Autism Counselling in Alexandria, NSW

Photo of Eka Goh - Luka | Counselling & Positive Behaviour Support, MC, ACA-L2, Counsellor
Luka | Counselling & Positive Behaviour Support
Counsellor, MC, ACA-L2
Verified Verified
1 Endorsed
Alexandria, NSW 2015
My approach is you-centered, which means whilst I would try to gently initiate explorations, you, the client, are always in the driver's seat. Further, my stance on providing trauma-informed care includes acknowledging that some of our pasts can still be a place too hard to revisit, too unbearable to face. I affirm that to do a deep work together does not necessarily need a revisit the gory details of your traumatic past. Still, trauma is a shadow with many faces; people also process differently. So when you'd wish & your safety toolkit is in place, I will be walking with you through every step of opening that can.
My approach is you-centered, which means whilst I would try to gently initiate explorations, you, the client, are always in the driver's seat. Further, my stance on providing trauma-informed care includes acknowledging that some of our pasts can still be a place too hard to revisit, too unbearable to face. I affirm that to do a deep work together does not necessarily need a revisit the gory details of your traumatic past. Still, trauma is a shadow with many faces; people also process differently. So when you'd wish & your safety toolkit is in place, I will be walking with you through every step of opening that can.
(02) 9100 0459 View (02) 9100 0459
Photo of Amy Newsom, PsyBA General, Psychologist
Amy Newsom
Psychologist, PsyBA General
Verified Verified
1 Endorsed
Alexandria, NSW 2015
“I am so looking forward to getting to know you as a unique individual, and working together to create the life you wish for. I believe that creating sustainable change is only possible when working with people holistically. I have always cringed at traditional, clinical styles of therapy, so instead I am committed to treating you as a real person and working together to help you live your best life. I love it when people take a proactive approach to their mental health. There isn’t a day that goes by where I don’t appreciate how much of a privilege it is to get to know my clients and work together with them in a meaningful way"
“I am so looking forward to getting to know you as a unique individual, and working together to create the life you wish for. I believe that creating sustainable change is only possible when working with people holistically. I have always cringed at traditional, clinical styles of therapy, so instead I am committed to treating you as a real person and working together to help you live your best life. I love it when people take a proactive approach to their mental health. There isn’t a day that goes by where I don’t appreciate how much of a privilege it is to get to know my clients and work together with them in a meaningful way"
(02) 8355 9708 View (02) 8355 9708
Photo of Tal Schlosser - MyLife Psychologists, MPsych, PsyBA - Clin. Psych, Psychologist
MyLife Psychologists
Psychologist, MPsych, PsyBA - Clin. Psych
Verified Verified
Alexandria, NSW 2015
Our team of experienced Clinical Psychologists provide help to adults, adolescents and couples navigating a wide variety of mental health concerns and challenges. We understand that life can be challenging, and everyone deserves compassionate and professional guidance to navigate these difficulties. At MyLife Psychologists, we're dedicated to helping you achieve your goals. Whether you're feeling overwhelmed, stuck, or unsure of the next steps to take, we're here to help. It’s important to us that you feel heard and understood – and that you’re not alone.
Our team of experienced Clinical Psychologists provide help to adults, adolescents and couples navigating a wide variety of mental health concerns and challenges. We understand that life can be challenging, and everyone deserves compassionate and professional guidance to navigate these difficulties. At MyLife Psychologists, we're dedicated to helping you achieve your goals. Whether you're feeling overwhelmed, stuck, or unsure of the next steps to take, we're here to help. It’s important to us that you feel heard and understood – and that you’re not alone.
(02) 9100 0547 View (02) 9100 0547
Photo of Jane Rabie- Play Therapist, AASW, Clinical Social Work/Therapist
Jane Rabie- Play Therapist
Clinical Social Work/Therapist, AASW
Verified Verified
1 Endorsed
Alexandria, NSW 2015
Often children don’t have words to describe their experiences and feelings and instead reveal them through behaviours which can be misunderstood. They may get into trouble, be labelled, or disconnect. I work with children and families just like this. As a carer, reaching out for support can be the hardest step. I work closely with you and your child through Play Therapy which is relationship based therapy for children aged 3-12 years. Play is a child’s natural way of communicating and Play Therapy creates the environment where the therapist enters into a child’s world and understands the experience from their perspective.
Often children don’t have words to describe their experiences and feelings and instead reveal them through behaviours which can be misunderstood. They may get into trouble, be labelled, or disconnect. I work with children and families just like this. As a carer, reaching out for support can be the hardest step. I work closely with you and your child through Play Therapy which is relationship based therapy for children aged 3-12 years. Play is a child’s natural way of communicating and Play Therapy creates the environment where the therapist enters into a child’s world and understands the experience from their perspective.
(02) 9100 0607 View (02) 9100 0607
Photo of Alex Dunwoodie, MC, PACFA, Psychotherapist
Alex Dunwoodie
Psychotherapist, MC, PACFA
Verified Verified
Alexandria, NSW 2015
I am a Person-centred Counsellor and Psychotherapist, my goal is to create a safe and nurturing space where clients can explore their strengths, develop coping strategies, and enhance their self-awareness. I provide support for a wide range of mental health concerns including trauma, anxiety, depression, relationship issues, life transitions, parenting and personal growth.
I am a Person-centred Counsellor and Psychotherapist, my goal is to create a safe and nurturing space where clients can explore their strengths, develop coping strategies, and enhance their self-awareness. I provide support for a wide range of mental health concerns including trauma, anxiety, depression, relationship issues, life transitions, parenting and personal growth.
(02) 8000 0822 View (02) 8000 0822
Photo of Katie Summerfield - Heart Of Play Therapy Katie Summerfield
Heart Of Play Therapy Katie Summerfield
Verified Verified
Alexandria, NSW 2015
Like a flower, we bloom in the right environment; in the play therapy room I work with empathy and acceptance to create a safe space for children and families in order for them to work through their issues and “grow”. I recognise the importance of family and offer assistance to parents and carers to work towards a safer, happier and more relaxed home environment in a strength-based way. Child-centred Play Therapy is a gentle, trauma-informed and neuro-affirming way of supporting children in their unique reactions to coping with daily life, big life events or trauma and attachment issues.
Like a flower, we bloom in the right environment; in the play therapy room I work with empathy and acceptance to create a safe space for children and families in order for them to work through their issues and “grow”. I recognise the importance of family and offer assistance to parents and carers to work towards a safer, happier and more relaxed home environment in a strength-based way. Child-centred Play Therapy is a gentle, trauma-informed and neuro-affirming way of supporting children in their unique reactions to coping with daily life, big life events or trauma and attachment issues.
(02) 9100 0375 View (02) 9100 0375

