ࡱ> GIFq` R 5bjbjqPqP8:::+ B08LL$0IVVV$hI9VVx  jp0I0tV|dVVVXVVVI000 000000 The Hong Kong Polytechnic University Department of Rehabilitation Sciences Research Project Informed Consent Form Project title: The Use of Memory Strategies among secondary school students with and without developmental disability. Investigator(s): Karen Liu, Ph.D., Assistant Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University Chan Ka Ki Maggie, research student under Master of Science in Rehabilitation for people with developmental disability. Project information: In this project, you are invited to participate in a 40-minute assessment session. During the session, there will be one assessor to give rating on your behavior using the Memory Strategies Brief Test, Digit Span Test, Judgment of Line Orientation Test and a verbal fluency test. The process of the test will be taped and the study carries no risks to you. The study results will help the rehabilitation professionals to correlate cognitive ability with preferred memory strategy. This may incorporate into future studies looking at the method of memorization and learning effect, with an ultimate aim of enhancing the rehabilitation progress for people with different cognitive abilities. You can contact the chief investigator, Maggie Chan at 90254430 for any questions about this study. If you have complaints related to the investigator(s), you can contact Ms Michelle Leung, secretary of Departmental Research Committee, at 27665397. You know you will be given a signed copy of this consent form. Consent: I or my family, ___________________________, have been explained the details of this study. I and my family (Participant of the study) voluntarily consent to participate in this study. We understand that we can withdraw from this study at any time without giving reasons, and my withdrawal will not lead to any punishment or prejudice against us. We are aware of any potential risk in joining this study. We also understand that our personal information will not be disclosed to people who are not related to this study and our name or photograph will not appear on any publications resulted from this study. Signature: Date: Signature (witness): Date: (Relationship with participant): /nt]'Yx[_^lBvx[|xvz Taf xvzLv/nR-Nx[uNS g|vU\yvR-Nx[u@b(uvaelxvz le_U: ,gN/f/nt]'Yx[^_lBvyx[|xvzu saˊ Nb[N(N N1z\OSR) SN gܕaelKNxvz;mR0 xvzLv/nR-Nx[uNS g|vU\yvR-Nx[u@b(uvaelxvz xvzNT/nt]'Yx[^_lBvyx[| ^iOQZSX 00_^lBv|xvzu s V*t N Ta bP\gp`O2L'Y}40RvU0O0U0Ov{ WSbaS\laR0zz$ReR0Amf^SaV{euO(uv,nf0 U0ON z\g0te Pxvz Ng \ NibNUO0 dkU0Ovv/fcvzwRaV{euO(uKNvܕO xvzbgNS gRee_xvzܕeaRS dKNu`NXv_^}0 ,gNOI NSSRNRnje \U} \O[ Yg NSSR gNUOa Soa},gN(q90254430)0Y \xvzNT