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ASPERGER'S SYNDROME: CLINICAL FEATURES

Question

Do you have rating scale or checklist about interpersonal behavior for Aspergers children? Thank you so much for your attention.

Answer

We have included several “checklists” on a variety of parameters below:

ASPERGERS: CLINICAL FEATURES

One of the primary features of Aspergers is their passion for favorite topics or special interests. Some of these areas include:

• astronomy
• dinosaurs
• extraterrestrials
• geography
• history
• machines or machinery
• maps
• math
• metereology
• music
• reading
• science
• social studies
• space travel
• trains
• weather

Socialization deficits—

• Are inflexible and incapable of coping with change
• By school age express desire to fit in socially
• Described as being "in OUR world, but, ON THEIR OWN terms"
• Different from "typical" Autism
• Difficulties making social connections
• Easily stressed and emotionally vulnerable
• Frequently described as “odd” or selfish
• Highly frustrated by their social awkwardness/alienation
• Lack effective interaction skills — not desire
• Lack understanding of human relations and rules of social convention
• Naïve and lack common sense
• Preoccupied with own agenda
• Seldom interested in other's interests/concerns
• Unable to “read” others' needs and perspectives
• Unable to appropriately respond to social cues

Social Problems—

Many Aspergers kid’s social problems are not recognized until they enter preschool. The first things noticed may be a tendency to avoid spontaneous social interactions, to have problems maintaining a conversation and to have a tendency to repeat phrases and make odd statements. They may not make many friends and often have difficulty keeping them. Emotional responses such anger, aggression, or anxiety may be excessive or inappropriate to the situation. Aspergers kids also prefer a set routine to frequent changes in the environment.

Social rejection of Aspergers kids—

Because of their social ineptness Aspergers kids are often the focus of bullying, scape-goating, hazing and teasing. This often leads to anxiety, feelings of rejection, depression and withdrawal.

Adolescence may bring on crises for Aspergers kids because the very social skills they lack are central to adolescent social developmental. Successful adolescents have sensitivities to social nuances and variations in language that nerds lack.

For some teenagers, computers are an alternative from stressful social situations. Computers also provide a more linear, modulated form of socialization that Aspergers kids are more skilled and comfortable at handling. Since many Aspergers kids become very computer proficient, they become valuable resources to their peers. It also provides a media for social interaction in which they can feel competent and valued.

Aspergers adults can lead a normal life. They tend to pursue vocations that relate to their special interests, sometimes with great success, as with Einstein and Newton. Some are able to complete college and even graduate school. However, most will continue to show subtle differences in social style. The social and emotional demands of marriage can be demanding for them.

Use of Language—

• Concrete language rather than abstract
• Difficulty understanding humor
• Early years: repetitive phrases or language or stock phrases from memorized material
• Excessively formal or pedantic language
• Hyper-verbal (highly developed vocabularies)
• Laugh at “wrong time” with jokes or interactions
• Many have good sense of humor
• Misused or not used cultural slang or social idioms
• Problems with taking turns in conversations
• Prosody-speech volume, intonation, inflection, rate is frequently deficient or unusual
• Rote skills are strong
• Some have normal or early language development
others have speech delays, then rapidly catch up, making diagnosis between AS, autism, and speech disorders difficult
• Typically revert to favorite topic area
• Usually like word games and puns
• Weak pragmatic-conversational-skills

TEACHING STRESS REDUCTION SKILLS—

AS kids are:

• are often anxious and worrisome
• easily overwhelmed
• highly sensitive
• often engage in rituals

Practical Suggestions:

• consistent routines
• let them know what to expect
• minimize fears of unknown
• minimize transitions
• prepare them for altered plans, schedules or changes
• provide predictable, safe environments

Examples:

• Introduce to teacher, therapist or para-professional before work begins.
• Learn about youngster's favorite topics or special interests
• Take tour of building youngster will be working or learning in.

AS kids typically display impaired Social Interaction—

Practical Suggestions:

• Create cooperative learning situations
• Educate peers
• Praise classmates when supportive
• Promote empathy and tolerance
• Shield them from bullying and teasing

Examples: Use AS youngster's strengths in exchange for liabilities to foster acceptance:

• Encourage participation in conversations
• Insensitive or inappropriate comments from AS are usually innocent
• Model two-way interactions
• Rehearse proper response repertoires
• Teach and support proper reaction to social cues
• Teach WHAT to say, WHEN, and HOW to say it
• Teach/model correct emotional responding
• Teaching WHY & WHAT response is appropriate is necessary

COMMUNICATION AND GESTURES—

Six steps for understanding challenging communications:

(1) Try to figure out what your youngster is communicating with the challenging behavior.

