6s/rarls, 1967,4, 1- 18. Weikart, D. P., Kamii, C. K., & Radin, N. 1.. Perr Preschool Project Progress Keport, Upsilanti Public Schools, Upsilanti, Michigan, 1964. Welch, L. T h e development of size discrimination between the ages of 12 and 40 months. l o i ~ r r r diJ/'(;e?~e/icI-'syc.lio/og?, 1939, 55, 243-268. Wolf, M. M., Giles, D. K., & Hall, K. V. Experiments with token reinforcement i n a remedial classroom. Behn7~iozirRu.rmrch mid T/imc/q,1968, 6, 5 1-64, Wortis, H., Bardach,,]. L., Cutler, R., Rue, K., & Freedman, A. Child-rearing practices in a low socio-economic group. f'edicrlricr, 1963, 32,298-307. Zigler, E. Social deprivation and rigidity in the performance of feebleminded children. Joitmal ?[Abnormal and Social Psychology. 196 1,64. 4 13-42 1. Zigler, E. Research on personality structure in the retardate. In N. K. Ellis (Ed.), Iv/mrational rerriew o j research in mental retardation. Vol. 1. 1966. New York: Academic Press. Pp. 77- 108. Zigler, E. Familial mental retardation: A continuing dilemma. Scierrre, 1967, 155, 292-298.

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German Theory and Research on Mental Retardation: Emphasis on Structure1 LOTHAR R. SCHMIDT' UNIVERSITY OF SAARLAND, SAARBRUCKEN, GERMANY

AND

PAUL 8. BALTES WEST VIRGINIA UNIVERSITY, MORGANTOWN, WEST VIRGINIA

I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Theoretical Orientation ..................... A. Definition of Mental B. Theory Construction and General Research Emphases . . 111. Specific Research Emphases . . . . . . . . . . . . . . . . . . . . . . . . . . A. Basic Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Structure and Development of Intelligence . . . . . . . . . . C. Personality Functioning and Structure . . . . . . . . . . . . . . D. Diagnostic Process and Construction of Assessment ....... Instruments Instruments ....................... . . . . . . . . . . . . . . . ........................ IV. Education and Rehabilitation ......................... A. Educational System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Developmental Education, Rehabilitation, and Therapy V. Comparative Evaluation . . . . . . . . . . . . . . . . . . . ......... References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

~4~

:'IN)

I. INTRODUCTION

This review of German theory and research in mental retardation is limited by a number of restrictions. Some of these restrictions have been introduced on purpose, while others may be a function of selective biases of which the authors are less aware. The present review limits itself to psycholopcal research and theory '011 rese;idi leave a t I)ep;ir~~nent 01' Urbana-(:hampaigii, Illinois. Y4!)

Psy~hology, University

of' Illinois,

Lothar R . Schmidt and Paul B. Baltes

350

even though research on mental retardation is typically conceived of as being a multidisciplinary endeavor. Furthermore, it focuses on the discussion of early and late childhood mental retardation; studies dealing with adult or old-aged retarded populations have been included only when particular interrelationships to findings with children and adolescents have been suggested. The time span covered in this review is largely unspecified. Emphasis, however, is placed on empirical and experimental work reported during the last decade (1 958-1968). Earlier work is included when it clarifies particular historical or theoretical developments. It should be noted further that, without any political intentions, a number of studies published in the German Democratic Republic or by German speaking Swiss and Austrian, etc., researchers has been incorporated as well. This appears justifiable, since all of these countries have sufficient similarities with respect to their research efforts. Accordingly, the language of publication, rather than any political boundary, serves as primary selection criterion. A few topics have been given preferential treatment. For example, special attention is devoted to studies aimed at a structured measurement of mental retardation, in an attempt to integrate basic research with the development of assessment instruments. This selective treatment appears to be compatible with current research emphases. It also indicates where German research on mental retardation may have its highest standards. II. THEORETICAL ORIENTATION A.

Definition of Mental Retardation

The problem of defining a concept is, of course, a transcultural phenomenon. In addition, a review in a foreign language must cope with the vagaries of translation and the fact that the phenomenon itself may not be transculturally invariant. Accordingly, the behavioral domain of this review is not easy to delineate. First of all, the recent tendency of American researchers to prefer the concept of mental retardation over other related concepts (such as mental deficiency, feeblemindedness, etc.) is not yet shared by their German counterparts. As a matter of fact, in a strict sense there is no common German translation of the term “mental retardation.” The term most often used appears to be the German concept of Schwachsinn, which is literally closest to the American terms “feeblemindedness” and “mental deficiency.” Despite this difference in literal translation,

GERMAN THEORY A N D RESEARCH O N MENTAL RETARDATION

35 1

however, the German “Schwaclisinn” seems to convey connotations similar to those of the American term mental retardation. Basically, Schwaclisinn implies two different things, one descriptive, and the other etiological. With respect to the descriptive aspect-characterization of mental subnormality in its various levels of intensitythere exists generally fair agreement. The definition becomes shadowy, however, when etiological aspects are considered. This state of affairs parallels the situation in the United States (Brison, 1967; Heber, 1959; Robinson & Robinson, 1970) of a decade or so ago. For a long time, the discussion of mental subnormality had been largely in the hands of medical people and gPistuswissenschuftlicI1 oriented educators. Only in recent years have experimentally oriented psychologists contributed to research efforts. This recent development has produced a continuously stronger emphasis on the multidimensionality of the phenomenon of mental subnormality, with regard to both its descriptive and etiological aspects. Currently, attempts are under way to unify the language system by clearly separating descriptive from etiological considerations (e.g., Schniitz & Grossmarin, 1968; Wegener, 1969), arid by proposing a minimal classification system. Undoubtedly, it has become recognized that the behavioral construct under consideration is not a unitary phenomenon, with regard either to its description or to its explanation. Keeping the literal differences and the recent developments in mind, it seems justified to use the term mental retardation interchangeably with the German term Schwachsinn, at least as long as no particular etiological specifications are implied. Accordingly, in the following review the term mental retardation is used as a general classificatory concept of mental subnormality. Even though there is no generally accepted system of classification, there are “statistically” normal strateges employed to operationalize the concept of mental retardation. As is true for the bulk of American research, the level of intelligence in terms of a global IQis mostly used for a descriptive quantification. Three levels of mental retardation are distinguished in ascending order: moronity (Debililii~),imbecility, and idiocy. The exact boundaries of these categories often fluctuate and are dependent upon the measurement instrument. There is a strong trend, however, primarily with respect to research efforts, to get away from a global IQmeasure to a multivariate consideration of the pattern of intelligence. This approach of a qualitative classification of mental subnormality is associated with strong multivariate factor analytic research efforts, and these efforts will be discussed in greater detail below.

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Besides the performance on intelligence tests, school performances are often taken as descriptive criteria in categorizing mental retardates. In this case, the level of subnormality is typically defined either in conjunction with intelligence measures or according to the type of educational institution (see Section IV) the children are exposed to. In the latter case, the term “special school children” will be used to characterize mentally retarded children. As will be shown later, however, the definition on the basis of school performance leads to a rather heterogeneous population of retardates as far as the IQrange is concerned. In research practice, the multiplicity of etiological factors and syndromes is typically reduced to classification into three groups: (a) endogenous mental retardation, (b) exogenous mental retardation, and (c) psychogenic-reactive mental retardation. The definition of these terms is largely synonymous with the American terminology and, of course, shares similar shortcomings. The diagnosis of endogenous mental retardation rests primarily on three criteria: evidence of retardation in the family, absence of neurological pathology, and absence of pre- and/or postnatal brain injuries. Included also are those cases where genetic abnormalities, such as enzyme deficiencies, are assumed to be present (Funk, 1961; Gunther, 1961; Joppich & Schulte, 1968; Schteier, 1963, 1966; Stutte, 1960). The second group, exogenous mental retardation (Bannes & Fiedler, 1966; Bosch, 1954; Elert & Hiiter, 1966; Faust, 1960; Funk, 1961; Gunther, 1961; Huffmann, 1963; Joppich & Schulte, 1968; Kirchhoff & Kraubig, 1966; Laux, 1967, Laux & Bues, 1960; Leischner, 1962; Lindernann, 1963; D. Muller, 1969; Rehwald, 1956; Scheid, 1968; Sperling, 1967; Stutte, 1960, 1964, 1965; Wolf, 1968), is diagnosed in the demonstrated presence of organic prenatal or postnatal brain damage. Thus, the term exogenous mental retardation clearly excludes hereditary determinants and, on the whole, does not include psychosocia1 determinants. It is well recognized that, from the standpoint of causative factors, from the nature of the associated brain damage, and from the kind of behavioral correlates, this subgroup of exogenous retardates incorporates a heterogeneous class. Nevertheless, in most instances this subgroup is treated as an entity in psychological research. The third group, psychogenic-reactive mental retardation, is often discussed on a theoretical level, but the number of empirical and experimental studies is relatively meager. In connection with the concept of sociocultural deprivation (Wegener, 1969), this term subsumes all cases in which psychosocial determinants are held primarily responsible for mental retardation. A major subcategory of psychogenic-reactive

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mental subnormality is associated with the concept of pseudo-feeblemindedness (Pseudodebzlitat) which appears to be especially in vogue (Asperger, 1960; Busemann, 1959a; Dietrich, 1968; Lutz, 1961 ; Pfistner, 196 1 : Scholz-Ehrsam, 1967a; Stern, 1956; Wagner, 1965); sometimes this term is used synonymously with the term psychogenic-reactive. T h e range of psychogenic mental retardation runs the gamut from the diagnosis of hospitalism and cultural deprivation to such diagnoses as neurotic achievement inhibition and/or intelligence inhibition (Leistungs-, Irilelligenzhenimung), as discussed, for example, by Diesing (1959), Kassner (1964), Luckert ( 1 967), Luders ( 1 967), Stern (1956), and Stutte ( 1960). In this context, the term developmental retardation (Entwzcklungsz,erzoe~erung) is sometimes used, and it appears to carry the meaning which is literally associated with the word retardation, since it implies the potential occurrence of a mental growth spurt, provided appropriate treatments are administered. A number of additional concepts often treated within the framework of mental retardation need delineation. On the one hand, there is the area of school readiness (Scliulreifr) as defined by ability, sociability, personality, and physical characteristics, which attracts considerable attention. Whenever it has been argued that subnormal school readiness is associated with mental retardation, the research has been included in this review. An additional focus of German research concerns the phenomenon of reading and/or writing disability ((Legasthenze).On the descriptive level, reading and/or writing disability (dyslexia)typically rests on a marked discrepancy between general intellectual functioning (measured by tests in other areas of intellectual achievement) and the specific performance in reading and/or writing, with the latter exhibiting a decrement. In this case, it is questionable whether reading and writing disability should be subsumed under mental retardation. As a consequence, mental retardates, if diagnosed on the basis of school performance, run the risk of being confused with a considerable proportion of reading o r writing disabled children. Concerning the etiology of dyslexia, hereditary (Weinschenk, 1964, 1965), exogenous, and psychosocial factors (Biglmaier, 1960; Ingenkamp, 1967; R. G. E. Muller, 1965, 1967; Schenk-Danzinger, 1968) are suggested. A final concept related to mental retardation and reading/writing disability is the notion of a partial computing disability (partielle Rechenschwache; Weinschenk, 1967). Apparently, however, the base rate of this phenomenon is rather low, and its existence is not generally accepted. For further issues of terminology the reader is referred to a handbook on special education edited by Heese and Wegener ( 1965- 1969).

354 B.

Lothar R . Schmidt and Paul B. Baltes Theory Construction and General Research Emphases

By and large, the mode of scientific approach to psychological theory and research in mental retardation has been dominated by the pragmatic orientation of educators and psychiatrists. As a consequence, the research is largely descriptive, outcome-oriented, and less experimental. Thus, the inclusion of adequate control groups (MA, IQ CA) into the research designs (cf. Ellis, 1963) is only a recent feature of German research in mental retardation. Moreover, attempts to develop a systematic explication of the construct mental retardation within a psychological framework are rare. Only recently have an increasing number of psychologists turned their attention to this endeavor with the apparent realization that research on mental retardation may have theoretical significance for psychological theorizing in general. T h e most idiosyncratic and characteristic feature of German research in mental retardation is the strong impact that gestalt psychologists Lewin, Sander, Goldstein, Conrad, Gottschaldt, etc. -have had in this and related areas. Accordingly, German theory construction is largely descriptive, holistic, and configurational in nature. Gestalt laws, perceptual processes, and such concepts as priipanz, figure-ground, differentiation, and integration are of prime significance. Furthermore, it is typically argued that any behavioral abnormality has to be seen within the general framework of personality and should not be viewed as a separate phenomenon or process. Moreover, in the discussion of abnormal behavior, qualitative (structural) rather than quantitative differences between normal and abnormal behavior are emphasized. As a consequence, in contrast to American efforts, the bulk of German research is correlational in nature, focusing on the outcome rather than the process, thus underplaying the role of learning and other developmental processes in mental retardation. On the other hand, at least on a theoretical level, personality variables are seen as being of crucial importance, since their study necessarily contributes to a holistic conceptualization of mentally retarded behavior. In the context of general psychopathology, this gestalt approach has been extensively utilized by Conrad (1947, 1952). Subsequently, Wewetzer (1959), for example, has shown how gestalt psychological principles can be applied to theorizing and diagnosis in the psychological investigation of brain injury. Finally, regarding mental retardation research, the thinking of such people as Bleidick (1959, 1963), Duhm (1 968a, 1969b) Rosler (1955), and Wunderlich (1963), to name a few, is clearly dominated by the gestalt tradition. This remarkable historical influence of gestalt psychology extends to

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the most recent research emphases in mental retardation. Thus, it may be argued that the increasing utilization of factor analytic research methodology in the study of the retardate is also to a great extent related to the gestalt tradition. Apparently, factor analysis represents a more sophisticated research tool for a comprehensive and holistic description of the ability and personality domain. Moreover, it renders itself to the analysis of mental retardation in terms of gestalt-oriented criteria and in terms of qualitative differences. For example, such concepts as differentiation and structural change have been operationalized using factor analytic research methodology (Lienert, 1961: Keinert, Baltes, 8c Schmidt, 1965; Werner, 1948; Wewetzer, 1959). Whereas this development has a long Anglo-American history (e.g, Burt, 1919; Garrett, 1946) in the area of normal cognitive development, the use of comparative factor analysis in the study of retarded behavior appears to be a particular feature of current German research. Accordingly, the following review shall attempt to give that line of research preferential attention. It is hoped that this emphasis reflects the state of scientific activities in an unbiased manner. 111. SPECIFIC RESEARCH EMPHASES A.

