Photo of Paige Palsgaard, Counselor in Arizona
Paige Palsgaard
Counselor, MC, LAC
Verified Verified
Scottsdale, AZ 85254
My specialities include, but are not limited to: children, teens, young Adults, play therapy/sand tray, expressive arts interventions, depression, anxiety, Autism/ADHD, grief and loss, trauma, and stress management.
Children are incredibly resilient and honest and I strive to create as much space for autonomy and self-efficacy as a counselor. I have found that play therapy, expressive arts, and sand tray allows for children to express themselves in a natural and inviting way as well as create opportunities for children to learn to self-regulate and communicate their needs.
My specialities include, but are not limited to: children, teens, young Adults, play therapy/sand tray, expressive arts interventions, depression, anxiety, Autism/ADHD, grief and loss, trauma, and stress management.
Children are incredibly resilient and honest and I strive to create as much space for autonomy and self-efficacy as a counselor. I have found that play therapy, expressive arts, and sand tray allows for children to express themselves in a natural and inviting way as well as create opportunities for children to learn to self-regulate and communicate their needs.
(602) 483-6240 View (602) 483-6240
Photo of Lori Lichte-Brill, Psychologist in Arizona
Lori Lichte-Brill
Psychologist, PsyD
Verified Verified
1 Endorsed
Phoenix, AZ 85029
You don't have to do this alone. I have 20 years of experience dealing with issues affecting young children and their caregivers. I provide psychological assessment and treatment for Autism Spectrum Disorders (children and adults), parent/child relationship issues, abuse/trauma/neglect, and attachment/foster-care/adoption issues. All family members can receive assessment and treatment, regardless of age, in order to improve individual and family functioning, and the experience of joy. I also assess children in their school or daycare setting, and provide assistance with IEP/IFSP meetings. I use both relational and behavioral strategies for treatment.
You don't have to do this alone. I have 20 years of experience dealing with issues affecting young children and their caregivers. I provide psychological assessment and treatment for Autism Spectrum Disorders (children and adults), parent/child relationship issues, abuse/trauma/neglect, and attachment/foster-care/adoption issues. All family members can receive assessment and treatment, regardless of age, in order to improve individual and family functioning, and the experience of joy. I also assess children in their school or daycare setting, and provide assistance with IEP/IFSP meetings. I use both relational and behavioral strategies for treatment.
(623) 850-8954 View (623) 850-8954
Photo of Erika Huber, Counselor in Arizona
Erika Huber
Counselor, MS, LPC
Verified Verified
4 Endorsed
Tucson, AZ 85704
I love working with adults and adolescents on the Autism Spectrum.
My approach to therapy is to listen with a warm and empathic ear so that you can feel heard and begin to heal. I believe you have it within you to grow and change, and my role is to guide therapy and encourage you along the way. I will provide you with feedback and insight and consider myself to be a partner in your healing journey.
I love working with adults and adolescents on the Autism Spectrum.
My approach to therapy is to listen with a warm and empathic ear so that you can feel heard and begin to heal. I believe you have it within you to grow and change, and my role is to guide therapy and encourage you along the way. I will provide you with feedback and insight and consider myself to be a partner in your healing journey.
(520) 231-7165 View (520) 231-7165
Photo of Amanda Hackwell, Psychologist in Arizona
Amanda Hackwell
Psychologist, PhD, NCSP
Verified Verified
Phoenix, AZ 85028
Specialty areas include psycho-educational assessment, with specialties in autism spectrum disorder (ASD), dyslexia, learning disabilities, Attention Deficit Hyperactivity Disorder (ADHD), and giftedness.
Pre-book a free 30-minute consultation through our website. Our intake coordinator can answer your questions and help schedule your evaluation. www.amandahackwell.com/contact
Specialty areas include psycho-educational assessment, with specialties in autism spectrum disorder (ASD), dyslexia, learning disabilities, Attention Deficit Hyperactivity Disorder (ADHD), and giftedness.
