Autism Psychiatrists in Decatur, GA

Photo of Maria Elizabeth Johnson, MD, ABPN, Psychiatrist
Maria Elizabeth Johnson
Psychiatrist, MD, ABPN
Verified Verified
1 Endorsed
Decatur, GA 30030
I'm excited to help you get back in your stride. I can be there for you in your highs and your lows. You may wish to find that person you used to be or you may desire to move into a new version of yourself. Regardless, the options are full of hope and possibility. I treat a wide range of conditions, from Autism, Asperger's Disorder, Attention Deficit Hyperactivity Disorder, Bipolar, Depression, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, and Schizophrenia. My clients seek greater understanding about themselves and relief from disabling symptoms.
I'm excited to help you get back in your stride. I can be there for you in your highs and your lows. You may wish to find that person you used to be or you may desire to move into a new version of yourself. Regardless, the options are full of hope and possibility. I treat a wide range of conditions, from Autism, Asperger's Disorder, Attention Deficit Hyperactivity Disorder, Bipolar, Depression, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, and Schizophrenia. My clients seek greater understanding about themselves and relief from disabling symptoms.
(678) 504-6670 View (678) 504-6670
Photo of Dr. Judith Ngulefac Dnp, DNP, APRN, PMHNPBC, FNP-C, Psychiatric Nurse Practitioner
Dr. Judith Ngulefac Dnp
Psychiatric Nurse Practitioner, DNP, APRN, PMHNPBC, FNP-C
Verified Verified
1 Endorsed
Decatur, GA 30033
Dr. Judith Ngulefac, DNP, APRN, PMHNP-BC, FNP-C, DOT-CME is an experienced doctoral-prepared board-certified psychiatric nurse practitioner and family nurse practitioner with over 14 years of experience in diverse health care settings providing high-quality care to clients. Dr. Ngulefac believes that your mental health is as important as your physical health and requires the same attention. She provides an initial psychiatric evaluation that will enable her to diagnose & develop an individualized treatment plan with routine follow-up visits to monitor symptoms and medication effectiveness.
Dr. Judith Ngulefac, DNP, APRN, PMHNP-BC, FNP-C, DOT-CME is an experienced doctoral-prepared board-certified psychiatric nurse practitioner and family nurse practitioner with over 14 years of experience in diverse health care settings providing high-quality care to clients. Dr. Ngulefac believes that your mental health is as important as your physical health and requires the same attention. She provides an initial psychiatric evaluation that will enable her to diagnose & develop an individualized treatment plan with routine follow-up visits to monitor symptoms and medication effectiveness.
(470) 348-2404 View (470) 348-2404
Photo of Daphne Wacasey, PMHNP, Psychiatric Nurse Practitioner
Daphne Wacasey
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
Decatur, GA 30030
I worked eight years as an Adult Nurse Practitioner in several settings before expanding my specialty to Psychiatry/Mental Health. It was the best career decision I could have made. I started practicing in Psychiatry seven years ago in a correctional setting treating adolescents and adults. It was there that I recognized the significance of early mental health promotion, screening and treatment. For the past four years I’ve worked in a private practice with a diverse patient population across the lifespan. My main role is assessing, diagnosing, education and medication management but I occasionally incorporate therapy.
I worked eight years as an Adult Nurse Practitioner in several settings before expanding my specialty to Psychiatry/Mental Health. It was the best career decision I could have made. I started practicing in Psychiatry seven years ago in a correctional setting treating adolescents and adults. It was there that I recognized the significance of early mental health promotion, screening and treatment. For the past four years I’ve worked in a private practice with a diverse patient population across the lifespan. My main role is assessing, diagnosing, education and medication management but I occasionally incorporate therapy.
(470) 740-6357 View (470) 740-6357
Photo of Adaorah Abor, PMHNP, Psychiatric Nurse Practitioner
Adaorah Abor
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
Decatur, GA 30030
As a psychiatric mental health nurse practitioner, I bring empathy, an easygoing communication style, and a sweet sense of humor, making it easy to communicate with my patients and family members. Having worked both in crisis management centers, drug Rehabs, Adult psych hospitals and children’s psych hospitals, I decided to go back to school for my Master’s in Nursing 4 years ago to expand my knowledge and use my wealth of experience in good use. As a Psychiatric Nurse Practitioner, my goal is to educate and empower patients and family members.
As a psychiatric mental health nurse practitioner, I bring empathy, an easygoing communication style, and a sweet sense of humor, making it easy to communicate with my patients and family members. Having worked both in crisis management centers, drug Rehabs, Adult psych hospitals and children’s psych hospitals, I decided to go back to school for my Master’s in Nursing 4 years ago to expand my knowledge and use my wealth of experience in good use. As a Psychiatric Nurse Practitioner, my goal is to educate and empower patients and family members.