Basic Processes

In this section, research on basic psychological processes will be reviewed. As has been indicated above, this research is largely oriented toward pragmatic purposes, such as its application for diagnostic purposes. Pure “basic research” is rare (see Kluge, 1969). In addition, contrary to the American tradition, extremely little research concerning learning processes involving retardates can be found in the German literat ure. Accordingly, it appears most appropriate to discuss whatever learning research is available in conjunction with other content-oriented sections. 1. MOTOR BEHAVIOR

It has been reported rather regularly that mental retardates are also retarded with respect to their motor development when compared with the general population (Bondy, Cohen, Eggert, & Luer, 1967; Goertz, 1964; Kurzreiter, 1967; Liier, 1967; Scholz-Ehrsam, 1967a; Seebandt, 1964; Wegener, 1960, 1963a). It has been shown, moreover, that-especially when considering profile relationships in such subpopulations as defined by age, MA, etc. -information about motor performance is of significant value (Geisler & Forster, 1960). Thus, a number of

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studies have been conducted which, using motor behavior assessment techniques, were rather successful in differentiating between types of mental retardation. Parnitzke and Regel (1965), for example, succeeded in differentiating brain-injured children and controls using a battery of what consisted largely of motor tests; it is noteworthy that this differentiation held u p for all levels of IQ, Furthermore, Hunnekens, Kiphard, and Kesselmann (1967) presented data indicating a remarkable degree of concurrent validity using the springboard (trampoline) as diagnostic vehicle. These authors were able to identify 62% of the brain-injured children by their abnormal springboard behavior, while only 5% were classified as showing normal motor behavior on the springboard. On the other hand, only 11 % of the first control group (consisting of hospitalized children) and 7.5%of normal, not-hospitalized control Ss revealed abnormal motor behavior. Recently, Wunnerlich ( 1969) reexamining the validity of the springboard as a diagnostic vehicle, has generally supported its use as a first screening device. In this context, it might be noted that in the Hunnekens et al. study, the magnitude of concurrent validity of the springboard task was clearly superior to that obtained when applying Oseretzky's Motor Test which represents a standard instrument in the diagnosis of brain-injury in children (Geisler 8c Forster, 1960; Gollnitz, 1954). Using the latter instrument, 25% of the brain-injured children were classified as showing normal motor behavior in Hunnekens et al.'s study. Further evidence for the usefulness of motor behavior assessment for diagnostic purposes has been presented by Bondy et al. ( I 967). As part of a larger test battery, the Lincoln Oseretzky Test (for review, see Reinert, 1964) was a powerful discriminator between exogenous and endogenous imbecility. Similarly, in a discriminant function-analytic study designed to separate endogenous from exogenous imbeciles, the Lincoln Oseretzky Test and a long-jump test obtained the highest weights (Luer, 1967). All these data suggest that a systematic study of motor behavior, and its incorporation into test batteries, promises to significantly increase the validity of retardation assessment. 2. VISUAL PERCEPTION A N D VISUAL-MOTOR COORDINATION In the area of mental retardation, research on perceptual processes appears to be restricted to visual perception. It is in agreement with classical European theories of cognitive functioning (Koehler, Piaget, Wertheimer, etc.) that motor, perceptual, and cognitive processes show strong interrelationships which are of special relevance for develop-

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mental considerations. Accordingly, numerous attempts have been made to utilize the assessment of perceptual and visual-motor behavior for the diagnosis of the retarded. Thus, Bleidick (1959) maintains that a deficiency in analyzing gestalten ((;estn.ltglied~rungssc~iwuectie~ associated with a tendency for a diffuse-holistic perception is typical for the mental retardate. T h e significance of the ability to analyze and differentiate, however, is controversial. Kern (1954), for example, conceives of it as being the main indicator for school readiness and largely dependent upon maturational processes. Kemmler and Heckhausen ( 1 962) and Polzin ( 1 968), on the other hand, have presented data indicating that deficiencies in gestalt-analytic ability can be remedied rather rapidly by appropriate training strategies. Moreover, visual and visual-motor performances are regularly used in the diagnosis of brain-injury. Thus, most of the test batteries comprise subtests designed for assessing visual and visual-motor performance (Parnitzke & Regel, 1965; Regel, Parnitzke, & Fischel, 1965; Wewetzer, 1959). Similarly, the Rorschach has been validated for the evaluation of brain-injury (Wunderlich, 1963), and modified and validated recently by Bottenberg (1967, 1968). By and large, explanatory hypotheses for the subnormal performances of brain-injured children in such perceptual tasks are based on gestalt principles. Wewetzer ( 1 959), for example, argues that brain-injured children are less able to produce and memorize strong gestalten, and can be characterized as exhibiting a high degree of prugiunz lability. 3. LANGUAGE

Again, the type of research is clearly descriptive and outcome-oriented. Not one study dealing with acquisition of verbal behavior or with process-oriented aspects (e.g., verbal learning) could be located. Research on language appears to divide itself into two categories. A first category subsumes those studies that investigate the relationships between speech disorders and mental retardation; the second category includes that research which attempts to quantify language performance. T h e latter approach is closely interwoven with studies on intelligence, since intelligence tests typically include subtests which assess particular language performances. As a matter of fact, when intelligence tests are used to diagnose mental retardation, subnormal performance in language behavior is, of course, a defining criterion measure. A number of studies have investigated the incidence of speech disorders in the retardate. Kasielke (1967a), for example, has found that

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63% of mildly retarded children (CA: 7) exhibit multiple stammering. This finding was corroborated by Scholz-Ehrsam (1967a), who has observed the language behavior of special school pupils. It might be noted further, that boys typically show language disorders more frequently than girls. Bohme (1966) has investigated speech disorders in a sizeable group of brain-injured Ss (CA: 3-63) from all IQlevels. About 90% of the Ss revealed speech disorders: stammering was found in 30%, agrammatism in 27%, and stuttering in 19%. In addition, there was a positive correlation between IQ and incidence of stuttering, as well as a negative correlation between IQ and frequency of stammering. Finally, Atzesberger (1962, 1967) emphasizes the high frequency of disorders in retardates regarding dynamics, melody, rhythm, and the tempo of speech behavior. In this context, a proposal by Leischner (1967), who developed a classificatory system of speech disorders which is of particular relevance to the study of exogenous retardation, is also of interest. As would be expected from the high satiation of intelligence tests with verbal material, it is consistently found that retardates show a lower level of language ability. The language of special class pupils, for example, is characterized as being concrete, and the vocabulary as being limited and narrow (Hildebrand, 1956; Neuhaus, 1962; Rebmann, 1957, 1959; Pohl, 1958). In addition, Pohl (1967) reported a number of significant differences with respect to content, sentence construction, and word usage, when contrasting picture stories produced by retardates and controls, A rather comprehensive attempt to investigate language behavior in normal and retarded children has been made by Kasielke (1967a, 1967b). Taking into consideration three aspects of language (phonemic, grammatic-syntactic, semantic), and four levels of analysis (phoneme, word, sentence, story), Kasielke developed a battery of tests which she applied to normal, institutionalized and mildly retarded Ss of 5-7 years of age. A factor analysis of the normal sample resulted in six factors: (1) a tempo factor; (2)a semantic factor; (3) a phonetic factor (articulation); (4) a morphological factor (word formation); (5) a syntactic factor (thinking); and (6) a fluency factor (Eloquenz). The reported intercorrelation matrix of the subtests suggests that the factor loading pattern of the retardates might be structurally different from that of the normal controls. Quantitative comparisons revealed that in all subtests the mean performance of retarded Ss was significantly lower than that of the normal controls; retarded Ss were also inferior to the institutionalized children in most subtests. Moreover, Kasielke

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attempted to extrapolate the relative impact of age, intelligence, and environment on language behavior. She suggests that environmental variation appears to be of special importance with respect to the phoneme- and word-level of analysis. On the other hand, IQ, showed strongest association with syntactic and morphological characteristics of language behavior, whereas age differences were most distinct concerning the story-level of analysis.

B.

Structure and Development of Intelligence

In line with the gestalt tradition, research on intellectual functioning focuses on qualitative differences between normals and retardates. In addition, again in agreement with the gestalt orientation, emphasis is placed on analyzing the totality of intellectual behavior in terms of its structural and organizational aspects. As is true, however, for many gestalt concepts and principles, the experimental translation of these qualitative and holistic notions, for a long time, has been seriously hampered by inappropriate research methodology. Thus, Busemann’s (1 959a) attempt to systematize intelligence defects (Znlefligmutclj;kte) attracted considerable interest with educators, but remained largely a theoretical model with scarce experimental support. Busemann utilized a hierarchical layer model (Schichtmodell) for conceptualizing a theory of intelligence and its relationship to abnormal intellectual functioning. In short, he assumes four layers of intelligence: ( I ) a fundamental layer (energy, activity, tension, etc.); (2) a layer of sensual and perceptual contents (emotions, images, etc.): (3) a layer of objects (language, signs, persons, etc.): and (4) a layer of education (Bildung). Intellectual behavior, in the classical sense, refers primarily to the third layer, and it is in this layer where Busemann ( 1 959a, 1959b) locates the defects of retarded Ss. Another gestalt-oriented approach to the description of cognitive functioning centers on process aspects of intellectual behavior. Gottschaldt ( 1 Y54), fi)r example, used the term “primitive action” (,twirnitizw Gesclielien) in describing retardates. Primitive action, which according to Gottschaldt is typical for retardates, lacks long-range goal orientation, and can be further characterized as being uncoordinated and unintegrated over time and space. Rosler ( 1 955), investigating memory in children, supports this viewpoint and reports that behavior of retarded children lacks integration and hierarchical order. Moreover, studying adult S s , Bschor (1960) maintains that the responses of retardates are more specific and embedded in a subjective, dynamic field. In the last decade, it has become recognized that factor analysis may

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be a powerful tool for operationalizing some of the concepts advocated by gestalt theory in the description of retarded behavior, such as structure and differentiation. T h e term “structure,” for example, usually implies an enduring system o r organization of responses. Accordingly, it has been argued that factor loading patterns can be used as indicators for such structures. Moreover, the concept of differentiation implies a process of structural change toward greater complexity, which in turn should be reflected in particular changes of factor loading pattern characteristics. The degree of differentiation of a structure then would seem to be dependent, for example, on the number of factors that are necessary to describe the interrelationships among measurement variables, and the average size of the communalities associated with any particular measurement variable. Consequently, using comparative factor analysis, it is possible to compare the behavioral structures of criterion groups (age, sex, level of IQ, etc.) in terms of their factor loading patterns. T h e strategy of comparative factor analysis was, of course, first used in the study of intellectual developments in normal Ss by Burt (1919) and Garrett (1946). As a result, the age-dzfferentiation hypothesis (for review, see Reinert et al., 1965) was formulated, which postulated that with increasing age, the structure of intelligence (indicated by factor loading patterns) becomes more differentiated (more factors, lower communalities, etc.). This factor analytic approach to the study of intellectual development attracted considerable attention in the German literature, with regard to both normal and retarded behavior. Interestingly enough, the first application of this research approach in Germany was made in the area of mental retardation. Wewetzer (1958, 1959) reported that the factor structure of endogenous retarded children is less differentiated than that of CA-matched normal children. This finding led Wewetzer to formulate an ability-divergence hypothesis which postulates that the degree of factor differentiation correlates positively with the level of ability in terms of IQ. Subsequently, Lienert ( 1960, 196 1) argued that both the level of age and ability may be important for the degree of differentiation. Accordingly, he combined both hypotheses and proposed a so-called genetic divergence hypothesis. Finally, Reinert et al. (1965) reasoned that an increase in absolute performance (in terms of MA level or raw scores) is associated with both increasing CA and IQ. Consequently, they proposed a perfomunce-dzferentaution hypothesis, which assumes that the degree of differentiation is dependent upon the level of intellectual performance as measured, for example, by a MA-type index. This latter hypothesis was

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expected to be of a more general nature than any of the differentiation hypotheses stated previously. A number of studies have been conducted in the last several years to test these various hypotheses about the degree of invariance of the factor structure of intelligence. Some of them are particularly relevant for the study of mental retardation. Wewetzer’s (1 958, 1959) original comparison of normals with exogenous and endogenous retardates was based on Lewin’s assumption that retardates can be characterized as being rigid and less differentiated. T h e finding of a less differentiated factor structure in endogenous retardates substantiated Lewin’s theorizing. This result led Wewetzer to infer that endogenous retardates are not a bad copy of the normal child, but that the retardate is different because his behavior structure shows less complexity. The measurement variables included in Wewetzer’s study, however, appear to be highly saturated with visual-motor tasks. Consequently, it would seem doubtful that his results can be generalized to the total domain of intelligence. A number of studies have been conducted to obtain further evidence on Wewetzer’s ability-divergence hypothesis. Lienert ( 1961), contrasting 10- 1 2-year-old normal and superior children, found more differentiated factor structures for the superior group. Further support for the ability-divergence hypothesis was reported by Lienert and Faber (1963) who, comparing below-average I Q 90) with aboveaverage children IQ 110) of two age levels (CA: 9 vs. 12), obtained greater differentiation for the high IQgroups. It has to be noted, however, that both of these studies stayed well within the normal range of the IQ-distribution. There are also three negative studies in the literature. First, Amelang and Zimmermann (1968) have concluded that the factor structure of retarded children of mean age 9:7 is similar, from a differentiation point of view, to that published of normal children. This result was supported by Amelang and Langer (1968) who compared the factor structure of intelligence in two groups of children (mean age: 10:6) which differed in mean IQby 12-13 IQpoints. Again, no evidence for Wewetzer’s ability-divergence hypothesis was found. Furthermore, Eyferth ( 1963) contrasted adult-retarded (endogenous) Ss with normal adults of the same age and with performance-matched children. In contrast to Wewetzer’s ability-divergence hypothesis, Eyferth’s data even indicated that the factor structure of retarded adults is more differentiated than those of the comparison groups. Comparative factor analysis has also been used in the study of exogenous retardates. Wewetzer ( 1 959) interpreted his data as suggesting

