Informed Consent Form
You have been asked by Dr. Hilary Miller-Goldwater, PhD, Learning and Cognition Lab, Department of Psychology, Lawrence University to have your child participate in a research project. The purpose of this research is to understand how children learn science information from books. The participants in this research will be 3- to 5-year-old children. The study will be conducted at your child’s preschool. There will be one session that will last approximately 20 minutes. This research has been approved by Lawrence’s Institutional Review Board, which protects human subjects. Participation is completely voluntary – you may withdraw or decline to have your child participate at any time without penalty. The researcher also has the right to withdraw your child’s participation at any time. To withdraw your child, you can simply inform the researcher, Hilary Miller-Goldwater (hilary.miller-goldwater@lawrence.edu). The researchers will always obtain verbal permission from your child before completing the session (known as assent). The researcher will also not conduct the session or will end sessions early if they notice that your child is uninterested in participating. If you agree to let your child participate, the following will occur. A trained experimenter will read books to your child that are related to a science domain. Then the experimenter will ask your child some questions. The session will take place at your children’s preschool center (specific location determined by center), and you can sit with your child during the session if you would like to. We will record the session on an audio recorder. To the best of the researcher’s knowledge, there will be no more risk of harm than normally experienced in daily life; anticipated risks are minimal. Possible benefits of participating in this project include furthering knowledge of young children’s learning science from books. Your child may learn new science facts. However, there is no guarantee that your child will receive any benefit. At the end of the study, your child will receive a small prize for participating. Every effort will be taken to treat your child’s participation and data confidentially. The researchers will keep a participant list with your child’s first name and the first initial of their last name. This list will only be to match our records, such as matching age to the child’s data. Optional demographic including gender, race, and ethnicity information will be collected. All information that can identify your child (consent forms, participant list, and optional demographic form) will be kept in a locked cabinet in the Learning and Cognition lab at Lawrence University and will only be accessible to researchers affiliated with the project. All the data that the researcher collects during the session, namely the answers to study questions and audio recordings, will not include identifiable information. This data will be associated with a random identification code and be stored on secure password-protected servers as well as in locked cabinets in the lab. No information that personally identifies you or your child will be released or reported in any way unless required by law. The consent and demographic forms will be destroyed 3 years after group-level data from the study is published in scientific journals. The deidentified data will be stored indefinitely. You can ask the researcher any questions that would help you to decide whether to participate. If you have any questions, suggestions, concerns, or complaints, you can contact Hilary Miller-Goldwater, PhD by email (hilary.miller-goldwater@lawrence.edu) or phone (1-920-832-6705). If you have any questions about your child’s rights as a participant, you can contact the Lawrence University IRB Chair: irb@lawrence.edu.
Parent Name
*
First Name
Last Name
Back
Next
Child Information
Child's Name
*
First Name
Last Name
Name of Child's Preschool
*
Back
Next
Optional Demographics Form
This form is optional to complete. The researcher will use this form for data analysis and reporting sample characteristics at the group level. Please fill in as much or as little information as you feel comfortable. Filling out this form does not affect your child’s participation in the study.
Child First and Last Name
Child’s Gender, select one
Female
Male
I chose not to report
Other, please specify
Child’s Race, select all that apply
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
I chose not to report
Other, please specify
Ethnicity, select all that apply
Hispanic or Latino
Not Hispanic or Latino
I chose not to report
Other, please specify
Back
Next
Optional Future Contact Form
At the Learning and Cognition Lab, we have a variety of studies that look at children’s early learning as well as their language and memory development. We are located at Lawrence University. We often have other projects that your children may be eligible to participate in. If you are interested in possibly being contacted in the future about these opportunities, please complete this form. If you have any questions about these opportunities, you can contact the principal investigator, Hilary Miller-Goldwater, PhD by email (hilary.miller-goldwater@lawrence.edu) or phone (1-920-832-6705).
Parent/Guardian Name:
Parent Contact Information
Parent/Guardian Email Address:
Parent Contact Information
Parent/Guardian Phone Number:
Parent Contact Information
Name of Child:
Child Information
Child Date of Birth
-
Month
-
Day
Year
Date
List name and date of birth of any of your other children (under 12 years of age) who you may be interested in having participate in future studies (Name of child and date of birth (MM, DD, YYYY)):
Child Information
Submit
Should be Empty: