Verbal Assent Script for Children, 7-17 Years Old
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NOTE: This document is a guideline for investigators/research assistants to discuss participation
in the neuroimaging project with children. Prior to beginning any experimental procedures,
researchers will deliver the following information to and obtain verbal assent from the child.
Further details about the experimental task and neuroimaging procedures may also be included
in addition to this base script.
Hi, my name is [state your name]. I’m going to tell you why [you are here/I am talking to you].
We are asking you to take part in a research study. We are doing the study because we want to
learn more about how your brain works. Using special cameras that can see through your head,
we can actually see what your brain looks like and even which parts of your brain you’re using
when you think about something!
If you agree to be in this study you will be asked to lie down for a little while inside of the MRI
machine. In order for us to take a good picture of your brain, it is important that you try to stay
very still!
(Following are two sample descriptions of neuroimaging tasks that might be used during
scanning. Researchers may tailor the exact description to the precise task being used)
1. Inside the machine, there is a little tv screen and a button that we will give you. While we
take pictures of your brain, you’re going to play a game. The TV screen will show you
different pictures and you’re going to have to press your button when the right answer
appears. You will see a small x in the middle of the screen to begin with, then pictures will
appear. Try to keep your eyes on the x and not move your head or eyes!
2. Inside the machine, there is a little tv. While we take some pictures of your brain, we’re
going to put a movie on for you. While you’re watching the movie, remember to try not
moving your head or eyes!
I know that it can be hard to stay still, and being in the machine can be a little uncomfortable so
just do the best you can. If you have a question, if something is hurting you, or if you’re scared
about anything just press this button and talk. It’s a special microphone so you can talk to me –
I’ll just be over there in that room and if there’s a problem you can call me right away. Don’t try
to get out of the machine by yourself! Just call me and I will come help.
We will ask you to come visit us (1-3) times to help us with this science project. Researcher here
describes the purpose for the different visits/ what the participant will be doing at each visit.
Although the neuroimaging cameras we use to look at your brain can be a bit noisy and
uncomfortable, they shouldn’t hurt you! It’s normal to be a little scared or anxious your first
time, and because you need to stay still your muscles might get a little stiff or sore. Just
remember that I’m right nearby if you need to call me, or if you want to stop the experiment.
If you are in this study and feel any of the things I just talked about or feel bad in other ways,
please tell you parents right away. It’s important they call us about what you are feeling.
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Before you decide if you do or do not want to be in this research study, we want you to talk to
your parents. We will also ask your parents to give their permission for you to be in this study.
Even if your parents say “yes” you can still decide not to be in the study.
Being in this study is up to you and no one will be upset if you don’t want to participate or if
you change your mind later and want to stop. You can stop at any time for any reason and
nothing bad will happen and no one will mind.
If you have any questions about the study, what we’re doing or what exactly your part involves
you can ask me now. If you have questions later you or your parents may call me at any time.
My name is [insert name again] and I’m really glad you’re interested in my research.
[If applicable: You or your parents may call me to ask questions about your disease or this
treatment.]
You may also ask me questions about this study any time we meet.
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