Getting Involved

If you think you might like to become a subject in the MIT Twins Study of Language Development, please fill out the form below.

The answers to these questions will help us determine if your twins qualify for the study and will provide us with basic contact information so that we can get in touch with you.

The information you provide here will be treated as confidential by members of our staff and will not be made available to anyone outside our offices. Filling out this form does not obligate you to participate in the study.


YOUR FIRST NAME
YOUR LAST NAME
YOUR TWINS' NAMES:

"TWIN A"

 "TWIN B"
TODAY'S DATE:
HOME PHONE NUMBER: WORK PHONE NUMBER:
EMAIL ADDRESS (please type carefully):

General Information

    1. Birthdate of Twins:

    2. Sex of Twins:

    3. What language(s) do your children hear at home?


    4. What language(s) do you, your spouse, and your children's caregivers speak? (If different from above.)


    Medical Questions

    The following questions will help us to assess your twins' medical history. Although we need to know the answers to these questions to find out if you qualify for our study, you are not under any obligation to share this information with us. Furthermore, if you do not feel comfortable sending the information over the web, you can request a phone interview instead.

    5. How long was your twins' gestation period?


    6. What were your twins' birth weights?
    Twin A: Twin B:

    7. How much time did they have to spend in the hospital after they were born?


    8. Has either twin been diagnosed with any speech, language, or hearing problems?


    9. Does either twin have a history of ear infections?


    10. Does either twin have any physical or neurological problems that you are aware of?


    11. Has anyone in your (or the other parent's) immediate family been diagnosed with a speech or language disorder (for instance, prolonged speech therapy or dyslexia)?


    12. Is there any other information you think we should know about your twins?


    Thank you very much for taking the time to fill out this questionnaire. We will contact you soon regarding your participation in the MIT Twins Study.

    Copyright © 1998 MIT Twins Study. All Rights Reserved.
    questions or comments can be directed to mittwins@psyche.mit.edu

Back to the MIT Twins Study Homepage