Four Key SEMH Takeaways And Strategies To Focus On In 2024

Four Key SEMH Takeaways And Strategies To Focus On In 2024

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Summary

Are you working with students who get dysregulated easily, have difficulty learning social and emotional skills or learning from their past behaviour? But do you feel confused about where to start and what strategies to try?

If you answered yes, then join us for our special 3rd birthday edition of School Behaviour Secrets?. To celebrate we†re going to share four of our key takeaways from the last 12 months of interviews, to give you key SEMH insights and strategies that you can focus on in your classrooms in 2024.

Remember â€" four strategies done really well are worth way more than ten strategies that you can†t implement because you can†t remember them!

Important links:

Click here to hear all of episode 105 with Tom Brunzell.

Click here to listen to my interview with Dean Cotton in episode 115.

Click here for episode 130 with Gina Gomez De La Cuesta.

And finally click here for episode 154 with Monica Davis.

Get our FREE SEND Behaviour Handbook: https://beaconschoolsupport.co.uk/send-handbook

Download other FREE behaviour resources for use in school: https://beaconschoolsupport.co.uk/resources.php

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Show notes / transcription

Simon Currigan  0:00  

Are you working with students who get dysregulated easily, have difficulty learning social emotional skills or learning from their past behaviour? If that's true, then keep listening because in this special birthday episode, yes, it's our podcasts third birthday, we pulled out the four key insights we've had from the previous year and condense them down into takeaways and strategies you can start using today with your students. To quote the character Desmond from the early noughties series Lost, "I'll see you on the other side brother"... of this intro music.


 Welcome to the school behaviour secrets podcast. I'm your host, Simon Currigan. My co host is Emma Shackleton and we're obsessed with helping teachers, school leaders, parents and of course students when classroom behaviour gets in the way of success. We're going to share the tried and tested secrets to classroom management, behavioural special needs, whole school strategy and more all with the aim of helping your students reach their true potential. Plus, we will be letting you eavesdrop on our conversations with thought leaders from around the world. So you will get to hear the latest evidence based strategies before anyone else. This is the school behaviour secrets podcast. 


Hi there. My name is Simon Currigan. And welcome to School Behaviour Secrets. So our birthday episode this week with three years old. And that's made me kind of reflective. I remember, as my nan sat on her deathbed several years ago, I told her my dream of hosting an educational podcast focused on behaviour and the needs of SEMH children. And she turned to me and took a deep breath and through the painkillers. She said to me, "just don't XXXX It up Simon, like everything else you do. Just do one thing well." Nan, if you're listening in heaven right now, I just want to say, sorry, maybe I'll do the next thing better. But I'd also say nan, it's not entirely my fault. Because I didn't do this on my own. I made it with my co host, Emma Shackleton. Hi, Emma.


Emma Shackleton  1:58  

Hi, Simon.


Simon Currigan  1:59  

So before we get to the SEMH and behaviour stuff, it's been three years and we're going to be sharing our key takeaways from the last 12 months of interview episodes. And what we think people should be focusing on and implementing in their schools and classrooms right now. But before that, I'm feeling a bit nostalgic for when we first started the podcast. So I've got a very quick 2021 quiz for you. 


Emma Shackleton  2:23  

Okay, I'm just glad that we're through the terrible twos and I hope our third year will be better. 


Simon Currigan  2:29  

Year of tantrums. Yeah?


Emma Shackleton  2:32  

This is a bit different. But the one then this is exciting. Let's have a nostalgic look back to 2021. 


Simon Currigan  2:38  

Remember to play at home as you're listening to this. In October of 2021. The World Health Organisation endorsed the first vaccine, but for which disease? 


Emma Shackleton  2:49  

COVID-19 


Simon Currigan  2:50  

No, it was malaria.


Emma Shackleton  2:53  

Oh, okay. 


Simon Currigan  2:54  

Yeah, see what I did there took an unexpected twist. Okay, next question. Which country or artist won the Eurovision Song Contest in 2021. 


Emma Shackleton  3:04  

Absolutely no idea never watched it. 


Simon Currigan  3:06  

It was like that's ruined attention as me that's just sucked out any kind of for those who are playing at home, it was Italy and the group was Maskin. Okay, final question excited?


