Informed Consent

You have been invited to participate in a study of caregiver learning and implementation of the learning in early intervention. I hope to learn about how caregivers of very young children with hearing loss feel about information they learn in their intervention and their ability to use those things they have learned. You were selected as a possible participant because you have a deaf or hard-of-hearing child between three years and four years eleven months and were enrolled in an early intervention program that targeted developing listening and spoken language in children with hearing loss.

If you decide to participate you will be asked to participate in a one-on-one interview, lasting about one hour, with the researcher (via distance technology) about your experiences in early intervention. This interview will be recorded and transcribed. All data from this study will be de-identified and stored in a password-protected computer.

There are potential risks and benefits to participation in this study. The main benefit of participation is that your personal experiences with intervention will contribute to the knowledge of professionals about this topic. The risks may be that you may be inconvenienced by the time or that you may feel uncomfortable answering some of the personal questions.

Any information obtained in connection with this study that can be identified with you will remain confidential and will be disclosed only with your permission. All data from study participants will be combined and reported collectively. In any written reports or publications, you will not be identified or identifiable.

Your decision on whether to participate will not affect any future relationship with Fontbonne University and the researcher, Melissa Jensen, in any way. If you choose to participate, you are also free to discontinue participation at any time without affecting said relationship(s). If you have any questions, please ask. If you have questions later, you can contact Melissa Jensen at or Dr. Jamie Doronkin at and we would be happy to answer them.

You will be offered a copy of this form to keep.


You are making a decision whether or not to participate. Your continuation with the survey indicates that you have read the information provided above, and you have decided to participate. You may withdraw at any time without prejudice after completing this form should you choose to discontinue participation in this study.

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