My son is 4 years old and we have had extensive diagnosis for
him and he was labeled high functioning autistic. He has some
speech but uses it mainly for communicating his needs "I
want juice" "turn light on" etc., and not for pleasure.
He is very advanced in certain areas, especially math. He can
count really to an unlimited number just like an adult, he can
add, and I notice that he makes interesting advanced patterns
on his equations, such as 30, 60, 90, 120, 150, ... obviously
adding by thirty. He is completely obsessed with math, and has
developed his own math sign language, which is very complex and
goes over 100. I have heard that you should not indulge, and actually
discourage these obsessions, yet I just can't agree with that
and we spend a lot of time on math because he really enjoys it.
How do you feel about this?
Also, I am
lost in the department of discipline, he doesn't listen to me
no matter what I do, and he is a master at tuning me out. He doesn't
care about time outs, and doesn't find it a punishment. At preschool
the teachers just let him sit by himself and do puzzles and math
and he doesn't have to integrate more than he wants to but in
grade school this won't be the case. He will get obsessive about
the VCR or dvd player and play with the buttons, and he has broken
many things. But he will not listen when we tell him to stop.
Also regarding potty training, he will go to the bathroom on the
toilet only if he is at home and naked. This is fine at home as
he doesn't like wearing clothes so we usually don't push it, but
he is four and we need to train him. At preschool he uses a diaper.
any advice, I also wanted to add that he sees a speech therapist
once a week and a special Ed teacher once a week and we are getting
him into a regional center program here in California.
M.D.: In the past decade or so developmental psychologists
have realized that beginning at two or three years of age, children
begin to learn to two parallel capacities of processing information.
One, which has been termed "folk psychology" or "intuitive
psychology" involves understanding such things as human motivation,
and the numerous (and largely non-verbal) social signs and signals
which people use in communicating with each other. Over the years
people acquire detailed understanding of such matters, to the
point at which, without even thinking about it, they can size-up
a social encounter and generate the expected and appropriate social
response. The second capacity, termed "folk physics"
or "intuitive physics" encompasses understanding of
the world through factual knowledge, often mediated by verbal
information. Your son's ability to count and to identify patterns
within numeric arrays would seem to be an example of "intuitive
physics." Although most people develop good intuitive psychology
and intuitive physics, occasionally some people may develop the
second one well, while handicapped in the first. People with a
"high functioning" form of autism, which may also be
called Asperger's Disorder, may show such patterns of handicaps
That he "tunes
you out" is an indication of his inborn lack of any propensity
to note and respond to social signals, or perhaps to even understand
that you have a mind that is different from his. He may not realize
at all that you can feel joy if he pays attention to you, or engages
in social behaviors such as looking at you, hugging, or using
social gestures. Other children are programmed to do this naturally.
It is good that he is seeing a speech therapist and a special
Ed teacher. While there is no harm in doing math games with him,
it would be useful if you and his therapists used things he enjoys
doing to expand his range of social behaviors. Talk to the parents
of autistic children in your community; find out what specific
therapeutic approaches exist for enhancing children's social communication.
The regional center staff should also know this and can guide
you in finding therapies for your son as he grows older.
My son is 3 years old and diagnosed in the lower end of severe
ASD. He was born very premature and followed in a neurodevelopmental
clinic from birth so we were lucky to get an early diagnosis.
He currently attends a specialized preschool half days, 4 days
per week. He receives speech, occupational, and physical therapies
one time per week, 4 hours per week with a behavioral specialist,
and 25 hours per week with therapeutic staff support to help implement
ABA. We've made a ton of progress with this, however, communication
continues to be a huge hurdle. He cannot communicate even his
basic needs. We've tried sign language, and different picture
programs along with his speech to help, but he doesn't seem to
really get it. Although he does have some words, he mostly just
babbles them with no true meaning. I've read many books and have
attended a National Autism Conference, but I haven't found "the
key" for my son yet. Do you have any suggestions or ideas?
