Please fill out this initial interest form to get started today.
name: address: city: state: email: phone: What is your personal definition of autism (and how it affects your child)? How did you hear about RDI? How much do you know about RDI already? Why are you interested in RDI? Please tell me a little about your child (age, diagnosis, challenges, strengths) and why he or she would benefit from RDI? Please list the other interventions your child received or received (list dates also). If you have discontinued any therapies, please explain why. How do you prioritize remediation of autism through cognitive change and relationship building, academic and educational goals, and behavioral goals? What are the stressors your child brings to you and your family, and what other stressors do you have that impact your relationship with your child? Do you think you can manage fitting RDI into an already busy schedule? What challenges do you foresee? Will you be able to rearrange your schedule to make RDI a priority? Any additional information you would like to provide: Please help me to understand how much you already know about the RDI Program. Please mark the items that you have read, watched, or attended. RDI Two-Day Introductory Workshop with Dr. Gutstein RDI Four-Day Parent Training Workshop with Dr. Gutstein Going to the Heart of Autism: The Relationship Development Intervention Program DVD Autism/Aspergers: Solving the Relationship Puzzle by Dr. Gutstein and Dr. Sheely
