::Attendees visible:: [Bonni Goodwin] Okay. [Caitlynn Land] I wanna welcome everyone today to our Lunch and Learn. This Lunch and Learn is being brought to you by a collaboration between Oklahoma Human Services, University of Oklahoma Anne and Henry Zarrow School of Social Work, and the Oklahoma Adoption Competency Network. We appreciate everyone joining during your lunch or noon hour. We wanna get started so that we can make sure to respect everyone's time and the great information being discussed today. First, we're gonna go over a couple ground rules and a quick little video, but our presenter today is gonna be Ms. Lindsay Minyen. ::Screen shared for video - mostly silence:: [unintelligible background talk] ::Video - Lunch N' Learn Guidelines:: [Video starts] [Carlie van Woerkom] Brought to you by a collaboration between Oklahoma Human Services University of Oklahoma Anne and Henry -- [Video restarts] [Carlie Van Woerkom] This Lunch and Learn is being brought to you by a collaboration between Oklahoma Human Services, University of Oklahoma Anne and Henry Zarrow School of Social Work, and the Oklahoma Adoption Competency Network. We appreciate everyone joining during your lunch or noon hour. We want to get started so we can make sure to respect everyone's time and the great information being discussed today. First, let us go over a few housekeeping things for our time together this afternoon. We are recording this meeting. By participating, you are giving your consent to be recorded. Help us reduce distractions so we can all focus and participate. We have muted everyone to make it possible for everyone to hear the speakers. We want you to express your thoughts and questions. Please utilize the chat for this purpose. We will monitor the chat and questions will be touched upon during our Q&A time during the last 15 minutes of the webinar. We want to see you, so if you are willing and you can, please turn on your video if you are unable, that is fine also. To receive information about other post-adoption events, please list your name and email in the chat and we will make sure to add you to our contact list. Remember confidentiality. It is vital that we protect confidential information, so we will not share specifics like names or details about adoption cases, adults, or children. If you are a foster parent attending this training, you will receive one hour of training credits towards the 12 hours of in-service training that you need each year. These trainings are not yet available as CEU credits for professionals. However, you may submit this certificate to your agency and request training credit per your agency's policies. Please indicate in the chat if you would like to receive a certificate of attendance and participation. Thank you again for being with us today, and we hope you enjoy this presentation. [Video ends] ::Attendees visible:: [Caitlynn] All right, I wanna get everything turned over to Ms. Lindsay now. ::Slide - Fetal Alcohol Syndrome (FAS) AKA Fetal Alcohol Spectrum Disorder (FASD) [Lindsay Minyen] Hi, my name is Lindsay Minyen and I'm a child welfare nurse, and today I will be discussing Fetal Alcohol Syndrome, and it's also known as Fetal Alcohol Spectrum Disorder. ::Slide - Why?:: Fetal Alcohol Spectrum Disorder can occur when a person is exposed to alcohol before birth. Alcohol in the mother's blood passes to the baby through the umbilical cord. There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. There is also no safe time to drink during pregnancy. Alcohol can cause problems for a developing baby throughout pregnancy, including before a woman knows she's pregnant. All types of alcohol are equally harmful, including all wines and beer. To prevent Fetal Alcohol Spectrum Disorder, a woman should avoid alcohol if she is pregnant or might be pregnant. This is because a woman can get pregnant and should-- and do not know for up to four to six weeks. It is never too late to stop alcohol use during pregnancy because brain growth takes place throughout the pregnancy. Stopping alcohol use will improve the baby's health and wellbeing. ::Slide - Early Diagnosis:: Early diagnosis. Diagnosing fetal alcohol syndrome requires expertise and a thorough assessment. Early diagnosis and services can help improve child's ability to function. Um, your pediatrician can first diagnose if they have any concerns and, um, they can send to a child, um, the Child Study Center here in Oklahoma City at OU, or they can, um, send to a geneticist. ::Slide - To Make A Diagnosis:: To make a diagnosis, your physician will discuss drinking during your pregnancy, and that can happen through an OB exam or a midwife. Although doctors can't diagnose fetal alcohol syndrome before a baby is born, they can assess the health of the mother and the baby during pregnancy. Um, they can watch for signs and symptoms of fetal alcohol syndrome in your child's initial weeks, months, and years of life. This includes assessing physical appearance and distinguishing features of your baby's growth and development. A common misconception is a lot of people think that they have to have physical, um, the physical aspect, um, for a diagnosis, but that is not true. They can just have the developmental aspect of it. ::Slide - The Doctor Also May Assess For:: The doctor also may assess for cognitive ability and learning