Also: What therapies or treatment options do you recommend or
encourage? Do you believe there is any credence in biological
treatments for Autism? Can you recommend any good books? Thank
M.D.: Tracy, you are doing ALL the right things: ABA, speech,
occupational and physical therapy, and behavioral training. You
are a member of Autism Society of America, you go to their conferences
- you are doing it all! There is no good scientific evidence that
any of the diets or biological therapies you hear about (including
psychoactive medications) improve one's social communication or
language or intellectual skills. Anecdotal evidence of the effectiveness
of these treatments is not enough. Attached is an editorial that
appeared recently in the Journal of the American Academy of Child
and Adolescent Psychiatry on the subject. As for books, I am sure
you know the literature better than I do. I was recently doing
a workshop and when I came outside at the break and found that
the organizers had a long table covered with books on autism.
I counted 80 books! Much is being written. Here
is a short list of books I have been recommending to participants
at my workshops. I am sure that there are many others which are
Dr. Tanguay, What would be something that we should notice and
be aware of, as new parents, thinking our son may be autistic?
Is it obvious or are they little signs that become bigger as time
goes on? Thank you. Judy
M.D.: Hi Judy. See my recommendations about the CHAT
as described above. I hope this helps.
Is autism always the same or are there different kinds, different
degrees, or different symptoms? Does it last a lifetime?
M.D.: Our best clinical understanding of autism is that it
is an inborn disorder in the development of social communication,
to which may be added deficiencies in language, motor, and intellectual
development. Here is an extract from a clinical report that I
give to parents:
Leo Kanner first described the disorder we know as autism, and
in 1944, Hans Asperger described persons who appeared to have
similar problems but to a milder degree. In the current diagnostic
manual, the Diagnostic and Statistical Manual, Version IV (DSM-IV),
there is a category of disorder called Pervasive Developmental
Disorder, under which autism and Asperger's Disorder are listed.
The main difference between the latter two disorders is that
persons with Asperger's Disorder have had normal language skills
present since early childhood.
past fifteen years, many clinicians have come to see that Pervasive
Developmental Disorder appears to describe a spectrum of handicaps
in which the impairments range from profound to mild. Categorical
systems such as DSM-IV, which include a couple of well-defined
disorders with specific handicaps, inadequately capture a spectrum
disorder. It leaves out persons with milder but quite handicapping
conditions. The latter is unfortunate since services are often
available only to those persons meeting the criteria for the
more severe disorders of autism and Asperger's Disorder.
other experts, we have suggested that the concept of social
communication can be useful for better understanding individuals
within the category of Pervasive Developmental Disorder. DSM-IV
is still the only official diagnostic system, and it is likely
not to be updated for another dozen years, but we feel it is
important to describe the clinical handicaps of the spectrum
disorder now and in terms that can lead to a better understanding
of their symptoms and of what interventions may be effective.
refers to specific behaviors in which complex cognitive and
emotional information is communicated through facial expression,
emotional gesture, the prosodic melody of speech, and through
knowledge of the social rules of communication (pragmatics).
The latter include what has been called a "theory of mind",
i.e., knowledge that others have thoughts and feelings different
from our own that can be ascertained and used to enhance our
in the past twenty-five years has revealed that children come
into the world behaviorally programmed to begin to look at complex
stimuli (such as faces) and to interact with their caregivers
in ways that allow them to learn which facial, gestural, and
tone of voice cues are salient. They use this information to
construct a nonverbal understanding of how one interacts with
others. By 18 months of age children possess an extensive repertory
of social communication skills and knowledge, even though, at
this age, they are only beginning to learn spoken language.
Children who are not driven to interact with others will fail
to develop normal social communication skills, and will be diagnosed
as autistic. Around three or four years of age children begin
to develop two new and diverging sets of skills, which have
been called "folk psychology" and "folk physics".
Folk psychology is understanding that a person's behavior is
driven by inner motives, while folk physics denotes an interest
in learning about how things work, about facts, and about inanimate
objects. Young children learn how to guess the motives of others
by reading their nonverbal cues within the social context. This
ability has also been called "mind-reading", and its
absence "mind-blindness." Most children develop equal
skills as mind-reading and understanding the world of objects,
but occasionally one may see good folk physic skills in the
absence of the ability to mind- read.
may mistakenly think that a child with autism will always have
little or no language, or have a profound lack of social interaction,
or engaging in stereotypical behaviors such as hand flapping,
twirling, or turning on and off light switches. Some autistic
children may have such problems, but others have normal intelligence
and language, and only mild or moderate deficits in social communication
skills. Despite their good intelligence and normal speech, however,
such children can still be quite handicapped in dealing with
past several years, I and my colleagues have been studying how
best the various degrees of autism spectrum disorder could be
characterized in terms of social communication handicaps. Two
recently available interviews lend themselves well for identifying
social communication problems in children, as well as identifying
other types of common symptoms of autism. The interviews are
the Autism Diagnostic Interview (ADI) and the Autism Diagnostic
Observation Schedule (ADOS). Our current investigations suggest
that the spectrum of social communication problems can be described
within four domains:
Reciprocity: As noted earlier, this encompasses the extent to
which the person sends various social signals to others, through
facial expression, tone of voice, and social and emotional gestures.
