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ImpactADHD and Mindprint Learning Study Application

News Update: This research study has been approved and the results will be published in the poster sessions at the CHADD conference this November in Costa Mesa, California! The final deadline for registration is August 20, 2016. Read on to find out more…

In an effort to advance research on treatments for children with ADHD/ADD, we are excited to be able to offer two innovative programs to parents at an enormous discount. While we wish we could offer it for free, we have learned that a minimal investment improves reliability and accountability – ultimately, it improves the results for you and your child.

These programs would typically cost a combined value of $398. As participants in this study, you will only pay $100 (75% discount) TOTAL for both programs combined. When your application is approved, you’ll receive…

1. ImpactADHD’s Sanity School, an online behavior therapy parent training program, which includes six recorded classes and two months of support (weekly accountability emails, workbook, access to a moderated private forum, and twice-monthly group Q & A calls with a coach). Sanity School has demonstrated improved parent confidence, reduced parent stress, and improvements in behavioral symptoms of ADHD including independence and self-management of frustration.

2. Mindprint Learning’s Comprehensive Student Assessment and Toolbox, which includes a one hour online cognitive assessment of ten core learning skills in the domains of speed, executive functions, complex reasoning and memory. Neurocognitive research demonstrates that when teachers, parents and the child understand learning strengths and needs, instruction can be customized to the individual learner to improve outcomes. You will be provided with a personalized learning program to improve study skills, in-class learning, and test performance.

You will be required to complete brief questionnaires about your experiences with the programs. Initial participation will be completed no later than October 15, 2016. The aggregated data with no personal identifying information will be presented in a research study. Children must be between ages 8 and 19 and reading at a 2nd grade level. Children who take medication for ADHD or other conditions ARE WELCOME to participate in this study.

If you are selected for this study, you will receive a link for purchase and a start date. Please fill out the application below to apply or download the PDF version, fill out and email directly to shelley@touchstonecoaching.com.

Reminder: The FINAL deadline is August 20, 2016.

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First name:

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Last name:

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Mobile Phone Number:

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Mailing address:

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E-Mail:

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Child's First name:

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Child's Last name:

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1. What is your child’s gender?

Male

Female

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2. What is your child’s current age?

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3. Last grade in school?

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4. Has there been a formal diagnosis of:
(please check all that apply)

ADHD

Dyslexia

Depression

Anxiety

High Functioning/Autism

Other Learning Disabilities

Other (please specify)

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5. What type of support/treatments have you done to support your child:
(Children who take medication for ADHD are welcome to participate in this study. This information can be added to the "other" area. Please check all that apply)

Read Books

Parent Consulted a Therapist

Child worked with Therapist

Parent worked with Coach

Child worked with a Coach

Psycho-educational Evaluation

Parent Training Program

Special Education support

Other (please specify)

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6. Have you ever participated in an ImpactADHD Training program (Sanity School, Homework Headaches, Minimize Meltdowns or Parent Success System) or has your child ever taken the Mindprint Learning Assessment?

Yes

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The study will last for 8 weeks. In order to participate, you will need to commit to all 8 weeks of the study and promise to complete pre and post surveys and questionnaires. Your child must read on a 2nd grade level and be able to follow simple multiple-step directions independently. Your signature below indicates that you agree to these conditions.

Digital Signature

Date

Participants who are selected will be notified and sent a link for purchase and a start date. Prefer to download this questionnaire and fill it out for submission?
Click here to access the pdf version and then email directly to shelley@touchstonecoaching.com

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First name:

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Last name:

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Mobile Phone Number:

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Mailing address:

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E-Mail:

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Child's First name:

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Child's Last name:

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1. What is your child’s gender?

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2. What is your child’s current age?

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3. Last grade in school?

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4. Has there been a formal diagnosis of: (please check all that apply)

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5. What type of support/treatments have you done to support your child: (Children who take medication for ADHD are welcome to participate in this study. This information can be added to the "other" area. Please check all that apply)

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6. Have you ever participated in an ImpactADHD Training program (Sanity School, Homework Headaches, Minimize Meltdowns or Parent Success System) or has your child ever taken the Mindprint Learning Assessment?

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4. Has there been a formal diagnosis of:
(please check all that apply)

5. What type of support/treatments have you done to support your child:
(Children who take medication for ADHD are welcome to participate in this study. This information can be added to the "other" area. Please check all that apply)