Strategic Planning - Needs Assessment Survey

1. Needs Assessment Survey 2014

Question Title

Please rank (by category) the need for the following supports for people with autism and/or their families in North Carolina. Indicate which supports should be the highest priority (=1), second highest priority (=2), and so on until the lowest priority. *note, you will only be allowed to select a number one time (i.e. the survey
does not allow for several #1 priorities)

Question Title

* 1. Advocacy

	1 Highest Priority	2	3	4	5	6 Lowest Priority
Provide a voice for individuals and families in schools, in the community, and with medical professionals	Provide a voice for individuals and families in schools, in the community, and with medical professionals 1 Highest Priority	Provide a voice for individuals and families in schools, in the community, and with medical professionals 2	Provide a voice for individuals and families in schools, in the community, and with medical professionals 3	Provide a voice for individuals and families in schools, in the community, and with medical professionals 4	Provide a voice for individuals and families in schools, in the community, and with medical professionals 5	Provide a voice for individuals and families in schools, in the community, and with medical professionals 6 Lowest Priority
Individual support for families through information and referral	Individual support for families through information and referral 1 Highest Priority	Individual support for families through information and referral 2	Individual support for families through information and referral 3	Individual support for families through information and referral 4	Individual support for families through information and referral 5	Individual support for families through information and referral 6 Lowest Priority
Group or parent-to-parent support through chapters	Group or parent-to-parent support through chapters 1 Highest Priority	Group or parent-to-parent support through chapters 2	Group or parent-to-parent support through chapters 3	Group or parent-to-parent support through chapters 4	Group or parent-to-parent support through chapters 5	Group or parent-to-parent support through chapters 6 Lowest Priority
Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 1 Highest Priority	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 2	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 3	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 4	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 5	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers 6 Lowest Priority
Helping individuals to be self-advocates	Helping individuals to be self-advocates 1 Highest Priority	Helping individuals to be self-advocates 2	Helping individuals to be self-advocates 3	Helping individuals to be self-advocates 4	Helping individuals to be self-advocates 5	Helping individuals to be self-advocates 6 Lowest Priority
Support for siblings, grandparents, and other extended family	Support for siblings, grandparents, and other extended family 1 Highest Priority	Support for siblings, grandparents, and other extended family 2	Support for siblings, grandparents, and other extended family 3	Support for siblings, grandparents, and other extended family 4	Support for siblings, grandparents, and other extended family 5	Support for siblings, grandparents, and other extended family 6 Lowest Priority

Other (please specify)

Question Title

* 2. Training and Education

	1 Highest Priority	2	3	4	5	6 Lowest Priority
Parent education and training	Parent education and training 1 Highest Priority	Parent education and training 2	Parent education and training 3	Parent education and training 4	Parent education and training 5	Parent education and training 6 Lowest Priority
Raise public awareness of autism	Raise public awareness of autism 1 Highest Priority	Raise public awareness of autism 2	Raise public awareness of autism 3	Raise public awareness of autism 4	Raise public awareness of autism 5	Raise public awareness of autism 6 Lowest Priority
Education and training for school system and child-care personnel	Education and training for school system and child-care personnel 1 Highest Priority	Education and training for school system and child-care personnel 2	Education and training for school system and child-care personnel 3	Education and training for school system and child-care personnel 4	Education and training for school system and child-care personnel 5	Education and training for school system and child-care personnel 6 Lowest Priority
Education and training for Managed Care Organization personnel and other providers, clinicians	Education and training for Managed Care Organization personnel and other providers, clinicians 1 Highest Priority	Education and training for Managed Care Organization personnel and other providers, clinicians 2	Education and training for Managed Care Organization personnel and other providers, clinicians 3	Education and training for Managed Care Organization personnel and other providers, clinicians 4	Education and training for Managed Care Organization personnel and other providers, clinicians 5	Education and training for Managed Care Organization personnel and other providers, clinicians 6 Lowest Priority
Education and training for medical personnel	Education and training for medical personnel 1 Highest Priority	Education and training for medical personnel 2	Education and training for medical personnel 3	Education and training for medical personnel 4	Education and training for medical personnel 5	Education and training for medical personnel 6 Lowest Priority
Education and training for first responders (EMT, police, fire, etc.)	Education and training for first responders (EMT, police, fire, etc.) 1 Highest Priority	Education and training for first responders (EMT, police, fire, etc.) 2	Education and training for first responders (EMT, police, fire, etc.) 3	Education and training for first responders (EMT, police, fire, etc.) 4	Education and training for first responders (EMT, police, fire, etc.) 5	Education and training for first responders (EMT, police, fire, etc.) 6 Lowest Priority

