14981 Krieger to PhD

It was therefore recommended that Raymond be placed in a low borderline to educable mentally retarded setting with additional language stimulation and speech therapy. Kennedy Krieger

About This Book This memoir is about the lived experiences of the author’s traumatic brain injury and the roles his parents played during his academic journey. This book serves five purposes. First, it can be a motivator for individuals with learning disabilities with low selfesteem and who have trouble believing in themselves and their abilities. Second, this book is for parents who may begin to seek the services and resources to improve the education of their children. Third, this book can be a teaching mechanism for human service and private entities working with individuals with disabilities to develop strategies to enhance their abilities with service execution. About the Author Dr. Raymond Holmes is a scholar and a subject matter expert in Workforce Development. He holds a Global Career Development Facilitator’s certification (GCDF) from the Center for Credentialing & Education. He has over 20 years of management and leadership experience. His education includes an Associate of Arts degree from the Baltimore City Community College of Business Management, a bachelor’s in business administration from the University of Baltimore, a master’s in management, and a Doctor of Management degree in Organizational Leadership from the University of Phoenix. He is a Sigma Alpha Pi in the University of Phoenix Chapter of the National Society of Leadership Success. He has worked for private, nonprofit, and government entities. He is also the founder and Chief Executive Officer of Holmes Labor Market Concepts (503c).

FROM KENNEDY KRIEGER TO Ph.D. By Dr. Raymond Holmes, SME, GCDF

i Copy Right Copyright © 2024 Dr. Raymond Holmes. All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher, addressed “Attention: Permissions Coordinator,” at the address below. Limitation of Liability/Disclaimer of Warranty: This publication is designed to provide accurate and authoritative information with regard to the subject matter covered. It is sold with the understanding that neither the author nor the publisher is engaged in rendering legal, investment, accounting, or other professional services. While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional when appropriate. Neither the publisher nor the author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, personal, or other damages. Some names and identifying details of people described in this book have been altered to protect their privacy. ISBN: 979-8-9900940-0-0 (Paperback) ISBN: 979-8-9900940-1-7 (e-book) Library of Congress Control Number: TXU002408802 Front cover photograph by Shelly Williams. Book layout and design by Dr. Raymond Holmes. Book cover photographs from Kennedy Krieger images (kennedykrieger.org) Printed by Time Printer Inc., in the United States of America. First print edition 2024. Dr. Raymond Holmes, SME, GCDF [email protected]

ii Cover Shoots Shelly Williams Editor Dr. Raymond Holmes Reflections Minister Sandy Bellamy Photo Editing Dominik Apolonio Final Prayer Nicole Brown Reflections It may be hard at first for you to think of yourself as “Chosen” but pray and reflect on the special gifts, talents, and testimony God has given you and the opportunities. He has or may present for you to use them. Start small, think of a time you helped someone, and it made such a difference in their life. Use these lines (or your journal) to reflect on things you’ve learned from your life experiences that could help others avoid the same mistakes or free themselves from the bond that once held them down. Then pray and ask God to show and reveal His plan for preparing and using you in the special work He has chosen you to do. Minister Sandra G. Bellamy

iii A look at the author’s traumatic brain injury and impact on his academic journey Acknowledgements There are many people who have had a significant impact on my life that need to be acknowledgment and recognition. However, listing them all would require an additional two pages. These individuals are aware of their impact on my life, and I am grateful to you all. Education Professionals Friends Kennedy Krieger Institute Employers & Managers GOD Medical Professionals Family Home & Hospital Services Mentors Psychology for Behavior Management

iv Something for Everyone Students with Learning Disabilities Students with a learning disability can benefit from a boost in motivation to enhance their self-esteem. A case study conducted in 2009 revealed that more individuals with dyslexia have started their own business compared to those who work in corporate management positions (Logan, 2009). There are also comparable stories related to other disabilities. Parents and Guardians Parents who have children with learning disabilities can benefit from learning how to identify their children's strengths and the resources available to assist them. These families can provide a unique and dynamic perspective when engaging with their child's educational team, which extends beyond the school environment (Sears, 2020). Educators Ross, V. & Akin, L. (2002) stated that by the time a child with a learning disability reaches the third or fourth grade they are likely to result in a lack motivation, and morals. With this book, special education teachers and administrators might for the first time observe the lived experience of an individual with a learning disability who worked their way through the educational system, and they may learn where the challenges occurred as well as the ways in which those motivational factors occurred. Medical Professionals Medical professionals can use the author's lived experience with a traumatic brain injury (TBI) as a means to explore further studies with individuals who have learning disabilities. A recent study conducted by Li, L. M. et al. (2021) found that TBI patients often receive insufficient, unsuitable, or delayed treatment. Workforce Development Professionals Workforce development professionals and employers will learn through my experience that individuals with learning disabilities are just as qualified. The Department of Labor has a program to assist job seekers with disabilities with employers in private and government entities (U.S. Department of Labor, 2021).

