research. Working with and for children, which is the cornerstone of the child-computer interaction community, raises a number of ethical questions.

ETHICAL QUESTIONS

I’ve come to think that any discussion of the ethics of conducting research with vulnerable populations, such as children in the developing world, should be grounded in a three-part foundation. The first is that we must be willing to take the time and make the effort to be aware of and ask ourselves some of the difficult questions that arise when working with vulnerable populations. The second is that we must understand that we view the world through a lens of our own experience. In order to better understand vulnerable populations, we need to be willing to step away from this lens, ask questions, and listen deeply to the answers. The third is that we should consider the Belmont Report’s tenets of welfare, justice, and respect ( https://www.hhs.gov/ ohrp/regulations-and-policy/belmont-report/ index.html) in our dealings with vulnerable populations, keeping in mind that often what we ought to do is not always consistent with what we can do.

With this tripartite foundation in mind, there are five issues that I came up against in my work in Nepal. I pose them as questions here, which I urge you to consider when you work with any vulnerable population, whether that be children living in poverty or people of any age with physical or mental health challenges or the elderly in developed countries.

First, how can we feel relatively certain that we are providing benefits to the population we are working with? We may think that children can benefit from participating in our research or from using the computational systems that result from our research. But is this true? How do we know if the children we study are actually benefiting from our research? In answering this question, it is important to understand that we all make assumptions about what children’s development, education, and even their lives should look like.

In Crazy Like Us, the Globalization
of the American Psyche [ 3], Ethan
Watters suggested that mental health
professionals from industrialized
countries have generated modern
theories of the human psyche, created
treatments based on these models,
and then exported them to many of
the world’s cultures, sometimes with
devastating consequences. Can we
really take what we know about mental
health and well-being and transfer it to
other cultures? The assumption behind
this commodification is that everyone
is crazy like us. But is this true? Before
we can assess potential benefit, we
must be aware of the assumptions we
use to determine what benefit means.

In Nepal, we did this by working closely with the community at the school, including Nepali counselors, to set goals for the benefits we thought might come from our research.

Based on the results from informal
interviews, as well as detailed
observational notes and photographs
taken on site visits to the school and
to the surrounding communities, we
returned to Canada and built a BCI
application called Mind-Full (http://
www.mindfullapp.ca ). The system
provided neurofeedback depicted in
ways that we hoped the children could
understand, and that would make
their invisible brain states visible to
them as they learned to self-regulate.

Mind-Full comprised three games.

Two of the games showed children how to use their bodies to create calmer brain states (i.e., self-regulate anxiety), and the other game helped them learn to focus their attention. The games were based on everyday activities that the children already knew how to do, like blowing on a pinwheel to make it spin. The act of blowing (or deep breathing) produces a calmer brain state. We also built a second application that let the counselors calibrate the EEG data, adjust the difficulty of the games, and see each child’s brain state in real time. It would not have been possible to create this kind of system without trying to see the world through the eyes of the Nepali children and their caregivers.

Once we had the Mind-Full system designed and usability-tested in Canada, we went back to Nepal to conduct a controlled field experiment at the school. When we developed the assessment instruments for the

Showing rather than telling what children will do in Mind-Full sessions.

Can we really take what
we know about mental
health and well-being
and transfer it to other
cultures?