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IRB Forms to be completed - Essay Example

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APPENDIX A Approval from School Administrators Date: To: Researcher From: School Authorized Agent Address I [school authorized agent] an authorized agent of Ridgeville High School, grant [name of the researcher] permission to carry out research with the assistance of Ridgeville High School as specified herein…
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APPENDIX A Approval from School Administrators Researcher School ized Agent Address I [school ized agent] an ized agent of Ridgeville High School, grant [name of the researcher] permission to carry out research with the assistance of Ridgeville High School as specified herein. [Name of researcher] is granted permission to contact administrative staff at Ridgeville High to aid in the identification of students with disabilities who dropped out of high school and to further aid the researcher in establishing contact with the identified students with a view to requesting that they participate in face-to-face interviews, student journaling and social observations pursuant to an academic research project: “Understanding the Experiences of Students with Disabilities Who Did Not Complete High School”. Permission is also granted to seek assistance from administrative staff in reviewing and using student records. Signed ______________________ School authorized agent APPENDIX B Letter Requesting Students’ Participation in the Study Date: [Insert Date] [Recipient] [Title] [Company] [Address 1] [Address 2] [Address 3] Dear [Recipient]: As a graduate student in the Education at Liberty University, I am conducting research as part of the requirements for a Doctor of Education Degree. The title of my research project is “Understanding the Experiences of Students with Disabilities Who Did Not Complete High School”. The purpose of my research is to gain some insight into the link between the experiences of students with disabilities and their decision to drop out of high school near graduation. It is hoped that by understanding their experiences, this research will help to determine what can be done to alter those experiences and therefore reduce the dropout rate among students with disabilities. I am writing to request your permission to conduct my research at Ridgeville High School and solicit the assistance of administrators and staff at the school, to aid in the identification and recruitment of students to participate in my research study and to access and utilize student records. Participants will be asked to participate in a face-to-face interview, keep a journal of experiences in social interaction, and allow researcher to observe them in a real-life social situation, such as work. They may be asked to participate in a follow-up interview after completing the initial interview. The data will be used to identify and analyze whether the student’s experiences in social settings and school are related to their decisions to drop out of high school. Participants will be presented with informed consent information prior to participating. Taking part in this study is completely voluntary, and participants are welcome to discontinue participation at any time. Thank you for considering my request. If you choose to grant permission, please provide a signed statement on approved letterhead indicating your approval. Sincerely, Richard Wieringo Doctoral Student APPENDIX C Sample Consent Form Consent Form Identifying the Most Common Reasons Why Special Education Students Drop Out of High School Post-Graduate Dissertation Richard W. Wieringo Liberty University Education Department) You are invited to be in a research study of ascertaining the top reasons why high school students with disabilities drop out. You were selected as a possible participant because you dropped out of Danville City Schools during the 2009 to 2012 academic school years]We ask that you read this form and ask any questions you may have before agreeing to be in the study. This study is being conducted by: Richard Wieringo, Doctoral Student Background Information The purpose of this study is: to be able to obtain specific and accurate data on the most common reasons why high school special education students drop out. Procedures: If you agree to be in this study, we would ask you to do the following things: 1. Subject yourself to an intensive interview surrounding your personal and family background, as well as your disability, in order to pinpoint the variables for more accurate dropout characteristics. 2. Answer questions pertaining to the real reasons why you dropped out of high school. 3. Allow for the entire interview to be recorded. 4. Write a short summary on how you feel about how not completing high school has affected you. Risks and Benefits of being in the Study The study has several risks: First, you may need to open old wounds with regards to the difficult decision you have had to make in dropping out of high school and thus, suffer emotionally; second, you may need to confront the sad reality of the negative consequences of dropping out of high school and thus, suffer emotionally and mentally. The benefits to participation are: When considering the option of going back to school in order to graduate, the author of this paper will provide whatever assistance he can give you in Charlottesville High School. Compensation: You will receive payment: A small token of our appreciation in the form of a gift card upon competition of the interview/survey. For surveys sent by mail, participants will receive the gift card once