What Harvard's Research Means for Children who are DeafBlind Transcript Start Chris Montgomery: Okey‑dokey? All right. Let's introduce these folks. Matt Schultz: You guys met Dr. Judy Cameron from the University of Pittsburgh earlier. Next is Dr. Suzanne Zeedyk, this is a research scientist at the University of Dundee in Scotland. She completed her Ph.D at Yale University and is president of the U.S. Science Foundation postgraduate fellowship and the award for the most inspirational teacher in 2011 at the University of Dundee. [Applause]. In 2014 Suzanne founded an organization called Connected Baby. She and her team worked to help parents and professionals make practical use of the science of connection. And you can find out more about that ‑‑ more information about that at her website, suzannezeedyk.com. Welcome, Suzanne. We are so glad to have you. [Applause]. Montgomery: We are going to take turns here, so I've got Bernadette van den Tillaart. [ Laughter ]. Bernadette was ‑‑ oh my gosh. She was just key to our whole projects sort of grappling with and understanding this whole idea of interaction like what is that, what does that mean, how do you do that with a person with DeafBlindness? She spent a couple of years with us teaching us her interaction protocol. It was earth‑shattering for us to say the least. Now I'm going to read some stuff that I have written. So Bernadette currently works as a DeafBlind education consultant at the Ohio School for the Blind and she is a Ph.D scholar in DeafBlindness at Ohio State University. She's worked for many years in our field. She's collaborated with people like Paul Hart, Barbara Miles, Gunnar Vege, and she was the DBI's lead in the tactile network and if anyone has seen it or was here at our last Symposium, she was a key collaborator in the film "Landscape touch." Bernadette, thank you for being here again. [Applause]. Schultz: Next to Bernadette we have David Brown. David has been a special education teacher for more than 30 years. He has credentials with teaching students with DeafBlindness. David has worked as an itinerant teacher for the National Association for DeafBlind in England for 18 years before he moved to California where he got a similar position with the California DeafBlind Services. In 2013 David was awarded the DeafBlind International lifetime achievement award for his innovative and visionary work for people with DeafBlindness. [Applause]. In 2005 David was awarded the Stars in Charge Award, the highest award given by the CHARGE Syndrome Foundation. Welcome, David, we're thrilled to have you today. [Applause]. Montgomery: And the person way down on the end, I feel like you're a mile away, Robbie. Robbie Blaha: Okay. I'm the only one without a doctorate. [ Laughter ] I do want to thank each and every one of you smarty pants for being here today. Montgomery: Let me introduce you. Would you just stop a second? I was asked how am I going to interject. And I said I'm going to stand over here, Matt and I will stand over here and just stop, stop. So Robbie, if anybody out there doesn't know Robbie, she was the first person on our Texas DeafBlind Project. [Applause]. She like started this stuff, 30 years of the symposium, she's been here for all of those. Hello! [Applause]. She has been an absolute inspiration and mentor to so many people in Texas. For a long time. Schultz: Let's dig in a here. Montgomery: I can't verify it, but I'm going to say she was the first teacher of the DeafBlind in Texas, right? [Applause]. And then I will stop there. Schultz: Yeah. All right. Let's get started with our discussion. Dr. Cameron did such a wonderful job outlined her work and the work with the Harvard center and the developing child, so we're anxious to hear response to a lot of that information from our panel. Suzanne, we'd like to start with you. We saw a great video earlier that introduced us to the concept of serve and return, and its impact on the developing brain. From the video we see that the serve and return process is the process by which brain architecture develops, including emotional development. Can you talk more about serve and return in reference to young children with DeafBlindness, including the challenges our kids face and ways that we can overcome? Zeedyk: Absolutely. Can I check that you can hear me? Yes, yay, okay. Then my cortisol levels go down. [ Laughter ]. The lovely description that we got from the film presented by Judy talked about serve and return. So it's a bit like a tennis game, so the baby serves and any other adult, the parent a lot, but it could be a teacher, it could be the babysitter, it could be the stranger in the supermarket line. The baby serves something and the adult returns it, if they notice it. And if they think that it's significant enough to be returned. And they might do that unconsciously. They might do that consciously, but the point is that when it gets returned the baby's brain knows that somebody else noticed it and clocks it up themselves. So you just do that, play a tennis game. So that simple process of that's building neural pathways and building brain architecture, like it's ‑‑ it feels straightforward. That's why that lovely metaphor of serve and return is helpful and that's why Harvard has really sought to use that. Every time the call gets returned to the baby, the neural pathways get strengthened. So just knowing that helps us go, okay, I get it, that's how brains are built. Because then more interesting insights come. It turns out that you can respond to what the baby does positively or negatively. Because you might perceive that the baby is misbehaving. The baby didn't mean to misbehave, but you interpreted it as misbehavior. So when you respond in a negative fashion, the baby learns that that's a bad thing. If you respond positively the baby learns that's a positive thing. And they're learning about themselves, so it's not just that they're learning about the act. They are learning about themselves. Are they a good person or a bad person? Does that make sense? I'm using really simplistic language, but it helps us to get that idea. Okay. Now let's put that in the context of a DeafBlind child who's just like any other baby, responding to the world as their brain lets them do that, but of course their world isn't like the world of a person who can see and hear. So their behavior may not read the same to ‑‑ to those of us who are unconsciously expecting it to look like the behavior of a person who can see and hear. Especially if we don't know that the baby is having trouble seeing or hearing. So Selma Freiberg's work in the 1970s, studying babies who were blind, some of the key research that helped us to start to build up this field, she talked to mothers who when the baby turned away, probably orienting with their ear to hear what the mother was saying, and the mothers didn't know that the baby was blind, the mothers interpreted that as the baby didn't love them. Attendee: Awww. Zeedyk: I like that, who said awww. I like that example because it makes ‑‑ that makes sense to lots of us. Then we start to realize something about how our brains are reading the world, too. So we unconsciously expect people to look at us because that feels like the return, we served you a look, when you looked back you returned that to me and I feel good about myself. If your baby looks away, you can easily unconsciously read that as my baby doesn't like me, then I feel bad about myself. And then that starts to filter into the serve and returns within a relationship. And that serve and return goes on and on and on and it becomes part of the rhythm of the relationship. As well as part of the baby's neural pathways and part of the baby's understanding about what people are like. So those first lessons that you get about serve and return teach you about so much. They teach you about yourself. They teach you about the other person you're engaging with. And they teach you about what people are like. And the ‑‑ the fascinating, exciting, thing about DeafBlindness that is really important to the whole of the rest of this area of development is it helps us think about what happens when modalities don't match up and they are hard for another person to read. Does all of that make sense? Okay. So I'm going to add one more thing and then I'm going to stop. All of that developmental experience will be in all of us and in a person who is DeafBlind. So if you meet a person who is DeafBlind when they're 