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So if your child's issues are too severe for a social skills class...


SarahW
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...where do you take them?

 

 

Crazypant's school announced that there was an option to sign up for a 1x/week social skills class (after school). This was not run by the school itself, but the school was providing the facility.

 

So even though we're in the middle of evals, I thought "why not? can't hurt" and DH and I asked to sign CP up.

 

At the intake interview, however, the social worker (social worker isn't a good translation, "social services worker" might be better, the class is run by a health organization within the provincial municipality, and she works for that) talked to CP a bit and then told DH that his issues are too severe to benefit from the class.

 

:001_unsure:

 

She did say that she was going to schedule another appointment for us to come in and talk to her. She can offer advice to get DH some help with his issues and maybe she can find us something suitable for CP.

 

 

We have our next neuropsych appt on Tuesday. This is the parent's-only meeting, and I think we'll do behavior checklists? But since the intelligence test is getting rescheduled, I don't know how long it will take until we have final results.

 

 

In the meantime, if we can get in to see the social services worker again - What comes before a social skills class?

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I guess my confusion is, how could she tell just from an interview that his social issues are too severe to benefit? Is it behavioral or theory of mind issues she saw (in which case therapy/ABA might help) or they think he'd be too disruptive, or...?

 

My (ADHD) daughter is not very self-aware, but she does take a social skills class in school (and did privately as well) and they've all been beneficial. In her school social group are two children on the spectrum, one who seems to have severe SPD, who also benefit. Did they give you some idea of why they don't think it would be a good fit?

Edited by nature girl
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I guess my confusion is, how could she tell just from an interview that his social issues are too severe to benefit?

This is exactly what I was wondering, and something I would be questioning before deciding how to approach this.

 

I feel, the suitability of one on one vs. group approach, would depend on the child's personality, also.

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She might know she is not running an actual therapeutic social skills program at all.

 

That is what I wonder.

 

He could be ready for a therapeutic program in general -- just not specifically what this woman is doing.

 

She could be doing a nice program but just different from what you would want, that is my thought.

 

Bc the social workers here also do social skills groups but they may or may not be "social skills groups" like for a child where they need a more formal program.

 

They could be doing a nice thing but just not what I would be looking at for my son.

 

But he could still be ready for a different social skills program.

Edited by Lecka
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My DD did an intake interview with one local play therapist for a social skills group and the reason why my DD was not placed into the group was the language delay. Everyone in the group needs to be at roughly the same functioning level for it to work well and my DD's receptive and expressive language was simply too far behind at the time. The therapist offered 1:1 sessions but it would've been paying out-of-pocket for similar things as the insurance-funded ABA team was already doing.

 

She did a different social skills group that worked well because the program allowed her to join the group aimed at 3-6 y.o.'s. She was the oldest one there at 7.5 but it was a good match for her functioning level.

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My son is in a group, but he is also working one on one with the social worker running the group because it was clear he needed that from the first sessions. He's not the only one working one on one. I think he would have probably been better served had we just done that first, but it is what it is.

 

I would imagine the social services worker may believe that type of work needs to happen first. In some autism therapies, kids progress from one on one with therapist/parent, to one other peer, to smaller groups, etc.

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That makes a lot of sense, Crimson Wife. It's so much easier to decide when the professionals explain the reasons behind their recommendations. Each child is so different!

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I wasn't actually at the intake, something came up at last minute. DH just said that the social worker said that he would not fit into the planned class, that he would disrupt the activity (from the description, the class is game-based). Maybe she was indeed thinking he should start one-on-one.

 

Since I wasn't there, I'm not sure what behaviors he exhibited. But if it was at all like when we did the psych intake, he probably poked around the room, did some somersaults, screamed when he stubbed his toe, and interrupted a gazillion times with random questions. School was on vacation this week, and the weather has been bad, so he's been sitting at home a lot cooking up some sort of stew of hyper-crazy. So she probably saw him at his best (worst?). 

 

Usually in groups he's not so crazy, but that might just be the anxiety depressing the hyperactivity? Eh, maybe his issues are just too complex to keep track of in a group.

 

We're definitely going to talk to the social worker again. She said that she could find a program for over-18's for DH to get a good eval that wouldn't cost an arm and a leg, so we're really interested in that. I'm not sure what other programs or therapies her organization runs. I don't think they do much themselves, I think they are mostly "brokers" for info on available services and what gets paid by the government or insurance. Which is good info to know!

 

 

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Here's the problem. You're new to this and you're looking at behaviors and maybe feeling kind of defensive. Dollars for donuts it wasn't just behavior. If it was just hyperactivity, she would have said hey see you after the psych eval and your ADHD meds scrip, kwim? That wasn't what she was seeing. That's there, but it's more.

