Request for Direct Services Trainings and Consultation

The Direct Services Department with The West Virginia Autism Training Center (WV ATC) at Marshall University is excited to offer consultation services. The WVATC has worked alongside school professionals and community-based agencies to assist in meeting the needs of individuals with autism spectrum disorder (ASD) since the inception of our agency in 1984. Given the rise in prevalence of individuals diagnosed with ASD the demand for schools, agencies, and organizations to provide comprehensive services has increased as well. Given our staff’s experience and training in such areas as autism specific trainings, behavior support planning, and environmental design we are happy to expand our role in supporting individuals with ASD.

We are happy to offer the services below based on an hourly rate of $200* per hour (*out of region training will have additional travel costs associated). The number of hours needed will vary based on the complexity of the situation, but the ATC staff will work with you to explore options prior to the initiation of services.

Name(Required)

First Last

Email(Required)

Phone(Required)

Position/Title(Required)

School/Agency(Required)

County(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Have you requested training or consultation from Direct Services previously?(Required)

When and What?(Required)

i.e. Overview of ASD staff training in December of 2021

What type of request are you seeking?(Required)

Autism Specific Trainings(Required)

What is the timeline for your request?(Required)

i.e. Sometime in late March beginning of April. I am flexible but would like to have the training before the middle of April.

What is the targeted age range and/or grade level of students that will benefit from the technical assistance/training/professional development?(Required)

i.e. My after school staff work with students from PreK-5th grade/5-11 years old

What is the expected number of attendees for the training/professional development? Please describe the participants.(Required)

i.e. I am expecting all teachers (PreK-after school staff), our behavior support specialist, and counselor to attend. I would estimate around 30 attendees.

Please describe your environmental design needs(Required)

i.e. Our church would like to develop a more autism-friendly environment that congregate members with ASD would feel most comfortable

Given the scope of the work at the WV ATC our consultation services will be limited to students with an ASD diagnosis.

School-based consultation(Required)

What is the targeted age range/ grade range of the individual (s) with ASD that your school/agency would benefit from training?(Required)

i.e. Student identified with ASD in 3rd grade

Please describe the individual student needs, challenges, or concerns(Required)

Who are the educators/staff who would be included in coaching supports?(Required)

i.e. 3rd grade classroom teacher and aide

Please describe the desired outcome for educator/staff coaching(Required)

Please describe your environmental design needs(Required)

i.e. Our school would like to develop a sensory room

***Please provide 3 dates when you will be available to have an initial phone consultation to discuss your request.***

Choice 1(Required)

Choice 2(Required)

Choice 3(Required)

Plese include any other important information or details with this request.

Request for Direct Services Trainings and Consultation

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