Autism Therapists in Cottage Grove, MN

Photo of Peter Jason Meilahn - Peter Meilahn, MA, LPCC, LPCC, Licensed Professional Counselor
Peter Meilahn, MA, LPCC
Licensed Professional Counselor, LPCC
Verified Verified
Cottage Grove, MN 55016
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
(612) 295-0844 View (612) 295-0844
Photo of Kaitlynn Rivers, MA, Pre-Licensed Professional
Kaitlynn Rivers
Pre-Licensed Professional, MA
Verified Verified
Cottage Grove, MN 55016
My ideal client is someone who wants to improve behaviors and functioning. I love working with parents to best support the presenting needs of their children. I want to support and teach children who struggle with identifying and responding to overwhelming emotions manage symptoms of anxiety and depression. I want to work with clients who are seeking a supportive relationship with their provider and want to collaborate and be active in their treatment. I also enjoy working with the challenges that teens and young adults face as they navigate life transitions.
My ideal client is someone who wants to improve behaviors and functioning. I love working with parents to best support the presenting needs of their children. I want to support and teach children who struggle with identifying and responding to overwhelming emotions manage symptoms of anxiety and depression. I want to work with clients who are seeking a supportive relationship with their provider and want to collaborate and be active in their treatment. I also enjoy working with the challenges that teens and young adults face as they navigate life transitions.
(651) 413-3878 View (651) 413-3878
Photo of Youth Service Bureau Inc - Youth Service Bureau, Inc
Youth Service Bureau, Inc
Verified Verified
Cottage Grove, MN 55016
Do you want to help your child learn the skills needed to make healthier and smarter choices? What about improving positive relationships with peers or family? Is it important for your child to have the guidance to learn healthy communication and coping skills? Or are you a young adult looking for services? We would love to work with you!
Do you want to help your child learn the skills needed to make healthier and smarter choices? What about improving positive relationships with peers or family? Is it important for your child to have the guidance to learn healthy communication and coping skills? Or are you a young adult looking for services? We would love to work with you!
(651) 458-5224 View (651) 458-5224
Photo of Kristen Brechler, MS, LAMFT, MDiv, Marriage & Family Therapist Associate
Kristen Brechler
Marriage & Family Therapist Associate, MS, LAMFT, MDiv
Verified Verified
2 Endorsed
Cottage Grove, MN 55016
Waitlist for new clients
My practice is a collaborative healing process where you can be your authentic self in a trusting, respectful environment. My priority is to build a safe, caring, validating space where you can be known and understood. It’s a privilege to build strong relationships and notice the positive effects that therapy can have on their lives. I use a systemic, collaborative, strengths-based therapeutic approach to help you through the challenges of life, connecting with your strengths to help learn new ways to live in wholeness.
My practice is a collaborative healing process where you can be your authentic self in a trusting, respectful environment. My priority is to build a safe, caring, validating space where you can be known and understood. It’s a privilege to build strong relationships and notice the positive effects that therapy can have on their lives. I use a systemic, collaborative, strengths-based therapeutic approach to help you through the challenges of life, connecting with your strengths to help learn new ways to live in wholeness.
(651) 360-1420 View (651) 360-1420
Photo of Jacqueline Valek, MS,  LPC, NCC, Licensed Professional Counselor
Jacqueline Valek
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
2 Endorsed
Cottage Grove, MN 55016
Now Accepting New Clients! Jacqueline has extensive experience supporting individuals and families in repairing relationships, managing emotions, reducing anxiety, coping with stress, improving self care and overall wellness, building coping skills, and feeling better! Jacqueline supports clients through emotional, social, and academic/workplace concerns. Specifically, she helps clients navigate anxiety, depression, new mental health or medical diagnoses, identity, grief/loss, family change, life transitions, parenting, behaviors/dysregulation, and skill building.