Other (please specify)

Question Title

* 3. Direct Services – Children

	1 Highest Priority	2	3	4	5	6	7	8	9 Lowest Priority
Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services)	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 1 Highest Priority	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 2	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 3	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 4	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 5	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 6	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 7	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 8	Community services – Medicaid (CAP/Innovations), state-funded (respite or hab services) 9 Lowest Priority
Diagnostic services	Diagnostic services 1 Highest Priority	Diagnostic services 2	Diagnostic services 3	Diagnostic services 4	Diagnostic services 5	Diagnostic services 6	Diagnostic services 7	Diagnostic services 8	Diagnostic services 9 Lowest Priority
Early intervention services	Early intervention services 1 Highest Priority	Early intervention services 2	Early intervention services 3	Early intervention services 4	Early intervention services 5	Early intervention services 6	Early intervention services 7	Early intervention services 8	Early intervention services 9 Lowest Priority
Overnight camps like Camp Royall	Overnight camps like Camp Royall 1 Highest Priority	Overnight camps like Camp Royall 2	Overnight camps like Camp Royall 3	Overnight camps like Camp Royall 4	Overnight camps like Camp Royall 5	Overnight camps like Camp Royall 6	Overnight camps like Camp Royall 7	Overnight camps like Camp Royall 8	Overnight camps like Camp Royall 9 Lowest Priority
Recreation services (social groups, art groups, etc.)	Recreation services (social groups, art groups, etc.) 1 Highest Priority	Recreation services (social groups, art groups, etc.) 2	Recreation services (social groups, art groups, etc.) 3	Recreation services (social groups, art groups, etc.) 4	Recreation services (social groups, art groups, etc.) 5	Recreation services (social groups, art groups, etc.) 6	Recreation services (social groups, art groups, etc.) 7	Recreation services (social groups, art groups, etc.) 8	Recreation services (social groups, art groups, etc.) 9 Lowest Priority
Crisis intervention/behavioral consultation	Crisis intervention/behavioral consultation 1 Highest Priority	Crisis intervention/behavioral consultation 2	Crisis intervention/behavioral consultation 3	Crisis intervention/behavioral consultation 4	Crisis intervention/behavioral consultation 5	Crisis intervention/behavioral consultation 6	Crisis intervention/behavioral consultation 7	Crisis intervention/behavioral consultation 8	Crisis intervention/behavioral consultation 9 Lowest Priority
Behavioral therapy	Behavioral therapy 1 Highest Priority	Behavioral therapy 2	Behavioral therapy 3	Behavioral therapy 4	Behavioral therapy 5	Behavioral therapy 6	Behavioral therapy 7	Behavioral therapy 8	Behavioral therapy 9 Lowest Priority
Day camps, summer programs, afterschool programs	Day camps, summer programs, afterschool programs 1 Highest Priority	Day camps, summer programs, afterschool programs 2	Day camps, summer programs, afterschool programs 3	Day camps, summer programs, afterschool programs 4	Day camps, summer programs, afterschool programs 5	Day camps, summer programs, afterschool programs 6	Day camps, summer programs, afterschool programs 7	Day camps, summer programs, afterschool programs 8	Day camps, summer programs, afterschool programs 9 Lowest Priority
Residential services for children	Residential services for children 1 Highest Priority	Residential services for children 2	Residential services for children 3	Residential services for children 4	Residential services for children 5	Residential services for children 6	Residential services for children 7	Residential services for children 8	Residential services for children 9 Lowest Priority

Other (please specify)