(470) 470-6039 View (470) 470-6039
Photo of Omobolaji Oluseyi Oyebanjo Popoola, MD, ABPN, ABPM, Psychiatrist
Omobolaji Oluseyi Oyebanjo Popoola
Psychiatrist, MD, ABPN, ABPM
Verified Verified
Decatur, GA 30035
The mind set of a man determines the outcome of his life and the quality of relationships he enjoys. Hence the need for us to guard and nurture our minds with the best of cutting edge science and faith tools. My philosophy is that whatever affects your thinking, affects your life, your relationships, your God-given potential and ultimately your contributions to the society at large, the world needs you and we can't afford to miss out on your contribution to life! I am of the strong belief that not every disorder requires medications. Hence only after a thorough objective medical work up, will I consider a variety of treatments.
The mind set of a man determines the outcome of his life and the quality of relationships he enjoys. Hence the need for us to guard and nurture our minds with the best of cutting edge science and faith tools. My philosophy is that whatever affects your thinking, affects your life, your relationships, your God-given potential and ultimately your contributions to the society at large, the world needs you and we can't afford to miss out on your contribution to life! I am of the strong belief that not every disorder requires medications. Hence only after a thorough objective medical work up, will I consider a variety of treatments.
(770) 762-0525 View (770) 762-0525
Photo of Kalvin K Kapoor - Vital Psych MD, DO, Psychiatrist
Vital Psych MD
Psychiatrist, DO
Verified Verified
Decatur, GA 30030
Hi! Welcome to Dr. Kapoor's private practice. With over 10 years of experience in the field of mental health, our mission is to have a positive impact in your life by working on your present. Weather it is anxiety, depression, difficulty functioning at work or school, family conflicts, challenges in relationships, low self-esteem, or simply a desire to learn more about themselves; we can help. As a psychiatrist with deep expertise in the field, Dr. Kapoor creates a treatment plan that meets his client's needs. His style is guided by warmth and flexibility, with the goals of helping patients build insight and self esteem.
Hi! Welcome to Dr. Kapoor's private practice. With over 10 years of experience in the field of mental health, our mission is to have a positive impact in your life by working on your present. Weather it is anxiety, depression, difficulty functioning at work or school, family conflicts, challenges in relationships, low self-esteem, or simply a desire to learn more about themselves; we can help. As a psychiatrist with deep expertise in the field, Dr. Kapoor creates a treatment plan that meets his client's needs. His style is guided by warmth and flexibility, with the goals of helping patients build insight and self esteem.
(737) 510-2178 View (737) 510-2178
Photo of Omobolaji Oluseyi Oyebanjo Popoola, MD, ABPN, ABPM, Psychiatrist
Omobolaji Oluseyi Oyebanjo Popoola
Psychiatrist, MD, ABPN, ABPM
Verified Verified
Decatur, GA 30035
The mind set of a man determines the outcome of his life and the quality of relationships he enjoys. Hence the need for us to guard and nurture our minds with the best of cutting edge science and faith tools. My philosophy is that whatever affects your thinking, affects your life, your relationships, your God-given potential and ultimately your contributions to the society at large, the world needs you and we can't afford to miss out on your contribution to life! I am of the strong belief that not every disorder requires medications. Hence only after a thorough objective medical work up, will I consider a variety of treatments.
The mind set of a man determines the outcome of his life and the quality of relationships he enjoys. Hence the need for us to guard and nurture our minds with the best of cutting edge science and faith tools. My philosophy is that whatever affects your thinking, affects your life, your relationships, your God-given potential and ultimately your contributions to the society at large, the world needs you and we can't afford to miss out on your contribution to life! I am of the strong belief that not every disorder requires medications. Hence only after a thorough objective medical work up, will I consider a variety of treatments.
(470) 284-1397 View (470) 284-1397
Photo of Lori Darnelle Lewis - Manifesting Minds, LLC, PMHNP, APRN, MSN, MBA, Psychiatric Nurse Practitioner
Manifesting Minds, LLC
Psychiatric Nurse Practitioner, PMHNP, APRN, MSN, MBA
Verified Verified
1 Endorsed
Decatur, GA 30034  (Online Only)
I am Lori Lewis, a dedicated Board Certified Psychiatric Mental Health Nurse Practitioner. For years, I have been committed to making a difference in the lives of those struggling with mental health challenges. With a diverse background in healthcare, I bring a wealth of experience and expertise to my practice. My decision to specialize in mental health nursing came after a personal experience that transformed my life. As a survivor of sexual assault, I spent years running away from my own mental health struggles. As a mental health advocate, I strongly believe the significance of facing your fears while allowing yourself grace.
