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School-Age Parenting Resources

Once your child begins going to school, there might be instances where they, and let’s face it, parents too, might need a little extra help. Whether it be advice on when to fit in therapy appointments or helping your child with constipation challenges, our therapy team has put together some educational tools to help give you some relief.

Bicycling is an excellent way to meet the needs for physical and recreational activity. However, riding a bicycle can be a difficult activity for many children and adults. Fortunately, there are options for alternative bicycles or accessories that can be added onto a standard bicycle that can help to make biking successful!

Not sure about how to get started? Call our durable medical equipment experts in Sioux Falls,  (605) 444-9700 and in Rapid City, (605) 791-7400 to get your questions answered.

In this day and age, with a virtual world at our fingertips, it is easy to become excessively attached to our soft and comfy friend, The Couch. However, our bodies are made and meant for movement. Physical inactivity has been shown to lead to many adverse health consequences, including obesity, heart disease, and osteoporosis. A sedentary lifestyle can even affect our emotional well-being, which pre-disposes us to decreased mental alertness and even exacerbates the effects of depression.

The growing and developing minds and bodies of children can also be negatively impacted by lack of physical movement and exercise. Parents play a critical role in teaching their children important life skill routines and habits such as bathing, tooth brushing, and homework completion. Physical activity is another life skill habit that must be taught and encouraged to promote overall health and well-being for our kids.

A great thing to know is that increasing your family’s daily physical activity level does not require elite gym or sports memberships, expensive equipment, or body and soul crushing exercise regimes. Creating family routines that incorporate movement, play, and physical activity is a first step to promoting awareness, enjoyment of, and development of lifelong fitness habits for our kids.

Increasing your daily movement quota can begin simply and purposefully by making conscious choices to take the stairs, play a game of catch or hide and seek, walk or bike to a friend’s house, or (my personal favorite,) take the dogs for a daily walk. Make the choice to leave your davenport in the dust and to encourage your kids to move more and have fun in doing so!

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Learn more about our physical therapy services.

A child's vision is one of their most valuable assets. Optimal vision is essential for proper developmental progression in many areas from motor skill development to reading and even behavior. By age four, children have typically attained 20/20 acuity and should have early control over eye movements, meaning they can use their eyes to look around without turning their head. Between four and ten years old, this ocular motor control will continue to improve as their brain and sensory-motor systems develop. While many children may only need glasses to correct acuity issues, other children may suffer from eye movement problems that make it impossible for their eyes to work together and send messages to their brain correctly.

It can be difficult to know if your child is having these types of problems because they simply don't realize they are seeing things differently than their peers. Other children may complain of headaches, moving objects, burning eyes, wiggling lines, or floating words. Because children may have a difficult time telling you they are struggling with their vision, you may need to do some detective work. Children with vision problems may be struggling with academics, including learning to read. Or, their writing may have numerous letter reversals. They may also rub their eyes frequently while reading or tilt their head or cover an eye while completing their homework. In terms of daily living activities, these children may have difficulty locating their toys when searching their bedroom or become car sick more often than other children. Their motor skills may also be impacted with difficulties with tasks like catching a ball or completing age-appropriate puzzles. Some children with vision problems may even demonstrate highly active or inattentive behavior leading parents and teachers to question the presence of ADHD.

While some of the issues can be both frustrating and alarming, often these issues can be explained by impairments in visual skills, such as impaired tracking, convergence, or accommodation. These problems frequently arise due to weak eye muscles and can be corrected with treatment aimed at strengthening those muscles and improving how the eyes work together. Occupational therapists are trained to provide treatment addressing visual motor deficits. These interventions, often covered by medical insurance, can make significant and lasting impacts in a short period of time, with an appropriate carryover of home exercise programs.

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Learn more about our occupational therapy services.

It's a busy time of year, and especially so for families. School is in full swing, evenings are packed with practices, activities, and homework, and now, holiday activities could quickly put you over the top. It’s easy to become overwhelmed and feel one step behind while trying to stay on top of it all. Fortunately, there are ways to slow down, stay organized, and enjoy the moment.