25 or 56 or 14, they have those early experiences of people built into their brains. And some of those may happen really positive, if you had a family who could tune in and was curious, or some of them may not have been quite so enriching because you had a family who was confused or overwhelmed. So they bring with them those experiences. So this morning when Joe said sometimes he wondered if those early experiences of being in long‑term hospital had as much to do with the behavior of the people that he was working with as the DeafBlindness, I sat at my back table and went uh‑huh, uh‑huh, uh‑huh. If we can think more, if we can get curious about what developmental histories might have been, even if we don't know what they are, if we are curious, then we start to have more, you know, more avenues and insights as to how we can reach a person even now. Pathways continue to rewire. They rewire even after 25, just not as quickly or easily. So DeafBlindness really helps basic developmental psychologists to think about the process of matching modalities. I'm stopping now Matt. Schutz: We're going to come back to you here shortly. Okay. Thank you. Montgomery: Bernadette, for so many of our kids, social interactions can be stressful situations. Like ‑‑ like Suzanne was just kind of talking about, so I'm going to bounce this on down the table. That problem can manifest itself in forming those good and positive relationships. Can you talk to us a little bit about how we can help our kids manage that stress and then go on to form those good, positive, strong relationships? Bernadette: Yes, I can give it a try. [ Laughter ]. So I will start a little bit different. But it is a very good question. So I've been thinking about when Judy talked about the fulcrum, where is the fulcrum, you know, on the see‑saw. It's not only the middle, but where is the child. So that it easily fits negative or positive and how can we move the fulcrum of a child so that a positive experiences have quicker action and there's less stress and better brain architectural development. So I've been looking at if a child is born DeafBlind, then there are several issues. One is health. So that gives bodily stress. Then there are maybe areas in the brain that are damaged. Which makes it vulnerable and gives stress. And then there is the vision and hearing loss. And then when these children are in the world, and they try to survive, and then they try to develop, of course, there's a lot of medical care, which needs to be there, and then the brain damage can be to a certain degree maybe permanent, but maybe not, and then about the DeafBlindness. Does DeafBlindness affect the brain architecture? Yes. Because we know from research when people are blind, that for instance the ‑‑ the ‑‑ their visual cortex, like you talked about, in the back, is going to be used for touch and hearing. So those elements if there's a match. So that is ‑‑ then the same applies to hearing. What areas of the brain that were previously used, should have been used for hearing, will be used in some ways by touch or vision. So there is a certain impact on it that is not necessarily bad at all. All right? So ‑‑ but on the other hand, does DeafBlindness itself, vision and hearing impairment, really impact if a brain does not develop well? And I say it kind of direct, of course I'm more yeses and nos to it, but I think that the DeafBlindness and blindness combined is not actually the factor that impacts if a child can develop and if the brain architecture can develop or not. I think it can. So what are the factors then that are so harmful for our kids when they're born? So ‑‑ that is like Suzanne said, when they are born, it is so difficult for parents and others to recognize their behavior. They're not used to communicating with touch. In the beginning there's a lot of touch. But even that can be intrusive, right, when they do not pick up that the door goes open, or that mom looks before she picks up the child. So touch can be intrusive. And there's a lot of misunderstanding, the serve and return is not going to happen in a way that it creates reciprocity. Because there's a mismatch between where the strength of the child is in the sense of touch and what other people are used to with hearing and vision. So what happens then is that ‑‑ that there are misunderstandings. And all of they see misunderstandings is a tremendous amount of stress for the child. And for the parents and other people who aren't the child. It's not only that it gives stress to the child, but the child also feels tactilely the stress of people around them who feel difficult like what you described, does any child not love me. If it's tactile, you can feel that immediately, there are so many layers to touch and stress. So with all of these misunderstandings and if the relationship does not develop well, then of course the development of language is difficult and then of course exploration of the world is difficult. And so the intervention piece, which should move the fulcrum, is, of course, on the tactile serve and return, people who know me understand when I say the tactile serve and firm and return. And then one of the readings was so if you can establish, the serve and return, that needs to be a strong stable committed one person available for that child who can do that. And that leads immediately for all of our efforts to get [indiscernible] for our children. Then, of course, we have ‑‑ we have been working on video analysis and that will really help in the intervention. And I know that Adam tomorrow and ‑‑ Adam Graves and his team that he worked with will do a presentation on this, which will link very nicely with what he just heard from Julie. What I want to say, if I think about one student with CHARGE syndrome, he had a history of stress. She had a history of stress. She moved between schools when she was seven she moved to her fourth school, she came in, hitting, biting, scratching, kids, everything that you can imagine, adults. And the only thing that we started working on was ‑‑ was gentle touch. Gradually hand under hand and serve and return for the interaction. And we did that for a year. Of course, there were activities, but that was the goal. So this changed so much in this child that what happened now is that her attention is there, and that is also something that has to develop, it's neurological. Another thing is her processing time is decreasing. She can't attend, she understands. Her behavior regulation has decreased, she has no ways of asking for support when she feels the stress increasing. And the last thing you can say is that I strongly believe that we should not do any cognitive testing when we have not established with the child ‑‑ not that we shouldn't do it, but look at results and think about what it means. Because if a child does not have that reciprocity and no stress ‑‑ until that moment, the brain development cannot happen. And if we look at a child and we have opinions about all of the test results and we do not know anything about the potential. And that is, if we talk about brain architecture, brain development, you first have to establish that a child doesn't have stress, knows about reciprocity and then we can talk about the rest. Montgomery: Great, thank you, Bernadette. Schutz: David, we've talked a lot today about the impact that stress has on our students, their development and their ability to connect. But I'm wondering if you could speak to us a little bit about how stress impacts our families and on their development as family units and the impact it has on their ability to connect with services and support. Brown: Okay. As Judy said, about two weeks ago we had a video conference, all of us together, and we were really kind of jostling on position on who wanted to do what, and who knew what, and all that kind of thing. My instinctive response was, well, you can do it and I'll just sit there and smile. [ Laughter ]. And they weren't going to fall for that. But right at the beginning I made two points. First of all, we need to stop thinking about us and them. And one of the beauties of all of the presentations today, all four of the presentations before this panel ‑‑ I think there were four ‑‑ the presenters never assumed we were talking about us and them. It was always children with DeafBlindness are people just like we're people. And I think that's a really important point. We've all gone through adverse experiences in early childhood