Now Accepting New Clients! Jacqueline has extensive experience supporting individuals and families in repairing relationships, managing emotions, reducing anxiety, coping with stress, improving self care and overall wellness, building coping skills, and feeling better! Jacqueline supports clients through emotional, social, and academic/workplace concerns. Specifically, she helps clients navigate anxiety, depression, new mental health or medical diagnoses, identity, grief/loss, family change, life transitions, parenting, behaviors/dysregulation, and skill building.
(651) 615-5184 View (651) 615-5184
Photo of Catherine J Brightman, MA, LPCC, LADC, RYT, Counselor
Catherine J Brightman
Counselor, MA, LPCC, LADC, RYT
Verified Verified
1 Endorsed
Cottage Grove, MN 55016
Not accepting new clients
If you've ever felt broken, lost, or disconnected I'm the kind of therapist that can support you through your journey of finding lasting change. The beliefs you hold about yourself and the world, your emotions, your memories, and your habits all can influence mental and physical health. When we learn to quiet the mind and unite with the body we learn how to break free from habitual and painful ways of thinking, feeling, and acting.
If you've ever felt broken, lost, or disconnected I'm the kind of therapist that can support you through your journey of finding lasting change. The beliefs you hold about yourself and the world, your emotions, your memories, and your habits all can influence mental and physical health. When we learn to quiet the mind and unite with the body we learn how to break free from habitual and painful ways of thinking, feeling, and acting.
(651) 401-8327 View (651) 401-8327

More Therapists Nearby

Photo of Leanne Mairs, MSW, LICSW, Clinical Social Work/Therapist
Leanne Mairs
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Woodbury, MN 55125
I am also an Autism specialist, with experience helping children and adults on the Autism Spectrum.
My approach is focused on the solutions you want to achieve. When you work with me, we will articulate what it is you want and need to move forward, and then we will harvest the unique strengths you already have to get there. We will collaborate on changing the aspects of your behavior that are not working for you. My approach does not begin and end with problems or the past—we only make those inquiries in order to frame solutions for the present. My work draws from several theoretical frameworks, including CBT, Internal Family Systems, Solution-Focused Brief Therapy, CPT, and EMDR to help you achieve your goals and aspirations
I am also an Autism specialist, with experience helping children and adults on the Autism Spectrum.
My approach is focused on the solutions you want to achieve. When you work with me, we will articulate what it is you want and need to move forward, and then we will harvest the unique strengths you already have to get there. We will collaborate on changing the aspects of your behavior that are not working for you. My approach does not begin and end with problems or the past—we only make those inquiries in order to frame solutions for the present. My work draws from several theoretical frameworks, including CBT, Internal Family Systems, Solution-Focused Brief Therapy, CPT, and EMDR to help you achieve your goals and aspirations
(651) 433-6415 View (651) 433-6415
Photo of Lisa J Nippoldt-Baca, PsyD,  LP, ABPP, Psychologist
Lisa J Nippoldt-Baca
Psychologist, PsyD, LP, ABPP
Verified Verified
Woodbury, MN 55125
Nippoldt-Baca specializes in childhood and adult disorders, including: ADHD, Autism, learning disabilities, concussion, twice exceptional, evaluations for test accommodations, developmental disorders, fetal alcohol syndrome, traumatic brain injury, epilepsy, toxic exposure, and mental health disorders.
Dr. Nippoldt-Baca is a board certified clinical neuropsychologist and board certified subspecialist in pediatric neuropsychology. She is the team neuropsychologist and alternate team neuropsychologist providing concussion care to several professional sports teams in MN. Dr. Nippoldt-Baca serves on several committees for the Sports Neuropsychological Society, and has a podcast with five of her favorite power-women and sports neuropsychologists called, Drmomcast.
Nippoldt-Baca specializes in childhood and adult disorders, including: ADHD, Autism, learning disabilities, concussion, twice exceptional, evaluations for test accommodations, developmental disorders, fetal alcohol syndrome, traumatic brain injury, epilepsy, toxic exposure, and mental health disorders.