Keep a calendar: Don’t try to remember practice schedules, due dates for homework and projects, or items to send to school. Write it down on a monthly or weekly family calendar and look at it every day. Then, relax and return your attention to the present moment.

Plan ahead: Pack lunches and backpacks, pick out clothes, and find sports equipment for practice the night before. This will ease morning stress, save valuable time, and set a positive tone for the day.

Plan meals: Take time each weekend to plan meals and grocery shop for the week. Meal planning takes the rush and stress out of supper and minimizes the need for last minute trips to the store or drive through. Freezer meals are a huge time saver!

Enlist help: Have a list of age-appropriate daily chores for your children after school. When children contribute to the household, they feel a sense of belonging and begin to appreciate the value of a job well done. Chores could include completing homework, feeding a pet, or taking out the garbage. Make it fun by turning the list into a sticker chart with a prize at the end of the week, such as dinner out to their favorite restaurant or family game night.

Schedule time together: Set aside time to spend together as a family with no distractions. Schedule it on your family calendar. Make it your time to slow down and connect with one another while engaging in an enjoyable activity.

Declutter: Clean out closets and drawers. Do one room or even one drawer at a time to prevent it from feeling overwhelming. Donate unneeded items to local charities. Not only does this help children develop a generous heart, but it also declutters your home, making it easier to stay organized and find everything you need during the week. You'll feel so much better!

Simplify: Take an inventory of what you and your family value most in life. Eliminate obligations that do not line up with your values. Focus time and energy on those aspects that make life fulfilling and meaningful.

Call us for details: In Sioux Falls, (605) 444-9700.

Learn more about our clinical psychology services.

“Please get ready for school….. Go get ready for school………. Get ready for school, now....WHY ARE YOU NOT READY FOR SCHOOL?!?!?”

If you come to my house on a weekday morning during the school year, this is the glorious sound of dysfunction that fills the halls. Why must we ask our children 10 times in a progressively negative tone to get ready for school? Are they unmotivated? Not listening? Unable to process the instruction? Do they just want to get under our skin and push us over the edge?

According to Victoria Kindle Hodson, MA, co-author of Respectful Parents, Respectful Kids: 7 Keys to Turn Family Conflict into Cooperation, only about 20 percent of children are auditory learners. We assume our children hear us, process our instruction and are able to follow through with the necessary steps to meet our request, but this is not the case for 80 percent of children. By providing verbal instruction, we aren’t doing our part to help our child be successful or independent. In fact, we’ve created a stressful environment where our children expect us to give in and do the task for them, or hold their hand through something they are capable of doing on their own.

If nagging won’t work, how do we make this next school year different, and make our mornings--dare I say--functional? Here are some tips:

  • Use a schedule- include pictures for kids that are too young to read. Keep it simple!
  • Reinforce your child when they are able to complete the schedule- sticker charts, small tokens, stickers, etc.
  • Ensure there is enough time for them to wake up before being rushed into their routine.
  • Identify the difficult tasks and be present during those things, until the child can succeed on his/her own.
  • Choose your battles--no one cares if your child’s socks match. I promise!
  • Show them, don’t tell them. Remember, our children are not as successful with verbal directions, so use visuals.
  • Provide simple choices: Paw Patrol T-shirt or Superman T-shirt.

Is your child an auditory learner? Chances are he/she is not. So let’s change the way we are providing instruction and provide them with the environment they need to be successful. Who knows, maybe we will be morning people after all!

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Learn more about all of the Outpatient Therapy and Behavioral Health services.


The weather is prime for spending time at our regional lakes, rivers, and pools. Of all the many outdoor activities in which people will participate this summer, there is something special about swimming: regardless of your age, ability or fitness level, everyone in the family can have fun in the water together.

To prepare for your summer fun in the water, please consider these safety recommendations:

  1. Check your safety equipment before they are in use (life jackets, rescue flotation devices, etc.).
  2. Consider adding a barrier, such as pool fencing, to prevent unsupervised access to pools or hot tubs.
  3. Regardless of whether there is a barrier, always closely supervise children so they do not enter water without your oversight. And when swimming, supervise children closely, never taking your eyes off your child for more than a few seconds. Tragedies can and do happen that quickly.
  4. If your child is not yet a strong, confident swimmer, or is just learning about water safety, enroll them in swimming lessons before summer swimming season.