and language developmental difficulties, health issues, social and behavioral problems. ::Slide - FASD May Be Difficult to Diagnose:: A person with fetal alcohol syndrome might have low body weight, poor coordination, hyperactive behavior, difficulty with attention, poor memory, difficulty in school, especially with math, learning disabilities, speech and language delays, intellectual disabilities or low IQ, poor reasoning and judgment skills, sleep and sucking problems as a baby. Vision or hearing problems, problems with the heart, kidneys or bones, shorter than average height, small head size, abnormal facial features such as smooth ridge between the nose and upper lip. This ridge, um, here will be flat. Um, they may have an extra fold right here. This, the lip, the top lip will be really thin. A lot of these, um, symptoms may be noticed and just not bunched together to make this diagnosis. It may be, we may see that it's fetal alcohol syndrome, or I'm sorry, not fetal alcohol, but, um, failure to thrive, um, early on and we haven't made the connection. Um, so it really takes kind of a team approach, um, with really, maybe a child welfare nurse looking at the medical records. Um, looking at, is the, was the umbilical cord positive? Did we look at any, um, OB records, um, along the way? Um, did mom's urine at delivery, was that positive? Those types of things. And then following that child, um, through their school years as well, and seeing what the delays are in looking at that whole picture. ::Slide - Diagnosis Can Include:: The diagnosis is, can include Fetal Alcohol Syndrome, Alcohol-Related Neurodevelopmental Disorder, Alcohol-Related Birth Defects, Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure. ::Slide - Treatment:: There is no cure. Once they have been exposed, you can't remove the alcohol and the, the defects are there. Um, but research does show that early intervention treatment services can improve the child's development. Um, the most popular is, um, SoonerStart, um, but there can also be private OT, PT, physical therapy, those types of things. There are many types of treatment options, including medication to help with some symptoms. Um, the most common we think of is medications for ADHD, those types of things. Um, behavior and education therapy, parent training, um, such as, um, PCIT, uh, Parent Interactive Therapy. Um, and other alternative approaches, um, tutoring, those types of things. No one treatment is right for every child. Good treatment plans will include close monitoring and, um, that is, like I was talking about, at the OU Child Study Center it may include when the, the infant is born, if they test positive for alcohol, they will want to monitor, monitor them throughout their life. Because it may start with therapies, but then they may, um, transition into other types of, um, treatment such as medication, et cetera, follow-ups and changes as needed along the way. Also, protective factors can help reduce the effects of fetal alcohol, um, syndrome and help people with these conditions reach their full potential. If, um, the children are staying with the parents, um, helping the whole family, um, helping the parents get sober is the goal. ::Slide - Get Help:: If you, the parent or the doctor think there could be a problem, ask the doctor for a referral to a developmental pediatrician, child psychologist, or a clinical geneticist. A geneticist is someone who will piece all of the symptoms together and make that diagnosis. Um, the developmental pediatrician will also, um, make referrals to OT, PT, those types of things. Are there any questions? [Sarah Antari] I've got a question, Lindsay. [Lindsay] Mm-Hmm. [Sarah] Um, on one of your slides, it had several of the symptoms that also overlap other types of, ::Slide - FASD May Be Difficult to Diagnose (reshown):: um, mental health diagnoses, particularly ADHD, like with the difficulty with attention, um, the hyperactivity, um, poor concentration, that type of stuff. Um, is there often a misdiagnosis of ADHD or is that something that your doctor can, is like, there like a test that can be done to differentiate one between the other? [Lindsay] So as far as fetal alcohol, unless they have the physical features, um, unless they were tested as an infant, um, like at birth or mom has admitted to it, um, there's not necessarily a way to distinguish, um, but you treat the symptoms. So if they're having symptoms of ADHD, you're going to treat those. Um, could it, uh, be fetal alcohol syndrome? Absolutely. But they're still per, they're, the symptom of it is ADHD, so they're still gonna treat that underlying condition. [Bonni] Lindsay, it looks like you have a question in the chat that says, is there a way to diagnose FASD later in life? [Lindsay] If they have the physical features? Yes. Um, a good thorough, um, review of medical records at birth, um, if, uh, whatever symptoms they are having, if, if they have, um, if they're having any of those symptoms. And then a, um, psychiatrist or psycho-- psychological, sorry. Um, a if they want to go to a psychologist or, um, a geneticist could possibly diagnose it. ::Slide - Get Help (reshown):: [Sarah] So for our families that don't necessarily have either contact or, um, ability to get those records for the early years or for birth, um, the only way that they would