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Family Information Questionnaire

Thank you for agreeing to participate in our study on infant pointing.Please read each of the questions below and select the most accurate/appropriate answer. The questionnare should take a 3-5 minutes to complete. Once you have answered all of the questions, it is important that you press the "Submit Responses" button. We will then receive your responses electronically. On the following page, you will be given the option to receive your responses to your personal email so that you have a record of them.

If you have any queries or concerns about this questionnaire then please do not hesitate to get in touch with one of our researchers at

Part A
1. Has your child ever experienced any major medical problems? (required)
2. Has your child ever been treated for ear infections? (required)
4. Does your child have any colds or ear infections today? (required)
Was your baby born full-term? (required)

Part B
5. What is the highest level of education that you have completed? (required)
6. What is your household income per year? (required)
7. What is your ethnic group? (Tick all that are relevant) (required)
Consent (required)
Privacy notice
Data collected from this form are used solely for the purposes of our research. All information resulting from this research will be stored strictly confidential. All documents and computer files will be identified only by code and kept in a secure location (a university protected server). Participants will not be identified by name in any reports of the completed study. Data will be accessed by members of the research project and the PI, Sotaro Kita ( and his collaborator(s) on the project. The data will be kept as long as involved researchers are active in research or at least 10 years after the publication of the results. You may withdraw the data after the experiment, up to the point at which the results are reported in scientific publications. By pressing the "Submit Responses" button below you agree to the data use and storage as described above.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at

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