(x

(x

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that exogenous retardates show more differentiated factor structure than both normal and endogenous retarded Ss. This conclusion was corroborated in a study by Liier (1967). He compared the factor structure of exogenous and endogenous (IQ-matched) imbecile retardates and obtained greater differentiation for the exogenous sample. Wewetzer suggests that brain-injured children may not follow a continuous age-developmental trend toward greater factor differentiation. The differences in factor loading patterns found with this subpopulation might correspond rather to a basic structural transformation (Strukturwandel). However, further studies using a longitudinal approach and contrasting particular subsamples of exogenous retardates will be necessary before it is possible to evaluate the degree of invariance of the structure of intelligence in exogenous retardates. Thus far, neither of the various differentiation hypotheses of intelligence appears to be consistently supported by the empirical findings. Basically, this is not surprising in view of the limitations of the employed research methodology. The samples and the applied measurement instruments used in the different studies are far from being sufficiently comparable. Above all, it must be argued that in most cases the strategy of comparative factor analysis has employed inadequate rotational techniques in evaluating the degree of similarity and/or differentiation. By and large, the reported studies (as is true for the bulk of American factor-analytic research) factor the comparison groups separately, and do not use any of the recently proposed methods of direct factor matching (Eyferth & Sixtl, 1965; G. H. Fischer & Roppert, 1964; Kristof, 1964, 1967; Meredith, 1964; Sixtl, 1964; Taylor, 1967). Thus, one has to agree with Sixtl and Fittkau’s (1969) argument “that in all cases where the technique of similarity rotation had not been used, one cannot exclude the possibility that the differences are only of a peripheral nature and could be eliminated by similarity rotation.” In other words, any definite decision, whether two or more factor structures are invariant or not, requires the application of direct methods of factor matching which, in the case of similarity rotation, dictate that one objectively rotate the comparison structures toward maximum configurational similarity in terms of proportional factor loadings. Subsequent to similarity rotation, it is then possible to evaluate the degree of achieved invariance by computing a similarity coefficient which has a range from .OO-1.00. This index can be calculated for the total factor structure, for single factors, as well as for single variables. An additional complication, regarding the interpretation of the degree of factor differentiation, arises from the possibility of a “simulta-

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neous transposition” effect as discussed by Merz and Kalveram ( 1 965). Simultaneous transposition may be, for example, a function of a differential age-correlation (within comparison samples), which in turn is statistically reflected in more or less differentiated factor loading patterns. In this context, it may also be of value to briefly mention some other recent German work which deals with problems of invariance and other theoretical implications associated with the application of the factor analytic model (G. H. Fischer, 1967a, 1967b; Orlik, 1967; Sixtl, 1967a, 1967b; Vukovich, 1967). Despite the conflicting evidence, it might be feasible to explicate more concretely some of the implications associated with a lack of invariance of factor loading patterns when comparing, for example, endogenous with exogenous retardates and retardates with normals. If invariance is absent, one must question whether or not it is justifiable to use the same set of concepts and measurement instruments in assessing differences between normal and retarded Ss. In other words, lack of invariance will suggest that the differences between the subpopulations under consideration are of a qualitative (structural) rather than a quantitative nature, and that conventional measurement instruments would show differential convergent and discriminant validity, both on the level of observables and on the level of inferred constructs (Baltes & Nesselroade, 1970). Consequently, from a measurement point of view, the conventional strategy of quantitatively (differences in level) comparing retardates and normals would not seem warranted, since the comparison samples are qualitatively (structurally) different. Therefore, the question of invariance of factor structures appears to be of highest theoretical significance and deserves further attention. Apart from the utilization of similarity rotation, it will be necessary to more carefully select the comparison samples on the basis of both descriptive and etiological characteristics. In addition, it seems desirable to include both the ability and personality domain in order to more comprehensively map the construct of mental retardation. Moreover, it appears fruitful to disentangle age, IQ and MA relationships by SYStematic variation rather than controlled matching. Reinert’s (197 I ) study on the invariance of the factor structure of intelligence as a function of age, 19, and M A appears to approximate such a design, even though it is not specifically planned to incorporate the retarded population. Finally, some studies on the age-development of intelligence ought to be mentioned. Besides some studies reporting a rather stable I Q in mental retardates (Busemann, 1959a; Wittemann, 1965), a number of

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recent investigations have compared the age-developmental curves of normals and retardates. With the exception of Wenke and Miil1e.r (1966), the results suggest that the developmental rate of normals and retardates is comparable, save for differences in level. Thus, Duhm ( 1968b) presented data indicating that in a longitudinal study imbecile children exhibited an age progression in the Draw-a-Man-Test which parallels that of normal children, although their average performance was lower. Similar parallel age curves have been found by Klauer (1964a) observing special school children with the Progressive Matrices, and by Bondy et al. (1967) when contrasting the age development of mildly retarded and imbecile children. Furthermore, Schmidt (1969) compared normal and special school children in a testing the limits situation using certain subtests of the HAWIK(W1SC) as dependent variables. In analogy to a learning experiment, Schmidt repeatedly presented these subtests varying intertrial intervals ( 1 hour vs. 3 days) and reinforcement conditions. In agreement with the above mentioned findings, the normals and retardates showed comparable learning rates. In this context, it should be recognized that the quantitative comparison of age curves basically rests on the assumption that the measurement instruments show comparable construct validity in retardates and normals and in different levels of retardation and age, respectively. As has been argued above, however, such an assumption may not be a reasonable one. It is incompatible, for example, with the various differentiation hypotheses of intelligence which postulate structural differences in intelligence between subpopulations as defined by age, I Q and MA. The validity of such comparisons, then, is questionable until factor invariance has been shown to be existing across the comparison samples. In addition, it should be noted that any agedevelopmental study which is based on a cross-sectional approach confounds age and generational change (Baltes, 1968; Baltes & Nesselroade, 1970; Schaie, 1965). As a matter of fact, the magnitude of generation differences may be rather sizeable in light of the continuously improving educational system. It may be of interest to disentangle age from generational change in retardates in future studies by means of the recently proposed cross-sectional and/or longitudinal sequences. C.

Personality Functioning a n d Structure

On the whole; the area of personality has received proportionally strong attention in German literature as compared to the American literature, although the evidence is not overwhelming A lack of developmental personality theories and corresponding measurement instru-

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ments might be a primary reason for this situation. Moreover, cognitive criteria have for a long time dominated the definition of retardation, as is implicit in the compound term “mental retardation.” Thus, the available data appear to be more of a suggestive than a definitive nature. In line with the gestalt tradition, it is generally maintained that ability and personality variables ought to be considered simultaneously in the study of the retardate. Of particular theoretical interest appear to be questions about the developmental timing of the deficiencies regarding ability and personality characteristics. Which deficiencies are developmentally earlier, and what is the nature of the interactions between both domains? T h e systematic analysis of such interrelationships, as interesting as they are on a theoretical level would, however, require the investigation of much more carefully selected subpopulations and the use of a longitudinal methodology. 1. ACHIEVEMENT MOTIVATION

Gottschaldt (1954) describes a study in which the task consisted of building a high tower with blocks. According to Cottschaldt, retarded children do not experience either success or failure in this situation, and he argues that in retardates substitutive actions might lead to full satisfaction. However, he notes that his task might have been too difficult for retardates and that the results, therefore, should not be overgeneralized. An interesting study on achievement motivation in moderately retarded (imbecile) children was conducted by Heckhausen and Wasna (1965; also see Wasna, 1965). They contrasted imbecile children with MA-matched normal children, since they assume that achievement-oriented behavior is primarily dependent upon the recognition of a standard of evaluation. The task consisted of having each child compete with the experimenter in building a tower (see Fig. I). In addition, the experimenter systematically manipulated success or failure. Contrary to Cottschaldt’s results, imbecile children exhibited achievement-oriented behavior which was comparable to that shown by normal MA-matched children (Heckhausen & Roelofsen, 1962). T h e lowest MA, when achievement-oriented behavior was clearly observed, was 3.6. With increasing MA, conflicts related to achievement-oriented behavior were associated with higher levels of awareness; in addition, the evaluation of the competition situation became more realistic. T h e nature of this developmental change in achievement-oriented behavior appeared to be the same for normal and imbecile children. On the other hand, imbecile children showed less persistence in competing than MAmatched normal children.

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FIG. 1 . Differential reaction of retarded children to success or failure in a towerbuilding task. (a) and (c) show reaction to success condition (MA 3:3, CA 8:2; and MA 3:1, CA 1O:O. respectively), and (b) and (d) reaction to failure condition (MA 4:3, CA 8:2; and MA 4:6, CA 11 :2, respectively). Photographs are taken from Heckhausen and Wasna (1965) with the permission of the publisher.

An experiment by Rosler (1955) demonstrated that it is necessary to consider the interaction between achievement motivation and types of action. Studying the retention of completed vs. incompleted tasks, he distinguished two types of actions: (a) end actions in which the goal was predefined, and (b) series actions where the goal was largely unspecified. Retarded and normal children responded differently to both types

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of actions. Whereas retardates showed less achievement motivation with respect to end actions, and remembered more completed tasks than the normal children, the reverse was true for the series actions. Matthaei (1965) also used tasks of the series-action type and administered simple arithmetic and copying problems to special school children. Matthaei found that within the retarded population, the more intelligent children obtained higher scores, which may be taken as somewhat contradicting Rasler’s ( 1955) findings. This outcome led Matthaei to infer that even more intelligent special class children have already experienced so many failures that simple series-action tasks might result in experience of success. Duker (1968) showed that achievement motivation is also dependent on other situative contingencies. Thus, special school children performed much better under imposed tempo than under self-chosen tempo conditions. This effect was shown to subsequently generalize to performance under open time conditions. BEHAVIOR AND SOCIAL ADJUSTMENT 2. SOCIAL

On a theoretical level, it has been emphasized quite often that the social behavior of retardates is severely disturbed. Thus, Busemann ( 1 959a) focuses on ego weakness, a retarded differentiation between the ego and the environment, as the primary source for the social deficiencies of retardates. Similarly, Specht ( 1968) argues for the presence of a deficiency in basic socialization, and Lempp (1964a) for a disturbance in social distance behavior, in case of brain-injured retardates. The value of such propositions, however, appears to be seriously curtailed by the meagerness of empirical substantiation. A number of studies have employed various versions of Doll’s Vineland Social Maturity Scale. Several versions of this scale have been developed in Germany, and mental retardates examined with these variations show consistently subnormal performance when compared with normal Ss (Bondy et al., 1967; Eggert 8c Betche, 1969, Iiier, Cohen, & Nauck, 1966; Specht, 1963). In addition, Specht (1963) has presented data indicating a curvilinear relationship between I Q and S Q in retardates. Thus, mildly retarded Ss (in terms of IQ) showed frequently smaller SQs, whereas severely retarded Ss generally obtained a SQwhich was higher than their I Q Josef (1966) investigated the behavior of special school children with respect to their rules of game behavior according to Piaget. Only a few retarded children responded according to the highest level; i.e., showed an autonomous and democratic attitude regarding rules of

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game. Whereas normals of CA 10 already performed on this level, most of the special school children did not reach this level by CA 15, at which time they still exhibited some kind of atypical, transitional behavior. The ability to produce or perceive social rankings, however, seems to be present in mental retardates. Thus, Josef (1 966) reported a relationship between group popularity and mastering of rules of game. Furthermore, E p p l e ( 1 962) showed that special school children of age 9:6 (no younger children were observed) were able to give rank orders. T h e latter were primarily defined in terms of outward appearance, social class (Milieu), and school performance. On the basis of stability and quality criteria, Lapple suggests that the retardation in social experiencing of special class children of this age seems to amount to a period of about 2 years, when compared with normals. Wegener ( 1963a, 1963b, 1963c) emphasizes the general difficulty of retardates to adequately survey personal relationships and to adjust to changing role situations. Thus, Berg (1963, 1964) found a particularly strong mother attachment in retarded children which was associated with a restricted experience and life space. This limited life-space was shown to extend also to situations of leisure and vacationing behavior (Gehrecke, 1966; Kaufmann, 1965). An interesting study was conducted by Rick (1961). She compared the social positions of learning disabled children both during the time when they were attending a regular elementary school and after they were transferred to a special school. With few exceptions, the social positions became more positive. Apparently, the impact of weak school performance and outward appearance played a much less significant role in the special school situation. On the other hand, characteristics related to behavior disorders gained more significance. Another promising approach to analyzing social behavior in retardates consists in investigating social perception in terms of both autoand heterostereotypes. In a study by Kaufmann (1968), only 27% of special school children expressed a positive attitude toward their own school. Furthermore, von Bracken (1 967) contrasted auto- and heterostereotypes of special school and normal children. He found that the autostereotype of special school children already revealed a number of negative characteristics. On the other hand, the heterostereotype given by retardates with respect to normal children is remarkably positive. In addition, the projected heterostereotype of the special school children (as they believe others perceive them) turned out to be consistently negative; the degree of negativity, however, was even higher in the heterostereotype of special school children as expressed by normal chil-

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dren. In this context, a study by Krebs (1965) is also relevant. He found that the general knowledge about mentally retarded children and the interest in their fate is rather weak. This finding is corroborated by Lempp (1964a), Duhm (1 967b), and Andriessens (1968), who point out that inadequate attitudes of the immediate social environment of retarded children appear to contribute to their social maladjustment. Furthermore, an age by social adjustment interaction is often reported. Wegener (1963b), for example, presents data indicating that, if appropriate environmental conditions exist, the average retardate shows fairly good adjustment beginning with the third decade of his life span. That mildly retarded adult Ss succeed in adjusting is further substantiated by a number of studies dealing with either job performance or delinquency. With regard to job performance, it seems to be a common problem that retardates have trouble selecting an adequate position (Jorswieck & Sasse, 1966), and difficulties during the initial period of job employment. However, when an appropriate placement is obtained and initial difficulties are overcome, the job performance of mildly retarded adult Ss is quite satisfactory (Heydrich, 1963; Klauer, 1963; Naumann, 1963; Schade, 1963a. 1963b; Seifart, 1959; von Laak, 1963; Wegener, 1963a, 1963b). The correlation between intelligence and job performance (within the retarded population) is moderately positive. Hampel and Ewert (1 96 1) present data showing a hyperbolic relationship between intelligence and job performance. Thus, an I Q below 57 appeared to preclude working, under normal conditions. In this context, it should be noted, however, that the definition of jobadequate behavior is largely a function of cultural standards, and it might vary considerably between cultural entities. On the other hand, a number of studies demonstrate a relationship between intelligence and incidence of criminal offenses (Baltes, Wender, & Steigerwald, 1968; Gramm, 1963; Heydrich, 1963; Klauer, 1963; Seifart, 1959). However, as Klauer (1963) and Wegener (1963a) have emphasized, the validity of the interpretation of such findings may be jeopardized by various methodological shortcomings, such as the higher incidence of intelligent criminals not being apprehended. 3.

