Tuesday, November 29, 2022

6-9 Month Educational Goals

My baby is 6 months old, which means we've come to another checkpoint for her curriculum goals.

So, how is she doing on the goals I set for her three months ago? And what goals are we going to be working on next?

Life Skills

Eating

3-6 Month Goals

The current eating goals for 3-6 months were:

  • Getting a decent latch and sucking persistently until no longer hungry
  • Regulates quantity of foods consumed

The breastfeeding issue has been a serious struggle. She saw the lactation consultant and was diagnosed with a lip and tongue tie, and I was having some success with a nipple shield. I was full of hope.

Then I got her lip and tongue tie fixed, and the post-procedure exercises (which are painful) led to oral aversion. The lactation consultant gave me some advice on reducing the oral aversion, which worked, but also recommended a procedure that I think backfired badly. She called it the "24 hour cure", I called it a "maternity ward redo". Basically, I spent all day in bed with my baby and every time she showed hunger cues, I tried to breastfeed. She hated it, I was miserable, and it ended up with me feeling very depressed and her screaming anytime I even bring my nipple close to her mouth.

Since then, I basically gave it up for a while. I did get some breast-shaped bottles (Nanobebe) to mimic breastfeeding to reduce her aversion, with some success, but I've been too scared to try actual breastfeeding for quite awhile.

There have been some benefits to the tongue and lip tie release, even though it didn't do what I'd hoped. Last time, I commented that sometimes she'd drink too fast and have trouble with gas, spitting up or choking. Turns out it wasn't so much how fast she drank as how she drank that resulted in those issues, because she has been having much less issues since her procedure. She's also dripping less milk from the side of her mouth.

I also got a new type of bottle by LacTek called a direct pump to baby bottle. It's designed to allow you to pump into the bottle while simultaneously the baby is drinking from it. Basically, it's a double-ended bottle, with one end attaching to the pump and the other to a tube leading to a nipple for the baby to suck on.

I mention this because it's also become a new context for communicating hunger vs fullness. One of the most frustrating things about the direct to baby bottle is that she tends to lose the nipple and can't put it back in her mouth independently (though she tries!).

But this varies depending on her hunger. When she's desperately hungry, she keeps it in easily, by just sucking it consistently. When she's hungry but not totally desperate, she'll suck it a bit, stop and it falls, and then start fussing and trying to get it back. When she's only slightly hungry, she'll be less frantic trying to get it back or maybe not try at all, just wait for my help. And when she's full, she closes her mouth and doesn't accept the nipple back.

In addition, just recently, I finally had some success using an at-breast supplemental nursing system. Basically, this is a tube you attach to your breast that's connected to a bottle you can fill with formula or pumped breastmilk. I've most often heard of this used to compensate for low milk supply, which is not an issue for me. However, bottle-fed babies are used to a faster flow of milk, and my baby has been getting frustrated too quickly to actually trigger my letdown.

Watching her with the direct to baby bottle was part of my inspiration for this. I noticed how after her first few successful feeds with that system, she was a lot more willing to keep sucking on the nipple while waiting for me to get pumping. It's raised the hope that a few good feeds at the breast could encourage the same persistence with breastfeeding.

It's too early to tell if that's going to work, but I have managed to get one good breastfeed with the supplemental nursing system. She nursed longer than I've ever seen her nurse before, and I could feel her getting milk out of me.

6-9 Month Goals

Here's the goals we're starting on now in this area:

  • Feeds self with fingers
  • Drinks from cup held to lips
  • Reaches for and picks up cup
  • Returns cup to table
  • Drinks from a straw
  • Can be spoon fed and swallow the food without gagging
  • Feeds self with spoon

Several of these items have to do with solid foods. Her first experience with solid food was a bit of a false start for Thanksgiving (which is Oct 10 in Canada). I tried giving her mashed potatoes, but she looked very confused and then spat them out. So I decided to wait a while, and then on November 6th, I gave her a taste of peanut butter. Since then we've tried a few things, some she's liked and some she hasn't.

I have to admit that my approach has been less systematic than I'd planned. I always pictured myself preparing a bunch of one thing, feeding it for several days in a row, and then trying the next food. However, instead, I've found myself just offering her tastes of food I see her showing interest in. I don't know if I should feel guilty about this, but I do.