Pre-book a free 30-minute consultation through our website. Our intake coordinator can answer your questions and help schedule your evaluation. www.amandahackwell.com/contact
(602) 675-3288 View (602) 675-3288
Photo of Anna Bernasconi, Counselor in Arizona
Anna Bernasconi
Counselor, LAC
Verified Verified
Scottsdale, AZ 85251
Accepting New Clients. Welcome! I have over six years of experience working with teenagers and adults. I specialize in working with clients who have gender identity issues, including transgender, those on the Autism spectrum, ADHD, sex and pornography addiction, Men's issues, family relationship problems, personality disorders, self-harming and suicidal ideation. My therapeutic approaches I use include supportive counseling, person-centered, strengths-based, CBT, DBT and trauma informed. I am a gender affirming therapist.
Accepting New Clients. Welcome! I have over six years of experience working with teenagers and adults. I specialize in working with clients who have gender identity issues, including transgender, those on the Autism spectrum, ADHD, sex and pornography addiction, Men's issues, family relationship problems, personality disorders, self-harming and suicidal ideation. My therapeutic approaches I use include supportive counseling, person-centered, strengths-based, CBT, DBT and trauma informed. I am a gender affirming therapist.
(480) 482-1838 View (480) 482-1838
Photo of Melissa Joy Hahnke, Counselor in Arizona
Melissa Joy Hahnke
Counselor, LAC
Verified Verified
1 Endorsed
Phoenix, AZ 85032
Waitlist for new clients
Melissa has experience providing support for a variety of concerns including depression, anxiety, eating disorders, dissociative disorders, mood disorders, personality disorders, traumatic history, relationship concerns, family conflict, phase-of-life concerns, discrimination, bullying, substance use, chronic illness, grief, ADHD, OCD, and autism.
As an autistic person herself, Melissa is passionate about working with neurodivergent individuals and operates from a neuroaffirmative lens. Melissa prioritizes collaboration in the therapeutic process, believing that each person is the expert of their life–every person is different, with a unique set of lived experiences, identities, and perspectives, so she believes that treatment should be unique to each person, too. Treatment involves community and self-advocacy, incorporating intersectional cultural identities, supporting clients’ personal treatment goals, fostering self-compassion, and building community support.
Melissa has experience providing support for a variety of concerns including depression, anxiety, eating disorders, dissociative disorders, mood disorders, personality disorders, traumatic history, relationship concerns, family conflict, phase-of-life concerns, discrimination, bullying, substance use, chronic illness, grief, ADHD, OCD, and autism.
As an autistic person herself, Melissa is passionate about working with neurodivergent individuals and operates from a neuroaffirmative lens. Melissa prioritizes collaboration in the therapeutic process, believing that each person is the expert of their life–every person is different, with a unique set of lived experiences, identities, and perspectives, so she believes that treatment should be unique to each person, too. Treatment involves community and self-advocacy, incorporating intersectional cultural identities, supporting clients’ personal treatment goals, fostering self-compassion, and building community support.
(602) 609-5954 View (602) 609-5954
Kacey Chandler
Psychologist, PhD
Verified Verified
Tucson, AZ 85716
I support children, adolescents, adults and families affected by autism spectrum disorder (ASD) and other social communication disorders. I conduct comprehensive evaluations of ASD, consult with families on home, school and community challenges, provide individual therapy and conduct 'Social Thinking' and social communication groups for children, adolescents and adults.
I support children, adolescents, adults and families affected by autism spectrum disorder (ASD) and other social communication disorders. I conduct comprehensive evaluations of ASD, consult with families on home, school and community challenges, provide individual therapy and conduct 'Social Thinking' and social communication groups for children, adolescents and adults.
