Archive for the ‘Help for your child’ Category

Your NICU healthcare team

Tuesday, September 29th, 2015

NICU doctor and baby resizedAt times, it may seem that there is a constant flow of different people caring for your baby in the neonatal intensive care unit (NICU).  A team of professionals work together to give your baby every possible chance of achieving good health.

Some or all of these people may be part of the NICU team at your hospital:

chaplain – A person who provides spiritual support to NICU families.

charge nurse – A health care provider who has nursing training. The charge nurse makes sure that the NICU runs well. This nurse also oversees admitting babies to and discharging them from the NICU.

clinical nurse specialist – Also called CNS. A health care provider who has special nursing training in the care of children and their families. The CNS helps parents deal with their baby’s stay in the NICU. The CNS provides support and teaches parents about their baby’s health condition. The CNS is also involved in nursing staff education.

family support specialist – A person who provides information, help and comfort to families when their baby is in the NICU.

lactation consultant – A person who has special training to help women breastfeed.

medical geneticist – A doctor who has special training in diseases that are inherited and other birth defects.

neonatal nurse practitioner – Also called NNP. A health care provider who has special nursing and medical training in caring for sick babies. The NNP works with the baby’s neonatologist and other medical team members. The NNP can perform medical procedures and care for babies.

neonatal physician assistant – Also called PA. A health care provider who has special medical training in working with sick newborns. The PA works with the neonatologist, performs medical procedures and may direct your baby’s care.

neonatologist – A pediatrician (children’s doctor) who has years of additional medical training in the care of sick newborns.

neonatology fellow – A fully trained pediatrician who is getting additional medical training in the care of sick newborns.

occupational therapist - Also called OT. A health care provider who helps figure out how well babies feed and swallow and how well they move their arms and legs.

ophthalmologist – A doctor who has special medical training in the care of eyes and vision.

patient care assistant – Also called PCA. A NICU staff member who helps nurses change bed sheets, feed babies and prepare bottles.

pediatric cardiologist – A doctor who has special medical training in the care of a baby’s or child’s heart.

pediatric gastroenterologist – A doctor who has special medical training in the care of a baby’s or child’s digestive system. The digestive system is made up of organs and tubes that digest (break down) the food a baby eats.

pediatric neurologist – A doctor who has special medical training in the care of a baby’s or child’s brain and spinal cord. A spinal cord is a bundle of nerves that carries signals between the brain and the body.

pediatric pulmonologist - A doctor who has special medical training in the care of a baby’s or child’s lungs.

pediatric resident – A doctor who is getting medical training in taking care of babies and children.

pediatrician – A doctor who has special training in taking care of babies and children.

pharmacist – A person who has special training in how medicines work and the side effects they may cause. People get prescription medicine from a pharmacist. Pharmacists also provide medicines in the hospital and may visit patients with the NICU team.

physical therapist – Also called PT. A health care provider who looks at any movement problems babies have and how they may affect developmental milestones such as sitting, rolling over or walking. The PT helps a baby improve muscle strength and coordination.

registered dietitian – Also called RD. A health care provider who is trained as an expert in nutrition. The RD works with the NICU doctors and nurses to help make sure babies get all the nutrients they need. Nutrients, like vitamins and minerals, help the body stay healthy.

registered nurse – Also called RN. A health care provider who has nursing training. An RN in the NICU has special training in caring for sick newborns.

respiratory therapist — Also called RT. A health care provider who cares for babies with breathing problems. An RT is trained to use medical equipment needed to care for babies.

social worker – A person who is trained to help families cope with their baby’s NICU stay. The social worker can help families get information from health care providers about their baby’s medical conditions, give emotional support, help families work with medical insurance companies, and help plan for when their baby comes home.

speech and language therapist – A health care provider who has training to help people with speech and language problems. In the NICU, this therapist often helps newborns with feeding problems.

surgeon – A doctor who has additional specialized medical training in performing surgery and other procedures.

technician – A member of the hospital staff who may draw blood or take X-rays (a test that uses small amounts of radiation to take pictures of inside the body).

At one point or another, you may encounter many of the above people while your baby is in the NICU. They all work together to provide continuous care for your baby. Learn more about pediatric specialties and how they may help your baby.

