Autism Safety Survey

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Title: Safety Survey for Families of Individuals with Autism

Investigators: Jack Scott & Toby Honsberger

Purpose: Thank you for your interest in participating in our Autism Safety Survey. The purpose of this survey is to gather information pertaining to the safety of children with autism within their homes, including parent perceptions and concerns regarding the safety of their child.

Procedures: Completion of the survey should take approximately 15 minutes. You may choose not to answer any questions that make you feel uncomfortable. You are free to withdraw from the study at any time without penalty. To leave the survey at any time, you may click “Exit this survey” at the top right corner of the screen. Please do not include any identifying information about you or your family, responses from surveys will be kept totally anonymous.

Risks / Benefits: The risks involved with participating in this study are minimal but may include evoking traumatic memories involving injuries to your child. Potential benefits from participation in this survey include providing information that will contribute to future research and the development comprehensive training programs and recommendations for families of children with autism to help ensure a safe home environment shared via special education journals and conference presentations.

Consent: By completing the following survey, you give consent to participate in this study.

If you experience problems or have questions regarding your rights as a research subject, contact the Florida Atlantic University Division of Research at (561) 297-0777. For other questions about the study, you should call the principal investigator: Dr. Jack Scott, 561-251-4104 or Toby Honsberger 561-640-0270.
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