Participant Eligibility Form

Returning?

A A A

Welcome to the Brain Development Lab!

This 3 to 5 minute survey will allow us to get to know you and your child that you are filling this form on behalf of. Our research study hopes to learn more about how children learn to read in the brain, and if communication mode and hearing status change the brain! If your child is between the ages of 10-17, regardless of hearing status and communication mode, please take this time to fill out the questions below!

If eligible, we will contact you on next steps!

Eligible participants will have the opportunity to come down to Nashville, Tennessee with travel and meal accommodations for your visit, along with pictures of your child's brain and standardized test results!

You are invited to complete this eligibility survey. The Brain Development Lab is conducting this research study at Vanderbilt University. We are recruiting children with no hearing loss and deaf and hard of hearing children.

This eligibility survey will let us know whether or not you meet some of the basic criteria for the Reading study. If you choose to complete the survey, you will answer general information about your child's background and educational history.

Completing this screening survey does NOT obligate you to participate in the Vanderbilt Reading study. If your answers show that you might qualify, we will contact you to explain the study further. There may be no direct benefit to you for completing the screening survey. Only complete the pre-screening survey if you choose to do so. You may also skip any questions or quit the survey at any time.

Your response to the survey will be kept confidential to the extent allowed by law. This survey is on the Vanderbilt University web-based tool called REDCap. REDCap has features to help keep your information secure.

If you have questions about this pre-screening survey or this research study, please feel free to ask. You may contact the study team at braindevelopmentlaboratory@gmail.com. If you have complaints, suggestions, or questions about your rights as a research volunteer, contact the Vanderbilt University Institutional Review Board at (615) 322-2918.

The survey will take about 5 minutes to complete. By typing your name, you are indicating that you understand the information and agree to begin the pre-screening survey.

* must provide value

Agreement to be contacted:
If you meet the criteria for this study and would like the study team to contact you, include your name and preferred contact information below:

* must provide value

Expand

Permission for investigator to retain information and contact individual with future study opportunities:
Do you give your permission for the Brain Development Lab and Department of Psychology and Human Development to keep your answers on file and contact you regarding your willingness to participate in future research studies?

* must provide value

Yes, please keep my contact information and let me know about future study opportunities.

No. I would like my answers and contact information destroyed when the research study is over.

reset

Today's Date

* must provide value

M-D-Y

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.