Autism Therapists in Croton On Hudson, NY
![Photo of Eileen M Feliciano, PsyD, MSEd, Psychologist](https://photos.psychologytoday.com/af44a791-7c7c-4c53-ac4c-a57567e1bfed/1/320x400.jpeg)
I have extensive experience using relational and CBT strategies for individuals of all ages diagnosed on the autism spectrum, as well as for neurological conditions that affect mood, communicating, organization, attention, and relating.
We are all much more simply human than otherwise (Harry Stack Sullivan). I believe that one finds mental health in meaningful, connected relationships with others-our parents, partners, children, friends, siblings, and therapists. I bring warmth, humor, and honesty into my therapeutic work, and act as a support and guide as you work to improve areas of your life that you are inspired to change. I focus on growth and reparation, not pathology. I have a broad range of experience with all ages and ranges of problems, and can offer comprehensive treatment to children, adolescents, adults, couples, families, and groups.
I have extensive experience using relational and CBT strategies for individuals of all ages diagnosed on the autism spectrum, as well as for neurological conditions that affect mood, communicating, organization, attention, and relating.
We are all much more simply human than otherwise (Harry Stack Sullivan). I believe that one finds mental health in meaningful, connected relationships with others-our parents, partners, children, friends, siblings, and therapists. I bring warmth, humor, and honesty into my therapeutic work, and act as a support and guide as you work to improve areas of your life that you are inspired to change. I focus on growth and reparation, not pathology. I have a broad range of experience with all ages and ranges of problems, and can offer comprehensive treatment to children, adolescents, adults, couples, families, and groups.
![Photo of Benjamin R Okin, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/875f2cec-16c0-415e-a477-80d6ef0ddb7b/2/320x400.jpeg)
Childhood and adolescence is a trying time for those in it and their family. Your child may be struggling with ADHD, motivation, impulsivity, depression, difficulty with peers, anxiety, autism, video game addiction or other any number or combination of other challenges, and that is alright. Adversity is natural at all points in our lives, but there is worth in addressing and meeting these challenges to improve your child/adolescent's well being and help them function more effectively to achieve greater success and happiness as soon as possible.
Childhood and adolescence is a trying time for those in it and their family. Your child may be struggling with ADHD, motivation, impulsivity, depression, difficulty with peers, anxiety, autism, video game addiction or other any number or combination of other challenges, and that is alright. Adversity is natural at all points in our lives, but there is worth in addressing and meeting these challenges to improve your child/adolescent's well being and help them function more effectively to achieve greater success and happiness as soon as possible.
I am a PhD psychologist with a private practice in Croton where I work with children, adolescents, and their families. Many of the children and adolescents that I work with are on the autistic spectrum and/or have ADHD but I also work with neurotypical youngsters as well.I specialize in leading groups for children and adolescents where the focus is on helping group members learn how to make and keep friends, to express their feelings appropriately, to develop and awareness of their strengths and to improve their self esteem. I also consult with parents to develop effective ways to manage behavioral challenges their children present
I am a PhD psychologist with a private practice in Croton where I work with children, adolescents, and their families. Many of the children and adolescents that I work with are on the autistic spectrum and/or have ADHD but I also work with neurotypical youngsters as well.I specialize in leading groups for children and adolescents where the focus is on helping group members learn how to make and keep friends, to express their feelings appropriately, to develop and awareness of their strengths and to improve their self esteem. I also consult with parents to develop effective ways to manage behavioral challenges their children present
![Photo of Angela Rudden - Croton Children and Family Counseling, Clinical Social Work/Therapist](https://photos.psychologytoday.com/121ebed1-fbc7-4d59-b8d1-90015eaa0f00/1/320x400.png)
Croton Children and Family Counseling
Clinical Social Work/Therapist
Verified Verified
Croton On Hudson, NY 10520
Croton Children and Family Counseling is a trusted private practice dedicated to serving the Croton community and its surroundings. Our values and approach are rooted in a strengths-based, client-centered philosophy, prioritizing the well-being and growth of every individual and family we serve. We pride ourselves on being a new and growing practice committed to providing high-quality, personalized care. We are not a therapy mill; instead, we focus on building meaningful connections with our clients and fostering lasting positive change.