More Therapists Nearby

Photo of Ruth Minkov, MA, PsyBA General, Psychologist
Ruth Minkov
Psychologist, MA, PsyBA General
Verified Verified
Sydney, NSW 2000
I offer neuroaffirming neuropsychological, academic, Autism and ADHD assessment for teens and adults, both via Telehealth and in Abbotsford, Melbourne. I have a strong professional interest in identification of Autism in women and non-binary people, and my assessments take into consideration cultural differences and "masking". I offer follow-up sessions to assist you to process the diagnosis (or absence of a diagnosis), and to implement recommendations. I am experienced in working with the NDIS.
I offer neuroaffirming neuropsychological, academic, Autism and ADHD assessment for teens and adults, both via Telehealth and in Abbotsford, Melbourne. I have a strong professional interest in identification of Autism in women and non-binary people, and my assessments take into consideration cultural differences and "masking". I offer follow-up sessions to assist you to process the diagnosis (or absence of a diagnosis), and to implement recommendations. I am experienced in working with the NDIS.
(03) 7003 2743 View (03) 7003 2743
Photo of Gemma Illescas - always flying psychology, PsyBA General, Psychologist
always flying psychology
Psychologist, PsyBA General
Verified Verified
Sydney, NSW 2000
I work with children, adolescents and adults. Areas of expertise, ADHD, Sport & Performance Psychology. Clinics in Wahroonga, St Leonards & Kincumber. Other areas of work, Autism, Intellectual Disability, Behaviour challenges, Specific Learning Disorders, Anxiety, Depression, in the background of Trauma Informed Practices. Conduct ADHD assessments.
I work with children, adolescents and adults. Areas of expertise, ADHD, Sport & Performance Psychology. Clinics in Wahroonga, St Leonards & Kincumber. Other areas of work, Autism, Intellectual Disability, Behaviour challenges, Specific Learning Disorders, Anxiety, Depression, in the background of Trauma Informed Practices. Conduct ADHD assessments.
(02) 9158 6576 View (02) 9158 6576
Photo of Krysia Kostrz, MPsych, PsyBA General, Psychologist
Krysia Kostrz
Psychologist, MPsych, PsyBA General
Verified Verified
Sydney, NSW 2000  (Online Only)
Hi there! I provide Therapy for All Adolescents (16+) and Adults for Anxiety, Depression, Stress, ADHD support and sensory and learning differences. I also provide ADHD and Autism assessments for Adults via Telehealth. Appointments are available after hours and on weekends, and I have appointments available in the next 1-2 weeks. I love working with people who seek to discover more about themselves, I'm lucky to be part of that moment of realisation, of clarity and understanding - when everything finally makes sense! My work is personal, relational and collective.
Hi there! I provide Therapy for All Adolescents (16+) and Adults for Anxiety, Depression, Stress, ADHD support and sensory and learning differences. I also provide ADHD and Autism assessments for Adults via Telehealth. Appointments are available after hours and on weekends, and I have appointments available in the next 1-2 weeks. I love working with people who seek to discover more about themselves, I'm lucky to be part of that moment of realisation, of clarity and understanding - when everything finally makes sense! My work is personal, relational and collective.
(03) 4245 1035 View (03) 4245 1035
Photo of Anna Costello, Psychotherapist
Anna Costello
Psychotherapist
Verified Verified
Potts Point, NSW 2011
I'm Anna, a Psychotherapist and Art Psychotherapist I am registered with the Psychotherapy and Counselling Federation of Australia. I offer children, young people and their families a safe space to talk about what is going on for them. I believe visiting your therapist should be as routine as going to the gym. I've gained experience at Headspace, I have been working at Child Development Solutions for years where I facilitate social skills groups for children and young people on the Autism and/or ADHD spectrum and ODD. I am gentle and empathetic in my approach.
I'm Anna, a Psychotherapist and Art Psychotherapist I am registered with the Psychotherapy and Counselling Federation of Australia. I offer children, young people and their families a safe space to talk about what is going on for them. I believe visiting your therapist should be as routine as going to the gym. I've gained experience at Headspace, I have been working at Child Development Solutions for years where I facilitate social skills groups for children and young people on the Autism and/or ADHD spectrum and ODD. I am gentle and empathetic in my approach.
