ICCD Research Study Form
- WHAT IS THIS FORM?
This form will give you information about the study so that you can make an informed decision about your participation. Please ask as many questions as you need to before you decide if you want to participate.
- WHO IS ELIGIBLE TO PARTICIPATE?
Any individual who is a parent of a child between the ages of three to five years of age.
- WHAT IS THE PURPOSE OF THIS STUDY?
The purpose of this study is to learn more about challenges with self-regulation in early childhood. You are being asked to participate in a brief survey, so that the research team can obtain some information about the utility of a new screening tool.
- HOW LONG WILL THE SURVEY LAST?
The survey is a relatively short one and should take anywhere between 10-15 minutes to complete.
- WHAT ARE PARTICIPANTS ASKED TO DO?
Parents who choose to participate in this study will be asked to carefully read through and answer the STARS questionnaire. Parents are asked to consider how each question applies to their child and provide a response using a 4-point scale. The STARS consists of thirty questions.
- WHAT ARE THE BENEFITS OF PARTICIPATING?
Your participation will contribute to important research that aims to support children and their families by meaningfully identifying challenges in early childhood. Additionally, you have the opportunity to enter a drawing for a $50 Amazon gift card.
- WHAT ARE MY RISKS OF BEING IN THIS STUDY?
There is a possibility that answering questions about your child’s strengths and weaknesses may cause you some discomfort. There are no other foreseeable risks.
- HOW WILL MY PERSONAL INFORMATION BE PROTECTED?
ICCD will follow all applicable federal and state laws that protect personal and health related information (e.g., HIPAA), including maintaining appropriate physical, electronic, and procedural safeguards. The researchers will keep all study records (including any codes to the data) in a secure location, including a locked file cabinet and password protected computer. All electronic files (e.g. database, spreadsheet, etc.) containing identifiable information will be password protected. Any computer hosting such files will also have password protection to prevent access by unauthorized users. Only the members of the research team will have access to the passwords.
All researchers are well-trained to protect information from improper use and are bound by professional ethics to use patient information responsibly. At the conclusion of this study, the researchers may publish their findings. You and your child will not be identified in any publication or presentation. Information will be presented in summary format and all identifiers will be removed.
- CAN I DISCONTINUE PARTICIPATION?
Participation in this study is voluntary. As a participant, you may withdraw at any time for any reason, without explanation, and without penalty. You may choose not to answer any questions for any reason.
- WHAT IF I HAVE QUESTIONS?
If you have any concerns about your treatment as a research participant, or if you have any other questions or would like more information regarding this research project, please feel free to contact Dr. Carolyn Kuehnel at email@example.com.
If you do not want to talk to the investigator or study staff, if you have concerns or complaints about the research, or to ask questions about your rights as a study subject you may contact IntegReview. IntegReview’s policy indicates that all concerns/complaints are to be submitted in writing for review at a convened IRB meeting to:
3001 S. Lamar Blvd., Suite 210
Austin, Texas 78704
OR Email Address:
If you are unable to provide your concerns/complaints in writing or if this is an emergency situation regarding subject safety, contact the IntegReview office at 512-326-3001 or toll free at 1-877-562-1589.