I have finally gotten a bit more systematic by making a batch of applesauce with breastmilk for her and feeding it to her 1-2 times a day for a few days. She seems to have mixed feelings about it, partly because I unintentionally picked a fairly sour strain of apple, but she has enjoyed it several times. I've also since tried some other recipes as well.

My feeding method has been a mix of giving her stuff on my finger, spoon feeding her, letting her try to spoon feed herself (at her insistence!) and just letting her play with purees and make a mess. I try not to pressure her, just encourage her to experiment with this new way of eating.

I haven't really tried much stuff with cups yet. I have a couple sippy cups, but she's hated every attempt to use them so far. I don't think she's ready for that yet, but we'll work on it.

Hygiene

There are no new goals in this area. I had two hygiene goals, both pertaining to nose-wiping:

  • Allows nose to be wiped
  • Wipes own nose on own hands or random objects

Not much progress has occurred on these goals. She's been wiping her own nose occasionally, but not consistently, and she still regularly has a stuffed nose she can't clear independently. And as for allowing me to wipe, she's actually regressed there. She's gotten more adamant about resisting it and her improved mobility is making her resistance more effective.

Neither of these skills are really late, of course. I've recently started plugging in max ages as well as base ages for skills, with the max age being the point at which I'll worry about her falling behind, and the max ages I've set for these two skills are 3 years for self-wiping and 4 years for letting me wipe her nose.

Toileting

Here's my current goals for toileting, with no new ones yet.

  • Urinates in toilet
  • Voids bowels in toilet

Previously I'd said that peeing in the toilet was mastered. Well, she's had a bit of a regression here, too. I've been focusing more on trying to get her to nurse and kind of let EC slide on the backburner, and now I'm having more trouble catching her pees. On the good side, she's pooped in the potty again a few times recently, after quite a while with no poops in the potty.

I'm tossing around a few ideas for how to progress here, but I haven't settled on any yet. One of my thoughts involves getting a toilet training attachment for my toilet, since she's getting better at sitting upright and might be ready for a more adultlike toileting position. I've also considered getting a potty, but the idea of the cleanup involved grosses me out, so I'm hesitant to do that.

I'm also considering trying some more diaper-free time, either naked or with clothing that gets wet more obviously, but the logistics of that is complicated by the fact that she's getting more mobile. In addition, I've had some bad experiences with diaper free time where I didn't notice her peeing, so I am trying to figure out a way to make it more noticeable.

Toileting is not my biggest priority right now, but I feel really proud when it's going well, and I know I can get results if I try harder, so it might be worthwhile as an ego boost for me when I'm feeling down. I know it's silly to compare, but I like the thought that I'm able to get my baby to do something that many kids years older than her struggle with.

Dressing

So far there's no age-appropriate goals in this area, but she's been showing progress on advanced skills in this area:

  • Pushes limb into clothes.
  • Removes socks.

She's especially motivated to remove her socks. She has cute little socks with stuffed animals decorating the toes, and has figured out that pulling on the stuffed animals can help her take the socks off. (She's also pulled one of those toys off of the sock!) She doesn't seem to like wearing socks, but I don't want to take her out in a Saskatchewan winter with nothing on her feet, so if her outfit doesn't come with feet she gets socks whether she likes it or not.

On rare occasions she's pushed her arm through the sleeve as I'm getting her dressed, and the same for pushing her leg in her pants.

Motor Development

Equilibrium

3-6 Month Goals

Here's the 3-6 month equilibrium goals:

  • Begins to roll over, turning from front to back. (MD.E.7)
  • Begins to roll both ways. (MD.E.8)
  • Pushes up on extended arms. (MD.E.9)
  • Scoots along floor using arms and legs to propel body forwards. (MD.E.10)
  • Attempts to kick a ball without standing. (MD.E.33-1)

As I was writing this post over the course of about a week, she's made a drastic leap forward in this area. When I started writing this, she was rolling back to front consistently - obsessively, in fact - but couldn't consistently roll front to back, resulting in much frustration and disrupted sleep. That's not true any more. She is now readily rolling both ways. In addition, she's starting to crawl. She's still slow, but there's definite forward momentum.

