Facilitated Discussion ~ Response to Intervention Context, Evidence, Process
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Transcript of Facilitated Discussion ~ Response to Intervention Context, Evidence, Process
Facilitated Discussion ~Response to Intervention Context, Evidence, Process
Kentucky Big East Coop
Special Ed DirectorsJune 28, 2013
JoAnn Wiechmann, EdD, CCC-SLP
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Disclosure
Relevant financial relationship(s) & relevant nonfinancial relationship(s)I have the following relevant financial relationship(s) in the products or services described, reviewed, evaluated or compared in this presentation.ARtIC Lab ™, published by Super Duper, Inc.Language Lab™, published by Super Duper, Inc.
Description of financial relationship: I receive publication royalties on these products.
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RTI: What Is It? RTI: Where Does It Fit in Public
Education? RTI: Why Does It Matter Now? RTI: Do SLPs in Schools Have a Role?
RTI: What is the Evidence Base for RTI?
RTI: How can SLPs manage adding RTI to full caseloads?
3 Discussion Strands
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RTI: What is It?
RTI Defined
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RTI is the practice of
Providing high quality instruction/ intervention matched to student needs and
Using learning rate over time and level of performance to
Make important educational decisions.
RTI provides support w/ increasing intensity as needed
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Goal of RTI
Ensure that all children and adolescents have access to high-quality instruction and learning opportunities and
Struggling learners are identified, supported and served early and effectively.
Interventions are generally provided in the areas of: Academics (reading, math, S/L) Behavior
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…in other words…
There are systems in place to help every child meet grade level expectations in
academics and behavior…
“Whatever it Takes!”
(individualized, just-in-time, prevent failure, through general education)
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If the student responds to an intense diet of instruction, then s/he probably does not have a language learning disability or articulation disorder
RTI Hypothesis
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RTI
Is part of the general education system Parallels the spirit of individualized
education programs ~ previously available only through an “IEP” in special education
Emerged out of political agendas (funding, No Child Left Behind, national standards, era of accountability)
Is probably here to stay So…we better figure out how to be part
of it!9
RTI: Intuitive and Innovative
Intuitive: makes sense that professionals check to see if instruction is working…to determine if the learner is responding…and if not responding, someone takes action to do something about that.
Innovative: public education is universal but has not been individualized. The burden has been on the learner to fit the mold; not for the system to flex for the needs of each individual.
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RTI: Where Does It Fit in Public Education?
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Public Education in a Democracy
Democracy is based on the premise that well-educated, well-informed citizens will give input to the advancement of the society.
The universal right to a public education is not found in the Constitution of the United States of America,
So public education becomes the responsibility of the states and each local community.
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Texas Education Code §4.001(for example…implements the state constitution…)
The mission of the public education system of the State of Texas is to ensure that all Texas children have access to a quality education that enables them to achieve their potential and fully participate now and in the future in the social, economic, and educational opportunities of our state and nation. The mission is grounded on the conviction that a general diffusion of knowledge is essential for the welfare of this State and for the preservation of the liberties.”
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Public Education in the USA
States and Local Communities establish schools and colleges, develop curricula and learning standards, determine requirements for graduation, establish a means of funding schools.
Federal Funding = Purse Strings Legislation If you want $, then follow all the rules
Current Administration Favors National Standards Common Core State Standards NCLB and IDEA aligned accountability systems
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What about…The Purpose of Special Education…
To prepare students for further education, employment, and/or independent living
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Special Education
Based on federal education laws and the premise that “all children can (and get to) learn”
In order to access federal funds, states and local school districts must follow federal statutes, regulations, and rules
Speech Path listed as a special education instructional or related service in P.L.94-142 (1973 – first special ed federal law)
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SLP Services in Schools
SLP services are provided to students who have communication disorders that result in an adverse effect on educational performance
The setting affects the service delivery…services not in isolation…
Educational relevance is required!
Important to link SLP clinical services to grade level standards
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RTI: Why Does It Matter Now?