Remember – you are also an important member of the NICU team, too. Don’t ever hesitate to ask questions or speak up for your baby.

Have questions? Text or email

March of Dimes NICU Family Support® program offers services to over 90,00 families every year

Wednesday, September 23rd, 2015

Nurse and mom in NICUNow in its 14th year, this unique program offers comfort, support and information to families who have a baby in the NICU (neonatal intensive care unit) at over 120 hospitals across the U.S.

Babies in the NICU may have been born too small, too soon, or with a medical condition that requires intensive care. Throughout the NICU experience, parents can be involved in their baby’s care in a variety of important ways. The March of Dimes developed the NICU Family Support program to help support NICU families during their baby’s time in the NICU. The program also educates NICU staff about the best ways to support babies, families, and each other.

Specialized materials for long and short NICU stays

Hospitals with a NICU Family Support program are able to offer their families relevant, NICU-specific materials including a keepsake booklet, a guide for parenting in the NICU, and a NICU guide and glossary. As part of the program, hospitals also receive information for extended family members such as grandparents and siblings.

There are also materials for families whose babies stay in the NICU less than 14 days, a common experience that can also be very frightening and stressful.

Families can access March of Dimes NICU resources online from any device with an internet connection, in both English and Spanish. Topics include medical care, understanding equipment, how to hold and feed your baby in the NICU, becoming an informed parent, and many other important subjects.

Hospital staff education

NICU Family Support also provides ongoing education for hospital staff. This education focuses on best practices in supporting families, and the benefits of appropriate family-centered care for NICU babies at every stage of development. Training for staff is based on best practices and evidence based care, to help support them in their important role.

Parent to Parent online community

Support from other parents can be found on our online community, Share Your Story where current and “graduate” NICU parents reach out to help guide and comfort one another. Parents can log on and post a comment or question to join this warm and inviting group.


Have questions? Send them to

See other posts on how to help your child including how to transition from the NICU to Early Intervention services.


Changing seasons can be tough for a child with sensory issues

Thursday, September 17th, 2015

change of seasonsChange. Change. Change. For kids with special needs, change is one of the hardest aspects of their lives.

Just when your child has mastered adjusting to a new school experience, she is then faced with having to get used to the change in season. The difference in going from wearing summer clothes to fall clothes may not seem like a problem to you – but for a child with sensory issues, this can be a HUGE hurdle.

There are different kinds of sensory issues, also known as sensory processing disorder (SPD) or sensory dysfunction. Whether SPD is considered its own diagnosis, or a symptom of a larger diagnosis is still being debated by experts. However, if your child suffers from sensory issues, understanding their world and figuring out how to help them is key.

In this post, I am going to focus on the sense of touch.

For a child who hates the feel of certain kinds of fabric or tags on their clothes, changing from a summer to a fall/winter wardrobe can be traumatic. A short sleeve t-shirt does not feel the same as a long sleeve t-shirt. A collarless shirt is much more comfortable than a collared shirt that touches the neck. A blouse with ridges where the buttons meet the fabric may cause distress. The switch from shorts, where legs are not dealing with the light touch of a pant leg, to that of long pants, can be a huge feat to master.

Fabrics can have a huge effect on a child with sensitivity to touch. The “feel” of every material is different. For example, a soft flannel without buttons or zippers is usually much more acceptable than a wool blend or polyester.

And, then there are shoes…putting on closed toe shoes after a summer of toes free to wiggle inside open sandals can be like trying to cage a lion.

Some tips that may help

  • If your child can’t adapt to the sudden change from a short sleeve shirt to a long sleeve shirt, try dressing him in a short sleeve shirt, but give him a soft sweater or sweatshirt to put on it if he gets cold.
  • For girls, instead of going straight from shorts to long pants, try a middle approach first – Capri pants (below the knee), skirts, or even skirt/short combinations known as “skorts” that end just below the knee may be a good middle ground before you graduate to long pants.
  • It is tougher for boys who usually have to go straight from shorts to pants. In this case, if soft cotton sweat pants are allowed in school, this may be your safest transition pant. (“Sweats” would work well for girls, too.) Once he gets used to having his legs completely covered, he may be more able to tolerate pants that are stiff or hold their shape, such as jeans or khakis. Keep in mind that some clothing companies make flannel lined jeans and khaki pants – they are soft inside, so the stiff fabric and the seams will not irritate your child’s skin.
  • Parents should keep in mind which fabrics work or don’t work for their child. My daughter used to tell me which fabric gave her “pinches and itches.” It does not help to push a fabric on your child if her skin can’t tolerate it. Let her pick the fabrics that feel good to her – you’ll both be happier.
  • As far as shoes are concerned, for girls, “ballet flats” which are more open than sneakers or lace-up shoes can be a good transition shoe. They are not as rigid as typical shoes which will be more comfortable. For boys, short spurts of wearing shoes or sneakers may help your child slowly get used to the weight and feeling of a closed toe.