be able to, to know that fetal alcohol syndrome is an issue would be through the symptoms if they don't have the facial features? ::Slide - Treatment (reshown):: [Lindsay] I think the, the key point is not necessarily the diagnosis, but the treating the symptoms. So if they're presenting with any of those symptoms, ::Slide - Diagnosis Can Include (reshown):: because the, this treatment for fetal alcohol syndrome is to treat the symptoms of ::Slide - FASD May Be Difficult to Diagnose (reshown 2nd time):: the learning disabilities, the poor reasoning and judgment, any learning, or I'm sorry, any vision or hearing, um, poor coordination, all of those things. And so if they're having those, to go ahead, you would treat them still regardless of what the underlying diagnosis is. Um, sometimes it's harder because maybe in post-adoptions we are kind of at the tail end of it, and so we don't have, um, the earlier intervention part of it. Um, but as soon as we can get them into OT, PT, those types of things, we're gonna have the best outcomes. [Bonni] So Lindsay, what does, what does it look like? Um, what is the life... So I, I hear one of your biggest messages that you're sharing with us today is, is really intervention like that, like intervening in, in the moments, uh, with what's happening, the symptoms, the, you know, the challenges that, uh, that the child and maybe the family system as a whole are all facing, and you mentioned some really great intervention strategies like parent management training, some, uh, parent-child interaction, you know, uh, really enveloping the whole family system. What does it look like? Is there any, uh, ideas you can give us for like the, the lifespan? What does it, how does this impact an adult or a young adult? Um, uh, especially if they have had some good intervention as a child. [Lindsay] So they don't have a shortened lifespan physically, um, because of, because of fetal alcohol syndrome. [Bonni] So it's not a shortened lifespan. So they're, you know, able to have, what about, uh, some of the behavioral or emotional impacts? Like does it impact future relationships and ability to, you know, have, have their own children or what does that look like? [Lindsay] Sure. Good question. So, um, they can be, um, impulsive, um, have some hyperactivity, poor memory, those types of things. So, um, that, those can absolutely affect relationships. Um, but as far as having children, they can have children, um, they can, you know, always have successful relationships and those types of things as well. Um, counseling, those types of things are going to be, um, factors that would definitely play a big part, um, in, in positive outcomes and being successful. Um, even, um, these are kiddos that IEPs would be something that, uh, um, adoptive family would want to look into and being successful for the kiddo's future, that would definitely something that would be helpful. Um, counselors on their team would be something that would be successful. [Bonni] That makes sense. Yeah. Thank you. And also, um, do you, with the impact of how the, the alcohol has impacted and, and, um, I don't know the correct terminology, maybe adjusted, you know, cognitive ability or anything for that child, when they become an adult and have their own children, is that something that is potentially genetically passed on to their own children, or is it, is it, uh, less likely for it to be something that's, um, passed on to their own biological kiddos? [Lindsay] Do you, do you mean, um, like addictive? [Bonni] No, more, more like cognitive, uh, delay, any type of developmental, you know, um, some of those pieces, um, is it more specifically the impact of alcohol on them when they're developing, or does it, would it be passed on for future generations? [Lindsay] So the alcohol is what caused the damage. [Bonni] Yeah. [Lindsay] Um, so essentially if you think of like, if you were exposed to maybe, um, a type of chemical [Lindsay] during your pregnancy [Bonni] Mm-hmm. [Lindsay] Um, that caused a, a poor outcome to a fetus. Um, maybe say you, um, I don't know, were exposed to something and then it caused your child to have, um, I don't know, a heart condition because you took a medication, um, that would not necessarily mean that your child's child would have the same prognosis, um, because that child was not exposed to that medication. Does that make sense? [Bonni] Yeah. [Lindsay] Um, so if there was no more exposure to the alcohol, [Bonni] Yeah. [Lindsay] Then, uh, then there would be none. Um, we know that, you know, addiction can be something that is passed down through generations. Um, but I think having, you know, the counseling, all of those things on board definitely would have great out-- outcomes too, [Bonni] For sure. So it's possible, one thing we talk about a lot in, in post-adoption and in this group is really, um, just hope, right? The, be the, the belief that things that are, there are things in the future that are going to be, we can do things now to make the future even better. ::Attendees visible:: And, um, especially for our kiddos who have experienced so much challenge and, um, hardship and, you know, impact in their, in their young, young lives. Um, so that's really where my questions were going and, and thank you so much for that answer. 