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Context for Change
Two movements changed conditions in America’s schools: Standards-based reform
Improving America’s Schools Act and Goals 2000: Educate America Act (1994)
Challenging academic content and performance standards; Assessments aligned with standards
Accountability for student performance NCLB Adequate Yearly Progress IDEA 2004
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Context for ChangeResearch and Policy Considerations National Reading Panel (2000)
Identified essential components of early reading instruction
Important in special ed since most students with LD have reading problems
President’s Commission on Excellence in Special Education (2001) Focus on results not identification process Focus on prevention General ed first
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Context for ChangeResearch and Policy Considerations National Summit on Learning Disabilities (2002)
Sponsored by OSEP/USDE Traditional LD identification not grounded in research Supported “response to quality intervention”
National Research Council Panel on Minority Representation (2002) No research to confirm benefit of special ed for minority
students Should focus on prevention and early intervention 4-Tier system of intervention and treatment
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Platform for Change to RTI
In place for a decade Let’s work on systems, guidelines,
procedures for data-driven decisions, and intervention approaches
So that… SLPs have a clear, well-defined, and
measurable contribution for RTI: Intervention for Prevention and Identification
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Context for Change (a little more)Special Ed may not work well…
Research studies show little benefit from special education services for closing achievement gap
Special Ed instruction has been ~ Too general Unsystematic Provided too late…after history of failure
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So…In this era of accountability… We need to make sure all students meet
grade level expectations We need to make sure we teach students to
read in a way that matches how they learn We need deep understanding of the language
underpinnings of literacy We need deep appreciation for the fact that
without an intact language system…it is very hard to “do” school.
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RTI:
Do SLPs in Schools Have a Role?
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Speech-Language Pathology Services [CFR §300.34(c) (15)]
Identification; Diagnosis and appraisal of specific speech or
language impairments; Referral for medical or other professional attention
needed for habilitation of speech or language impairments;
Provision of speech and language services for the habilitation or prevention of communicative impairments; and
Counseling and guidance of parents, children, and teachers regarding speech and language
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The definition of speech-language pathology services in IDEA 2004 paves the way for involvement of the school-
based SLP in RTI.
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Roles and Responsibilities of SLPs in Schools: 2010 ASHA Position
Critical Roles in Education Working Across All Levels Serving a Range of Disorders Ensuring Educational Relevance Providing Unique Contributions to the Curriculum Highlighting Language & Literacy Addressing Cultural and Linguistic Diversity
Range of Roles & Responsibilities Prevention Assessment Intervention Program Design Data Collection & Analysis - Accountability Compliance
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Roles and Responsibilities in Schools2010 ASHA Position Collaboration
Collegiality with Educators Collaboration within the Community Partnerships with Universities Partnerships with Families Partnerships with Students
Leadership Advocacy Communication Supervision and Mentorship Professional Development Parent Training Lifelong Learning Research
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ASHA Position Statement includes Prevention
in Roles and Responsibilities of School-Based SLPs!!
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SLPs in RTI: Define R&R across Tiers Tier 1
All Students: effective, engaging, rigorous, individualized, standards-based instruction
Universal screening procedures Periodic progress monitoring School-wide behavior expectations/standards The key to RTI working well for students
Tiers 2 & 3 Students struggling to meet expectations get help Focused intervention on specific target skills needed to
support success in Tier 1 Frequent progress monitoring of target skills
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Tier 1 SLP Activities
Direct Services Expanded speech and language screening
Additional support in the classroom Classroom time during small group instruction to work on
speech or language development Assist young children with “good speech” in centers Provide lessons Co-teaching bursts
Indirect Services Classroom observations, parent education, student support teams,
homework programs, C&I consultation, staff development
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Tier 2 SLP Activities
Direct Services Focused intervention on specific skills ~ generally articulation
and language Intervention provided in addition to Tier 1 Frequent progress monitoring Frequent intervention ~ intervention period measured in
terms of hours (15 to 20 hours) Correct production of target followed by opportunities for
mass practice Indirect Services
Observe Tier 2 students to identify when struggle linked to speaking, listening, reading, writing; assist with progress monitoring; communicate Tier 2 progress to teacher & parent
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RTI:
What is the Evidence Base?
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3 Examples
ARtIC Lab (Super Duper) Effectiveness for preventing referrals Cost savings
Language Lab (Super Duper) Effectiveness for preventing referrals Program evaluation data
Story Lab (Pasadena ISD, Tx) Locally developed
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Evidence Base for Articulation(based on tracking results from ARtIC Lab)
Tier 2 Intervention Program for 1st – 3rd graders
One or two simple sound errors ~ may or may not meet eligibility criteria for IEP services
Nonstimulable for target sounds Monitor students who are stimulable;
treatment probably is not warranted. Research suggests that stimulable sounds
will develop without intervention (Gierut, 2007).
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Evidence Base for Articulation(based on tracking results from ARtIC Lab)
3 – 4 30 minute sessions/week Groups of 3 – 5 students Station rotation Quick correct production Mass practice ~ drill, drill, drill SLP monitors productions and shapes
sounds Treatment selection and randomization are
key!37
Data Collection
Summer pilot program Data collection in 2006 – 2007
RTI services IEP services
More data collection in 2007 - 2008
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Summer Pilot Program: Quantitative Data
StudentStudent Hrs. Hrs.