(520) 214-0870 View (520) 214-0870
Photo of Brooke Hoeferle, Counselor in Arizona
Brooke Hoeferle
Counselor, MA, LAC
Verified Verified
1 Endorsed
Phoenix, AZ 85048
Hello my name is Brooke! I primarily work with children, teens, and young adults, and support individuals navigating anxiety, depression, ADHD, Autism, and behavioral challenges, as well as those with learning and developmental differences, including gifted and twice exceptional individuals. I specialize in rebuilding parent-child relationships, addressing attachment wounds, and enhancing communication among family members.
Hello my name is Brooke! I primarily work with children, teens, and young adults, and support individuals navigating anxiety, depression, ADHD, Autism, and behavioral challenges, as well as those with learning and developmental differences, including gifted and twice exceptional individuals. I specialize in rebuilding parent-child relationships, addressing attachment wounds, and enhancing communication among family members.
(602) 844-4198 View (602) 844-4198
Photo of Davis Psychology, Education, & Behavior Solutions, Psychologist in Arizona
Davis Psychology, Education, & Behavior Solutions
Psychologist, PhD
Verified Verified
Scottsdale, AZ 85260
Dr. Debra Davis utilizes evidence-based diagnostic and treatment practices and specializes in psycho-educational evaluations; learning disabilities; functional behavior assessments; applied behavior analysis; cognitive behavior and behavior therapy; parent consultation and training; teacher consultation; ADHD; autism; developmental disabilities; and parenting of children experiencing chronic illness or divorce.
Dr. Debra Davis utilizes evidence-based diagnostic and treatment practices and specializes in psycho-educational evaluations; learning disabilities; functional behavior assessments; applied behavior analysis; cognitive behavior and behavior therapy; parent consultation and training; teacher consultation; ADHD; autism; developmental disabilities; and parenting of children experiencing chronic illness or divorce.
(480) 467-5498 View (480) 467-5498
Photo of Carol McLean, Psychologist in Arizona
Carol McLean
Psychologist, PhD
Verified Verified
Scottsdale, AZ 85260
McLean and her team specialize in the early identification of Autism Spectrum Disorder beginning at 12 months of age through 16 years of age.
Dr. Carol McLean, Ph.D., has been in private practice since 2003. She specializes in development throughout the lifespan. Developmental & Educational Psychological Services provides high quality comprehensive assessments to identify numerous psychological and developmental conditions. Psychological assessment is a valuable tool for exploring issues to determine treatment and access intervention and support. Without accurate identification of a developmental or psychological condition it is difficult to effectively treat symptoms. Get a clear understanding of your child’s psychological or developmental issues.
McLean and her team specialize in the early identification of Autism Spectrum Disorder beginning at 12 months of age through 16 years of age.
Dr. Carol McLean, Ph.D., has been in private practice since 2003. She specializes in development throughout the lifespan. Developmental & Educational Psychological Services provides high quality comprehensive assessments to identify numerous psychological and developmental conditions. Psychological assessment is a valuable tool for exploring issues to determine treatment and access intervention and support. Without accurate identification of a developmental or psychological condition it is difficult to effectively treat symptoms. Get a clear understanding of your child’s psychological or developmental issues.
(480) 405-1003 View (480) 405-1003
Photo of Jessica M Trotter, LPC Intern in Arizona
Jessica M Trotter
LPC Intern
Verified Verified
1 Endorsed
Tempe, AZ 85282
My passion is individuals and families affected by the autism spectrum.
I am an intern at Raise Behavioral Health Service, offer counseling to children, adolescents, families and individuals. I have a passion or aiding others who may be going through a rough time or phase of life change. I like to look at behaviors in a very analytical way as I was also an in home behavioral coach for children with high behavioral needs. Raise offers a free consult call, so call today and see if I am a good fit for you!
My passion is individuals and families affected by the autism spectrum.
I am an intern at Raise Behavioral Health Service, offer counseling to children, adolescents, families and individuals. I have a passion or aiding others who may be going through a rough time or phase of life change. I like to look at behaviors in a very analytical way as I was also an in home behavioral coach for children with high behavioral needs. Raise offers a free consult call, so call today and see if I am a good fit for you!
