[E247] Understanding FASD: The Diagnosis 90% of Doctors Miss with Sandra Flach

[00:00:00] Speaker A: Foreign. [00:00:04] Speaker B: To the Empowered to Connect podcast where we come together to discuss a healing centered approach to engagement and well being for ourselves, our families and our communities. Hey everyone. I'm here today with a friend of etc. Sandra Flack. And I'm so excited to let you hear a little bit about her wisdom as an adoptive parent and also as a professional. So Sandra, we're so glad to have you on the podcast today. Tell us a little bit about yourself. [00:00:36] Speaker A: Hi Jesse, thank you so much for having me. It's an honor to be here. I've just followed Empower to Connect way back in the early days of our adoption journey, was able to found the connected child and got to sit under Dr. Karen Purvis's teaching when she was still with us and became an Empowered to Connect parent trainer for a season. So just honored to be here. And these days I really focus on talking about Fetal Alcohol Spectrum disorders because my youngest two who are now in their 20s, both are diagnosed with Fetal Alcohol syndrome. So that's an area that I'm passionate about educating and training and supporting parents on through all of the work that I do through our podcast, the adoption and foster care journey, as well as FASD training and support group and coaching and all of the things just wanting to serve and support foster and adoptive parents. [00:01:36] Speaker B: Wonderful. You know, so many of us come to the work that we come to because we're needing it personally in our home. I just relate so much to that. So it sounds like that's kind of how you have found your way to FASD and supporting parents in that arena. And so why don't you. Let's just start. Tell us a little bit about Fetal Alcohol Spectrum Spectrum disorders. Fetal Alcohol syndrome. Give us kind of a primer if this is kind of new information to us. [00:02:09] Speaker A: Yeah. So the crazy thing I find with this is it shouldn't be new to any of us because it is so highly prevalent and not just in foster care and adoption. It's actually 1 in 20 people in the United States have been prenatally exposed to alcohol. And then in the child welfare space, 70% of children who were prenatally exposed are in foster care. So it's higher rates, but it's the general population. And it's really, we call it an invisible disability because it's not. You can't tell somebody has it by looking at them. And it is a spectrum where you can have the extreme end of the spectrum, which like my two boys are diagnosed with Fetal Alcohol syndrome and then there are actually like six other diagnoses within fasd. FASD in and of itself is not the diagnosis, but it's such a variable it varies because it depends on how often a birth mother drank. Did she binge drink? Was it, you know, one glass of wine every Friday night, or was it, you know, multiple shots or whatever? Multiple times. When in the pregnancy, throughout the pregnancy, only up until we knew we were pregnant. That kind of thing. There were so many variables. So it's like you meet one child or one person with FASD and you've met one person and it's. I don't want to say it's the best kept secret because it's terrible, but people are shocked when they learn that FASD is the leading cause of developmental and learning disabilities worldwide, yet nobody really knows a whole lot about it, or they've heard of FAS and don't realize how, how much of a spectrum it is and how vast it is and how many people are really affected. And like with our kids, we had adopted. You know, we adopted, we did a kinship placement. We had three bios, kinship, knew nothing about trauma, knew nothing about prenatal exposure, didn't, wouldn't have even thought we should then adopted internationally. We adopted three siblings by then. I read a book on attachment because somebody told me I should. And then somebody else mentioned fetal alcohol syndrome being highly prevalent in children adopted from Eastern Europe, which ours were. So read a little bit, but it was like, you know, very, very, like naive and ignorant or whatever. But actually our three kids came home and it wasn't. I mean, it was crazy, but it wasn't so hard that we were desperately looking for help until we brought home their youngest sibling a few years later. And this one little five year old rocked our world so that he, and then his next older sibling both were diagnosed at ages 6 and 8 with fetal alcohol syndrome and ADHD, which is very common. Our kids tend to have the whole Alphabet soup of diagnoses, right? Adhd, asd, odd, rad, ptsd, whatever letters you want to put there, which may or may not be accurate. It's highly likely that they're all there because of prenatal exposure. So our boys were diagnosed and the developmental pediatrician handed us a pamphlet on adhd. Nothing for the fas. And that was it. We were like, it was like, have a nice day. Had nothing. But at that point I had found the connected child book and we just dove into that, because then as we were learning about trauma and applying all of those things that we were learning all the TBRI principles that was helping our family. And. But then by the time they. And so we had connection, we had attachment, and I fully endorse and recommend the connected child and empowered to connect to every adoptive and foster parent that I encounter. And people who are just starting out and they're wanting to know, what book should I read? Right? That's the go to. That's the gold standard. But by the time our boys became teenagers, it was like, all right, we've got this. There's so many things going good, but then there's these crazy things that are happening. And by that time, we realized, all right, this must have something to do with the FAS and we don't really know enough about it. And that's when I took my deep dive into fasd because. And as I learned, just to help my family, like you were saying, I started talking about it more and more on our podcast. And then I was just getting swamped with emails from listeners like, oh, my gosh. You described my child. Oh, my goodness. Because of what you said, we went and sought a diagnosis, and our child has this. And it's so. It's so highly prevalent, but nobody really knows. It's hard to get a diagnosis. It's just. It's a difficult journey, and you feel like you're on it alone. And I want to change that because there's actually so many of us out there, and there is help and there are resources, and that's what I'm passionate about providing and doing. [00:07:02] Speaker B: Oh, I can tell. I can tell you're passionate about it. And I. I want to relate with the early you and maybe even some of our listeners today. You know, you don't know what you know until you learn it, right? And that's just true for pretty much everything in life and especially in adulth and in parenting. I'm listening to you describe this and realizing, you know, I was really excited about talking with you today, Sandra, because I actually only know the bare minimum about FAS and I. So I would kind of consider myself an early version of, you know, the naiveness or the. The ignorance that you describe. Not out of, you know, intentionality, but just, we only know what we know until we learn it. So if you're listening along and you're like, oh, I don't. I just realized I don't know a lot about this either. Like, welcome. Welcome to the learning session that I'm using for myself today. And let's hear a little bit more about this. You know, Sandra, you were talking about receiving that diagnosis, and I wonder what kind of led you to that point? Who was doing the diagnosing and what was required, required in order to get that diagnosis for fas? I thought, oh, I don't even know how I would go about exploring that or knowing that's a diagnosis that I need to pursue for a child or for even, you know, maybe somebody's listening today that is like, could I pursue a diagnosis for myself? [00:08:36] Speaker A: Yes. Yeah. And I've, I've actually had parents recognize in themselves. Oh, my gosh, I, I think I have this. And, and there have been many, many people on the national stage training in the space of FASD who have, along the way, discovered that they themselves were prenatally exposed. But for our parents, Right, our listeners, it is challenging because it's not diagnosed. It can be difficult to get a diagnosis, especially