Communication Development Workshop for Parents - Interest Form

Please complete this form to express interest in a 2-part virtual parent training at no cost for parents and caregivers of children with autism spectrum disorder.

The goal of the program is to help parents recognize early communication difficulties and to provide them with basic strategies for facilitating communication. The program will cover early communication skills: joint attention, joint referencing, first words and reciprocity in language and play.

Sessions are 60 minutes long and will be held in the winter 2024 via Zoom! The sessions will be held Thursdays, December 5th and 12th.

We look forward to hearing from you!

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* 1. Your full name:

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* 2. Your child's full name:

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* 3. County of residence (Albany, Rensselaer, Saratoga, etc.):

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* 4. Child's current age in years:

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* 5. Source of your child's diagnosis (e.g., pediatrician, psychologist, etc.)

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* 6. How would you best categorize your child's sentence use?

Uses full spoken sentences

Uses words or phrases

Gestures and signs

Uses an AAC device

Other (please specify)

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* 7. Contact Information:

Email Address

Phone Number

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* 8. Please select your preference for group meetings. The sessions will be held December 5th and 12th.

(Group meetings are 60 minutes in length.)

Mornings (anytime between 9-11 AM)

Lunchtime Group (12-1 PM)

Afternoons (anytime between 1-3 PM)

Evenings (anytime between 4-6 PM)

Late Evenings (anytime after 7 PM)

I'm flexible! Anytime works for me!

Communication Development Workshop for Parents - Interest Form

Question Title

* 1. Your full name:

Question Title

* 2. Your child's full name:

Question Title

* 3. County of residence (Albany, Rensselaer, Saratoga, etc.):

Question Title

* 4. Child's current age in years:

Question Title

* 5. Source of your child's diagnosis (e.g., pediatrician, psychologist, etc.)

Question Title

* 6. How would you best categorize your child's sentence use?

Question Title

* 7. Contact Information:

Question Title

* 8. Please select your preference for group meetings. The sessions will be held December 5th and 12th. (Group meetings are 60 minutes in length.)

* 8. Please select your preference for group meetings. The sessions will be held December 5th and 12th.

(Group meetings are 60 minutes in length.)