Emma Shackleton  3:18  

Not really. But go on 


Simon Currigan  3:19  

The stars of which popular 90's sitcom reunited for one show, drawing in Sky One's biggest ever live audience. What was the sitcom?


Emma Shackleton  3:31  

Friends? 


Simon Currigan  3:32  

It was friends. Well done. 


Emma Shackleton  3:33  

So I got one out of three. Brilliant. Hopefully people at home did better than me. Okay, that was marginally interesting. And it's almost time to get into those key insights and strategies to focus on in your classrooms in 2024. But before we get to that, I just like to ask you if you're listening at home to like and subscribe so that future episodes are downloaded onto your podcast app. And that means you will never miss a thing


Simon Currigan  4:02  

That said, it's time to get a hot cup of tea, have a quick dunk and lick the jam out of the crumbling jammie dodger we call behaviour. So we're going to do something slightly different on this episode, we're going to play some excerpts from previous discussions from earlier interview episodes across the year and we're going to start with the idea that feeling regulated can actually feel scary for some children. And this is something that came up in discussion with Tom Brunzell in Episode 105, where we talked about supporting kids with a trauma informed approach to learning. So here's a quick excerpt from that podcast. 


One of the points you make in the book related to that that jumped out for me is if we do get kids who come in dysregulated very, very heightened and we help them regulate and calm suddenly they're used to having their bodies full of adrenaline and when that drains away for some of them, that might be a scary feeling, because they're just not used to it.


Tom Brunzell  5:04  

Im also going to add positive emotion can also be scary for them. 


Simon Currigan  5:10  

Absolutely. 


Tom Brunzell  5:11  

In terms of just what they feel in their body, we've had very, very difficult unsafe days after excursions when the excursion was full of fun and probably too much other and the kids were just like adrenaline up with fun and that adrenaline, they can't hold it, so it spills out. And some of the roughest days for some of our own teachers was the car ride home after that excursion, whether we call it positive emotion or excitement, or adrenaline, or cortisol, the stress hormones, it's so important for educators to understand that, well, we're assisting kids to manage their escalation, we also need to help them manage wait for it, their de escalation, which is such an important part of body. You know, some of the kids that we support, they don't feel like human beings, unless theyre cortisolled and adrenalined up. Like they're on a bit of this cliff all day long of like, I need to feel this buzz in my body, because that's how they feel primed for survival and scanning and kind of hyper vigilantly getting through their day. But also, these are kids whose resting heart rate might be upwards of 120 beats per minute, and that's resting. And we know this for a fact, because we encourage the teachers we work with to teach our kids to measure their heart rates as part of a psychoeducation approach in terms of maths and sciences and all this stuff. But it is important for us to realise that the kid that looks super calm, is maybe at a resting heart rate of 120 beats per minute. So one poke one wrong answer game on and this kid is in hardcore survival mode. They can't hold that adrenaline and it is going to spill out until they crash, as you said, and that crash can also be alarming and somewhat mysteriously unsafe for some educators when they're not used to this up and down the sense of like real madness. And so all of this is to help us understand that the literacy around escalation, de escalation, understanding your body, this is the core of our trauma informed practice.


Emma Shackleton  7:24  

What really jumps out here is different forms of being dysregulated. As educators, I think we tend to focus on anger or anxiety, but it really is more complicated than that. And you do see kids getting overexcited, getting the giggles, maybe unable to stop laughing when they're dysregulated. That's what it can look like for them in the classroom.


Simon Currigan  7:50  

So we need to see being regulated as a more generalised skill. Also, we often think about kid's sensory loads, but that's another form of dysregulation. I think Tom's point here is really, really true. And you will have seen this, if you've worked with kids with background of aces or trauma or consistently get dysregulated in the classroom, you'll see the kids there, and you actually got them calm, and they're regulated on their on a piece of work. And then something changes. It's almost like a switch flicks. And for those kids who aren't used to being amped to full of adrenaline, that sense of just sitting there, and being calm and regulated can actually feel scary, because they're just not used to it. They're not used to the biological experience of having their muscles relaxed, and breathing slowly. So for them, it's strange. And for kids who get dysregulated, often, things that are strange are scary. So if we're teaching kids how to manage their emotions, how to stay regulated or get regulated, then one thing we often miss out, is that you're going to feel entirely different. And we need to specifically teach them what to expect, and that this new way of feeling in your body might feel strange, it might feel worrying, it might feel unusual, but actually, it's okay. And this is how most people feel most of the time. 