She's pushing up on her arms occasionally, but still not doing it consistently. She has been kicking a ball from a seated position occasionally, but is more interested in hitting objects lately. That's not a really important goal, though, I added it mostly because I was impressed that she started doing it. In general, these two goals haven't shown much progress, especially compared to the drastic changes in other motor skills.

6-9 Month Goals

And now for the new goals. One of which has already been mastered:

  • Grasps feet. (MD.E.22)

She's been grasping her feet for a long time. I marked this as mastered on October 8, and she'd been doing it for awhile by then.

She first started doing this while being toileted. The elimination communication hold puts her feet in very easy reach, while toileting is also somewhat boring. However, it wasn't long before she started grabbing her feet while sitting in her car seat or with support on the ground, and grabbing them as she lay on her back or side.

And for the ones that still need work:

  • Sits, supporting self with hands. (MD.E.12)
  • Sits without support for short periods. (MD.E.13)
  • Gets to sitting position without assistance. (MD.E.14)
  • Gets onto hands and knees. (MD.E.15)
  • Gets from sitting to crawling position without assistance. (MD.E.16)
  • Stands with support./Supports whole weight on legs. (MD.E.19/21)
  • Pulls body into upright position. (MD.E.20)
  • Climbing on or off of things.

The climbing goal I added myself because she's learned how to climb out of her car seat. I've gotten into the habit of putting her in it for naps away from home, or just to be able to do things I can't do while holding a baby. But I'll have to learn new habits, because now whenever she's awake in her car seat and isn't strapped in or being distracted by milk, she's climbing out. First, she rolls over to her tummy and then slides her legs off. Then she bounces up and down on her legs a bit until she tips the seat way forward, and then she pivots around to climb off. I'm not counting this as mastered yet, though, because this is the only thing she has such success climbing off of, and she can't climb back on.

She's sitting a lot better lately. I'm waiting for some more reliable balance to mark the sitting goals as mastered, but it's not far off, I'm sure. Currently I still need to be ready to catch her, but she's able to sit quite a while without my help. She's also getting a lot better at maintaining balance seated while she's simultaneously playing with her hands.

She's not great at transitioning in and out of sitting, though. She's shown no ability to get herself sitting upright from lying down, and going from sitting to crawling position is still mostly just falling and then making the best of it.

She's been able to stand with an adult's help for a long time, as well as pulling to a stand while holding our hands. She still can't pull to a stand on furniture, though she is trying. She can often stand quite a while supported by furniture, but her balance is poor and I keep having to catch her. The cats are great motivation - she loves to stand and look at them sleeping on the couch or the rocking chair, and then reach out to touch and grab their soft fur. I've also been working on supporting her lower - she can stand pretty much indefinitely with upper body support, but can also stand with effort with just hip or thigh support.

Her current crawling technique involves face planting as she lifts her butt and then pushing forward, and she can't really do the hands and knees thing yet.

Mainly what I’ve been doing to encourage her development here is just playing on the floor with her regularly. She’s very motivated to chase this one particular large, knobbly yellow ball she has, and will readily crawl towards it if I put it a few feet ahead of her.

Advanced Goals

  • Walks with assistance. (MD.E.23)

Recently she's figured out that when I'm holding her standing, she can step towards things she wants. Sometimes I'll help her walk all the way across the room, following her lead to something that caught her attention. She gets tired sometimes, but she's getting stronger.

Hand Control

3-6 Month Goals

Here's the 3-6 month goals for hand control:

  • Begins to observe own hands (MD.HC.4)
  • Purposeful grasping and shaking of objects. (MD.HC.6)
  • Uses whole hand, raking grasp. (MD.HC.7)
  • Co-ordinates use of both hands working together. (MD.HC.18)
  • Brings hands together.
  • Reaching a hand across the center of their torso during intentional manual activities.
  • Frees up hands enough to touch or grasp an object while lying on their stomach.

I've never seen her show much interest in observing her own hands, but I feel like we're getting past the stage where that particular milestone is relevant, and it's not really essential. She's definitely been working on hand-eye coordination while manipulating objects, anyway. She's also regularly bringing her hands together - often to hold an object in both hands - and she's very good at using her hands during tummy time now.

She's definitely mastered purposeful grasping of objects, but isn't really shaking things consistently. She's starting to bang objects, which I'll discuss later, and has been banging her maraca instead when trying to imitate me shaking it. So that half of this goal is still ongoing. She's also still working on crossing the midline.