depending on where in the country you are. Some states, like Florida, have an FASD clinic, a diagnostic center, but not a lot of places do. My boys were diagnosed by a developmental pediatrician. A neurologist can diagnose. Anybody who can diagnose using the DSM 5 can diagnose. But not everybody knows that FAS isn't, isn't listed there. I'm not going to get deep in the weeds on that. [00:09:34] Speaker B: Sure. [00:09:34] Speaker A: But, you know, doctors aren't. It's challenging because. And I've interviewed a few doctors who specialize in this. It's challenging because it's really not taught in medical school. Believe it or not, the doctors that I've interviewed who specialize. Specialize in this now said, you know, maybe five minutes in a lecture in medical school, maybe a paragraph in a medical book. I was just at a conference where I had an information table in my state, which is in New York, and it was a conference for mental health clinicians across the state and college students about to graduate to be mental health clinicians. And when they walked by our table and I asked, you know, are you familiar with fasd? They were all like, no. And if I said fetal alcohol, they're like, oh, yeah, Fetal Alcohol syndrome. I know about that. And I'm like, yeah, well, you know, [00:10:24] Speaker B: they probably know about it the way I know about it, which is that you shouldn't drink alcohol excessively when you're pregnant. That's about the extent to what I know. And I graduated with a degree in child development. [00:10:36] Speaker A: So, you know, and so it's so that you. Then you really begin to realize how it's not really known. And there's a lot of stigma around alcohol because, yes, you know, most People in our culture drink alcohol and a lot of women who, unless you're planning a pregnancy, you and you don't you and you would know to abstain from drinking. You could be several weeks pregnant and be just drinking socially, a glass of wine every Friday night. There's no safe amount of alcohol to consume during a pregnancy. There's no safe time in a pregnancy. And especially in those early weeks of a pregnancy when the brain and the central nervous system, all of these very important parts are being formed. Alcohol is a teratogen. It crosses the placental barrier and literally goes into the amniotic fluid. So it's like if birth mom is drinking, baby is drinking. And it doesn't just affect the brain, it alters the brain, the structure and the function of the brain. Absolutely. But this is a whole body condition because it affects every cell during development. So, you know, one of the shocking things I learned along the way is, you know, some recent studies have shown that there are 428 co concurring health conditions highly prevalent among the population of people with fasd. You know, so heart conditions, vision problems, hearing problems, I mean these are kiddos that, you know, chronic, chronic ear infections as babies, they don't sleep well, failure to thrive. Right. A lot of, you know, gastrointestinal issues, a lot of autoimmune conditions, musculoskeletal conditions. One of our boys, when we adopted him at age 3, had severe scoliosis. His little spine was like a corkscrew at 3 years old. Had to have multiple surgeries, you know, rods, spinal fusion, all of these things. And if you really look close at him, his, his spinal, his, his muscular, you know, his skeletal system is a little wonky. If you really looked at him, and he's 23 today and he's 5 foot tall if we stretch him and you know, 99 pounds if we dip him in water. Right. So his, his orthopedic surgeon knew nothing about fasd, he just knew about scoliosis. And this is what he's going to fix. But it's like, you know, now I, knowing what I know, birth mom was probably drinking quite heavily while his skeletal system was being formed. Right. So, you know, so there's a lot of things going on and it's a lifelong condition, you know, that affects the brain, it affects the body, but most people don't know about it. And unfortunately for diagnosis, getting back to where we started with that, you know, doctors and clinicians, practitioners, they want, they're looking for two things, facial features and there are Sentinel facial features associated with fetal alcohol syndrome, which my boys have that diagnosis and they have the facial features, but that is only, you know, less than 10% of the population of people with FASD will present with the facial features. So when doctors rely on that to diagnose, they're missing 90% of the cases. And the other thing that is required still is maternal admission of alcohol consumption during pregnancy and especially in foster care, adoption, you're not, we don't get that information. We don't know. Right. Or birth moms are asked if they drank alcohol or if they drink, if they use drugs during pregnancy, they're not often asked about the alcohol. There's a lot of stigma associated with it because most people drink. It's an awkward conversation to have and it's not really understood the harm that is caused. It's the most toxic substance with long, the longest lasting effects come from alcohol exposure during utero. [00:14:31] Speaker B: I'm just even thinking about the fact that so much of this, if you've internationally adopted there, I mean, then you're familiar with the fact that there are so many question marks that you can't fill in the answers. And so maternal admission would be one where for most international adoptions, you're not getting that information. And so if you are parenting a child who you don't know their history or you don't know, you know a lot of information about their history, how would you start to untangle this? What would you be watching for? And what does maybe acknowledging that this is at play at the least or even formally getting a diagnosis, what does this allow you to be able to do? [00:15:22] Speaker A: So the, and that's the other tricky thing with FASD is a diagnosis, you can get it. But like in my case, we got the diagnosis and our boys were, they were internationally adopted and we had these translated medical records that indicated the parents were both alcoholics, you know, so. And I also think because there was no birth mom to shame or stigmatize, and we never want to shame a birth mom, but because she wasn't in the picture, right, it's an international adoption and our boys had the facial features, it was easy to get their diagnosis. Diagnosis, really it's the individuals, it's the kiddos that do not have the facial features and they may have normal, you know, average to above average IQs. And that makes it difficult because this is really, it's a hidden disability because you can't see it, it's not visible. And the symptoms are behavioral. So a lot of the things and they very Much overlap with the symptoms of trauma. So we'll get, we'll get to symptoms. I'm sure we're going to cover that. But, you know, if you get the diagnosis like I did, we got nothing else to go with that. There was no, no, nothing to refer us to. I went home, got on the Internet, looked it up, and back then, especially if you researched fetal alcohol syndrome, it was like dark and hopeless, like these are kids are going to grow up to become homeless, addicted, in jail, or high rates of suicide. Right. That was. So I just like turned off the computer and refused to accept that, you know. Yeah, that diagnosis, that, that, you know, perspective, and then dove into the connected child because that was the one thing I had. But then it was, you know, that. And that was helpful. But again, as time went on, it got harder. And that's oftentimes what happens with FASD is, you know, you're. You're trying to just keep the kids, you know, because all of the trauma symptoms, the things that you're going through when they're little and then when they become teenagers and Even into their 20s, it gets harder because you'll begin to notice a difference. There's a wider gap between where a child or an individual with FASD is compared to where their neurotypical peers are. Right. So the gap widens, it becomes harder, they become more frustrated, it's harder to parent. The consequences get bigger with the choices that they're making. So it's going in. You know, we want to be educated so that we can go after that diagnosis. And now there are. There's more out there. You know, federal legislation was just passed by the FASD Respect Act. I'm