Approval No HREC 10169
Approval No HREC 10169
THE UNIVERSITY OF NEW SOUTH WALES AND NEUROSCIENCE RESEARCH AUSTRALIA
PARENTAL (OR GUARDIAN) INFORMATION STATEMENT
The utility of on-line motor imagery software
You are invited to permit your child to participate in a study of motor imagery, the feeling or imagination of moving without really moving. We (i.e. the investigators) hope to learn what "normal" motor imagery is. Your child was selected as a possible participant in this study because you indicated on the noigroup.com.au or bodyinmind.com.au web sites that you may be interested in helping with research and you have a child who is aged between 5 and 18 years old.
If you decide to permit your child to participate, we would like you/your child to answer some questions about your child's health. Following this we would like your child to click on a link that will take you to a web page where your child will complete some motor imagery tasks. These tasks will involve making judgments about photographs of the hands during different tasks (e.g. holding an object).
We do not expect there to be any risks, side-effects or discomforts. The possible inconveniences include the time it takes to fill out an online questionnaire and to conduct the motor imagery tasks. This is not likely to take longer than 20 minutes.
Any information that is obtained in connection with this study and that can be identified with you or your child will remain confidential and will be disclosed only with your permission, except as required by law. If you give us your permission by ticking the consent form, we plan to discuss/publish the results in scientific peer reviewed journals, books, conferences, seminars and popular media (e.g. New Scientist, Catalyst etc). In any publication, information will be presented in such a way that you or your child will not be able to be identified.
There is no recompense to either you or your child for participating in this study.
Complaints may be directed to the Ethics Secretariat, The University of New South Wales, SYDNEY 2052 AUSTRALIA (phone 9385 4234, fax 9385 6648, email email@example.com). Any complaint you make will be investigated promptly and you will be informed of the outcome.
We will give participants the opportunity to join the recipient list for a laboratory newsletter, which provides information about publications and lay description of main findings. We will also provide a summary of the study findings for participants who request this information by ticking the box at the end of the questionnaire.
Your decision whether to not to permit your child to participate will not prejudice you or your child's future relations with the University of New South Wales and Neuroscience Research Australia. If you decide to permit your child to participate, you are free to withdraw your consent and to discontinue your child's participation at any time without prejudice.
If you have any questions, please feel free to contact Dr Lorimer Moseley (E: firstname.lastname@example.org; T: +61 2 93991266) who will be happy to answer them.
You should print and keep a copy of this form to keep.
You are making a decision whether or not to permit your child to participate. Your tick in the following box indicates that, having read the information provided above, you have decided to permit your child to participate.