I actually deleted the raking grasp milestone, because I couldn't figure out how to distinguish it from just general grasping. If too many of the examples for multiple milestones are the same, I feel like it's a sign that they're not distinct enough.

6-9 Month Goals

Here are the new goals for 6-9 months:

  • Transfers objects from hand to hand. (MD.HC.10)
  • Purposefully grasps and releases objects. (MD.HC.11)
  • Controls fingers. (MD.HC.12)
  • Intentionally works with hands to manipulate objects. (MD.HC.8)
  • Holds books the correct way up and turns pages. [cloth or board books] (2S6-1)

These are all ones that she's showing definite progress on. She's definitely been purposefully grasping for a long time now, but I'm not sure how purposeful her letting go of things is yet. She transfers hand to hand sometimes.

She still has trouble controlling her fingers, but she's making a lot of progress there. Just recently, she's gone through a leap in her ability to provide inputs to a touch screen*, and instead of just random touches, she's now specifically reaching for interactive elements on the screen to touch. She's also been working on the difference between grabbing and stroking with cats' fur and uncle's beard, and learning that living creatures like being stroked better than having their pelt grabbed and pulled on.

Incidentally, the turning pages one is another goal I've split in two, with the version involving paper pages being a kindergarten goal from the Monseigneur Bekkersschool curriculum, which I used to find reading goals for Dutch. I split this goal when I was blown away watching her trying to turn the pages on her crinkly carrot book, and realized that the closest goal in my database was for 3-5 year olds.

I'll also throw in a goal from the Standards Based Life Skills curriculum here:

  • Uses technology for entertainment

She's definitely been working on learning how to play with technology. In addition to the tablet skills she's starting to show, she's also learned that hitting the spacebar and number pad on the keyboard causes interesting reactions from YouTube videos. I even got her to play a minigame from one of my first childhood video games - Jam Dance from 102 Dalmatians, which is a music game where hitting buttons changes the music a puppy is dancing to.

Advanced Skills

And speaking of which, here's one advanced skills for this area that she's making progress on:

  • Pokes with index finger. (MD.HC.15)

This one I credit to my lack of techphobia. She's just starting to make a few attempts at one-finger touches on touch screens. She still finds it hard to isolate her finger, but she's working on it.

Communication

Hearing & Understanding

3-6 Month Goals

Here's the goals in this area for 3-6 months:

  • Responds to loud sounds in environment (L.H&U.1)
  • Recognizes voice of parent or primary care-giver (L.H&U.3)
  • Moves eyes towards direction of a sound (L.H&U.4)
  • Notices objects that make a sound (L.H&U.6)
  • Turns head towards direction of a sound (L.H&U.10)
  • Reacts to different sounds (VA.A.1)
  • Responds to changes in tone of voice. (L.H&U.5)
  • Responds with enjoyment to simple word and movement games and finger-plays. (L.H&U.9)

Last time, I expressed some concerns about her responsiveness to sound. Not anymore. She's mastered almost all of these items already, except for tone of voice.

I do think she probably understands different tones of voice, but I'm not sure, so I'm not marking it as mastered yet.

And for more visual forms of communication:

  • Distinguishes facial expressions (VCSL 8)
  • Joint reference (ex: parent and child look at same object) (VCSL 9)
  • Participates in communicative play (ex: peek-a-boo) (VCSL 10)
  • Responds to an adult "pointing" at something. (L.H&U.15)

Like with tone of voice, I suspect she understands facial expressions but I'm not entirely sure. She's just starting to notice pointing, and still seems confused by it.

She loves communicative play and I'm considering this one as mastered.

6-9 Month Goals

Here's the new goals for this period:

  • Responds to music by bopping up and down and/or turning in circles, swaying side to side, etc. (L.H&U.16)
  • Recognizes common household words. (L.H&U.12)
  • Recognize that signs produce meaning. (C.FS.K.1c)
  • Responds to "no" by briefly stopping activity and looking at adult. (L.H&U.14)

I was going to track another goal, related to following eye gaze, but then it occurred to me that I can't follow eye gaze well enough to know if she's following my eye gaze. So I'm not going to worry about tracking that one.

She’s very interested in music, but she’s not consistently trying to move in time with it yet. She’s done it a few times, though.

