Autism Society - Autism Advocate Reader Survey

*1.

Question - Required - Are you a person on the autism spectrum?

2.

Question - Not Required - If no, please indicate your relationship to someone on the autism spectrum.

3.

Question - Not Required - Please specify below.

*4.

Question - Required - Please indicate the age group in which you are interested.

*5.

Question - Required - Please indicate the diagnosis(es) in which you are interested.

	Autistic Disorder
	Asperger's Disorder
	Childhood Disintegrative Disorder
	Rett's Disorder
	PDD-NOS
	Other

6.

Question - Not Required - Sometimes autism is accompanied by related syndromes or disorders. If this is the case, please indicate which one(s) you are interested in.

	Epilepsy
	Minor physical disabilities
	Down Syndrome
	ADHD
	Tourette Syndrome
	Phenylketonuria
	Depression
	Anxiety disorder
	Fragile X syndrome

*7.

Question - Required - What are the most pressing concerns you have regarding treatment of autism or improving the living standards of people on the autism spectrum (more than one answer allowed)?

	Safety/preventing physical injury
	Making and maintaining friendships
	Diminishing compulsive and ritualistic behavior
	Improving language & communication skills
	Improving responsiveness
	Regulating bodily functions and motor skills
	Preventing tantrums
	Improving self-hygiene and diet
	Developing self-esteem and independence
	Alleviating allergies
	Services
	Biomedical treatments
	Learning about different approaches
	Hearing personal stories

*8.

Question - Required - What autism-related products and services have you purchased in the past year (more than one answer allowed)?

	Books on treating the social and psychological needs of individuals with autism
	Special foods free of gluten, dairy, wheat and other ingredients
	Nutritional supplements
	Awareness merchandise
	Biomedical supplies
	Sensory toys
	Personal hygiene products
	Teaching supplies
	Cookbooks
	Dietary supplements (e.g., fish oil)
	Tutorials
	Protective/safety gear
	None

9.

Question - Not Required - How much do you spend each year on autism-related products and services?

*10.

Question - Required - When it comes to buying autism-related products and services, how difficult is it for you to find what is currently available on the market?

*11.

Question - Required - Please indicate which educational facility you have utilized for autism services (more than one answer allowed).

	Local public or private school
	Special education school
	Autism treatment center
	Behavioral clinic
	Special camp
	Vocational/training center
	Other

*12.

Question - Required - Do you currently belong to or plan to join an autism-related organization? Yes
No

13.

Question - Not Required - If yes, please specify

*14.

Question - Required - Are you interested in attending workshops or conferences that provide information, classes and exhibitions on the treatment and care of people on the autism spectrum?

*15.

Question - Required - Are you interested in purchasing investment products and services to help meet the financial challenges of autism-related care?

16.

Question - Not Required - If you are a professional, what is your specialty in the area of autism (more than one answer allowed)?

	Diagnosis
	Prognosis and treatment
	Parenting skills training
	Advice and consultation
	Behavioral monitoring and improvement
	Other
	N/A

17.

Question - Not Required - As a professional, what are the autism-related products and services you purchase (more than one answer allowed)?

	Books and journals
	General medical supplies
	Monitoring equipment
	Sensory tools and equipment
	N/A

*18.

Question - Required - How long have you been an "Autism Advocate" reader?

*19.

Question - Required - Do you pass along copies of the "Autism Advocate" to others?

20.

Question - Not Required - If so, approximately how many additional people read your copy of the "Autism Advocate"?

*21.

Question - Required - Approximately what percentage of the "Autism Advocate" do you read?

*22.

Question - Required - What are your favorite sections or departments in the "Autism Advocate" (more than one answer allowed)?

	Spotlight
	Feature articles
	Creative Corner
	Navigating the System
	Personal Perspectives
	What's New at the Autism Society
	Message from the Autism Society
	Message from the Autism Society Panel of Professional Advisors
	Book Reviews

23.

Question - Not Required - What specific articles have you read recently in the "Autism Advocate" that you found particularly helpful and why?

24.

Question - Not Required - How has reading the "Autism Advocate" changed the way you view and think about autism?

*25.

Question - Required - Do you recommend the "Autism Advocate" to other parents or professionals?

*26.

Question - Required - Do you read advertisements in the "Autism Advocate" to gain information about available products and services?

*27.

Question - Required - Have you purchased a product or service because you saw it advertised in the "Autism Advocate"?

28.

Question - Not Required - What other publications do you read regarding autism?

(Maximum response 255 chars, approx. 5 rows of text)

29.

Question - Not Required - Please share with us any comments you have regarding your experience treating and caring for individuals on the autism spectrum.

Optional questions:

30.

Question - Not Required - What is your gender?

31.