and we're still doing it now decades later. We've all had to struggle with various levels of sensory integration and sensory differentiation dysfunction. I know personally that those problems get more pressing with the passage of time and that's unavoidable to me these days, that realization. So that was the first point. And then the other point I made was if we're talking about trauma, adverse experiences and stress, we have to remember ‑‑ I've always been an itinerant teacher rather than a classroom teacher, so I haven't worked directly with children. I've always worked with parents and family members or professional teams. And so much of my time is spent observing and analyzing and trying to understand the stresses and the capabilities and the motivators of those adults before I even begin to focus on the child and start trying to work out who they are. And that was what led to this question, but I think we could have a three‑day conference on families and professionals and stress. So I want to come back to the children and just make a few points that I'll be making tomorrow in much more detail. There's a tradition in the DeafBlind field, making a joke, you all know that real estate, buying and selling houses, is about three main things, location, location, location. And it's a kind of lame joke really, but you have to laugh and say oh, very witty. [ Laughter ]. And then somebody had the brilliant idea of saying, working with students with DeafBlindness is about three main things, communication, communication, communication. And I always disagreed. I thought that was far too limiting actually because it's about way more. And then about two years ago I had a sudden ah‑ha moment and I thought yeah, the three communications are first for the child in terms of their experience and the most urgent in terms of the way their brains ‑‑ our brains are wired is communication between the child's brain and the child's own body. And if that communication is impaired, which it will be in DeafBlindness because increasingly we're seeing a population with complex multiple disability and multisensory impairment. It's not to think about vision and hearing and then bring in touch as the compensating sense. We have to think of all the sensory systems. And if the senses are not working properly, if the brain doesn't have effective contact with the body, the very first serving that that brain has to do is to ask its body to respond. And the child develops movement patterns on what we dismissively called self‑stiming behaviors as a way of getting that stimulating between the brain and body. And once that's in place on some level that brain is then able to focus on the second communication which is the more traditional meaning of serve and return with another person, especially a significant other person. And then third communication would be communication between the child and the more extended social world and the more extensive inanimate world around it. And I think that's quite a useful way to think about this in every situation, is that child's brain in contact with the body effectively so that it's available for the things I'm trying to do with the child. And my last point I learned from [indiscernible] decades ago that everything the child does has meaning, and our first job is to interpret and understand what that meaning is. And if we accept that everything the child does is a serve, they are ‑‑ everything they do, every movement, every sound, every change in breathing, every eye movement is a potential serve that we can respond to, we're going to be in a much better position to build a relationship with the child because these kids are very hard to understand. And I'll stop there. One of my anxieties about this panel is we can all talk all day. [ Laughter ]. We're all being so good. [ Laughter ]. Montgomery: But we love it, David. Thank you. Robbie, way down there on the end, I feel like I need to walk down there ‑‑ anyway, I won't. So ‑‑ I've heard you say this so I'm kind of reiterating a question back at you on serving you up. I'm returning your serve with another serve, I guess. So our field has long had best practice methods, but very little DeafBlind specific research. And I'm wondering if you could give some thoughts, has the Harvard center on the developing child's work validated or strengthened our field's best practices? Again, your words, can we now say owe "Because Harvard said so, dude"? Blaha: I know, I really appreciated the information Dr. Cameron sent earlier. It was a big relief to read it. You know, when our field got started in the '70s, education back then was very compliance based. Most of the research came out of Peabody school, Vanderbilt and things, and they had objectives like follow a two‑step command, which is very common thinking. And also that lesson plans were called task analysis where you brought down tying a shoe into 80 steps and then they learned them. And it was very train‑y training, you trained this person. And the other person who was really big at that time was Dr. Wovoss, who at some point was using adversives ‑‑ and these were quite famous people. And when I started working at pilots, we had these mimeographs, we called them Jan van Dijk, but he gave such a different spin and because of him the field did a sharp 90‑degree field and left the field of special education and started following his teachings. And he made a huge point that these children have attachment disorders due to the DeafBlindness, due to sensory deprivation. This is a baby undergoing sensory deprivation. This is a baby who can't tell what people are up to because all the people who contact them for months hurt them. And their mother who cuddles them, hands them over to the people who hurt them. So they don't understand people. They think we're loose cannons. And so in order to teach them we have to engage them. And in order to engage them you have to follow the child. You have to watch what they do and do it back to them. And when you sit and bring this up in an IEP meeting, it is ‑‑ you know, you can't be faint of heart because people are like, well, that's interesting. And it's tough to sell the best practices without research. And we are very rich in best practices due to the quality of support of the information that did come from the Netherlands and from Europe who were very different in their approach than the Americans, frankly. And now we are rich in practices, but we are weak in research. And I didn't care for awhile. I really didn't care. And it will come back and it will bite ya. And to say serve and return and say this is Harvard, this builds connections, this fosters brain development. Because without this engagement and interaction, these children do not have experiences that do anything but prune. They do not build connection unless what we do is very carefully engineered to match what they're experiencing. So I love fact we have this research. I'm glomming on to serve and return. I'm glomming on to charging stations. Because we needed this term because one of the things that we talk about, Dr. Cameron, when we go into classrooms, and we get called in a lot on behavior issues because we see children who have really been through significant adversity from their perspective because when you're DeafBlind you either get ‑‑ it's very easy to misinterpret the experiences of what's going on around you. They're very chaotic. We certainly don't achieve a high degree of practice, which implies continuity. If you have eight people working with that child, you know? So you have to do things like tell people you're going to have to limit the number of people who work with this child in order to provide the degree of consistency and the bonding that they need to start making connections. And so when we're talking about related services and you're talking about interveners, you need to make a case for how do you limit the content ‑‑ the contact and funnel these things through to the child in a way that's engaging and consistent enough for the connections to be built? And so ‑‑ I think that's a very powerful recommendation and your charging stations I love. It's always space ‑‑ you go into a classroom, we don't have a good term for it, we're going to call is charging stations from now on. [ Laughter ]. I was always looking for what ‑‑ I don't have a tattoo, before I'm 70 I'm getting a tattoo. I thought what do I want it? Maybe charging station. [ Laughter ]. Maybe that. [ Laughter ]. Because what we do is we go in and say you need to make this child a spot. And what we mean by spot, Matt, can you ‑‑ we grabbed some spots. What we mean is this child needs a place in the room that is so engineered for them that they feel secure and engaged. They need to go recharge. This ‑‑ this is a ‑‑ to me a charging station. This is a bean bag under a refrigerator box because sometimes that kid needs to go there and recharge before they can come out and be engaged. This is designed for a particular kid. Okay. Because of the objects under it. There is some denning going on there, things the child likes to pull apart. If you ever grab one of those thing, you have to really rip it off, it feels pretty good. They will rip it off, put it on the floor and they feel great. They don't take smoke breaks, which is what people do. Unless you want to teach them to smoke you had better give them a charging station. [ Laughter ]. So the next, I love this. This little classroom. It's an egg. The child would get in there and close themselves up for a little bit. You give it a name. Give it a symbol. Put it on their choice board of what you need to do or schedule it in their calendar. But you give them this space. I see this working all the time for children with DeafBlindness. They are engineered according to their sensory needs. And it's a haven and they can always find it, you know. Why is it the only spot in the room that belongs to the teacher and she's got her coffee there, she's got her little pictures,her trip to Vegas, that's her spot, she's got the spot. This kid needs the spot. Now I'm going to call it the charging station. Because it's difficult to get this in the accommodation, you need to have it in the accommodations if you have to put it under technology. But under supplemental aids and services during the IEP, this ‑‑ designing a spot, a consistent spot with a name and engineered for that child is a very powerful strategy to consider. Because when you need them to come back out, we can take the finish basket, and then you reengage, reengage, reengage. This is a very powerful strategy that a child who has been undergoing significant adversity needs. And, also, I want to say Dr. Cameron took this stuff into refugee camps. This is about children who have been in trauma. I think it's very respectful to treat DeafBlind children as that way. I like the way that your research validates some of our best practices and enables us to maybe communicate with them with more effectiveness to IEP teams as we develop programming. That we get these strategies that began long ago with respect to the chide, responding to the child and reading that child, engaging that child rather than controlling that child. You know, it's nice to have the research, really is. You drive away sometimes going am I crazy?!! Am I crazy?!! You know, now we know we're not because Harvard said so. [ Laughter ]. Schutz: Thanks, Robbie. Suzanne I saw you scribbling some notes a few minutes ago. Would you like to share them with us? Zeedyk: Lots of notes. I want to throw in one more word that has not yet come up at all today. I'm trying to quick do my metaphors, I'm not coming up with one, okay? Charging station, when we think of a charging station, we think of it, you know, giving us energy, zapping. It's got another half to it. A charging station is also a safety station. Okay? So safety is ‑‑ is the one concept that I would throw in that's really important that we get today. Because attachment is effectively about seeking a sense of safety and if you ‑‑ if you don't feel safe in the world, then you can't go exploring and take risks. And until you have a sense of safety, you keep seeking safety. And safety comes from two sources. Primarily it comes from attachment, connection to one other human being. You can ‑‑ you can have attachments to more than one, but you need at least one. Romanian orphans, to give a short version of the story because we often think about Rumanian off fans died because they didn't have an attachment to one person. And those that didn't die were often very, very traumatized in a way that they couldn't recover from that. Okay? I just use that example to give the picture in our heads. So you need a connection to at least one other person to have a sense of safety. And then trust, and safety comes through, lots of serve and return, you will pay attention to my needs. And so when you have calmed down, because you feel safe, and you know that you can always get back to your safe base, you can go off and exploring. You don't want to go off exploring if you don't know that your safe base is going to stay put. So all of us need a sense of safety, including children who are DeafBlind. But to go back to what Bernadette is saying, their sense of safety may be harder to achieve because of that mismatch. And in today's world, of course, there are more and more children who are born premature, that's where, you know, some DeafBlindness originates from. Their lives began in pain. Where people stuck things in them and life was uncomfortable. That's their first memories and conscious memories, lessons about life. That's different than if DeafBlindness came from a different source. So if we think in terms of safety as well as charging, then we start to give our children the key things that they need. So I think the first ‑‑ especially if you have a child that's having behavior problems, challenging behavior, what they need is to reclaim a sense of safety so that their body can calm down. So I think that's the one key idea that we need. And I'll add one more thing. I grieve the fact that psychology, developmental psychology, discovered many of these connection concepts a long time ago. So attachment research began in the '40s. Connection, we knew a lot about that by the 70s. But that information has somehow not been much use to people. Where it has now caught on is because of the neuroscience. When I go places everywhere people are excited about the neuroscience and about the sorts of things that Judy was talking about. But what I find that people don't yet put into that picture is an understanding that you come into the world biologically connected to other people. I will talk about that tomorrow. So that's partly because as Judy said the neuroscientists haven't thought so much about that. If we can put those two pieces together, that you arrive connected, everything is about connection with the brain development, then we have all of the key tools that we need to make things different for lots of children and adults in this world. [Applause] Montgomery: Thank you. We're loving this. Are you guys loving this? And like we said before, you guys, feel free to ‑‑ if you have a question we are going to totally have at the end the last few minutes ‑‑ time to set aside ‑‑ in the meantime if you want to come up and say something, please do. Doctor Cameron, if you would like to jump in at any time please do it, okay? I had a question I wanted to throw out to the panel. This is not something that I have given you all in advance. So earlier we saw Joe talking about ‑‑ I thought this was so cool. He was talking about building this house with these people with DeafBlindness. And it was like, okay, you know, I've been walking into this thing forever, but I don't know how it got here. I know nothing about it. I don't know the concepts behind it, right? How are things made? How are nails made? How do you put up the wood? What are these walls made out of? I just think about the connections that happen with that. The concepts that are developed through that. The brain architecture that's developed through that. I'm going to throw it out for ‑‑ if you guys might have any ‑‑ any more comment on that after ‑‑ now that we've heard Dr. Cameron talk. Bernadette: I think ‑‑ you talk about experience like Dr. Cameron talked about experiences, right? You think about experiences in life, experiences are ‑‑ are built in ‑‑ within the body, so early in life experiences are very bodily. It's not talking about something and thinking about something. It's really bodily experiences. And children with DeafBlindness, of course, I have seen they will keep their experiences more tactile, unless language fully kicks in and then [indiscernible]. So if I think about brain development, brain architecture, I think that those bodily experiences, if they can be part of a shared experience with someone else, and that that experience