(602) 878-8605 View (602) 878-8605
Photo of Nicole Schuster, Counselor in Arizona
Nicole Schuster
Counselor, LAC
Verified Verified
Tempe, AZ 85283
I also utilize motivational interview, CBT, and have training in Autism.
I find great joy in helping clients who vary in presentation from anxiety to suicidal ideation to trauma. I work with young adults and teens who may be experiencing difficulty with perfectionism, developing relationships, family dynamics, identity development and various other difficulties. Helping clients reveal and create an identity that feels authentic to them is especially important to me. I firmly believe that people know themselves best; they just need the right environment to encourage this. Connection and acceptance along with gentle challenging is key to my approach with clients.
I also utilize motivational interview, CBT, and have training in Autism.
I find great joy in helping clients who vary in presentation from anxiety to suicidal ideation to trauma. I work with young adults and teens who may be experiencing difficulty with perfectionism, developing relationships, family dynamics, identity development and various other difficulties. Helping clients reveal and create an identity that feels authentic to them is especially important to me. I firmly believe that people know themselves best; they just need the right environment to encourage this. Connection and acceptance along with gentle challenging is key to my approach with clients.
(520) 457-7203 View (520) 457-7203
Photo of Arizona Psychology Clinic; Dr Shalini Wahi, Psychologist in Arizona
Arizona Psychology Clinic; Dr Shalini Wahi
Psychologist, PhD
Verified Verified
Tempe, AZ 85284
The Arizona Psychology Clinic offers Neuropsychological and Psychological Testing Services for ADHD, Learning Disabilities, Autism, Gifted IQ, Twice Exceptional and Personality Issues. Additionally, testing for accommodations on Standardized Tests such as the SAT, ACT and GRE is also offered. Testing protocols for receiving accommodations within school and college settings are a focus of the practice as well.
The Arizona Psychology Clinic offers Neuropsychological and Psychological Testing Services for ADHD, Learning Disabilities, Autism, Gifted IQ, Twice Exceptional and Personality Issues. Additionally, testing for accommodations on Standardized Tests such as the SAT, ACT and GRE is also offered. Testing protocols for receiving accommodations within school and college settings are a focus of the practice as well.
(480) 789-9934 View (480) 789-9934
Photo of Paula J McCall, Psychologist in Arizona
Paula J McCall
Psychologist, PhD, NCSP
Verified Verified
Chandler, AZ 85224
Services include individual assessments related to school performance as well as in the areas of depression, anxiety, Autism, and ADHD.
***I am mostly unable to accept new therapy clients. I am only accepting clients for psychological, psychoeducational, DDD, and gifted evaluations at this time. Wait time for a psychological eval is approximately 6 months. Wait time for a gifted eval is about 4 weeks*** My goal to assist children, teens, and young adults in reaching their full potential. I seek to provide services that better equip a child or adolescent to make positive choices, to overcome and move forward from significant loss and negative experiences, to feel good about him or herself, and to feel capable of achieving all that he or she desires.
Services include individual assessments related to school performance as well as in the areas of depression, anxiety, Autism, and ADHD.
***I am mostly unable to accept new therapy clients. I am only accepting clients for psychological, psychoeducational, DDD, and gifted evaluations at this time. Wait time for a psychological eval is approximately 6 months. Wait time for a gifted eval is about 4 weeks*** My goal to assist children, teens, and young adults in reaching their full potential. I seek to provide services that better equip a child or adolescent to make positive choices, to overcome and move forward from significant loss and negative experiences, to feel good about him or herself, and to feel capable of achieving all that he or she desires.