Dr. Nippoldt-Baca is a board certified clinical neuropsychologist and board certified subspecialist in pediatric neuropsychology. She is the team neuropsychologist and alternate team neuropsychologist providing concussion care to several professional sports teams in MN. Dr. Nippoldt-Baca serves on several committees for the Sports Neuropsychological Society, and has a podcast with five of her favorite power-women and sports neuropsychologists called, Drmomcast.
(651) 376-0767 View (651) 376-0767
Photo of Julie Hoyez, MSW, LICSW, LCSW, ASDCS, Clinical Social Work/Therapist
Julie Hoyez
Clinical Social Work/Therapist, MSW, LICSW, LCSW, ASDCS
Verified Verified
2 Endorsed
Hastings, MN 55033  (Online Only)
I am a passionate Clinical Social Worker with over 30 years of experience. I have a special interest in working with clients struggling with anxiety, depression, autism, ADHD, intellectual disabilities, life transition, grief and loss, and women's issues.
I am a passionate Clinical Social Worker with over 30 years of experience. I have a special interest in working with clients struggling with anxiety, depression, autism, ADHD, intellectual disabilities, life transition, grief and loss, and women's issues.
(651) 372-1956 View (651) 372-1956
Photo of Dr. David Connor Nathan, PsyD, LP, Psychologist
Dr. David Connor Nathan
Psychologist, PsyD, LP
Verified Verified
1 Endorsed
Eagan, MN 55120
I offer ADHD and Autism Spectrum neuropsychological testing for children, teens and adults between the ages of 7 and 70. I have extensive training and experience in mental health assessment, including a year at the University of Minnesota Discovery Clinic, the UMN child/adolescent neuroscience center during my doctoral studies. I completed my doctoral Internship at Fraser where I also specialized in assessment. Testing is not just about the process of testing, but the quality of feedback and recommendations that can be made based on feedback. I am happy to offer detailed testing results to my clients and their families.
I offer ADHD and Autism Spectrum neuropsychological testing for children, teens and adults between the ages of 7 and 70. I have extensive training and experience in mental health assessment, including a year at the University of Minnesota Discovery Clinic, the UMN child/adolescent neuroscience center during my doctoral studies. I completed my doctoral Internship at Fraser where I also specialized in assessment. Testing is not just about the process of testing, but the quality of feedback and recommendations that can be made based on feedback. I am happy to offer detailed testing results to my clients and their families.
(651) 412-1661 View (651) 412-1661
Photo of Carrie K. Wolfson, LMFT, Marriage & Family Therapist
Carrie K. Wolfson
Marriage & Family Therapist, LMFT
Verified Verified
Eagan, MN 55123
Waitlist for new clients
Working with children/youth who have social and emotional deficits is my passion. As a systems therapist I am committed to assisting each child/youth while also working with the family to handle difficulties that come with having a child with unique needs. My clients may have autism, ADHD, anxiety, depression, or other mood/impulse control concerns which cause behavioral and relationship difficulties. Treatment plans are based on concepts of "Social Thinking" as well as behavioral and play-based interventions, CBT and Family Therapy approaches to maximize the learning and retention of skills across multiple settings.
Working with children/youth who have social and emotional deficits is my passion. As a systems therapist I am committed to assisting each child/youth while also working with the family to handle difficulties that come with having a child with unique needs. My clients may have autism, ADHD, anxiety, depression, or other mood/impulse control concerns which cause behavioral and relationship difficulties. Treatment plans are based on concepts of "Social Thinking" as well as behavioral and play-based interventions, CBT and Family Therapy approaches to maximize the learning and retention of skills across multiple settings.
(612) 326-3882 View (612) 326-3882
Photo of Dr. Krista Yucuis, PsyD, LP, Psychologist
Dr. Krista Yucuis
Psychologist, PsyD, LP
Verified Verified
1 Endorsed
Saint Paul, MN 55119  (Online Only)
Whether you're new to therapy or have seen several therapists, diving into it can be a bit much. But therapy's this awesome chance to grow, heal, and change things up for the better. My goal is to create a safe and supportive environment where you can openly share and explore any challenges you're facing in life. My areas of expertise include various psychological challenges, including Anxiety Disorders, Depression, ADHD, Autism Spectrum Disorder, and Life Transitions. I also provider ADHD evaluations for individuals ages 18 and older.