becomes that serve and return is part of the total experience, then you get the connection between what the thing is or the event is and what happens between the child and the person the child is with, and if that is in a reciprocal manner, then the child will feel at ease and be followed and then the child will really be able to have a lot of connections, neural connections being made. Then of course with the secure attachment, daring to go out into the world. [ Laughter ]. Montgomery: David? Brown: I think one of the notes I made for myself was that all experiences are sensory. Cameron: Yes. Brown: And if a child can't see them, the child doesn't experience them, so they aren't experiences. And I think of all the times I've gone into schools to see a child who is profoundly deaf and people are talking to the child, not because that's their natural way of expressing, but because they seem to think that the child can hear them, but the child won't respond. And they are under the impression that somebody like me has come in to make the child respond. And I think it's ‑‑ you know, everything starts and finishes with the individual child. I'm glad we started the whole day by talking about the I in IEP. You've got to know or have an idea of what that child's sensory perception abilities are, what they depend on, how they vary from situation to situation, how they vary from time of day to another time of day. How they vary from one person, being with one person to another person or in one activity or another activity. And we all know children who are ‑‑ have much better vision and hearing and motor coordination in the swimming pool than they do when they're sitting at a table in the classroom. And that shouldn't be mysterious because we can explain that very clearly. So getting to understand what the limits are on their sensory perception in every sensory system is really important so that we can start to make sure that we're delivering experiences that really are experiences for them, meaningful experiences. And I come back to what I said the first time I spoke. If you ‑‑ I'm a big believer in observing children. And if I'm going in to meet the child or assess a child, I watch and listen and ask lots of questions and scribble lots of notes. And people will often say to me, especially in the school setting, when would you like to start your assessment? And for two hours I've written six pages of notes. And they think somehow you have to do something to a child in order to find out who they are. And if we could just spend a bit more time finding out what children do, I think we would get at least 50% of our assessment data from what the children are doing because children don't do anything unless it's either meaningful or pleasurable or essential to them. It has to have a function for them or they wouldn't be doing it. And I know those behaviors can become habitual over time, but they all start with sensory need and sensory motivation. So we have to keep going back. And I was saying earlier today through most of my career, and I never make apologies when I'm working with a much older student, because even with older students and adults, we have to try to go back to the beginning of their life to try and think what we're seeing now came from those early experiences. And that's one of the beauties of what came out of Judy's presentation. It's all being laid out right from the very beginning. And I know Suzanne talks about this a lot as well. So constantly going back. And back to Jan van Dijk, I remember he said once, when you work with a baby you must make the effort to see them in 25 years' time in your mind's eye. And I thought, and when you're working with a 25‑year‑old you must make an effort to see them when they were three months old to try and fill out the picture. And last point, Robbie's delighted that Harvard has kept us okay to keep doing these crazy things. I made a list of why ‑‑ a very casual list and I actually sent it to the Texas team the other day. Good quality DeafBlind education. And off the top of my head think about Judy's presentation. Good quality DeafBlind education has a focus upon sensory perception, self‑regulation, executive function, emotional well‑being, self‑confidence, relationship building and communication and language development. There's the link, however peculiar that things we do seem to the outside world, it all fits absolutely with everything you and Suzanne are talking about. And I should say I said this to Judy, I've been to other conferences where ‑‑ DeafBlind conferences where an outsider is brought in with no DeafBlind experience and it's not terribly useful. And I think that this is a wonderful experience. The idea of having Judy present and then having this panel where we're put on the spot to try and say, does this mean anything, is this relevant, does it link? Because all the presenters I've seen it's been very relevant, but that hasn't been clarified for the audience. And I think you get DeafBlind trained and doing it for 25, 30 years, you can see the relevance, but if not you do need it pointed out to you. [Applause]. Montgomery: Thank you, David. Zeedyk: I want to jump back in. Usually I'm fine when I talk to audiences about all of this kind of stuff, is that right about now when you really have begun to get what it means, all the grownups get scared. And I'm glad you're laughing, and Judy did a great job of trying to keep us laughing at the expense of her own children. [ Laughter ]. So thank you to her children, who probably didn't give her permission to tell stories about the lost keys, but she was trying to do us a service by trying to keep us laughing as well as give us stories that would embed it in our heads. And that becomes really, really important because when you get this stuff something important and difficult happens. And it troubled me when I first began working with the public, and now I've decided as part of the process, when you get it, you wonder if you damaged your children. [ Laughter ]. And I'm glad you're laughing because I actually mean that. [ Laughter ]. You wonder if all those students that you taught for a lot of years that you didn't notice little tiny things, did you not serve them. And so this really fascinating, tricky things happen. You somehow have to really get this stuff ‑‑ you have to help people move into when we missed byes for attention, sometimes our children got scared and maybe we actually helped to establish some patterns that we never meant to, we were entirely unaware of it and now we get how some of their behavior patterns may have gotten established and it had smog to do with us. Okay. If you're going that far I want to say thank you and I want to congratulate you because you're willing to get it and you're willing to really feel what it means. So how do we help people do that while also holding them and not having them feel guilty? Because if we tip them over into guilt, we haven't helped, we've actually made things worse. So holding them in this really tricky line becomes important. And I think the solution is to try to move us to curiosity. So we all have the capacity to hurt other people without ever having meant to. So when my colleague and I were driving down and he was getting used to driving on the other side of the road and make the car work, we pissed some guy off behind us who clearly was on the edge of road rage! And I just thought, you are not curious enough to wonder what our experience might be and you don't know we've been up for 24 hours and it's dark. So to be curious about another person's experience always, if we can be curious about our children, just wondering if that little tiny hand wave means something, don't know what it could mean, but I wonder if it could be meaningful because somebody up on that panel said it was, and if we can be curious about our own experiences, then I think that keeps us on this side of not being a guilt. Tells us something about our own power, both the responding and missing things. I want to add one more thing. Ali shore oh, is another important researcher in all of this, talks a lot about the rupture repair cycle. So when I look at that side of the room, I'm not looking at that side of the room and they might feel left out, but I'm looking at you. So then I need to come back here because I don't want you to feel left out. Now I've created a rupture there. The important thing in the rupture‑repair cycle, which is just part of ordinary