• “I can't remember what I'm supposed to do”
• “I'm mad…scared…confused”
• “This is too difficult for me”

(2) Consider how you can adapt the situation.

• Youngster expressing confusion? -> consider how to make the situation easier to understand. Make it more concrete, routine, or predictable
• Youngster overwhelmed or overstimulated? Try reducing amount of time in situation, or avoiding it in future.

(3) If the message must be communicated, come up with alternate way in which your youngster can communicate his or her needs or wishes more appropriately.

• Help your youngster develop appropriate ways of conveying requests/needs. If screaming when confused by a task, teach youngster to raise hand, ring a bell, or say: “I need help with this…this is too hard”

(4) Practice the “new way” of communicating.

• model more appropriate phrase or nonverbal signals
• have youngster practice the “new phrase” or behavior
• during the situation, remind (prompt) youngster to use new phrase or behavior

(5) Reward your youngster for using the strategy by showing that it gets his or her needs met.

• if asks to leave situation, provide her with immediate break
• if needs attention, stop what you're doing and provide some time/interest
• if your youngster requests help assist her immediately

(6) Be sure that the challenging behavior is no longer effective in getting your youngster's needs met.

• ignore problem behaviors
• provide prompt for the “new, appropriate one
• if youngster screams to avoid situation, prompt her to use an appropriate phrase. Do NOT allow her to leave the situation while she is screaming.

My Aspergers Child: Preventing Meltdowns and Tantrums

Balancing Time Between the Aspergers Child and His Siblings

Question

How can I balance things so that I spend enough time with my son with Aspergers and his siblings?


Answer

Every mother struggles to create balance in her life. Work, household chores, spouse, and kids all compete for a woman’s attention. A youngster with Aspergers (high-functioning autism) will demand attention. Other people and areas of life will fall to the wayside as the mother struggles to meet the needs of that youngster.

It is possible to accomplish the goal of a balanced home life. It will take planning and dedication, skills you already exercise every day as a mother. Here are some areas that you can work on.

Be an involved parent. Support all of your kids at school and at home. Get in the floor with them to play, watch movies, or just hang out. Talk about everything. Know what’s going on in their lives, show interest in their friends, and recognize their hobbies and special interests. Make every minute count for all of your kids.

Do your homework. Find books that will help you deal with tough issues and give you guidance on how to improve the relationships within your home.

Make therapy a family project. It can actually be fun. Spreading the work among several people will make it easier to stick to a therapy plan. It will teach your kids about teamwork, social skills, and what it means to be part of a family.

Make time for work and for play. Household chores should be shared by all. It is important for all of your kids that you keep your youngster with Aspergers involved. He needs to learn these important life skills and his siblings need to experience a home of fairness. On the other hand, make sure you schedule plenty of structured and free playtime. Your kids need to play together. Your typical kids will learn the value of tolerance while your youngster with Aspergers will learn those important social skills.

Schedule time with each youngster. One-on-one time is invaluable for building your kid’s self-confidence. Plan regular alone time with each of your kids. Encourage each youngster to talk about things that happen with their siblings. Be open and honest about Aspergers. These outings are the perfect time to answer questions the siblings may have about your youngster with Aspergers.

My Aspergers Child

Parents’ Management of Tantrums in ASD Children

Kids with high functioning autism have been known to have a tantrum or two. Think about why a youngster may have a tantrum. That's right, they work! Tantrums can get kids what they want, or they would not have them. What do kids want? Candy, attention, favorite toys, not to go to bed, to continue self-stimulating, not to take medicine, more cookies, no more broccoli, and on and on. 
 
CLICK HERE for the full article...

My 5 year old was just diagnosed with aspergers...

Question

My 5 year old was just diagnosed with aspergers. Where do I start to help him and where do I start to educate myself? I feel alone and scared. I live in a small area and I don't even know if we have anyone here that is well educated to guide us. How do I find that out?

