Salem State University Institutional Review Board (IRB) 
Disclosure Statement
 
Understanding Autism Spectrum Disorder and Sleep: Is Sleep Being Addressed by Occupational Therapy Professionals in Pediatric Outpatient Clinics?
                                                                                   
INTRODUCTION: Jennie Lacolla and myself, Lyndsey Collette are currently enrolled in the masters of occupational therapy program at Salem State University, located in Salem Massachusetts. This questionnaire/survey will ask you questions about sleep participation and if it is being addressed for children with autism spectrum disorder. The purpose of this research is to identify if sleep is being addressed, what interventions are being used, and the frequency of these interventions. Our goal is identify potential barriers impacting the ability to provide sleep interventions for children with ASD. If sleep is not being addressed, researchers want to explore potential barriers impacting the ability to provide sleep interventions for children with ASD.

This survey will take approximately 15-20 minutes to complete. Please complete the survey within 2 months of receiving the initial recruitment email. If you belong to both the AOTA and a state organization, please only submit one survey to prevent duplication of results.

Thank you for taking the time to complete this survey,

Lyndsey Collette, OT/s & Jennie Lacolla, OT/s
                                                  
PARTICIPATION: Participation in this survey is completely voluntary. You may stop your participation at any time. You are free to decline to answer any question you do not wish to answer. There are no right or wrong answers. All answers will remain completely anonymous.                                                    

RISKS: There are no foreseeable risks involved in participating in this study other than those minimal risks encountered in day-to-day life and/or if  you find some of the questions to be sensitive in nature regarding personal occupational therapy practice experiences.

BENEFITS: Potential benefits to this exploratory study include gaining information for future research in regards to occupational therapy sleep interventions for children with autism spectrum disorder (ASD) and to be able to identify potential barriers impacting the ability to provide sleep interventions for children with ASD.                                         
ANONYMITY/CONFIDENTIALITY: Your name or identity will not be used in reports or presentations of the findings of this research. Information provided to the researchers will be kept anonymous by disabling IP tracking and SSL encryption will enabled.

The data collected from the surveys will be on  password protected computer until it gets destroyed (data will be kept for three years on primary investigator’s computer and then destroyed). This research project has been approved by the Institutional Review Board at Salem State University. Thank you for your help.

CONTACT: For questions, concerns, or if interested in the findings about the research, please contact:

Primary investigator: Jennie Lacolla j_lacolla@salemstate.edu
Student researcher: Lyndsey Collette l_collette@salemstate.edu
Research faculty: Jill Turcotte DOT, MHPE, OTR/L jturcotte@salemstate.edu

For concerns about your treatment as a research participant, please contact:
Institutional Review Board (IRB)
Salem State University
352 Lafayette Street
Salem, MA 01970
(978) 542-7177 or irb@salemstate.edu
ELECTRONIC CONSENT: Continuing with this survey indicates that you have read the above information, that you are voluntarily agreeing to participate and that you are 18 years of age or older.

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* 2. How helpful is the customer support for our software?

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* 7. Are you currently working in an outpatient occupational therapy clinic?

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* 8. If 'yes' to question 7, how long have you been working there?

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* 9. If 'no' to question 7, what year is your last experience working in an outpatient occupational therapy clinic?

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* 10. Do you have any of the following or are you currently working on certifications in specialty areas listed by the AOTA? Please check all that apply.

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* 11. Please describe your experiences working with children with autism utilizing sleep interventions in outpatient clinics.

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* 12. Do you currently have clients with autism?

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* 13. Are you currently addressing sleep participation for children with ASD?

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* 15. If ‘no’ regarding question 13, have you addressed sleep participation for children with ASD in the past?

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* 16. Below is a list of commonly used sleep interventions. Please check all that you use or have used in the past within the outpatient clinic.

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* 17. Below is a list of commonly used sleep interventions. Please check all that you have recommended for parents/guardians to use in the home.

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* 18. Describe sleep participation interventions you have used that you feel have had positive outcomes.

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* 19. Potential barriers for not addressing sleep. Please check all that apply.

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* 20. If you selected a specialty certification within the demographic portion of the survey, do you feel the certifications have increased your knowledge, preparedness, and comfortability for addressing sleep participation for children with ASD?

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* 21. Any additional comments, thoughts, feedback, and information you feel may benefit this study would be greatly appreciated. Please comment below. 

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