interactions, is the repair bid. Repair is more important than rupture. I call that making up is more important than messing up. So if we remember that if we get it wrong, it doesn't matter. What matters is to come back and reconnect. And then we can be comforted. It doesn't matter what you didn't know. It doesn't matter what you get wrong. What matters is that you reconnect and that we don't have to feel bad and this stuff can stop scaring us and can excite us. And if you can get that then can you it go tell all the other people out there who don't yet know all about this because this is relevant to children and people without DeafBlindness as it is to those of us in this room, but a lot of other people don't get a chance to hear this. [Applause] Schutz: Robbie, We see you writing notes down, do you want to share with us. You know, this ‑‑ this has been real helpful to me because I think it shows the importance ‑‑ you can have a good strategy or best practice for DeafBlindness, but if you don't have a theory behind it, it becomes really dry and useless. And I see this happen with calendar systems. In classrooms. And I think that this is something that we recommend strongly is a strategy for every ‑‑ every individual with DeafBlindness. Beginning with children with ‑‑ with just emerging language, emerging attachment. The theory behind this is definitely about, number one, engagement. Because these kids do care about what's going to happen to them. They do have some things that they're interested in. And they would like to know if it is ever going to happen again. They also need to know who is coming ‑‑ what people are going to be approaching them. Who is scheduled to be here. All of this information, one of the things that always amazed me about the calendar system is when we sat down with the kids, we always start with the activities they care about. And those of you who are familiar with the calendar methodology know that it incorporates a high degree of repetition and practice. There's a structure to it. Every time you do it. So that they get the scaffolding of the education so they can start building connections because then they know you are starting at this end and talking about something, this is the future. And you see them start leaning in. And the calendar has really been one of the most powerful tools that we've received from Dr. Jan van Dik and it is very based on theory. When we lose the engagement piece and the importance in terms of creating safety and enthusiasm in children, we miss the point and all it is is a daily schedule that's kind of look a to‑do list. It is not a daily schedule. That is not the point of calendars at all. It was always about engagement, it was always about safety for children. It's amazing the degree of participation and attention you can get from a child doing that activity because it's about their next, what's going to happen to them. Also, that is the one place where you can start building the connections of adding additional facts. Because they even happen ‑‑ before that even happens to them, you can talk about the future. You are going to eat and you know what you're going to eat something in a package like this. You can give them information in a way that's so cleaned up and repetitive that they remember and understand it. You are giving them a highly engineered experience. There are constant connections, that's why we see the kids start ‑‑ if they love Ketchup that is the first sign they're going to learn, that is if you take the Ketchup bolts and cut part of it up, that becomes the object they remember. These connections this is all about what Dr. Cameron has been talking about. It's a good example of a strategy that's bundled. A lot of her recommendations. So I think that we need to remember it when we sit down to do these things. We're building brains, we're building connections with human beings. These strategies are brilliant. And we're very fortunate to have them and to go back to why we really do them is important for us who work with children with DeafBlindness. If we're bored and detached they sure are, because they're not being paid to sit there. So if it's ‑‑ it's very important that you be loving it, too. And, you know, I just ‑‑ I appreciate looking at these like yes that is another strategy with DeafBlindness. That is absolutely validated by Dr. Cameron. [Applause] Schutz: Thanks, Robbie. While we're on the topic of strategies and things that we can do to help our students in their happy and healthy learning and development, does anyone else have thoughts to share with our educators out there and our families out there? Things that they can do to help with that? Bernadette and David I think both want to take a turn here. Bernadette: I'm sorry if I didn't respond to the question about [indiscernible] I did not. I had another thought. Schutz: Whatever you want, Bernadette. Bernadette: I was thinking that I have the idea until now, because we have talked so much about young children, we have talked about children with congenital deabblindness. I've been thinking also about Dr. Cameron's model in regards to those with ‑‑ with Usher Syndrome because they, you know, have one at eight years old, have two at puberty. When their vision is deteriorating, it changes their worlds, their brain has to be adapted because ‑‑ because all of the visual information that they were used to getting in is not coming in as it was. It will not give them information. And then it's such an invisible process for persons themselves often that in the beginning their diminished contact ‑‑ because the serve and return with peers is going to be affected. Their difficulties with homework and getting instruction, that they blame that on themselves. Especially in the time periods that their body is changing in many ways, don't feel secure anyway. And I have not thought through enough, but I think we have to think also about these young adults because the impact of losing vision and then losing structuring of the brain and then also the restructuring how serve and return [indiscernible] have established how are they going to look like and you hear me, I haven't thought it out. But there are a lot of things that come up in my mind that I would like to see this ‑‑ these ideas that you present, also to our ‑‑ to students who acquire DeafBlindness. [Applause] Montgomery: Thanks, Bernadette, Schutz: David, did you want to speak to her issue of strategies? Brown: My first point is not a strategy, but again I made a graphic note when Judy was speaking. The key phrase in our world, if you are doing DeafBlind education, right, comes from, surprise, surprise, from Jan van Dik. To follow the child. When Judy said it's the child who serves, your job is to respond, I just thought yeah, Jan van Dik followed the child. You know, this is ‑‑ this is so‑called normal development and DeafBlind development over-lapping and fitting together beautifully. But needing in the DeafBlind situation needing a lot more work, a lot more observation, a lot more planning and things have to be clarified, clutter has to be removed, consistency has to be built in, pacing has to be individualized for the student, not for you. And ‑‑ the point that I wanted to make really about strategies is I always ‑‑ as an itinerant teacher, I always worried about going into a home or a classroom and saying, "All you need to do is be totally available all the time." [ Laughter ]. You need to be completely observant all the time. And you need to be ready to respond at any time the child serves you anything. And of course I'm exaggerating, but only a little bit. And the fact is good, quality DeafBlind education is incredibly labor intensive. When we had the awards this morning, the thing that brought tears to a lot of people's eyes was when 14 professionals got up on the platform. To be honored for their work with one student. And it was just a reminder that you're not just looking for the one good teacher who gets it. Sometimes that's all you've got. Sometimes you don't even have the one good teacher. But really it takes an awful lot of people and the child has to learn serve and return with their own bodies and with the environment, not just with other people. I want ‑‑ I'm going to broaden ‑‑ if you can't be there and be available, think about environments that are responsive to the child, but Robbie already touched on it with the box and the Velcro and I'm thinking about Lilli Neilsen's active