It could be seen as a type of instinctual drive whose function
is to cause a child to send social signals to others, and to
look for social signals. The more the child is driven to interact
with others, the more he or she can learn the meaning of such
signals. Affective reciprocity is also shown by empathic behaviors,
greeting others with pleasure, and spontaneously offering to
share toys or food with others.
Joint Attention: By 12-15 months of age, children are eager
to share their interests with others. They show things to others,
they try to share their enjoyment, they babble reciprocally,
and they direct others' attention to objects which interest
them. They have a responsive social smile and are affectionate
Joint Attention: Later, when children develop phrase speech,
they ask about others' interests and ideas, and try to share
this interest. They can engage in give-and-take conversation,
and can chat just to be sociable.
of Mind (mind-reading skills, social imagination): Pragmatic
skill represents knowledge about the "rules of social communication".
In its simplest form, this includes knowing how to begin a conversation,
how to continue a conversation, how to end a conversation, and
how to choose topics of conversation which are appropriate to
the situation at hand. Theory of Mind implies the ability to
correctly infer what another person's intentions may be. It
allows one to automatically and successfully respond to others,
while furthering, through the interaction, one's own needs and
goals. One must have an adequate Theory of Mind in order to
use "good common sense." Theory of Mind is learned
through years of interacting with others.
in Affective Reciprocity are seen in young children with PDD,
or in persons who are very autistic. In moderate degrees of
autism and Asperger's Disorder, one may find mostly Joint
Attention and Theory of Mind problems. In older persons, and
in the mildest cases, one finds poor Theory of Mind expressed
Dear Dr., I read recently that exposure to metals and other substances/chemicals
might be a cause of autism. The article included mercury in tuna.
What are your thoughts? Thank you.
is no reliable evidence that heavy metals in our foods or in the
air we breathe causes autism, but heavy metal ingestion (particularly
lead) can cause decreased intellectual development. Heavy metal
poisoning (from ingestion of large amounts) can produce many abnormalities
in brain and somatic functioning.
What are some signs to look for in a toddler? I've read a
few that my son matches but I'm not sure if it's because he's
a toddler or if it's due to autism, such as walking on his toes,
not looking me in the eye, etc.
my note on the CHAT. Walking
on the toes is pretty non-specific; my oldest grandson did it
as a toddler, and he still occasionally does at 8 years of age.
Otherwise he is quite typical of children in general. When he
realizes that it may look "odd" to others I expect he
will concentrate on not doing it.
have a six year old with Autism. Has anything ever been linked
genetically to the male side? Say what the father may have done
in his past to contribute to the disorder. We hear about vaccines,
pitocin and head size but no one says much as far as factors from
the father. We had him tested genetically and it wasn't found
to be. Thank you for your time.
my answer to the first question above. Head size abnormalities
have been reliably observed to be abnormal in autism. There is
a recent article by Courchesne in the AMA Journal on this: he
reports abnormally small heads at birth followed by abnormally
rapid head circumference growth in the first year of life, leading
to large head circumference by the second year of life. This finding
needs to be replicated before we can believe it, but it is very
interesting. Neither vaccines or pitocin have been reliably linked
to development of autism. There are some three or four large studies
of the effects of MMR vaccine in millions of children, and they
have not at all supported the notion that MMR vaccine caused autism.
As one author stated, "If it causes autism it does so at
rates that are too small to be statistically identified."
Are the genetic
factors inherited from the father than the mother? Interesting
question, now that we are seeing that genes may have quite different
effects depending which parent passed on the gene. No one has
studied this in autism since we have no specific autism genes
to study at this time. Negative results on genetic testing can
be important to rule of Fragile-X, but beyond this a negative
results means very little since we have not yet identified which
genes to look at.
