Transcription
[music] Well, here we are in the beautiful Valentine Auditorium. We welcome you. For those of you who are old friends, we hope this is going to be a useful webinar for you. And for everyone who is new, uh, we hope this all makes sense. And if you have any questions along the way, that you'll send those questions to us so we can get them answered.
Well, welcome to the institutes. We're here on our beautiful campus and we're so lucky to have the wonderful campus that we do. We've been here for 68 years. And I guess if we had one wish for everyone who's attending today who has a child who's struggling, it is to welcome you and your child to this campus one day sooner rather than later.
Well, who are we? We are a team that, as I say, we date back to our earliest members back to 1955 when the institutes was founded by Glenn Doman, my father. In those days, in the early days, uh, on this campus, we had, we created a rehabilitation center for 60, 70, and 80-year-old stroke patients. [clears throat] And that was the very first rehabilitation center in the state of Pennsylvania. And it was my father in partnership with the great Temple Fay, neurosurgeon here in Philadelphia. They decided they were going to get their 60, 70, and 80-year-old stroke patients well. They, right from day one, they were very focused on results and they found, not to their happiness, that after several years their patients weren't getting better at the rate they wanted them to. Even though they were using the conventional treatment and using it very, very properly and and well, they weren't getting results. So they threw that treatment away and they, they at that time made, I don't think they thought it was a radical statement, but it turns out to have been. They said, "Brain injury is in the brain, and we're not treating the brain right now. We're treating everything but the brain. The elbow, the lips, the ankles, the arms and legs. We're treating the periphery." And so they made a decision to stop doing that and to find ways to actually directly treat the brain. And that was really the very beginning of our field, which now is child brain development.
It wasn't long before they looked around and realized that, well, they watched their patients getting better with the new treatments that they were developing based on stimulation of the brain and opportunity for the brain. It wasn't long before they looked around and said, "Gee, we're getting our 60, 70, and 80-year-olds. We're getting them much better." But while we're successfully doing that, there are two, three, and four-year-old severely brain-injured kids who are essentially being medicated, warehoused, and forgotten. And when they realized that, little by little, they started to shift their attention to children until one day we woke up and it was really all kids.
Well, that was our, those were our earliest days. And the kids that we started to see ranged from kids who were blind and deaf and paralyzed. Well, kids who were in a coma to kids who were blind and deaf and paralyzed, to kids who could walk but not talk, or kids who could talk but not walk. Kids who had severe learning problems, or moderate, or mild learning problems, all the way to a kid who's almost perfect but not quite and not making it in life. Those kids arrived here from all over the world. They still do today. And they arrived not with a proper diagnosis of where they were hurt in the brain, but rather with a symptomatic label. And those symptomatic labels, we've watched those labels grow over time. There are now hundreds of different labels that are used to describe what is really an injury to the brain. Those labels may be cerebral palsy, autism, attention deficit disorder, global developmental delay, dyslexia, more than 350 different symptomatic labels to describe a brain-injured child.
Well, this doesn't help our parents. This makes our parents' lives very difficult because they end up chasing that label and chasing symptomatic treatment which never, ever works. So those are our kids, from the most hurt kid in the world to the least hurt kid in the world, and every kid in between, children who were hurt in the central nervous system.
Well, you know, we have a bit of history with the whole subject of results because when we shifted our attention from our adult stroke patients to very young, severely brain-injured children, because for the most part the children we've been treating over the years have been profoundly or severely brain-injured. When we shifted our attention, of course, my father and Dr. Fay were still very focused on results. But they realized there's no way to understand the results without some way to measure the child. And they looked for measurement tools, and there weren't any measurement tools. [snorts] And again, looking at a little bit of our history, here's my father. Here's Glenn Doman. [snorts] And here's what he said in those earliest days. "We don't agree with everyone about brain-injured children. Our disagreement begins with diagnosis, extends to classification, identification, treatment, technique, methods, philosophy, and ends up with objective. We are positive that the goal should be to make brain-injured children well, and we sometimes do. The world believes that to be impossible and therefore never does."
Well, you know, that was the case 50 years ago. It's the case pretty much around the world today. It is, the brain-injured child is always given a miserable prognosis. He'll never walk. He'll never talk. He'll never read. He'll never write. He'll never, never, never, never, never, never. It's, it's a very dark prognosis for brain-injured kids. And so the very first problem really was, well, how do we evaluate our kids? How do we measure them? So our first challenge was measurement. How do we know if the new things we're doing are actually working?