affiliated with the FASD United, the national organization on fasd. So it just depends on what state you live in, what's going on, but you have to really fight. I find that parents have to learn and become the expert on this. And then they have to educate the educators, the, you know, the doctors, the lawyers, relatives, babysitters, you know, everybody around them, because it looks like willful disobedience and defiance when really we have a kid that's really having a hard time and we'll get into the symptoms, but you have to have a diagnosis. It's so important to get that it's hard to get. And when you get it, it doesn't necessarily get you anything else. Symptoms often look very similar to autism. And I know families who've accepted an autism diagnosis knowing it's not that. But that was the only path towards services and support and resources, which we're working really hard to change that because you should be able to get services and support based on your actual diagnosis. But it's a desperate place to be and families will, you know, you're going to get help however you can get it. [00:19:08] Speaker B: That's what I'm thinking about as you're describing this. And to talk about an invisible disability or the need for support and services, even to accept a different diagnosis in order to get access to those things, to be able to, you know, I hear you saying the further this plays out, the more need you are maybe presented with for accessibility and for just access to services and support that you're describing. And that that makes a difference for a person not just in how they're being compared to a peer, but in what they're needing in order to be successful in their, in their lives and even, maybe even changing what success means and what the goal is for that person to live successfully in their, in their lives. Would you describe it that way? [00:20:07] Speaker A: Yes, absolutely. Because some again, being a spectrum, and it's not even a spectrum, that's a straight line. It's really like a scribble. It's all over the place. And it just depends on where they are developmentally. You know, one of the, one of the symptoms is we used to call it dysmaturity. So it's just oftentimes they're younger developmentally than their birthday age with a lot of kids. But that might not be in every, every area. It's a scattered profile. So you might have a kiddo who's 12 years old who, you know, in so many ways they're almost like a six year old. You know, when it comes to social interactions, when it comes to academics, when it comes to emotional things. Right. When it comes to even daily living skills, things like that much, much younger. Right. Likes to play with younger children interested in things much younger than a 12 year old. However, on the soccer field, they play like a 16 year old. Right. That's their strength. And, and oftentimes we see that individuals with an FASD will have, I call it a superpower. Right. They have strengths and abilities beyond their years. So, and so then it looks like, well, why can they do that? But then they can't, you know, remember to brush their teeth ever or you know, change their clothes or remember where they put their shoes or whatever. Right. There's, there's these frustrating things that play out throughout the day and it doesn't line up and that's very much FASD because it's scattered. They may be able to do certain things on Monday, Tuesday, Wednesday and by Thursday and Friday they can't do it. And it looks like they're, you know, but we know you knew this, you've done this before, why can't you do this now? Well, when the body is taxed, when the brain is taxed, you know, they may be exhausted and in fact people with fasd, kids with FASD fatigue and are more exhausted because their bodies and brains have to work so much harder than everybody else's just to navigate the same things. And IQ also, you know, they could have average iq, above average, below average. One of my boys, average iq, he drives, he goes to work, he's a volunteer firefighter, needs some support at work, needs a nap after work, but can do a lot of great things. But then his biological brother, same exact diagnoses, but with a much lower IQ also at 17, got and got, you know, we did new testing, neurodevelopmental testing, the neuropsych eval, all of those things and actually scored where he now has also an intellectual disability. But the intellectual disability in the ADHD is really only present because of the prenatal exposure to alcohol. But he's got all kinds of services, this kiddo. He doesn't drive. Will he ever drive? I don't know. He has a part time job with a lot of support, does pretty well with that, but he needs a lot of one on one support and guidance throughout the day. And will he always. Maybe, maybe not. But those things are present because of the prenatal exposure to alcohol. So it's everybody, it presents a little bit different. Not everybody with FASD has all of the symptoms and we can go over those primary symptoms. But you know, in my boys, both of my boys, they do have every symptom and in varying degrees. So it's just one of those things that until you've really learned about it and you really know it, you're then you're then, you know, you know, until then it can look like so many other things and it can also, you know, you realize it's not quite that, but it's kind of like that. [00:23:54] Speaker B: Yeah, sure. I'm thinking of two resources, etc has that might be valuable to parents that are looking more into. This one is our developmental snapshot. You've probably seen that Sandra, just where you're describing where you might have a developmental age, a cognitive age, an athletic age, an academic age in the sense that sometimes it's matching up with that chronological age that you are. And sometimes it might be behind, sometimes it might be ahead. And this is just true for children. But I'm hearing, especially with fasd, that that might be at play, that you're having a lot of differing ages in that snapshot. [00:24:38] Speaker A: Yes, yes, absolutely. That is, that is, that is one of them that, you know, the, the developmental, where they're at, at their developmental timeline. And it, and that's one of the areas where it gets a little bit more challenging as they become teenagers and even into their young adulthood because that's where the gap widens and they start noticing there's, they're different and they want to do all of the things that their peers are doing and it might not be safe for them to do all of those things or they might not even be able to really navigate those things without support and help. And we don't outgrow an FASD. So it's not like they'll turn 18, they'll be able to go off to college, get a job and live happily ever after. You know, it's not gone at age 21. In fact, a lot of times we see that it's not until they're 30 when things begin to level off a little bit. And you know, think about it. You know, it's like the years that we're in school, that's the only time in life we're really grouped by age. And that's when it's really obvious. Anytime you're trying to group them, whether it's in, you know, like we homeschooled, my boys didn't fit in the homeschool co op when they grouped them by grade level or, you know, church, you know, children's ministry because they, they couldn't read at the same level. They weren't socially, you know, able to, to keep up with those peers. They just, they just didn't fit necessarily wherever you grouped them by, by age. And now in their early 20s, both of them, their primary friend group, are older adults. We make sure they're safe adults, but they're older adults because they don't really fit with their peers. And it may not be safe for them to be with their peers, depending on the peers. Right. And then, you know, they don't really want to hang around with littler kids, even though some of their interests might line up with that. So it's when you start noticing things like that when they're little, they might like to play with younger kids because they fit in better there. But as they age, they actually are more comfortable with older adults because there's less stress and less the difference isn't as obvious. And there's more. I find that they're more welcomed and accepted by older adults who understand there's something going on here that's a little bit different and they can give grace. [00:26:50] Speaker B: I'm also