PERSONALITY STRUCTURE

As has been mentioned earlier, research aimed at a comprehensive analysis of the personality structure of retardates is scarce, even though this would seem to be in line with the holistic and configurational view of the Gestalt tradition. T h e scarcity of such research concerns especially the endogenous retardate, whereas more research has been con-

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ducted to investigate the personality structure of brain-injured Ss who, however, are not necessarily mentally retarded. It does not appear feasible to describe in great detail the personality characteristics that are typically associated with brain-injured Ss. Usually, the personality disorders are maintained to center around such concepts as the organic psychosyndrome and/or axes syndrome; and such features as reduced, increased, or uncontrolled drive levels (Bosch, 1954; Lempp, 1964a; Specht, 1968; Wewetzer, 1959) are emphasized. Further characterization concerns, for example, aspects of control of stimulation (Lempp, 1964a; Wewetzer, 1959), and aspects of attention and persistence behavior (Gllnitz, 1954; Grossmann & Schmitz, 1966; Specht, 1968; Wewetzer, 1959). There are indications of a higher incidence of psychopathology in the retarded and the brain-injured population (Brengelmann, 1967; Klauer, 1963; Lempp, 1964a, 1964b; Roeder, 1960; Weinschenk, 1957). Lempp ( 1964a, 1964b) has investigated the relationship between brain injury and neurotic behavior and has reported significant relationships which he interprets as suggesting the existence of a strong constitutional determinant for neurotic behavior. Strunk and Faust (1 968), however, raise doubts with respect to the latter interpretation and point to a number of methodological shortcomings. Concerning emotional disturbance, data are presented (Achilles, 1964; Pohl & Hanssen, 1968; Reinartz, 1959) suggesting that retardates seem to deviate from the general population of children with respect to anxiety and aggression. Brengelmann ( 1967) investigated the personality structure of adult, institutionalized retarded Ss of a mean CA of 39, ranging in I Q from 15-77. He concludes that “motivation” (defined as a measure related to rigidity and security feeling) appears to be the critical personality variable. He showed that his index of motivation correlated negatively with intelligence and a number of learning and performance scores. Finally, some typological approaches aimed at the description of personality structure of retardates remain to be briefly mentioned. The classical distinction in erethistic and torpid retardates is still often retained, even though sound substantiation is lacking. Berg (1963, 1964) used behavior ratings to categorize special school children into three typological classes, and then attempted to cross validate his classification using alternative assessment techniques. While the data look promising, the methodology clearly needs further refinement in terms of demonstrating convergent and discriminant validity. Undoubtedly, much more research is needed to throw some light on the personality structure of the retarded population. As was argued when reviewing

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studies on intelligence, comparative factor analysis (especially on the basis of Q correlations) would seem to be a highly powerful tool for describing qualitative (structural) and quantitative differences in personality between normal and retarded Ss. D.

Diagnostic Process and Construction of Assessment Instruments

Any advancement in the diagnostic assessment of mental retardation requires a close interaction between basic research of the construct itself and the construction of measurement instruments. Thus, an increasing convergence between a set of concepts characterizing the construct, and a corresponding set of assessment instruments having convergent and discriminant validity, is the basis for more powerful diagnostic strategies. Before describing the measurement instruments that are commonly used in the diagnosis of mental retardation, it appears appropriate to briefly sketch some recent developments related to the diagnostic process in general. As seems to be the case in the United States, there is wide variation with regard to the strategy of diagnosis of German clinicians. In practice, an intuitive-clinical approach still dominates, whereas the theoretical literature exhibits a strong trend toward greater clinical sophistication. Examples of this development are the publications by Boesch (1964), Brengelmann (1963), Cohen (1965), Duhm (1967a, 1969a), Fahrenberg (1968), Heiss ( 1 964), Hormann ( 1964a), Michel and Iseler (1968), Schmidt (1970), and Wewetzer (1966). I n addition, one might mention another interesting development concerning the general theory of test construction. G. H. Fischer (1968) and Sixtl (1968), for example, point to a number of inadequacies inherent in classical test theory and attempt to advance a novel type of test theory as proposed by the Danish statistician Rasch (1960). I t can be expected that this line of research will have considerable impact on test construction over the next few years. In this context, only the assessment instruments with a broad range of applicability will be discussed. Most of the instruments designed for the evaluation of specific functions have been mentioned in conjunction with research on the corresponding behavior categories. A variety of battery-type instruments is available for the assessment of mental retardation. Most such instruments are of non-German origin and have been adapted for the German language area. As is true for the United States, intelligence tests in Germany still play the most prominent role, at least in everyday practice, although their application is typically supplemented by additional instruments covering the per-

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ceptual and motor domains. Groffmann (1964), Priester (1 964), and Wewetzer ( 1964) examine the common tests of intelligence and their German adaptation. Both the WAIS (HAWIE) and the WISC (HAWIK) have been adapted and standardized for the German area (Hardesty & Priester, 1956; Wechsler, 1956). A number of studies which are relevant for the assessment of mental retardation have appeared, elaborating on aspects of standardization, reliability, and validity of the Wechsler and Binet instruments (Hohn, 1962; Hofmann, 1959, 1961; von Kerekjarto & Schmidt, 1962; Priester, 1958, 1959; Priester 8c Kukulka, 1958; Priester & von Kerekjarto, 1960; Schmalohr, 1962).

Besides the Wechsler tests, two German versions of the Primary Mental Abilities are available (Horn, 1962; Kemmler 8c Langheinrich, 1967). In addition, the Begabungstestsystem (Horn, 1956; Josef, 1965) appears of particular importance for the diagnosis of mild retardation. Furthermore, the RAVEN Progressive Matrices Test is often used for assessment purposes, as are a number of German developmental tests (Entwichlungstests) which have been critically reviewed by Reinert ( 1964), and which find application primarily with preschool children. Engels (1966) and Wolff (1967), for example, have applied the Biihler-Hetzer Developmental Test, and Kassner ( 1964) and Wolff ( 1967) the Schenk-Danzinger Developmental Test to retarded populations. It might be noted that Wolff (1967), employing both tests, found only one common factor in retardates which suggests that both tests (which supplement each other regarding the age range) show comparable factorial validity. Recently, Wolff (1968) presented a short version of the Biihler-Hetzer and Schenk-Danzinger Developmental Tests for mental retardates. The most differentiated test battery for the assessment of mental retardation has been developed by Bondy and associates (Bondy, Cohen, Eggert, & Luer, 1969; Bondy, Cohen, Luer, & Schmidt, 1964; Eggert, 1969). The main aim of this battery is the evaluation of moderate-severe retardation, especially of imbecility, which can be assessed only insufficiently by existing instruments such as the Wechsler’s and the Binet’s. The first version of this battery included 51 tests covering the following behavioral domains: general intelligence, learning ability, perception, motor ability, language, independence, rigidity, and emotionality. It was shown, however, that a factor analysis of these 51 instruments resulted primarily in a strong g factor when applied to 7-12 year-old children of IQs below 70. One might argue, on the other hand, that this strong g factor may be a reflection of the heterogeneity in CA.

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Subsequently, this first battery was reduced to 11 variables: Colored Progressive Matrices, Columbia Mental Maturity Scale, Stickboard, Peabody Picture Vocabulary Test, Numerical Speed, Verbal Learning, Perceptual Speed, Adherence to Instructions, Punctuation of Circles, Standing Long Jump, and Lincoln-Oseretzky Test. Using these 11 instruments, Luer (1967) was rather successful in separating exogenous and endogenous imbeciles ( I Q 40-55) by means of a discriminant function (Fig. 2). In this analysis, the Long Jump, Lincoln-Oseretzky, Perceptual Speed, and the Peabody Picture Vocabulary Test obtained particularly strong beta weights. Moreover, the over-all performance was lower for exogenous than for endogenous retardates. Since this latter battery of 11 tests is rather time-consuming, a further reduction to the following six subtests was undertaken: (1) Columbia Mental Maturity Scale (after Burgemeister); (2) Colored Progressive Matrices (10 novel matrices and original Raven version); (3) Peabody Picture Vocabulary Test (after Dunn); (4) Punctuation of Circles (own version); ( 5 ) Adherence to Instructions (similar to Cattell's Culture Fair Intelligence Test); and (6) Lincoln-Oseretzky Motor Development Scale (after Sloan). Concurrent validity studies resulted in good separation of mildly and moderately retarded children. In addi-

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Composite scwe

FIG. 2. Distribution 0-f composite scores resulting from a discriminant analytic study separating exogenous (X CA = 11:O) and endogenous-familial (X CA = 11:O) retardates with comparable IQlevel (40-55). Adapted from Luer (1967) with the permission of the publisher.

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374

tion, it was possible to clearly discriminate between exogenous (‘jT I Q 60), endogenous IQ 61), and mongoloid children (X IQ 51). Endogenous retardates performed highest in all tasks, followed by the exogenous and mongoloid children in that order. Moreover, the profiles of the three groups appeared to be of additional value for diagnostic purposes. An additional battery for the diagnostic evaluation of normals, braininjured, and endogenous retardates has been constructed by Wewetzer ( 1959). This battery is currently undergoing revision and is primarily designed for the differential diagnosis of brain injury in children. The new version (yet unpublished) includes the following domains: motor behavior, visuo-motor functioning, short- and long-term memory, intelligence, and personality. A further battery for the assessment of brain injuries has been proposed by Parnitzke and Regel (1965). Finally, Brengelmann’s attempt ( 1967) to construct a test battery for the evaluation of personality structure in adult retardates is of interest, since this is one of the first attempts to comprehensively map the personality domain. Brengelmann utilizes both questionnaires (neuroticism, extraversion, motivation) and objective tests as observational media. A final version of this instrument is not yet available. Erke’s (1968) review of ongoing research projects in Germany, however, indicates that this battery is currently undergoing further refinements. Undoubtedly, its completion will represent a major step forward in the structured assessment of mental retardation.

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IV. EDUCATION A N D REHABILITATION

A.

Educational System

The administrative system of special education is not uniform for the Federal Republic of Germany as a whole, since the system is largely state controlled. Consequently, the educational arrangement varies from state to state as does the denotation of the various types of educational institutions. However, as a function of a permanent conference of the secretaries for culture and education from the different states, the gap between states is continuously diminishing. It is not necessary to give here a detailed report on the German educational system, especially since such an overview has been prepared in the English language by Schultze and Fuhr (1966). Historical aspects of the special education system are discussed more recently by Jussen (1967), Kanner (1964), Klink (1966), Lesemann (1966), and Schomburg (1963). Furthermore, a report by the UNESCO (1960) may be

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used as a first overview on statistical aspects related to the special school system in both the Federal Republic of Germany and the German Democratic Republic, even though the information is somewhat obsolete. I n most states, the German child has a minimum of nine years compulsory education (age: 6-15). This is also true for the mentally retarded. There are two types of special schools which are of particular significance for the mentally retarded population: (1) the special school for the slow learning child (Sonderschuie fur lernbehinderte Kinder, type L), and (2) the special school for the mentally deficient child (Sonderschule fur geistig behinderte Kinder, type G. T h e literal translation for both types of special schools (learning disabled child vs. mentally disabled child) might seem misleading, since the designation does not imply any particular specification of etiological factors. The distinction between both types of special schools, however, comes close to the classification of the retarded population into educable and trainable retardates. Accordingly, the special school for slow learners is geared towards the mildly retarded, and the special school for the mentally deficient towards the imbecile child. In addition, there are special schools for the blind and visually handicapped, special schools for the hard-of-hearing and deaf, special schools for the physically handicapped, special schools for speech defectives, and special schools or institutions for socially maladjusted children. Moreover, there are occasionally special schools and/or institutions geared towards the preschool population and towards adolescents in vocational training. It is difficult, however, to assess what proportion of mentally retarded children attend these additional types of special schools, and no further description will be given. Both the special school for slow leurning children, and the special school for mentally deficient children are an outgrowth of the earlier school for backward children (Hilfsschule), which had accommodated the majority of educable and trainable retarded children. T o date, type L is concerned with the mildly retarded with a lower IQlimit of about 60. For a detailed description of the organizational aspects, the interested reader is referred to publications by Bernart, Geist, and Speck (1967), Busemann (1959b), Ederer (1967), Klauer (1967), Schade (1962), and Stranz (1966). T h e teaching program of the special school type L is not too different from that of the regular primary school. By and large, the same subject matters are covered. Unfortunately, then, it appears that one is mostly using some kind of watered-down curriculum, similar to that in the regular grades, only presented at a much slower pace (some 2 years time-lag) with a greater number of repetitions.

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The referral to a special school is typically initiated by the teacher of the regular prizary school. In other words, the great majority of retarded children begin their education in the regular primary school system, even though attempts are under way to assess the predictive validity of preschool diagnosis (Josef, 1968a). In the typical case, then, poor classroom performance (twice repeating a grade) is the usual initial and/or final criterion for transferral. Sometimes, attempts are made to consult a school psychologist. However, school psychologists are rare, and if psychological testing is employed, this is usually done by a special school teacher rather than a trained psychologist. It is generally agreed that this selection procedure is far from optimal. It is argued, for example, that the symptomatology of school failure is diverse, and Bleidick (1964) and Stranz (1966) maintain that total failure is extremely rare. Failures in writing and reading are most common, and particular problems of evaluation relate to differences in teachers, school systems, and geographical areas with respect to the use of evaluative standards. Thus, the use of school failure as primary criterion for transferral to a special school clearly illustrates the fact that the definition of mental retardation is, to a great extent, dependent upon individual and social conditions rather than upon absolute criteria. Consequently, it is no wonder that the population of special school children (type L) is rather heterogeneous. The average proportion of mildly retarded children in special school type L is estimated at 60-70%. In addition, such subgroups as borderline intelligent, braininjured, reading or writing disabled, and socially maladjusted children (to name a few subgroups) are represented (cf. Bleidick, 1964; Busemann, 1959b, 1959c; Hege, 1968; Reinartz, 1959; Schade, 1962; Schmalohr, 1962; Scholz-Ehrsam, 1967a, 196713). This heterogeneity of the type L population is especially evident when the I Q i s considered. Thus, mean IQs of 70-80 with a standard deviation of about 10-15 are reported for special school (type L) children (Bleidick, 1964; Busemann, 1959b; Gaing, 1966; Hohn, 1959, 1962; Hofmann, 1959, 1961; Priester, 1959; Priester & von Kerekjarto, 1960; Schmalohr, 1962; Stranz, 1966). Accordingly, the overlap (in terms of 19) between special school and regular school children is considerable. Bleidick (1964) even argues that in many instances, this broad IQvariation results in performance-oriented teaching strategies which paradoxically may lead to a high incidence of failures in special schools. The second type of special school for the retarded population, the special school for mentally akjcient children, is conceptualized as including the moderately retarded (imbecile), trainable child. For a long time, the

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majority of these children either attended the type L special school, were institutionalized in public or private homes, or did not acquire any formal education at all. T h e foundation of a parental organization in 1958 (Lebenshilfe fur dm geistig behinderte Kind) significantly contributed to the recent advancements, and for some years now imbecile children have been subject to compulsory education. At least, if the IQdistribution is considered, the population attending the special school for mentally deficient children is quite homogeneous ( I Q 50-60), even though (primarily because of multiple deficiencies) the picture is different when etiological factors are considered. T h e school curriculum is rather different from that of the regular school systems and the special school type L. Much less emphasis is placed on such cultural skills as reading, writing, and computing. Various educational programs for the moderately retarded child have been proposed (cf., Bach, 1966, 1968; Dierlamm, 1967; Ederer, 1967; J. Fischer, 1967; Hoss, 1965; Josef, 1968b; Osmers, 1966; Ziebell, 1966) which focus primarily on basic socialization goals and the training of physical, perceptual, and cognitive functions which seem most relevant for societal adjustment. In addition, emphasis is placed on the teaching of job behavior characteristics, including basic skills, to increase the probability of the retarded developing into a productive and self-supporting adult. In general, it is intended to extend this training both to the preschool and postschool period. Thus far, however, this appears to be the exception rather than the rule. 6.