Question Title

* 4. Direct Services - Adult

	1 Highest Priority	2	3	4	5	6	7	8	9 Lowest Priority
Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 1 Highest Priority	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 2	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 3	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 4	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 5	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 6	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 7	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 8	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation 9 Lowest Priority
Meaningful day programming	Meaningful day programming 1 Highest Priority	Meaningful day programming 2	Meaningful day programming 3	Meaningful day programming 4	Meaningful day programming 5	Meaningful day programming 6	Meaningful day programming 7	Meaningful day programming 8	Meaningful day programming 9 Lowest Priority
Transition services into adulthood	Transition services into adulthood 1 Highest Priority	Transition services into adulthood 2	Transition services into adulthood 3	Transition services into adulthood 4	Transition services into adulthood 5	Transition services into adulthood 6	Transition services into adulthood 7	Transition services into adulthood 8	Transition services into adulthood 9 Lowest Priority
Services for those aging with ASD	Services for those aging with ASD 1 Highest Priority	Services for those aging with ASD 2	Services for those aging with ASD 3	Services for those aging with ASD 4	Services for those aging with ASD 5	Services for those aging with ASD 6	Services for those aging with ASD 7	Services for those aging with ASD 8	Services for those aging with ASD 9 Lowest Priority
Overnight camps like Camp Royall	Overnight camps like Camp Royall 1 Highest Priority	Overnight camps like Camp Royall 2	Overnight camps like Camp Royall 3	Overnight camps like Camp Royall 4	Overnight camps like Camp Royall 5	Overnight camps like Camp Royall 6	Overnight camps like Camp Royall 7	Overnight camps like Camp Royall 8	Overnight camps like Camp Royall 9 Lowest Priority
Recreation services (social groups, art groups, etc.)	Recreation services (social groups, art groups, etc.) 1 Highest Priority	Recreation services (social groups, art groups, etc.) 2	Recreation services (social groups, art groups, etc.) 3	Recreation services (social groups, art groups, etc.) 4	Recreation services (social groups, art groups, etc.) 5	Recreation services (social groups, art groups, etc.) 6	Recreation services (social groups, art groups, etc.) 7	Recreation services (social groups, art groups, etc.) 8	Recreation services (social groups, art groups, etc.) 9 Lowest Priority
Residential services/shared living for adults	Residential services/shared living for adults 1 Highest Priority	Residential services/shared living for adults 2	Residential services/shared living for adults 3	Residential services/shared living for adults 4	Residential services/shared living for adults 5	Residential services/shared living for adults 6	Residential services/shared living for adults 7	Residential services/shared living for adults 8	Residential services/shared living for adults 9 Lowest Priority
Vocational services (supported employment)	Vocational services (supported employment) 1 Highest Priority	Vocational services (supported employment) 2	Vocational services (supported employment) 3	Vocational services (supported employment) 4	Vocational services (supported employment) 5	Vocational services (supported employment) 6	Vocational services (supported employment) 7	Vocational services (supported employment) 8	Vocational services (supported employment) 9 Lowest Priority
Crisis intervention/behavioral consultation	Crisis intervention/behavioral consultation 1 Highest Priority	Crisis intervention/behavioral consultation 2	Crisis intervention/behavioral consultation 3	Crisis intervention/behavioral consultation 4	Crisis intervention/behavioral consultation 5	Crisis intervention/behavioral consultation 6	Crisis intervention/behavioral consultation 7	Crisis intervention/behavioral consultation 8	Crisis intervention/behavioral consultation 9 Lowest Priority

Other (please specify)

How would you rate the quality of ASNC in the following areas? How well are we doing on areas indicated
below? For areas that are rated as low quality, please provide suggestions for improvement.

Question Title

* 5. Advocacy

	very high quality	high quality	average	low quality	very low quality
Legislative advocacy	Legislative advocacy very high quality	Legislative advocacy high quality	Legislative advocacy average	Legislative advocacy low quality	Legislative advocacy very low quality
Individual and family advocacy/Information and referral	Individual and family advocacy/Information and referral very high quality	Individual and family advocacy/Information and referral high quality	Individual and family advocacy/Information and referral average	Individual and family advocacy/Information and referral low quality	Individual and family advocacy/Information and referral very low quality
Self-advocacy	Self-advocacy very high quality	Self-advocacy high quality	Self-advocacy average	Self-advocacy low quality	Self-advocacy very low quality
Chapter/support groups	Chapter/support groups very high quality	Chapter/support groups high quality	Chapter/support groups average	Chapter/support groups low quality	Chapter/support groups very low quality
Advocacy for rights of individuals with autism	Advocacy for rights of individuals with autism very high quality	Advocacy for rights of individuals with autism high quality	Advocacy for rights of individuals with autism average	Advocacy for rights of individuals with autism low quality	Advocacy for rights of individuals with autism very low quality
Support for siblings, grandparents, and other extended family	Support for siblings, grandparents, and other extended family very high quality	Support for siblings, grandparents, and other extended family high quality	Support for siblings, grandparents, and other extended family average	Support for siblings, grandparents, and other extended family low quality	Support for siblings, grandparents, and other extended family very low quality

