ASL MEG study interest form

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Hello! We are a group of researchers from Linguistics and Speech and Hearing Sciences at the University of Washington. We are currently looking for hearing signers and non-signers to participate in a brain study using MEG. In this short interest form, we will gather some information about your language background. If your background fits our research criteria for the signers group, we will contact you to schedule a 1-hr online ASL behavioral test to determine fit for the study. You will receive $20 in gift card after completion of the online ASL test. If you are a good fit, we will then schedule with you for a 2-hour in-lab MEG experiment. The experiment takes place at the UW Seattle campus. You will receive $50 in gift cards for your participation. This form will take no more than 5 minutes to complete. If you have any questions while filling in the form, please contact us (email: nllab@uw.edu) for assistance. All information gathered from you will be kept confidential and will only be used for research purposes. This project is approved by the UW Human Subjects Division (UW IRB STUDY00014995).

Email *

Consent: I agree to provide personal information and to be contacted by the researchers in the future. *

Yes

What's your full name?
*

What's your year of birth?
*

What's your gender?
*

What words would you use to describe your ethnic or cultural background? *

What's your hearing status? *

Normal hearing

Unilateral hearing loss

Hard of hearing

Deaf

Other:

Please check the option that applies to your vision. *

I have normal vision and do not wear glasses or contact lens.

I have normal vision, corrected with glasses.

I have normal vision, corrected with contact lens.

I do not have normal vision.

Other:

If you have corrected vision, what is your eye prescription? *

Do you have unremovable metals in your body (e.g. cochlear implants, pacemaker, etc)? *

Yes

Other:

Which hand do you use most often? *

Right hand

Left hand

Both hands

Other:

Please list all languages you know in chronological order with the age of first exposure and your current proficiency level. E.g.: English (0, native); ASL (10, intermediate); Arabic (16, beginner)
*

Have you ever been diagnosed with a language, cognitive, psychiatric, or neurological disorder? If so, what was the diagnosis?
*

Please select all possible time slots for you to take a 2-hour MEG experiment at UW Seattle. *

Monday afternoons (between 1:30-5pm)

Tuesday afternoons (between 1:30-5pm)

Wednesday afternoons (between 1:30-5pm)

Thursday afternoons (between 1:30-5pm)

Friday afternoons (between 1:30-5pm)

Other:

Required

Do you have past experience learning/using a sign language *

Yes

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