Other ideas

Your child can’t help the way she feels. The more you understand her issues, the more you can help her.

Feel free to share your ideas on the blog, and text or email questions to We love hearing from you! And check out our blog series on how to help your child.


Learning differences, disabilities and disorders – are they all the same?

Wednesday, September 9th, 2015

girl at schoolIn a word…no.

People learn differently. Some people need to hear information in order to learn it; others need to see or write down items in order to remember them. Yet other people need to physically DO the activity in order to learn it completely. And then there are those people who need a combination (seeing and hearing and doing, etc.) in order to fully learn a new subject or task.

These different types of learning styles – visual (seeing), auditory (hearing) and kinesthetic (physically doing) – are called learning differences. Once you understand the kind of learner your child is, the easier it will be to help him learn.

A learning disorder or disability is a bit different.

When a child is exposed to typical teaching methods repeatedly, yet he struggles and cannot learn material in a way that is similar to his peers, then he may have a learning disorder or learning disability. The two terms mean nearly the same thing, but come from different places:

Learning disorder is the medical term for the diagnosis of persistent difficulties in reading, writing, spelling, arithmetic calculation, and mathematical reasoning. The DSM V (the official diagnostic manual) states that “Specific learning disorder disrupts the normal pattern of learning academic skills; it is not simply a consequence of lack of opportunity of learning or inadequate instruction.” A child with a learning disorder is bright – he has average or above average intelligence – and he is NOT lazy. He tries hard but struggles to learn.

There are different kinds of learning disorders, and a qualified specialist can test your child to determine the kind of disorder your child may have. A specific learning disorder is biologically based, and is usually discovered during formal years of schooling. It often runs in families, too.

Specific learning disability (SLD) is the term that is found in our special education law – IDEA (Individuals with Disabilities Education Act). IDEA’s defines SLD as “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations…The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities; of intellectual disability; of emotional disturbance; or of environmental, cultural, or economic disadvantage.”

In other words, SLD is the legal label that is necessary in order for your child to receive special education services.

Which term should you use?

In a world that is becoming more and more sensitive towards individuals with differences, it is logical that we would gravitate toward using “learning difference” when we talk about our kids who are struggling in school. And it seems that even professionals use the terms “disorder” and “disability” interchangeably. However, it is important that the correct term be used in the right situation, so that you give your child the help he needs in order to be able to learn.

For example, special education services are available only to children with disabilities. If your child has a specific learning disability, he may qualify to receive specialized educational instruction, accommodations and curriculum modifications in school. In order to be considered to receive services, he must have the “disability” label. If your child qualifies, the special education team at your child’s school will meet with you to discuss and implement an individualized educational program (IEP) to meet your child’s needs.

Even if your child does not have a disability or disorder, he may still learn differently from his friends. It is important for your child to be taught in the way in which his brain learns. If he is in a classroom where all information and directions are given verbally, he may only process part of the information and the rest may not be absorbed or be easily forgotten. If the auditory directions are combined with a visual direction and/or perhaps even a kinesthetic direction, there is a greater chance that your child will learn and master the information.

For example, to learn the letter “C,” a child can say “C” out loud, while tracing a large, colorful letter C with his finger. His brain is taking in the information visually, auditorily and kinesthetically, and is able to process it the way his brain works best. The result is that your child will have a better chance of remembering the letter C. When different senses are used to activate learning, it becomes more fun for the student and it also makes it more likely that your child can learn and remember the information.

Try not to get hung up on the labels. As I mentioned in the beginning of this blog post – everyone learns differently. But, if your child is struggling, consider having your child evaluated to determine whether he qualifies for specialized help. The earlier he gets the help he needs, the better off he will be.