learning approach. The Little Room and especially the resonance board. I use the resonance boards in England for 17 years, with ‑‑ with students from three months old to ‑‑ through to some 19‑year‑olds. Environments where they can go and do things that aren't just purely seen as self-stimulation. That aren't just poking the eyes or flapping the hands or blowing raspberries, but are actually interacting with something outside of their own bodies. So even if you can't be there for them, you have given them the option of doing something outside their own body space, which is sometimes the very best that you can do. But also I think should be seen as the least that you can do. When no one is actually there to ‑‑ to be available to them. [Applause]. Schutz: This is kind of amazing to me. I think to everybody too. And I want to ‑‑ we've got about 10 or 15 minutes. And let's open it up to your questions. So come on up to the mics. Schutz: Two microphones in front of us, guys. You're welcome to step up and ask your question, okay? Hurst: First I just have to say, oh my gosh, you've made me so happy, so very happy! But one of the things I'd like y'all to just sort of share your thoughts about, you know, one of the things we talk about in DeafBlindness is doing with, not for. And when I was listening to Dr. Cameron this morning and she talked about the importance of stepping back and letting the child do. And then what David just talked about with Dr. Neilsen and her whole notion that the child has to be able to do things on their own, of their own volition, all that. Whatever you want to share about that, please share it. I just love what y'all are sharing. Brown: Can I jump in? I want my hobby horse. For two years I've been trying to write an article, which has never come to be. The title was why self‑stimulation is great and why we should be encouraging much more of it. Because I'm tired, I'm tired of that strange prejudice that sees us as not self‑stimulating, but children with developmental difficulties do self‑stimulate and it's very bad and we've got to stop it. And I learned more from children's self‑stimulation behavior than I do from the IEP, very often. It's children serving all the time. Those behaviors are fulfilling a need and over time they acquire a social component and maybe they're self‑stimulating to avoid working or to piss you off, but that comes later. That's not where they started. It started with a sensory need. And I think it speaks to the way these children are to the way these children are desperately undervalued by our societies and I've worked in Latin America and in India and in Australia. These kids are undervalued in the same ways all over everywhere I go. And we have to keep fighting that with the kind of evidence that we've heard about today. But for me it's always been the work Jan van Dijk and Lilli Neilsen and jean [indiscernible], the occupational therapist who came up with sensory integration. They're my three gurus. And they all pushed very strongly that children do things that have meaning for them and we need to work out what that meaning is before we decide to step in and to be ‑‑ and to change things or stop things, unless it's dangerous or illegal, we should not be ‑‑ it should not be a primary goal of education to stop the child from doing things. That turns everything completely the wrong way around. So think of self‑stimulation as children giving you insights into them, what's working, what's not working, what's providing for a need so that you're then in a much better position to know how to respond and how to behave with them. Bernadette: Can I say maybe just one sentence? That I often see exactly the behavior that you describe as related to what Dr. Cameron said about self‑regulation, because that ‑‑ if you understand that behavior, you get to the source of the stress, be it from boredom or be it from something that was intrusive. And then you can get to helping the child by acknowledging it and letting the child know, but then maybe doing it together so that a child knows if I can do it together and that person is with me in the stress and now we go to solve it together. You. I have one example. A little student, 12 years old, and every time when she experienced a stress, and it was only biting and such, but it's now really rocking, but really heavy rocking. So now she walks up to the teacher or the aide and she turns around, gets them and asks them to rock. And they rock with her, you know, in the right way. And now she is not biting. So if we can understand that kind of behavior as an effort for them to regulate their stress, then together with them and not leaving them alone with their behavior, we can as return, we can help regulate the stress and they can find ways to ask you for resolve. [Applause]. Brown: And this enormous power for the child, in you letting them know that you're aware they've served, even if your answer is no, we're in the wrong place so it's the wrong time or there's no way we can go swimming when it's 10:00 at night at home, and there's no pool at home. Letting them know they're being listened to, they're being noticed, even if the answer is no, I can't provide what I think you're asking for, but I am here for you. And maybe you want to use the diversionary tactics, but first it's good to let them know because this is all about ‑‑ as Bernadette was just saying, it's about relationship building, it's about making those connections so then maintaining those connections. I think it's too often that children will do something and people will say, oh, she's asking for that, but it's the middle of the morning. She's not going to have a bath. And nobody actually let's her know that that's been seen and it's been understood, but it's not an appropriate time. And then with the calendar system of some kind, especially in prelanguage, you have your calendar system that can you fall back on to let them know perhaps when the bath will be coming or when swimming will be coming. Blaha: And I always think one of the important strategies is learning to wait and the word wait means yes. They need to understand "Wait means yes much, absolutely swimming is wonder much, and we're going to wait and then we're going to get wet and we're going to get our towel and flip‑flops, yes. And we're waiting for swimming and we're scheduling up here like a contract in the future box." And I think that that ‑‑ teaching that wait means yes is a validation of what ‑‑ I got you, I understood you. And that's always such a relief when people understand you. It's such a relief when people understand you. Zeedyk: And to stress, all the things that we're saying here are because these children are human children. They're not children from Mars. [ Laughter ]. And therefore everything that we're saying here applies to all the children who don't have DeafBlindness as well. Every single thing we have said here is good for children, whatever sensory capacities, mental health capacities, poverty, whatever situation they live in and body they live in, all of this is good for them. And so take temper tantrums. We live in a society that sees temper tantrums as children behaving badly. It's children coping with disappointment whose brain is not yet to ‑‑ the prefrontal cortex that Judy is talking about is coming to really understand that. Supermarket managers put chocolate at their level is clearly meant for them. [ Laughter ]. And their mother who said that she loves them and who they were put in day care all day long for, and they coped with parting from her in the morning, and they coped all day long, and they waited, and she got there late, and I'm going to make this really bad, okay, just so we all get this. And she arrived with her mobile phone, and the child is waiting to see her, and she had her mobile phone on, because she's trying to tell daddy that they're going to be late, and she knows daddy will be irritated by that. But the child has waited all day long to see her. So when the child serves up their smile, the response that the child gets is this. And the child codes that as a response. It's not a non‑response, it is a response, but it's a response of non‑acknowledgment. I know lots of people are out there going ‑‑ I know people are going I know that I have picked that kid up there. I'm not trying to make you feel guilty. I'm trying to make you laugh. But trying to get that children's brains are do something with that, so we can get curious and