Developmental Education, Rehabilitation, and Therapy

A comprehensive review of work related to aspects of educational programs, rehabilitation, and therapy of the mentally retarded would seem to require a chapter of its own, even though the experimentally minded behavioral scientist might not be very satisfied with the type of research conducted. Specific suggestions regarding teaching strategies are regularly published in Zeitschrijl fur Heilpadugogik, the journal of the German organization of special schools. Additional journals, such as Actu Paedopsychiatrica, Der Schulpsychologe, Heilpudagogische Forschung, Lebenshilfe, Praxis der Kinderpsychdogie und Kinderpsychiatrie, and Schule und Psychodogie also regularly include material on developmental education of the mentally retarded. For example, Bach (1968), Duhm (1968b),J. Fischer (1967), Josef (l968b), and Neikes (1966) discuss general issues and strategies in rehabilitation of mentally retarded children; and Fahlisch (1967), Konig (1959), and Reichenbach (1961) report on training procedures for mongoloid children. Furthermore, extensive

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training programs for use in motor rehabilitation are given by Duhm (1968b), Gollnitz (1963), Goertz (1964), Hunnekens and Kiphard (1960, 1963), Kiphard and Huppertz (1968), Lindemann (1963), Michaelis, Nolte, and van ter Meulen (1968), and Weiss (1968). Here, however, only a few studies of theoretical interest will be described. With reference to Thurstone’s “Learning to Think Series” (1950), Baar (1958) has compiled training sheets for special education (Arbeitsbliitter fiir die Schulraye-Entzuicklungshalf) which are primarily designed for the preschool and early school periods. Klauer (1964b) used this program in training special school children ( I Q 59-89) over a period of 10 weeks. When compared with a control group, these children showed significant improvements (total 1% verbal 1% performance 19) in the HAWIK, the German version of the WISC. Baar’s program was also applied by Schuttler-Janikulla ( 1966) and Schuttler-Janikulla and Krohne ( 1 966) who trained kindergarten children E Q 90) who had not been admitted to the regular school program for being developmentally retarded. In this study, only a few subtests exhibited significant increases, while the average E Q raised about 10%. Recently, Klauer (1969) published an impressive series of studies aimed at examining transfer effects on measures of intelligence when using the Baar (1958) training programs with special school children. A number of significant transfer effects resulted, indicating both quantitative increments in performance and structural changes in intelligence patterns. In addition, the effects obtained were dependent upon the age levels considered. Only a few systematic attempts could be located in the literature which dealt with the teaching of writing and/or reading in special schools (Bartmann, 1967; Knappek, 1962). Some interesting work, however, has been done to utilize Piaget’s theory of cognitive development for teaching purposes. Thus, Aebli (1961, 1963) applied Piaget’s theory of intelligence in the formulation of general teaching strategies. Furthermore, Piaget’s theorizing has been used for the development of programs related to the teaching of the number concept and arithmetic in retarded and preschool children (Bleidick, 1966; Bottcher, 1966; Bogards, 1964; J. Fischer, 1968; Langenohl, 1966). Wegener (1964), Klauer (1964a), and Jantzen (1969), on the other hand, have discussed the application of programmed instruction in special school teaching and have proposed some modifications. Generally, however, programmed instruction does not yet play a prominent role in the German regular or special school system. Overall, it appears fair to state that the German system of special education is rather differentiated, and that a great number of educators and psychologists are engaged in discussing the merits and demerits of the various programs. Undoubtedly, however, much more

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emphasis ought to be placed on the use of experimental strategies to evaluate the effectiveness of existing programs and any innovations that are currently under consideration.

V. Comparative Evaluation

The amount of German research on mental retardation is impressive, although these authors feel that its scientific status still suffers from a lack of methodological sophistication when compared with German psychological research in general. Much of the research, as is true for the United States, is conducted with an immediate service role in mind. Accordingly, the bulk of German research is outcome oriented, and neglects a systematic strategy of construct explication. Moreover, the inclusion of appropriate control groups (MA, 19, CA, etc.) is only a recent phenomenon. Undoubtedly, however, an increasing number of basic research-oriented behavioral scientists is attracted by the phenomenon of mental retardation, and research is becoming more systematic and experimental. When German research is compared with the current American trend, a few characteristics are especially noteworthy. First, because of the strong impact of Gestalt psychology, German research highlights structural aspects and qualitative differences between the retarded and the normal population. Moreover, a holistic approach, incorporating the consideration of personality variables and focusing on the interrelationships among behavioral domains, is emphasized in structuring the behavior of mental retardates. In line with this emphasis, the utilization of comparative factor analysis is of particular significance and deserves attention in the international literature. In addition, it seems fair to conclude that German research on diagnostic assessment, based on a structured measurement approach, is advanced and comparable to the American counterpart. In this area, the interaction between basic research and the construction of assessment instruments is rather intensive and promising. Thus, an increasing convergence of a holistic, theoretical orientation, with an appropriate multivariate methodology, might most adequately feature current and future German research in mental retardation. On the other hand, there are a number of theoretical approaches to the study of mental retardation which have barely been touched in the German literature, but which play a prominent role in American research. The most drastic disparity concerns the neglect of process-oriented research and theorizing in Germany. In keeping with the emphasis on structural and static concepts, studies on learning phenomena or studies dealing with the testing of theoretical concep-

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tualizations stemming from learning or memory theory are more or less nonexistent. If process research is conducted, it is typically restricted to the investigation of motor and perceptual behavior. Another disparity of American and German research pertains to the weak consideration that is given to the experimental study of psychosocia1 determinants of mental retardation. Systematic research explicating psychosocial antecedents of mental retardation appears to be more a characteristic of the environmentally oriented American behaviorist, while the German accentuation appears to lie on the biological and organic determinants. It is an open question whether the increasing amount of attention that German behavioral scientists are paying to the study of mental retardation will significantly alter this picture. Research on the effectiveness of educational programs for the mentally retarded is scarce. This concerns the investigation of both the effects of rehabilitation efforts and the effects of the institutionalized system of special schools. Moreover, recent American developments relating operant conditioning techniques and/or general learning theory to rehabilitation and therapy are not yet sufficiently assimilated, although the utilization of programmed instruction techniques is increasing. On the other hand, it appears that the German administrative arrangement of special schools is differentiated and shows a positive attitude toward innovative endeavors. What is apparently needed, is both a closer interaction between educators and psychologists and more emphasis on training educational psychologists in experimental research methodology. German psychology, in the last years, has shown how rapidly it is able to assimilate, and contribute to, the international standards in various areas of psychology. It is the prediction of these authors that any future review of German research will reflect such an accelerated development in the area of mental retardation as well. ACKNOWLEDGMENTS We are grateful to Peter Becker for his excellent bibliographic work, to Margret M. Baltes, Eugene A. Quarrick, and Hilde Schmidt for their critical reading of the manuscript, and to John P. MacCallum for his valuable editorial assistance.

REFERENCES Achilles, M. Versuch einer statistischen Erfassung der Triebstruktur von Hilfsschiilern. Praxis der Kinderpsychologie und Kinderpsychiatrie, 1964, 13, 177-181. Aebli, H. G r u n d f o m des Lchrens. Stuttgart: Klett, 1961. Aebli, H. Psychologische Diduktik. Stuttgart: Klett, 1963.

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Author Index Numbers in italics refer to the pages on which the complete references are listed.

Bach, H., 377,381 Badham, J. N.,159,204,208 Baer, D. M., 117, 124, 132, 133, 140, 142,

Abbo, G . , 54,55,69,81 Abbott, P., 159, 204,208 Abdou, F. A., 159, 204,208 Abelson, R.,29.48.49, 55, 57,68, 75.78 Achilles, M., 370, 380 Adamson, W. C., 155, 160, 194, 202,208 Aebli, H., 378,380 Alexandris, A., 158, 163. 175, 176, 192,

143,311,319,327,343,345

Bagchi, B. K., 161,202,210 Bailey, J., 116,142 Bair, H. V., 156, 194,208 Baird, H. W., 158, 161, 162, 198,202,208 Baldwin, A. L., 313,342 Balla, D., 32 I, 327, ?42,348 Balow, B., 12,81 Baltes, P. B., 355, 360, 363, 364, 369.381,

204,208

Allee, R.,316,346 Allen, M., 159,204,208 Allen, P., 123,143 Alstrom, C., 15, 75 Amelang, M., 361. 381 Amnel, G., 162, 198,213 Anastasi, A., 305, 310, 31 1, 315, 316, 319,

389

Baltig, W. F., 230, 261,266 Bandura, A., 178,208 Bannes, M. L., 352,381 Bardach, J . L., 336,347 Bardon, L.M., 159,204,208 Barkauskas, A., 159,204,215 Barnes, K. R., 187,200,204,208,216 Barnett, C. D., 133, 135, 143, 166,200,

342

Anderson, E., 12.81 Anderson, V. E., 7, 2 1, 75,3 11,333, 342 Andriessens, P., 369,381 Anger, D., 137,142 Anton, A. H., 165, 192,208 Ansherry, M.. 28, 33,81 Arbitman, H. D., 154,208 Archer, E. J., 227,266 Arnold, E., 157, 196, 208 Arthur, B., 163, 165, 192, 194,218 Asch, S. E., 250,266 Asperger, H., 353,381 Astin, A. W., 154,208 Atchison, C. O., 314,342 Atkinson, B., 52, 60, 78 Atkinson, R. C., 259,266 Atzesberger, M.,358,381 Azrin, N. H., 131, 145

208,273,299,300,322,342

Baroff, G. S., 122, 123, 125, 126,145.314, 342

Barr, M., 28,29,81 Bartmann, T., 378, 381 Bauer, A. M., 161,204,213 Baumeister, A., 24, 54, 75,88.97,109, 222,225,226,233,239, 240,241,242, 243,245,246, 248, 252, 254, 256, 258, 262,266,268,319, 323,324,325,342, 343,345 Bayen, Mme., 35,36,40,41, 79 Beaudry, P., 160, 176,204,208 Beecher, H. K., 170,208 Beechley, R., 44,66, 77 Beedle, R.,324, 343 Bell, A., 164, 165, 176, 192, 196,208 Bell, W.A., 163, 165, 192, 194,219

Baar, E., 378,381 Babcock, S. D., 157,200,217 393

Author Index Bellak. L., 172,208 Belmont, E. H., 161,204,217 Belmont, J. M., 263,266,272,273,274, 286,297,299,300 Belmont, L., 17, 76 Benda, C., 5.9. 33, 34,36,37,40,47, 75 Benda, H., 158,202,208 Bender, L., 1 I , 75 Bensberg, G. J., 3 16.3 17.32 I , 322,343 Benton, A. L., 314,343 Berg, K.-H., 368,370,381 Berger, F. M., I5 I , 208 Berger, S., 20, 76 Bergin,]. T. F., 158,202,208 Bergin, M. M., 158, 202,208 Berkson, G., 21,60,64, 72, 75,80, 164, 176,184, 192,209,317,319,324,343 Berlyne, D. E., I 17. 142 Berman. H. H., 166,200,209 Bernart, E., 375,381 Berry, F. M., 227, 239, 240, 241, 242,243, 245,246,248,258,262,266 Berry, H., 30,81 Berry, M., 34,75 Berstein, B., 312, 330,343 Bessman, S., 18, 19, 75 Betche, D., 367,383 Bialer, I . , 164, 176, 192,214 Biglmaier, F., 353, 381 Bijou, S. W., 10, 1 I , 76, 115, 132, 133, 134, 135, 137, 140, 142,144,311, 327, 330, 339.343 Bilovski, D., 6, 52, 68, 76 Birch, H., 17, 18,52,68, 76 Birch, J., 5,81 Birnbrauer,J. S., 121, 123, 125, 127, 130, I3 I , 142,308, 332,336,343 Blacketer-Simmonds, D., 35,36,46, 58, 67, 70, 76 Blake, A.. 159,204,208 Blanchard, I., 19, 76 Blanchard, R. J., 230,266 Bleidick, U., 354, 357,376, 378,381 Blessing, K., 45, 67, 76 Blough, D. S., 132, 136, 139, 142 Blue, A. W., 159, 166,198,204,209 Blum, A., 27,61,63,72, 79 Blumberg, E., 158,200,209 Boersma, F. J., 257, 259,268 Boesch, E. E., 37 I , 381 Bogards, W., 378,381 Bohme, G., 358,381

Bonafede, V. I., 156, 194,209 Bondy, C., 355,356,364,367,372,382 Boren,J. J., 139,142 Boring, E. G.. 309,343 Borkowski, J. G . , 251,252,267 Bosch, G., 352,370,382 Bostock,J., 165, 196,209 Bottcher, H. F., 378,381 Bottenberg, E. H.,357.382 Bowling, E., 165, 192.211 Bowman, P. W., 158,200,209 Bradley, C., 163,209 Brady, J. P., 178,209 Brawler, E. R., 118,143 Breese, F. H., 313,342 Breitmeyer, J. M., 181, 198,204,209 Brengelmann, J. C., 370,371,374,382 Bricker, D., 132,142 Bricker, W. B., 132,142 Brison, D. W., 351,382 Brofenbrenner, U., 319.343 Brousseau, K., 34,36,37,38,40,43,59, 76 Broverman, D. M., 154,217 Brown, R.,58,59, 76 Brown, S.,45.67.81 Brown, S. C., 245,267 Brown, W., 119,145 Bschor, F., 359,382 Bucher, B., 122, l23,125,130,131.142 Buckley, P., 157, 163, 165, 194, 196,213 Buehler, R. E., 339,343 Bues, E., 352,387 Bufford, R. K., 174,209 Buoniconto, P., 157, 161,226 Burgemeister, B. B., 161, 166, 175,200, 204,219 Burk, H. W.,161,198,209 Burke, C. J., 155,213 Burness, F. R., 157, 196,209 Burt, C., 355, 360, 382 Busemann, A,, 353, 359, 363, 375,376. 382 Bush, S., 298,300 Butterfield, E. C., 235,236,258,262,263, 268,272,274,277,286,300,326,327. 343,348 Butterfield, W. H.. 308,336,347 Byck, M., 27,63, 72, 76 Caldwell, B. M.,313, 319,343,344 Caldwell, W. L., 160,215