Answer

A great place to start is with The Aspergers Comprehensive Handbook: Help for Parents with Aspergers Children.

Raising Aspergers Children: Symptoms and Parenting Strategies

Aspergers (high functioning autism) is a developmental disorder falling within the autistic spectrum affecting two-way social interaction, verbal and nonverbal communication and a reluctance to accept change, inflexibility of thought and to have all absorbing narrow areas of interest. Individuals are usually extremely good on rote memory skills (facts, figures, dates, times etc.) many excel in math and science. There is a range of severity of symptoms within the syndrome, the very mildly affected youngster often goes undiagnosed and may just appear odd or eccentric.

While Aspergers is much more common than Autism it is still a rare condition and few people, including professionals, will know about it much less have experience of it. It seems to affect more boys than girls. In general terms they find making friends difficult, not understanding the subtle clues needed to do so. They often use language in a slightly odd way and take literal meanings from what is read or heard. They are happiest with routines and a structured environment, finding it difficult to decide what to do they fall back on to their preferred activities. They love praise, winning and being first, but find loosing, imperfection and criticism very difficult to take. Bad behavior often stems from an inability to communicate their frustrations and anxieties. They need love, tenderness, care, patience and understanding. Within this framework they seem to flourish.

Kids with Aspergers are for the most part bright, happy and loving kids. If we can help break through to their 'own little world' we can help them to cope a little better in society. They have a need to finish tasks they have started. Strategies can be developed to reduce the stress they experience at such times. Warnings that an activity is to finish in x minutes can help with older kids. With younger kids attempts to 'save' the task help - videoing a program, mark in a book etc.

As the kids mature some problems will get easier, but like all other kids new problems will emerge. Some teenagers can feel the lack of friendships difficult to cope with as they try hard to make friends in their own way but find it hard to keep them. This is not always the case, many have friends who act as 'buddies' for long periods of time. Social skills will have to be taught in an effort for them to find a place in the world ... so take all opportunities to explain situations time and time again ..... and one day.......it may work!

Please bear in mind that booklets such as this do tend to detail all the problems which can be found within a syndrome but that does not mean every youngster will have all of them. Each youngster will also have different levels of achievements and difficulties. They are after all just as the others ... individuals!

Is Aspergers The Same As Autism?

The debate on this question still continues, some experts say that Aspergers should be classified separately, others argue that the core difficulties are the same, only the degree to which they are seen in the kids actually makes the difference. One expert - Uta Frith - has referred to Aspergers kids as 'Having a dash of Autism'.

Autism is often interpreted as a withdrawal from normal life - to live in the persons own fantasy world. This is no longer the real meaning of Autism. The severity of the impairments is much greater than in Aspergers, and often the youngster will have little or no language. Learning problems are more common in classic Autism. In Aspergers speech is usual and intelligence (cognitive ability) is usually average or even above average.

For the moment it is taken that the similarities are enough for both Autism and Aspergers to be considered within the same 'spectrum' of developmental disorders. Whilst a clear diagnosis is essential, it can change through life. The autistic traits seen in young kids can often seem less severe as the youngster matures and learns strategies to cope with his/her difficulties.

Key Features—

The main areas affected by Aspergers are:

• Communication
• Narrow Interests / Preoccupation's
• Repetitive routines / rituals, inflexibility
• Social interaction

Social Interaction—

Kids with Aspergers have poor social skills. They cannot read the social cues and, therefore, they don't give the right social and emotional responses. They can lack the desire to share information and experiences with others. These problems are less noticeable with moms and dads and adults, but it leads to an inability to make age appropriate friends. This in turn can lead to frustration and subsequent behavior problems. They find the world a confusing place. They are often alone, some are happy like this, others are not. They are more noticeably different among peer groups in unstructured settings i.e. playgrounds. Their naiveté can cause them to be bullied and teased unless care is taken by assistants or buddies to integrate and help protect them. They can often focus on small details and fail to see the overall picture of what is happening in any situation.

Communication—

Both verbal and nonverbal communications pose problems. Spoken language is often not entirely understood, so it should be kept simple, to a level they can understand. Take care to be precise. Metaphor s (non-literal expressions - 'food for thought') and similes (figures of speech - 'as fit as a fiddle') have to be explained as kids with Aspergers tend to make literal and concrete interpretations. Language acquisition - learning to speak - in some cases can be delayed. They make much use of phrases they have memorized, although they may not be used in the right context. A certain amount of translation may be needed in order to understand what they are trying to say.

