Transitioning Towards Successful Adulthood for Teenagers Chicago IL

Transitioning Towards Successful Adulthood for Teenagers Chicago, IL 27 -30 May 2008 Presented by Stephen M. Shore, Ed. D. www. autismasperger. net 1

INTRODUCTION 2

W H O A M I? Introduction — The Past The Autism Bomb Loss of speech & tantrums Self-stims Environmental withdrawal 3

W H O A M Introduction I? 4

W H O A M I? Introduction — Adult AGE E V E N T S 0 1. 5 2. 5 4 6 8 10 13 19 Typical development Turn over at 8 days Rapid physical and motor development Autism bomb hits Withdrawal from environment Tantrums Putnam evaluation of atypical developmen t, strong autistic tendencies & psychotic Early intervention from parents who refute recommend ations for removal from home Enter Putnam Condition improves to “neurotic” The wonderful world of watch motors Echolalia and return of speech Eating baby food Kindergarten Social & academic difficulties Discovered making a mess of myself while eating BBQ chicken wings Loved cats but dogs… Yikes bikes! Cracking rocks Special interests in astronomy and weather Teacher concerns for reading and math difficulties Concern about dropping the letter “e. ” My friend says “he feels like a pizza” and I argue with him that he does not look like a pizza and probably does not feel like one either Middle and high school Finally getting it together but still often in left field Discovering the band room Time to focus more on people and not their bicycles College More friends Dating Others really do think differen tly Utopia! Finishing doctoral dissertation on comparative educational approaches for engendering success for people with autism and Asperger Syndrome 5

AREAS TO CONSIDER FOR SUCCESSFUL ADULTHOOD Overview What we are doing now that has implications for adult life Interdependent Living Biomedical Residential Employment Behavioral/ Developmental/ Educational Relationships (including sexual) Continuing Education Sensory Self-Advocacy and Disclosure 6

NAVIGATING THE SEA OF INTERVENTIONS 7

THE SEA OF INTERVENTIONS Three Areas of Intervention Educational/Behav Educational. Behavioral Sensory Biomedical • DTT/ABA • • • Daily Life Therapy TEACCH Miller Method DIR (Floortime) RDI SCERTS Stephen Edelson, personal communication, December, 2004 Sensory Occupational Therapy to Treat Imbalances of the Outer and Inner Senses • Sight • Touch • Taste • Smell • Hearing • Vestibular • Proprioception Biomedical Treating chemical imbalances caused by internal and external factors • Digestion • Nutrition • Chelation • GFCF Diet • Vaccines • Dysbiosis • Immunology • Feingold Diet • Mercury and other heavy metal toxicities [metallothionein & glutathione] 8

A POSSIBLE INTERVENTION PROFILE Three Areas of Intervention Educational. Behavioral Biomedical Sensory Stephen Edelson, personal communication, December, 2004 9

SOME PROMISING INTERVENTIONS Lovaas (ABA): Watson, Skinner, Operant conditioning, Shaping behaviors, Antecedent-behavior-consequence TEACCH: Employs approaches based on the needs of a person’s needs and emerging capabilities (Trehin, 1999). Daily Life Therapy: Kito Kitihara, Platonic, Order of the physical, emotional and intellectual. Miller Method: Miller, Developmental-Cognitive Systems, Elevation, Piaget, Vygotsky, Luria, Werner, Bertalanffy. DIR (Floortime): Greenspan, Developmental-Affective, Circles of communication. Relational Development Intervention: Gutstein, Experience sharing rather than instrumental relationships. SCERTS: Prizant, Social-Communication, Emotional-Regulation, Transactional Support. Biomedical: Medical-Chemical, Diet (GFCF), Adjusting chemical imbalances, Persistent measles, Heavy metal toxicities. Other: Sensory integration, PECS, Inclusion, Social stories, Power cards, CCT 10

COLLABORATION MODEL FOR SOCIAL INCLUSION IN THE UNITED STATES Nine Domains of Educational Accommodations 1. Size 2. Time 3. Level of Support 4. Input 5. Difficulty 6. Output 7. Participation 8. Alternate 9. Substitute Curriculum Adapted from Adapting Curriculum and Instruction in Inclusive Classrooms: A Teacher's Desk Reference, by Deschenes, C. , Ebeling, D. , and Sprague, J. , 1994. 11