Learn more about the different kinds of learning disabilities, as well as what they ARE and are NOT.

Have questions? Send them to

See other topics in the Delays and Disabilities series here.


Vocabulary at age 2 may predict kindergarten success

Wednesday, September 2nd, 2015

parents reading to toddlerThe size of a child’s vocabulary at age two may predict how well he will do in kindergarten, according to a new study. The larger the oral vocabulary, the better prepared he will be for school.

The study looked at 8,500 children in the United States. The researchers found that:

  • preemies or babies with a very low birth weight, and babies whose mothers had health issues had smaller vocabularies.
  • children with parents who frequently interacted with their children and read to them on a regular basis had larger vocabularies.
  • girls tended to have a larger vocabulary than boys.
  • children from higher socioeconomic homes had larger vocabularies.
  • children with larger vocabularies at 24 months of age did better in reading and math and had fewer behavioral problems.

The researchers believe that interventions should be started early enough so that children who are at risk due to medical/health problems or socioeconomic disadvantages, have the time to develop and catch up. Interventions need to be targeted especially to toddlers who are living in disadvantaged homes.

Keep in mind that no two children develop exactly alike. Some are early bloomers while others are later bloomers. And one study cannot predict an individual child’s development.

What can you do?

The single most effective way to help your baby expand his vocabulary is to read to him. Start when your baby is born, and read every day. Reading aloud helps promote language skills – vocabulary, speech and later on, reading comprehension. See this post to learn just how important reading is for your baby and to learn where to get books. See the AAP’s article for tips on how to make it fun. And remember, the best parts about reading to your little one are the snuggles and cuddles that go along with it.

If your baby is showing signs of a developmental delay, speak with his health care provider, or contact your Early Intervention Program and ask for a free screening. If your child qualifies, he may receive personal, targeted intervention (such as speech therapy) to help him catch up.

Don’t delay with delays!

Have questions? Text or email them to

The study appeared in the journal Child Development.

Learn how to help your child in our Delays and Disabilities series.

Kids with special needs head back to school

Wednesday, August 26th, 2015

school-bus-and-stationeryThe start of school is an exciting time for most children and their parents. Many children with special needs eagerly anticipate the start of a new school year. But lots of kids are incredibly anxious at the thought of all the unknowns: new classroom, teacher, friends or school.

If you are the parent of a child with special needs, how are you feeling about the start of the new school year?

Are you…

Scared or fearful – Will your child’s particular needs be met?

Afraid – How will your child react to new smells, lights, sounds and routines?

Overwhelmed – Is your child going to a new school? Are you wondering whether he will be able to handle the transition?

Unprepared – Do IEP meetings make you feel like you don’t know what you are doing?

Alone – Do you feel like you are the only parent with your concerns?

Worried – Is your child going to do well in a class with “typically developing” peers?

Insecure – Are you wondering when to swoop in and help your child versus sitting back and watching him and the school handle any hiccups or problems?

Nervous – Will your child make friends? Will he be by himself on the playground?

If you are experiencing any or all of the above emotions, you are not alone. There is no doubt that starting a new school year is hard on students AND parents. But, when you mix in the complications of dealing with a disability and the necessary accommodations or supports that need to be in place in order for your child to succeed, it can be very stressful!

This blog series, and all of the resources listed in each post will help you tackle whatever comes your way. By being prepared, you will calm your nerves. Hopefully, you will become excited, confident and in-control. Your little one will sense your positive outlook and enthusiasm, and it will rub off on him, too.

Check out these tips to smooth the back to school transition for your child. Learn helpful ways to make the transition from summer to school do-able and realistic, including changing bedtime hours, adjusting meds and meeting your child’s teacher.

Please share your feelings about the new school year – good, bad, up, down, and anything in between. Got any tips? Let’s hear them. We all learn from each other.


Have questions?  Text or email them to We are here to help.

Children with Congenital Heart Defects and Their Use of Special Educational Services

Wednesday, August 19th, 2015

A guest post by Coleen Boyle, PhD, MSHyg
Centers for Disease Control and Prevention

Teacher and studentsSome new research gives us encouraging information showing that children living with birth defects are getting the services they need. Specifically, several of my colleagues and I found that children with congenital heart defects (CHDs) received special education services more often than children without birth defects.