survey is mailed back in the postage paid envelope that will be provided. Confidentiality: The records of this study will be kept private. In our official records, codes will be used to keep the identity of all participants confidential. The people that all participants will personally meet will not, in any way, try to take a photo or take anything that will prove the participant has been part of the study. Research records will be stored securely and only researchers will have access to the records. In any sort of report we might publish, we will not include any information that will make it possible to identify a subject. Voluntary Nature of the Study: Participation in this study is voluntary. Your decision whether or not to participate will not affect your current or future relations with the Liberty University or with Danville City Schools. If you decide to participate, you are free to not answer any question or withdraw at any time without affecting these relationships. Contacts and Questions: The researcher conducting this study is Richard Wieringo. You may ask any questions you have now. If you have questions later, you are encouraged to contact him at 436 Pinecrest Drive, Danville, VA 24541, (434) 251-2255 E-mail: Also, you may contact his advisor Dr. Verlyn Evans at If you have any questions or concerns regarding this study and would like to talk to someone other than the researcher(s), you are encouraged to contact the Institutional Review Board, Dr. Fernando Garzon, Chair, 1971 University Blvd, Suite 2400, Lynchburg, VA 24502 or email at You will be given a copy of this information to keep for your records. Statement of Consent: I have read the above information. I have asked questions and have received answers. I consent to participate in the study. Signature:____________________________________________ Date: __________________ Signature of parent or guardian:__________________________ Date: __________________ (If minors are involved) Signature of Investigator:_______________________________ Date: __________________ Appendix D Individuals with a Severe Disability [Education] Law and Legal Definition According to 34 CFR 350.5 [Title 34 – Education; Subtitle B -- Regulations of the Offices of the Department of Education; Chapter III -- Office of Special Education and Rehabilitative Services, Department of Education; Part 350 -- Disability and Rehabilitation Research Projects and Centers Program; Subpart A – General] the term individual with a severe disability means -- “(1)(i) An individual with a disability who has a severe physical or mental impairment that seriously limits one or more functional capacities (such as mobility, communication, self-care, self-direction, interpersonal skills, work tolerance, or work skills) in terms of an employment outcome; (ii) Whose vocational rehabilitation can be expected to require multiple vocational rehabilitation services over an extended period of time; and (iii) Who has one or more physical or mental disabilities resulting from amputation, arthritis, autism, blindness, burn injury, cancer, cerebral palsy, cystic fibrosis, deafness, head injury, heart disease, hemiplegia, hemophilia, respiratory or pulmonary dysfunction, mental retardation, mental illness, multiple sclerosis, muscular dystrophy, musculoskeletal disorders, neurological disorders (including stroke and epilepsy), paraplegia, quadriplegia, other spinal cord impairments, sickle cell anemia, specific learning disability, end-stage renal disease, or another disability or combination of disabilities determined on the basis of an assessment of rehabilitation needs to cause comparable substantial functional limitation; or (2) An individual with a severe mental or physical impairment whose ability to function independently in the family or community or whose ability to obtain, maintain, or advance in employment is substantially limited and for whom the delivery of independent living services will improve the ability to function, continue functioning, or move towards functioning independently in the family or community or to continue in employment, respectively.” (Authority: Section 7(15)(C); 29 U.S.C. 706(15)(C)) (USLegal, Inc., 2011) Appendix E Personal Information To Be Requested from Participants I will request the following personal information from each subject interviewed: Name Gender Age Birthdate (This serves as a form of data triangulation to test the reliability of the information presented in the age section.) Ethnicity Native Language Number of Siblings Parental Employment (both mother and father) Family Income Type of Disability Level of Disability School Record: Grades. I will take note of failing marks in what subjects and if the student has been retained by a year Absenteeism Behavior: especially disruptive and emotionally unstable behavior This is an intensive interview, and I will let students answer freely and then code and analyze the data into categories later. School Climate (follow-up questions may be needed depending on the answers given): 1. Please describe your general experience in school. Are you happy to be in that school? Why or why not? 2. How do you feel about your teachers’ attention to your learning needs? Do you feel that the school was able to provide you with a good education? 