'Cause I think it really does bring that sense of hope and, and a future orientation of that our, our kids, even though they've been impacted by some of the early, uh, things they didn't have control over, right? Um, they, they, when we're able to pour into them and, and do counseling wraparound and, and really have some family support and outside community support, um, school support, all the stuff that you've mentioned, then they can really move on to have a pretty normal life and be able to, to have their own children and have their own families and, and be able to pour into future generations. So, um, thank you so much for that information. I see you've got a couple other people with hands up, so I will, I will hush and turn it over to y'all. [Carlie] My question was just, I know we're talking a little bit more specifically about fetal alcohol syndrome today, but I'm just wondering if with, if the symptomology of fetal alcohol syndrome kind of carries over or overlaps, how that overlaps with other substances in the system at birth. So substance, you know, drugs at birth or different, different things that, that the, our kiddos are born with, if that makes sense. [Lindsay] Mm-Hmm. So like polysubstance use? We do see a lot of polysubstance use. Um, that is something, um, you know, alcohol's a downer. Sometimes we'll see an upper and a downer together. Um, and a lot of times we will, I know that I've talked to Sarah about this, we will see, um, a lot of times we focus kind of more on the illegal substances and not so much on things that are legal. Um, however, how much is being used, um, what is safe, what is not safe, you know, how much is being utilized, those types of things. Um, and, and how, how do we interpret what, what is, what is out-- what does the public know and what they don't know? And there's really kind of mixed reviews. A lot of people don't know about alcohol and, and what they can use, what they can't use and that kind of stuff. So, um, and you only know what you don't, or you only know what you know, right? Like what you family has done before you and those types of things. So I think good education is, is really kind of key. And so, um, that's so important on these cases is early intervention, um, and really getting in and working with, with the families on early intervention on these cases and kind of treating all of them, um, not just the, the, the meth or whatever else we're seeing, but also the alcohol and, and what to look for in the future and who to reach out to. [Carlie] Okay. So as far as, um, what our kiddos are experiencing symptom-wise, does that look pretty similar with alcohol versus substances, other substances, drugs, things like that, whether it's legal or not, um, are those symptoms similar? Because you had mentioned a lot of them are, um, you know, the impulsivity, hyperactivity, we start to see really, really big behaviors and they kind of, that lack of self-control. Um, so is that very similar with sim, similar symptoms with substance, other substances other than alcohol? [Lindsay] So other substance substances we typically see right after birth, and it puts them in a very quick safety risk, where DHS intervenes very quickly because they are not safe and they need very quick interventions. Whereas, um, with alcohol, they don't have that quick intervention and it's later in life and they need resources. Whereas methamphetamines need, um, you know, maybe methadone or something at birth [Carlie] Immediate treatment. [Lindsay] --at birth. [Lindsay] Mm-Hmm. Medical treatments. [Carlie] Okay. Okay. So what I'm hearing you say is, usually for substances other than alcohol, you start to see those that, that symptomology right at birth versus that al -- fetal alcohol syndrome, you really start to see that those symptoms come out as the child ages. [Lindsay] Correct. [Carlie] Okay. [Grace Cameron] Um, could you go more in depth about the specific screening tools that you could go to, say if you went to a developmental pediatrician versus a clinical geneticist? Like what that would look like? [Lindsay] Sure. So, um, uh, developmental, um, pediatrician, there's no, um, well first there's no once, like, swab you could do to go back in time and test for birth or anything like that. Um, I'll take you kind of first back to, um, birth and in the very beginning. So an umbilical cord will test, um, 20 weeks to birth. Um, and that is a confirmatory test. So that is very, very accurate. Urine will test about 72 ish hours. Um, it is not confirmatory. Um, now, a urine, typically they will test the baby's urine and then mom's urine. Um, then we are given the question, what do we do with the urine, right? What if the urine's positive, um, what are we going to do with that information? Um, or the cord, what are we going to do with that information? Um, we're going to send them and we're going to, you know, are they gonna have withdrawals? What is the immediate safety threat? And so, um, like I said before, there might not be an immediate safety threat. We wanna work services, we wanna help give them services, those types of things. Um, now if we send them for services, the doctors are not going to reswab them or retest them, you know, every, every so often or anything like that. So the children, once they, um, are they showing facial features? All of those? That will give you a diagnosis automatically. Um, some