Emma Shackleton  9:17  

That's really interesting. And actually, I think some adults can probably resonate with that feeling as well. The world is very fast paced, and lots of us are used to working at top speed all of the time. And some of us find it really difficult to stop and relax and do nothing because we're used to being on that treadmill of doing doing doing all of the time. So yeah, it's a really, really interesting perspective there from Tom. 


Simon Currigan  9:42  

Yeah, absolutely. So the next insight we're going to look at is that small questions can have a big impact and this came out of our interview with Dean Cotton earlier in the year so we're going to play the extract and in our conversation we were talking about Post Incident Learning. And that's the conversation you have with a child following an incident or a blow up in school where you're sort of discussing what happened and what should happen in the future and encouraging them to change their behaviour and take responsibility for their choices and so on. So here's a bit of a conversation that I recorded with Dean Cotton all the way back in episode 115. 


So you ran a really interesting piece of in school research that looked at the significant impact that different approaches to that post incident conversation can have, can you tell us what your research was, what it looks like what you did, and then what you discovered? 


Dean Cotton  10:37  

Yeah, I've actually run several studies in this area, and two of them have been quite significant. So the first study I did in this area, we developed a structure for post incident learning based on things like motivational dialogue, counselling, lifespace, interviews, cognitive behaviour, therapy, a whole range of different talking therapies. And then what we did, we simplified the structure to make it more accessible for everyone. So we took the key elements of those therapies, and just focused on those which was basically the experience that the individual had, how it made them feel, and what they could do next time they feel that way. And then what we did is we trained staff in that structure in a semh school, and the pupil referral unit, we put a system in place to make sure that whenever a child had been involved in an incident, the structure that we developed was followed. We got a very similar semh school and a very similar pupil referral unit. And we taught them to talk to children following an incident and try and give them as much support as they possibly could. And again, we put a system in place to make sure that that was carried out following every incident.


Simon Currigan  11:47  

So just to be clear, before we move on one set of schools is using a specific structure for that conversation that you've given them. And the other just being told us your best efforts. 


Dean Cotton  11:56  

Yes, absolutely. Absolutely. And the services that were told just to use their best efforts actually saw very little change in behaviour, one of them saw a 10% reduction in behaviour incidents, but the other one actually saw a 10% increase in behaviour incidents, they said that a lot of their children didn't like them talking to them following an incident, which sort of suggests that they were doing it a little bit too soon, maybe, or maybe saying the wrong things. But the services that followed the structure, so huge reduction in behaviour incidents, one of them so 45% reduction in behaviour incidents, and the other one, saw 64% reduction in behaviour incidents by following the simple structure. So that was one piece of research we did. And the other piece of research we did we it's only a small scale study. But we actually got a school to replace their detention system with a post incident learning system. And that actually resulted in a 64.5% reduction in behaviour incidents over a three month period. 


Simon Currigan  12:57  

That's massive, isn't it? 


Dean Cotton  12:58  

Absolutely. It makes so much sense, though, you know, rather than you know, punishing a child for something that often they can't help or talking to them about it, you know, I don't think it's rocket science that talking to them about their incident is going to have a better outcome.


Emma Shackleton  13:14  

Ah, so the takeaway here is that we can sometimes overcomplicate things, and actually small, simple questions and interventions can have a really big impact. And this is important for school leaders, sometimes we feel that we need to have our teachers following an exact and complicated process in order to get an outcome. For example, a conversation that requires so many steps that you have to have an actual script to be able to follow it, or have all of the pieces of that process written out on a visual on a line yard in order for us to remember it all. But actually simple, easy to remember, processes can be super powerful, too. And I think it's much easier to get consistency amongst your team, when you're trying to do a smaller number of things in a really clear and simple way, rather than having lots and lots of different processes to follow. So there is a saying isn't there that don't let perfect be the enemy of the good. So striving for something that is good enough and being happy with that because it works rather than overcomplicating and making a huge, imperfect system. 


Simon Currigan  14:34  

I don't know about you, but in the context of our work or going into schools and supporting teachers, actually, sometimes it can be tempting to drown people in strategies because you want them to have all of the information they need to support children in school. But actually, sometimes, two strategies done really, really well are worth way more than 10 strategies that you can't implement because you can't remember them. You can't remember how to do them or you don't have time to implement them all. Again. and not letting the perfect be the enemy of the good. And the power of small, simple things done well can't be underestimated. 