Well, you know, there, there is no science without measurement. You have to be able to measure. And first, to be able to measure, you have to really know, well, what is a, to understand the hurt kid, you have to know what a well kid is. What are the critical stages in the development of the well child? If you don't know that, then you have no comparison for the brain-injured child. And in those early days, no one even attempted to make a comparison. In the world of hurt kids, really, when a kid would come back through the door, it was, "Well, how does he look today? Can he hold his head up better? Is he evacuating his bowels better? Does he look better?" Well, that was certainly not good enough for Dr. Fay or my father. They did not see [snorts] those things as real results. They were completely subjective. One person might look at a kid and say, "Yes, he looks better." And another person might look at the same kid and say, "Well, he doesn't look better to me." It wasn't, there was no science there. There was no real measurement tool.
Well, that was the first challenge. They had to make a tool, and a tool that would be consistent and accurate and useful. And you see behind me, kind of the backdrop here in the Valentine Auditorium for me today, is our solution. Our solution was to create the Institute's Developmental Profile. And you see a bit of it behind me. I'm going to show you what it looks like in one piece. You won't be able to read it. It is a, it is a difficult document to teach in a PowerPoint world, but you can see enough to see that we are looking at seven different levels, starting from birth and ending with the 72-month-old. So, we're starting at birth with all the reflexive abilities of the newborn. And at the very top, we have all the sophisticated abilities of a well six-year-old. And basically, the profile is saying to us that a well six-year-old has all the neurological equipment he needs to make it in life. And really, you and I are a six-year-old neurologically, with experience and knowledge that the six-year-old doesn't have, and wisdom. That's what we add. But basically, a six-year-old has the most fundamental equipment by age six. So, we see the critical levels to get that child all the way from birth and those reflective levels, reflexive levels, all the way to level seven at the top. You also see that the profile is divided between the sensory side, where we see the sensory pathways that are critical for human beings: vision, auditory, and tactile. And then on the motor side, you see the motor pathways coming out of the brain: mobility, language, and manual competence.
With this tool, we could now measure our brain-injured kids. We could see where does this kid compare? Where is he in vision? Where is he in auditory? Where is he in tactile, mobility, language? We'd put six different lines on this profile to show where he is in each of those areas. And then we could literally calculate a neurological age and compare that to chronological age. And that would show us, well, this brain-injured child is growing. His neurological age is 25, but he's 50 months old. So, he's growing at 50% of a well child. That would give us a baseline. That would mean when that child returned after doing six months of the program, we could then measure him again in the same six areas, the same levels, and see, is he changing? And is he changing fast enough? Is it a significant change? So this profile was critical so that we could begin the process of actually measuring the program that we were developing for stimulation and opportunity.
Now, we used the profile as we started to see our kids change on the profile, which was very exciting. We began to realize that we needed to record these results and make them known to parents and to our, our fellow healthcare providers. And as we looked at the profile, we realized, well, you can see the profile, it has seven levels, it has six, there are 42 boxes, but those 42 boxes are not equal. Some of the functions on the profile are hugely important, critical to life, and others less so. For example, if you're at level one in vision, right down at the bottom, that red area, you're blind. And if we successfully get you to level three, that yellow area, it means you can see detail. And if you can see detail perfectly, that means you can see as well as I see and as well as you see. When we looked at the profile, we said, "That's a life-changing result. That's a life-changing result. That's a result that we need to record, and we need to make known that it is possible to take a kid from the very bottom of that profile up to level three and get them actually seen." That seemed very significant to us. So, we looked at the profile and we picked out those points that we believed were essentially life-changing. And we, we called those points on this profile "victories."
Well, what are the victories? Well, let's take a look. The first one, seeing. That's the one we just talked about. That's going from either level one or level two and making it to level three. Perfect. That's someone who was blind and can now see. That seemed a pretty substantial result worth recording. The next victory was hearing, which is essentially the same victory, only in the auditory pathway. Kids who would come here unable, some kids unable to hear anything, and who would make it up to being able to hear words. Um, that's life-changing. I think we would all agree. So that became one of the victories.