Whether you're new to therapy or have seen several therapists, diving into it can be a bit much. But therapy's this awesome chance to grow, heal, and change things up for the better. My goal is to create a safe and supportive environment where you can openly share and explore any challenges you're facing in life. My areas of expertise include various psychological challenges, including Anxiety Disorders, Depression, ADHD, Autism Spectrum Disorder, and Life Transitions. I also provider ADHD evaluations for individuals ages 18 and older.
(651) 505-8445 View (651) 505-8445
Photo of Taylor Cravey, MSSW, LICSW, Clinical Social Work/Therapist
Taylor Cravey
Clinical Social Work/Therapist, MSSW, LICSW
Verified Verified
1 Endorsed
Oakdale, MN 55128
I believe that every person, no matter their age, deserves to have a space where they are unconditionally accepted. I work with children (ages 2 and up), teens, young adults and families to provide a safe, nonjudgmental space for my clients to come as they are and untangle life’s complexities. I hold extensive experience working with Autism, ADHD, adoption and foster care, trauma and attachment challenges. I work to provide a safe, culturally responsive space for individuals and families, am social and racial justice oriented and LGBTQIA+ affirming. Additionally, I hold space for individuals of all abilities and identities.
I believe that every person, no matter their age, deserves to have a space where they are unconditionally accepted. I work with children (ages 2 and up), teens, young adults and families to provide a safe, nonjudgmental space for my clients to come as they are and untangle life’s complexities. I hold extensive experience working with Autism, ADHD, adoption and foster care, trauma and attachment challenges. I work to provide a safe, culturally responsive space for individuals and families, am social and racial justice oriented and LGBTQIA+ affirming. Additionally, I hold space for individuals of all abilities and identities.
(651) 661-2547 View (651) 661-2547
Photo of Mallaigh McGinley, MA, Pre-Licensed Professional
Mallaigh McGinley
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Oakdale, MN 55128
As a queer person who lives beyond binaries, I look for creative approaches to my clients' unique concerns. I work with children, teens, and adults for individual and family therapy. I specialize in trauma (personal, systemic), interpersonal communication (family dynamics, peer relationships), emotional processing (anxiety, anger, depression, grief), neurodivergence (autism, ADHD), and identity (gender, sexuality, race).
As a queer person who lives beyond binaries, I look for creative approaches to my clients' unique concerns. I work with children, teens, and adults for individual and family therapy. I specialize in trauma (personal, systemic), interpersonal communication (family dynamics, peer relationships), emotional processing (anxiety, anger, depression, grief), neurodivergence (autism, ADHD), and identity (gender, sexuality, race).
(651) 390-7599 View (651) 390-7599
Photo of Lori Migdal, PhD , LP, Psychologist
Lori Migdal
Psychologist, PhD , LP
Verified Verified
1 Endorsed
Oakdale, MN 55128
I am a licensed clinical psychologist who specializes in psychological assessments for ADHD, 2e autism, gifted and talented, and learning disorders. My specialty is twice-exceptional youth and adults. I enjoy assessing both children and adults to help you understand more about your own or your child's strengths and weaknesses. I am able to help you figure out the next steps for yourself or your child in their journey through school or work. In addition, I provide psychotherapy for ages 5 on up and offer parent guidance support. My unique approaches to therapy includes nutrition and supplement guidance. I also offer neurofeedback.
I am a licensed clinical psychologist who specializes in psychological assessments for ADHD, 2e autism, gifted and talented, and learning disorders. My specialty is twice-exceptional youth and adults. I enjoy assessing both children and adults to help you understand more about your own or your child's strengths and weaknesses. I am able to help you figure out the next steps for yourself or your child in their journey through school or work. In addition, I provide psychotherapy for ages 5 on up and offer parent guidance support. My unique approaches to therapy includes nutrition and supplement guidance. I also offer neurofeedback.