3. Do you feel that the school has all the tools and facilities that you needed? What were lacking or what was great about the facilities? Sense of Belonging (follow-up questions may be needed depending on the answers given): 1. Were you a member of clubs? What types of clubs? What other extracurricular activities were you involved in? 2. Did you enjoy these activities? Why or why not? 3. Can you say that you have a lot of friends? Why or why not? 4. Do you feel that you belong in the school? Why or why not? 5. When you wake up in the morning to get ready for school, what’s the first thing that comes to mind? Why do you think that is? Attitude toward School (follow-up questions may be needed depending on the answers given): 1. What is your dream? What’s your goal in life? 2. Do you think it’s important to go to school to achieve this dream? Why or why not? 3. Can you say you’re a good student? Why or why not? 4. Do you think you got the grades that you deserved? Why or why not? Educational Support in the Home and Stressful Life Events (follow-up questions may be needed depending on the answers given): 1. What aspects of your personal life do you think negatively affected your studies? Positively? 2. Can you say that your family values education? Your education? (Sometimes parents tend to be biased, valuing the education of one son or daughter while ignoring the other) 3. Was the decision to drop out your decision or that of your parents? 4. Did anything happen that contributed to your decision to quit school? 5. What are the top three reasons that you can say contributed to your dropping out of high school? Why? 6. What consequences do you think dropping out has? Do you think you’ll still get a good job? 7. Do you still want to study and graduate? How about college? APPENDIX F Triangulation Matrix Research Question Data Source #1 Data Source #2 Data Source #3 1. What are the common experiences of students with disabilities who drop out of school? Student interviews, follow-up interviews, and active observations during all interviews Real-world observation of students either at work or in some other social setting Student journaling/one-page reflection of how dropping out of school impacts life today 2. How are these experiences related to the decision to drop out of high school? Student interviews, follow-up interviews, and active observations during all interviews Real-world observation of students either at work or in some other social setting Student journaling/one-page reflection of how dropping out of school impacts life today APPENDIX G Sample Interview Questions 1. How would you describe your relationships with your peers leading up to your decision to drop out of high school? 2. How would you describe your relationships with your teachers leading up to your decision to drop out of high school? 3. How did you feel about assessments and other standardized tests? 4. How did you score on those tests? 5. Did those test results influence your decision to drop out of high school? 6. Did you have difficulties at home that interfered with your ability to go to school regularly? (If the answer is yes, the difficulties will be explored further with follow-up questions such as “What specifically happened to you at home that made it difficult for you to go to school regularly?”) 7. Did you have problems that made you uncomfortable in school? (This question will be involving follow-up questions such as “What were the problems? Why did you feel uncomfortable?”) 8. Did you have help at school with those problems? 9. Did you know where to go for help at school? APPENDIX H Sample Field Notes Sample field notes on Student AG: Student AG appears to be a bit nervous and anxious. Relaxes after introductory exchanges and reassurances of privacy and identity protection. A bit hesitant to answer the first question: “How would you describe your relationship with your peers leading up to your decision to drop out of high school?” Also asked: did you feel comfortable with other students? AG indicated that some students did isolate her, others were good. AG was asked to talk about her experiences with students that isolated her. Body language, good. Seemed animated and a bit emotional recalling experiences with students who isolated her. Was asked if this treatment made it difficult to come to school every day. AG said it played a part in discomfort at school, but there was support from her friends that made it bearable. Wishes she didn’t have to deal with it, but accepts that it was a part of the whole school experience since the beginning. Sample field notes on student journaling: Student AG’s notes were neat, but lacking in detail. The journal reads more like a schedule and offers a list of activities with very little detail about AG’s experiences. AG’s notes indicate, however, that she is under constant supervision. Unfortunately, she does not explain how this makes her feel. She notes that she takes lunch alone. May have difficulties forming social relationships at work. Appears to be in an uncomfortable work environment, but AG does not specifically state this. Sample field notes on observations: AG works as a cashier at a convenience store. She reports to work at 7 and leaves at 1. During the work day, she has experienced some difficulties with customers at the checkout counter and had to call the manager out a few times. On one occasion the manager asked, “What is it now?” He appeared to be annoyed and AG appeared too indifferent to this reaction while explaining the problem. The manager spoke firmly and AG did not appear to be engaged or interested. She appeared to be going through the motions. When it was time to take a lunch break, AG was more animated and enthusiastic than she had been at any time during the day. This experience appears to be what AG has become accustomed to: work, perhaps like school: something she has to tolerate. Not something she enjoys or is committed to. Read More
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