Croton Children and Family Counseling is a trusted private practice dedicated to serving the Croton community and its surroundings. Our values and approach are rooted in a strengths-based, client-centered philosophy, prioritizing the well-being and growth of every individual and family we serve. We pride ourselves on being a new and growing practice committed to providing high-quality, personalized care. We are not a therapy mill; instead, we focus on building meaningful connections with our clients and fostering lasting positive change.
![Photo of Kate Duffy, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/77e12317-75b3-480f-9722-22f14f2df1e5/3/320x400.jpeg)
Kate Duffy
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Croton On Hudson, NY 10520 (Online Only)
Waitlist for new clients
You feel alone in ways you can't always explain or even identify to yourself. You can’t shake the feeling that you're weird, out of place, or that things are just harder for you than you think they should be. I help neurodiverse and anxious adults deepen their understanding of themselves and alleviate feelings of shame, inadequacy, and isolation. My clients seek to connect to and embrace their unique needs while pushing back against a world that tells them they're deficient for being different. As your therapist, I'll be a supportive guide for you as you explore these needs and build trust in yourself.
You feel alone in ways you can't always explain or even identify to yourself. You can’t shake the feeling that you're weird, out of place, or that things are just harder for you than you think they should be. I help neurodiverse and anxious adults deepen their understanding of themselves and alleviate feelings of shame, inadequacy, and isolation. My clients seek to connect to and embrace their unique needs while pushing back against a world that tells them they're deficient for being different. As your therapist, I'll be a supportive guide for you as you explore these needs and build trust in yourself.
![Photo of Tina Marie Maxwell, LMSW, BC-DMT, Clinical Social Work/Therapist](https://photos.psychologytoday.com/18d8667f-6608-4c1a-a487-812146cc7350/1/320x400.jpeg)
Tina Marie Maxwell
Clinical Social Work/Therapist, LMSW, BC-DMT
Verified Verified
Croton On Hudson, NY 10520
Do you feel stuck ? Do you feel overwhelmed by your emotions? Using the language of movement in conjunction with talk therapy, we will establish a conversation toward change. Coping techniques will be explored in order to navigate through difficult life changes .I primarily work with issues related to aging, and acceptance of life changes that aging brings as well as embracing the future. Traditional talk therapy is also utilized to underline and support effective change. Group and individual sessions available
Do you feel stuck ? Do you feel overwhelmed by your emotions? Using the language of movement in conjunction with talk therapy, we will establish a conversation toward change. Coping techniques will be explored in order to navigate through difficult life changes .I primarily work with issues related to aging, and acceptance of life changes that aging brings as well as embracing the future. Traditional talk therapy is also utilized to underline and support effective change. Group and individual sessions available
![Photo of Katherine Friedman, MA, LMHC, LPC, CST, Counselor](https://photos.psychologytoday.com/ae6ab0a4-fba2-4607-8656-81afb4864db3/1/320x400.jpeg)
Katherine Friedman
Counselor, MA, LMHC, LPC, CST
Verified Verified
2 Endorsed
Croton On Hudson, NY 10520
I help clients to develop curiosity and compassion about their inner lives and desires, guiding them towards healing, pleasure, and joy. I approach therapy as a collaboration in which we get to know your inner world together. I help you to uncover the psychological, somatic, and sensory experiences that have shaped how you approach the world, providing opportunities for freedom, choice, and transformation. In both individual and couples therapy, I use mindfulness and embodiment to help you build awareness of your own wants, needs, emotions, and desires, creating a foundation for clear communication, intimacy, and understanding.