Comments

Question Title

* 6. Training and Education

	very high quality	high quality	average	low quality	very low quality
Raise public awareness of autism	Raise public awareness of autism very high quality	Raise public awareness of autism high quality	Raise public awareness of autism average	Raise public awareness of autism low quality	Raise public awareness of autism very low quality
Bookstore	Bookstore very high quality	Bookstore high quality	Bookstore average	Bookstore low quality	Bookstore very low quality
Annual conference	Annual conference very high quality	Annual conference high quality	Annual conference average	Annual conference low quality	Annual conference very low quality
Training of ASNC staff	Training of ASNC staff very high quality	Training of ASNC staff high quality	Training of ASNC staff average	Training of ASNC staff low quality	Training of ASNC staff very low quality
Training for parents and other caregivers	Training for parents and other caregivers very high quality	Training for parents and other caregivers high quality	Training for parents and other caregivers average	Training for parents and other caregivers low quality	Training for parents and other caregivers very low quality
Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders	Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders very high quality	Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders high quality	Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders average	Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders low quality	Training for the community – school systems, child-care providers, MCOs, other providers, medical professionals, and first responders very low quality

Comments

Question Title

* 7. Direct Services

	very high quality	high quality	average	low quality	very low quality
Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation	Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation very high quality	Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation high quality	Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation average	Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation low quality	Community services – Medicaid (CAP/Innovations), state-funded, and Vocational Rehabilitation very low quality
Camp Royall	Camp Royall very high quality	Camp Royall high quality	Camp Royall average	Camp Royall low quality	Camp Royall very low quality
Recreation services (social groups, art groups, etc.)	Recreation services (social groups, art groups, etc.) very high quality	Recreation services (social groups, art groups, etc.) high quality	Recreation services (social groups, art groups, etc.) average	Recreation services (social groups, art groups, etc.) low quality	Recreation services (social groups, art groups, etc.) very low quality
Residential services for adults	Residential services for adults very high quality	Residential services for adults high quality	Residential services for adults average	Residential services for adults low quality	Residential services for adults very low quality
Meaningful day programming	Meaningful day programming very high quality	Meaningful day programming high quality	Meaningful day programming average	Meaningful day programming low quality	Meaningful day programming very low quality
Adult transition services	Adult transition services very high quality	Adult transition services high quality	Adult transition services average	Adult transition services low quality	Adult transition services very low quality
Vocational services (supported employment)	Vocational services (supported employment) very high quality	Vocational services (supported employment) high quality	Vocational services (supported employment) average	Vocational services (supported employment) low quality	Vocational services (supported employment) very low quality
Behavioral consultation	Behavioral consultation very high quality	Behavioral consultation high quality	Behavioral consultation average	Behavioral consultation low quality	Behavioral consultation very low quality
Crisis services/consultation	Crisis services/consultation very high quality	Crisis services/consultation high quality	Crisis services/consultation average	Crisis services/consultation low quality	Crisis services/consultation very low quality
Behavior therapy	Behavior therapy very high quality	Behavior therapy high quality	Behavior therapy average	Behavior therapy low quality	Behavior therapy very low quality

Comments

Question Title

* 8. Please list 2 to 3 things that you believe ASNC could do more of or do better to support the needs of the
autism community.

Question Title

* 9. Please list 2 to 3 things that you believe ASNC is currently doing well to support the needs of the autism community.

Thinking beyond ASNC, please rate HOW WELL you think the following needs are being met today by and other organizations.