395

AUTHOR INDEX

Callahan, R.J., 160, 161, 176,202,212, 216

Campbell, C., 256,266 Campbell, R.,37, 78 Cantor, G. N., 58,7 1, 76,305,3 17,3 19,

Crowley, H. T., 166, 176,200,213 Cruz, F., 157, 196,213 Culter, M., 164, 192,210 Cutler, R.,336, 347

32 1,343,344

Capes, L., 48,68, 79 Carney, R.,57, 70, 79 Carter, C., 28,29, 77 Carter, C. H., 156, 158, 161, 166, 167, 194, 198,200,202,209

Carver, M., 31, 76,77 Cassel, R. H., 320, 322, 344 Cattell, R. B., 84, 110 Cavers, D. F., 170,209 Centerwall, S., 17, 76 Centerwall, W., 17, 76 Chagnon, M., 54.69.81 Champney, H., 313,344 Charatan, F. B. E., 156, 194,209 Chassan, J. B., 169, 171, 172,208,209,217 Chung, C.-Y., 17,29,54, 55, 67,80 Clader, D., 12, 76 Clarinda, M., 158, 202,216 Clark, R. C., 139, 143 Clarke, A., 58, 59, 76 Clarke, A. M., 309,344 Clarke, A. D. B., 309,344 Clarke, C., 313,344 Clausen, J., 53,69, 76, 165, 176, 196,210, 314,344

Cleland, C., 155, 160, 194,202,208 Cohen. R.,355,356,364,367,372,382, 387

Cole, J. 0..150, 191,210 Conners, C. K., 150, 165, 175,210 Connor, F., 14, 45, 67, 76 Conrad, K., 354,382 Cook, H., 181,217 Copeland, R. A., 151,210 Cornwell, A., 17, 52, 68, 76 Corrigan, F., 20, 76 Cone, E., 133, 144 Costa, E., 160,206,212 Costello, J., 330,346 Cox, D. L., 257, 259,268 Craft, M., 151, 155, 157, 158, 162, 163, 176, 192, 198,202,210

Cromwell, R. L., 164, 176, 192,214,317, 344

Cronhach, L. J.. 84, 110 Crookshank, F., 13.33, 76

Danehower, H. S., 322,344 Darnell, A., 17.29, 54, 55, 67, 80 Darrow, C. W., 150,210 Davenport, R. K., 176, 184,209 Davies, T. S., 156, 167, 194, 200,210 Davis, D. R.,313,344 Davis, K. V., 151, 171, 176, 178, 180, 184, 200,204.21 0,216

Davis, W. L., 245,267 Deatrick, R. W., 161,216 DeBaca, P. C., 332,336,345 Decker, H., 44.67, 76 Denhoff, E., 156, 174, 194,210 Denny, R. M., 225,267 Devine, J . V., 332, 336,345 Dexter, L., 76 Dice, N., 161,202,210 Diedrich, W., 31, 76 Diensthier, R.,20, 76 Dierlamm, T., 377,382 Diesing, U., 353,382 Dietrich, H., 353, 382 Dingman, H., 45.67.81 Dinsmoor, J . A., 118,143 Dogan, K., 180,218 Domino, G., 46, 47,48,67, 68, 77 Donnell, G., 7, 77 Dorf, H. J., 196,213 Doris, J., 11, 13,80 Doty, D., 176,210 Douglas, V., 174, 176, 180,218 Down, J., 33, 36,37,38, 77 Doyle, L. T., 251, 252,267 Draguns, J. G., 154,217 Drake, M. E., 157, 180, 192,217 Drew, C. J., 251,268 Drew, L. R. H., 166,167,192,198,210 Droulord, K., 40,81 Duhm, E., 354, 364.369, 371, 377, 378, 382,383

Diiker, H., 367,382 Dunn, L. M., 330,344 Dunsdon, M., 28,29, 77 Durling, D., 156, 158, 194, 202,210,211 Earl, C., 42, 66, 77

396

Author Inah

Fischer, E., 161,202,211 Eastman, F. C., 227,267 Fischer, G.H.,362,363,371,377,378, Ebenholz, S. M.,250,266 383,384 Edelson, R. I., 179,210 Fish, B., 150,170,211 Ederer, K.A.,375,377,382 Fish, C.H.,165, 192,211 Efron, D. H.,150,151,210,217 Fisher, G.M.,314,344 Egeth, H.E., 93,I10 Fisher, G.W.,166,198,211 Eggert, D.,355,356,364,367,372,382, Fisher, L.,57,59,70,77 383 Fisher, S., 151, 174,211,215 Eisenberg, L.,33.63,77,148,150,175, Fishler, K.,7,77 210,211 Fixen, D.L., 115, 138,143 Eisenson, J., 34,75 Ekstrand, B. R.,230,231,232,250,259, Flamer, G. B.,227,267 Fleming, J. W.,165,196,211 267,269 Elert, R., 352,354,383 Foley, J. P.,Jr., 310,311,315,316,319, Ellis, A.,44,66,77 342 Ellis, N. R., 84,108, 109,110,133, 135, Forehand, R., 240,241,242,243,262,266 143,225,255,267, 272,273,274,275, Forster, C.,355,356,384 277,279,286,297,298,299,300,317,Fowler, G. W.,151,214 Freed, H.,151,211 322,342,344 Engels, H. J., 372,383 Freedman, A.,336,347 Freeman, R. D.,149, 150,151, 176,211 Engle, H.A., 163,196.211 Friedlander, B. Z.,116, 143 Engler, M.,33,34,36,37,39,40.77 Friedrich, D.,319,345 Entwisle, D.R.,227,267 Frye, R.,165,196,212 Erke, H.,374,383 Fuhr, C.,374,390 Esen, F. M., 156, 158, 194,202,210,211 Fuller, R.,18,19,77 Estes, W.K.,8Y, 11 0 Funk, F., 352,384 Evans, G.,33 1,344 Furniss, J. M., 339,343 Eveloff, H.H.,150.211 Eyferth, K.,361,362,383 Eyman, R.,45,67,81 Ewert, 0.M.,369,384 Galambos, M., 163,196,211 Gallagher, J. W.,228,267 Gardner, J. M., 115. 143 Faber, C., 361,387 Cardner, W.I., 122, 123,143,323,344 Fagan, J. F., 277,300 Garfield, S., 31, 77 Fahlisch, K.,377,383 Garrard, S. D.,6,11, 77,310,344 Fahrenberg, J., 371,383 Garrett, H.E.. 355,360,384 Faretra, G.,168,206,211 Garrison, M. Jr., 156, 161, 194,202,211 Faust, C.,352,383 Garrod, A.,27,35, 37, 77 Fedge, A.. 7, 13,79 Gates, J. J., 115, 138,143 Fehr, F., 179,200,211 Gehrecke, S., 368,384 Ferster, C. B.,131, 143,328,336,344 Geisler, E., 355, 356,384 Fiedler, E., 352,381 Geist, W.,375,381 Fields, E. M., 165,196,211 Gerjouy, H.,228,267 Gerjouy, I. R.,228,258,267 Findley, J. D.,332,344 Fine, R. H.,160,206,211 Gerritsen, T.,310,347 Gibbs, E.. 56,70,77 Fineman, M., 165, 176,196,210 Gibbs, F., 56,70,77 Finley, S.,29,54,77 Gibson, D.,7,21,28,29,55.56.69,70,77, Finley, W.,29,54,77 80,160,176,204,208 Fisch, R., 12,81 Gilbert,F., 118,119,137,138,143,144 Fischel, W., 357,388

397

AUTHOR INDEX

Giles. D. K.,308,336,340,347 Gillie, A. K., 157, 198,211 Ginzberg, E., 309,344 Girardeau, F. L.,8,58,7 1, 76,77. 1 15, 334, 132,133, 140,144,237,267,327,

345,347 Gladwin, T., 305, 308,310,315,346 Glick, B. S., 172,212 Glidden, L.,89,I I0 Goertz, G., 355,384 Goff, G.. 326.348 Giiing, F., 376,384 Goldberg, I., 14,45,67,76 Goldberg, J. B.,196,213 Goldiamond, I.. 332,346 Goldschmid, M.,46.47,67,77 Goldstein, H., 54,77 Gijllnitz, G., 356,370,378.384 Gollub, L. R., 133,143 Gomulicki, B. R., 27 1,298,300 Gonzales, R., 167,200,216 Gordon, A., 59,60.71,78,298,300 Gordon, D.,252,254,266 Goshen, C.E.,313,345 Gottesman, 1.1.. 31 1.3 15,333,345 Gottschaldt, K.,359,364,384 Cotway, M.A.. 25 1,268 Could, L.,320,348 Goulet, L.R.,225,230,251,267 Gozun, C.,168.206.21I Graham, B. D., 157, 160,161, 176.202,

212,216 Graliker, B.,7, 77 Gramm, L.,369,384 Grant, Q.R.,151,212 Graubard, S. R., 170,212 Gray, S. W.,308,331,338,339,345 Green, C.,326,345 Greene, F. M.,332,345 Greenwold, W.E.,189,200,217 Greer, M.,165,192,208 Greiner, T.,170,212 Grice, G. R., 88,110,171,212 Grigg, A., 5 I , 68,80 Groffmann, K.J., 372,384 Grossmann, G., 351,370,384,389 Grossman, H. A., 151,212 Guidicelli, G., 1 1,20,78 Giinther, W., 352,384 Guzman, A., 180,218 Hall, R. V., 308,336,340,347

Hallenbeck, P., 14,78 Halpin, V. G., 6,78.319,345 Hamilton, J ., 123,124,128,130. I3 1, 133,

143 Hampel, B., 369,384 Hampson, J., 13,78 Hanford, P. V., 119,145 Hanssen, E.,370,388 Hardesty, F. P., 372,384 Hargis, C. H., 157,192,202,214 Harkins.]., 11, 15.81 Harley, W.F.,Jr., 261,267 Harris, F. R., 118,143,319,345 Harrison. G., 172,200,216 Hart, B. M.,118,143 Hartlage, L.C.,170,176,212 Hawke, W.,11, 15, 78 Hawkins, W.F., 319,324,325,342,343,

345 Haywood, H. C., 315,345 Headricks, M. W.,8, 80,133, 140,143 Heaton-Ward, W.A., 162,167,176,198,

200,212 Heber, R. F., 3,6,27,78,304,345,351,

384 Heckhausen, H., 357,365,384,386 Heese, G., 353,384 Hege, A,, 376,384 Heider, J., 313,319,344 Hein, H.,7, 13,79 Heiss, R.,371,385 Henry, C.E., 165,176,196,210 Herberg, E.,44,67,76 Hermelin, B.,59,60,65,72,78,80 Herold, L.M.,156,194,208 Hess, R. D..312,317,318,319.336,345 Heydrich, U.,369,385 Hildebrand, W.,358,385 Hill, A., 19,78 Himwich, H. E.,151, 157,158, 160, 161,

162,192,196,198,202,204,206,212, 216 Hinsie, L.. 37,78 Hirsch, W.,56,70,77 Hively, W.,332,345 Hodgden, L.,326,348 Hofmann, K.H., 376,385 Hohn, E., 372,376,385 Holden, E. A., 275,276,278,280,282, 284,285,286,287,288,289,290,291, 292,293,294,295,296,300,301 Holden, R. H., 156,174. 194,210

398 Holland, J. C., 332,345 Holland, J. M., 325,345 Hollis,J. H., 139, 140, 143, 156, 194,212 Holloway, S. M., 139, 144 Holtzman, W. H., 169,212 Hom, G. L., 115,140,144,228,269 Homme, L. E., 332,336,345 Honig, W. K., 132, 143 Horan, E. M., 228,267 Horenstein, S., 156, 161, 194, 202,212 Hormann, H., 371,385 Hormuth, R., 13,78 Horn. W.,372,385 Horowitz, L. M.,230,267 Hoss, H.. 377,385 House, B. J., 84,87,89,91, 102,110,111, 171,212,239,270 Houston, J. P., 242,267 Hoy, E., 180,218 Hsia, D., 7, 78 Huddleston, W., 165, 196,212 Huffmann, G., 352,385 Hiinnekens, H., 356,378,385 Hunt, B., 6, 78,305,315,326,329,346 ‘Hunt,J. McV., 305,315,329,346 Hunter, H., 155,160, 176,194,206,212 Hunter, J. J., 88,110 Huntley, R.,28,29, 77 Huppertz, H., 378,386 Hiiter, K. A., 352,383 Hyman. J., 6.52,60,69,71,78

Ilem, P. G., 156, 158, 168, 194,202. 206, 212 Illingworth, R. S.,315,346 Ingenkamp, K., 353,383 Iseler, A., 371,388 Ison, M. G., 156, 194,212

Jacobs, J. A., 165, 196,212 Jancar. J. A., 162,167, 176,198,212 Jantzen. W.,378.385 Jaquith, W.L., 157,200,212 Jenkins, J. J., 227,228,246,267,269 Jensen, A. R., 224,258,267,268 Jensen, E. S., 161, 202,213 Jervis, G., 2, 78 Jeune, H., 11,20,78 Johnson, R.,29,48,49, 55,57,68, 78

Author Index Johnston, A. H.,156,161,194,204.213 Jones, B. E., 166, 176,200,213 Jones, D., 151,213 Jones, H., 189, 200,217 Jones, H. E., 305, 323,346 Jones, R. W., 323, 346 Joppich, G., 352,385 Jorswieck, E., 369,385 Josef, K., 367,368, 372,377,385,386 Josephs, M. C., 160,215 Joubert, E., 248,266 Jung, J., 230,262,268 Jussen, H., 372,386

Kalhorn, J., 313,342 Kalveram, K. T.. 363,387 Kamii, C. K., 308,347 Kanner, L., 35, 37, 39, 40, 46, 78, 374,386 Kaplan, B., 313,319,344 Kaplan, M., 46,47,67, 77 Kaplitz, S. E., 156, 157, 196,200,213,216 Karlin, I., 11, 78 Kasielke, E., 357,358,386 Kassner. R.,353, 372,386 Kaufman, M. E., 320,346 Kaufmann, I., 368,386 Kausler, D. H., 251,268 Keele, D. K., 157, 198,217 Keely, S. M., 181,213 Kellas. G., 97,109,233,235,236,252, 254,258,262,266,268,324,342 Keller, F. S., 306,327,346 Keller, S., 3 12,346 Kelly, S., 17,29,54,55,67,80 Kemmler, L., 357, 372,386 Kennedy, W. A., 178,213 Keppel, G.,230,260,268,269 Kern, A., 357,386 Kernohan,G. A,, 157, 158, 176, 196,202, 218 Kerr, N.,117,144 Ketty, S. S., 170,213 Kety, S., 3, 78 Kibler, G., 290,301 Kidder, J. D., 308,332,336,343 Killian, E., 155, 160, 194,202,208 Kiloh, L. G., 166, 198,211 Kinder, M. I., 118, 119,144 Kiphard, E. J., 356,378,385,386 Kirchhoff, H., 352,386