I help clients to develop curiosity and compassion about their inner lives and desires, guiding them towards healing, pleasure, and joy. I approach therapy as a collaboration in which we get to know your inner world together. I help you to uncover the psychological, somatic, and sensory experiences that have shaped how you approach the world, providing opportunities for freedom, choice, and transformation. In both individual and couples therapy, I use mindfulness and embodiment to help you build awareness of your own wants, needs, emotions, and desires, creating a foundation for clear communication, intimacy, and understanding.
![Photo of Vanessa C Andrews, MA, CCLS, ATR-BC, LCAT, RPT, Art Therapist](https://photos.psychologytoday.com/61349ed1-a66f-4628-827e-af4c0c7f74ac/2/320x400.jpeg)
Vanessa C Andrews
Art Therapist, MA, CCLS, ATR-BC, LCAT, RPT
Verified Verified
1 Endorsed
Croton On Hudson, NY 10520
Please use email for new client inquiries, accepting clients between the hours of 8a-2p only). Children express themselves most naturally through play and art, especially when words are difficult and fail to capture the emotions they may be experiencing. Creative play and art therapy interventions to help children explore therapy in a fun, safe and natural environment. Individual sessions allow children to become comfortable in therapy while exploring the power of play and the creative process.
Please use email for new client inquiries, accepting clients between the hours of 8a-2p only). Children express themselves most naturally through play and art, especially when words are difficult and fail to capture the emotions they may be experiencing. Creative play and art therapy interventions to help children explore therapy in a fun, safe and natural environment. Individual sessions allow children to become comfortable in therapy while exploring the power of play and the creative process.
![Photo of Nichole M Rankin, LCSWR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/0847366d-b97e-4cd9-8c80-36dbeaf391c5/1/320x400.jpeg)
Nichole M Rankin
Clinical Social Work/Therapist, LCSWR
Verified Verified
1 Endorsed
Croton On Hudson, NY 10520 (Online Only)
I am a Licensed Clinical Social Worker with 15 years of experience in psychotherapy. I work with individuals, families and couples ranging in age from early childhood through late adulthood. I have worked in community based, inpatient, private, and special education settings. My professional experiences have focused on issues including depression, anxiety, mood, relationships, attachment issues, interpersonal/ familial conflict, trauma, identity, esteem, grief, stress management, and life changes.
I am a Licensed Clinical Social Worker with 15 years of experience in psychotherapy. I work with individuals, families and couples ranging in age from early childhood through late adulthood. I have worked in community based, inpatient, private, and special education settings. My professional experiences have focused on issues including depression, anxiety, mood, relationships, attachment issues, interpersonal/ familial conflict, trauma, identity, esteem, grief, stress management, and life changes.
![Photo of Curtis Reynolds Au - Calm in a Storm, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/e35d6f43-9851-47cd-92d3-c1a90ebbc5d2/3/320x400.jpeg)
My name is Curtis Au and I'm a licensed clinical social worker. I started Calm in a Storm, my private practice, to offer a relaxed, therapeutic approach to grief counseling and caregiver support. As the name implies, I see my role as being a calm and steady presence for my clients, helping them navigate times of loss, uncertainty and stress. Helping them move forward with greater knowledge, clarity and purpose. I do that by creating a safe space for my clients. A place of honesty, empathy and compassion.
My name is Curtis Au and I'm a licensed clinical social worker. I started Calm in a Storm, my private practice, to offer a relaxed, therapeutic approach to grief counseling and caregiver support. As the name implies, I see my role as being a calm and steady presence for my clients, helping them navigate times of loss, uncertainty and stress. Helping them move forward with greater knowledge, clarity and purpose. I do that by creating a safe space for my clients. A place of honesty, empathy and compassion.
More Therapists Nearby
![Photo of Rebecca McKee - The 13th Child Autism & Behavioral Coaching, Inc, MSEd, BCBA](https://photos.psychologytoday.com/4923dade-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
The 13th Child Autism & Behavioral Coaching, Inc. is a consulting company focused on those living with Autism Spectrum Disorder & other socio-behavioral uniqueness. Direct teaching is available in a 1-1 setting within the home or school, as well as incidental teaching in the natural environment of classrooms and households. We focus on children, teens and adults that struggle academically, behaviorally and socially.