 

What she's looking at it whether your dc has enough social thinking and theory of mind to do the activities. Social Thinking concepts start off really, really basic, with things like "body in the group" and "group plan." So does your ds get that there's a group plan and his body is not in the group and he's not on board with the group plan? Obviously not. He could be ADHD but still get group plan, still get body in the group, and still act appropriately.

 

So yes, she could tell pretty quickly where his starting point is and what his next step is.

 

Honestly, I wouldn't let it get really personal. It's just skills they learn. It's not that you're a bad parent or failed. You're a GOOD parent!! You're getting him diagnosed and you're getting your dc social skills work. And man, what an amazing dh that HE is onboard too and getting his own social skills intervention!!  Do you know how HUGE this is? Do you know how PIVOTAL that will be in your success? Everything your dh learns there will be at this higher cognitive level, with him able to process and trickle it down. It's gonna be JET FUEL for social skills in your home. This is awesome!

 

You've got a lot of good things going here. Just ride it out and do what she says. So she's wrong on something. No mess-up, you just change. But I'm guessing she's seeing it accurately and is assessing where he fits in the curriculum and what his next best steps are. You haven't seen the curriculum, so to you it's just kinda vague. I think when you see the materials, it will make sense. 

 

Ride it out and work through the process. It's gonna be fine! :)

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I don't think they do much themselves, I think they are mostly "brokers" for info on available services and what gets paid by the government or insurance.

 

So even though we're in the middle of evals, I thought "why not? can't hurt" and DH and I asked to sign CP up.

Sarah, quoting a couple of your comments and, not knowing your exact situation (I'm in Canada and a lot is different here), I would like to ask, why is this being recommended prior to the completion of CP's evals? See, here is my concern, if CP's services are government funded, is there a $$$ funding limit? If there is a limit, and depending on what your insurance covers of course, is it possible that the funds would be better allocated towards other services that he may need more at the moment?

 

I'm not sure if the point I am trying to make is coming across! Just saying, maybe it's best if you wait for the evals to be completed so that you have a better idea of what you are dealing with and what your resources are, before deciding on services/ therapies.

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Sarah, quoting a couple of your comments and, not knowing your exact situation (I'm in Canada and a lot is different here), I would like to ask, why is this being recommended prior to the completion of CP's evals? See, here is my concern, if CP's services are government funded, is there a $$$ funding limit? If there is a limit, and depending on what your insurance covers of course, is it possible that the funds would be better allocated towards other services that he may need more at the moment?

 

I'm not sure if the point I am trying to make is coming across! Just saying, maybe it's best if you wait for the evals to be completed so that you have a better idea of what you are dealing with and what your resources are, before deciding on services/ therapies.

 

Oh, this is something we would pay privately, though the cost was quite low. And I don't think there's a funding limit here.

 

Though when we get the follow-up appt with the social worker, that's a good question to ask her.

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Here's the problem. You're new to this and you're looking at behaviors and maybe feeling kind of defensive. Dollars for donuts it wasn't just behavior. If it was just hyperactivity, she would have said hey see you after the psych eval and your ADHD meds scrip, kwim? That wasn't what she was seeing. That's there, but it's more.

 

What she's looking at it whether your dc has enough social thinking and theory of mind to do the activities. Social Thinking concepts start off really, really basic, with things like "body in the group" and "group plan." So does your ds get that there's a group plan and his body is not in the group and he's not on board with the group plan? Obviously not. He could be ADHD but still get group plan, still get body in the group, and still act appropriately.

 

So yes, she could tell pretty quickly where his starting point is and what his next step is.

 

Honestly, I wouldn't let it get really personal. It's just skills they learn. It's not that you're a bad parent or failed. You're a GOOD parent!! You're getting him diagnosed and you're getting your dc social skills work. And man, what an amazing dh that HE is onboard too and getting his own social skills intervention!!  Do you know how HUGE this is? Do you know how PIVOTAL that will be in your success? Everything your dh learns there will be at this higher cognitive level, with him able to process and trickle it down. It's gonna be JET FUEL for social skills in your home. This is awesome!

 

You've got a lot of good things going here. Just ride it out and do what she says. So she's wrong on something. No mess-up, you just change. But I'm guessing she's seeing it accurately and is assessing where he fits in the curriculum and what his next best steps are. You haven't seen the curriculum, so to you it's just kinda vague. I think when you see the materials, it will make sense. 