This is important news, because earlier studies have shown us that children with some types of CHDs have a greater chance of having problems with brain development and function as compared to children without birth defects. Knowing that children with CHDs may benefit from—and are receiving—special education services is reassuring. Special education services are those specifically designed to meet the unique needs of a child with a disability.

So what do these findings mean? They demonstrate the importance of developmental screening—short tests usually conducted by a child’s doctor to determine if their basic learning skills are where they should be—for all children with CHDs to ensure they receive the services they need. The American Academy of Pediatrics recommends all children receive these screenings at 9, 18 and 24 or 30 months of age during well visits with the doctor. Screenings may include observing, talking with, or playing with the child to see how he or she plays, speaks, behaves, and moves.

CHDs are heart problems that occur before birth and are the most common type of birth defect in the United States. About 1% or nearly 40,000 births each year are affected by CHDs. Of these, about 1 in 4 is considered a critical CHD, in which surgery or other procedures are needed within the baby’s first year.

Some of the specific findings from the study show that
• Children with CHDs and no other birth defect were 50% more likely to receive special education services than those children without birth defects.
• This increased use of special education services occurred in children with critical CHDs and in children with noncritical CHD.

For this study, we looked at information about children born with a CHD from 1982 to 2004 in metropolitan Atlanta; we also examined a similar sample of newborns without a birth defect. After linking information about these children to special education services they later received (from 1992 to 2012), we determined that children with CHDs more often received those services than children without birth defects.

The Centers for Disease Control and Prevention (CDC) and our partners not only conduct research such as this to identify the scope of the issue and how it is being addressed, we also
• Fund programs and conduct research to help us determine where and when birth defects occur and whom they affect;
• Track CHDs among teens and adults to learn more about their health issues and needs; and
• Collaborate with partners such as the March of Dimes to provide information to families, experts, and organizations to address CHDs.

We at CDC and in particular the National Center on Birth Defects and Developmental Disabilities (NCBDDD) along with our partners, including March of Dimes, strive to help ensure individuals born with these conditions get the care they need throughout their lives.

To learn more read the Key Findings document and the research article abstract.

dr-coleen-boyleThe March of Dimes wishes to thank Dr. Coleen Boyle for this guest post. Dr. Boyle is the Director of NCBDDD and has authored or co-authored more than 100 peer-reviewed and other scientific publications.

Brain bleeds in premature babies

Wednesday, August 12th, 2015

brainThe younger, smaller and sicker a baby is at birth, the more likely he is to have a brain bleed, also called an intraventricular hemorrhage (IVH). If you or someone you know has a baby with a brain bleed, it can be a very scary and upsetting experience.

Bleeding in the brain is most common in the smallest of babies born prematurely (weighing less than 3 1/3 pounds). A baby born before 32 weeks of pregnancy is at the highest risk of developing a brain bleed. The tiny blood vessels in a baby’s brain are very fragile and can be injured easily. The bleeds usually occur in the first few days of life.

How are brain bleeds diagnosed?

Bleeding generally occurs near the fluid-filled spaces (ventricles) in the center of the brain. An ultrasound examination can show whether a baby has a brain bleed and how severe it is. According to, “all babies born before 30 weeks should have an ultrasound of the head to screen for IVH. The test is done once between 7 and 14 days of age. Babies born between 30-34 weeks may also have ultrasound screening if they have symptoms of the problem.”

Are all brain bleeds the same?

Brain bleeds usually are given a number grade (1 to 4) according to their location and size. The right and left sides of the brain are graded separately. Most brain bleeds are mild (grades 1 and 2) and resolve themselves with few lasting problems. More severe bleeds (grade 3 and 4) can cause difficulties for your baby during hospitalization as well as possible problems in the future.

What happens after your baby leaves the hospital?

Every child is unique. How well your baby will do depends on several factors. Many babies will need close monitoring by a pediatric neurologist or other specialist (such as a developmental behavioral pediatrician) during infancy and early childhood. Some children may have seizures or problems with speech, movement or learning.

If your baby is delayed in meeting his developmental milestones, he may benefit from early intervention services (EI). EI services such as speech, occupational and physical therapy may help your child make strides. Read this series to learn how to access services in your state.

