1. Informed Consent/Assent

*Both must complete survey in same session! On this first page, both read and mother answers first question then individual with ASD completes question 2 & 3. Then mother completes pages 2,3,4 herself and child does pages 5,6,7. Please complete separately and don't discuss answers*

You are being asked to participate in a study to investigate aspects of relationship between relational aggression (RA) and High Functioning Autism Spectrum Disorders (HFASD) that have not yet been examined in the extant literature. The prevalence of RA within the HFASD population has not been studied via self-report. A comparison between perceptions of children, adolescents, and young adults with HFASD and their parents regarding potential relational victimization has not yet been presented in the relevant literature base. Most importantly, the study will explore the impact of Theory of Mind ability on perceptions of RA. Lastly, this study may provide further exposure of the existence of relational aggression within our society and more specifically within the HFASD community.

Participants are individuals aged 13 through 25 whom are diagnosed with HFASD and their mothers. Mother and child will both need to consent/assent to participate. High functioning autism disorder is defined as those individuals diagnosed with either PDD, NOS, Asperger's disorder, or autistic disorder and who have an IQ of 80 or higher.

If you decide to take part in this study, you will participate via an online survey. Participants first must complete informed consent/assent online which will then allow them to begin the survey. Those under age 18 will give assent and their mothers will give consent. This is all that will be required of participants. Survey should take approximately 25 minutes to complete.

Some questions might be disturbing to some participants as they may remind participants of painful memories. Any participant can discontinue participation without any negative consequence. Additionally, those individuals can seek counseling to address issues aroused by participation at such places as The Watson Institute, Community Counseling Center, Familylinks, etc.

Participation in this study may provide some personal insight and understanding regarding the nature of relational aggression and theory of mind. Further, participation may encourage individuals to enact change in their environment and/or seek assistance in dealing with relational aggression. Lastly, participants will be contributing to the psychological research base which may in turn assist those struggling with these issues.

Identifying information such as name, date of birth, and address will not be collected whatsoever. Any information about you obtained from this research will be kept as confidential (i.e., private) as possible. All records related to your involvement in this research study will be stored in a secure computer.

Your participation in this research study is completely voluntary. Your decision to consent or not consent to participate in this research study will have no effect on your current or future relationship with Carlow University or this researcher.

This activity has been approved by the Carlow University Institutional Review Board. This Committee administers both the General Assurance of Compliance with the United States Department of Health and Human Services Policy for the protection of Human Subjects and the University policy covering the protection of human subjects. The Committee may be contacted through the Chairperson by calling 412-578-6349 to discuss any questions or concerns.

Thank you for your valuable contribution to this research.

Your voluntary response to this request constitutes your informed consent to your participation in this activity. You are not required to participate. If you have questions about this study you may contact Michael Greisler at 724-981-7141, extension 190 or mjgreisler@live.carlow.edu
Child and Mother each complete portions of this survey. Mother's the first half and the child with ASD completes the second half.

Question Title

* Parents must give consent for themselves and consent for a child under age 18. Do you give your consent to participate in this study?

Question Title

* If you are an adult (age 18 and beyond) with high functioning autism spectrum disorder you must give consent to participate in this study. Do you give consent to participate?

Question Title

* If you are an individual with high functioning autism spectrum disorder and are younger than 18, do you give assent to participate in this study?

Page1 / 7
 

T