 

Ride it out and work through the process. It's gonna be fine! :)

 

 

I was able to get some longer alone time with DH this morning and I asked for more detail about his behavior at the intake. DH said the main thing the SW said prevented him from the class was the inability to follow directions (and the emotional response he gave to having to do something he wasn't keen on doing - like sitting in the chair) and his hyperfocus, getting stuck on one activity or topic.

 

I understand that. It's just that sometimes he's worse than at other times. Can these things come in phases? Like, last weekend we were with my SIL and we had CP tag along to his cousin's handball team practice. He threw a ball around on the sidelines while the team did their drills, and then he joined in on the game at the end. He was a bit awkward, I guess, but it wasn't bad. And in the game when he didn't understand a rule he just went up to the coach and asked and then jumped back in. Afterwards he said he had fun. But, hmm, if you just ask him "do you want to go somewhere and play a game with kids?" he'll probably say that he's never done that before, and he hates that, and doesn't want to do it.

 

This week has been especially tiring because of the change in routine. Which seems to have set off worse behavior in him. That's all.

 

It's just such a crapshoot. If I ask him to do something he is sometimes very responsive and even realizes the reason why I made the request. Other times, I get a stubborn refusal and an emotional upheaval. It's like there's a 50/50 chance. I guess the SW thought those odds were too bad for a group with kids with their own issues?

 

I don't think I'm a bad parent. He's a good kid. I'm sick in bed with a cold and he just asked if I needed anything and brought me coffee.  :thumbup1:   He's generally thoughtful and kind and plays nicely with his baby brother. It's just sometimes...it's like something has flipped a switch, and I just want to wave my hands in the air and yell "But that's so inexplicable!"

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Our behaviorist has us keep data using log sheets. We track % compliance, % attention, behavior situations (ABC=antecedent, behavior, consequence), programs/skills that were successful, food, all sorts of things and we have them for shifts 1, 2, and 3 in the day. (It will vary during the day and they want to see that.) I think some of what you're seeing with the % compliance varying has bigger patterns than just the 10 minutes before, kwim? That's where taking data over a week or two and having a behaviorist look at it can get you something. They can help you find the patterns. 

 

Compliance is a huge, huge issue, yes. Again, I wouldn't question the social skills instructor. Just roll with it. Individual is better anyway. Sometimes group stuff is half worthless. Individual is really where it's at. 

 

And yes, my ds can have a string of days where we're really on and then wake up the next morning stimming and just GONE, like poof GONE. I was asking a friend, like what did I do WRONG?!?! and she's like oh it's the weather. I have no clue. Maybe there was a pattern. But whatever it is, it shows that his difficulties are enough that our skills are not yet consistent. It's not enough that he's compliant for you but not another adult. It's not enough that he's compliant in a preferred activity but not a non-preferred. It's not enough that he's regulating his emotions at home, in familiar situations, when he's not anxious, but not when he's in an unfamiliar setting. Kwim? Like there are levels to everything, and now you're seeing the holes.

 

You've done a lot of GOOD with him and laid some good foundation. Now you're going to step it to the next level. 

Edited by OhElizabeth
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Fwiw, another thing we track on our data forms is mood. Like just a basic thing of where he's at emotionally. We have a list of words and just tick them (compliant, grouchy, tired, happy ,etc.). So then they can quickly see and correlate moods and % compliance, kwim? We can start to see patterns in the data. We can start to predict what he's going to be successful with when he's a certain way, because we're tracking what he did that worked when he was that way before.

 

I was just reading some research on fatigue and aggression. Like it sounds really obvious when you think about it, but tired kids aren't at their best and are more likely to have behaviors. I kind of wonder if maybe like our kids are doing really well so we do things, then they're tired the next day or two, kwim? Like it's really challenging to make your expectations *consistent* and to keep them within reach. 

 

I don't know, just thinking out loud there. I remember thinking that with dd years ago, but for her it was school work, like the really heavy mental work, that was fatiguing. With ds, I think just the act of complying and working together is fatiguing, even if it's fun stuff like games.

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Fwiw, another thing we track on our data forms is mood. Like just a basic thing of where he's at emotionally. We have a list of words and just tick them (compliant, grouchy, tired, happy ,etc.). So then they can quickly see and correlate moods and % compliance, kwim? We can start to see patterns in the data. We can start to predict what he's going to be successful with when he's a certain way, because we're tracking what he did that worked when he was that way before.

 

I was just reading some research on fatigue and aggression. Like it sounds really obvious when you think about it, but tired kids aren't at their best and are more likely to have behaviors. I kind of wonder if maybe like our kids are doing really well so we do things, then they're tired the next day or two, kwim? Like it's really challenging to make your expectations *consistent* and to keep them within reach. 