children, um, even if the they have facial features, they will ha-- may not have any of the developmental delays or anything like that. Um, so we're always, the treatment may be very different for children who have those delays and facial features, all of that, it's gonna be customized to them. Um, they, the testing may look very diff, they may do like ADHD testing, they may do those types of testing. The, the window, there's no more alcohol testing done at that point. Um, so all of the testing will look very much like you would if you brought your child in for, um, you know, "My child's getting Ds in class," "he's not able to, um, sit in his seat," you know, all of those testing. So you may have a, a child who got no prenatal care who delivered on the side of the road, um, and has no facial features or anything like that. You may not even get that diagnosis of fetal alcohol syndrome. Um, but you may have a mom who was arrested during that pregnancy for a DUI. And so it's really a lot of pulling all of those medical records, all of the, you know, looking at that key, that key picture, and then having a very good physician, um, like a developmental, um, pediatrician, kind of pull all those records and go from there. But the treatment is not gonna change regardless. The child's still gonna be tested for the same things. Um, and then the treatment may be ADHD medicine, or it may be a tutor, or it may be a parent-interactive therapy, learning how to train or how to work with your child on certain meltdowns, those types of things, working on IEP, those types of things. [Sarah] So Lindsay, um, our families obviously have had these kids after, after birth. Um, how long, I kind of have two questions. How long do they have before alcohol is completely out of the child's system so they can't test for it anymore? And we've talked a lot about the facial features and I think everybody here understands and knows what But for people that don't, don't know, when we talk about facial features, can you go over some of that? [Lindsay] Sure. So, um, the umbilical cord, um, 20 weeks to birth, um, urine will stay, it'll be about 72 hours in their urine. And then facial features, they'll have a thin lip. Um, the smooth right here, we, we typically have a bridge right here. Um, but theirs will be smooth. The nasal bridge may be smooth, their eyes, very small eyes and may have an extra fold here. [Bonni] Do we have -- this is gonna be a crazy question. Um, I'm sorry, Caitlyn, if I jumped in, but I just have a follow-up question on that. The facial features you had mentioned earlier right, that not every child who's been impacted by alcohol has facial, facial features. Do we know why? Like, why some do and some don't and kind of, is it like amount of alcohol or a certain time or, what do we know about that? [Lindsay] Sure. So in utero, different things are developing at different times. And so it just depends on the consumption during that time. [Bonni] Gotcha. I gotcha. So it's really just about when, when that part of the, the baby is developing. I understand. [Lindsay] Mm-Hmm. [Bonni] Caitlynn, I see you're talking, but I can't hear you. [Sarah] Did you turn your... [Caitlynn] Can you hear me now? Okay, cool. Um, I had a quick question about maybe afterwards, maybe a mom did make it through pregnancy without drinking because they realized that they needed to stop, but afterwards they continued. How does breastfeeding and alcohol affect? [Lindsay] Sure. So there's kind of a lot of controversy about breastfeeding and how much can you do? And, um, there's, um, I would say to, um, every pediatrician is kind of different, too. Some will say, um, I worked for a pediatrician, um, who said, if you're okay to drive, then you're okay to breastfeed. Um, but everyone's level is a little different too. So, um, I, um, alcohol does go through the breast milk. Um, so I think that that is something that you would need to just talk to your pediatrician about. But alcohol does pass through the breast milk. [Bonni] So here's a question for every, everyone here, uh, everyone in child welfare, um, for our, for our kids who were, um, maybe removed from home at an older age, um, like five and above, do we, do we always have that information? I mean, we don't always have information about prenatal, but then we also don't know about breastfeeding, like what, what we just talked about, right? I'd never thought about that, about the impact of how parents are, man-- like navigating and even Lindsay's like, you know, it's gotten, no one really knows this definite answer. It depends on your pediatrician, you know, and, and they all have different, kind of different thoughts there. So that's an interesting concept to think about. There are a number of things, um, that we just don't know. We just, that are always gonna be a little bit of unknown unless there is a really special, uh, experience where you have a good open relationship with birth parent and are able, you know, to have that level of conversation where, you know, you can ask those questions and they're able to feel safe enough and, and trusting enough to be able to share that information. Um, so that can be, I think, I just think that's an interesting thing that's come up in this conversation of, um, there are, there are impacts that we might not always have any, any