Only hermits live independently INTERDEPENDENT LIVING AND APPROPRIATE HOUSING Along with COMMUNITY INVOLVEMENT 12

AREAS TO CONSIDER FOR SUCCESSFUL ADULTHOOD Residential We ain’t gonna be around forever…. Interdependent Living • Home/Apt. – Roommates? Group Living • Shared Home/ Apartment/Institution • Degrees of Supervision – Minimal to Live-in • Degrees of Supervision – Part to Full-time Least Restrictive Environment Continuum 13

WORK? WHERE? WHAT? HOW? 14

REAL WORLD O F WORK Defining Work – Adding Meaning to Life Work is more than just a livelihood or paycheck; it is the key to a satisfying and productive life. For many on the autism spectrum, it is the glue that keeps our lives together in an otherwise frustrating and sometimes confusing world. Certainly, my life would not be worth living if I did not have intellectually satisfying work. Developing Talents: Careers for Individuals with Asperger Syndrome and High-Functioning Autism, Temple Grandin However… 15

REAL WORLD O F WORK Reality for People on the Autism Spectrum Most adults on the Autism Spectrum are either unemployed or underemployed. Many, if given proper opportunities and training, have skills and abilities that would be valuable in appropriate work settings. 16

REAL WORLD O F WORK Characteristics of Autism – A Reframing ASA (2005) A complex developmental disability that typically appears during the first three years of life. Autism Spectrum Disorder results from a neurological condition that affects the functioning of the brain. Reframe DSM IV-TR (2000) Miller (2000) Social interaction • Communication (but no significant clinical delay • Socialization for AS) Repetitive motions and restricted • Restricted interests Interests Anything that interferes with the central nervous system getting the needed information from the environment. OOPS!!!!! WHAT ABOUT SENSORY INTEGRATION ISSUES? 17

REAL WORLD O F WORK Characteristics of Autism – Confusion and Chaos Overly sensitive to loud noises… e pl o pe o nt ine… i s nl p m i Bu er… y eat Pick Difficulty paying at tention… Difficulty with hair washing and brushing… Proble ms wit h hand w riting… y… Clums Alw ay s“ on the go” … Only likes certain types of clothing… Adapted from Myles, Cook, Miller, Rinner & Robbins. (2000). Asperger Syndrome and sensory issues : Practical solutions for making sense of the world. Shawnee Mission, KS: Autism Asperger Publishing. P. 5. 18

REAL WORLD O F WORK Gearing Work Towards Interest/strength Implications for Career Subway maps and computers Design maps for web pages of a public transit authority Horses and medicine Equestrian veterinarian Hypersensitive sense of smell and engineering Airplane engine trouble shooter 19

REAL WORLD O F WORK Determining Career Matches – Possible Employment Structures • • Competitive employment Full-time employment Part-time employment Permanent employment Short-term jobs Seasonal jobs Self-employment / Micro-enterprise 20

REAL WORLD O F WORK Matching Needs to Possible Positions Personal Characteristics Preferred Job Attributes Possible Positions Deficit in verbal and nonverbal communication Few communication requirements Stock shelves Challenges in socialization Limited contact with public, more solitary job duties Filing, sorting, stapling paper shredding, after-hours cleaning Unusual response to sensory stimulation Provider of preferred sensory input, ability to avoid noxious sensory stimulation Hanging clothes, washing cars (for those enjoying that type of tactile input Difficulty with change and transition Few changes, stable work environment, little staff turnover, same work task all day Small business, family business, assembly line Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley. 21

REAL WORLD O F WORK Matching Needs to Possible Positions Personal Characteristics Preferred Job Attributes Possible Positions Strong visual-motor skills Requires good visual-motor skills Small-parts assembly, manufacturing, printing Behavior challenges Few antecedents to challenging behaviors, with situations where possible problems don’t endanger others Situations where behavior doesn’t cause dangerous situations; avoid factories or jobs using heavy machinery Savant skills Responsibilities capitalizing on these strengths Matching stock numbers to packing lists, mathematically oriented positions for those with good math skills Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley. 22

