If you are interested in learning more about participating in the infancy
research program, please call us at: (973) 353-1080 ext. 3216 or 3204. You may 
also email us at: babylab@axon.rutgers.edu. Alternatively, you may simply print 
out this page, fill in the blanks, and mail it to us at the address above.
         
Please contact us before your child is 6 months old (preferably well before then)
to participate in the longitudinal (ATCE) study. In some cases, we may be able 
to see children for single visits at older ages. Contact us for more information 
about these opportunities.
         
         
       Parent's Name(s)  ________________________________________________
         
       Street Address    ________________________________________________
         
       City, State, Zip  ________________________________________________
         
       Telephone Number  ________________________________________________
         
         
       Baby's Name       ________________________________________________
         
       Actual D.O.B.     ________________________________________________
         
       Expected D.O.B.   ________________________________________________
         
       Birthweight       ________________________________________________
         
         
Has an older sibling or parent been diagnosed with a language problem (e.g., 
delayed speech, dyslexia, central auditory processing deficit, or specific 
language impairment)?   [ ] Yes   [ ] No
         
         
       If yes, please specify type of problem and age at diagnosis:
         
       __________________________________________________________________
         
       __________________________________________________________________
         
         
We appreciate your interest and will be in touch with you soon to discuss the
possibility of your participation.