I am Lori Lewis, a dedicated Board Certified Psychiatric Mental Health Nurse Practitioner. For years, I have been committed to making a difference in the lives of those struggling with mental health challenges. With a diverse background in healthcare, I bring a wealth of experience and expertise to my practice. My decision to specialize in mental health nursing came after a personal experience that transformed my life. As a survivor of sexual assault, I spent years running away from my own mental health struggles. As a mental health advocate, I strongly believe the significance of facing your fears while allowing yourself grace.
(678) 403-6669 View (678) 403-6669

More Psychiatrists Nearby

Photo of Zehra Erdeve Temiz - MD Psychiatry Clinic , MD, Psychiatrist
MD Psychiatry Clinic
Psychiatrist, MD
Verified Verified
Sandy Springs, GA 30319
My long standing passion for working with children, adolescents and young adults, which allow me to develop and grow long-term relationships with patients and their families.Among the many groups of children with whom I have had the pleasure of working particularly is children/adolescents with ADHD, Autism Spectrum Disorder, Disruptive Mood Dysregulation Disorder, PTSD, Bipolar Disorder, Schizophrenia Spectrum Disorder .
My long standing passion for working with children, adolescents and young adults, which allow me to develop and grow long-term relationships with patients and their families.Among the many groups of children with whom I have had the pleasure of working particularly is children/adolescents with ADHD, Autism Spectrum Disorder, Disruptive Mood Dysregulation Disorder, PTSD, Bipolar Disorder, Schizophrenia Spectrum Disorder .
(678) 403-6781 View (678) 403-6781
Photo of Anthony J. Hall, MSN, APRN, PMHNP, Psychiatric Nurse Practitioner
Anthony J. Hall
Psychiatric Nurse Practitioner, MSN, APRN, PMHNP
Verified Verified
1 Endorsed
Atlanta, GA 30326  (Online Only)
At Ascension Psychiatric Services we believe that emotional wellness is complex and often misunderstood. It is a result of the combination of biological, psychological, and environmental factors. We employ the use of evidenced based therapeutic techniques along with judicious use of medication to address each of these components. It is our mission to Ascend above expectations by providing compassionate and personalized care to all, while building relationships and trust.
At Ascension Psychiatric Services we believe that emotional wellness is complex and often misunderstood. It is a result of the combination of biological, psychological, and environmental factors. We employ the use of evidenced based therapeutic techniques along with judicious use of medication to address each of these components. It is our mission to Ascend above expectations by providing compassionate and personalized care to all, while building relationships and trust.
(404) 737-3006 View (404) 737-3006
Photo of Ranjan Kumar Avashti - Nak Union Behavioral Health, MD, Psychiatrist
Nak Union Behavioral Health
Psychiatrist, MD
Verified Verified
Atlanta, GA 30348
Dr. Ranjan Avasthi, is a double board certified Adult and Child Psychiatrist. He is currently the medical director for the Peace of Mind Psychiatric Services Clinic as well as the lead psychiatrist for the Southern Crescent Behavioral Health System Partial Hospital Program, that specializes in substance abuse and recovery. Dr. Avasthi completed his Psychiatry fellowship at the Medical College of Georgia, a part of Augusta University. He stayed on to work as an Assistant Clinical Professor in the Department of Psychiatry and Health Behavior. He also serves as an Adjunct Clinical Professor for Morehouse School of Medicine.
Dr. Ranjan Avasthi, is a double board certified Adult and Child Psychiatrist. He is currently the medical director for the Peace of Mind Psychiatric Services Clinic as well as the lead psychiatrist for the Southern Crescent Behavioral Health System Partial Hospital Program, that specializes in substance abuse and recovery. Dr. Avasthi completed his Psychiatry fellowship at the Medical College of Georgia, a part of Augusta University. He stayed on to work as an Assistant Clinical Professor in the Department of Psychiatry and Health Behavior. He also serves as an Adjunct Clinical Professor for Morehouse School of Medicine.
(678) 582-2526 View (678) 582-2526
Photo of Brian Bortnick, MD, Psychiatrist
Brian Bortnick
Psychiatrist, MD
Verified Verified
Atlanta, GA 30327
Brian Bortnick is a Psychiatrist in Georgia who has been practicing since 1995. He completed his Bachelor of Arts in Psychology at Boston College, his Medical School at Virginia Commonwealth University, and his Psychiatric Residency at Emory University School of Medicine. With more than 25 years of experience, Brian incorporates both psychotherapy and pharmacology to ensure his patients receive an individualized treatment plan that they feel comfortable with and can remain consistent with longterm. Brian strongly believes that patients should feel heard and understood.