399

AUTHOR INDEX Kirk, D. L., 161, 204,213 Kirk, S. A., 85, 110 Kirman, B. H., 168, 192,213 Kivalo, E., 162, 198,213 Klatskin, E. H., 312,346 Klauer, K. J., 364,369, 370,375,378, 386 Klaus, R. A,, 308,345 Klink. J . G., 374,386 Kluge, K. J., 355.386 Knappek, R.. 378,386 Knief, L. M., 315,346 Knights, R.,6,52,60,69,71, 78 Koch, R.,7, 77 Koenigsknecht, R.,325,343 Kohler, C., 11,20, 78 Kohn, M. L., 312,346 Konig, K., 377,386 Kouw, W. A., 298,301 Kratter, F., 30, 78 Kraubig, H., 352.386 Krebs, H., 369,387 Kreger, K. C., 159, 161, 198,204,217 Kristof, W., 362,387 Krohne, H., 378,390 Kugel, R.,7, 13, 17, 79 Kugelmass, I. N., 151,213 Kukulka, R.,376, 388 Kurland, A. A,, 196,213 Kurzreiter, J., 355,387

Labrune, B., 7,35, 79 Lampert, R., 166,200,208 Langenohl, H., 378,387 Langer. I., 361,381 Langheinrich, D., 372,386 Lanning, M., 157, 161, 196,204,217 Lapple, F. T., 368,387 Lasagna, L., 149, 169,213 Laties, V. G., 139, 143 Launay, C., 35,36,40,41, 79 Laux, W., 352,387 LaVeck, G. D., 157, 163, 165, 194, 196, 213 Lawlis, M. G . A., 160,206,213 Lawrence, D. H., 332,346 Lawrence, E. S., 322,347 Lazar, M.,166, 200, 209 Leger, Y 159, 204,213 Leischner, A., 352,358,387 Leitenberg, H., 122, 143 Lejeune, J., 22, 28, 79

.,

Lempp, R., 367,369,370,387 Lenz, W., 7, 17, 79 Lesemann, G., 374,387 Leuba, C., 116, 143 LeVann. L. J., 159, 160, 162, 198,204, 206,213 Levin, H.,312, 336,347 Levine, J., 150,210,320, 348 Levy, J. M., 166, 176,200,213 Lewis, D., 155,213 Lewis, 0 . 3 12,346 Lezdins, V., 157, 161, 196,204, 217 Lienert, G . A., 355, 360,361,387 Lindemann, K., 352,378,387 Lindholm, O., 168,206,214 Lindquist. E. F., 168, 171,214 Lindsley, 0. R.,333, 346 Lipman, R. S., 148, 149, 151, 155, 170, 172, 174, 176,214,215,225,268 Lippman, L. G.. 133, 143 Lipsitt, I.. 1 17, 143 Little, J. W., 164, 192,210 Lobb, H., 163, 177, 192,214 Locke, B.J., 136, 143 Logan, D. R.,251,268 Long, E. R., 132,144 Lourie, R.S., 151,214 Louttit, R.T., 175, 214 luvaas, 0. I., 118, 119, 120, 121, 123, 125, 126,128,130,131,142,144 Lowery, V. E., 157, 196,217 Lowther, G. H., 160, 206,214 Lubman, C., 43,66,79 Lucas, A. R., 151,214 Liickert, H., 353,387 Luckey, R. E., 124, 127,144 Liiders, W., 353, 356, 387 Liier, G., 355, 356, 364, 367, 372, 373, 382,387 Lundell, F. W., 158, 163, 175, 176, 192, 204,208 Lutz, J., 353, 387 Lyle,J., 7, 17, 41, 44, 56.67, 70, 79 Lytton, G. J., 159, 166, 198,204,209

Maccaby, E. E., 312, 336,347 MacColl, K.,156, 194,214 MacGillivray. R. C.. 164, 168, 174, 177, 192,214,215 MacKay, D. N., 157, 158, 176, 196,202, 218

400 MacKay, P., 8.80 Maginn, D. W., 157,196,208 Maley, M. C., 166, 200,209 Mallet, R., 7, 35, 41, 67, 79 Mandell, A. J ., 170, 214 Margolis, R. A., 172,212 Margolius, G., 239,270 Martin, C. H., 156, 161, 194, 204,213 Martin, C. J., 238,257, 259,268 Martin, E., 230,234, 249,268,269 Martin,J., 174,218 Martin, W., 27, 61, 63, 72, 7Y Mathews, C., 6, 79 Mathieson, C. M., 164, 168, 174, 177, 192, 214,215 Matin, L., 290,301 Matthaei, F. K., 367,387 Mautner, H., 151, 156, 168, 194, 198,210, 214 McCandless, B. R., 305, 309, 3 15,346 McCarry, F., 157, 192,202,214 McCarthy, J. J., 85, 110, 116, 143 McCarthy, K., 89, I I0 McConnell, O., 8, 79 McConnell, T. R., 164, 176, 192,214 McCord, H.,44,66,79 McGrath, R. W., 25 1,252,267 McKenzie, M. E., 176,202,214 McLain, R. E., 228,268 McReynolds, L., 330,346 Melton, A. W., 90, I 1 0 Menolasino, F., 14, 15, 16, 19, 28, 29,42, 66, 79,81, 161, 175, 198,209,218 Menzer-Benaron, D., 13,80 Meredith, W., 362,387 Meyer, M. E., 133,143, 150,214 Meyerson, L., 116, 117, 142,144 Men, F., 363,387 Michael, J. L., 117, 144 Michaelis, R., 378,388 Michaux, M. H., 196,213 Michel, J., 57, 70, 79 Michel, L., 371,388 Miller, J. G., 150, 217 Miller, M. B., 314,346 Miller, 0. W., 159, 166, 198,204, 209 Millichap,J. G., 151,214 Millward, R. B., 132, 142 Minde, K., 151, 176, 180,218 Ming, C., 157, 161, 196,204,217 Mitchell, A. C., 157, 192, 202,214 Molitch, M., 164, 192,214

Author Index Money, J., 13, 78,79 Montessori, M., 308, 346 Moore, B., 48,68, 79 Moore, J. W., 156, 194,214 Moore, R., 332,346 Mordock, J. B., 225,268 Morris, J. P., 115, 137, 144 Morris, J. V., 164, 168, 174, 177, 192,214, 215 Morris, T., 13, 80 kloskowitz, H., 164, 192,215 Miiller. D., 352,388 Miiller, R., 353,388 Miiller, R. G. E., 353,388 Miiller, U., 364,391 Murphy, M., 43.66, 79 Murray, F., 166, 198,211 Musgrave, R. S., 165, 196,212 Musick, J. K., 124, 127, 144 Nagler, B., 13,80 Nail, H. R., 157, 200,213 Nakamura, H., 52,69,80 Nash, H., 170,215 Nauck, W., 367,387 Naumann, E., 369,388 Neikes, J.-L., 377,388 Neisser, R., 86, 110 Nellis, B. P.,155, 160, 194, 202,208 Nelson, D. L., 230,268 Nesselroade, J. R., 363, 364,381 Neuhaus, W., 358,388 Neville, J., 42,66,80 Nickerson, R. S., 102,110 Noble, C. E., 227, 240,268 Noce, R. H., 161,204,215 Noe, O., 166,200,209 Nolte, R., 378,388 Norman, D. A., 262,268 OConnor, N., 59,60,71, 78,80 Ogdon, D. P., 316,346 Ogonik, J., 161, 204, 217 Orlando, R., 132, 133, 135, 137, 140, 142, 144,165,196,211 Orlik, P., 363,388 Osmers, G., 377,388 Osterheld, R. G . , 156, 158, 168, 194,202, 206,212 Otis, M., 227,268 Overton, D. A., 177,215

AUTHOR INDEX

Paine, R., 7.80 Paivios, A., 261,268 Pakszys, A. M., 167, 200,215 Palermo, D. S., 227, 228,251, 254,268 Palk, B. E., 317,344 Pallister, P. D., 161, 215 Park, L. C., 174,215 Parnitzke, K. H., 356, 357, 374,388 Pasamanick, B., 310,346 Patterson, F., 93, 110 Patterson, G. R., 339,343 Patterson, R. M.. 326,346 Pauling, L., 150,204,215 Payne, D., 48, 75 Pearce, D., 290,301 Penrose, L.,7, 17,28,29,35,37,39,40,80 Perloff, B.,125, 144 Perrot, M. C., 331,336,344 Peterson, W. M., 320,346 Petre, R. D., 330,346 Pfistner, H. J., 353,388 Pilkington, T. L., 158, 163, 166, 194, 196, 198,202,215 Pohl, R., 358,370,388 Polani, P., 7,28,80 Polzin, G., 357,388 Poser, C., 3 1, 76 Postman, L., 232,246,247,269 Pototzky, C., 51, 68,80 Potts, W., 34, 36, 37,81 Powers, C., 157, 192,202,214 Pozsonyi,J., 7, 21.28, 29, 55, 56, 59,70, 77,80 Pregelj, S., 159, 204,215 Prehm, H. J.. 225,226,228,251,268,269 Priester, H. J., 372,376,384,388 Pryer, M.W., 133, 135, 143,273,299,300, 322,342 Prysiazniuck, A., 27,63,72,80

Quay, H. C., 187,218 Quaytman, W.. 51,80

Rabinowitz, F. J., 246,269 Radin, N. L., 308,347 Rapaport, W., 161,204,215 Rasch, G., 37 1,388 Rebmann, W., 358,388

40 1 Reeves, P. O., 159,204,208 Regel, H., 357,388 Rehwald, E.. 352,389 Reichenbach, P., 377,389 Reinartz, A., 370, 376, 389 Reinert, G., 355, 356, 360,363, 372, 389 Reisman, L., 17, 29, 54, 55, 67, 80 Reitan, R., 6, 79 Reque, D., 17, 79 Rettig, J. H., 156, 160, 194, 206,215 Reynolds, M. D., 139,143 Reynolds, N.J., 118.143 Richmond, J. B.,6, 11, 77,310, 319,344 Rick, G., 368,389 Rickels, K., 174,215 Rickert, E. J., 332,336.345 Rinaldi, F., 157, 158, 161, 162, 192, 196, 198,202,204,206,216 Risley, T. R., 122, 123, 124, 125, 127, 130, 131.144 Ritchie, E., 245,267 Robb, H. P., 156, 158, 196,202,215 Robinson, H. B., 35 1, 389 Robinson, N. M., 351,389 Roeder, E., 370,389 Roelofsen, 1.. 365,384 Rohwer, W. D., 258,268 Rollin, H., 27,28,42,46,57,66,70,80 Rosanoff, A. J . , 227,267 Rose, D., 159, 204,208 Rose, J. D., 323,343 Rosecrans, C., 29,49,54,69, 77,80 Rosenblum, S., 157, 160, 176, 179, 202, 204,212,215,216 Rosler, H.-D., 354, 359,366,367,389 Ross, 8. M., 108, 110 Ross, L., 8, 80 Ross, R. T., 156, 158, 161, 174, 176, 196, 204.21 7 Ross, S., 149, 154,208,216 Roswell-Harris, D. A., 176, 202,214 Rothchild, G. H., 150, 165,210 Rowley. J. D., 156, 196,216 Rubenstein, B. D., 118, 119, 144 Rubin, H. K., 156, 158, 161, 174, 176, 196, 204.21 7 Rudy, L.H., 157, 158, 161, 162, 192, 196, 198,202,204,206,212,216 Rue, R., 336,347 Runge, G., 155, 160, 194,202,208 Runquist, W. N.,229,264,269 Russell, R. W.,174, 179,216

402 Sabbath, J., 13,80 Sahhar, F. H., 40,81, 158,202,217 Saltz, E., 239, 243,269 Sarason, S. B.. 1 I , 33,80, 305, 308, 309, 315,346 Sasse, O., 369,385 Schade, W.,369,375,376,389 Schaefer, H. H., 123,144 Schaeffer, B., 118, 119, 120, 121, 125, 126, 130,144 Scheerenberger, R. C., 304,347 Scheffelin, M., 27,61,71,80 Scheid, W., 352,389 Schenk-Danzinger, L., 353,389 Schiller, H., 157, 161, 166, 168, 194, 200, 204,206,209,216 Schickedanz, D. I., 180,200,204,216 Schmalor, E., 376,389 Schmidt, G . I . , 372,382 Schmidt, L. R., 355, 360, 364, 370, 371, 389 Schmitz, W., 351,370,384,389 Schoenfeld, W.N.,306,327,346 Scholz-Ehrsam, E., 353, 355, 358, 376,389 Schomburg, E., 374.389 Schreier, K., 352,389 Schulman, J. L., 158,202,216 Schulte, F.J., 352,385 Schulue, W.,374,390 Schulz, R. W., 227, 229,230,231,234, 236,269 Schuster, C. R., 151,217 Schiittler-Janikulla, K., 378,390 Schwartz, M.L., 156, 196,216 Scott, K. G., 85, 89,90, 93, 110,111, 164, 180, 187, 192,216,217,272,301 Scott, M. S., 89, I10,272,301 Sears, R. R., 312,336,347 Seebandt, G., 355,390 Segal, E. F., 139, 144 Segal, L. J., 162, 174, 198,216 Segall,J., 157, 200,217 Seifart, O., 369,390 Selinger, S., 115,143 Sergovich, F., 28,29,81 Shackleton, M., 165, 196,209 Shaffer, J., 7,80 Shannon, G., 159,204,208 Shapiro, M. B., 169,216 Share, J., 6,52,68, 76 Sharpe, D.S., 160,206,216

Author Index Sharpe, L., 175,210 Sheppard, W.C., 117,144 Sherlock, E., 36,37,38,40,80 Shiffrin, R. M., 259,266 Shimmel, G., 20,80,81 Shipe, D., 17,29,54,55,67,80 Shipman, V. C., 312,317,318,319,336, 345 Shotwell, A. M., 322,347 Shuman,J., 18, 19, 77 Shuttleworth, G., 34,36.37,80.81 Sidman, M.,116,144,332,347 Siegel, F., 12, 24, 54, 75,81 Siegel, G., 1 I , 15.81 Siegel, P. S., 116, 144 Siegel, S., 155,216 Silverstein, A. B., 14,46,67,81,228,269 Simmons,J. Q., 118, 119, 120, 121, 123, 125, 126, 128, 130, 144 Simundson, E., 157, 196,213 Sixtl, F., 362, 363, 371, 383,390 Skeels, H. M., 308,347 Skinner, B. F., 135,144,306,327,328, 336,344,347 Sloan, W., 316,317, 322,343,344 Sloop, E. W., 178,213 Smith, A., 172, 200,216 Smith, B. S., 157,200,213 Smith, E. H., 167,216 Smith, G . , 17,35,39,8U Smith, J. O., 330,344 Smith, T. E., 323, 324,343 Soforenko, A. Z., 116,143 Soltan, H., 28,29,81 Son,C. D., 164, 176, 192,214 Specht, F., 367, 370,390 375,381 Speck, 0.. Sperling, E., 352,390 Sperling, G., 109, I10 Spitz, H. H., 258,267, 298, 299,301 Spooner, C. E., 170,214 Spradlin, J. E., 115, 132, 133, 140,144, 327,334,345,347 Sprague, R. L., 149, 151, 164, 171, 176, 178, 180, 181, 184, 187, 189, 192, 200, 204,210,211,216,217,218 Sprogis, G. R., 157, 161, 196. 200, 204, 217 Staats, A. W., 308, 336,347 Stacey, C. L., 319,344 Staiger, R. C., 165, 196,212