Well, of course, in mobility, there were many critical stages and many kids came here paralyzed. They didn't move at all. Being able to get those kids able to move all by themselves with no help, no assistance, on their bellies from point A to point B in mobility. I can tell you, after many, many years of experience now, that is the single biggest victory there is. That's the hardest victory to achieve if you're paralyzed. And that is a huge, huge victory. But we don't stop there. The next big mobility victory is creeping. When that same kid who's on his belly moving forward can push himself up on his hands and knees and actually use creeping as a means of transport in his household. Again, a life-changing event. And of course, walking. Um, this is really full citizenship for the baby in the world of, of kids, to be able to walk and get out there in the rough and tumble. Um, and again, we see the kid who perhaps is eight years old, he arrives here paralyzed. He has to get a crawling victory. He has to get a creeping victory. And you can imagine when he gets a walking victory, what a spectacular achievement. And finally, in mobility, of course, we want to get our kids running. So those four victories are the heart and soul of our physical program. Those are vital.
If we go back to the sensory side of the profile, the next thing that we said is the life-changing event is being able to understand. And again, many, many kids come here with no understanding, especially if they're deaf. There's no way to understand words if you can't hear them. But even kids who arrive here who are not deaf often have very poor or very inconsistent understanding. So the victory here is understanding at least as well as a three-year-old. And if you know three-year-olds, you know that their understanding is pretty sophisticated. So, we looked at the profile and said, when a kid makes it to the understanding of a three-year-old, he gets an understanding victory. Very important and life-changing.
Next, again, going back to the motor side of the profile, speech. Speech is a huge problem for children injured in the central nervous system. From the child who may be paralyzed, even to the child who may walk and talk a little bit, speech can be an enormous problem. So being able to talk for the first time, to express yourself, to be understood, this is a life-changing event. And so we've taken that first speech on the profile and highlighted that as a victory. Of course, at the very top of the profile, we've taken reading and designated as a victory because it is the single most important thing that will happen to a human being, certainly academically, in their lifetime. There is nothing more important from the time a child enters school than being able to become a terrific reader. So when our hurt kids begin to be able to read the beginning stages of reading, they get a reading victory.
On the other side of the profile, kind of the, the matched pair to reading, of course, is writing. And again, to obtain this victory, a child has to be able to use the, have the manual competence to actually write. Many of our kids type well before they can actually write. So we have many, many, many kids typing at much younger ages than we have them writing. But writing, when we say writing here for this victory, it literally means old-fashioned pencil or pen in hand writing.
Now, there are two physiological victories that we designated that are not actually on the profile. The first is a health victory. And I think this victory will interest you. Uh, the average American child, believe it or not, is sick eight to 10 times a year. Now, that's a well child. Our goal, a health victory in our clinic with our children, is to be 100% healthy. 100% healthy for 12 months. Not 10 illnesses, or nine, or eight, or none. Zero. If a kid even gets a cold, the year starts again. It's remarkable how many of our severely brain-injured children can make this victory when often kids arrive here chronically ill. And that really means they have more days of illness than they have of wellness. And yet, maybe a year or two years later, they're the healthiest member of the family.
And the final victory, uh, also a physiological victory, is detoxification. Many kids come here on medications that may be suppressive to the central nervous system. They may have a sedative effect, and it's our job, as we see it, to give the best stimulation, the best opportunity for each child. And you really can't do that in the face of sedation. So once we know our kids very, very well physiologically, then our medical team can take a look and see how can we safely and very conservatively, very gradually, wean our kids off of those things that may be actually sedating the brain. Uh, and that's what this victory is. When a kid is completely off any of those medications, then he gets a detoxification victory.
So, those are the victories. Now, we, we started maintaining careful records for all those victories. And next slide, please. And in so doing, we realized that we had to make that information available. That parents needed to know what was possible, and our fellow, our colleagues across the street needed to know what was possible. And so we very, I think logically, my father said, "Well, we'll find a journal that is devoted to what's happening with brain-injured children, and we'll submit these results, these victories, for publication." And when we looked around the world, and this was now many decades ago, we couldn't find such a journal. And so we, we came to the conclusion that for the time being, we'd have to publish these things ourselves. And we said, "You know, it's going to be maybe take two or three years." And so we created a little journal, and we called the journal "The IN Report," short for "The Institutes Report." And that journal was a place where we could publish those victories on a regular basis, and it was a place where we could add articles and updates on the work of the institutes as well. So it, it was very well-received, especially for our parents. And, you know, we, we kept, we made an editorial policy for "The IN Report" that is still there today. It's the same policy. We haven't changed one word of it. And it basically says, "If there's any individual, any group, any clinic, any college, any university, any hospital, any organization anywhere currently treating brain-injured children and getting a result, we would be more than happy to make space in our journal for your results." And do you know that this little journal has been publishing that for many, many years? And this journal just celebrated, six months ago, its 50th anniversary. So the little journal we thought, "Well, we'll do this for two or three years," is now 50 years old and still faithfully publishing those victories so that parents can see what's possible. And it still has the same editorial policy. So if there is anybody out there publishing or needing publishing for their results, we are more than happy to provide the space to do that.