Brian Bortnick is a Psychiatrist in Georgia who has been practicing since 1995. He completed his Bachelor of Arts in Psychology at Boston College, his Medical School at Virginia Commonwealth University, and his Psychiatric Residency at Emory University School of Medicine. With more than 25 years of experience, Brian incorporates both psychotherapy and pharmacology to ensure his patients receive an individualized treatment plan that they feel comfortable with and can remain consistent with longterm. Brian strongly believes that patients should feel heard and understood.
(770) 824-1095 View (770) 824-1095
Photo of Dr. Jed Mangal, MD, Psychiatrist
Dr. Jed Mangal
Psychiatrist, MD
Verified Verified
Atlanta, GA 30319
My ideal client is motivated to get better and get better now. This includes individuals and people with families. I offer initial and followup evening and weekend appointments within 2 weeks to best accommodate students and professionals working towards personal improvement while continuing their professional lives.
My ideal client is motivated to get better and get better now. This includes individuals and people with families. I offer initial and followup evening and weekend appointments within 2 weeks to best accommodate students and professionals working towards personal improvement while continuing their professional lives.
(404) 941-3611 View (404) 941-3611
Photo of Gloria Chine, PMHNP, Psychiatric Nurse Practitioner
Gloria Chine
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
1 Endorsed
Atlanta, GA 30308  (Online Only)
Are you struggling to balance your mental health? Are things becoming overwhelming & unmanageable? My name is Gloria Chine, a board-certified Psychiatric Mental Health Nurse Practitioner with over 10 years of mental health experience. I have extensive inpatient and outpatient experience. I provide comprehensive mental health evaluations, medication management & therapy. My areas of focus include depression, anxiety, bipolar, anger issues, ADHD, PTSD (trauma), schizophrenia and not limiting to other mental illness. I have daily appointments.
Are you struggling to balance your mental health? Are things becoming overwhelming & unmanageable? My name is Gloria Chine, a board-certified Psychiatric Mental Health Nurse Practitioner with over 10 years of mental health experience. I have extensive inpatient and outpatient experience. I provide comprehensive mental health evaluations, medication management & therapy. My areas of focus include depression, anxiety, bipolar, anger issues, ADHD, PTSD (trauma), schizophrenia and not limiting to other mental illness. I have daily appointments.
(470) 730-7793 View (470) 730-7793
Photo of Dr. Christopher Mora, MD, Psychiatrist
Dr. Christopher Mora
Psychiatrist, MD
Verified Verified
Atlanta, GA 30307
I am an experienced psychiatrist committed to providing individualized care to each patient, with a strong emphasis on collaboration and shared decision making/informed consent. My goal in working with patients is to foster growth, strength and resiliency, while working together to manage underlying psychiatric and medical conditions impeding their progress. My treatment approach is integrative, often combining various modalities including medications, psychotherapy, medical/diagnostic labwork, nutrition, exercise, and other wellness focused approaches catered to each individual's values.
I am an experienced psychiatrist committed to providing individualized care to each patient, with a strong emphasis on collaboration and shared decision making/informed consent. My goal in working with patients is to foster growth, strength and resiliency, while working together to manage underlying psychiatric and medical conditions impeding their progress. My treatment approach is integrative, often combining various modalities including medications, psychotherapy, medical/diagnostic labwork, nutrition, exercise, and other wellness focused approaches catered to each individual's values.
(404) 494-0097 View (404) 494-0097
Photo of Ubhs Inc Telehealth, MD, NP, PhD, LCSW, Psychiatrist
Ubhs Inc Telehealth
Psychiatrist, MD, NP, PhD, LCSW
Verified Verified
Atlanta, GA 30341
UBHS began 10 years ago upon the recognition of a need for mental health care for those who otherwise would be without services. Our team partners with hospitals, rural clinics, nursing homes, pediatricians, and other specialists to provide comprehensive psychiatric care across the lifespan. Our staffing makes it possible to be seen same week of appointment request. Also inquire if self pay, about our affordable rates for those without insurance.
UBHS began 10 years ago upon the recognition of a need for mental health care for those who otherwise would be without services. Our team partners with hospitals, rural clinics, nursing homes, pediatricians, and other specialists to provide comprehensive psychiatric care across the lifespan. Our staffing makes it possible to be seen same week of appointment request. Also inquire if self pay, about our affordable rates for those without insurance.