hearing a lot of coping strategies that you're describing or adaptive behaviors. I've heard Tana say she doesn't like when we talk about maladaptive behaviors because really, our kids don't know that it's a maladaptive behavior. Right. They are just adapting to what they have access to, whether it's maladaptive to us or not. And so just thinking about how children are coping with what they have to work with in their environments and with the people that they're relating with. I'm hearing that from taking a nap after work in order to support your stress capacity and your physical, you know, capacity to changing the environments that you're in, to maybe selecting a friend group that's younger because that is able for you to better able for you to navigate socially. But even just thinking about the stress capacity will link to. To a resource we have on that. Just in terms of, you know, you're talking about at the end of the week maybe not being able to handle as many things or your coping strategies are failing more than they were at the beginning of the week. And just being able to take that into account of what's going to support someone's stress capacity in terms of what they're facing during the day. [00:28:13] Speaker A: Yeah, there's a lot of stress and anxiety, which is really a secondary symptom of this because they're really just trying to survive. And because it's an invisible disability, it looks so much like willful defiance and that they're being difficult or they're being lazy or whatever. However it would look on the outside when really their brain is just having a hard time. There's so many things that they can't do. It's not that they won't, it's that they can't do it. And so then it can become very frustrating when the expectation is set upon them. You look like you should be able to do it. You could do it last week. Your peers can do this. You're at that age where you should be able to do this, and then they can't. And then they're punished oftentimes for it. And, you know, especially when it comes to, you know, school, you know, and until parents, I mean, I remember, you know, issuing Those consequences all the time before I understood that, you know, this child's brain works differently. And it's not that they're not going to learn from, you know, what I've come to understand is they don't learn from the consequence. They need teaching, they need repetition, they need support, they need accommodations. Because you know, to be able to learn from a consequence, the brain, you have to have really good executive function skills. And that's one of the areas of the brain that's highly affected by fasd, by prenatal exposure, is executive function. You know, and that's, you know, that is in charge of impulse control and memory and transitioning from, you know, one task to the next or from, you know, I'm playing this video game and now I'm being told to do homework or clean my room or whatever it might be. And so, you know, there's that frustration, there's that meltdown, you know, self regulation, being able to follow steps and sequences and planning and organizing and you know, so many things are involved with executive function and that's one of the areas of the brain that's highly affected by prenatal exposure to alcohol. So you know, again, they can be, it just, they become very frustrated because it's, they're misunderstood all the time and they need support. It's just most people don't look at them and think they need the support that they need. You know, sensory, sensory processing, you know, that's a big area with our kids as well. Language and communication challenges, understanding. They mask very well. They can, you know, kind of talk the talk a lot of times, but then they can't walk it out. They don't, they can't follow through, they can't really apply it. They don't really understand. They have a hard time with that and they may look like they understand it, right? They can repeat something back and to you and you're like they got it. And then you come back later and it's like you never, they never did what it was that you explained to them. And they seem to understand that they needed to do it. You know, I tell a story a lot of times with one of my boys when he was a teenager. We were trying to teach appropriate boundaries and appropriate words, right? These are very important things for a 15 year old boy to know. But when you have a 15 year old boy, you know, really, he, he might have been more like a 9 year old boy and a 15 year old boy, his body with all of the raging hormones of a 15 year old boy. So we're having these conversations, and then, you know, he was agreeing with me and nodding his head and, yep, yep, that's great. That's like, yep, you're right. And then something at the end of the conversation had me ask him, and you know what I mean by appropriate, right? And he was like, no, what does that mean? And I could have walked away thinking, we're good here. And we were not good. So we had to really boil it down to that simple script before we went anywhere. You know, it was good words, good boundaries. We taught that. We practiced that, and then we had that script, because, again, it's not something that he could, you know, he. He just didn't understand. And then it was probably two years later, he was getting ready to go to school. It was an unusually warm day, an unusually warm spring. And he went to put, you know, shove his feet into winter boots. And I said, oh, no, dude, just wear. You know, wear your Crocs or whatever. And he was like, no, I'm gonna wear these, because they were right there by the door. I'm like, nowhere. And, you know, finally I just said, well, those aren't appropriate for today. And he was like, I didn't say anything wrong. Because he learned the word appropriate when it came to words and boundaries, and he didn't know that he could. Like. He just didn't apply that to, like, clothing or anything else. [00:32:38] Speaker B: Right. [00:32:38] Speaker A: So it's being able to generalize and just, you know, you assume that you would know. Once you've learned the word appropriate, it could be applied in lots of different ways. So a lot of language and communication challenges, a lot of slow processing pace. Auditory. There's that slow processing where they're not catching every word that is being spoken to them. A lot of times, they only catch that last thing that was said. And then if you're, you know, you give them a verbal list of things to do, and then you come back and check, and they haven't done all of them, or they only did the last thing, and then they're in trouble because they didn't follow directions or they were disobedient or whatever you would want to say. Really, it's because they didn't catch it all. Their brain can't catch all of that information and hold it and then execute on it. So they tend to have that slower auditory processing pace. You know, just the whole Nutrition can be a challenge. We've got kids who have extreme sugar cravings. Right. Like, beyond just the junk food. Right. But, you know, I spoke to one mom who found a five pound bag of sugar underneath her son's bed with a spoon in it and it was half gone, like he was eating straight up. Sugar, sugary beverages, things like that. Not every kid, you know, one of mine gravitates towards sugary beverages. The other one not so much. And then, you know, that, that brain gut connection where we know that we're hungry or we know that we're thirsty or we know that we're full, a lot of times that's not working well. So you have kids who are eating excessively or not knowing to eat, and that can, you know, that can cause difficult time too. So lots of different things that come into play and it can look like it overlaps so much with the symptoms of trauma. [00:34:24] Speaker B: Yeah, let's talk about that for a second. Because so much of this is, I mean, if you were to sit in on a training of the impacts of trauma and how it impacts body biology, behavior, beliefs, all of the things, it can sound very similar. I also have learned a lot about ADHD and inattentive add, and these symptoms can overlap too, or even anxiety can overlap a lot of different things. So. So how do you pull all that apart, Sandra? [00:34:56] Speaker A: Yeah, so it's tricky. So I find in, you know, in our audience, who is listening, foster and adoptive parents. Right. All of our kids have experienced some level of trauma