Question Title

* 10. Advocacy

	very well met	well met	not met	not met at all
Provide a voice for individuals and families in schools, in the community, and with medical professionals	Provide a voice for individuals and families in schools, in the community, and with medical professionals very well met	Provide a voice for individuals and families in schools, in the community, and with medical professionals well met	Provide a voice for individuals and families in schools, in the community, and with medical professionals not met	Provide a voice for individuals and families in schools, in the community, and with medical professionals not met at all
Individual support for families through information and referral	Individual support for families through information and referral very well met	Individual support for families through information and referral well met	Individual support for families through information and referral not met	Individual support for families through information and referral not met at all
Group or parent-to-parent support through chapters	Group or parent-to-parent support through chapters very well met	Group or parent-to-parent support through chapters well met	Group or parent-to-parent support through chapters not met	Group or parent-to-parent support through chapters not met at all
Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers very well met	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers well met	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers not met	Advocacy for rights of and a voice for individuals with autism in the legislature and with local policy makers not met at all
Helping individuals to be self-advocates	Helping individuals to be self-advocates very well met	Helping individuals to be self-advocates well met	Helping individuals to be self-advocates not met	Helping individuals to be self-advocates not met at all
Support for siblings, grandparents, and other extended family	Support for siblings, grandparents, and other extended family very well met	Support for siblings, grandparents, and other extended family well met	Support for siblings, grandparents, and other extended family not met	Support for siblings, grandparents, and other extended family not met at all

Other (please specify)

Question Title

* 11. Training and Education

	very well met	well met	not met	not met at all
Parent education and training	Parent education and training very well met	Parent education and training well met	Parent education and training not met	Parent education and training not met at all
Raise public awareness of autism	Raise public awareness of autism very well met	Raise public awareness of autism well met	Raise public awareness of autism not met	Raise public awareness of autism not met at all
Education and training for school system and child-care personnel	Education and training for school system and child-care personnel very well met	Education and training for school system and child-care personnel well met	Education and training for school system and child-care personnel not met	Education and training for school system and child-care personnel not met at all
Education and training for MCO personnel and other providers	Education and training for MCO personnel and other providers very well met	Education and training for MCO personnel and other providers well met	Education and training for MCO personnel and other providers not met	Education and training for MCO personnel and other providers not met at all
Education and training for medical personnel	Education and training for medical personnel very well met	Education and training for medical personnel well met	Education and training for medical personnel not met	Education and training for medical personnel not met at all
Education and training for first responders (EMT, police, fire, etc.)	Education and training for first responders (EMT, police, fire, etc.) very well met	Education and training for first responders (EMT, police, fire, etc.) well met	Education and training for first responders (EMT, police, fire, etc.) not met	Education and training for first responders (EMT, police, fire, etc.) not met at all

Other (please specify)

Question Title

* 12. Direct Services - Children

	very well met	well met	not met	not met at all
Community services – Medicaid (CAP/Innovations), state-funded	Community services – Medicaid (CAP/Innovations), state-funded very well met	Community services – Medicaid (CAP/Innovations), state-funded well met	Community services – Medicaid (CAP/Innovations), state-funded not met	Community services – Medicaid (CAP/Innovations), state-funded not met at all
Diagnostic services	Diagnostic services very well met	Diagnostic services well met	Diagnostic services not met	Diagnostic services not met at all
Early intervention services	Early intervention services very well met	Early intervention services well met	Early intervention services not met	Early intervention services not met at all
Overnight camps like Camp Royall	Overnight camps like Camp Royall very well met	Overnight camps like Camp Royall well met	Overnight camps like Camp Royall not met	Overnight camps like Camp Royall not met at all
Day camps, summer programs, afterschool programs	Day camps, summer programs, afterschool programs very well met	Day camps, summer programs, afterschool programs well met	Day camps, summer programs, afterschool programs not met	Day camps, summer programs, afterschool programs not met at all
Recreation services (social groups, art groups, etc.)	Recreation services (social groups, art groups, etc.) very well met	Recreation services (social groups, art groups, etc.) well met	Recreation services (social groups, art groups, etc.) not met	Recreation services (social groups, art groups, etc.) not met at all
Residential services for children	Residential services for children very well met	Residential services for children well met	Residential services for children not met	Residential services for children not met at all
Crisis intervention/behavioral consultation	Crisis intervention/behavioral consultation very well met	Crisis intervention/behavioral consultation well met	Crisis intervention/behavioral consultation not met	Crisis intervention/behavioral consultation not met at all
Behavior therapy	Behavior therapy very well met	Behavior therapy well met	Behavior therapy not met	Behavior therapy not met at all

Other (please specify)