Spoken language can sometimes be odd, perhaps they don't have the local accent or they are too loud for a situation or overly formal or speak in a monotonous tone. If the youngster with Aspergers has a good level of spoken language you must not assume their understanding is at the same level. Some talk incessantly (hyper verbal) often on a topic of interest only to themselves without knowing the boredom of the listener.

Difficulties in using the right words or forming conversations are part of semantic-pragmatic difficulties. They appear often to talk 'at' rather than 'to' you, giving information rather that holding proper conversations. Body language and facial expressions of a youngster with Aspergers can appear odd (stiff eye gaze rather than eye contact) and find 'reading' these things in others gives rise to further difficulties. Early age is known as Hyperlexia. Some kids have remarkable reading abilities although you should check if they also understand the text. The ability to read fluently without understanding the meaning is known as Hyperlexia.

Narrow Interests / Pre-occupations—

One of the hallmarks of Aspergers is the youngster's preoccupation (or obsession) with certain topics, often on themes of transport - trains in particular-or computers, dinosaurs, maps etc. These pre-occupations, usually in intellectual areas change over time but not in intensity, and maybe pursued to the exclusion of other activities.

Repetitive Routines / Inflexibility—

Kids often impose rigid routine on themselves and those around them, from how they want things done, to what they will eat etc. It can be very frustrating for all concerned. Routines will change from time to time, as they mature they are perhaps a little easier to reason with. This inflexibility shows itself in other ways too, giving rise to difficulties with imaginative and creative thinking. The youngster tends to like the same old thing done in the same old way over and over again!. They often can't see the point of a story or the connection between starting a task and what will be the result. They usually excel at rote memory - learning information without understanding, but it can still be an asset. Attempts should always be made to explain everything in a way they can understand. Don't assume because they parrot information back that they know what they are talking about.

Education—

If the youngster with Aspergers is to be educated in a mainstream school it is important that the correct amount of support is made available. In order to get the correct support a Statement of Special Educational Needs should be drawn up from the various advice supplied by you and the specialists. This procedure, when it begins, can take 6 months and be a very stressful and confusing time - don't be afraid to contact people who can help, this need not be a professional it may just be someone who has done it all before.

It is beneficial if the school of your choice is willing to learn about the difficulties that they and the youngster will face, some schools are better than other on this score. Looking at several schools will give a better picture of exactly what is available. The support currently offered in mainstream school is by Special Support Assistants (SSA) for a certain number of hours each week based on the youngster's needs in order to help the youngster access the curriculum and develop in a social setting. A support teacher with specialist knowledge of Autism should support the youngster, SSA, teacher and school in understanding and teaching the youngster. Other professional input may also be required such as speech and language therapy to help develop skills.

The home/school link is vital, a diary can prove invaluable giving two way communication on achievements and problems on a regular basis.

Parenting Strategies—

Parenting your youngster with symptoms of Aspergers can be a daunting task. You may have just discovered that your youngster has a diagnosis of AS and you are thinking “What now?” Or you may have a youngster who you know is different and/or a health professional has said that he or she has some attributes of Aspergers or Mild Aspergers but is still considered in the normal range. You are probably feeling a little overwhelmed and it might seem like you are the only person or family going through these issues. We know because that’s exactly how we felt.

Like you, we are moms and dads who would like nothing more than for all of our kids to reach their maximum potential. Because they only match some of the assessment criteria needed for an Aspergers diagnosis, we have had to find help for our kids ourselves. And we have found this help in some of the most unexpected places. This makes us uniquely positioned to show you how to get help from a variety of sources for your “normal” youngster or kids.

I wonder, do your youngster’s specific behavioral problems seem worse after lunch or a party? He or she may be intolerant to certain types of food. We can give you information about food intolerances and share with you our expertise of what we have learned. While there is not much scientific evidence that foods affect AS, we can show you information that you may want to look into.

Have you noticed that your youngster doesn’t like loud noises, bright lights, tight or loose fitting clothes and reacts inappropriately to any of these particular things? Does your youngster crave fast movement or are they almost impossible to get moving in the morning? The good news is there is an answer. They may have Sensory Integration Disorder (SID). There is growing evidence that links SID and Aspergers. Sensory Integration Disorder is easily manageable with techniques you can learn and do at home.