(07) 4520 2366 View (07) 4520 2366
Photo of Ayna Hennessy, MA, PACFA, Counsellor
Ayna Hennessy
Counsellor, MA, PACFA
Verified Verified
2 Endorsed
Sydney, NSW 2000  (Online Only)
Overwhelmed? I have lived experience and extensive knowledge of the complexities of ADHD, Sensory Processing, Autism, disordered eating & chronic pain. My unique life with exposure to diversity and unexpected curveballs has shaped me into an insightful, reflective and understanding counsellor. My thirst for knowledge, hyper-focus skills and resolve to fight led to me seeking out my own answers surrounding my health. It finally paid off, & I hope it can help you. I am now treated/mentored/supervised and trained by the MVPs in ADHD & Autism & its many comorbidities. I do not refuse vulnerable & complex clients; I used to be one.
Overwhelmed? I have lived experience and extensive knowledge of the complexities of ADHD, Sensory Processing, Autism, disordered eating & chronic pain. My unique life with exposure to diversity and unexpected curveballs has shaped me into an insightful, reflective and understanding counsellor. My thirst for knowledge, hyper-focus skills and resolve to fight led to me seeking out my own answers surrounding my health. It finally paid off, & I hope it can help you. I am now treated/mentored/supervised and trained by the MVPs in ADHD & Autism & its many comorbidities. I do not refuse vulnerable & complex clients; I used to be one.
(03) 7003 2926 View (03) 7003 2926
Photo of Theodora (Dora) Binasis, PsyBA - Clin. Psych, Psychologist
Theodora (Dora) Binasis
Psychologist, PsyBA - Clin. Psych
Verified Verified
Dulwich Hill, NSW 2203
Not accepting new clients
I am a passionate and dedicated Clinical Psychologist specialising in work with children and their families with a demonstrated history of working in private and community mental health settings. I work with and support people with a range of mental health goals including emotion regulation, anxiety, behaviour, tics, trauma, with a special interest in Autism, ADHD, and Selective Mutism. I am particularly passionate about working with neurodivergent individuals in an affirming manner. I hope to educate families and the wider community about Neurodivergence not being a disorder but rather a unique way of experiencing one's world.
I am a passionate and dedicated Clinical Psychologist specialising in work with children and their families with a demonstrated history of working in private and community mental health settings. I work with and support people with a range of mental health goals including emotion regulation, anxiety, behaviour, tics, trauma, with a special interest in Autism, ADHD, and Selective Mutism. I am particularly passionate about working with neurodivergent individuals in an affirming manner. I hope to educate families and the wider community about Neurodivergence not being a disorder but rather a unique way of experiencing one's world.
(02) 8105 5138 View (02) 8105 5138
Photo of Anne-Maree Armstrong - Art Therapy Creates, AThR, Counsellor
Art Therapy Creates
Counsellor, AThR
Verified Verified
Saint Peters, NSW 2044
I have extensive experience working and supporting children, young people and adults with Mood Disorders and with children on the Aspergers Autism spectrum.
I am an Art Therapist who is committed to support the development of my clients, physical, mental and emotional wellbeing. Art therapy creates a visual language of communication and personal expression as an alternative to 'talk only' therapy, when words or feelings are hard to express. My person-centred and psychodynamic approach to therapy is also informed by IFS and Mindfulness practice. I am a creative and thoughtful individual who works in a collaborative and compassionate manner with children, young people and adults when their emotions, thinking and behaviour is out of balance.
I have extensive experience working and supporting children, young people and adults with Mood Disorders and with children on the Aspergers Autism spectrum.
I am an Art Therapist who is committed to support the development of my clients, physical, mental and emotional wellbeing. Art therapy creates a visual language of communication and personal expression as an alternative to 'talk only' therapy, when words or feelings are hard to express. My person-centred and psychodynamic approach to therapy is also informed by IFS and Mindfulness practice. I am a creative and thoughtful individual who works in a collaborative and compassionate manner with children, young people and adults when their emotions, thinking and behaviour is out of balance.
