How should assent from children be obtained and documented?

• A. Obtain parental consent only; assent is not required.
• B. Obtain child assent only if the parent agrees.
• C. Provide age-appropriate information; obtain child assent in addition to parental consent; document and respect dissent.
• D. Do not inform the child about the research.

Answer: (C)

Assent from children is about inviting their voluntary participation in a way they can understand, recognizing their growing ability to make personal decisions about research involvement. To do this well, you provide information that is age-appropriate and tailored to the child’s level of comprehension, covering what the study involves, potential risks and benefits, and the right to withdraw at any time. Then you seek the child’s assent in addition to obtaining the parent’s or guardian’s informed consent. Importantly, you must document the child’s assent (or dissent) and respect a child’s decision to refuse participation. This dual process protects the child’s developing autonomy and ensures that participation is truly voluntary, not just because a parent agrees. The other options fail because they omit either the child’s agreement, undermine the child’s ability to make an informed choice, or ignore the child’s right to be informed and to dissent.