Emma Shackleton  15:06  

Absolutely, sometimes it's really helpful to sit down and give people space to reflect and strip back what they're doing. Rather than adding in more and more, it's sometimes really helpful to just think, hold on, what can I drop here that isn't working? Let's go back to basics, and do those simple things really well.


Simon Currigan  15:29  

The power of subtraction. The next conversation we're going to listen to is an extract from my conversation with Gina Gomez De La Cuesta, which is all about the power of practising a skill in context. And we'll talk about this more on the other side of the excerpt. This is part of the conversation where we're talking about how to use Lego therapy, to support kids with their social development and the importance of actually practising physically practising that skill and not just talking about it.


Gina Gomez De La Cuesta  15:58  

So the brick by brick approach is really hoping and aiming to help children's confidence and to help them have positive experiences of social situations so that they maybe feel less anxious in those kinds of situations out in the world. And we've certainly had young people telling us that because they've practised and, and used skills in a real way, in brick club, it's not hypothetical, this is they're using them in real life that's helped them know what to do outside of the brick club session. So in their day to day lives, so they might feel more confident socially, they might feel less anxious socially. And you know, in loads, there's so many skills involved in Lego building motor skills, and visual, spatial skills, executive function, planning, organising, there's so much going on, you think it's just playing with Lego, but it's not there's loads happening. And for us, I guess the most lovely thing is when children start to make friends in brick club, and they meet other children who are a bit like them. And that's a really powerful and important and validating experience for children and young people. So they meet someone like them, and then then they might meet up at home in their, you know, in their home life and have a good time, play each other's houses, or meet up and build a Lego model, you know, and develop a friendship. So that sort of sense of feeling empowered and accepted for who you are a sense of belonging, and friendship is, you know, over time that can happen really beautifully.


Simon Currigan  17:20  

Listening to you speak actually, one thing that strikes me that's powerful about this method is the children are learning the skills in contexts. So often, kids who are neurodiverse, they'll sit down with a social story, and I have nothing against social stories, they're fine. But it's very much kind of an abstract, we're sitting down and learning about something rather than using it in the real world. And that seems really powerful to me, because they're sort of picking those skills up incidentally, and supported by the adult, but they're using them for real 


Gina Gomez De La Cuesta  17:48  

Exactly. For me, that's just a really fantastic aspect of this programme. And of course, they can learn, you know, all these skills now in other programmes, but they can implement them and use them in a real context in brick club. So the brick by brick programme is all about thinking about what's happening now. And why do I need to use this skill now to help me build my LEGO model with my friend and learning in the moment makes it so much more meaningful and learning through play is, you know, there's five characteristics of learning through play, and one of them is meaningful that play has to be learning has to be meaningful to the child and, and in Brick Club, it really is. 


Emma Shackleton  18:26  

Teaching children's social, emotional, and mental health skills can be quite abstract when we learn about the skills instead of actually practising them. So that's great for semantic knowledge, like learning facts like you would in the classroom, soaking up the information, and being able to remember and retain that information. But for procedural knowledge, that means learning how to actually do something, it's much more powerful when you actually practice and physically go through the motions of doing that skill, you have to have a go at it and reinforce your understanding around it by doing it, rather than just being told about it or hearing about it or reading about it. So a good example, then is if you're learning to swim, for example, you wouldn't read a book about how to swim and learn about the mechanics of the stroke and then just jump into the pool at the deep end and hope for the best. When we're learning to swim, we are coached step by step how to do it, we start from where the child is at, we build up their confidence in the water, maybe just dipping their toe in the water to start with maybe dipping their face into the water getting used to the sensation of the water around them losing their fear of it, and then gradually building up we break down swimming into a series of small steps. And then we physically take the child through those steps so that their body learns how to do the movements, and it's exactly the same when we're teaching SEMH type skills. They're about people and bodies and feelings and emotions, rather than facts and figures that we just want them to be able to bark out later. 