Question Title

* 13. Direct Services - Adult

	very well met	well met	not met	not met at all
Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation very well met	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation well met	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation not met	Community services – Medicaid (CAP/Innovations), state-funded and Vocational Rehabilitation not met at all
Meaningful day programming	Meaningful day programming very well met	Meaningful day programming well met	Meaningful day programming not met	Meaningful day programming not met at all
Transition services into adulthood	Transition services into adulthood very well met	Transition services into adulthood well met	Transition services into adulthood not met	Transition services into adulthood not met at all
Services for those aging with ASD	Services for those aging with ASD very well met	Services for those aging with ASD well met	Services for those aging with ASD not met	Services for those aging with ASD not met at all
Overnight camps like Camp Royall	Overnight camps like Camp Royall very well met	Overnight camps like Camp Royall well met	Overnight camps like Camp Royall not met	Overnight camps like Camp Royall not met at all
Recreation services (social groups, art groups, etc.)	Recreation services (social groups, art groups, etc.) very well met	Recreation services (social groups, art groups, etc.) well met	Recreation services (social groups, art groups, etc.) not met	Recreation services (social groups, art groups, etc.) not met at all
Residential/shared living services for adults	Residential/shared living services for adults very well met	Residential/shared living services for adults well met	Residential/shared living services for adults not met	Residential/shared living services for adults not met at all
Vocational services (supported employment)	Vocational services (supported employment) very well met	Vocational services (supported employment) well met	Vocational services (supported employment) not met	Vocational services (supported employment) not met at all
Crisis intervention/behavioral consultation	Crisis intervention/behavioral consultation very well met	Crisis intervention/behavioral consultation well met	Crisis intervention/behavioral consultation not met	Crisis intervention/behavioral consultation not met at all

Other (please specify)

Question Title

* 14. Please select the Autism Society of North Carolina services/events that you have used or experienced:

Chapter/support group

Autism Resource Specialists (Parent Advocate)

Workshops

Camp Royall

Annual conference

Bookstore

Run/Walks for Autism

Community services

Recreation services

Residential services

Adult day programming

Adult transition services

Vocational services

Behavioral consultation

Crisis consult/Services

Behavior therapy

Website/social media/other communications

Main office/admin staff

Other (please specify)

Question Title

* 15. Of those services/events listed above, how would you rate our quality and customer service? Consider how quickly staff responded to you, were able to find an answer to your question, were knowledgeable, how
eager staff were to help and how well they listened to you.

	extremely high quality	high quality	average	below average	lowest quality
Chapter/support group	Chapter/support group extremely high quality	Chapter/support group high quality	Chapter/support group average	Chapter/support group below average	Chapter/support group lowest quality
Autism Resource Specialists (Parent Advocates)	Autism Resource Specialists (Parent Advocates) extremely high quality	Autism Resource Specialists (Parent Advocates) high quality	Autism Resource Specialists (Parent Advocates) average	Autism Resource Specialists (Parent Advocates) below average	Autism Resource Specialists (Parent Advocates) lowest quality
Camp Royall staff	Camp Royall staff extremely high quality	Camp Royall staff high quality	Camp Royall staff average	Camp Royall staff below average	Camp Royall staff lowest quality
Annual conference staff	Annual conference staff extremely high quality	Annual conference staff high quality	Annual conference staff average	Annual conference staff below average	Annual conference staff lowest quality
Workshop staff	Workshop staff extremely high quality	Workshop staff high quality	Workshop staff average	Workshop staff below average	Workshop staff lowest quality
Bookstore staff	Bookstore staff extremely high quality	Bookstore staff high quality	Bookstore staff average	Bookstore staff below average	Bookstore staff lowest quality
Run/Walks for Autism (staff/volunteers)	Run/Walks for Autism (staff/volunteers) extremely high quality	Run/Walks for Autism (staff/volunteers) high quality	Run/Walks for Autism (staff/volunteers) average	Run/Walks for Autism (staff/volunteers) below average	Run/Walks for Autism (staff/volunteers) lowest quality
Community services (local office/staff)	Community services (local office/staff) extremely high quality	Community services (local office/staff) high quality	Community services (local office/staff) average	Community services (local office/staff) below average	Community services (local office/staff) lowest quality
Recreation service staff	Recreation service staff extremely high quality	Recreation service staff high quality	Recreation service staff average	Recreation service staff below average	Recreation service staff lowest quality
Residential service staff	Residential service staff extremely high quality	Residential service staff high quality	Residential service staff average	Residential service staff below average	Residential service staff lowest quality
Day program staff	Day program staff extremely high quality	Day program staff high quality	Day program staff average	Day program staff below average	Day program staff lowest quality
Adult transition service staff	Adult transition service staff extremely high quality	Adult transition service staff high quality	Adult transition service staff average	Adult transition service staff below average	Adult transition service staff lowest quality
Vocational service staff	Vocational service staff extremely high quality	Vocational service staff high quality	Vocational service staff average	Vocational service staff below average	Vocational service staff lowest quality
Behavioral consultation staff	Behavioral consultation staff extremely high quality	Behavioral consultation staff high quality	Behavioral consultation staff average	Behavioral consultation staff below average	Behavioral consultation staff lowest quality
Behavior therapy staff	Behavior therapy staff extremely high quality	Behavior therapy staff high quality	Behavior therapy staff average	Behavior therapy staff below average	Behavior therapy staff lowest quality
Website/Social Media/other publications	Website/Social Media/other publications extremely high quality	Website/Social Media/other publications high quality	Website/Social Media/other publications average	Website/Social Media/other publications below average	Website/Social Media/other publications lowest quality
Main office or Admin staff	Main office or Admin staff extremely high quality	Main office or Admin staff high quality	Main office or Admin staff average	Main office or Admin staff below average	Main office or Admin staff lowest quality

