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1. Summit Evaluation

Dear Participants,

Thank you for your active participation and engagement at the Act Early Region X Summit which took place February 4-5, in Seattle, WA. As discussed at the Summit, we would like to solicit your input and comments on the Summit. Please provide us feedback through completing the following survey.

Sincerely,

AUCD Staff

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* 1. Please indicate your state team or affiliation.

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* 2. The Act Early Summit brought together key stakeholders in my state to discuss early identification and intervention.

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* 3. The objectives of the Act Early Summit were clearly described through pre-Summit invitation materials, pre-summit teleconferences, and by AUCD staff during the Summit.

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* 4. The pre-summit webinars/teleconferences were helpful in understanding the Kellogg logic model and developing the state action plan.

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* 5. The content of the Keynote presentations from the Summit were useful.

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* 6. The content of the Policy and Legislation Panel (day one) was useful

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* 7. The content from the National Autism Initiatives Panel (day two) was useful

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* 8. Prior to the Act Early Summit, I had collaborated with ___% of team members on early identification and early intervention initiatives in autism spectrum disorder and related developmental disabilities.

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* 9. I learned new information about my state from other members of my state team.

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* 10. I learned new information from members of OTHER state teams.

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* 11. Every person on my state team had opportunities to participate in the discussion and planning process.

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* 12. I am interested and willing in continuing to work with my state team.

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* 13. My state team identified obstacles and opportunities for enhancing early identification and action within my state.

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* 14. My state team has a plan for continuing to work together after the Summit.

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* 15. The Kellogg Logic Model was useful in guiding the dialogue to develop state action plans.

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* 16. The facilitator provided helpful guidance in the discussion and development of the state action plan.

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* 17. The Summit provided an opportunity for me to network and interact with peers

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* 18. The logistics of the Summit were well organized (e.g. timing, travel, lodging, financial).

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* 19. I was familiar with the “Learn the Signs. Act Early.” campaign before the Act Early Summit.

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* 20. I have used “Learn the Signs. Act Early.” campaign materials prior to the Summit.

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* 21. I intend to use “Learn the Signs. Act Early.” campaign materials in the next few months.

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* 22. I was familiar with the Combating Autism Act Initiative prior to the Act Early Summit.

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* 23. Do you have suggestions for future Summits?

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* 24. Do you have suggestions regarding effective ways AUCD can provide technical assistance and support your state team in the continued development and implementation of the activities developed in the state action plans?

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