(02) 8069 5430 View (02) 8069 5430
Photo of Arzu Aksu Chapman, ACA-L2, Counsellor
Arzu Aksu Chapman
Counsellor, ACA-L2
Verified Verified
1 Endorsed
Sydney, NSW 2000
Tailored strategies for ADHD and Autism empower individuals, while couples benefit from a nuanced understanding of neurodivergent dynamics and LGBTQ+ relationship nuances.
You, seeking understanding and connection in a world that often feels overwhelming. My ideal client navigates the intricate landscape of neurodivergence—be it ADHD, Autism, or related experiences. In couples, I welcome those facing unique dynamics, including neurodivergent and LGBTQ+ pairs. Your issues may vary, but the core need is universal: a safe space to explore challenges, cultivate understanding, and forge a path towards fulfillment. As a passionate therapist specializing in neurodiversity and couples therapy, my approach transcends conventional methods. Let's embark on a journey where acceptance and growth intersect.
Tailored strategies for ADHD and Autism empower individuals, while couples benefit from a nuanced understanding of neurodivergent dynamics and LGBTQ+ relationship nuances.
You, seeking understanding and connection in a world that often feels overwhelming. My ideal client navigates the intricate landscape of neurodivergence—be it ADHD, Autism, or related experiences. In couples, I welcome those facing unique dynamics, including neurodivergent and LGBTQ+ pairs. Your issues may vary, but the core need is universal: a safe space to explore challenges, cultivate understanding, and forge a path towards fulfillment. As a passionate therapist specializing in neurodiversity and couples therapy, my approach transcends conventional methods. Let's embark on a journey where acceptance and growth intersect.
(02) 8403 1928 View (02) 8403 1928
Photo of Tara Megan Scott - Tara - Cathartic Collaborations, AASW, Clinical Social Work/Therapist
Tara - Cathartic Collaborations
Clinical Social Work/Therapist, AASW
Verified Verified
1 Endorsed
Sydney, NSW 2000
Hello! I'm Tara (they/them). I have immediate availability for therapeutic support in person in Nundah, Brisbane or telehealth Australia wide. I am queer, neurodivergent (Autism & ADHD) and non-binary. I am passionate about providing therapeutic support to neurodivergent (particularly Autistic folks and ADHDers) and LGBTQIA+ adolescents and young adults.
Hello! I'm Tara (they/them). I have immediate availability for therapeutic support in person in Nundah, Brisbane or telehealth Australia wide. I am queer, neurodivergent (Autism & ADHD) and non-binary. I am passionate about providing therapeutic support to neurodivergent (particularly Autistic folks and ADHDers) and LGBTQIA+ adolescents and young adults.
(07) 2100 4431 View (07) 2100 4431
Photo of Nikki Bray, MPsych, PsyBA General, Psychologist
Nikki Bray
Psychologist, MPsych, PsyBA General
Verified Verified
3 Endorsed
Sydney, NSW 2000  (Online Only)
I offer neuroaffirming Autism assessments for adults.
Clinical Psychologist and Owner at BrayPsych Clinical Psychology on the Gold Coast. I have availability for new adult clients for therapy via telehealth only. I also offer neuroaffirming Autism assessments for adults. I I like to describe myself as an enthusiastic and compassionate therapist. My values are empowerment, self-advocacy and authenticity. I provide support for adults experiencing depression, anxiety, stress, panic, phobias, OCD, chronic pain, emotion dysregulation difficulties, insomnia, perimenopause, low self-esteem, perfectionism, autistic burnout, and supporting neurodivergent adults.
I offer neuroaffirming Autism assessments for adults.
Clinical Psychologist and Owner at BrayPsych Clinical Psychology on the Gold Coast. I have availability for new adult clients for therapy via telehealth only. I also offer neuroaffirming Autism assessments for adults. I I like to describe myself as an enthusiastic and compassionate therapist. My values are empowerment, self-advocacy and authenticity. I provide support for adults experiencing depression, anxiety, stress, panic, phobias, OCD, chronic pain, emotion dysregulation difficulties, insomnia, perimenopause, low self-esteem, perfectionism, autistic burnout, and supporting neurodivergent adults.
View
Photo of Lisa Formosa
Lisa Formosa
Verified Verified
1 Endorsed
Sydney, NSW 2000  (Online Only)