Do you find routines hard to establish and maintain? Using Visual Aids for your Aspergers youngster might just benefit you and your youngster as it has benefited us.

Moving Forward—

All this might seem a little daunting at the moment. However, with experience and help, including ours, you can teach your youngster to rule their Aspergers rather than have their Aspergers rule them.

On the pages of this site, you will find reference to many useful books and resources that help us and our kids cope with life. The books include those on AS as well as Sensory Integration and Food intolerances. You will also find information and links to other sites that provide information on other disorders related to Aspergers.

There are many things you can do to help your youngster better understand the world and in doing so make everyone's lives a little easier. The ideas below are only suggestions which you may or may not find helpful:
  • Begin early to teach the difference between private and public places and actions, so that they can develop ways of coping with more complex social rules later in life.
  • Don't always expect them to 'act their age' they are usually immature and you should make some allowances for this.
  • Explain why they should look at you when you speak to them.... encourage them, give lots of praise for any achievement - especially when they use a social skill without prompting.
  • Find a way of coping with behavior problems - perhaps trying to ignore it if it's not too bad or hugging sometimes can help.
  • In some young kids who appear not to listen - the act of 'singing' your words can have a beneficial effect.
  • Keep all your speech simple - to a level they understand.
  • Keep instructions simple ... for complicated jobs use lists or pictures.
  • Let them know that you love them - wart's an' all' - and that you are proud of them. It can be very easy with a youngster who rarely speaks not to tell them all the things you feel inside.
  • Limit any choices to two or three items.
  • Limit their 'special interest' time to set amounts of time each day if you can.
  • Pre-warn them of any changes, and give warning prompts if you want them to finish a task... 'when you have colored that in we are going shopping'.
  • Promises and threats you make will have to be kept - so try not to make them too lightly.
  • Teach them some strategies for coping - telling people who are teasing perhaps to 'go away' or to breathe deeply and count to 20 if they feel the urge to cry in public.
  • Try to build in some flexibility in their routine, if they learn early that things do change and often without warning - it can help.
  • Try to get confirmation that they understand what you are talking about/or asking - don't rely on a stock yes or no - that they like to answer with.
  • Try to identify stress triggers - avoid them if possible -be ready to distract with some alternative 'come and see this...' etc.
  • Use turn taking activities as much as possible, not only in games but at home too.

Remember, they are kids just like the rest, they have their own personalities, abilities, likes and dislikes - they just need extra support, patience and understanding from everyone around them.


Children with Aspergers: Tips for Teachers and Parents

Children with Aspergers are unique, and they can affect the learning environment in both positive and negative ways. In the classroom, the Aspergers child can present a challenge for the most experienced teacher. These children can also contribute a lot to the classroom because they can be extremely creative and see things and execute various tasks in different ways. Teachers can learn a lot when they have a child with Aspergers in their class, but the teacher may experience some very challenging days too.

Here are some tips for teachers and parents to consider:

Aspergers children and showing work: Many teachers require children to "show their work"; in other words, illustrate how they got the answer to a problem."Showing work" is a demand that usually accompanies math homework. This may not be the best strategy with the Aspergers child, and may in fact lead to a big disagreement with the child. Since many Aspergers children are visual learners, they picture how to solve the problem in their heads. To make them write out how they got they answer seems quite illogical to them. Why would you waste your time writing out something you can see in your head? The requirement of "showing work" simply does not make any sense to them, and it may not be worth the time it would take to convince them to do the requirement anyway.

Aspergers children frequently are visual learners. Despite difficulties with eye contact, many Aspergers children are visual learners. Much of the information presented in classrooms is oral, and often children with Aspergers may have difficulty with processing language. Often they cannot take in oral language quickly, and presenting information visually may be more helpful. Many Aspergers children are "hands-on" learners.

Avoid demanding the child with Aspergers maintain eye contact with you. Eye contact is a form of communication in American culture; we assume a person is giving us their attention if they look at us. The Aspergers child experiences difficulty with eye contact; it is extremely hard for them to focus their eyes on a person for any extended period of time. Limited eye contact is a part of the disability. Don't demand an Aspergers child look you in the eye as you are talking to them--this is extremely difficult for them to do.

