You are being asked to participate in a research project entitled Common Use of Weighted Tools with School aged Individuals. The purpose of the research is to determine the perceived most common use of weighted tools for school aged individuals.

The study is anonymous and data will be maintained on a password protected computer only accessible to the researchers. There is minimal risk for breach of confidentiality and emotional upset when participating in the survey. The survey is voluntary, and you may stop or skip questions at any time.

If you consent to participate in the survey, please check the consent box placed below. The survey will ask questions regarding your demographic information, knowledge, opinions, procedures, and behavioral observations noted with the use of weighted tools.

Participation is voluntary, I understand that I may at any time during the course of this study, revoke my consent and withdraw from the study without any penalty. I have been given an opportunity to read and keep a copy of this agreement and to ask questions concerning the study. Any such questions have been answered to my full and complete satisfaction.

The research is being conducted by a study under the guidance of faculty.
Cayla Callan, Marissa Key, Occupational Therapy Masters Students, Russell Sage College

Debra L. Collette, OTD, OTR/L, Program Director, Occupational Therapy Masters and Doctoral Programs, Russell Sage College Professor, Occupational Therapy, Primary Principle
Investigator (PPI)

If you have any questions, you can contact Dr. Debra Collette at 518-244-4591 or email colled@sage.edu

This research has received the approval of Russell Sage College Institutional Review Board, which functions to insure the protection of the rights of human participants. If you, as a participant, have any complaints about this study, please contact:
Dr. Theresa Hand
Provost
Russell Sage College
65 1st Street
Troy, New York 12180
518-244-2069

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* 1. By checking this box, I provide consent to participate in this study:

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* 2. Are you a

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* 3. What is your education level?

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* 4. How long have you been practicing?

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* 5. How long have you been working at your current facility?

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* 6. What state do you work in?

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* 7. Do you work with school-aged children? If not, please include the field.

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* 8. Are you allowed to use weighted tools in your setting?

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* 9. How often do you use a weighted tool with children?

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* 10. What age range do you use the weighted tool with? Select all that apply

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* 11. What diagnoses have you used the weighted tool with? Select all that apply

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* 12. What weighted tools do you use? Select all that apply

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* 13. How did you learn about weighted tools? Select all that apply.

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* 14. Do you administer a sensory evaluation prior to using the weighted tool? Select all that apply.

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* 15. To determine the weight used, what percent of body weight do you follow?

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* 16. How is the actual weight determined?

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* 17. What do you use for weights? Select all that apply

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* 18. For how long is the individual using the weighted tool? Select all that apply.

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* 19. Where is the weighted tool being used? Select all that apply.

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* 20. In a typical child's weighted tools protocol, how often would you use a weighted tool? (Specify the number of days per week)

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* 21. During what activities are the weighted tools used? Select all that apply.

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* 22. What are your goals for the use of weighted tool? Select all that apply.

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* 23. What behaviors are you targeting with the use of the weighted tool? Select all that apply.

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* 24. How are you documenting the behaviors? Select all that apply.

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* 25. What were the overall outcomes with use of the weighted tool?

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* 26. Based on the previous question, provide any other additional information below to assist us in understanding your protocol, rationale and outcome with the use of the weighted tool.

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* 27. If you have a great way of documenting the use or outcomes of weighted tools, would you be willing to share.

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