How Should Research Be Explained Differently to Children of Different Ages?

Should a six-year-old and a sixteen-year-old receive the same research explanation?

Probably not. Imagine explaining a blood draw to a six-year-old using the phrase “venipuncture for biospecimen collection.” Technically accurate, perhaps. Communicatively successful, probably not.

Now imagine giving a 16-year-old only a brightly illustrated sheet saying, “We want to learn about your health. You can help us if you want.” That may be understandable, but it could be far too superficial for an adolescent capable of engaging with the research in considerably greater depth.

Developmentally appropriate assent therefore requires more than making every sentence shorter. Researchers need to adjust how information is explained while preserving an accurate account of what participation actually involves.

The explanation should become more detailed as the child's capacity increases

Developmentally appropriate does not mean merely simplifying vocabulary

Start with what the child needs to understand about the experience

For children whose developmental level limits their ability to comprehend the full nature of research but who can still be meaningfully consulted, OHRP suggests focusing on an accurate picture of what participation is likely to be like.

That may include what will happen, where it will happen, approximately how long it will take, whether anything may hurt or feel uncomfortable, what the child will be asked to do, and whether the child has a meaningful choice about participation.

This approach reflects the purpose of assent. The researcher is not trying to turn a young child into a miniature research-methodologist. The aim is to give the child enough understandable information to participate meaningfully in the decision.

There is no universal script for each birthday

Ages can help researchers anticipate developmental differences, but they should not be treated as precise cognitive boundaries. The ability to meaningfully assent does not begin at one universal age, and children of the same age may differ in maturity, literacy, communication, prior experience, and understanding.

Consequently, age bands are best treated as practical design guides rather than rigid psychological classifications. The IRB or research ethics committee may also impose specific institutional requirements for particular participant groups.

For younger children, make the experience concrete

Young children may understand immediate, observable experiences more readily than abstract concepts. Explanations can therefore focus on what the child will see, hear, do, or feel.

Instead of saying, “A biospecimen will be collected for laboratory analysis,” a researcher might explain that a trained person will take a small amount of blood from the child's arm with a needle and describe honestly whether it may hurt. Instead of discussing “study duration,” explain how long today's activity will take using a comparison the child can understand when appropriate.

Concrete language should remain accurate. Researchers should not promise “this won't hurt” merely because that sounds reassuring if discomfort is reasonably possible.

For school-age children, explain both the activities and the choice

As children become better able to understand sequences, reasons, and choices, the explanation can include more about why the research is being conducted and what participation requires.

A school-age child may be able to understand that researchers are trying to answer a question, that joining the study is different from ordinary schoolwork or clinical care, that certain activities will happen because of the research, and that the child's own agreement matters when assent is required.

Researchers should still use ordinary language and explain unfamiliar terms. More information is useful only if the child can make sense of it.

For adolescents, do not oversimplify merely because they are minors

OHRP specifically advises that when adolescents have a capacity to understand similar to adults, the assent procedure should include information similar to what would be provided for adult informed consent or parental permission.

This may include a fuller explanation of the study's purpose, procedures, duration, foreseeable risks or discomforts, potential benefits, alternatives when relevant, confidentiality, voluntary participation, and the ability to stop participating, subject to the applicable protocol and legal framework.

An adolescent capable of discussing these issues should not receive an artificially juvenile explanation merely because the document is called an assent form.

Use ordinary words without making the explanation misleading

OHRP recommends replacing technical terminology with ordinary language where possible. “Taking blood from your arm with a needle,” for example, may communicate more effectively than “venipuncture.”

Plain language does not require removing every scientific term. Sometimes a term matters and should be introduced, but it can be defined immediately in words the child understands.

The test is functional: after hearing the explanation, does the child have a reasonable understanding of what the research experience will involve?

Adapt the presentation, not only the words

Developmental adaptation can involve more than rewriting sentences. Depending on the child and study, researchers may use conversation, pictures, diagrams, demonstrations, short videos, electronic materials, or other communication methods approved for the research.

Electronic methods can also be used for pediatric assent. Joint OHRP and FDA guidance emphasizes that the method used should not impede the child's ability to assent and that the language and presentation must remain understandable to the child.

Visual materials should clarify rather than decorate. A cheerful cartoon needle that makes a potentially painful procedure appear painless may be child-friendly in appearance while being ethically poor communication.

Check understanding rather than assuming readability equals comprehension

Researchers should create opportunities for children to ask questions and should pay attention to whether the child actually understands the central features of participation.

This need not become an intimidating oral examination. Simple conversational prompts can reveal much more than asking, “Do you understand?” A researcher might ask the child to describe what they think will happen or what they could do if they no longer wanted to continue.

The purpose is to identify misunderstanding and explain again, not to make the child earn the right to participate by passing a quiz.

Language and culture also matter

Age-appropriate wording is not necessarily understandable wording if the child does not speak the language fluently or the explanation relies on unfamiliar cultural assumptions. Communication should account for the participant's language and relevant communication needs in addition to developmental level.

Researchers should follow applicable IRB requirements for translated materials, interpreters, and assent procedures involving participants who use languages other than the research team's primary language.

Do not confuse a shorter explanation with permission to omit consequential information

Developmental adaptation involves selecting and presenting information in a form the child can understand. It should not become a convenient reason to conceal an unpleasant procedure, meaningful discomfort, or other information necessary for the child to appreciate what participation will actually be like.

The appropriate depth will vary. The commitment to an accurate description should not.

One research procedure, three different explanations

These are illustrative rather than universal scripts. The exact information should reflect the actual protocol, its risks, the child's abilities, and the IRB-approved assent process.

Notice what does not change across the examples: none disguises the needle, pretends that discomfort is impossible, or tells the child only what would make participation sound attractive. Developmental adaptation changes the communication, not the underlying facts.

Common mistakes when explaining research to children

Design the explanation around the children you will actually recruit

Do not begin by writing one assent form and then trimming words until its readability score looks sufficiently low. Begin with the participant population and the actual research experience.

Your protocol should explain how information will be adapted, particularly when the study recruits children across substantially different developmental stages. The IRB should be able to see not only what researchers intend to tell children but why the communication is appropriate for the proposed population.

Also plan for children who communicate differently from the assumptions built into a standard written form. An inability to engage with one format does not necessarily establish an inability to assent.

Finally, make room for an actual response. Assent is not a lecture delivered to a child before adults proceed with a decision already made. If the child is capable of assent, the explanation should culminate in a genuine opportunity to agree or decline. When a child does not verbally refuse but clearly appears unwilling to participate, researchers should not use the absence of the word “no” as evidence that the communication process succeeded.

Before explaining a study to a child, check the communication

Frequently asked questions about explaining research to children

Change the explanation, not the truth

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