The 13th Child Autism & Behavioral Coaching, Inc. is a consulting company focused on those living with Autism Spectrum Disorder & other socio-behavioral uniqueness. Direct teaching is available in a 1-1 setting within the home or school, as well as incidental teaching in the natural environment of classrooms and households. We focus on children, teens and adults that struggle academically, behaviorally and socially.
![Photo of Melissa Danielle Knopp - In Love We Learn , MSEd, BCBA](https://photos.psychologytoday.com/5e63569a-31c0-4e76-a688-e03a52d9d41a/2/320x400.png)
In Love We Learn provides support for individuals with sensorimotor differences (autism and otherwise), their families, and their team of practitioners. Sensorimotor differences can impact so much. Life is complex, and can become even more so when considering someone living with and experiencing these differences. Families may struggle to find clinicians who can provide fulfilling guidance and support. My clients are looking for someone who can provide a unique perspective to their families' care. They are looking to build an intentional lifestyle around their loved one who is motor-impacted.
In Love We Learn provides support for individuals with sensorimotor differences (autism and otherwise), their families, and their team of practitioners. Sensorimotor differences can impact so much. Life is complex, and can become even more so when considering someone living with and experiencing these differences. Families may struggle to find clinicians who can provide fulfilling guidance and support. My clients are looking for someone who can provide a unique perspective to their families' care. They are looking to build an intentional lifestyle around their loved one who is motor-impacted.
![Photo of Regina L Camillieri, LMFT, NBCCH, IBCLC, Marriage & Family Therapist](https://photos.psychologytoday.com/f725b422-3e32-4843-a6f8-477be5b738fa/1/320x400.png)
Regina L Camillieri
Marriage & Family Therapist, LMFT, NBCCH, IBCLC
Verified Verified
1 Endorsed
Montrose, NY 10548 (Online Only)
I am a New York licensed Marriage and Family Therapist and a Hypnotherapist. I am also an Internationally Board Certified Lactation Consultant. I have over 25 years of experience counseling people. I have experience with, but not limited to, depression, anxiety, autism, maternal mental health, substance abuse, divorce proceedings, couples abuse, and people in the LGBTQ+ community. With all the counseling I have done I became aware of the limitations of “talk therapy” when I worked with veterans. Hypnotherapy is another way of helping people with trauma. anxiety, depression, smoking, and eating disorders.
I am a New York licensed Marriage and Family Therapist and a Hypnotherapist. I am also an Internationally Board Certified Lactation Consultant. I have over 25 years of experience counseling people. I have experience with, but not limited to, depression, anxiety, autism, maternal mental health, substance abuse, divorce proceedings, couples abuse, and people in the LGBTQ+ community. With all the counseling I have done I became aware of the limitations of “talk therapy” when I worked with veterans. Hypnotherapy is another way of helping people with trauma. anxiety, depression, smoking, and eating disorders.
![Photo of Christine Peters, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/91d926c4-204e-45af-bc82-9e60b10e5225/1/320x400.jpeg)
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
![Photo of Christine Peters, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/65edc68d-240c-4a6a-a260-37a72698f08f/1/320x400.jpeg)
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
![Photo of Anne Marie Norberto, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/35818ace-5c79-4ffc-b634-4daf3493b1c2/1/320x400.jpeg)
Anne Marie Norberto
Clinical Social Work/Therapist, LCSW
Verified Verified
Yorktown Heights, NY 10598
I have over 24 years of experience with special needs children and their families. I use a whole child/family approach to wellness and the use of family systems. I work as part of interdisciplinary teams of therapists who are addressing other needs of the child also. I have experience in most of the school districts in northern westchester and with the department of health system for younger children. I am currently in the dissertation phase of my doctorate, which focusses on the parent-child relationship in with children on the autism spectrum and their parents.