gNUOvb4 Soa}萀xvzy^NyfhsYX(Mrs. Michelle Leung) (lQ[q:27665379)0Y NKN/ec0 ]y u;m a_ KLrs p 2 P \ ` a j l 䮝{m[III#hKM0h'CJOJaJnHo(tH#hKM0h'>*CJOJaJnHtHhKM0h'>*CJOJaJ hKM0h]wCJOJaJnHtH hKM0h'CJOJaJnHtH hKM0h]wCJOJaJnH tH #hKM0h'CJOJaJnH o(tH &hKM0h'6>*CJOJaJnHtHhKM0h'6>*CJOJaJhKM0h'CJOJaJhKM0h'5CJOJaJ%KLstp j k <$`a$$a$$a$45l   H i j   K ⾱{lYEYEYE2E$hKM0hD\HCJOJPJaJnH tH 'hKM0h'CJOJPJaJnH o(tH $hKM0h'CJOJPJaJnH tH hKM0h'CJOJPJaJ$hKM0h'CJOJPJaJnHtH hKM0h'CJOJaJnHtH#hKM0h'CJOJaJnH o(tH hKM0h'CJOJaJ#hKM0h'CJOJaJnHo(tH#hKM0h]wCJOJaJnHo(tH hKM0h]wCJOJaJnHtHhKM0h]wCJOJaJK c i l ! $ U X f  ^Ų~qdWq~q~dq~q~qIq~q~qhKM0h'>*CJOJaJhKM0hpSCJOJaJhKM0h6CJOJaJhKM0h'CJOJaJ#hKM0h'CJOJaJnHo(tH hKM0h'CJOJaJnHtH hKM0h'CJOJaJnH tH $hKM0h'CJOJPJaJnHtH'hKM0h'CJOJPJaJnH o(tH 'hKM0hD\HCJOJPJaJnH o(tH $hKM0hD\HCJOJPJaJnH tH XZ]_`c$,0<|~©{eO+hKM0hVhCJOJPJQJaJnHo(tH+hKM0h,RPCJOJPJQJaJnHo(tH+hKM0h'>*CJOJPJQJaJnHtH.hKM0h'5>*CJOJPJQJaJnHtH1hKM0h'5>*CJOJPJQJaJnHo(tHhKM0h'OJnHtH hKM0h'CJOJaJnHtHhKM0h'CJOJaJ#hKM0h'CJOJaJnHo(tH<~rLNVZzF,,,,,>-D- 1$7$8$H$]$`a$gdVh` ^` $a$$a$"02pr~X鼦{fQ(hKM0h'CJOJPJQJaJnHtH(hKM0hVhCJOJPJQJaJnHtH(hKM0hpSCJOJPJQJaJnHtH+hKM0hVhCJOJPJQJaJnHo(tH+hKM0hpSCJOJPJQJaJnHo(tH.hKM0h'5CJOJPJQJaJnHo(tH(hKM0h'CJOJPJQJaJnHtH+hKM0h'CJOJPJQJaJnHo(tHXbdlHJѹt_CC7hKM0h'CJOJPJQJ^JaJmHnHo(sHtH(hKM0h'CJOJPJQJaJnHtH,hKM0h'CJOJPJQJ^JaJnHtH/hKM0h'CJOJPJQJ^JaJnHo(tH+hKM0h+CJOJPJQJaJnHo(tH/hKM0h+CJOJPJQJ^JaJnHo(tH+hKM0h'CJOJPJQJaJnHo(tH/hKM0h+CJOJPJQJ^JaJnHo(tHJLNTV TVXZxz,,2,4,D,F,,,,,<->-кккккqqк\G(hKM0hXrCJOJPJQJaJnHtH(hKM0h`/CJOJPJQJaJnHtH+hKM0hpSCJOJPJQJaJnHo(tHU(hKM0hpSCJOJPJQJaJnHtH7hKM0h'CJOJPJQJ^JaJmHnHo(sHtH+hKM0h'CJOJPJQJaJnHo(tH(hKM0h'CJOJPJQJaJnHtH4hKM0h'CJOJPJQJ^JaJmHnHsHtH s V*t-_^lBv|xvzu /nt]'Yx[_^lBvx[| ************************************************************************* Vh dk^iOQZSXSx[us V*t: ,gN__________ ][hQf}v/f!kxvzvgQ[0,gNS[N (SR) CNXS/f!kxvz0,gNf}vY,gNSSR(WxvzgcQNUOt1uQ /f NgS0RNUOapbt0bf}vSxvzvNUO0,gNNf}v,gNSSRvNR PNnje \U} \O[0 ,gNwS\rs_ TafoR,gNN0 ,gN * Xa/ NX[N______________aSR/nt]'Yx[N gܕ/nR-Nx[uNS g|vU\yvR-Nx[u@b(uvaelxvz;mR0 =|r: ___________________________ eg: ________________________ =|r (IN): ___________________ >-B-D-R-^-`-b-v----....///////44444444444444{yqmqmqmqmc]c h'0Jjh, 00JUh%ajh%aUU(hKM0hpSCJOJPJQJaJnHtH+hKM0h+CJOJPJQJaJnHo(tH.hKM0h'>*CJOJPJQJaJnHo(tH+hKM0hpSCJOJPJQJaJnHo(tH(hKM0h'CJOJPJQJaJnHtH+hKM0h'CJOJPJQJaJnHo(tH#D-b-.//////444444444444444 r #  9r #h]hh]h&`#$]gdpS$a$(SRܕO___________________) eg: ________________________     PAGE 5 Bristol ADL Scale (June 2000) 4444444444445555 5ܵܩ(hKM0h'CJOJPJQJaJnHtHh%ah'CJOJh'CJOJnHo(tHh'B*phh'B*OJphh'nHtHh6Jh' h'0Jjh, 00JUh'0JmHnHu445555 5]  9h]h6&P 1h:p~U. 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