Don't assume the child with Aspergers is disrupting class or misbehaving to get attention. More often than not, children with Aspergers react to their environment, and sometimes the reaction can be negative. Sometimes the child may be reacting to a sensory issue, and other times the child may be reacting to a feeling of fear. The Aspergers child feels fear because of a lack of control over his/her response to the environment or because of a lack of predictability. The child with Aspergers does best with clear structure and routine. A visual schedule can be helpful for the child.

Every youngster with Aspergers is different. As a teacher you want to take the information you have acquired and apply it, but every Aspergers child is different, so it's difficult to take knowledge you have gained from one experience, and apply it to a situation with another child with Aspergers. Remember that each youngster with Aspergers is unique, and strategies that have worked with other children in the past may not work effectively with the Aspergers child because they perceive the world in a unique way, and they sometimes react to their environment in unpredictable ways.

If the child with Aspergers is staring off into space or doodling, don't assume they're not listening. Remember the Aspergers child may experience difficulty with communication, especially nonverbal communication. What appears to the teacher to be behavior illustrating a lack of attention on the part of the child may not be that at all. In fact, the Aspergers child who is doodling or staring off may actually be trying to focus him or herself through the act of doodling or staring. The child is unaware that nonverbally s/he is communicating to the teacher that "I'm not listening, or I'm bored." Doodling or staring may actually help the child with Aspergers focus more on what the teacher is presenting. You might simply ask the child a question to check if he or she is listening.

Sensory issues affect learning for the child with Aspergers. Often Aspergers children are distracted by something in the environment that they simply cannot control. To them, the ticking of the clock can seem like the beating of a drum, the breeze from an open window can feel like a tremendous gust, the smell of food from the cafeteria can overpower them and make them feel sick, the bright sunshine pouring through the windows may be almost blinding to them. This sensory overload the Aspergers child experiences may overwhelm them, so focusing can be difficult and frustration occurs. Frustration can then lead to disruptions from the child. To cope with frustration the child might choose to repeatedly tap a pencil on a desk (or another disruptive behavior) to focus themselves because s/he is experiencing sensory overload. What appears disruptive to the teacher and the rest of the class may actually be a way for the Aspergers child to cope with the sensory overload. Obviously, a teacher does not want disruptions in the classroom. Take time to evaluate the classroom in terms of sensory stimulation, and how the environment affects the child with Aspergers. Perhaps some modifications can be made, or the child can be taught some coping skills that are not disruptive to classmates, like squeezing a squishy ball in their hand or some similar activity.

Children with Aspergers experience difficulty with transitions. Often a child with Aspergers gets "stuck" and has difficulty moving from one activity to another. They may need to be coached through the transition, and if a typical school day is loaded with lots of transitions, the child faces increased anxiety. Moving from one activity to another is not a challenge for most children, but for the child with Aspergers transitions can be monumental tasks. Some possible strategies a teacher, paraprofessional, or parent can use: visual schedules, role-playing or preparing the child by discussing upcoming activities. Appropriate strategies are dependent on the age of the child and his/her abilities.

Children with Aspergers may experience difficulties with focusing as well as lack of focus. Focus involves attention. Sometimes Aspergers children focus all their attention on a particular object or subject; therefore, they fail to focus on what information the instructor is presenting. All their energy is directed toward a particular subject or object. Why? Because that object or subject is not overwhelming to them and they understand it. To overcome this problem, the teacher can try to establish some connection between the object or subject of interest and the area of study. For example, if a child is fascinated with skateboarding, the child could learn reading and writing skills through researching a famous skateboarder and writing a report. Math skills could be taught by looking at the statistics involving competitive skateboarders. The possibilities for instruction are endless, but it will take some time and creative planning on the part of the teacher.

As a teacher, paraprofessional or parent of a youngster with Aspergers, it's important to recognize the youngster's gifts as well as limitations. Children with Aspergers present a challenge for the people who work with them, but these kids also enrich our lives. So when you're feeling frazzled, take a deep breath and remember that tomorrow is another day. This youngster will grow up and make a contribution to our world in some way we can only imagine, and you can help this youngster.

My Aspergers Child: Preventing Meltdowns and Tantrums at Home and School

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