Teacher Consent Form

Impact Study: Lessons in Character Program

Att_LIC Teacher Consent Form

Sampling and Gainng Cooperation

OMB: 1850-0826

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Teacher Consent Form





Teacher Consent for Lessons in Character Program Evaluation


Dear Teacher,


Your school is being asked to participate in a research project designed to evaluate the effects of the Lessons in Character Program on academic performance, school behavior and motivation, and endorsement of values consistent with good character. The Lessons in Character program is designed to improve children’s literacy skills and promote the ethical, social, and personal integrity of students. The program is scheduled to be implemented during the 2007/08 and 2008/09 academic years. Over the course of the study (2007-2009), the study data collection activities (e.g., questionnaires, interviews etc.) will take approximately 3 hours to complete. The research is conducted by WestEd with funding from the U.S. Department of Education. It is directed by Dr. Thomas Hanson and Dr. Barbara Dietsch.


The Lessons in Character Program is an English Language Arts-based character education curriculum that uses a collection of multicultural literature (lap books) and audiocassettes to teach lessons of character through literature. The curricular material is comprised of two components: (1) the core curriculum, Lessons in Character (LIC); and (2) support materials, Daily Oral Language With Character (DOL) and Writing With Character (WWC), that are designed to reinforce the traits of good character and support language arts learning standards. LIC consists of 24 lessons to be delivered weekly during the course of the academic year. The DOL materials consist of sentence correction activities followed up by short writing assignments. DOL is designed to be used daily to augment the regularly taught language arts program. The WWC materials (3rd-5th grade only) consist of weekly writing assignments that allow students to practice character-centered composition and writing skills. The lessons focus on both the mechanics of writing as well as character education themes.


To find out how well the program is working, we will administer short surveys to each participating student during the fall and spring semester of 2007/08 and the spring semester of 2009, and examine student records. We will also ask teachers to complete surveys asking about students in their classroom each spring. Some parents of children participating in the study will also be asked to complete surveys asking about their children’s behavior. The information we collect will help us to better understand how the program is working.


If you volunteer to participate in the study, you will be asked to distribute consent forms to parents of students in your classroom. You will also be asked to complete questionnaires about the students in your classroom each spring semester that will take about 3 to 4 hours to complete. As compensation for your participation in the study, you will receive a $100 gift certificate each year upon completion of the questionnaire. If you are in a school assigned to implement Lessons in Character in 2007/08, you will receive $150 as compensation for participation in the 1-day training session in summer/fall 2007 if your school or school district is not paying you to attend the professional development.

Of schools participating in the study, about half will be selected to immediately participate in the Lessons in Character training and be provided Lessons in Character curriculum materials. The remaining half will be offered the training and materials about 24 months later.


Survey Content. The survey will gather information about your teaching background, your perception of the school as a caring community, the general behavior of students in your school, and the specific behavior of 12 randomly selected students in your classroom. A copy of the survey is available in the school office.


Teacher Selection. All 1st-5th grade teachers in your school are being asked to participate in the research study.


Participation is Voluntary. Your participation in the study is entirely voluntary and you can refuse to participate without penalty or loss of benefits to which you are otherwise entitled. If you volunteer to be in this study, you may withdraw at any time without consequences of any kind. You are being provided with a copy of this form to keep for your reference.


Collected Data are Confidential. No names will be recorded or attached to the survey forms or data, but an identification code will be assigned to each survey form. This is necessary to track changes in during the next three years. Data from this survey will be sent to the evaluator, WestEd, for processing and analysis under strict confidentiality controls. Access to identifying information will be limited to select personnel and will be password protected. All data will be reported only in aggregate form to prevent inadvertent disclosure of information.


Potential Risks. There are no known risks to participating in the study.


Where to Turn for Further Information. If you have any questions or concerns about the research, please feel free to contact Barbara Dietsch, Project Director, WestEd, 4665 Lampson Avenue, Los Alamitos, CA 90720, (562) 799-5126. You may examine a copy of the survey in the school office.




I understand the procedures describe above. My questions have been answered to my satisfaction, and I agree to participate in this study. I acknowledge that my answers are private. I have been given a copy of this form.





_____________________________________ _______________

(SIGNATURE OF PARTICIPANT) (DATE)



According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1850-0826.  The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:  U.S. Department of Education, Washington, D.C. 20202-4700.  If you have comments or concerns regarding the status of your individual submission of this form, write directly to:  Ok-Choon Park, U.S. Department of Education, 555 New Jersey Avenue, N.W., Room 506E, Washington, D.C. 20208.




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