(480) 685-5896 View (480) 685-5896
Photo of Ashley Lynch Gaede, Licensed Professional Counselor in Arizona
Ashley Lynch Gaede
Licensed Professional Counselor, LPC, BCN
Verified Verified
3 Endorsed
Queen Creek, AZ 85142
Waitlist for new clients
Through my 15 years of being a foster/adopt parent, I have experienced how trauma, attachment, anxiety, learning disorders, Autism, ADHD, and mood disorders, affect daily functioning and the ability to enjoy life. I have come to appreciate how important it is to feel a sense of safety and belonging. We are biologically wired to need connections/relationships for optimal growth and development. However, negative life experiences, the inability to self-regulate our emotions, and or other mental health concerns, can negatively affect the way we interact with others, causing difficulties in building those positive relationships we need.
Through my 15 years of being a foster/adopt parent, I have experienced how trauma, attachment, anxiety, learning disorders, Autism, ADHD, and mood disorders, affect daily functioning and the ability to enjoy life. I have come to appreciate how important it is to feel a sense of safety and belonging. We are biologically wired to need connections/relationships for optimal growth and development. However, negative life experiences, the inability to self-regulate our emotions, and or other mental health concerns, can negatively affect the way we interact with others, causing difficulties in building those positive relationships we need.
(833) 922-0392 View (833) 922-0392
Photo of Marian C Eberly, Clinical Social Work/Therapist in Arizona
Marian C Eberly
Clinical Social Work/Therapist, LCSW, RN
Verified Verified
Phoenix, AZ 85029
Marian C.Eberly LCSW,RN: Dually licensed, Providing a unique blend of compassionate, highly experienced, mental and behavioral health care with 30 years of inpt/outpt treatment center Leadership.Competencies include: treating children, adolescents, families, marriage, adults: integrating the psychological, medical & spiritual needs of a person; with the unique knowledge of understanding the pharmacology, nutrition and medical conditions co-occurring with mental disorders. Exper inDiagnosing mental disorders such as Autism L-1/ (Formerly known as Asbergers) Anxiety/Depressive Disorders & Marriage Counseling and Adolescent Therapy.
Marian C.Eberly LCSW,RN: Dually licensed, Providing a unique blend of compassionate, highly experienced, mental and behavioral health care with 30 years of inpt/outpt treatment center Leadership.Competencies include: treating children, adolescents, families, marriage, adults: integrating the psychological, medical & spiritual needs of a person; with the unique knowledge of understanding the pharmacology, nutrition and medical conditions co-occurring with mental disorders. Exper inDiagnosing mental disorders such as Autism L-1/ (Formerly known as Asbergers) Anxiety/Depressive Disorders & Marriage Counseling and Adolescent Therapy.
(623) 321-2080 View (623) 321-2080
Photo of Tamara Zoch, Psychologist in Arizona
Tamara Zoch
Psychologist, PsyD
Verified Verified
Tucson, AZ 85718
Dr. Tamara Zoch is a licensed psychologist in Arizona and Texas. She currently only provides neuropsychological assessment services (no therapy / counseling). She is a member of the American Psychological Association (APA) and the Society of Clinical Child and Adolescent Psychology (SCCAP). Dr. Zoch’s passion and specialty lie in pediatric psychology, evaluating children and adolescents with suspected neurodevelopmental disorders (e.g., Autism Spectrum Disorder, Global Developmental Delay, Intellectual Disability, Attention-Deficit/Hyperactivity Disorder, and Specific Learning Disorder).
Dr. Tamara Zoch is a licensed psychologist in Arizona and Texas. She currently only provides neuropsychological assessment services (no therapy / counseling). She is a member of the American Psychological Association (APA) and the Society of Clinical Child and Adolescent Psychology (SCCAP). Dr. Zoch’s passion and specialty lie in pediatric psychology, evaluating children and adolescents with suspected neurodevelopmental disorders (e.g., Autism Spectrum Disorder, Global Developmental Delay, Intellectual Disability, Attention-Deficit/Hyperactivity Disorder, and Specific Learning Disorder).
(520) 253-7257 View (520) 253-7257
Photo of Tamara Woodard, Clinical Social Work/Therapist in Arizona
Tamara Woodard
Clinical Social Work/Therapist, LCSW, MSW, ADHD-CS, ASDCS
Verified Verified
Mesa, AZ 85210
Services include individual/family/group counseling & autism evaluations for ages 12 months to young adults.