Hello, Dr. Tanguay. My son is four years old. We have had extensive
diagnosis for him and he was labeled high functioning autistic.
He has some speech but uses it mainly for communicating his needs
"I want juice," "turn light on" etc. And not
for pleasure. He is very advanced in certain areas, especially
math. He can count to an unlimited number just like an adult,
he can add, and I notice that he makes interesting advanced patterns
on his equations, such as 30, 60, 90, 120, 150... obviously adding
by thirty. He is completely obsessed with math, and has developed
his own math sign language, which is very complex and goes over
I have heard
that we should not indulge, and actually discourage these obsessions,
yet I just can't agree with that -- we spend a lot of time
on math because he really enjoys it. How do you feel about this?
Also, I am lost in the department of discipline, he doesn't listen
to me no matter what I do, and he is a master at tuning me out.
He doesn't care about time outs, and doesn't find it a punishment.
At preschool the teachers just let him sit by himself and do puzzles
and math and he doesn't have to integrate more than he wants,
but in grade school this won't be the case. He will get obsessive
about the VCR or DVD player and play with the buttons, and he
has broken many things. But he will not listen when we tell him
to stop. Also regarding potty training, he will go to the bathroom
on the toilet only if he is at home and naked. This is fine at
home, as he doesn't like wearing clothes, so we usually don't
push it, but he is four and we need to train him. At preschool
he uses a diaper.
any advice, I also wanted to add that he sees a speech therapist
once a week and a special Ed teacher once a week, and we are getting
him into a regional center program here in California.
please read the references which I have already sent to StorkNet
on the subject of autism. (links in answers above) Your son appears
to be quite good at what had been called "intuitive physics"
but not too good at "intuitive Psychology." The former
(the name is not a good choice) pertains to being interested in
and learning factual knowledge, including, in his case, mathematics.
The latter is the ability to learn about what motivates others,
and to develop a body of knowledge about social expectations and
responses, which people can call upon automatically and quickly
as needed. Children become more and more skilled in intuitive
psychology as they grow older, and quite adapt at it by eight
or nine years of age. I advise you to continue working with the
speech pathologist, special Ed teachers, and others who can provide
In the past
few years therapists have been experimenting with "social
coaching groups" in which children practice such skills as
"starting a conversation with others", "talking
at lunch", "asking directions", "meeting others
for the first time" etc. What is important is that the persons
with autism have an ACTIVE learning experience (rather than simply
being told what to do, or watching others engage socially), in
which they try things out and practice. Some groups use older
normal children as well as therapists as social coaches, and use
videotape as part of the process. Arranging for other children
to come and play with your son at home is another ploy: but the
play has to thought out in advance and taught to him, and the
play with the friend has to be closely coached and supervised.
I don't know what is available in your community. Ask other parents
in your local autism society what they have found. Although your
son may wish to spend all his time on math, he also needs to spend
as much or more time in social coaching situations. Also: rules
should be established about his experimenting with and using the
VCR, DVD etc.
Thanks so much for doing this -- I am full of questions, actually.
At the risk of overloading you, here are a handful of them:
up I'd never heard of a single case of autism, now suddenly it
seems like there is an autistic kid on every block. Are the rates
of autism really rising as rapidly as they seem? What do you think
of the claims that this is just the new fad illness, or that we
are over-diagnosing what should just be considered a "different"
type of personality?
is a question which many have asked in the past year. The opinion
of most experts is that this is mainly an ascertainment increase,
especially driven by our understanding autism as a spectrum disorder,
with mild, moderate, and severe cases. There is no doubt that
the prevalence rate of autism as one in 250 is correct. The recent
(and ongoing) studies by the Center for Communicative Diseases
are very well done and have established these figures as definitive.
If autism is actually rising then no one has any idea why this
If the number of cases are truly rising the way they seem to be,
then what is your best guess as to why?
have no idea why. Over the past 10 years various environmental
causes ranging from soil contamination to the MMR vaccine have
been touted, but none have stood up to careful follow-up study.