and loss, and it's most likely they've also experienced fasd, a prenatal exposure to alcohol. And so can you separate it? Not usually. Because all of his parents say, because I used to do this. Is this from the trauma? Is this from the prenatal exposure? [00:35:25] Speaker B: That famous question, is this adoption related or is this related to a disability? Or is this, you know, we have so much trouble with it. Right? Yeah. [00:35:34] Speaker A: So. And you know, at the end of the day, I just say, yes, it's all of it. It's all of it. Because you really can't separate it out so much. You need to support it. [00:35:43] Speaker B: Right. [00:35:43] Speaker A: So, you know, just like we want to, you know, empower, you know, and connect with our kids, it's very much that. It's no matter. I teach what I call the neurobehavioral approach. So it's understanding the brain works differently. What are the symptoms of that? And I just listed off some symptoms. And when you know what those symptoms are, when you know, where a kiddo struggles, if they struggle with memory, if they struggle with impulsivity, if they struggle with, you know, auditory processing, then we're going to apply some accommodations that are going to help them. And whether or not it's from the trauma, whether or not it's from adoption, whether or not it's from prenatal exposure, you know, whatever it's from, it doesn't really matter. It's how. What are you going to do with that symptom, right? So very simply applying accommodations, just understanding this kiddo is doing the best that they can. They just need some help, right? So, you know, super simple. If they have slow auditory processing, we're going to use less words. We're not going to give them that big verbal lecture or speech or a verbal list of things that they have to do. We're going to give one step directions at a time. We're going to maybe provide a list like age appropriate reading level appropriate, Whether it's a post it note, or if they have a whiteboard or whatever visual aid you want to use, you're going to, you know, knowing that because, you know, I know that with my kiddo, right? My young, my younger, my son who's 21, you know, he. He has that slow processing. So we don't give him a whole lot of words. In fact, if we're in being only human and being a person who likes a lot of words and talks a lot, as you could probably tell, I can very easily revert back into trying to tell him some things. And then his. It's like, he'll describe it as like, this hurts my brain. He can't have all of that. Like, he did not. We ended up finishing him out homeschooling because too much talking, too many people, he becomes overwhelmed and shuts down or aggravated. [00:37:43] Speaker B: Right. [00:37:43] Speaker A: And frustrated. So we've learned not to give him too many verbal words. [00:37:49] Speaker B: Right? [00:37:50] Speaker A: Sometimes it's that list, sometimes it's a note card. Like one thing I need him to do if he's having a really rough day, and I know if I say one more word out loud, it's not going to go well. I'll just give them a note card. So it's making, you know, understanding what their symptoms are. And then how can we accommodate. What does this kiddo need? Right? Because of sensory processing, he does not do well in loud, crowded places. We don't go into restaurants that are loud and crowded. We have ones that we prefer that are more quiet. We'll let him pick. So it's really just making those accommodations based on what we know is a better fit for this kiddo. We make accommodations for all kinds of different disabilities, right? If you have a kiddo you know, sometimes I'll. I'll explain it as if you have a kiddo who, you know, has some kind of injury and they're in a wheelchair. Right? [00:38:40] Speaker B: They. [00:38:40] Speaker A: They're in a wheelchair. We automatically know there's going to be certain things that we're going to do to support this kiddo in every environment. Right. The wheelchair is. Is an accommodation. We're going to put a ramp on our house. Their bedroom is going to be on the main level of the floor. The bathroom is going to be modified. Our vehicle probably will be modified. The school bus that picks them up will have a lift, and they're going to be able to use the elevator at school. They're not going to have to run track and PE Class in order to pass pe. [00:39:09] Speaker B: Right. [00:39:10] Speaker A: There's all of these accommodations that when we look at them, we know, Right. That we're going to have to make [00:39:16] Speaker B: these accommodations, and we wouldn't ever force that kid to do it the other way. That would be cruel. That would be just. That would be inappropriate. Yes. Yeah, yeah. [00:39:27] Speaker A: But then with. With an invisible disability, this. This child or person needs these accommodations just as much. It just doesn't look like they do. [00:39:36] Speaker B: Right. [00:39:36] Speaker A: So. [00:39:37] Speaker B: And we said, especially with the masking that's happening that you described. [00:39:40] Speaker A: Absolutely, absolutely. So it is just providing those supports and accommodations and understanding that we're the ones that really. We have to adjust our expectations based on what their brain can do. And years ago, I remember, And I think Dr. Purvis is probably the only person who could ever get away with saying this. I don't even use this language now, but I remember for me, and this was before I really understood FASD like I do now. My boys had their diagnosis. We were in a really. You know, I think our youngest was nine, and it was like, oh, my gosh, right? The dumpster was always on fire. And I was at. I was wherever. I think it was an Empower to Connect conference when she was still teaching in Present Ethos. And I remember her saying something along the lines of, if you have a child with fas, you have a child with brain damage. And I remember going, huh? You know, like, is as. As hard and harsh as that sounds, I suddenly realized I'm not parenting a bad kid, and I am not a bad parent. My child, his brain has been harmed by this. You know, and then that just changed my outlook to, okay, how are we gonna. Like, we're on team kid, right? We're on their team, and we're gonna advocate and we're gonna do everything we can to support. Because it. If, you know, if you had a kid who, you know, neurotypical and was in, God forbid, a car accident and had a brain injury, you're gonna do everything to support the healing, you know, and whatever. Whatever level of healing that. That is gonna be able to take place. That's what we're gonna do. We're not gonna punish or consequence. You know, if you have a kiddo who has, you know, you know, a diagnosis and he. And they have a seizure and they knock over a lamp in the midst of a seizure and the lamp breaks, we're not going to punish them for breaking the lamp. Right. We understand what happened there, but with fasd, it's not often understood. And these kids are getting consequences, and they're. And they're getting punished, and they're often misunderstood, and that becomes very frustrating. And then things really begin. If we're. If they're not supported well and we're not providing the accommodations, it goes beyond just. It's frustration. It is. They get. They get frustrated, they get aggravated. They can get aggressive. They can, you know, get into. They're in trouble at school, we start seeing patterns. They're in trouble at home, they're in trouble at school, they can get in trouble out in the community. They're having a really hard time, and things begin to unravel. And sometimes that's where parents are at, right? They. They're starting to seek help because things are imploding. But if. But understanding that this is a brain that works differently and this kiddo needs that support and needs, you know, services. They need accommodations because. And it could be a lifelong. It is a lifelong condition because they're not ever going to outgrow it. The older they get, they're able to, you know, be able to do certain things. I know adults with FASD who are married and who have kids, who have jobs, but they still have accommodations in certain ways. I have. I have an adult friend who is in her 40s now. Two kids, one just went off to college, diagnosed with FAS. She was an adoptee. Didn't get diagnosed until she was 30. Wow. And. But the natural way that her marriage progressed