Simon Currigan  20:12  

Absolutely. And you need to practice those skills where you're going to need them. So you've got the same cues around you. So if you've got a child is having difficulty with their emotions outside on the football pitch, well, you're not going to get much mileage, talking about staying regulated and looking for triggers by doing a worksheet in the classroom. Ideally, you want to be outside, practising and rehearsing those skills where the kids are going to use them on the football pitch. So the takeaway here is if we're teaching kids a social skill, and a regulation skill, or any other form of SEMH strategy to get them to make progress and to use the skill in the real world, it's about practising that skill where they're going to need it in the right context. So they are learning about how to do it in the same way as a swimming coach would teach a child to swim. Rather than sitting down in a classroom, and soaking up a PowerPoint as you would learn factual information.


Emma Shackleton  21:07  

I think that's really great advice. Actually, Simon, because I know that many schools run small group interventions, such as anger management classes, for instance. And in those small group settings, the children are often really, really successful. And they can talk about what they need to do next time they get angry, they can roll out three or four strategies of what they need to do, they need to walk away, they need to tell the teacher they need to do some deep breathing. And then what usually happens is they go back into class or back onto the playground, something happens, they quickly get angry and dysregulated, they lash out, they don't apply any of the knowledge that they spoke about in the little intervention room with the pastoral lead. And everybody gets really frustrated because they feel like the child has been taught the skill. So why are they not applying it. But as you identified there, when you're not in context, that learning is very separate, you got to be doing it in situ and practising it in situ, in order for it to be effective.


Simon Currigan  22:11  

There's another example of this that everyone will have experienced in their real lives. And that is when you bump into someone, and they're not where you expect them to be. So you know, someone, you've got an acquaintance, let's say, you know them from another school, and then you bump into them into the town centre. And because they're not where your brain is expecting them to be, and because you're not in a certain school, and in the school, there are cues and there are rooms, and there are things on the walls, all of those things help you link that person's face to their name, your brain has soaked up all that information and contextualised it. And without that context and those environmental cues. When you're walking through the shopping centre, your brain is having to work extra hard just to remember the name that goes with the face that you've bumped into. So accessing, you know, regulation skills is going to be even more difficult than simple recollection. So the next thing we're going to look at the next thing to focus on and think about over the next year is that we have to teach social and emotional skills more specifically than ever. This comes from my interview with Monica Davis, who talked about how to teach kids the skills they need to resolve conflicts for themselves. Her approach was to break those skills down into the tiniest steps and really specifically teach them. Here's the audio from that part of the conversation. 


Why do you think it is kids nowadays find active listening harder? And how do you help students structure and develop their active listening skills?  I'm asking for a friend.


Monica Davis  23:46  

Your funny, active listening is becoming more and more difficult because it's just not a skill that's commonly practised. And you know, like you and I mentioned earlier, children are more inundated with technology and screen time than they're having actual conversations with each other. And so there's no conversations there are no active listening being modelled or practised. Plus our attention span is becoming less and less due to YouTube shorts and Tick Tock videos. And so our patience muscles aren't being strengthened, which causes a detriment when we're trying to actively listen to someone who may be talking longer than our attention can hold. So there are a couple of ways I help my students with this. The first is I require them to repeat back instructions. So for example, if I'm giving them three to four tasks that need to be completed for dismissal at the end of the day, I'll call on a student to repeat back what I said to check for active listening. Now the second way occurs during role playing once the offended person has had the opportunity to express their concern. I have the offender reply with I'm hearing you say that dot dot dot repeating back in their own words, what the offended person just communicated. So an example might be I'm hearing you say that when I joke around, it hurts your feelings and this method has been very effective in strengthening my student's active listening skills. And I highly recommend it.


Simon Currigan  25:05  

Does that increase empathy as well, for the other person's point of view? In your perspective? What do you see with the kids that you work with?


Monica Davis  25:11  

Oh, absolutely, because they're listening actively. And they're hearing what the other person is saying, to the point where they actually can take it in and repeat it back. It builds that empathy within them, which is so important. 


Simon Currigan  25:25  

Yeah. Because without empathy, you can't move past conflict. And you can only see your own point of view. 


Monica Davis  25:30  

Exactly. 


Simon Currigan  25:31  

Really, really interesting. I think, to bring it back again, to things like tablets and phones, people are having FaceTime discussions as we speak. And right now we're using something that looks a little bit like zoom. But you lose a lot of detail, physical detail when you're not sat sort of two or three feet away from a real person, because our faces contain loads and loads of information about how we're feeling and FaceTime. And a screen just seems to eliminate a lot of that


Monica Davis  25:54  

Agreed. In fact, I read a book once that mentioned that social media is really not social at all, 


Simon Currigan  26:00  

In what respect? 