So, the children's victories we publish, and we publish exactly where that kid was, what country he's from, and where he was on that profile before he made it to that victory. So, that is all there. Real kids, real moms, real dads, real addresses, right there in "The IN Report."
Well, we started, you know, if we go back to 1998, we started to, we created a sophisticated database at that time and started to put all of this data into that database, and we review that database faithfully every year. So the results achieved, taking those results that we put in "The IN Report," we're now up to 3,551 kids since 1998 in that database. So this is, this takes us up to the end of last year. Soon we'll be doing 2023. And so it's a pretty, it's a, a precious database, unique in the world. Um, a real archive which tells us a great deal about each kid. Each child that's in that database, we have a careful, um, very extensive developmental history. So again, um, it's a unique archive where we can see exactly the story of what happened to a brain-injured child, and then what happened, what happened for him to get injured, and then what happened when we intervened with stimulation and opportunity.
Well, let's take, just so this is a little more real, so it's not just numbers. Let's just take one victory and take it a slightly deeper dive, and let's look at the seeing victory that we've already talked about. From that statistic of those 3,000-plus kids, it turns out 424 of those children were blind. And that means, what does that mean, blind? It means some of them had no light reflex. So they were right at the bottom of the profile. No light reflex in either eye, or maybe they had a light reflex but no outline perception. That would be level two on the profile behind me. Both of these levels, these kids would, it would be termed blind. Or perhaps they had poor ability to see detail within a configuration that is designated as functionally blind. So the kids in that statistic either had no light reflex, no outline perception, or poor ability to see detail within a configuration. And I would say for the most part, because our kids are profound and severe, for the most part, they would have been level two or below. Not so many arrive here at level three.
Well, what happened to those 424 kids? Of the 424 children who were blind, 355 of those kids, or 83% of them, saw for the first time. And of those kids, 303 children learned to read. That's a pretty high standard for seeing. I think we would all agree. And in this group, the oldest kid in this group was 22 years old. So that's a pretty old kid to be able to see for the first time at age 22. Now, that could have been a kid who was blind from birth, or that could have been a kid who had a traumatic brain injury at age 15 and was blind from 15 to 22. Because we see every kind of ideology, every kind of cause of injury in that statistic. So, of the 424 children who were blind, we succeeded, 355. And you know, here's the thing I want to say about this victory, being able to get blind kids seeing, which is a pretty spectacular result, I think you'd agree. It would be more accurate to say mothers got 83% of our kids seeing, mothers strongly aided by fathers, older brother, grandmother, and the hard work of our kid doing the program. Because that result was not achieved here at the Institutes for the Achievement of Human Potential. That result was exclusively achieved at home with mother and father, hundreds or thousands of miles from here. In short, we didn't lay a finger on that child. That was done by Mom and Dad. Wow. That's the real miracle. So again, this profile helped us to see what mattered in way of results, to measure those results, and to pinpoint the critical life-changing results that stimulation and opportunity brought about.