is her husband does all the cooking because she's like, I cannot figure out how to get, like, the meat and the vegetable done at the same time. And she said, I can follow a recipe. And I still. It just. It frustrates her. She can make very simple things, but her husband is the chef at their house, and that's really an accommodation when her children were little and they needed to have, you know, their backpacks ready in the morning and all of the things ready and out the door to serve a certain time, her husband handled all of that because she had all she could do to get herself ready and out the door to work on time. Right. So that's an adult person and there's accommodations, right? [00:43:37] Speaker B: Yeah. And I have a feeling a lot of listeners are thinking about the accommodations that are in place in their life maybe. And they are not, you know, they're not diagnosed with a disability. They're just seeing how they are accommodating each other and their families and how family members accommodate each other. Yeah. [00:43:56] Speaker A: And that is really, you know, that's the strategy with these kiddos. Whether or not you get a diagnosis. It's understanding, all right? The brain is working differently for whatever the reason might be. And this kiddo needs support. Right. And providing that support. [00:44:13] Speaker B: My. I have this unique experience. When I was in college, my dad was diagnosed with a disability. It was a syndrome that was going to get progressively worse and affect him physically. And before that, before that syndrome progressed, he was putting some accommodations in place in order to slow the progression. He ended up using a wheelchair for the last 20 years of his life. But before he reached that point point, it was showing up as fatigue and muscle weakness. And so it was invisible before it became visible in his body. And I'm thinking a lot about how, how much shame he felt or embarrassment to, in this really successful job, be taking these meetings all day and then go to his office and shut the door and take a 30 minute nap on his couch in order to sustain his physical well being for the day. And there were, there were things in our family that we immediately had to put into practice in order to support him. And I'm just, I'm hearing that in the way that you have chosen to see your child, Sandra, your children. And it could have been this battle of either unwillingness to see your child because of what you might have to grieve and let go of those expectations that, that reality that you wanted, but you were willing to face what you were truly able to see in order to love that child. Well, in order to see them and celebrate them. And I wonder if you would just share a little bit about that process as we're starting to wrap up. Because I think it's one thing to talk about what this is and how it shows up and how we can support and accommodate. It's quite another when that's happening right in front of us. And it's coming right up against the things that we wanted and dreamed for our children. I know that has to be really real for you. And so how. How would you. I guess maybe how would you help us start to think about grieving and letting go of old expectations that we had as we start looking at how to celebrate the child in front of us? [00:46:45] Speaker A: Yeah, there's a lot of grief. There's a lot of grief because. And I think we learned that, you know, early on with the. With the trauma becoming trauma informed and understanding. Okay, this is a different journey than maybe we thought. And TBRI definitely laid a great foundation for me to have that perspective. Like, okay, what is going on? Like, really, what's behind this behavior? So that was. That foundation had already been laid. So then as I learned more about the brain and how. Okay, so I have. I have kids with brain differences. Right. And understanding that this is going to be lifelong, there is grief because my husband is retired and I get to do what I get to do. [00:47:25] Speaker B: I. [00:47:26] Speaker A: But will we ever have an empty nest? Not likely. [00:47:30] Speaker B: Right. [00:47:31] Speaker A: We've learned this word called interdependence because, you know, our two boys, you know, one is living. You. It might look like he's living independently, but he lives in an apartment attached to our garage and can do really great things. And then there are other things where he just needs support with. Right. In order to be able to navigate life in a safe way. So I've really come to see it as, okay, the Lord put these children in our family. None of this was a surprise to him. And I've been able to learn a lot of things that can help us support them and help them. So I'm grateful for what I have learned from, you know, the empowered to connect, you know, in TBRI to all of the FASD stuff that I've learned. But understanding that, all right, the Lord put this child in our family. He's called us to this. He's equipped us for this. And this is a long haul. You have to have the long view in mind. And I just shared, we have a support group called Hope for the FASD Journey. It's an online support group for parents of kiddos with fasd, diagnosed or not, because it's hard to get a diagnosis. And many of us are moms who are, you know, in our 50s, in our 60s. We have a couple parents in their 70s. Right. Because it's the long journey and we don't know how it's going to play out. And, you know, we have to look towards the future and set certain that we have guardianship of our youngest. He's got, you know, lots of services and supports that he'll have lifelong. For a person with a developmental disability, we had to put all those things in place. But you're grieving, but it's understanding that you're not on this journey alone. It can feel very isolating. You know, a lot of our parents are like, I thought I was the only one. Because you'll. And you know, you probably get this a lot too. Like you could tell a story and you exp. In the average family, their jaw would drop, right? And in our group, everybody's like, yeah, that's a typical, typical day in our house. You know, it's, it's just unless you're parenting a kiddo with an fasd, you don't really get it, right? Because this is hard and it's the long haul and it's understanding that, trusting the Lord to walk with us through it. We don't know we can't control the outcome. And it does get harder and a lot of parents have a hard time swallowing that, but it gets harder until we can kind of get them in their 30s and they can stabilize a little bit. But you have to have, when we hear this a lot in this space. You have to have your community, your tribe, right? Of people who are on the same journey that you can link arms with and encourage each other and pray for each other and with each other. Because we all have really hard days and then we'll have some good days. We want to celebrate the wins together because we do have wins. You know, my one, my youngest son has a job, a part time job as a dishwasher and he has now successfully completed two years of that job. And he works nights, it's like four or five hours. He has support and accommodations. Three times over the past two years I have gone in and washed dishes with him because of different things that have happened. He was really struggling and we didn't want him to get into this pattern of if I'm having a hard time, I could just. We want him to, you know, so we. I've gone in three times and supported and so it's just knowing. But he's kept this job for, for two years and which is really with somebody with fasd, that's like a miracle because they have a hard time getting a job and they have a hard time keeping a job. And so we support and so we celebrate the win. He's had the job for two years and we celebrate the fact that he's got a boss that understands that he has a disability. It's a battle every day because he doesn't ever want to go to work. Right. Every day it starts in and he needs lots of extra sleep because he's working nights. So it's just our life is really shaped by his schedule, really. But I've come to that place where I'm just like, the Lord has called us to this, and I give my grief to him and try to focus on gratitude and know that he's walking with us through it and that's in. No matter what the diagnosis is, that's really what we have to do, is keep our eyes on the Lord and stay the course. It's a long