I have over 24 years of experience with special needs children and their families. I use a whole child/family approach to wellness and the use of family systems. I work as part of interdisciplinary teams of therapists who are addressing other needs of the child also. I have experience in most of the school districts in northern westchester and with the department of health system for younger children. I am currently in the dissertation phase of my doctorate, which focusses on the parent-child relationship in with children on the autism spectrum and their parents.
![Photo of Christine Peters, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/b6336989-0705-4400-86f5-199b55dd3c78/1/320x400.jpeg)
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
![Photo of Christine Peters, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/a7648a92-571c-4f7c-9957-ce0ad8c7d4b4/1/320x400.jpeg)
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
Christine has over 10 years of therapy experience, utilizing Cognitive Behavior Therapy, Dialectical Behavior Therapy, and other approaches. She received her degree from New York University and is also a Board Certified Behavior Analyst. She has experience working with children, adolescents, and adults for a variety of issues. These include depression, Obsessive-compulsive disorder (OCD), anxiety, phobias, panic, anger, stress, insomnia, ADHD, autism, developmental delays, and work/home/school issues.
![Photo of Kathy Keefe-Cooperman, PsyD, Psychologist](https://photos.psychologytoday.com/28b0e40c-7f18-4813-a831-c1c693d5f27c/1/320x400.jpeg)
I conduct Autism Spectrum Disorder testing.
I help with mental health struggles and provide clear techniques to practice in daily life. We are a team, and my work is to find the strategies that will work for you or your child to improve quality of life and daily functioning. I am there for you using science and expert knowledge. My goal is to provide honest, accurate and caring treatment. I have extensive experience helping people who struggle with anxiety and/or depression.
I conduct Autism Spectrum Disorder testing.
I help with mental health struggles and provide clear techniques to practice in daily life. We are a team, and my work is to find the strategies that will work for you or your child to improve quality of life and daily functioning. I am there for you using science and expert knowledge. My goal is to provide honest, accurate and caring treatment. I have extensive experience helping people who struggle with anxiety and/or depression.
![Photo of Christopher Kotecha - Abundant Life Counseling, MA, LMHC, Counselor](https://photos.psychologytoday.com/e4914bdf-b770-4ff4-9288-09ca13691da9/1/320x400.jpeg)
Chris is certified in counseling Autism and Asperger's Syndrome from The International Association of Neuro-Diverse Christian Marriages and has received specialized training in Structural Family Therapy from the Minuchin Center.
Jesus said, “The thief comes only to steal, kill and destroy. I came that they may have life, and have it abundantly.” (John 10:10). What would abundant life look like for you? And are there any roadblocks you've encountered? For some its loss, fear, sadness, regret, shame, disappointment or a toxic relationship. I don't presume to have all of the answers, but I am here to partner with you on your journey. Whether it's discovering what your goals are, or just the cherry on the top. Counseling can be an investment in yourself and your future.
Chris is certified in counseling Autism and Asperger's Syndrome from The International Association of Neuro-Diverse Christian Marriages and has received specialized training in Structural Family Therapy from the Minuchin Center.
Jesus said, “The thief comes only to steal, kill and destroy. I came that they may have life, and have it abundantly.” (John 10:10). What would abundant life look like for you? And are there any roadblocks you've encountered? For some its loss, fear, sadness, regret, shame, disappointment or a toxic relationship. I don't presume to have all of the answers, but I am here to partner with you on your journey. Whether it's discovering what your goals are, or just the cherry on the top. Counseling can be an investment in yourself and your future.
See more therapy options for Croton On Hudson
Nearby Autism Therapists Searches for Croton On Hudson
- Briarcliff Manor
- Chappaqua
- Cortlandt Manor
- Mount Kisco
- Nanuet
- New City
- Nyack
- Ossining
- Peekskill
- Pleasantville
- Shrub Oak
- Yorktown Heights
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.