Infant Perceptual Study Consent Form
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IMPORTANT!
Your privacy is very important! The videos we film of you and your infant will only be used for research on sign language acquisition. They will never be sold for profit, circulated to the general public on the internet or released to the community without your consent. Also, your consent is completely optional! You are in no way required to give permission to show video data of you and/or your infant.
INSTRUCTIONS
Please read this consent form carefully and respond to the questions up until the "Documentation of Consent" section, then hit SUBMIT. When we meet in person, we will print out a copy of this form and ask you to sign the paper copy. At that time, you will have the opportunity to ask any questions you may have before agreeing.
What is the purpose of this study?
During this study, we use a simple, engaging task to test your baby’s awareness of the difference between two
unknown sign languages. We are trying to determine if infants can tell the difference between sign languages they have never seen before. This information will contribute to our knowledge of infant development in several ways:
1) This type of study is generally done with spoken languages. This project will allow us to see how infants respond to visual languages.
2) This type of study has been run with hearing infants but not many have been done with Deaf infants. We do not currently know much about how Deaf infants will respond to unknown sign languages.
3) Ultimately, we hope that this project will show the importance of early language experience for infant cognitive development. It may also provide a useful tool for assessing cognitive development.
What are the procedures for this study? What will I be asked to do?
During this study, we use a simple, engaging task to test your baby’s awareness of the difference between two unknown sign languages. Your child will be seated comfortably at your home while watching short videos of unknown sign languages on a screen. There are two sets of videos (each set is around 5 minutes long). Your child’s eye gaze to the videos will  be recorded and later analyzed. We will ask you to fill out some background forms and answer some questions about your child’s language experience. That’s all!
What are the risks or inconveniences of the study? Can I withdraw if I change my mind?
Participation in this project carries no risk beyond the minimal level of everyday life. Infants may become bored or restless, or fail to attend to the video information. You have the right to stop and withdraw from the study at any point. If you choose to withdraw your participation during or after testing, your data will be discarded, and you will still receive compensation for any portion of testing that you completed.
What are the benefits of the study?
This work is important for many reasons, but one reason is that it can help to show the importance of early language experience for deaf children. Although participation in this study is not expected to bring any direct or tangible benefit to you personally, the data from this study will be an invaluable resource for future research on Deaf infant development and early language experience.
How will my personal information be protected?
The information gathered is confidential and we respect your rights to privacy. We will take all measures possible to protect your privacy as a participant in our research. No images or identifying information will be used without your permission. The data collected will be reported in aggregate, and no individual identifying information will be shared. All infant participants are assigned a pseudonym that will be used instead of real names in analyses and reports of our findings. When we complete the research, our findings will be discussed with other child language researchers and potentially written up for publication in academic journals.

We will be taking video of your infant's eye gaze during the experiment, but this is purely for analysis. These videos will only be shown to researchers involved in the project, all of whom have completed training in ethical research practices and confidentiality.

Your video footage will be stored and shared according to your specifications on the Video Release Form. We will not share your images unless you give permission. You decide who may see your videos, and how widely photos or clips taken from the videos may be used in handouts and publications.
Will I receive payment for participation?
You will receive $20 compensation (gift card) for your participation in this study.
Who do I contact if I have questions about the study?
Take as long as you like before you make a decision. We will be happy to answer any question you have about this study. If you have further questions about this project or if you have a research-related problem, you may contact the principal investigator, Shane Blau (shane.blau@gallaudet.edu), or the supervising advisor, Deborah Chen Pichler (Deborah.Pichler@gallaudet.edu). If you have any questions concerning your rights as a research subject, you may also contact the Gallaudet University Institutional Review Board (IRB) irb@gallaudet.edu .
Name: *
Preferred contact information (text/email/phone/VP): *
I. Acknowledgement of Video Recording
I agree to allow video recording of myself and my infant as part of my participation in the study, "Perceptual Narrowing in Deaf Infants", conducted by Shane Blau.
II. Confidentiality and Storage
I understand that the video will not have identifying information on it. I understand that the video will be kept in a secure place and not shared with anyone outside of this research project without my explicit consent.
III. Access and Dissemination
I understand that access to the video will be limited to the principal investigator, Shane Blau, the faculty advisor, Deborah Chen Pichler, and research assistants under their direct supervision, all of whom have been certified in ethical research practices (CITI). I understand that clips from the video may be used for publications and conference presentations only with my explicit consent.
IV: Video Maintenance
At the termination of the research project, the videos will be maintained, destroyed or archived as directed by the participants. If directed to be destroyed, all electronic copies of the data will be removed from any computers and storage devices and all hard copies will be returned to the participant or destroyed. If archived, one copy will be retained in the Department of Linguistics (see details below).
This question asks about the use of your video data in future studies. If you grant permission, then these videos may be used for future work conducted by the same researchers. We will still protect your privacy and will not share any identifying information without explicit consent. Please select one of the following options. *
This question asks about using video or images from this study in scholarly presentations or publications. Please select one of the following options. *
This question asks about maintenance of your video data once the research is complete. Please select one or more of the following options. *
Required
Please check the box below to indicate that you consent to participate. *
Required
Signature (please type full legal name) *
Date *
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Documentation of Consent

Signature of Person Obtaining Consent: _______________________________________________  

Date: _________________________________

Print Name: Shane Blau
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