Are you the type of parent who understands that your child needs more than a bandaid approach or a one-size-fits-all solution for your child? Are outbursts, panic attacks, social anxiety, or shutting down preventing you or a loved one from truly thriving? Perhaps you are a young adult struggling with social anxiety, low self-esteem, and difficulty connecting with others. Tamara can provide you with a customized approach to help with overcoming, not only the immediate challenges of today, but to begin thriving for the future.
Services include individual/family/group counseling & autism evaluations for ages 12 months to young adults.
Are you the type of parent who understands that your child needs more than a bandaid approach or a one-size-fits-all solution for your child? Are outbursts, panic attacks, social anxiety, or shutting down preventing you or a loved one from truly thriving? Perhaps you are a young adult struggling with social anxiety, low self-esteem, and difficulty connecting with others. Tamara can provide you with a customized approach to help with overcoming, not only the immediate challenges of today, but to begin thriving for the future.
(480) 608-9130 View (480) 608-9130
Photo of Heather Koch Gonzales in Arizona
Heather Koch Gonzales
PhD, BCBA-D, LBA
Verified Verified
Phoenix, AZ 85016
I am a firm believer that autism is a distinct neurotype and that neurodivergence is not a condition to be cured or an autistic person radically changed. Instead, I believe that autistic people can be supported in learning skills that can improve their quality of life in a nurturing and collaborative teaching environment that builds on their strengths and interests. I am not qualified to diagnose autism. I am not a counselor or a psychologist. I specifically focus on skill building and problem behavior reduction through ABA.
I am a firm believer that autism is a distinct neurotype and that neurodivergence is not a condition to be cured or an autistic person radically changed. Instead, I believe that autistic people can be supported in learning skills that can improve their quality of life in a nurturing and collaborative teaching environment that builds on their strengths and interests. I am not qualified to diagnose autism. I am not a counselor or a psychologist. I specifically focus on skill building and problem behavior reduction through ABA.
(623) 462-1632 View (623) 462-1632
Photo of Carlos Garcia - Arukah Healthcare, PLLC, Clinical Social Work/Therapist in Arizona
Carlos Garcia - Arukah Healthcare, PLLC
Clinical Social Work/Therapist, LMSW
Verified Verified
Tempe, AZ 85288  (Online Only)
As a bilingual Master Social Worker Licensed in Arizona and pastoral counselor with over 20 years of experience working with children and families, I specialize in using a multicultural approach to assist people with healing from trauma and overcoming issues related to parental attachment, family/couples conflict, autism, and neurodiversity.
Do you feel distant from others and yourself? Do you put yourself last? Should life become better? Happier? People are more anxious, overwhelmed, and confused about maintaining relationships, jobs, and lifestyles than ever. Not taking the time and ignoring your needs can lead to long-term health problems. Healthy living shouldn't be hard. I empower clients to use cultural and spiritual resources for growth, support, and healing in my holistic treatment. I invite clients to explore unique and shared cultural values to enrich and enhance life and create hope for future wellness.
As a bilingual Master Social Worker Licensed in Arizona and pastoral counselor with over 20 years of experience working with children and families, I specialize in using a multicultural approach to assist people with healing from trauma and overcoming issues related to parental attachment, family/couples conflict, autism, and neurodiversity.
Do you feel distant from others and yourself? Do you put yourself last? Should life become better? Happier? People are more anxious, overwhelmed, and confused about maintaining relationships, jobs, and lifestyles than ever. Not taking the time and ignoring your needs can lead to long-term health problems. Healthy living shouldn't be hard. I empower clients to use cultural and spiritual resources for growth, support, and healing in my holistic treatment. I invite clients to explore unique and shared cultural values to enrich and enhance life and create hope for future wellness.
(623) 343-0483 View (623) 343-0483

Autism Therapists

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.