Other, or feedback if you ranked low - how can we improve?

Now we are going to ask some questions about you. This information is for background/demographic purposes only.
Please only answer if you feel comfortable. Please also be reminded individual responses are held confidential and will not be shared.

Question Title

* 16. What is your association with the Autism Society of North Carolina? (check all that apply)

Personally on the autism spectrum

Family member of someone on the autism spectrum

Friend of someone on the autism spectrum

ASNC Staff

ASNC Board Member

ASNC Chapter/Support Group Leader (present or past)

ASNC Volunteer

Support professional outside of ASNC

Other (please specify)

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* 17. What is the age of the person(s) with autism with whom you are associated? (check all that apply)

0 – 5 years

6 - 12

13 - 18

18 - 29

30 - 55

56 or older

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* 18. If you are a resident of North Carolina please indicate the county you reside in.

	NC Counties
Please choose from the following list	Please choose from the following list NC Counties menu

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* 19. What is your age?

18-25

26-35

36-45

46-55

56-65

66 or older

Other (please specify)

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* 20. What is your ethnicity?

Hipanic/Latino

Native American

Asian

Pacific Islander

African American

White

Other

Other (please specify)

Thank you so much for taking the time to share your information on the needs of the autism community in
North Carolina.

Please email Kerri Erb, kerb@autismsociety-nc.org, if you have questions about this survey or additional
information to provide.

Once our strategic planning process has concluded we will post the information on our website.

Thank you again for your time.

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* 1. Advocacy

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* 2. Training and Education

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* 3. Direct Services – Children

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* 4. Direct Services - Adult

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* 5. Advocacy

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* 6. Training and Education

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* 7. Direct Services

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* 8. Please list 2 to 3 things that you believe ASNC could do more of or do better to support the needs of the autism community.

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* 9. Please list 2 to 3 things that you believe ASNC is currently doing well to support the needs of the autism community.

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* 10. Advocacy

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* 11. Training and Education

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* 12. Direct Services - Children

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* 13. Direct Services - Adult

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* 14. Please select the Autism Society of North Carolina services/events that you have used or experienced:

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* 15. Of those services/events listed above, how would you rate our quality and customer service? Consider how quickly staff responded to you, were able to find an answer to your question, were knowledgeable, how eager staff were to help and how well they listened to you.

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* 16. What is your association with the Autism Society of North Carolina? (check all that apply)

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* 17. What is the age of the person(s) with autism with whom you are associated? (check all that apply)

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* 18. If you are a resident of North Carolina please indicate the county you reside in.

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* 19. What is your age?

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* 20. What is your ethnicity?

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* 8. Please list 2 to 3 things that you believe ASNC could do more of or do better to support the needs of the
autism community.

* 15. Of those services/events listed above, how would you rate our quality and customer service? Consider how quickly staff responded to you, were able to find an answer to your question, were knowledgeable, how
eager staff were to help and how well they listened to you.