InterventionIntervention
Sound Sound
ErrorsErrors
# of Errors: # of Errors:
EntryEntry
# of Errors: # of Errors:
ExitExit
ChandlerChandler 77 s, zs, z 1616 33
MaryMary 88 s, zs, z 1010 55
RalphRalph 88 ch, sh, jch, sh, j 3232 1717
RyanRyan 1010 r r 1212 22
SaturnSaturn 99 rr 1414 1313
JeffreyJeffrey 10 10 r r 2121 77
KatyKaty 1111 r r 1111 11
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2006-2007 Fall Data
18 elementary campuses 89 RtI students 97% (87) Responders 3% (2) Non – Responders needed referral for
special education evaluation
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2006-2007 Fall Data(same approach for students with IEPs)
Students with an Individualized Education Program (IEP) for articulation 18 elementary campuses 91 students with an articulation IEP 25 dismissed or ready for dismissal 27% reduction in caseload
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2007-2008 Fall Data(data snapshot 1 – 20 hours of intervention)
Elementary campuses: 21 RtI students: 110 97% (107) Responders
20% of Responders (22) exited RTI 80% of Responders (85) continued
3% (3) Non-responders referred for special education (speech) evaluation
The closer to 20 hours of intervention, the more students are ready to exit
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Cost SavingsArticulation (only) Referral Paper
Approximately 52 pages per student 52 pages X 89 = 4,628 pieces of paper
Time investment Approximately 7 hours X 89 students = 623
hours Personnel costs
Approximately $24,920 to test/place 89 students
Preventing pull-out IEP services? Priceless.
Evidence Base for Language(based on tracking results from Language Lab)
Tier 2 intervention program K – 4th grade Students struggling with oral language
Fail reading comp portion of reading universal screener
Fail story retell screener Teacher concern
Groups of 4 – 5 students 2 – 3 30 minute sessions/week
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Evidence Base for Language(based on tracking results from Language Lab)
Station rotation Homework Component Designed to work on:
Nouns, adjectives Verbs, adverbs Connecting language Narrative skills
Story Station with SLP Work on target skills through connected
narrative language 45
Language Lab: RTI Program
Data Outcomes of Pilot Programs 3 districts (2 Texas, 1 Nevada) Spring 2010 pilot focused on program
development Fall 2010 pilot focused on student responsiveness During the fall semester, 81% of students exited or
were progressing at the expected rate to recommend continuing Language Lab
19% students did not respond at expected rate-referred for special education testing
Limitation: n of 3246
Program Evaluation Language Lab Studied SLP reported effectiveness of the
program Examined utility, feasibility, and accuracy of
Language Lab as a program for use with students struggling with oral language
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What were the Outcomes?
Research Question 1: How effective were the instructional strategies in the program in reducing the need for referral for special education evaluation?
Data sorted by responders and non-responders Responders—exited (n=131) or continued in
program (n=111) Non-responders—referred (n=102) 70.3% reduction in referrals (n=242)
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What were the Outcomes?
Research Question 1: Overall effectiveness ratings (effective/very effective
Exited students 90% Continued students 60% Referred Students 70%
Value ratings for Intervention Data (effective/very effective) 90% of SLPs
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What were the Outcomes?Research Question 2: In what ways did the program
improve oral language and narrative skills? Common Themes
Student Improvement Generalization of Skills Specific Instructional Strategies
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What were the Outcomes?
Question 2: Student improvement
90% commented about improvement (1 participant did not respond)
“syntax improved notably”, “syntax improved by direct instruction”, “some improved especially with irregular past tense and plurals”
“narrative skills improved”, “all students used skills and showed proficiency”, “story telling skills improved…stories sequenced correctly”
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What were the Outcomes?
Question 2: Generalization or carryover of skills (7 SLPs)
“students began self-correcting”, “techniques were able to be carried over into the hallways and at home”, “objectives were evident in their conversational speech”
Specific Strategies Visual prompts or supports Scaffolding Corrective feedback Naturalistic modeling
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What were the Outcomes?
Research Question 3: Which components of Language Lab™ were most effective? Skill Drill 90%* Talk Aloud 70%* Listen ‘n Learn 70%* Story Station 100%* Curriculum Connections 70%*
* Effective/Very Effective
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What were the Outcomes?
Research Question 4: In what ways were the printed instructions effective or ineffective in implementing components of Language Lab™, considering time sufficiency and clarity?
Clarity of Printed Instructions Skill Drill 80%* Talk Aloud 70%* Listen ‘n Learn 70%* Story Station 90%* Curriculum Connections 80%* *Effective/Very Effective
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Significance of Findings
Overall findings supported and validated use of Language Lab™ for improving students’ oral language skills and reducing referrals for special education
evaluation.