REAL WORLD O F WORK Matching Needs to Possible Positions Personal Characteristics Preferred Job Attributes Possible Positions Rituals and compulsions Attention to detail and Positions with repetitive tasks that must be done with high accuracy, such as counting items to be placed into packages or looking over products for defects Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley. 23

REAL WORLD O F WORK The Hidden Curriculum – Peter Gerhardt, 2004 THE HIDDEN CURRICULUM Practical Solutions for Understanding Unstated Rules in Social Situations Bob Sam Brenda Myles http: //www. esoterically. net/log/archives/2003_01. html Melissa Trautman Ronda Schelvan Sam arrives after Bob. What two rules did he break? Autism Asperger Publishing Company 24

THE HIDDEN CURRICULUM - INCIDENTAL BOOKS 25

RELATIONSHIPS 26

THE STAGE RAGE CYCLE COMMON BEHAVIORS Rumbling Increased verbal behaviors such as swearing, nonsense noises, unusual changes in vocal volume, or making threats Increased stereotypical behavior such as grimacing, fidgeting, rocking, flapping, tearing paper, or tapping foot Increased movement, including pacing, walking in circles, or leaving the room Rage Verbal behaviors such as screaming Emotional expressions such as explosive impulsiveness and rage at self Physical behaviors such as destroying property, biting, hitting, kicking, and self-injury Recovery Sleeping Denial of rage behaviors and withdrawal into fantasy Apologizing Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 27

IMPROVING SELF–ASSESSMENT Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 28

SOCCSS Situations — Options — Consequences — Choices — Strategies — Simulation Jan Roosa (1995) in Myles, B. , Trautman, M. , and Schelvan, R. (2004). The hidden curriculum, Shawnee Mission: AAPC. p. 22 Situation Who: David and Tom When: At recess after lunch What: Tom pushed David when they were both standing in line at the slide. Mrs. Why: Smith saw them and had both of the sit out for the rest of recess. David started teasing Tom about the coat he was wearing. Options Consequences Ignore David’s comment. David could continue to say mean things. Avoid being around Davis at recess. Choice If David is playing on the slide, Tom would not be able to be there and he likes the slide David might stop saying mean things. Tell David to stop; if he The teacher would tell David to stop. doesn’t, tell the teacher. √ The teacher would tell Tom to ignore him. Strategy - Plan of Action The next time that David says something mean to Tom, Tom will tell him to stop If David doesn’t stop teasing Tom, Tom will tell the teacher. 29

SOCCSS Situations — Options — Consequences — Choices — Strategies — Simulation Jan Roosa (1995) in Myles, B. , Trautman, M. , and Schelvan, R. (2004). The hidden curriculum, Shawnee Mission: AAPC. p. 22 Situation Who: David and Tom When: At recess after lunch What: Tom pushed David when they were both standing in line at the slide. Mrs. Smith saw them and had both of the sit out for the rest of recess. Why: David started teasing Tom about the coat he was wearing. Options Consequences Ignore David’s comment. David could continue to say mean things. Avoid being around Davis at recess. If David is playing on the slide, Tom would not be able to be there and he likes the slide Tell David to stop; if he doesn’t, tell the teacher. The teacher would tell David to stop. Choice David might stop saying mean things. √ The teacher would tell Tom to ignore him. Strategy - Plan of Action The next time that David says something mean to Tom, Tom will tell him to stop If David doesn’t stop teasing Tom, Tom will tell the teacher. Simulation - Practice A. Visually B. Verbally C. Role-playing 30

Seek… to understand all aspects of the hidden curriculum Observe… what people are doing and NOT doing Listen… to what people are saying and NOT saying Vocalize… questions and check for understanding Educate… teach and learn… knowledge is power 31

Stop… what you are doing in order to… Observe… what people are doing and NOT doing in order to… Deliberate… to determine the next step of… Act… based on the information you now have. 32