 

This. A couple of weeks ago, DD was having a horrible time in school. Not sitting still, not following directions or staying on task. It was that way all week, after she'd been doing absolutely FABULOUSLY, really disconcerting and we thought it must mean she'd outgrown her dose and we should try the next dose.

 

So over President's Day weekend (we had a 4-day break) we went up to the next dose for two days, and she did fine, no better, no worse than usual. I decided to go back to the regular dose for the next two days just to make sure...but really she also seemed just fine. So I used the lower dose at school, and low and behold the teacher said she was back to her regular compliant self. And then we realized...All week, she'd been waking up early. She's usually an early riser, but this was about an hour less sleep. That was the ONLY variable that we could see...and apparently it was enough to push her over the edge. She's been sleeping regularly now, and we don't have any issues.

 

But there are certainly many things that can affect behavior, it's more complex than we realize. Changes in routine, stress, amount of exercise, food, fluctuations in hormones...If you think about it, everybody has good days and bad days, it's just the bad days for our kids can be much more severe and noticeable.

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Our behavior therapist constantly reminds me of this. . . always asks how his sleep patterns are (and eating, because he is a horrible eater). Tired, hungry typical developing kiddos are harder to manage. . . add in the challenges from non-typical brain wiring and you're going to have more issues. DS was having a patch of rough behavior a few weeks ago and BT was here on a home visit. He had an outburst that she handled for me, and could tell I was discouraged. . . reminded me that he had been sick the last week, and though better, was likely still tired and drained from being up in the night, etc, and had not eaten well. She thought things would even out in a few days. . . by Friday when she called, he was back to a more even keel. He also had some rough patches with the long weekend. Disruptions in schedule are hard for these kids. I tend to always think meds are failing, we need more intervention, etc. . . and she comes in and gently reminds me of the obvious. Ha ha. Thankful for her gentle presence. . . I tend to make things more complicated at times.

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I was just reading some research on fatigue and aggression. Like it sounds really obvious when you think about it, but tired kids aren't at their best and are more likely to have behaviors. I kind of wonder if maybe like our kids are doing really well so we do things, then they're tired the next day or two, kwim? Like it's really challenging to make your expectations *consistent* and to keep them within reach.

 

There's mental fatigue and there's physical fatigue. I wasn't quite sure which you were referring to. Either way, I did not come across anything supporting this theory. It would be useful if you could provide the source.

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OK, just to clarify that this speaks specifically about poor sleep linked to behavior problems, and the research was limited to 81 children.

 

A quote:

 

"Kids who woke repeatedly during the night had the most trouble with behavior, exhibiting higher levels of physical aggression, hostility, lack of attention and hyperactivity, the study found. Other issues including how long a child slept and the sleeping disorder parasomnia were also associated with increased behavior problems.

 

Though it’s unclear what’s driving sleep challenges in those with autism, the researchers said their findings highlight the importance of considering sleep habits, especially when evaluating behavior."

 

It does not speak about fatigue due to physical activity or mental fatigue due to a heavy workload in school, for example. Good to know exactly what we are talking about.

 

Thank you for the link.

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Perhaps some may find this useful. It's a short article, so I'll quote it fully and include a link to the source.

 

From the Autism Research Institute in San Diego:

 

"Written by Stephen M. Edelson, Ph.D.

 

One of the most effective treatments for autistic people is exercise. Studies show that vigorous or strenuous exercise is associated with decreases in stereotypic (self-stimulatory) behaviors, hyperactivity, aggression, self-injury, and destructiveness. Vigorous exercise means a 20-minute or longer aerobic workout, 3 to 4 days a week; mild exercise has little effect on behavior. Many autistic children gain weight if they have an inactive life-style, and weight gain brings another set of problems.

 

In general, exercise is important for both physical and mental health. A number of studies have shown that vigorous exercise is one of the best treatments for depression. Exercise can reduce stress and anxiety as well as improve sleep, reaction time, and memory.

 

Since stereotypic behaviors interfere with teaching, an exercise program might improve the student's attention in the classroom. Parents and teachers should consider including a rigorous exercise program in the student's Individualized Education Program (IEP). (One should not assume that the student gets adequate exercise during recess.)

 

Since exercise is inexpensive, safe, and healthful, it makes sense to try an exercise program to reduce behavior problems rather than to use more expensive and possibly harmful treatments, such as drugs."

 

https://www.autism.com/treating_exercise

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Really, it only makes sense that it would apply to the non-autistic population. How do you feel when you haven't gotten enough sleep? How do you react when you're mentally stressed by too much work or other stresses? Of course it affects our kids, and I've read in numerous places how important sleep is for ADHD kids. If you search on ADHD and sleep, you'll find numerous links saying it worsens inattention and behavior.