Monica Davis  26:01  

In the fact that what you just mentioned how it's called social media, which is interesting. But unless you're face to face, it loses a very important element, 


Simon Currigan  26:11  

The human element?


Monica Davis  26:12  

Exactly. 


Simon Currigan  26:13  

I saw some interesting research as well about what people would be willing to put in a message on social media or even a video that they record on social media and you become willing to say, sort of quite hurtful, hateful things because you're not seeing the reaction on your the person's face. And if you did that in person, then your amygdala would look or your prefrontal cortex would look at the impact of your words on the other person's face. And then your empathy would naturally kick in. And it will kind of work as a preventative for going too far. Without you'd immediately think, Oh, I'm hurting this person I need to back off. But on social media, you don't get that you drop your bomb, and then you leave 


Monica Davis  26:49  

Exactly it desensitises you.


Emma Shackleton  26:52  

So, and this takeaway ties in really nicely with the previous one, which is we need to break down the skills that we're teaching into precise steps in order for our students to be able to follow them. So in that interview, Monica tells them exactly what to do to actively listen, she gives them the precise steps that they need, and then reinforces their learning by giving them exercises to go ahead and practice those steps. repetition helps us to get things locked into our brains.


Simon Currigan  27:27  

So if we're talking about teaching someone to receive a compliment, and a lot of kids find, a lot of adults find it difficult to receive compliments actually, it makes them feel uncomfortable. And then they're kind of botch and bungle that social situation, what we might need to do in that case is break it down into the person gives you a compliment, what do we do first, we pause to control our emotions. And we practice that. And then the second step might be smiling, however you feel uncomfortable about the compliment that you've just given. Smile at the other person, and practice what smiling naturally looks like. Making eye contact, if that's appropriate for the child, obviously, and then just practising and rehearsing, saying thank you in a friendly way, going through all those steps broken down into concrete detail is going to help the child manage that social situation more successfully. And they're going to have to practice each of those individual steps individually, to achieve the success that you want them to achieve. Because if they're having difficulties with SEMH, what we can't do is make assumptions about what they know and what they don't know what they do and what they can do. There's an old saying that assume makes an asset of you and me, that's often quite true. I've can think about my own career where I've been working with children and trying to teach them you know, regulation skills or social skills, let's take regulation as the example. Then six months down the line, you suddenly realise they don't know what the word frustrated means where they can't link the physical sensations they experience in their body as frustration to the label. And all the work we've been doing really has been built on really weak foundations. And we have to go back step by step by step and dig down into those kind of building blocks that will make the intervention successful.


And those are our four key SEMH takeaways and strategies to focus on in 2024. So the first one is to remember for kids feeling regulated it can sometimes feel scary.


Small questions can have a big impact.


Emma Shackleton  29:30  

The power of practising a skill in context,


Simon Currigan  29:34  

We have to teach social and emotional skills more specifically, than we've ever done before. And if you want to go back and hear the entirety of any of those conversations, I put direct links to them all. In the show notes. All you have to do is open up this episode in your podcast app, and tap on the links.


Emma Shackleton  29:50  

Perfect and don't forget if you find today's episode interesting or valuable, just take 20 seconds please just share it with three colleagues or friends who you think would also find it helpful. And while you've got your podcast app open, make sure you leave us a rating and review. It's a really small thing, but it genuinely helps the podcast to grow. That could be your gift to us on our birthday. You'll be doing your bit to help us get our information out to other teachers, school leaders and parents who really would benefit from it


Simon Currigan  30:24  

And to celebrate subscribing. Why not give it to the man? Now, I don't know who the man is on I don't know what you're giving him. And I don't know what's appropriate to give the man at this time of year, but I'd encourage you just hand it over.


Emma Shackleton  30:38  

We're going to finish by singing happy birthday...To Us!


Simon Currigan  30:43  

The saddest chorus.


Emma Shackleton  30:45  

That's it for this week. We hope you have a brilliant week and we look forward to seeing you next time on school behaviour secrets. Bye for now


Simon Currigan  30:52  

Take Care


(This automated transcript may not be 100% accurate.)