403

AUTHOR INDEX

Standahl, J., 123,124, 128, 130, 131,143 Stattelman, A., 181,217 Stearns. P. E., 40.80, 158, 202.21 7 Steigerwald, F., 369,381 Steinhorst, R., 332.336.345 Steinman, W. M., 118,145 Stephens, B. A., 123,143 Stephenson, C. M., 155, 160, 176, 194, 206,212 Sterling, H. M., 162, 198,217 Stern, E., 353.390 Sternberg, S., 86.90,91, 94.96, 108, 109, 110, 111,187,217 Stevens, G . , 5,81 Stevenson, H., 326,348 Stoddard, L. T., 116, 144,332,347 Stranz, C., 375,376,390 Strauss, A. A,, 164, 192,210 Strayer, D.W., 136,143 Strazzulla, M., 11, 43, 78,81 Stritch, T., 165, 196,212 Strok, E., 20, 76 Stroud, J. B.. 315,346 Sturges, T. P., 115, 142 Stutte, H., 352,353,390 Sullivan,J. P., 164, 192,214 Sulzbacher, S. I., 330,346 Sundland, D. M., 239,269 Sutherland, B., 30.81 Svenson, S.E., 169,217 Sykes. D., 176, 180.218

Tang, F., 54, 69,81 Tansley, A. E., 162, 174, 198,216 Tapp, J. T., 315,345 Taque. C. E., 332.343 Tarjan, G., 45,67, 81, 157, 196,217 Tate, B. G., 122, 123, 125, 126, 145 Taylor, M. R., 157, 200,213 Taylor, P. A., 362,390 Terrace, H.S., 332,347 Thompson, T., 15 I , 217 Thulin, H., 48,68, 79 Thurstone, T. G., 378,390 Timberlake, W. H., 161,204,217 Tizard, J., 18.76 Toppe, L. K., 180,216 Touchette, P. E., 332,347 Traganza, E., 172,200,216 Tredgold, A., 34,36,37,38,81

Trembath, J., 7, 13, 79 Tucker, C., 29,54, 77 Tucker, I. F., 230,269 Tulving, E., 262, 269 Turner, R. K., 177, 178,217,218

Ucer, E., 157, 159, 161, 196, 198,204,217 Uhlenhuth, E. H., 174,215 Uhr, L., 150,217 Ulrich, R. E., 131,145 Underwood, B. J., 90,111,223,227,229. 230,231,234,236,260,264,269 Updegraff, R.,308,347 Urbano, R. C., 85, 89, 90, 110. 111 Urquhart, D., 324,343 Usdin, E., 151,217

van ter Meulen, G., 378,388 Vasconcellos.J., 160,206,217 Venables, P., 65, 72, 78 Vincze, L., 159,204,208 Vogel, W., 154,217 von Bracken, H., 368,390 von Kerekjarto, M., 372,376,388,391 von Laak, D., 369,391 Vukovich, A., 363,391

Wachs, T. D., 330,347 Waggoner, R. H., 161,202,210 Wagner, I., 353,391 Waisman, H. A., 310,347 Waites, L., 157, 198,217 Walley, M. R., 166, 198,211 Wallin. J., 11, 36, 37, 39,40,81 Wardell, D. W., 156, 158, 161, 174, 176, 196,204,217 Wasna, M., 365,384,391 Watson. C. M.. 124, 127,144 Watson, L. H.,93, 111 Watson, L. S., 332,347 Wechsler, D., 372,391 Wegener, H., 351,352,355,368,369,378, 384,391 Weikart, D. P., 308,347 Weiner, H., 133, 145 Weinschenk, C., 353,370,391 Weir, T. W. H., 157, 158, 176, 196, 202, 218

404 Weisberg, P.,1 17, 132, 145 Weiss, B., 139, 143 Weiss, E., 239, 252,270 Weiss, G., 151, 174, 180,218 378,391 Weiss, J. W., Welch, L., 332,347 Wellman, B. L., 308,347 Wender, K., 369,381 Wenke. W., 364,391 355,391 Werner, H., Werry, J. S., 149, 151. 164, 171, 174, 176, 178, 180, 184, 187, 189, 192,200,204, 210,216.2 1 7.2 18 West, R.,28, 33, 81 Westman, J. C., 163, 165, 192, 194,218 354, 355, 357, 360.361, Wewetzer, K.-H., 370,37 1,372,374,391 White, S. D., 157, 161, 196,204,217 Wicijowski, P., 27, 63, 72.80 Wickens, D. D., 239,269 Williams, D. B., 161, 204,215 Williams, H. M.,308,347 Williams, J., 24, 54, 75, 326,348 Winer, B. J., 62.81, 171, 172,218 Winters, J. J., 228,267 Witte, K. L., 246,269 Wittenborn, J. R., 150,210 Wittmann, M., 363,392 Wittson, C., 31, 76 Wohl, N., 165, 176, 196,210 Wolf, M.M.,308,319,336, 340,343,345, 347 Wolfensberger, W., l9,81, 170, 175,218 Wolff, H.,352, 372,392

Author Index Wolfson, I. N., 157, 161, 196,204,218 Wollersheim, J. P., 180,218 Wortis, H., 336, 347 Wozny, M., 6,60,69, 71, 78 Wright, S. W., 157, 196,217 Wright, W. B., 162, 192,218 Wunderlich, C., 354,357,392 Wunnerlich, A,, 356,392 Wunsch, W., 43.56, titi, 81 Wyckoff, G., 157, 161, 196,204,217

Yannet, H.,28,81 Young, A. M., 159,204,208 Young, G. C., 177,178,217,218 Y o u t h , J., 108, 110 Yuille, J. C., 261,268

ZarfdS, D., 28, 77 Zeaman, D.,84,87,89, 91.93, 110,111, 171,212,239,270 Zellweger, H.,54,55,69,81 Ziebell, H.,377,392 Zigler, E., 225,270,277, 301,306, 31 1, 320,526,327,333,343,345,347,348 Zimmerman, D. W., 117,145,311,348 Zimmerman, F. T., 161, 166, 175,200, 204,219 Zimmerman, J., 117, 118, 119,145 Zimmerman, K. W., 361,381 Zrull, G. P., 163, 165, 192, 194,218 Zubek, J. P., 164, 165, 176, 192, 196,208

Subject Index Achievement motivation, 365-367 Acquisition strategies, model for. 259-264 stages of learning and, 257-259 Activity, methylphenidate and thioridazine effects on, 186- 189 Adjustment, social, 367-369 Amphetamine, 163- 164, 192- 193 &Amphetamine, 164-165, 192-193 Anatomy, cultural-familial retardation and, 310-312, 332-333 Behavior, see also Medical-behavioral research: specijc behaviors consequences of, 338-340 modification, drugs and, 178-1 79 Biochemistry, cultural-familial retardation and, 310-312 Butyrophenones, 16 1- 162

Celactrw paniculala, 168, 192- I93 Centrophenoxine, 168,l V2- 193 Coding, acquisition strategies and, 261-262 Conditioning. see Operant procedures Control problems, perceptual reinforcers and, 115-117 Cue selection, i n paired-associate learning, 238-249 Cultural-familial retardation, 303-348 correlational research, 315-31 7 descriptive research, 309-314 environment and, 305-306 manipulative research, 323-327 nonmanipiilated group comparison research, 317-323 population and, 304-305 systematic approach to, 327-340 classes of variables and. 328-340 Deanol, 165, 196-197 Dibenzazepine, 166- 167

Diphenylmethane derivatives, 162 Dosage, 174-1 75 standardization of, 153 Double-blind procedures, 152- 153, 172-174 Drugs. see Psychopharmacological studies Education, mental retardation in Germany and, 374-379 Environment, cultural-familial retardation and, 305-306,329-332,333-338 medical-behavioral causation and, 10- I9 /-Ephedrine, 168, 198- I99 Feedback, acquisition strategies and, 262-263 Genealogy, cultural-tamilial retardation and, 309-310 Illusory displacement, see under Stimulus trace Intelligence, structure and development of, 359-364 IQtest, as index of drug effects, 175-176 Isocarboxazide, 167, 198-199 Language, 357-359 Latency, accuracy of response and, 105- 106 Learning, backward, 249-257 dissociation of, 177- I78 drug effects on, 176-178 methylphenidate and thioridazine, 181-184, 186-189 paired-associate, see Paired-associate learning Learning stages, see under Paired-associate learning 405

Subject Index Marble dropping, methylphenidate and thioridatine effects on, 180 Medical-behavioral research, 1-81 historical aspects, 4-9 methodology and, 9-32 causation and, 10-23 research designs and medical-behavioral variables and, 23-32 mongolism and, 33-75 clinical studies, 33-44 experimental studies, 44-65 historical aspects, 65-75 Memory, see Recognition memory; Retention Mental retardation in Germany, 349-392 education and rehabilitation and, 374-379 developmental education, rehabilitation and therapy, 377-379 educational system, 374-377 specific research emphases, 355-374 basic processes, 355-359 diagnostic process and construction of assessment instruments, 371-374 personality functioning and structure, 364-371 structure and development of intelligence, 359-364 theoretical orientation to, 350-354 definition and, 350-353 theory construction and general research emphases, 353-354 Methylphenidate, 166, 198-201 dosage effects of, 189-191 learning and activity and, 186-189 learning and retention and, 181-184 marble dropping and, 180 stereotypy and nonstereotyped operant behaviors and, 184- 186 Mongolism, see under Medical-behavioral research Monoamine oxidase inhibitors, 167 Motivation, achievement, 365-367 Motor behavior, 355-356 Nialamide, 167, 200-201 Operant procedures, 113-145 punishment and, 122-131 reinforcement and, 114-122

conditioned negative, 119-122 conditioned positive, 117- 1 I9 historical aspects, 1 14- 1 15 naturally developing schedules of, 134- 135 perceptual reinforcers and control problems and, 1 15- 1 17 schedules of as formal rules, 132-134 response rate and, 135-141 as multicontrolled measure. 140-141 refinement of, 135-137 spatial dimensions of, 137-139 temporal dimensions of, 137 topography of and collateral behavior, 139- 140 Paired-associate learning, 22 1-270 acquisition strategies and, model for, 259-264 stages of learning and, 257-259 associative learning stage in, 237-257 backward learning and, 249-257 cue selection and, 238-249 methodology for, 225-229 response learning in, 23 1-233 response stage of for retardates and normal children, 233-237 Parents, foster, cultural-familial retardation and, 315 Pentylenetetrazol, 166, 200-201 Perception, visual, 356-357 Personality, functioning and structure of, 364-371 Phenothiazines, 155-160 Physiology, cultural-familial retardation and, 3 10-3 12,332-333 Placebo control, 152 Practice, recognition memory and, 102-1 03 Probe, recognition memory and, 101-102 Propanediols, 162- 163 Psychopharmacological studies, 147-2 19 drug classifications and, 151 methodology of, 169-180 design of, 170-175 ethical considerations for, 169- 170 measurement and, 175- 180 methylphenidate and thioridazine effects, on learning and activity, 186-189

SUBJECT INDEX

on learning and retention, 1 8 I - 184 on marble dropping, 180 on stereotypy and nonstereotyped operant behaviors, 184- I86 methylphenidate dosage effects, 189- 19 I minimum requirements for, 151-154 monoamine oxidase inhibitors and, 167 stimulants and, 163-167 tranquilizers and, 155- 163 major, 155- 162 minor, 162- 163 Punishment, operant procedures and, 122-131

Rauwolfia akaloids, 160-161 Recognition memory, 83-1 1 1 experimental designs for, 87-89 historical aspects of, 89-90 latency and accuracy of response and, 105- 106 methodology for, apparatus, 93 procedure, 91-92 stimuli, 92-93 practice and, 102- I03 research strategy for, 86-87 retention interval and, 103-104 stimuli and, duration and pacing of, 98-100 number of, 98 simultaneous or successive presentation of, 94-98 type of probe and, 101-102 within sessions effects and, 105 Rehabilitation, mental retardation in Germany and, 377-379 Reinforcement, conditioned negative, 1 19- 122 conditioned positive, 117-1 19 perceptual, control problems and, 115-1 I7 schedules of, 132- 135 as formal rules, 132- 134 naturally developing, 134- 135 Response, accuracy of, recognition memory and, 105- 106 Response rate, operant procedures and, 135- 141

407 as midticontrolled measure, 140-141 refinement of, 135-137 Spatldl dimensions of, 137-1 39 temporal dimensions of, 137 topography of and collateral behavior, 139- I40 Retention, methylphenidate and thioridazine effects on, 1 81- 184 Retention interval, 103- I04 Rote repetition, 262 Rules. schedules of reinforcement as, 132- I34

Sequential integration, see under Stimulus trace Social behavior, 367-369 Socioeconomicstatus, cultural-familial retardation and, 3 15-3 16, 3 17-3 19 Stereotypes, 4-5 Stereotypy, methylphenidate and thioridazine effects on, 184- I86 Stimulants, 163-167 Stimulus presentation, duration and pacing of, 98- 100 simultaneous and successive, 94-98 Stimulus trace, 271-301 illusory displacement studies of, 28 1-297 experimental parameters and, 2x2-297 relationship of to theory. 282 process, 272 sequential integration studies of', 273-281 experimental parameters, 275-28 1 relationship of to theory, 274-275 theory, 272-273 Strategy, see under Paired-associate learning

Tests, cultural-familial retardation and, 315-3 17 Therapy, mental retardation i n Germany and, 377-379 Thioridazine, 204-205 learning and activity and, 186-389 learning and retention and, 181-184 marble dropping and, 180

Subject Index

408 stereotypy and nonstereotyped operant behaviors and, 184-1 86 Trace, see Stimulus trace Tranquilizers, major, 155-162 minor, 162- 163

Twins, cultural-familial retardation ;~ncl, 315

Visual-motor coordination, 356-357 Visual perception, 356-357