S O C I A L S T O R I E S – by Carol Gray Using vignettes to describe how social interactions work employing… Descriptive Sentences: Background of situation Directive Sentences: Suggests action and decode meanings Affirmative Sentences: Suggests commonly shared values or opinions • • • When the teacher asks a question, many students would like to provide an answer. Descriptive It’s hard for a teacher to hear when several students try to answer at once. Descriptive Students in a classroom need to take turns talking. Affirmative When I want to answer a question that the teacher asks in class, I will try to sit quietly and raise my hand. Directive The teacher may call on me to answer or the teacher may give another student a turn at answering the question. Descriptive If the teacher does not call on me this time maybe next time she will ask me to answer her question. Descriptive Adapted from Gray, C. The new social story book. Future Horizons 33

Madeline Teaches Becca How to not Stress Out Remain Calm Power Card Scenario: About 15 minutes into her weekly music lesson, Becca, a 9 year old girl with AS consistently throws herself into a coach crying that she “will never be able to do it” and “that is no use. ” After 10 minutes, Becca’s mother calms her down and the lesson continues with a doll named “Madeline”. This behavior occurs during other activities too. Task: Develop a Power Card to address Becca’s tantram. Analysis: Behavior Tantrum 15 minutes into the music lesson Possible cause Lack of ability to sense and handle frustration Motivator: Special Interest/Hero The doll Madeline 34

Madeline Teaches Becca How to not Stress Out Remain Calm Power Card Madeline wan ts you to rem ember to cho to help calm ose one of th yourself if y e following w ou get frustr answering a q ays ated when yo uestion. If o u have diffic ne of the wa If you need h ulty ys does not w elp to answer ork try anoth the question you can do it er. this time, pe all by yourse rhaps next t lf. ime 1. Take 5 de ep breaths e xhaling slowly after each breath. 2. Close you r eyes and slo wly count backwa rds from 10 to 1. 3. Get a hug from Mommy . 4. Take a sh ort bre ak. 35

THE RAGE CYCLE Teachable Moments Rumbling Rage Recovery Teachable Moments 36

THE STAGE RAGE CYCLE COMMON BEHAVIORS Rumbling Increased verbal behaviors such as swearing, nonsense noises, unusual changes in vocal volume, or making threats Increased stereotypical behavior such as grimacing, fidgeting, rocking, flapping, tearing paper, or tapping foot Increased movement, including pacing, walking in circles, or leaving the room Rage Verbal behaviors such as screaming Emotional expressions such as explosive impulsiveness and rage at self Physical behaviors such as destroying property, biting, hitting, kicking, and self-injury Recovery Sleeping Denial of rage behaviors and withdrawal into fantasy Apologizing Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 37

THE STAGE Rumbling RAGE CYCLE POSSIBLE INTERVENTIONS Antiseptic bouncing Quiet room with work Walk and no talk Rage Keep child, other and possessions safe Recovery Keep demands very low Favorite activity Not a time for social autopsies or other discussions of behavior Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 38

THE Teachable Moments Rumbling RAGE Rage CYCLE Recovery Teachable Moments Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 39

IMPROVING SELF–ASSESSMENT Adapted from Myles, B. , & Southwick, J. Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 40

RELATIONSHIPS Circle of Relationships Stranger Acquaintance Friend Family -->Significant other Passerby, Classmate, Coworker, Fellow Commuter Neighbor Classmate, Coworker Close Neighbor Classmate, Coworker Mom, Dad, Sibling, Other Boy/Girlfriend, Fiancé, Spouse Develop a social narrative 41

R E L A T I O N S H I P S Talking About Sex - Myths of Sexuality - Peter Gerhardt Common Myths • Persons with autism… - have little to no interest in sex - are hypersexual - are solely heterosexual So… How can we help people on the autism spectrum deal with this important part of life? But the Truth is… • Persons with autism are as diverse sexually as everyone else - and, sexuality education is complicated by challenges in language, communication, and social differences. While sexual feelings and interest may be high, a primary information source is usually not available – non-spectrum teens (Volkmar & Wiesner, 2003). - With proper support people with autism can have relationships; often with a person having a difference. 42

