CONSENT FORM

I hereby give my consent for my child's participation in the

project entitled: A STUDY ON EFFECTIVENESS OF NEUROMOTOR
TASK TRAINING COMBINED WITH KINAESTHETIC TRAINING IN
CHILDREN WITH DEVELOPMENTAL COORDINATION DISORDER.
I understand that the person responsible for this project is Mr.
SUNDARESAN C, (Principal Investigator and Research student) has
explained that this study is a part of a project that has the objective to assess
my childs motor skill performance, determine his/her level of competency
(age-appropriate standards using The Test of Gross Motor Development 2
TGMD2, Ulrich, 2000) and if Developmental Coordination Disorder is
suspected to administer him/her with Neuromotor Task Training and
Kinaesthetic Training.
I understand that the skills tested and trained are typical motor
behaviors that my child performs in physical education classes and in every
day life. I have also been advised that my child can request the testing and
training to be stopped at any point where he/she feel unusual discomfort.
I have been informed that every effort will be taken to minimize
any risk of adverse effects and every precaution will be taken during the test
and training protocol to prevent any injury to occur.
Mr. SUNDARESAN C, agree to answer any inquiries I may have
concerning the procedures and to inform me that I may contact him at school
office or by calling 09444749091.
By signing this sheet, it means that I read this form and that all of my
questions were answered.
______________________________
Childs Name
______________________________
Signature of Parent/Guardian
____________________________
Signature of Investigator
____________________________
Signature of Witness

___________ _________
Birth Date
Age
___________ ________
Date
Phone#
__________
Date
__________
Date

Consent Form
I hereby give my consent for my child's participation in the
project entitled: A STUDY ON EFFECTIVENESS OF NEUROMOTOR
TASK TRAINING COMBINED WITH KINAESTHETIC TRAINING
IN CHILDREN WITH DEVELOPMENTAL COORDINATION
DISORDER. I understand that the person responsible for this project is Mr.
SUNDARESAN C, (Principal Investigator and Research student) has
explained that this study is a part of a project that has the objective to assess
my childs motor skill performance, determine his/her level of competency
(age-appropriate standards using The Test of Gross Motor Development 2
TGMD2, Ulrich, 2000) and if Developmental Coordination Disorder is
suspected to administer him/her with Neuromotor Task Training and
Kinaesthetic Training.
The following procedures to be performed during this project
were informed to me. My childs locomotor skills (i.e. running, hopping etc.)
and manipulation skills (i.e. catching, throwing etc) will be tested using a
field testing tool for motor performance (TGMD2). Testing will take place at
his/her school premises(Bharathidasan Matric Hr Sec School) and will

require about 30 minutes to conduct. The administration of training in group

sessions of about 40 minutes per day ,five days per week for seven weeks.
I understand that the skills tested and trained are typical motor
behaviors that my child performs in physical education classes and in every
day life. I have also been advised that my child can request the testing and
training to be stopped at any point where he/she feel unusual discomfort.
I have been informed that every effort will be taken to minimize any risk of
adverse effects and every precaution will be taken during the test and
training protocol to prevent any injury to occur.
I acknowledge that my child's participation in this project is
voluntary and her/she will not be penalized in any way should he or she
decide not to participate. Additionally, I realize that there is no financial
payment involved for my child's participation in this project. It has also been
explained to that there is no known physical, social/economic, legal or loss
of confidentiality risks involved in my child's participation.

Only Mr. SUNDARESAN C, and other recognized authorities will

have access to the individual records, and or data collected for this study. All
records and data will be coded and all records or data that are personally
identifiable will remain strictly confidential. Any recordings to be presented
or published in the public domain will not identify the subject.
Mr. SUNDARESAN C, agree to answer any inquiries I may have
concerning the procedures and to inform me that I may contact him at school
office or by calling 09444749091.
By signing this sheet, it means that I read this form and that all of my
questions were answered.
______________________________
___________ _________
Childs Name
Birth Date
Age
______________________________
___________ ________
Signature of Parent/Guardian
Date
Phone#
____________________________
__________
Signature of Investigator
Date
____________________________
__________
Signature of Witness
Date