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Social Skills Group Sign-up
This group will aim to provide a structured environment for ~8-12 year olds to develop and practice social skills. It will last 1 hour per week (from 4:30-5:30 PM Wednesdays) and run for 12 weeks. This group is being provided for free by Paragon Autism Services. To help us to ensure appropriate group composition, please answer the following questions to the best of your ability:
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What is your (parent/caregiver) first and last name?
Your answer
What is the best contact number for you (parent/caregiver)?
Your answer
What is your email address?
Your answer
What is your child's first name?
Your answer
How old is your child?
*
Your answer
Is your child able to communicate in sentences?
*
Yes
No
Other:
Is your child able to answer questions on preferred topics?
Yes
No
Other:
Clear selection
This group will be held in-person at our Fredericksburg and/or Woodbridge office (depending on your preference), and until further notice will require wearing a mask, per Paragon policy, are you and your child comfortable attending in-person events?
Yes
No
Other:
Clear selection
When your child is in a learning environment, how many adult prompts to engage, behave, or pay attention are typically needed in one 30 minute period?
1 or less
1
2
3
4
5
6
7
8
9
10
10 or more
Clear selection
This group will be held once per week in the late afternoon/evening and will require regular attendance and adult supervision (no drop offs allowed, 18+ parent/caregiver required), although not necessarily adult interaction. Please mark your child's afternoon availability here:
Monday
Tuesday
Wednesday
Thursday
5:00 - 6:00 PM
6:00 - 7:00 PM
Monday
Tuesday
Wednesday
Thursday
5:00 - 6:00 PM
6:00 - 7:00 PM
To help your child acquire and generalize new social skills each week, homework is required. Completing homework is the parent's responsibility for this course and it will involve creating opportunities for your child to practice important social skills, and then documenting the results. Will you agree to complete the homework/practice each week?
Yes
No
Clear selection
At which location would you prefer to attend this group?
Fredericksburg location
Woodbridge location
Neither, prefer a virtual setting
Clear selection
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