Why should swimming lessons be a priority to you? To be frank, because everyone in water is at risk of drowning. In the U.S., drowning is the fifth leading cause of accidental death. On average, two children under the age of 14 die from drowning every day. Worldwide, drowning is the third leading cause of accidental death, commonly affecting children. Our awareness has been raised again by the recent death of the toddler daughter of Olympian Bode Miller. It can happen so very fast.

If traditional styles of swimming lessons are not a good fit for your child, an Adapted Aquatics program can be an effective alternative format. At LifeScape, the Adapted Aquatics program is offered to all ages and abilities. The primary goal of the program is to teach aquatic safety, but also to increase confidence, comfort, and skill in the water. Certified instructors draw upon Red Cross training as well as a person-centered approach to create a unique swimming lesson sequence for each student. Adaptive Aquatics swimming lessons often integrate goals and strategies of any other concurrent therapies, reinforcing and building skills beyond just swimming.


  • Centers for Disease Control & Prevention: Unintentional Drowning: Get the Facts
  • World Health Organization: Drowning Prevention

As parents, we highly value respectful behavior in our children. Since kids are quick to take their cues from us, it’s important to model respectful language and behaviors. This is especially true regarding people with disabilities, who only too recently have been recognized as equals to be treated with dignity.

Here are ten things to know and teach about being respectful toward people with disabilities:

  1. People with disabilities are people first. Use person-first language when talking about a person with a disability. For example, “a child with autism” vs. “an autistic child” or “a person who uses a wheelchair” versus “a handicapped person or disabled person.” Often you’ll find you don’t need a label at all.
  2. Extend the same courtesies to a person with a disability that you would extend to anyone. If you don’t make a habit of leaning or hanging on people, why would you lean or hang on a person’s wheelchair?
  3. Treat adults as adults and children as children. Adults with intellectual disabilities are NOT big kids. Talk with them as you would with other adults.
  4. Speak directly to a person with a disability, not their companion. For example, if a person with a hearing impairment uses an interpreter, keep eye contact with the person you are talking with, not the interpreter.
  5. If you can’t understand someone with a disability who is speaking to you, kindly ask them to repeat themselves. Never pretend to understand if you aren’t able to do so. If you still cannot understand them, state “I’m sorry, I can’t understand what you are saying/asking.” See if they can write something for you to read or point to something they may need.
  6. When talking for more than a minute or two with someone who uses a wheelchair, place yourself at their eye level. This will spare both of you a stiff neck!
  7. When greeting someone with a significant vision loss, always identify yourself and others who may be with you. Use directional descriptors, such as “I’m here with Jon, who is standing on my right.” Use a normal tone of voice and volume for the situation.
  8. If you would like to help someone with a disability, ask if he or she needs help before you act. Listen to any instructions that he or she may give you.
  9. Be patient and considerate of the extra time it might take a person with a disability to get things done or said. Let the person set the pace.
  10. Don’t be afraid. If a person with a disability exhibits sounds or behaviors that make you uncomfortable, that’s okay, but it’s not okay to stare, to be exclusionary, or to place judgement upon the person or their caregiver.

With modeling and a few well-used teaching moments under their belts, your child will do you proud, growing into an adult who treats others with dignity and respect.

With busy schedules, it is often difficult to eat a healthy, balanced diet. We often resort to easy, ready-to-eat foods by either grabbing fast food or making quick, unhealthy foods that lack nutritional value (i.e. processed chicken nuggets and macaroni and cheese). While these foods are acceptable to make on occasion, it can also promote and prolong picky eating in our children. Below are some tips to help with preparing healthy meal options for breakfast, lunch, and dinner.

