VT Learning Study Interest Form 

Dear Parent(s)/Caregiver(s),

Thank you for your interest in our Virginia Tech research study (IRB 24-1349) on understanding the association among executive functions, self-regulation, chronic stress, and learning outcomes in first and fourth grade students. We are recruiting children that are first or fourth graders, and can read and speak English, and their parents/caregivers who also need to be able to read and speak English. Your child’s participation entails a single session which will last approximately 60 minutes.

In this study, your child will complete literacy, math, self-regulation, and executive function activities with a researcher during the 60-minute session. The session can take place at the Virginia Tech campus, your home (available only if located in the New River Valley area or Roanoke area), or a community-based location (in the Roanoke area), and you will have to be with your child while they complete the activities. 

As a way to show our appreciation for your time, your child will receive small prizes (e.g., stickers, fidget) throughout the session. You will receive a $20 electronic gift card upon completion of the session and surveys if it takes place at the Virginia Tech campus, Virginia Tech Carilion Roanoke campus in Roanoke, or the participant’s home.

Please provide answers for the following questions. We will review your eligibility and get back to you with more details about scheduling your participation in the study.

Thank you again for considering being part of our project!

Sincerely,
Isabel Valdivia, PhD Candidate
Human Development and Family Science, Virginia Tech

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What is your first name? *
What is your last name? *
Please provide your email address and phone number so we can send you further information about the study and to schedule a location, date, and time to have your child’s session.
Email: *
Phone number: *
What is the month and year of birth of your child? If you have multiple children, please complete one of these forms for each child.
Month:
 *
Year: *
What is your child's gender? (If other, please specify) *
What grade is your child currently in? *
Can your child read and speak English? *
Can you read and speak English? *
This study can be conducted in the Learning and Development Lab in Wallace Hall located on the Blacksburg campus of Virginia Tech (parking is provided), your home (available only if located in the New River Valley area or Roanoke area), or a community-based location (in the Roanoke area). Regardless of the location, you need to be present throughout the 60-minute session. 

Please indicate what your preference for the session location would be.
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