She’s shown signs of understanding English words here and there, like getting mad when I mention to grandma that I should probably clean her nose. So far she hasn’t shown clear signs of understanding any of the other spoken languages she’s being exposed to, but I suspect she understands a few signs. She hasn't shown any sign of understanding no.

Expressive Language

3-6 Month Goals

Here’s the 3-6 month expressive language goals she was working on:

  • Babbling begins to resemble more mature speech and contains some consonants (p, b, m). (L.S.5)
  • Vocalizes other emotions such as excitement and displeasure. (L.S.7)
  • Responds to spoken "bye-bye" by waving. (L.S.9)
  • Nonverbally uses appropriate social rules such as greetings, farewells, thank you, getting attention (SCS-PC 17-1)
  • Hand babbling emerges (ex: opens and closing hands, wiggles fingers, wrist twist) (VCSL 2)
  • Waves "bye-bye" (VCSL 3)
  • Copies physical movements involving the arms, hands, head, and face (VCSL 4)

She’s mastered L.S.7. She makes this really distinct and wonderful happy coo noise when she’s excited, especially when she’s interacting with the cats or when grandpa is playing with her. She also laughs at the dog, at uncle bouncing her ball, and other things she finds entertaining.

She has been consistently making ‘m’ sounds, but only occasionally makes ‘b’ sounds and I haven’t heard any ‘p’ sounds yet.

She hasn’t tried to wave goodbye yet, either in response to the words or spontaneously. She also doesn’t really show any signs of trying to greet people or thank people yet. She is starting to show more deliberate attempts to get people’s attention nonverbally, but that’s not consistent yet, either.

She was hand-babbling a bit around 3-4 months, but hasn’t been doing it as much lately.

She’s been imitating more and more actions lately. I’m not marking this as mastered yet because she’s not doing it consistently yet, but we’re definitely seeing progress in this area.

6-9 Month Goals

Here's the new goals for this age:

  • Babbles "dada" and "mama". (L.S.10)
  • Babbling includes a range of sounds and gaps which resemble phrases. (L.S.11)
  • Uses sounds [other than crying] to attract and hold attention of others - communication. (L.S.12)
  • Imitates a large variety of speech sounds. (L.S.14)
  • Laughs when seeing fingers approaching to tickle. (VCSL 16)
  • Choose from an array of preferred and non-preferred items? (CM4)
  • Nonverbally compares and contrasts qualities of two objects, actions or situations. (SCS-PC 42)
  • Criticizes others nonverbally. (SCS-PC 27)

She's been babbling "mama" for quite awhile, but not "dada". I don't think it's just because she doesn't have a father - she doesn't seem to know how to make the d sound yet. She's not yet getting sentence-like cadence in her babbling, either.

As I'll mention later, she's actually starting to say a few words, and she seems to be using them meaningfully to get attention.

She's shown some attempts at imitating speech sounds, but she's not consistently doing that yet. She's also starting to recognize signs that she's about to be tickled and get excited, but this is still emerging.

I've tried to get her to choose options a few times, but I don't think she understands that concept yet. She's shown no sign of trying to compare things yet either. Both of these ones I'm just guessing at appropriate ages for, so it's possible they're too advanced.

Around 3-4 months old she developed a reproachful look that she uses to show disapproval. She has used it to let me know that I should hold her bottle properly instead of trying to hold it with my chin so I can free up my hand, for example. So she's definitely starting to criticize things nonverbally!

Advanced Skills

And here's advanced goals in this area that she's making progress on:

  • Has some recognizable words. (L.S.18)
  • Says "mama" for specific person. (L.S.15)
  • Uses gestures to communicate (VCSL 28)
  • First ASL signs using simple handshapes (ex: c, a, s, 1, 5) (VCSL 30)
  • Uses appropriate social rules such as greetings, farewells, thank you, getting attention using 1-3 words (SCS-PC 17)

So, as I mentioned above, my baby has started using spoken words meaningfully. She's been consistently using "mum-mum" and "hi". She uses both words to request attention, and "mum-mum" especially when she needs help or is distressed. (She's starting to show a preference for me over her grandparents and uncle when she needs comforting.)

She's got a stander toy that I put her in sometimes when she's full of energy and I'm not. She likes it for a while, but when she gets tired, she wants out. I've been doing a routine where before I take her out, I hold my hands out and say "do you want out?" or "do you want to be picked up?" and wait for her to put her hand in mine. She's since generalized this to other situations where she wants to be picked up as well.