  • Don’t wait until morning – prep lunches the night before.
  • Get together with a friend and prepare healthy freezer meals/lunches in advance.
  • Make hard-boiled eggs and keep them in your fridge for the week for a quick breakfast or lunch.
  • Clean and cut fresh vegetables when you get home from the grocery store. Make sure they are completely dry and then you can store them in Ziplocs or storage containers for the week.
  • Meal plan – plan out your meals for the week and complete early prep for any of the items that you can.
  • Make waffles, pancakes, egg bake (in muffin tins) – and freeze them. You can place them in the microwave or toaster for 60 seconds for an easy breakfast option.
  • Instead of frozen/processed chicken nuggets, make your own. These also freeze well, and they are easy to make! Not to mention so much healthier!
  • Double a recipe, so that you can eat the same meal for two nights.
  • Keep bedtime snacks healthy – nuts, fruits, applesauce (without added sugar), deli meat, sliced cheese, Greek yogurt, etc.
  • Sit down and eat as a family as much as possible. If you are not eating with your children, try to at least sit down with them, and make sure the TV and electronic devices are off. This allows you to have your children understand the social aspect of meal times, and also allows you to work with them on eating new foods.

For the most part, kids eat what they are raised to eat, so make sure you take the time to teach good habits. It will benefit your children for the rest of their lives.

Learn more about our Feeding and Swallowing therapy services.

Children with good vision and great sight can still be dealing with vision problems like when it comes to Visual Perception.  That’s the brain’s ability to take in the things our eyes see and make sense of them. When you complete activities such as mazes, word searches, and puzzles, you are using your visual perception.

If a person has difficulties with visual perception, they may have difficulties completing the following activities:

  • Dot-to-dot pictures
  • Puzzles
  • Remembering the alphabet without a model
  • Remembering left and right
  • Remembering sight words
  • Reading
  • Getting dressed
  • Organizing personal belongings at home and school

So, how can you help improve your child’s Visual Perception skills?  Here are a few options:

  • Use hidden picture activities (Where’s Wally)
  • Dot-to-Dot sheets
  • Memory games
  • Copying block designs
  • Construction activities (building blocks, Legos, Duplo blocks)
  • Word searches
  • Puzzles
  • Work on identifying objects by touch

Difficulties with visual perception can lead to troubles with completing self-cares independently, reading, completing worksheets in school, anxiety, and poor self-esteem when comparing themselves to peers academically.

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Learn more about occupational therapists services.

The Harvard Center on the Developing Child describes executive function and self-regulation skills as “the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.” We use these skills every day at home, school, work, and in the community. Executive functioning requires the ability to take time to think before acting, stay focused, use mental flexibility with new ideas, tolerate unexpected changes, remember information, and organize our self and our environment.

Challenges with executive functioning can be seen in children with a diagnosis of sensory integration dysfunction, ADHD, and learning disabilities. As a parent, we may see this with our child struggling to remember and carry out directions, difficulty following a schedule and figuring out where they should be, disorganization with remembering when an assignment is due, and losing assignments that may or may not be completed. In addition, the parent may see poor ability to change perspective, rigidity in thinking or movement, difficulty with doing a task such as math in their head, acting without thinking—which can cause behaviors with others, challenges with emotional outbursts when overwhelmed, and poor self-regulation and working/moving too fast, or taking too long to complete a task. Telling a story or remembering what happened during the day, poor initiation of how to start a task, and difficulty with changing plans or getting new information may impact your child’s success during the day.

Here are some ideas to manage life with your child now, as well as provide tools for future success:

Working Memory: Make a list or notes with important information needed for the task or for the day. Practice self-talking, ask for written directions from teachers, use visual imagery to portray what has happened in this situation or what could happen. Put objects in the same place every time and take advantage of routines. Ask your child to repeat directions.

Cognitive Flexibility: Provide cues before or during the task. Forewarn and develop strategies for changes in schedules or information. Play familiar games using different rules and teach flexible thinking with alternative ways to do a task.

Planning and Organization: Teach your child how to make and use a checklist. Use color coding for assignments or due dates and teach how to break a project down into manageable parts. Make a step-by-step plan for a task or activity, providing visual and verbal prompts as needed. A checklist can be simple—such as items to bring to school every day—or it can be a detailed step-by-step process for something as complex as a science fair project. Explore using time managers such as age-appropriate organizers or watches with alarms to stay on track or finish on time. Teach your child how to stop and check the progress of the activity. Schedule time to organize the workspace or have different workspaces for different tasks. Provide additional time for planning, organizing, and execution of the task. Try not to rush your child. Model and practice how to start a new task and take the first step.