R E L A T I O N S H I P S Talking About Sex - Jerry Newport How? Sex is a normal yet a very private act and is clean. • Discuss in a developmentally appropriate manner Find the balance between not too much and not too little • Make sure you understand the question(s) being asked • Explain in a matter of fact manner Why? People find out about sex anyways from classmates, mass media, books, etc. 43

R E L A T I O N S H I P S Talking About Sex - Masturbation - Peter Gerhardt Redirecting Inappropriate Masturbation 1. Interrupt the behavior as early in the chain as possible 2. Remind the individual as to the parameters of time and place 3. Redirect the person to… A. activities requiring the use of both hands B. activities requiring preferred levels of attention, focus, or physical movement C. the appropriate place for that activity 4. Make the alternate activity intrinsically reinforcing 5. Consider scheduling “alone time” in their room if appropriate 6. Avoid redirection to places other than an individual’s bedroom (e. g. bathroom) 44

R E L A T I O N S H I P S Talking About Sex – Resources Aston, M. , The other half of Asperger Syndrome. Hénault, I. , Asperger’s Syndrome and sexuality: From adolescence through adulthood. Lawson, W. , Sex, sexuality and the autism spectrum. Mesibov, G. , The TEACCH approach to autism spectrum disorders. Newport, J. & Newport, M. , Autism-Asperger’s and sexuality: Puberty and beyond. Shore, S. , & Rastelli, L. , Understanding autism for dummies. Sicile-Kira, C. , Autism spectrum disorders: The complete guide to understanding autism, Asperger’s Syndrome, pervasive developmental disorders, and others ASDs. Wrobel, M. , Taking care of myself: A hygiene, puberty, and personal curriculum for young people with autism. 45

SELF-ADVOCACY & DISCLOSURE 46

The road to successful self- advocacy starts by accurately assessing your circumstances. 47

S E L F-A D V O C A C Y D E F I N E D Self-advocacy involves knowing when and how to approach others in order to negotiate desired goals, and in order to build better mutual understanding, fulfillment, and productivity. Successful self-advocacy often involves an amount of disclosure about oneself that carries some degree of risk, in order to reach a subsequent goal of better mutual understanding. 48

WHEN TO TELL… The Twin Challenges of Disclosure and Self-Advocacy The issue of disclosure begins… …As soon as it is known that a person has a difference in their way of being 49

WHY TO TELL… The Twin Challenges of Disclosure and Self-Advocacy REALITY CHECK Most people are busy with living Most people are not in the mindset of accommodating people with differences 50

S U C C E S S F U L T R A N S I T I O N Self-Determination —> Disclosure —> Self-Advocacy 1. Make the child aware of their strengths and challenges through verbal, pictorial, and other communication. 2. “Rack up” strengths and challenges. 4. Present the label summarizing a condition rather then a name for a set of deficits. 5. Making ones needs known in a way that others can understand comply; hopefully in a proactive manner. 3. Non-judgementally compare characteristic with other role models. 51

Self-Initiated Individual Education Plan (Cont. ) Who must we get on board? • Student - Student’s Guide to the IEP - Helping Students Develop Their IEP www. nichcy. org • Parents • Special Education Teacher • Regular Education Teacher(s) • Administrators A Guide to the Individualized Education Program. Office of Special Education Programs. 16 June 2002. • Others 52

Self-Initiated Individual Education Plan To my IEP Team, I like the way Mr. Dowd teaches math. He makes it fun and easy for me. Mrs. Sugarmans’ English class is very difficult. I don’t understand when she diagrams sentences on the board and the scratching of the student pencils during writing time makes it very hard for me to concentrate. Truly yours, Joey 53

Self-Initiated Individual Education Plan (Cont. ) N I C H C Y TECHNICAL ASSISTANCE GUIDE Helping Students Develop Their IEPs Partial Table of Contents • • Laying the Foundation Introductory Work with Students Introducing the IEP Writing the IEP Getting Ready for the IEP Meeting During the IEP Meeting After the Meeting N I C H C Y A Student’s Guide to the IEP Partial Table of Contents • What is an IEP? • How do I develop my IEP? • What to do before the IEP meeting • Writing the IEP • Getting ready for the IEP meeting • Participating in the IEP meeting • After the IEP meeting www. nichcy. org 54