I've previously discussed her using signs really early. She hasn't made much progress there, but she did recently imitate Ms Rachel signing "more". I've been trying to sign more often to her lately, so hopefully she makes more progress in signing as well.

Science and Sensory

I've decided to combine these for now since they both fall under the heading of exploring her physical environment.

Sensory Development

3-6 Month Goals

Here's the sensory goals from 3-6 months:

  • Recognizes familiar objects and people (VA.V.3)
  • Looks at the visual environment with alertness (VCSL 14)
  • Chew on or mouth objects with a variety of shapes and textures.
  • Explores textures. (GOT.T.2)
  • Makes sounds with objects and reacts to the sounds produced. (VA.A.3)

All of those have been mastered. She's very visually attentive and clearly recognizes her family, favorite toys, milk bottles, and other things. Pretty much everything she can grab goes straight into her mouth. She's fascinated by textures and loves to stroke things. And she loves to play with toys that make noise and definitely understands that she can make noises with them.

6-9 Month Goals

Here's the new goals in this area:

  • Eats food with varying textures. (GOT.G.1)
  • Begins to show preferences in the tastes of food. (GOT.G.2)

Obviously, both of these relate to starting solid foods. She's been doing pretty good with purees, but struggles when I don't make her food smooth enough, so the texture thing is still a work in progress. She's definitely starting to show taste preferences - sour apples aren't very nice whereas egg puree (dehydrated egg crystals mixed with breastmilk) and grandma's stew taste amazing to her.

Science

3-6 Month Goals

Here's the goals from 3-6 months in science:

  • Finds a partially hidden object. (OPE.OP.1)
  • Purposefully attempts to reach objects that are out of reach. (OPE.OP.2)

She's mastered OPE.OP.2, since she's starting to crawl and assisted walk towards things she wants to explore. She's starting to figure out partially hidden objects as well.

6-9 Month Goals

  • Here's the new goals for this age range:
  • Purposefully explores objects through shaking, banging, throwing, dropping, etc.
  • Reacts to anticipated future events.

She's been shaking and banging things a lot, but not throwing or dropping much yet. She's also starting to recognize and predict routines sometimes, such as dance routines we do to Super Simple Songs.

Learning Plans

I found Imagination Learning's Infant Year Long Lesson Plan online while looking for ideas for inspiration for learning activities. They just have the name of the activity and the objective for it - I'm guessing that the description of how to do the activity is elsewhere, not available online. But that much information is enough to give me fun ideas, and if I'm really stumped or don't have the necessary equipment for something I can just skip it. I've got an app that lets you track school assignments and check off ones you've completed, and it's been really helpful for giving me a sense of completion and helping me get ideas for fun things to do to help my baby learn.

And then I decided to expand it. Since before my baby was even born, I've been trying to practice the ASL translations of the monthly words from PrAACtical AAC's Year of Core Vocabulary, but I haven't really been very consistent. This time, I decided to try using the calenders by [insert name] for inspiration for interactive ASL activities with my baby each month. So, I added some ASL Year of Core activities to the mix.

And then I found Nattalingo Productions' daily French challenge and decided to try that, too. And then I thought about getting more Japanese practice, so I set some goals to pick a sentence structure and practice it with different words to model Japanese to my baby - for example, saying (noun)をください (o kudasai = o marks the object of the sentence and kudasai means please) with various Japanese nouns.

I may have gotten a bit excessive, to be honest. I'm going to refrain from adding any more activities for a bit and just try what I've already got. And be ready to ditch some activities if I'm getting overwhelmed.

But I think this is good practice for the more systematic learning activities I'll be doing once she's older, like teaching her to read.


* I don't believe that "screen time" in general is bad for children under 2, especially not now that I've seen how my baby learns from it. I think leaving your kid with non-interactive media as a "babysitter" too often is bad for them, but playing interactively with media is just as beneficial as playing interactively with anything else. And touch screens in particular have been linked to better fine motor development, for reasons I think my baby is currently demonstrating. Currently, she has very little interaction with tiny targets that need precise touches, because they're a potential choking hazard. But she can't eat something on a touch screen, so we can work on more precise touches that way.

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