Learning to Look and Listen Entry Survey

The purpose of this online form is to see if you meet the criteria for taking part in our research study of how children who are d/Deaf or hard-of-hearing and children with typical hearing process speech sounds and learn language.

Information about you that you provide in this form will be kept as confidential as possible as required by law. It is possible that the Food and Drug Administration, and other federal and state authorities, may inspect this record.

If you qualify to take part in the study and are interested in taking part, we will record your name and information; this will be kept confidential, but there is a small risk that people outside of the research team could learn this information. If you are not interested in the study, then we will destroy the personal information you give us.

The benefit to you of submitting this form is that you will find out whether you can take part in the study. You will not be paid for answering questions in this form, since it is only to see whether you qualify to take part.

If you have any questions, concerns, or complaints about this form, contact Meg Cychosz at (310) 206-2684. If you want to talk to someone separate from the research team about a concern, complaint, or your rights as a possible research subject, please contact the Stanford Institutional Review Board (IRB) at 650-723-5244 (for medical studies), 650-723-2480 (for nonmedical studies), or toll-free at 1-866-680-2906.