 

Thanks for the quote about exercise...I know it's made a great difference in my DD, it increases both dopamine and serotonin. (This is why we all feel happier after exercise! Now during that exercise...not so much, lol.)

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Well, I was still sick today, but well enough to get out of bed and do laundry and the afterschooling.

 

Tracking his behavior sounds like an excellent idea. But I am having a hard time picturing it. With all the different things to checkmark, I'm envisioning an 8ft by 8ft wall chart! lol.

 

Keeping sugar intake low helps even out his mood. But the diet here is so sugary and starchy, and the foods he'll eat so limited, that I feel like I'm just on the level of doing damage control. We keep a variety of sugar free drinks in the house, since DH's diabetic, but he's now declared that all those drinks, all drinks, make his stomach hurt. He can only drink water (which he isn't keen on) or eat popsicles, which are not sugar-free. 

 

Exercise is a good point. I think part of the issue last week is that he missed his school recess and gym time. We're planning to get him signed up again with swimming lessons. And hopefully soon we'll be able to set up the backyard trampoline.

 

Sleep - he doesn't sleep a lot. Not for a kid. 9 hrs. seems to be his max. He has a hard time getting to sleep, and sometimes at bedtime he has an anxiety attack so we stay up together until it's done or he's fallen asleep.

 

I try to tell him advance what we're going to do, and keep changes to a minimum.  But even sometimes advance notice set him off.

 

And then there's how much we say "no" to him during a day. That'll get him grumpy.

 

So people put this on a spreadsheet and track it? Hmmmmmmm........

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It is very possible to only have water to drink. Cheaper, too :)  None of us in this house drink anything but water and the occasional beer or herbal tea - largely because my kids are small and make juice messes and we are non-dairy, but also because they'd just drink 3 quarts of apple juice in a day if I had it in the house.  we also don't have popsicles ever (again with the messes)

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OhE, I have heard this home grown thing mentioned before, and I just don't get it! Should people that use methods different than the norm on this board not have a voice? Are we going to put others in danger or destroy their families?

 

Nothing I do with my kids is homegrown. It stems from all the reading I have done. And I don't recommend anything I do to anyone else. It's a board where you share your personal stories and experiences with challenges your kids are faced with, so that is what I am doing. Nothing different from anyone else on here.

 

OhE, I think you are making assumptions about my life because you don't understand. You view things differently. If you read biographies, like I do, you will see that many many people have had successful lives living differently than the social norm of the majority. Yesterday, my 13 yr old and I read a biography on Anna Comstock (you know, the author of the Handbook of Nature Study). It was exactly what we were discussing. How different her and her husband's life was from what most consider normal.

 

Trust me, my kids will not do less than I, but it will not be the same as your normal. I encourage my kids to be what they want to be. That is a successful life, for me, and my husband as well. Hubby and I are a team and on the same page about life and values. We don't decide for them how social or not social they should be. We make decisions as a family and our kids have a lot of say in the decisions.

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DS is in social skills classes at school. Now that he is at school, we are learning more about his social abilities than we did when we were homeschooling. Neither perspective is wrong or bad; they are just different. He functions differently in different environments.

 

The social demands are different in a group at school than they are at home, even though we function as a "group" at home as well. I'm also finding that his social abilities are different in the social skills class than they are outside the social skills class. We have our IEP update meeting tomorrow, and some of the things that the SLP says he has made progress on in class....well, we haven't seen progress on those things out in real life. He's not generalizing. Or at least not enough. He may be doing better in the environment at school, but he still has issues when in the environment out in the world.

 

The social skills thing is all a big puzzle. We're working on it from multiple angles at the same time.

 

Just for clarity -- DS is not diagnosed as autistic (he has NVLD) but has very low pragmatic scores.

 

Also, we say "no" here a lot. Not because it was a parenting strategy from the get go. We'd rather not have to say no as often as we do. But we do what has proven to be effective. DS does not respond well to logic and reasoning. He simply argues and argues and argues, and it takes a straightforward "No" for him to understand that "No" is what we mean. We also do a lot of discussing and explaining, so that he can understand why. But he never comes around to see our point of view when we reason with him.

 

People just respond differently. What works for one doesn't work for another.

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Some members have approached the conversation of SN with some presumptions that can be a bit abrasive. I don't believe these views are held by the majority, but by a very vocal minority.

 

Choices for therapy and education are very personal. To assume that someone is not doing the right thing because they are not doing what someone else would do is inappropriate. It serves no one to attempt to justify insistence on following a single path by claiming that it is the only informed decision one could make. My life experience tells me that people who are certain they always know best, seldom do. 

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