Designed for
Childhood

Please take a minute to complete it so we can make the most of our time together.

🌱 Welcome. Let’s Begin with Where You Are.

This is not a test. It’s a soft landing. A way to gently take stock of what’s growing, what’s been hard, and what’s ready for support.

Just your thoughts and words are enough.

First Name *

Email *

Section 1: You – the Parent/Caregiver

1. How are you feeling lately? *

Overwhelmed

Hanging in there

Finding small joys

I don’t know anymore

2. If you could name one word to describe your parenting season right now, what would it be? *

3. What’s been the hardest part of supporting your child’s communication? *

4. What’s been surprisingly beautiful or joyful about it? *

5. When do you feel most connected with your child? *

6. What do you wish professionals (teachers, therapists) better understood about your child—or about you? *

7. Have you had support for your own mental health and emotional wellbeing? *

Yes, currently

In the past

Not really

I’d like some but don’t know where to start

8. What tends to help you feel more grounded or regulated as a parent? *

Please specify if you checked "other"

10. If we could change just one thing in your family rhythm or communication right now—what would help most? *

Section 2: Your Child and Your Family

11. How would you describe your child’s communication right now? *

Please specify if you select "other"

12. What are your child’s communication strengths? *

13. When does communication feel hardest or most frustrating—for them or for you? *

14. What does that frustration usually look like? *

15. Have you noticed any patterns—times of day, places, routines—where communication flows more naturally? *

16. What does your child love? *

17. What do they tend to avoid or dislike? *

18. What routines or rhythms are currently working in your home? *

19. What does your family structure look like right now? *

20. How would you describe your current season as a family? *

Please specify if you select "other"