Self-Initiated Individual Education Plan (Cont. ) Accommodation Menu Note: This form is not required by IDEA Student: __Somebody______ Date: ___10/28/07_______ Teacher: __Anybody______ IEP Manger: __Everybody_______ Used? Effectiveness (1 -5) Accommodation Used? Effectiveness (1 -5) Placement √ 4 Preferential seating Small group Sensory √ 2 Assignments √ 5 Reduced paper/ pencil tasks Extended time Accommodation Lighting Hat with visor Standing at desk Other √ 5 Outline with due dates for assignments Adapted from Mc. Gahee et al. (2001). Student-led IEPs: A guide for student involvement. Arlington, VA: Council for Exceptional Children in Shore (Ed). (2004) Ask and tell: Self-advocacy and disclosure for people on the autism spectrum. Shawnee Mission, KS: Autism Asperger Publishing Company. P. 91. 55

Telescoping Forward to the Future MY ADULT LIFE Student: ___________ Date: ____________ Employment Goals Current Accommodations Future Accommodations Recreation and Leisure Home/Independent Living Community Involvement/Volunteer Work Postsecondary Education/Training Adapted from Shore (Ed). (2004). Ask and tell: Self-advocacy and disclosure for people on the autism spectrum. Shawnee Mission, KS: Autism Asperger Publishing Company. P. 92. 56

CONTINUING EDUCATION 57

SOME STEPS FOR A SUCCESSFUL COLLEGE EXPERIENCE A. S Univ O So rg a ci ni Li ur • se w or k • • • za vi ng Co al tio n • Friends - Aides - Dorm? - Single? Parties Appropriateness Carbon-based Silicon-based • Home? Part time? • Full time? Accommodations? 58

Looking For The Right College (Cont. ) Preparation Questions that need answering • Documentation… • Where is the office of student support? - Appropriate - Recent - Suggestions for reasonable accommodation Issues to consider • Is assistance needed with… - Academic Accommodations - Independent Living Skills A. S. - What is needed to obtain accommodations? Univ - Are they friendly? - Do they know what AS is? - Knowledgeable? - Willing to learn? 59

M a k i n g C o l l e g e R i g h t (Cont. ) ACCOMMODATIONS WORKSHEET Name: Any Student School: Any State College Counselor: Unnamed Somebody Date: August 15, 2007 Challenge Cause Suggested Accommodation Taking tests with multiple questions per page. Visually over 1. stimulating, gets 2. lost in all the words. Unable to concentrate under fluorescent lights. Perception of 60 Hz cycling due to visual sensitivity Explore alternate lighting, sit next to window, wear baseball cap in class. Scheduling long term assignments. Poor executive function. Regularly meet with professor (perhaps once a week) to keep on target with lengthy assignments. Only one question per page. Two sheets of paper to cover distracting verbiage. 60

AUTISM & SUC C ES S 61

S U C C E S S W I T H A U T I S M Some Examples… Zack Kassiane “a guck goo…” AAU tumbling state champion; 3 rd national (Special Interest) 62

S U C C E S S W I T H A U T I S M Some Examples… Sarah Teacher of and seller of beads (Special Interest) Laura A study in synesthesia 63

S U C C E S S W I T H A U T I S M Some Examples… David Shawn Finishing a master’s in meteorology 1 st place ribbon in State Science Fair (Special Interest) 64

SUCCESS ON THE AUTISM SPECTRUM Some Examples… Valerie Takamimori Founder of school for children with AS Sumo Wrestler (Personal Experiences) www. youtube. com/watch? v=aj. QWQrxn 1 hc (Special Interest) 65

MARRIAGE FROM THE SPECTRUM Definition If you are productive and fulfilled with your relationship you are probably successful the l in s al ey It’ urn jo You a re ex ac you n eed t tly wher e o be right now 66

Thanks for your participation! Stephen Shore www. autismasperger. net 67

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