Where can parents find support?

Having a baby with a brain bleed can be overwhelming. The March of Dimes online community, Share Your Story, is a place where parents can find comfort and support from other parents who have (or had) a baby in the NICU with a brain bleed. Just log on and post a comment and you will be welcomed.

You can also leave a comment here on our blog, or send a question to where a health education specialist is ready to assist you.


Breastfeeding a baby with a cleft lip or cleft palate

Wednesday, August 5th, 2015

cleft lipBreastfeeding can be challenging for any mom. But, for the mother of an infant with a cleft lip or cleft palate, it can be daunting.

In honor of World Breastfeeding Week, I am featuring a very helpful post on breastfeeding a baby with a cleft lip or cleft palate, written by our March of Dimes blogger and Lactation Counselor. Thank you Lauren, for this post filled with useful, practical tips.


A cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening. A cleft palate is a similar birth defect in a baby’s palate (roof of the mouth). A baby can be born with one or both of these defects. If your baby has a cleft lip, a cleft palate, or both, he may have trouble breastfeeding. It is normal for babies with a cleft lip to need some extra time to get started with breastfeeding. If your baby has a cleft palate, he most likely cannot feed from the breast. This is because your baby has more trouble sucking and swallowing. You can, however, still feed your baby pumped breast milk from a bottle.

Your baby’s provider can help you start good breastfeeding habits right after your baby is born. The provider may recommend:

• special nipples and bottles that can make feeding breast milk from a bottle easier.

• an obturator. This is a small plastic plate that fits into the roof of your baby’s mouth and covers the cleft opening during feeding.

Here are some helpful breastfeeding tips:

• If your baby chokes or leaks milk from his nose, the football hold position may help your baby take milk more easily. Tuck your baby under your arm, on the same side you are nursing from, like a football. He should face you, with his nose level with your nipple. Rest your arm on a pillow and support the baby’s shoulders, neck and head with your hand.

• If your baby prefers only one breast, try sliding him over to the other breast without turning him or moving him too much. If you need, use pillows for support.

• Feed your baby in a calm or darkened room. Calm surroundings can help him have fewer distractions.

• Your baby may take longer to finish feeding and may need to be burped more often (2-3 times during a feed).

• It may help to keep your baby as upright as possible during his feeding. This position will allow the milk to flow into his stomach easier, which will help prevent choking.

How breastfeeding can help your baby:

• His mouth and tongue coordination will improve, which can help his speech skills.

• His face and mouth muscles will strengthen, leading to more normal facial formation.

• If your baby chokes or leaks milk from his nose, breast milk is less irritating to the mucous membranes than formula.

• Babies with a cleft tend to have more ear infections; breast milk helps protect against these infections.

If your baby is unable to breastfeed: 

• Feed your baby with bottles and nipples specifically designed for babies with clefts. Ask your baby’s health care provider for recommendations.

If you are concerned if your baby is getting enough to eat, or if he is having trouble feeding, speak with a lactation counselor, your baby’s provider or a nurse if you are still in the hospital.

If you have any questions about feeding your child with a cleft lip or palate, email us at


Tips for family travel with your child with special needs

Wednesday, July 29th, 2015

air travelIt is the end of July already, and many summer programs or camps are beginning to wind down. Some families like to take a few days or more to spend together. But, often traveling with a child who has complicated or special needs can be difficult.

Here is a blog post on how you can vacation with your child with special needs. It includes tips on what to do ahead of time, how to enhance communication while on your trip, and how to implement a positive reward system to help encourage desired behaviors. This post also includes travel ideas, such as the best places for your family to go with your child.

Accommodations help vacationers with special needs reviews special offerings and assistance available in many theme parks, sports stadiums and ball parks as well as hotels, pools and restaurants, thanks to the ADA. Even airlines will let individuals with cognitive or physical disabilities pre-board flights, to make life easier for you and your child.

There is no need to stay home when you and your family can get a change of scene and pace with just a little pre-planning and inquiring. vacation-family-carHopefully, these posts will give you the tools you need to make it work for you and have an enjoyable vacation.

If you have had a good experience at a particular destination, we’d love to hear about it. Please share.


Have questions? Send them to

See other posts in the Delays and Disabilities series, here.