ability to find out. Um, but again, just kind of bringing it back to the, to what we were saying earlier of, of that there is the possibility of being able to, to build up enough support, um, at the individual, family, and community level. I just think that's such a huge message of what you're sharing with us, Lindsay, of some really great information, but also this understanding of that it's, it's, there's, there are things that we can do, there are tools that we have and, um, there's some great, great hope for the future of our kiddos who have been ex-- who have been exposed to alcohol, um, in utero or as a, a little baby during breastfeeding. So, Grace, go ahead. [Grace] Um, is there any correlation that we've seen between someone who has diagnosed fetal alcohol syndrome and later on in life abusing substances themself? If you know any of those statistics? [Lindsay] Um, I don't have any studies to pull up or anything like that. Um, I would imagine yes, with, um, just genetically, um, you're predisposed to, to have addiction, that doesn't mean it can't be broken. Um, and there's just as many studies too that I'm sure have, you know, with all positive supports and all of that. But. [Bonni] I think, I think one thing that that brings up for me, Grace, thanks for asking that question too, is, is the importance of, uh, for our professionals who are watching this, the importance of having some good strategies and tools and how to support parents', uh, conversations with their kids who have had this in their ex-- in their history to talk about, this is, this is what you have and this is why. And, um, it also means that, you know, all children, uh, all people I think should have the conversation of like, what does it mean to have, um, what, what is addiction, but also what does it mean to have more of tendency towards addictive, uh, behaviors? What does that mean for us as human beings? And, um, I just think it increases the, the critical aspect of, of encouraging those open, uh, vulnerable, honest conversations, which we talk about a lot in adoption competent mental health of, you know, telling their them their whole story, that they should have all of that information even when it's hard and painful. And a lot of times our parents are very nervous and scared, um, thinking it's gonna hurt their children more. Uh, and so they would rather withhold it. But, but that, you know, that impacts development, that impacts the understanding of Who am I," um, and then also the important things that we need to, to know about ourselves to, to make good decisions in the future and, and be, uh, have good self-care and awareness of, um, how my, my genes, my DNA, and my experiences can impact me, but also how, how I can, how I can guide myself and how I can create good experiences and, and good support for myself and my future. Um, so I think that's really an important reminder for our professionals to, to think about that. How can you best support families and being able to talk, talk about all of those pieces? This has been a great conversation, Lindsay. Does anybody else have any questions? [Bonni] Okay, so I have one last one. What, Lindsay, what would be, if you were to share with, uh, and maybe I'm sure you already have, but with, with post adoptive families, um, and also I would say young adult adoptees, so those who are really in that process of understanding what my history means about me and where am I going, um, what would be maybe some words of wisdom or words of hope that you, that you give or would like to give to families and to adoptees themselves? [Lindsay] Hmm.m I think that they write their own story. [Bonni] I love that. [Lindsay] Um, none of the diagnoses define them. [Bonni] That's powerful. Lindsay, I feel like we need to put that on a T-shirt. "You, you get to write your story. This doesn't define you." Um, man, I got, I have had the opportunity a few times to spend some time with some of our, um, 16, 17 year olds in, in care right now. And, and that's exactly the message that I share with them too, of that what you've been through, what is on paper about you, what diagnoses that have been put on your file, that doesn't define who you are, that you get to define who you are. Um, even your genetic history doesn't define who you are, right? Um, we do have those things impact us, definitely, but we do have the capacity as human beings to be able to interact and adjust and change and, um, strengthen and do all the things, um, when we are able to reach out to, to good support and have stable relationships and all those important things that, that we as humans crave and long for. So thank you so much, Lindsay. This has been really, really helpful. Um, I, I appreciate the information. I've learned quite a bit today. So, um, Caitlynn, I'm gonna pass it back to you. [Caitlynn] Awesome. Well, we wanna thank everyone for joining us today. In the chat you'll find a QR code that'll take you to the Adoption Competency page on OKfosters.org. Um, there you can find resources and links that will tell you about our next events, um, that we, that are wrapped around supporting adoptive families. If you are needing a training certificate, go ahead and let us know. We'll email one to you shortly. Also, please complete the survey at the link below to provide feedback over this section. Thank y'all.