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2014
July
A
Autism Research
Autism Research
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Hello:
You are invited to participate in our questionnaire Autism Meal Selectivity. In this survey, approximately 30 people will be asked to complete a survey that asks questions about barriers at mealtimes. It will take approximately 20 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. Please feel free to answer the questions as best as you can. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Amanda Holst at 408-608-5904 or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Who conducts meals in your household?
Me
My spouse
A sibling
An extended family member
A caretaker/nanny
Other
Describe mealtimes in your house
Mealtimes are
stressful
manageable
somewhat challenging
pleasant
Other
List the foods child typically eats:
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