(770) 212-9126 x1 View (770) 212-9126 x1
Photo of Panchajanya Paul, MD, Psychiatrist
Panchajanya Paul
Psychiatrist, MD
Verified Verified
Atlanta, GA 30305  (Online Only)
I am board certified in Child, Adolescent & Adult Psychiatry. I see children, adolescents, teenagers, and adults in my office in Dunwoody and am accepting new patients. I specialize in the use of medications and other holistic approaches to treat mental health conditions. I am also the Medical Director of Southern Live Oak Wellness. Treating clients with respect, integrity and compassion are my priorities. When managing medications, I incorporate the most current and best evidence based practices.
I am board certified in Child, Adolescent & Adult Psychiatry. I see children, adolescents, teenagers, and adults in my office in Dunwoody and am accepting new patients. I specialize in the use of medications and other holistic approaches to treat mental health conditions. I am also the Medical Director of Southern Live Oak Wellness. Treating clients with respect, integrity and compassion are my priorities. When managing medications, I incorporate the most current and best evidence based practices.
(678) 883-7328 View (678) 883-7328
Photo of Cindy Milligan, MSN, FNP-C, Psychiatric Nurse Practitioner
Cindy Milligan
Psychiatric Nurse Practitioner, MSN, FNP-C
Verified Verified
Atlanta, GA 30326  (Online Only)
As a Nurse Practitioner specializing in behavioral health and addiction treatment management, my top priority is to provide compassionate, comprehensive care to my patients. I understand that seeking help for mental health conditions can be daunting, overwhelming, and some feel hesitation taking the first step. I am dedicated to creating a safe supportive environment where my patients can feel comfortable expressing their feelings and concerns.
As a Nurse Practitioner specializing in behavioral health and addiction treatment management, my top priority is to provide compassionate, comprehensive care to my patients. I understand that seeking help for mental health conditions can be daunting, overwhelming, and some feel hesitation taking the first step. I am dedicated to creating a safe supportive environment where my patients can feel comfortable expressing their feelings and concerns.
(470) 769-9883 View (470) 769-9883
Photo of Fatimat Olumayowa Olufunmilayo Agbojeyin, PMHNP, Psychiatric Nurse Practitioner
Fatimat Olumayowa Olufunmilayo Agbojeyin
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
Atlanta, GA 30324  (Online Only)
Mayo Agbojeyin, NP is a board-certified Advanced Practice Psychiatric Mental Health Nurse Practitioner. She has over 20 years of nursing experience in pediatric nursing, supportive and palliative care, and pain management. Her areas of clinical interest and expertise include pediatrics and addiction medicine. Mayo enjoys music and traveling. I specialize in Anxiety, Depression, PTSD, Eating disorders, Bipolar disorders, Psychosis, Schizophrenia/Schizoaffective disorders. I create a warm, friendly, and relaxing atmosphere for my clients to express themselves and feel listened to through therapeutic communication.
Mayo Agbojeyin, NP is a board-certified Advanced Practice Psychiatric Mental Health Nurse Practitioner. She has over 20 years of nursing experience in pediatric nursing, supportive and palliative care, and pain management. Her areas of clinical interest and expertise include pediatrics and addiction medicine. Mayo enjoys music and traveling. I specialize in Anxiety, Depression, PTSD, Eating disorders, Bipolar disorders, Psychosis, Schizophrenia/Schizoaffective disorders. I create a warm, friendly, and relaxing atmosphere for my clients to express themselves and feel listened to through therapeutic communication.
(470) 327-8254 View (470) 327-8254
Photo of Melveena Johnson-Bolden, PMHNP, Psychiatric Nurse Practitioner
Melveena Johnson-Bolden
Psychiatric Nurse Practitioner, PMHNP
Verified Verified
Atlanta, GA 30316
My name is Melveena Johnson Bolden, and I am Board Certified Advanced Practice Psychiatric Mental Health Nurse Practitioner. My goal with my patients is to meet their needs in a collaborative, comfortable, and conscientious manner, focusing on the whole patient and not the hole in the patient. My approach to mental healthcare is a little eclectic because each person requires something unique. I utilize the Humanistic approach because it focuses on person-centered care, which emphasizes empathy to facilitate personal growth.
My name is Melveena Johnson Bolden, and I am Board Certified Advanced Practice Psychiatric Mental Health Nurse Practitioner. My goal with my patients is to meet their needs in a collaborative, comfortable, and conscientious manner, focusing on the whole patient and not the hole in the patient. My approach to mental healthcare is a little eclectic because each person requires something unique. I utilize the Humanistic approach because it focuses on person-centered care, which emphasizes empathy to facilitate personal growth.
(470) 517-7529 View (470) 517-7529
Autism Psychiatrists

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.