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Discrepant Findings
Two areas of findings needed further explanation (not necessarily discrepant findings) Overall effectiveness ratings
Study did not require students to have completed the program
Time sufficiency for Story Station There was not a format for SLPs to provide additional
explanation Interpreted responses to mean time was not enough
to finish the lesson Possible contributing factors: # of target skills, pace of
presentation of lesson
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Story Lab (Pasadena TX)
Co-teach, Gen Ed Tier 1 Story telling Question asking/answering
2 30 min lessons / week Data gathered: writing portfolio, wh-Q
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Story Lab
Data Tracking
Name Who What When Where Why How
Sally /// //
Tom //
Dick //
Harry // //
Alice //
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Story Lab: Benefits
By scanning the story, they really develop main idea.
Meaningful question asking and answering is developed.
They learn the structures of a story without getting stuck in prescriptive writing (and then, and then).
Increases descriptive language. Increases expression of feelings/ emotions. Segues nicely from oral language to written
language.
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Discussion Topics
What can you do to collaborate to gather an evidence base for: Articulation Intervention/s Language Intervention/s
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RTI:
How can SLPs manage adding RTI to an already full
caseload?
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1. SLP RTI embedded in the district processes and procedures Work in the same system ~ not in a separate system
for… Identification of students (universal screening) Decision making – which tier, moving between tiers, exiting
RTI, referral for evaluation Progress Monitoring Evaluating effectiveness of interventions
Example from Irving, TX 3 RTI Pillars – Academics, Behavior, Language Proficiency Academics – Reading, Math, Artic & Language
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2. Develop Consistent Procedures
Expanded Screening for Speech/Language Identification for
Tier 1 support Tier 2/3 interventions
Progress Monitoring Procedures Decision Points
Exit RTI Continue RTI Refer for special education evaluation
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3. Provide Tools
Forms for decision making and documentation Forms/software for progress monitoring Intervention programs for articulation and
language Expanded Screener for artic and language
Develop your own Purchase
Consistent RTI Reporting Protocol (to document prevention)
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4. Specify Tier I RTI for Speech/Language Identified target skills
Establish a baseline Provide teacher/aide with Tier I activities and simple data
collection sheets Define dosage of intervention (how often, how long, how
many weeks) Progress Monitoring probes (at defined weeks) done by SLP Recommendation to teacher and RTI committee regarding
adjustment to Tier I Options: progressing, continue Not progressing, change RTI plan Not progressing, refer
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5. Use a Workload Approach
Describe direct and indirect intervention services through RTI
Focus on educational relevance and helping students master CCSStandards
Continuum of service delivery models – most often for RTI: classroom based for Tier 1 and some Tier 2; pull-out for Tier 2/3
Flexible scheduling Data Driven Decisions
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6. Scheduling Issues
If school has an intervention period during school day one or more days per week, use time to provide artic and language interventions
Schedule at beginning and/or end of school day
Start small…no more than 15% of time on RTI activities E.g. one artic group and 1 language group 3 hours of direct Tier 2/week; 1 hour Tier 1 direct & indirect
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7. Document RTI Effectiveness
Keep track of the number of referrals prevented through RTI
Keep track of (non-responder) students referred for evaluation Eligible? How RTI data used to augment evaluation and
recommendations Evaluate RTI processes and procedures
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RTI
Why is it a Good Thing?
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RTI: Why It Is a Good Thing
Allows SLPs to provide intervention for prevention of speech-language-communication disorders
Allows SLPs to provide intervention as part of dynamic evaluation to provide new component to eligibility deliberations
Allows SLPs to contribute to strong language learning systems for all students
Allows SLPs to participate in school reform
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RTI ~RADICAL Change Potential General Education ~ new locus of
support for struggling learners Just-in-Time ~ not Wait-to-Fail Teachers and SLPs work like detectives Master schedules change in order to
“invent time” Everyone has access to an IEP Different attitudes about learners and
learning
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References & Resources
American Speech-Language-Hearing Association (2010). Roles and Responsibilities of Speech-Language Pathologists in Schools. [Professional Issues Statement}. Available from www.asha.org/policy.
Klotz, M.B. & Canter, A. (2006). Response to intervention (RTI): A primer for parents. www.nasponline.org/resources/factsheets/rtiprimer.aspx.
McCook, J.E. (2006). The RTI guide: Developing and implementing a model in your schools. Horsham, PA: LRP Publications.
National Association of State Directors of Special Education. (2006). Response to intervention: Policy considerations and implementation. Alexandria, VA: Author.
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Rudebusch, J. (2007). Guide to RTI. East Moline, IL: Linguisystems.
Rudebusch, J. (2008). The source for RTI. East Moline, IL: Linguisystems.
Wiechmann, J. & Balfanz, D. (2008). Artic Lab: A bilingual response to intervention (RtI) program for articulation. Greenville, SC: Super Duper Publications.
Wiechmann, J., Rudebusch, J. & Kuhles, N. (2011). Language Lab. Greenville, SC: Super Duper Publications.
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