Receive individualised support to create the life you choose. Choose a practitioner who understands Autism, ADHD, neurodivergence, high sensitivity and introversion. Share what its like inhabiting a world that hasn’t understood you. Develop your inner self knowledge. Access Neurodiversity Affirmative Practice.
Receive individualised support to create the life you choose. Choose a practitioner who understands Autism, ADHD, neurodivergence, high sensitivity and introversion. Share what its like inhabiting a world that hasn’t understood you. Develop your inner self knowledge. Access Neurodiversity Affirmative Practice.
(03) 7302 8068 View (03) 7302 8068
Photo of Thalia Koulas - Therapy Shmerapy, ACA-L2, Counsellor
Thalia Koulas - Therapy Shmerapy
Counsellor, ACA-L2
Verified Verified
3 Endorsed
Sydney, NSW 2000  (Online Only)
Therapy Shmerapy specialises in supporting the LGBTQIA+ and neurodivergent communities, with focus on autism, ADHD, LGBTQIA+ issues, and complex trauma. I have experience working with people aged 14 and above. I aim to create a non-judgmental space, ensuring inclusivity and genuineness in every session. I can work with people at all stages of life, from queer people out in the community, to people suspecting they may be autistic. I take particular interest in AFAB and neurodivergent people, and the entire LGBTQIA+ community. I am not suitable for people seeking CBT.
Therapy Shmerapy specialises in supporting the LGBTQIA+ and neurodivergent communities, with focus on autism, ADHD, LGBTQIA+ issues, and complex trauma. I have experience working with people aged 14 and above. I aim to create a non-judgmental space, ensuring inclusivity and genuineness in every session. I can work with people at all stages of life, from queer people out in the community, to people suspecting they may be autistic. I take particular interest in AFAB and neurodivergent people, and the entire LGBTQIA+ community. I am not suitable for people seeking CBT.
View
Photo of Lachlan King, PsyBA General, Psychologist
Lachlan King
Psychologist, PsyBA General
Verified Verified
Surry Hills, NSW 2010  (Online Only)
I am a Registered Psychologist with experience working with various presentations pertaining to neurodiversity (e.g. Autism and ADHD), anxiety, depression, familial challenges, sexuality and relationship challenges. I also have an interest in sports psychology and HR selection. I am passionate in supporting my clients to navigate barriers and empower them to live fulfilling lives. I like to think my approach is professional and insightful but warm and authentic at the same time.
I am a Registered Psychologist with experience working with various presentations pertaining to neurodiversity (e.g. Autism and ADHD), anxiety, depression, familial challenges, sexuality and relationship challenges. I also have an interest in sports psychology and HR selection. I am passionate in supporting my clients to navigate barriers and empower them to live fulfilling lives. I like to think my approach is professional and insightful but warm and authentic at the same time.
View
Photo of Dr Shelley Viskovich, PhD, MAPS, Psychologist
Dr Shelley Viskovich
Psychologist, PhD, MAPS
Verified Verified
Sydney, NSW 2000
I offer neurodivergent affirming assessments (17+ Autism/ADHD) in person at Pullenvale (Queensland) and via telehealth.
Assessment only - therapy books are closed, I am not waitlisting clients, and sadly I am unable to provide referral options. Welcome and thanks for taking the time to view my profile. I am a clinical psychologist specialising in assessing complex neurodivergent clients (Autism, ADHD, PDA, BPD, CPTSD, Bipolar, OCD) particularly those who do not present in stereotypical ways or mask heavily, preventing earlier identification. Being neurodivergent myself, I have lived experience in addition to extensive clinical training to support clients.
I offer neurodivergent affirming assessments (17+ Autism/ADHD) in person at Pullenvale (Queensland) and via telehealth.
Assessment only - therapy books are closed, I am not waitlisting clients, and sadly I am unable to provide referral options. Welcome and thanks for taking the time to view my profile. I am a clinical psychologist specialising in assessing complex neurodivergent clients (Autism, ADHD, PDA, BPD, CPTSD, Bipolar, OCD) particularly those who do not present in stereotypical ways or mask heavily, preventing earlier identification. Being neurodivergent myself, I have lived experience in addition to extensive clinical training to support clients.
View