think at a deeper level. Now after all of that day, mom puts the child in the car, with the ‑‑ perhaps the car seat in the back that's facing backwards, because it's required by law, and then we drive to the supermarket. The child has coped with all of that, now all they want is this chocolate that was put at their level. [ Laughter ]. And you tell them no. [ Laughter ]. And they have coped all day long and now they feel betrayed and bereaveed and disappointed, and they haven't got a physiological system and a prefrontal cortex that let's them cope with this melt down. They have a melt down, you know. Which embarrasses you. So you now want the kid to save you from embarrassment from Mrs. Smith that's standing at the end going, can you not keep that kid under control? [ Laughter ]. You get it, right? Okay. The child is coping with disappointment and betrayal and coming to understand that love sometimes hurts and they don't have a brain to help them do that yet. Okay. That's ‑‑ that's kids who don't have deaf ‑‑ who aren't DeafBlind. Everything that we're talking about here works and is as important to them as for children who do have DeafBlindness. So if the DeafBlind community can get this, you can help a whole lot of other communities get it, too. [ Laughter ] you matter in a way that lots of people will not fully realize that you matter because they think they don't know what to do with DeafBlind children. But it turns out that they are human children, and not Martian children, and all of us need these very basic things that we are talking about. Because to go back to what Joe said first thing this morning, it really is all about connection. And if we get that, a whole lot of problems begin to be more easily solved. Off my soapbox now. [Applause] Schutz: Well, I see a lot of teachers out in our audience. I think to use Suzanne's word, they are curious. And they're wondering about what they've heard today and how they can apply it to their students. I'm wondering, Robbie, if there's tools or procedures, advice that you can share for our teachers that we want to implement these type of ideas and follow up on their curiosities on these topics, what do you have? Blaha: Well, you know this is a really cool question and if you will pop up a picture. Because a while back, David Brown recommended a curriculum that came from Scotland where Joe worked at Sense. Okay. This curriculum is free and downloadable. Because David liked it, I went on and looked at it. Then I started sharing it with people. What I found was this curriculum that's in Birmingham, England, is so based in theory it has Lilli Neilsen's work in it, Jan van Dik's work in it, it has interaction training that you do as part of the staff, and it also addresses Suzanne's safety issues and also her concern for adults who can't ‑‑ can feel very overwhelmed without a reliable curriculum that said these are the steps, these are the strategies, actually, and combinations that you can do for four levels of children with DeafBlindness. It starts with children who are really withdrawn and not interactive and not coming out of their bodies, even to interact with objects, much less people, and moves through four levels of children on occupy to the formal language. So thank you, David, thank you for the panel. Because this also, we have research now that says these best practices work. I really think this is a good educational tool and Dr. Cameron has shared educational tools with us today. And I would like to share this. Adam Graves on our team has gone through it, Matt has, Chris has. We've looked very carefully at this and we have followed the ‑‑ like follow the child. But there's like under engagement to people, one of the domains, you look as it builds across from the very early things and it talks about with this first level of child you have one or two people working with them only. Their world is within ‑‑ it talks ‑‑ everything they're talking about is in there, it's a good tool. I'm embarrassed that I didn't know about it before now. But I love it. And so ‑‑ so it's free and downloadable. Just go to Google Sense, with an S. Scotland. Type in DeafBlind. It will come up on their website. So I ‑‑ I do think ‑‑ it's English. I'm sorry, Joe. Not your Sense, English Sense. I'm so sorry, it's English Sense. But you know I don't travel much. [ Laughter ]. It's over there. [ Laughter ]. Zeedyk: If we're talking resources I can Chuck in one other that maybe really helpful to people that I'm going to ‑‑ that I was going to speak about tomorrow, but people may not all be at my workshop. There was a ‑‑ there's a book published in 2008, I know about it because I edited it. By Jessica Kingsley called ‑‑ promoting social communication ... contact? Something like that. It's got my name on it. Okay. You are supposed to know the name of your own books. But the reason that I'm suggesting it now, it is an edited book and it's based entirely on the theory about connection and intersubjectivity and [indiscernible] in one morning here, but each of the chapter authors came from a different ‑‑ different sector. That's not the right word. A different ‑‑ so there's one on autism, there's one on dementia, there's one on ‑‑ multiple disabilities. And there's one on DeafBlindness. Written by someone from Joe's ‑‑ of Scotland Sense. I'm saving Robbie here. Blaha: Nice save, Suzanne. Zeedyk: I'm just mentioning that because what it does it puts DeafBlindness in the context of a whole lot of other challenges. And trying to unpack the theory across all of those. So it kind of pulls together some of the themes of this. And you can now get it on ebook. So you could get it tonight if you're really excited. Part of what I get frustrated by, people think that you are only talking about one little bit. When they hear Judy talk, they go oh, that's "Normal" kids or DeafBlind children we need to do something with them, autistic children they're really different. If we understand these issues about self flagellation, how needs develop, the need for safety, contact, attachment, we get how all of these are the same issues and the same kinds of solutions that they just look different. And it becomes easier and more exciting to get what the solutions are. Montgomery: Thank you. Judy, would you like to put a bow on this? Cameron: Well, I certainly would. This has been an incredible panel. Judy, I'm going to ask you to hold it. I'm sorry, we have a question here. I have a little question. I'm going to hold her up here. Okay. Are you ready? People that have hearing aids, do they have to wear hearing aids all the time? Montgomery: People who have hearing aids, do they have to wear hearing aids all the time? Zeedyk: What a great question! Bernadette: Shall I? Schutz: Sure. Bernadette: I think that the people who have hearing aids, they do not need to wear them all the time. Because it depends on the person who has the hearing aids. Sometimes a person has hearing aids gets very tired of listening and they like to take them out. I cannot do that so I am jealous. But sometimes people like to take them out. It is important, if you know someone who takes the hearing aids out, to look why is that person taking the hearing aids out? Then if you can figure that out, then you will have an answer to your question, all right? Montgomery: Thank you. [Applause] Thank you. Judy? Cameron: So I want to thank all of you. This has been a very enlightening afternoon for me. And I want to come back to something that actually each person said in their own way. But I think David started by saying that there were many general principles that I covered today that resonated and it made you realize the children with DeafBlindness are children and then we heard that they're not Martians. [ Laughter ]. They're children. The take‑home message to me is that you are doing an incredible job and I really am impressed by you. I would like to be able to use some of the examples I heard today. And if you think that I don't ask my children permission, I actually don't ask anybody permission. [ Laughter ]. And so some of these wonderful stories and things that you are doing to put into action, the principles I talked about, I will be sharing with other audiences. So thank you. [Applause] Montgomery: Thank you, panel. This was absolutely amazing. Absolutely amazing. Thank you so much for sharing your thoughts. Thank you, Dr. Cameron for leading the whole thing off. [Applause]. And to the rest of our speakers.