Please enable JavaScript in your browser to complete this form.Has your family ever canceled a family outing because you were concerned about your child's behaviors?YesNoDoes your child become aggressive when upset?YesNoDoes your child struggle to get to sleep or stay asleep?YesNoDoes your child become overly stressed when the schedule is changed?YesNoDoes your child need a very structured routine?YesNoIs your child an extremely picky eater?YesNoDoes your child have problems wearing clothes with tags or certain textures?YesNoDoes your child have a large amount of unexplained anxiety?YesNoDoes your child struggle to pay attention in school?YesNoDoes your child struggle with learning new concepts?YesNoName *FirstLastPhone Number *Email *Submit