Do you know of any links between the rise of autism and the rise
of ADD/ADHD? It just seems odd that they are both suddenly so
have been quite interested in seeing the rise in ADHD. I think
it is entirely iatrogenic, i.e. caused by physicians and psychologists
willingness to call everything ADHD. There are persons with ADHD,
but not at all to the extent that it is being diagnosed. I know
this from the numerous persons I have seen in teaching and practice
who have been mislabeled. Even worse is the over-use of medication
- or rather overuse with those who do not have ADHD, and under-use
with some who do, as recent studies suggest. Although a recent
book by Diane Kennedy argues for a link between ADHD and autism,
I am not convinced this is so. There is a book Running on Ritalin
by a San Francisco pediatrician that I have found useful in understanding
the over-diagnosis of ADHD. Everyone wants a simple answer and
a quick fix! I look at my boisterous grandchildren and think how
some physicians would immediately want to label ADHD. There are
other children who are under-socialized and who are labeled ADHD.
Medication will not teach them better behavior.
Are there any early warning signs of autism? What sort of behaviors
should we consider to be red-flags? Do the symptoms begin gradually,
making it hard to spot, or do they hit all at once?
M.D.: See the article on the CHAT
that I sent. This is still the best check-list for autism in the
second year of life. The symptoms may only seen as the child fails
to achieve certain social and language skills. Theoretically it
is possible to spot these symptoms at six months of age, but since
most people are not looking for them at that time they are usually
missed. Some parents report a more abrupt onset in the last second
year - this is hard to study retrospectively, however.
Bottom-line: how do I know if my child is normal but "different"
(quiet/introverted/a late bloomer/an "odd duck") or
if he has a mild form of autism? Where do you draw the line?
M.D.: We have not studied where one should label a person
as definitely handicapped or as merely "different."
Jon Constantino at Washington University in St. Louis has told
me about his studies of "social reciprocity" in typical
children. He found that it was distributed at a bell-shape normal
curve. So the question is: is this person merely at the left-hand
side of the curve, or might he have genetic abnormalities leading
to more handicapping social communication lags. This needs to
be studied and we, as a society, need to decide, for service availability,
what is normal versus abnormal. We have done this for mental retardation
and I expect we will do it for autism.
Finally: I've heard that a lot of parents are putting their autistic
kids on wheat-free, dairy-free diets with good results. What is
your opinion on possible dietary links?
M.D.: There is no hard scientific evidence to support this.
Thanks again for taking the time - with so many of my friends'
kids being diagnosed, and with an "odd duck" of my own,
it is a topic of great interest! Amy
M.D.: You are welcome and best of luck.
Is it true that they still think there is a link to autism and
vaccinations? If so, is there any way that I can make my child's
immunizations schedule any safer? I have heard that having them
done separately, or at later ages is better. I am a nurse and
have concerns about not getting my children vaccinated as I know
how deadly some of the diseases can be also.
M.D.: There is no scientific evidence that MMR vaccine causes
autism. Several large studies have addressed this, and, as one
concluded, "if there is a link it is too rare to be measured
statistically. The same goes for the mercury preservative that
was used in MMR vaccines. See link
Also, is there any correlation to the fact of genetics playing
a role in autism. My husband's nephew is autistic and now that
I have a baby boy, I'm terrified of the disorder.
is plenty of good evidence that genetics plays some role in autism.
Careful studies have not been able to identify where the genetic
abnormalities reside, or what is their nature. One large multicenter
study concluded that at least 10 genes may be involved. So much
for any easy answer!
I live in Europe and have a dear friend whose 8 year-old son is
autistic. He currently is in school 2 hours a week and in a specialized
day center part-time. He does not communicate with language and
has had problems recently with cataracts. I would like to know
what you could tell us about the causes of autism. My question
is perhaps frivolous given all that parents have to deal with
every day, but I am saddened to see my friend additionally burdened
by people who think that Thibault is autistic because she didn't
"bond" with him while he was an infant. Is there any
truth to the supposed link between aluminum and autism?
M.D.: I have been a consultant to groups in Europe. Only in
France, Italy, Switzerland is autism "still caused by bad
mothers." It is very unfortunate that psychiatrists think
this way. Blame old-fashioned psychoanalysis for this situation.
Until the parents rise up in revolt and shout "The emperor
has no clothes" this may continue. This is what the parents
did in the U.S. in the 1960s. It was not necessary for them to
do so in England since the "bad mother" hypothesis never
really took root there.