one, but we don't go it alone. [00:52:07] Speaker B: Absolutely. I've got two more questions for you. One is, I hear so much opportunity for shame and embarrassment in this journey, and I wonder what your advice is for abolishing that or for untangling it, for removing it, for dissolving it. [00:52:29] Speaker A: Yeah, I talk to people. I mean, you want to protect our kids stories, right? So we're not telling everything about everything, you know, But I find that with my. My two boys, you know, it doesn't take long to talk to them to realize something's up. Right. A lot of people might just assume they have, you know, that they're autistic because a lot of the symptoms overlap with that, you know, so I'm fine with that if they don't really know them, but just I have. I have found people, by and large, we haven't dealt a whole lot with. With that, with. With shame other than they struggle and they know they're different. They knew, you know, my. My son, who's 23, As I was really learning about this, and we were talking about the brain and how everybody's to going. His brain works differently. He is adamant. He doesn't want to have a disability. He doesn't want to be labeled that, you know, but yet he understands he needs certain accommodations and he's found acceptance in. He's. Like I said, he's a volunteer firefighter. So he's got firefighter and police officer friends. So he's. And he's got this. He's this small guy and with a huge personality. So he's been embraced really by his community. He did well in high school and special education. He did pretty well there. And then our younger son, who's even more impacted, it presents more as an intellectual disability. We found people in General to be accepting. Although he's frustrated because he wants to live independently and he wants to drive and he wants to, you know, do these things. And then, you know, it's just a [00:54:17] Speaker B: lot of times layers of grief, it sounds like. Yeah. [00:54:21] Speaker A: And our kids will. And that really begins to happen as they're in their teen years and into their 20s. It is them coming to terms with that. You know, we try to look at it as like, it's not a no, never. Like, I'm not going to tell him you'll never be able to drive a car because he can drive the lawnmower, he can drive a four wheeler, he can drive a dirt bike, you know, but on the road where there's other cars and passengers. And he also has a lot of anxiety. So it's like he stresses out when I'm driving and I don't think it's my driving, but just, just all of the things going on. Right. But it's, it's a, it's a. It's never a no, you will never. It's more like, not yet. Not yet. We'll see. You know, and if you want to do that, then there are. I mean, the other day he was really pretty adamant. He wanted to join the FBI. Right. So there's, there's some of that, like, not realistic expectation, you know, how this, how this can present. So we looked it up and we were researching it and I'm like, well, you have to be able to run. I don't know what it was like 1.5 miles or whatever. And I'm like, so you could start now and practice that. Like, that's one thing you can. He was like, no, I don't want to. [00:55:28] Speaker B: I don't want to run deal breaker. [00:55:31] Speaker A: So I'm like, well, until you can do that, you know, you also need to have a driver's license. So, you know, we did get you the book where we could study together. The book of, you know, so it's like, you know, trying to not be like, oh, you'll never be able to do that. To where it's like, well, let's. What do you have to be able to do in order to do that? Let's try to work and learn. Learn those first step. [00:55:51] Speaker B: Yeah. [00:55:52] Speaker A: You know, so it's. But it is very. It can be very frustrating, disappointing. And they do have their own grief. And I guess shame hasn't really been. I haven't let it be something that, you know, labels our kids or our family or our parenting. I mean, I did you know, I remember a time when, before I knew and understood trauma, by the time we had adopted our kids internationally and I was, you know, finally getting the training and the TBRi, recognizing that the first child who came into our home, our daughter, who came through a kinship placement way back in 1999, and we didn't know anything about anything. When I began to realize that, oh, my gosh, she had experienced trauma, and we never really understood that or knew what that was. I just, you know, but again, you don't know what you don't know until you know it, and then you're responsible to apply it and learn it and. And grow from there. So I feel like, you know, we don't ever want to, like, shame is from. Is not from the Lord, right? It's from the enemy. So we want to focus on the positive. And. And he calls us to this. He will equip us for it. He created our kids. He does have a plan and purpose for them. Mine for gold. I always tell parents, mine for gold. What are their strengths? What can they do? Well, what is their natural talent? Let's build on that, because they can thrive. You know, my. My. My one son, you know, he was the Lego. Like, he loved to play Legos, and then he loved to build things out of wood, and then he learned welding in school, and now he's. He works on small engine repair. That was always an area of strength for him. He can build things and fix things. So that's part of his job that he does. So build on those strengths and celebrate those and look ahead that way. [00:57:44] Speaker B: I'm thinking of our listeners. So many people come and listen to this podcast from different backgrounds, right? And so we may have people who are caring for kinship placements and are still close with biological parents in fostering situations or adoptive situations. We may have biological families who are learning connected parenting strategies. And for those of you who are listening and kind of connecting dots, and maybe this is coming back to your own behavior when your child was in utero or your own or actions of people you love. I think I just want to dispel shame in terms of. It's reminding me a lot of. My husband used to work in lung cancer, and there was this stigma around lung cancer that not everyone who smokes gets lung cancer, but then there is this population of people who are diagnosed with lung cancer that have smoked, and it was this almost this thing present where they didn't. Sometimes they didn't believe they had the right to treatment because they had caused the problem in their minds. And I'm connecting that with this in terms of there's just no room for shame in what is moving forward. Right. That there is gold to be mined. That there is a set of circumstances that we can grieve and we can regret our actions and we can know what we know now. But to move forward means embracing the person in front of us and the accommodations that they need, the accommodations we need. And to be able to move forward with our current reality, with all those layers of grief and celebration that get mixed together. Yeah. [00:59:44] Speaker A: And so often, even in this day and age, it's not understood that a woman should not drink any alcohol during pregnancy. And one of my daughters just had a baby in January, and when she first found out she was pregnant, she, like, called me and she was like, I can't have sushi, which is like one of her favorite foods. And I'm like, you'll live for the next nine months not having sushi. But I was like, did they tell you not to drink alcohol? Now she knows me and knows not to. But she was like, no, they didn't tell me that. But I can't have sushi. Like, she was hung up on the sushi, and I'm like, all right. [01:00:17] Speaker B: So told her that, that she couldn't have sushi. [01:00:20] Speaker A: Couldn't have sushi. You can't have, like, lunch meat, things like that. And I went to a doctor's appointment with her when she went in for her ultrasound. I got to go, and I'm sitting in the doctor's office and I'm looking around and there's pamphlets and posters on all kinds of things. There was not a single pamphlet or poster about not drinking alcohol during pregnancy. So it's, it's, it's. Again, it's not even just this, this space of people who have alcohol use disorders or substance use issues. It's the general population. The education is really not out there. And I've got other adult kids who. And I've got 11 grandkids. So I've, you know, I've