Five Root Causes Assessment Application

When you're stuck with some autism challenges that just won't budge, or are improving far too slowly, this assessment will help you identify your specific blend of underlying (and causal) health challenges, and identify your top interventions.

Name of Autistic Person (if different)
Brief Life History of Autistic Person*
Details of pre-birth pregnancy, birth experience, and potential autism recognition points which prompted you to seek a diagnosis (or research to find one for yourself).
Brief Interventions History for Autistic Person*
If you've done therapies, medications, supplements, and skills development, tell me what it was, how long/often you did it, and what results arrived (if any).
What worries keep you from sleeping?*
If you think about the big picture of what's going on in your own life because of autism challenges, where do you feel most stressed, and why?
Your Top 3 Goals for Change*
Describe the symptoms you are most struggling with, and the change which you would like to see.
Name*
First Last
Email*