See more therapy options for Alexandria

Autism Counsellors

What is the most effective treatment for autism?

Applied Behavior Analysis (ABA) has come to be considered the standard treatment for children with autism spectrum disorder, and research has confirmed its effectiveness for many children. Therapists trained in ABA techniques work with children (and their parents) on developing social skills, communication and learning abilities, and everyday habits of hygiene and grooming. The clinician will tailor their program to the child’s particular need but the overarching goal will be to help them advance as far as possible toward independence based on their level of symptoms and decrease the need for additional special services. Families should seek a mental health professional specifically trained in ABA, and holding special certification in the technique, who has extensive experience not only with the approach but in using it with children with the same level of symptoms as the child who needs care.

How does ABA work?

Applied Behavior Analysis (ABA) sessions, which typically focus on positive reinforcement, can be intensive, lasting two or more hours several times a week, and continuing for two years or more. Therapists can also be expected to ask parents to take an active role in reinforcing lessons. Research has found that the technique can lead to major improvements that decrease the need for additional special services.

How does treatment for autism work?

Therapy sessions based on Applied Behavior Analysis will likely be frequent, intensive, and highly structured. After a thorough assessment, a therapist will help a child understand and develop skills in a range of areas, including communication, motor skills, social skills, self-care, play, and academic skills, as well as routines of daily living like hygiene. Typically, the therapist will help a child break down the components of a behavior—often referred to as the antecedent (what prompts an action), the behavior, and the consequence(what immediately follows)—and then reward the child at every step, while also asking parents to reinforce the lessons, and the rewards, throughout the day. This core therapy may be supplemented by occupational or speech therapy, and antidepressants, antipsychotics, and anticonvulsants may be prescribed to address specific severe symptoms.

How long does therapy for autism take?

Some people with autism spectrum disorder may be engaged in some level of therapy for many years, but research shows that treatment will be most effective if it is begun early and delivered intensively. When therapy begins by age 3, children tend to be better able to grasp and adopt the skills needed to manage everyday life, including attending school and establishing social relationships. This type of early-intervention treatment regimen is highly structured, typically involving 20 to 40 hours of one-on-one therapy per week, along with additional hours of engagement managed by parents, for a period of two years or more, although the duration of treatment is dependent on the child’s level of symptoms and pace of progress.