Well, let's, let's look at a case history and we're going to focus in on that visual pathway since we've decided to look at blindness. Let's look at a real kid for a minute, um, who came here blind and see what happened. So, we're going to look at the case history of Marietta, and I'm going to read her case history. Marietta was born in Germany. Mother had a healthy pregnancy and a natural birth. But two days after Marietta was born, she contracted bacterial meningitis. She was treated with antibiotics for two weeks. At one month of age, Marietta had another episode of bacterial meningitis and received another month of antibiotics. Soon, tests revealed that she had extensive injury to the brain, loss of brain tissue, and that her visual center was gone. Her prognosis was that she would never see and she would never be a normal child. A university professor at Dusseldorf said, "She's not going to change." Marietta's parents learned of the institute's work and traveled to the United States to attend the "What to Do About Your Brain Injured Child" course when she was just 7 months old. At 7 months of age, she was blind. Oh. And they were told she, there was no treatment. At seven months of age, she was blind, deaf, insensate, and immobile. Pretty, pretty hurt little girl. And her parents returned home. She wasn't able to move at that point or to use her hands. They returned home to begin the treatment program that we outlined for them. And based on everything they learned in the course, her program included visual, auditory, and tactile stimulation. And here we see that first program she had when she went home. And we see what that program of visual stimulation looked like. And of course, at this time, she had the maximum opportunity for movement on the floor. Despite Marietta's acute illness following birth and her dire prognosis and the lack of development in the first year of her life, she started to significantly improve due to her parents' determined efforts. She began to notice people and objects in her environment. She began smiling at her mother from a distance of two meters and spotting toys further away. She began crawling toward the toys, and soon she was able to crawl all around the house. She was understanding all that was around her, and she began speaking her very first words. Before her first visit to the institutes at 16 months of age, she began creeping on her hands and knees. The institute staff designed another program for her, which they continued at home. At her next visit at 19 months of age, Marietta was creeping a kilometer a day, saying many words and using couplets. Although diagnosed with microcephaly, her head size was increasing. Her vision had developed significantly, and she had begun an early reading program. Her home program was redesigned once again. At Marietta's next visit, just before her second birthday, she began to walk. Intellectually, she was now ahead of other children of her age. Prior to Marietta's third birthday, she was able to run 100 meters non-stop. She had had perfect health for 18 consecutive months, which was now half of her whole life. At four years of age, she was ready to graduate from the institute's program. She'd come a very long way from a baby not expected to live, then not expected to see or move, to an above-average little girl who was charming with an especially bright future. She was fluent in German, her native language, and she'd begun to understand in both English and French. She passed the entrance exams and was accepted at the international school of their choice. And here she is, I think. Here we see her first school picture. That doesn't look like a blind child, does it? And that's because she's not a blind child. Marietta's mother recently wrote to us to give us a little update. "I'm happy and proud to let you know that Marietta just graduated from high school with excellent grades. Her best subjects were math and German, where she reached the highest grades you can get. We're very thankful we were able to attend the 'What to Do About Your Brain Injured Child' course 18 years ago and do the intensive treatment program for almost four years. During her school life, Marietta was very successful in track and field. So, she's an athlete, too. Now she is on a German DR team and hopefully will compete at an Olympic level one day." We're so happy and delighted to receive this news, but we're not surprised. And here we see Marietta today. What a beautiful girl. Marietta's parents could have accepted that their beautiful baby girl would go through her life blind and immobile, but they did not. Instead, they fought for her future. They never gave up. And little Marietta was tough and determined, too. She worked just as hard as her parents, and she still does. Her story as an adult is just beginning. What a privilege it has been to know her and be part of that story. We believe she will continue to inspire others and to make the world a better place. Next slide.
Well, I want to begin with some of the questions that we often get. Um, that will handle many, many people's questions in one fell swoop. So, let's look at the first question, and this is, I think, understandable. Is cortical visual impairment, often abbreviated to CVI, in the brain? I mean, is this a problem in the eye? Um, in which case we wouldn't treat that, or is this problem actually in the central nervous system? And of course, it is in the central nervous system. Yes, this is cortical, another way of calling this is cortical blindness, and that's what we're talking about, cortical blindness, not a problem in the eye. The eye is damaged or injured, we cannot treat the periphery. We're talking about blindness which is in the brain, and very, very treatable. Well, I think 83% of our blind kids, that statistic tells you how treatable it is.