(651) 409-5143 View (651) 409-5143
Photo of Kathryn M Stemwedel, MA, LPCC, Counselor
Kathryn M Stemwedel
Counselor, MA, LPCC
Verified Verified
Afton, MN 55001  (Online Only)
Making the step to address mental health and relationship issues is difficult and I appreciate this. My approach in therapy is positive, person-centered and collaborative. I use eclectic modalities to tailor therapy to individual personalities and personal experience, goals, and needs. I encourage clients to identify their strengths to foster long-term positive change. My specialties include anxiety, trauma, relationships, divorce, ADHD, Autism Spectrum Disorder, depression, OCD, eating disorders and attachment disorders. I have over 20 years of experience working with children and families in therapy, mediation, and education
Making the step to address mental health and relationship issues is difficult and I appreciate this. My approach in therapy is positive, person-centered and collaborative. I use eclectic modalities to tailor therapy to individual personalities and personal experience, goals, and needs. I encourage clients to identify their strengths to foster long-term positive change. My specialties include anxiety, trauma, relationships, divorce, ADHD, Autism Spectrum Disorder, depression, OCD, eating disorders and attachment disorders. I have over 20 years of experience working with children and families in therapy, mediation, and education
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Photo of Peter Jason Meilahn - Peter Meilahn, MA, LPCC, LPCC, Licensed Professional Counselor
Peter Meilahn, MA, LPCC
Licensed Professional Counselor, LPCC
Verified Verified
Newport, MN 55055
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
(763) 363-4584 View (763) 363-4584
Photo of Lisa Krueger, MA, MS, Pre-Licensed Professional
Lisa Krueger
Pre-Licensed Professional, MA, MS
Verified Verified
Inver Grove Heights, MN 55076  (Online Only)
I tend to gravitate towards those that are entering or exiting single parenthood, those that have been through or are going through domestic violence or some kind of impactful relationship change, those that are late diagnosed with ADHD, Autism, or both, those that are new to their kid(s) being diagnosed, and those that just need to put themselves first in this space amidst all of the overwhelm of life. I love working with individuals that are in the midst of navigating life transitions, stressors, and new phases.
I tend to gravitate towards those that are entering or exiting single parenthood, those that have been through or are going through domestic violence or some kind of impactful relationship change, those that are late diagnosed with ADHD, Autism, or both, those that are new to their kid(s) being diagnosed, and those that just need to put themselves first in this space amidst all of the overwhelm of life. I love working with individuals that are in the midst of navigating life transitions, stressors, and new phases.
(651) 240-3859 View (651) 240-3859
Photo of Peter Jason Meilahn, MA, LPCC, Licensed Professional Counselor
Peter Jason Meilahn
Licensed Professional Counselor, MA, LPCC
Verified Verified
West Saint Paul, MN 55118
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
(651) 299-6579 View (651) 299-6579
Photo of Peter Jason Meilahn - Peter Meilahn, MA, LPCC, LPCC, Counselor
Peter Meilahn, MA, LPCC
Counselor, LPCC
Verified Verified
Inver Grove Heights, MN 55076
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
My clients can change anxiety, ADHD, autism, or pain with live heart and brain feedback called biofeedback or neurofeedback in online visits. Clients control music volume on their phones with their calm attention levels with free biofeedback equipment I provide. It is easy mindfulness therapy for kids and adults. It is proven to work as well as medication for anxiety, ADHD, and pain. I have years of experience as a therapist, and have taught clinicians at The University of MN Medical Center and elsewhere. Insurance covers this service. To schedule a 20 minute call, click here: https://neurotherapy.intakeq.com/booking
(612) 351-4958 View (612) 351-4958

See more therapy options for Cottage Grove

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.