LETTER OF INFORMATION/CONSENT
The Impact of Concussions on Children’s Mental Health
You are invited to participate in a study that is being done by researchers at the University of
Toronto, OISE. The study will be run in collaboration with Honsberger Physiotherapy Clinic and
athletes whom suffer from concussions will be asked to partake in the study.
My name is Megan Mueller and I am a student at the University of Toronto, completing my
Masters in Developmental Psychology and Education. My supervisor is Dr. Richard Volpe, who
is a professor at the University. If you have any questions about the study please do not hesitate
to contact myself of my supervisor. Our information is below:
Researchers: Megan Mueller
Principle Investigator: Dr. Richard Volpe
University of Toronto, OISE
Toronto, Ontario, Canada
Purpose of the Study: The purpose of this study is to determine the impact that suffering a
concussion has on the depressive symptoms of child athletes and how active rehabilitation
Role as a Participant:
Following your child’s visit to the clinic you will be asked through email
if you are interested in participating in the study. If you do not wish to be a part of the study,
there will be no punishment and your service from the clinic will not be altered. If you choose to
participate in the study, you and your child will fill out a short questionnaire. 4-6 weeks postconcussion
you and your child will fill out the survey a second time, after they have gone
through their rehabilitation. Researchers will also have access to your child’s baseline
concussion testing if available (the SCAT-5). If you and your child choose, you may take part in
an optional follow up interview after their final assessment.
Your child will be given a corresponding code when they participate in the study and therefore
their names will not be connected to their data. Only myself and my supervisor will have access
to the names and the codes. Once the study is complete all names will be deleted and only the
codes will remain. If at any point during the study you choose to remove you and your child
from the study, you may do so by contacting either of the numbers mentioned above. Your
child’s information will then be deleted and removed from the study If you are uncomfortable
answering any questions in the assessment you may refuse to do so. Data collection will be done
online through an encrypted secure web survey host approved by the Toronto Research Ethics
Guidelines. The Toronto Research Program may have confidential access to the data to ensure
participant protection procedures are followed.
If you have any questions about your child’s rights as a participant please contact the Office of Research Ethics at: email@example.com or 416-946-327.
Potential Harms, Risks, or Discomforts:
There is medium risk associated with this study. Children
and parents may feel uncomfortable answering questions and may bring up certain topics causing
psychological discomfort. If this is the case we encourage parents and children to let the researcher
know and the correct steps will be taken to ensure you and your child are comfortable. Children
and parents can remove themselves from the study if they feel uncomfortable. Children and
parents may use this assessment to become more open to being aware and talking about symptoms
mentioned in the assessment. This could be helpful in the child’s coping and recovery.
Publication: When the study is complete, we are hoping to publish the result. If you would like to
receive a copy of a summary of these results, please check the box and leave your email address
Available External Resources: If at any time children are in need of contacting external resources
in regards to their depressive symptoms or any kind of upset, the following resources are suggested
for participants. Children are also encouraged to contact their family doctor or school guidance
counsellor if they wish.
Sunnybrook Youth Program
Kids Help Phone
Text: send the work “text”to 686868
Distress Centres of Greater Toronto
To learn more about the specific details of the study, please visit this link: https://www.honsbergerphysio.com/blog/Concussion-Research-Impact-of-Concussions-on-Children-s-Mental-Health~6910.html
• I have read and understand the information presented in the information letter about the
study conducted by Dr. Richard Volpe and Megan Mueller from University of Toronto,
• If I have any questions I have been given the contact information of those running the
study and will contact them for additional details if needed.
• I understand that if myself and my child participate in the study, I can withdraw at any
time up until May 1st, 2020.
• I agree that myself and my child will participate in the study.
Child’s Name: Date:
Name of Parent/Guardian:
I would like to receive an email about the results once the study has been complete.
My child and I are interested in participating in the follow-up interview after they have
recovered from their concussion.