Is age a factor in getting results? Well, of the answer to this has to be yes and no. Obviously, we all love to start as early as possible with any brain-injured child because time is the enemy of the brain-injured child. Every day he's not getting better, all of his peers are getting better. So time is always an enemy to a brain-injured child. In most illness, time is a friend. Every day you survive the illness, you're getting better. But that's not true in brain injury. If we're not treating the child and he's not getting better, in truth, every day he's falling further and further behind his peers. So, of course, age is a factor in that regard. But I have to say, do we treat 15-year-olds successfully? Yes, we do. I would like to remind everyone, we started with 60, 70, and 80-year-olds. And the results were so encouraging with that gang that we said, "Gee, we're, we're fixing a 60-year-old. Why don't we fix a three-year-old?" So, the brain is an amazing, amazing organ with tremendous, tremendous plasticity. It's the most changeable and fixable organ of the body. The brain is literally changing every second of every minute of every hour of every day, from, from the earliest time when we can call it a brain in utero right up to the instant before we die. The brain has to be changing all the time. It has to be relating the environmental information to the owner of the brain at all times. It's getting hotter. Put on your coat. It's getting colder. Put on your coat. It's getting hotter. Take off your coat. You're coming to a step. Every second the brain is telling us what's happening. Do something about it. So, of course, it's changing all the time. All the time. Okay.
With our next question. How long does it take to see results? Well, I, I think that's a very understandable question. How long does it take? [snorts] Well, you know, when you see kids who range from kids in a coma all the way to kids who are almost perfect but not quite. Of course, for the mildest kid, if you do something right for him, do you think you're going to see a change rather quickly? Yeah, you are. If you've got a kid who's desperately, desperately injured, do you think there's a chance you can do something for him physiologically that might change him very quickly? And the answer is yes. I think if the question is, how long does it take to get a kid well? Well, we have no crystal balls. We couldn't have looked at Marietta and said, "Yes, we're going to get her seeing, and yes, it's going to take four years to do that." But by the way, if we had said to her parents, if we did have that crystal ball, which we don't, and if we had said to her parents, "Well, look, we think we, we think we know we can get her seeing. Crystal ball says that," and [snorts] it's going to take four years, I don't think there's any doubt in the world they'd say, "We're on. What do we do?" Because that would seem like a pretty spectacular result if you've been told your kid was blind, deaf, and paralyzed and gonna stay that way. So, no, we don't have any crystal balls, but we expect to see change. Every child we see, we expect to see change. Every child we see, we give them goals for six months from now: intellectual goals, physical goals, physiological goals, social goals to meet. And sometimes we make all of those goals. Sometimes we make none of those goals. But always our kids have goals, and for the most part, they're meeting them.
My child made every goal the doctor said she would never make. When I proudly took her back to kind of show off, they said, "It would have happened anyway." I was furious. What should I say to them? You know, I can't tell you. This shouldn't make me laugh because this is infuriating. There's nothing funny about it. But I guess we've heard this question so many times, so many times over the last half century, because it's natural. If you were told your blind kid's never going to see, and you've been to four different famous places, and they've all said that to you, and not only do you get her seeing, but you get her reading. Of course, there's a temptation to go back and say, "Look, she not only reads, she's at the top of her class." We always tell parents, "Don't do that. It's a waste of your time. Don't do that." But some parents do. And almost always the answer they get is, "Well, it would have happened anyway. It would have happened anyway." Well, you know, more than 25 years ago, when the Institutes was reaching its 25th birthday, we wanted to give my father something very special. And we decided, since we're very close to a very famous stained glass studio, we're very lucky, that we would get a small, because we couldn't afford much, stained glass window, and we would inscribe something special on it. And we wanted to inscribe something that my father said very often, and that is kind of the answer to this mother's question. Here's the stained glass window, and you can see it has Latin there. We had the expression put into Latin. This sits in what was my father's office, and what is now my office. And that Latin, when you translate it, says, "This is the place where the things that were going to happen anyway happen."
Well, you've been a very good gang, very patient. If you have a question, write that question down, go up to our website and send it to us, and we will be so happy, so happy to answer your questions. And one question that we always get, "What do I do next?" Well, for those of you who have a hurt kid and you need answers for your child, when you go up to that website, you'll find places to make a Calendly call appointment so that you can get together with our staff and answer your questions. And I think we're going to put a link up here so that you can get directly to that Calendly calendar to make that appointment. And if you go to the website, you'll also see our telephone number, regular business hours from 9:00 to 5:00, 5 days a week. If you call that number, you'll get a real-life human being. You will not get a machine. And our wonderful Kathy Nell, who's on that phone, will be happy to make sure you get your questions answered. Okay.
Well, this is the first in a series on results. We've only just cracked a little bit. We've given one example with vision, but we intend to come back and look at each of those victories, at all the results. And we hope that that will be very helpful to you.