Self-Regulation: Teach awareness if the child’s activity level matches the task or setting, and if not, how to change the activity level. Explore using hand fidgets, alternative seating, and quiet spaces when overwhelmed by noise. Try noise canceling headphones to block out distractions. Use first/then statements such as first use the toilet, then get in the shower. Provide quiet time during the day for emotional recovery where the child can read, color, or play with toys. Encourage movement opportunities before sit-down time

Inhibition: Help your child learn how to stop an activity without stress or behaviors. Play “freeze” games to take a deep breath or mentally shift before moving to a different challenge. You can practice waiting before acting or reacting. Practice ‘go with the flow’ on calm days.

Occupational therapy focusing on sensory integration can help address executive functioning challenges. Contact LifeScape to learn more by calling (605) 444-9700 for Sioux Falls, or (605) 791-7400 for Rapid City. You can also visit our Occupational Therapy page or email to learn more.

Parents of school-aged children know that the fastest 3-4 hours of the day are those between school and bedtime. If homework, dinner, and bedtime routines weren’t already enough, then adding extracurricular activities is sure to maximize our stress levels! Adding in a recurring appointment for your child, whether it be speech therapy, counseling, or tutoring – now that just feels impossible!

When those hours are limited to begin with, there are some options and things to consider when scheduling your child’s therapy appointments:

  • Check to see if early morning appointments are available. After-school times are in high-demand, so an appointment at 7:30 or 7:45 may be a great solution.
  • Ask to be on a call-list for when your provider gets cancellations. It does require flexibility, but cancellation rates tend to be higher in the pediatric population so there is a good possibility that you can get a coveted afternoon session. If the time doesn’t work for that day, simply pass and another may still come along in the same week.
  • Take advantage of school holidays. Most providers are closed only for major holidays, so you may be able to get the session in earlier in the day, leaving the rest of the school break open for other fun activities….or just much-needed downtime!
  • Therapists, counselors, and other health professionals get sick and take vacation time too. Consider seeing a different provider if your regular professional is gone. Having someone different work with your child can provide another perspective or new ideas. It also presents an opportunity for your child to be challenged without negatively impacting the rapport built between the child and regular provider.
  • If your child is involved in other activities, consider a short break from one of them, allowing the time to commit to the therapeutic service. Therapies or counseling should not go on for many months or years. In fact, the more intensive services are, the sooner goals are typically achieved. Committing to a six-week episode of therapy services, even if twice a week, seems more realistic than doing something once every two weeks, with no end-date.

Time is precious with our kids, but knowing that we are giving them every opportunity to be successful and the best version of themselves is one of the best rewards of parenting. Creating time for improving health, wellness, social skills, or other areas of development will prove to be an excellent investment for your child later on.

Call (605) 444-9700 for our Outpatient Therapy services in Sioux Falls or (605) 791-7400 for Rapid City.

You can also learn more about all of the Outpatient Therapy and Behavioral Health services.

When a child is first potty training, parents or daycare providers are typically very aware of how often a child is having a bowel movement, if the child is struggling with constipation, and if there are any other concerns related to the child passing a bowel movement. Once a child has successfully potty trained, it becomes less of a focus or topic of conversation, especially once they start school. It is important to continue to have these conversations with your child to ensure they are not struggling with constipation.

It is also important to find out if there are any barriers to your child having bowel movements at school. They may not feel comfortable wiping independently or passing a bowel movement while peers are in the bathroom. They may be fearful of automatic flushing toilets or hand dryers, or worry they are going to miss out on something while they are in the bathroom. Depending on the teacher’s policy for asking to use the bathroom, the child may not like to draw attention to themselves in front of the entire class. Addressing any roadblocks to your child having a bowel movement at school could positively impact their constipation. Some possible solutions may include:

  • Have the option for a child to use a private bathroom or a bathroom that does not have noisy hand dryers and toilets, such as the nurse’s office.
  • Work with the child’s teacher to discuss possible options for discretely asking to go to the bathroom. This could be a written pass that the child can hand to the teacher, using the sign for “potty” to signal the need to go, or permission from the teacher for the child to get up and go to the bathroom when needed without asking for permission.
  • Encourage the child to take time when they get home from school or get to after-school care, to sit and try to have a bowel movement, which can be very helpful if the child has been withholding a bowel urge all day.

