PLAAY Interest Form 
Parent-Led Autism Treatment for At-Risk Young Infants and Toddlers aims to pilot an innovative treatment procedure to facilitate very early intervention of infants (0-18mos) and toddlers (18mons - 5 years) “at-risk” for ASD. 

We will be recuriting participants for this upcoming summer. If you are interested in your child enrolling in Project PLAAY, or being added to the waitlist for future cohorts, please fill out the form below. 
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Email *
Your Name
Your Phone Number 
Your Child's Name 
Your Child's Birthday
Does your child have an older sibling diagnosed with autism? 
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Has your child been screened for autism? If so, what were the results? 
Please mark your top 2 conserns for your child
How does your child typically communicate their needs or wants? 
Please select the days/times you would be available to attend Project PLAAY sessions: 
Would you have other children attending with you who may need childcare during the session? 
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How did you hear about Project PLAAY? 
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