Several readers posted questions to our guest asking if there
is a relationship between the MMR vaccine and autism. Dr. Tanguay
explains that he has answered this (above in this interview) with
a "no." He goes on to say,
cautionary tale: In 1970 in England there was a claim that was
widely circulated that the mumps vaccine could cause terrible
brain damage, as it certainly could in perhaps 2 in a million
children. By 1972 the mumps vaccination rate dropped from 90%
to 30%. Ten years later there was a mumps epidemic that killed
70 children. These deaths would all have been preventable with
Is it possible to spot a baby as having autism when a woman is
still pregnant. If so, in what way?
M.D.: No, not with our current technology.
My son was just diagnosed with Asperger's Syndrome at the age
of 10. He had a previous diagnosis of ADHD at the age of five. The main
recommendation from the doctor was to begin a Social Skills Training
group. She gave me a name and number to call but I have some concerns.
When I called my insurance company they didn't have any listing
for this person. I have no idea what this costs or whether it
can be paid by insurance. Do you have any experience with Social
Skills Training and what I can expect?
M.D.: Social skills training is essential - see my answers
above. But the person who does it better know what they are doing
or it may not work very well. Will your insurance pay? Probably
not - they will say it is an educational rather than a medical
My son is going through the diagnostic process right now. Friday
is the big day when I guess they make their decision. Regardless,
my son is going to be in the spectrum. He will be four in January
and has improved so drastically over the past year. My question
is... Is it likely that he will continue to make such improvements
and since he is VERY social and I gather that's an uncommon thing
for an autistic child, do you think he could suddenly withdraw?!
always hard to prognosticate - but it sounds like he is in the
group who are more likely to continue moving ahead. Will he regress
- not that I have ever seen. In fact, if he begins to regress
severely I would be concerned that there is some other abnormality
I have a friend with an autistic son. He had testing done recently
and they found that he had severe mercury poisoning. He is taking
very strong medication to get it out of his system.
I strongly suggest getting another reputable lab to do the testing
and see if it is true. Chelation therapy is expensive and not
needed if the person does not really have heavy-metal poisoning.
My question is this- if the symptoms of mercury poisoning are
the same as the symptoms of autism....is there a chance that he
is not autistic?
M.D.: The chance is more likely that he does not have mercury
poisoning. Severe mercury poisoning in this country is very rare
- unless you work in mercury factory and inhale the fumes.
My son, who is five, doesn't talk yet. He hardly recognizes his
name. Does he have autism? The doctors say that it's not likely
and that he's just shy.
son should a comprehensive screening by a competent speech and
language person, or knowledgeable professional immediately. Not
to speak by age five must be investigated now.
My three-year-old son has PDD NOS, and has just started on ritalin
for hyperactivity. Should I be seeing improvement right away?
assume that he has hyperactivity, and if this is so, Ritalin could
be helpful within a day or two. If it isn't then he may need a
trial of another ADHD medication. Ritalin will not help his language
or social handicaps.
son was born seven weeks early. His weight, length and head circumference
were all in the fifth percentile at birth. Between three and six
months, his head grew to the 90th percentile. We were sent for
a CT to rule out hydrocephalus, and it came back just fine. Now
at 15 months old, his head is in the 95th percentile, and his
height and weight are still in the 10th. I have read that rapid
head growth can be a marker for autism, and am worried about my
son. He is globally delayed, but making great progress with therapy.
I've also read that some autistic babies will develop skills normally
for awhile, then lose those skills as their autism becomes evident.
I'm asking, is my son at a higher risk due to his head size? And
if so, what should I watch for in order to get a diagnosis that
would enable him to get the help he'd need faster? Any advice
or reassurance you could give would be appreciated! Thanks for
M.D.: Erica, see Eric Courchesne's recent article in the Journal
of the American Medical Association. He answers your question
in the article. Unfortunately I do not have a copy of the article
to send by email. Any university medical library will have a copy.
Here is what my workshop slide says: Evidence of Brain Overgrowth
in the First Year of Life in Autism (2003), Courchesne, E et al.,
JAMA, 290:337-344. "The clinical onset of autism is preceded
by two phases of brain growth abnormality: a reduced head size
at birth and a sudden and excessive increase in head size between
1 and 2 months and 6 and 14 months. Abnormally accelerated rate
of growth may serve as an early warning signal of risk for autism."
Dr. Tanguay, thank you very much for your time and expertise.
You have given our readers some valuable information and direction.
We appreciate that you have stopped by to share your knowledge
and support here at StorkNet and please know that you are welcome
back any time!
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