got a lot of, A lot of. A lot of babies happening in our family. But, you know, if they don't, you know, I've had some of my daughters in law say, you know, well, my one friend who's also pregnant, her doctor said it's okay to have a glass of wine at night sometimes if you're feeling stressed because all that stress isn't good for the baby. And I'm like, you know, my head's wanting to explode because there's Such mixed messaging there is. [01:01:21] Speaker B: Yes. [01:01:22] Speaker A: So no mom wants to harm her baby, would not intentionally do that during pregnancy. Most of the time they either did not know that they were pregnant because you could be several weeks pregnant. Unless you are planning that pregnancy and watching that calendar, you might not know. And that's oftentimes how. How it goes. Or, you know, then we do have parents in this space that, you know, do have substance use issues. And sometimes our kids, we might know that, you know, the birth parent, the birth mom was using drugs. But we, there's no question, nobody asked about alcohol. And typically they go hand in hand. Right. Because alcohol is legal, it's easily accessible, it goes hand in hand with the other substances and causes more harm. So never, ever want to shame a birth mom. Never, you know, want to put that shame. And sometimes our, you know, shaming, we don't want to shame our kids because sometimes our, you know, the way if we're saying, and I remember being like this way back before I even understood the impacts of trauma. Like, I remember saying things like, like, why would you do that? Why would you think that was a good idea? You know, you're old enough to know better. Right? Those, those are very shaming statements. We're doing that without realizing that we're shaming them. But when it's. When it's a child who has a brain difference, it is a shaming statement. So we want to even make sure that we're not contributing to that shame inadvertently by saying those things. We really have to look at the child and understand, like, okay, their brain works differently. What's going on and how does this kiddo need support? And, you know, we don't want to, you know, beat up ourselves because a lot of us came to this not knowing until we did know. And we certainly don't want to shame birth parents or our kids for the way their brain works. [01:03:14] Speaker B: Yeah. You talked about the long journey that you're on and how maybe you have a different end goal now. And so I wonder, what is your end goal? Would you inspire us as we finish out today? Yeah. [01:03:32] Speaker A: Ultimately, you know, I think we all want kids who love the Lord and walk with him. And then beyond that, it's really life skills trying to get our, you know, our two boys, like I said, one does work. He's living, you know, somewhat independently, has to be reminded to eat, has to be reminded to wash his clothes, so he needs some support in areas. And then, you know, our. Our younger son who still lives with us. And like, that is a Long term, you know, anything could happen, right? There's, there are. You have to educate yourself about different, you know, supports that are out there. Sometimes there are supported living situations. There's lots of different things. You have to figure out what's best for your kiddo and for your family. And, you know, right now we're, you know, we're, we love our son. He's really fun and we do lots of great things together. He's a pleasure to be around. It's still hard. There's lots of hard things. But right now we're focusing on daily living skills. You know, being able to cook, being able to clean something up, being able to remember to shower, to put on clean clothes in the morning. And you know, our son is, is pretty impacted, right, with fetal alcohol syndrome. And again, it's a spectrum. So you may have a kiddo who's not going to need as much support. Right. Neither one of our boys were bound for college. So it's really just daily living skills, employment, having a support person to be able to watch over them, to make sure that they're safe, nobody's taking advantage of them. It's a lot to look to, to be able to look that far ahead and realize that you have to set up these things. Some families opt for, you know, we have guardianship, some families opt for power of attorney for certain things. You have to, the older your kids get, these are the things that you have to look at. But connection, right, is key because building that connection puts us in a position where they will rely on us because they don't like to be told what to do. Especially the older they get. They want to be able to do what they want to do. But we want to be able to have that connection because a lot of them might not be able to do those things without help or support. And you want to be able to be there because they're going to need that long term relationship with you so that you can speak into their life. So that's one of the areas that, you know, building connection all the time with our kids, no matter that doesn't stop when they turn 18 or 21. That's, that's part of the long haul. Part of the long game is building that connection because they are going to need you there are, they are going to need support, you know, moving forward. And you want to be able to speak into their life and give them some guidance. You can't control the outcomes, but to be able to be in that position where they do trust you and they do know that they can come to you no matter what is going on. That is so important for their future [01:06:31] Speaker B: too, that I hear that connection that you have with each other and then I'm also hearing the belonging that you have found and built around your kids and yourself in that support system and community that they can belong to and belong with, which is just a beautiful picture. Thank you so much for coming to, to educate me today, Sandra. I've learned so much. I hope our listeners have too. And yeah, I'm, I'm a better, I'm, I'm a better person today knowing what I have learned from you. So I appreciate it. [01:07:11] Speaker A: Yeah. Well, Jesse, thank you for the opportunity to come on and to share with your audience. I do want to mention our support group in case anybody is interested, if you find that you are, whether you know or not, for sure, if you're parenting a kiddo with fasd, we do have an online support group for parents and caregivers. It is faith based. We pray for one another, we encourage one another, we learn from one another. We've got parents in the group that have kids from 4 years old to 25 years old, so lots of experience on this journey if you're interested in that. I also offer online training on this topic of fasd so you can go to our website to learn about that. My podcast, the Adoption and Foster Care Journey, we talk about all of the things, but we talk about FASD a lot, so that's a great place to tune into. And can I tell them about a free gift I have? [01:08:05] Speaker B: Please do it. We love free stuff. [01:08:08] Speaker A: Yeah. So my, my most recent book is a devotional for foster and adoptive moms. It's called Soul Care Saturday 52 devotions for foster and adoptive moms. In each one week, I offer a breath prayer which is based on scripture. So if you go to my website, you can actually download a one page of 12 breath prayers to steady your heart. So it's just an easy printout. You just put in your email address and we'll email you that. And my website for the Freebie is Sandra Flack.com but all of my, all of our resources around FASD, the, the support group, the podcast, the training that is at our nonprofit website, which is justicefororphansny.org and I'll send you those links that you can share with listeners. [01:08:56] Speaker B: Fabulous. We'll put them in the show notes so you can go down and look at those if you're wanting to, to find those resources. Thanks so much for being with us. Today. [01:09:05] Speaker A: Thanks Jesse. I appreciate. [01:09:11] Speaker B: We hope you enjoyed the episode. If you're interested in learning more, head to empoweredtoconnect.org for our library of resources. Thank you to Kyle Wright, who edits and engineers all of our audio, and Tad Jewett, the creator of our music. On behalf of everyone at Etc, thanks for listening and we'll see you next time on the Empowered to Connect podcast. In the meantime, let's hold on to hope together. [01:09:36] Speaker A: Sam.