If you are not sure if your child is struggling with constipation, talk with your child’s physician regarding how often your child is having a bowel movement and what those bowel movements look like.

If your child continues to have problems with constipation, LifeScape’s Constipation Management Clinic team is here to help. Our team, comprised of a physical therapist, occupational therapist, and clinical psychologist, works in conjunction with your child’s medical team to address the concerns impacting your child’s constipation.

Call (605) 444-9700 for Sioux Falls or (605) 791-7400 for Rapid City.

Tantrums come with the territory when raising a toddler. It can be difficult to take your little one out without someone (you or them) having a meltdown. Tantrums are normal and even expected during the early stages of development, but they don’t have to become a regular part of your routine.

It’s important to remember that children often have tantrums to communicate a want or need. They are very effective tools of communication, and are often more easily reinforced than extinguished. To minimize tantrums, you’ll need to teach your child the skills to appropriately communicate their wants and needs. This may be verbally or with the help of an assistive communication device—like a picture card or even a gesture. Be sure you respond to your child’s attempts at appropriate communication immediately; this lets them know what gets your attention, and potentially gets them what they are asking for.

Conversely, it is important to communicate with your child that whining and tantrums are not going to get them what they want. The most effective ways to do this are to 1.) pre-teach appropriate attention-seeking behavior when they are calm and attentive and 2.) completely ignore all inappropriate attempts at communication. This is difficult to do in the freezer section of the grocery store while fellow patrons stare at you and your child, but it is important to remember that consistency is key. The more regular you can be with attending to desired behaviors, the clearer it will be that tantrums will not get your child what they want.

Another way to prevent tantrums in public settings is to give your child a small job to do to help make the outing more enjoyable. This could be something as small as pointing out all the items with labels of their favorite color. It is also helpful to bring along a small bag of toys and activities to engage the child during situations that may be exceptionally boring. Remember, children have not learned to manage their emotions when faced with mundane tasks and they will create entertainment any way possible.

It is also important to know when to seek additional help. Some signs that you may need additional help are:

  • A child who is often inconsolable
  • Several tantrums a day, making it difficult to complete even simple tasks
  • Violent tantrums
  • A child who is unable to communicate their wants or needs due to speech and language delay

Talk to your pediatrician if you have concerns, or call LifeScape at the numbers below to get help from our one of our clinical psychologists.

In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Children typically experiment with walking on their tip toes between one and two years of age – after they first begin walking. Every couple of steps may be on their toes or they may walk on their toes for several days, but children should outgrow this quickly.

By three years of age, children should begin walking with a more mature walking pattern. This includes placing the heel of the foot first and pushing off their toes. If your child is walking on their tip toes for long periods of time, you should ask your health care provider for a more detailed physical exam.

While there can be many reasons for idiopathic toe walking (ITW), one cause can be abnormal bone growth. Another can be weakness in your child’s tummy and/or leg muscles. Walking on the toes allows the child to lock the ankles, knees and hips in a straight position and reduces the work that the muscles do. Toe walking can also be one of the first signs of a sensory integration disorder, which can be evaluated by a pediatric occupational therapist.

Toe walking can cause problems and pain for children, by putting abnormal stress on the bones and ligaments in the knees, hips and lower back. Over time, bones can grow incorrectly and/or ligaments can be overstretched. Toe walking can cause excessive tightening of some muscles and weakening of others. Children then are at risk for injuries and joint pain as they grow older, and often will struggle with walking long distances or participating in physical activities for longer periods of time.

Treatment for toe walking includes evaluation of the movement in your child’s foot and ankle and observation of how your child walks without shoes or socks. A physical therapist that specializes in ITW may use stretching and strengthening exercises along with gait activities to promote a typical walking pattern. Serial casting is a process involving repeated cast applications that may be utilized when other therapy activities are not successful in decreasing toe walking. Supportive orthotics may be recommended to help maintain improved gait in conjunction with idiopathic toe walking treatment.

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Learn more about our physical therapy services.

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