You have been selected to participate in this survey based upon your lived experience as either a caregiver or professional who works with children with autism. Your responses will provide valuable information that only comes from those who have lived experience working with children with autism. Your input will inform the process of developing a comprehensive and interactive emergency preparedness guide for children with autism and their caretakers that focuses on emergency sheltering. This survey should take approximately 7 minutes to complete and all answers can be anonymous if you choose.

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* 1. Have you provided care to a child with Autism Spectrum Disorder (ASD)?

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* 2. In what capacity was your experience gained?

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* 3. Have you cared for a child with ASD during a disaster?

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* 4. Have you cared for a child with ASD in a temporary mass shelter?

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* 5. Do you have an up to date disaster preparedness plan that your child with ASD understands and has access to?

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* 6. Scenario for the rest of the questions: You are caring for a child with ASD during a disaster in a temporary mass shelter during a natural disaster.

Question: Below is a list of common stressors within a mass shelter that could have an impact on your child if exposed. Rank each stressor on the level of impact it would have on your kid.
Use the scale: 0 (no impact) to 10 (severe impact)

  0
(no impact)
1 2 3 4 5 6 7 8 9 10 (Severe Impact)
Bright Lights
Crowds
Loud or consistent Noise
Lack of Nutritional Options
Change of Routine
An Unfamiliar Environment
Forced socialization

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* 7. Below is a list of common stressors that can occur within a mass shelter. Select the reaction(s) that your child may have to the corrilating stressor.

  Increased irritability Hiding Stimming Physical symptoms Run away Yelling Violent behavior Tantrum/Meltdown Emotional withdraw
Bright Lights
Crowds
Loud or consistent Noise
Lack of Nutritional Options
Change of Routine
An Unfamiliar Environment
Forced socialization

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* 8. Below is a list of common reactions to stressors. Select the intervention(s) that would be helpful in mitigating the correlating reaction.
(Scroll to the right for more reaction options)

  Physical pressure Quiet environment Dark environment Personal space Explanations of circumstance Counseling Stim device Food of choice Electronics (TV/games) Personal items (i.e. toys, blankets..)
Increased irritability
Hiding
Stimming
Physical symptoms
Run away
Yelling
Violent behavior
Tantrum/Meltdown
Emotional withdraw
Physical withdraw

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* 9. Considering the answers in the table, fill in the blanks below with up to 5 items that were or would be beneficial to mitigating stress for a child with ASD in a mass shelter. (i.e. weighted blanket, and headphones)

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* 10. Provide up to 3 preparedness tips would you suggest for a caregiver of a child with ASD if having to seek emergency mass shelter

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* 11. For those who have cared for a child with ASD in a mass shelter:

What knowledge or resources do you wish you had before entering the shelter?