v Table of Contents Reflections....................................................................................................................................................... ii Acknowledgements......................................................................................................................................... iii Something for Everyone.................................................................................................................................. iv CHAPTER ONE................................................................................................................................................. 2 Introduction ........................................................................................................................................................ 2 CHAPTER TWO................................................................................................................................................. 5 History of The Department of Education ............................................................................................................... 5 Special Education Program............................................................................................................................... 6 Sample Individual Education Plan..................................................................................................................... 8 CHAPTER THREE............................................................................................................................................. 9 Traumatic Brain Injury......................................................................................................................................... 9 Traumatic Brain Injury Explained ................................................................................................................... 10 Permission to Admit to Kennedy Krieger........................................................................................................ 12 Admission to Kennedy Krieger....................................................................................................................... 13 She Never Told Me .................................................................................................................................... 13 The Scar That Caused It All............................................................................................................................ 15 Brain Imaging............................................................................................................................................ 15 Right Occipital Temporal Encephalomalacia Explained.................................................................................... 16 CHAPTER FOUR............................................................................................................................................. 17 Traumatic Experience from the Loss of Siblings.................................................................................................. 17 Loss of First Sister......................................................................................................................................... 18 Loss of Second Sister..................................................................................................................................... 19 I Have to Protect Susan!.............................................................................................................................. 19 Susan’s Final Report Card and Graduation................................................................................................... 20 Loss of Third Sister........................................................................................................................................ 22 CHAPTER FIVE............................................................................................................................................... 24 Government Agencies Get Involved.................................................................................................................... 24 Application for Public Assistance ................................................................................................................... 25 Department of Social Services Files a Complaint............................................................................................. 26 Department of Health Takes Action............................................................................................................. 26 The Impact of Lead Poison............................................................................................................................. 27 CHAPTER SIX................................................................................................................................................. 29 Kennedy Krieger Department of Education ......................................................................................................... 29 About the Kennedy Krieger Institute' .............................................................................................................. 30 The Drop Off............................................................................................................................................. 30 Education Evaluation..................................................................................................................................... 31 U.S. Department of Education..................................................................................................................... 33 Social Security Administration Disability Insurance......................................................................................... 34 Your Claim Has Been Denied ..................................................................................................................... 35 CHAPTER SEVEN........................................................................................................................................... 36

vi Elementary School............................................................................................................................................. 36 Transition from KKI to the Public-Schools System .......................................................................................... 37 George G. Kelson Elementary School.......................................................................................................... 37 Kindergarten Collaboration......................................................................................................................... 37 Baltimore City Public Schools........................................................................................................................ 38 Special Education Program............................................................................................................................. 38 Elementary School Photos.............................................................................................................................. 39 George G. Kelson .......................................................................................................................................... 40 Grade Level Placement .................................................................................................................................. 40 Mother Tongue Language............................................................................................................................... 41 Malcom X Transcripts................................................................................................................................ 42 Grover Park Elementary................................................................................................................................. 43 Grover Park Transcripts.............................................................................................................................. 44 Edgecombe Circle Elementary School............................................................................................................. 46 Westside Elementary...................................................................................................................................... 47 Kennedy Krieger Institute’s Sixth Grade Assessment....................................................................................... 48 Westside Transcripts................................................................................................................................... 49 CHAPTER EIGHT............................................................................................................................................ 53 Middle School................................................................................................................................................... 53 Middle School Photos.................................................................................................................................... 54 Father Charles A. Hall Catholic School........................................................................................................... 54 No More Bullying.......................................................................................................................................... 55 From Public Schools to Catholic School.......................................................................................................... 56 From Catholic School Back to Public Schools................................................................................................. 57 Harlem Park............................................................................................................................................... 57 Harlem Park Report Card............................................................................................................................ 58 Services at Kennedy Krieger Terminated......................................................................................................... 59 Middle School Photo...................................................................................................................................... 60 CHAPTER NINE.............................................................................................................................................. 61 High School...................................................................................................................................................... 61 High School Photos........................................................................................................................................ 62 Upton School Foundation ........................................................................................................................... 62 Home and Hospital Program ....................................................................................................................... 62 High School Admission.................................................................................................................................. 63 Southwestern Senior High School................................................................................................................... 64 Failed 9th Grade............................................................................................................................................ 65 Dropping Out of School ................................................................................................................................. 66 I Will Fire Your Ass................................................................................................................................... 66 The Upton School Foundation ........................................................................................................................ 67 Home And Hospital Program.......................................................................................................................... 67 The School’s Police Came to Arrest Me....................................................................................................... 67 History of the Upton School Foundation.......................................................................................................... 68

vii Repeat 9th Grade......................................................................................................................................... 74 Transportation Service................................................................................................................................ 74 Employment and Training Program................................................................................................................. 75 10th Grade Year Report Card...................................................................................................................... 76 11th Grade Year Report Card...................................................................................................................... 77 Street Law Program ....................................................................................................................................... 78 Southwestern Industry.................................................................................................................................... 78 Project Program............................................................................................................................................. 80 Peer Project Certificate................................................................................................................................... 81 12th Grade Progress Report............................................................................................................................ 82 Mid Quarter Progress Report....................................................................................................................... 82 12th Grade Report Card............................................................................................................................... 83 High School Completion Checklist ................................................................................................................. 84 Momma I’m Going to Graduate................................................................................................................... 84 Congratulations from BCPS Administration .................................................................................................... 85 S.A.T. Scores................................................................................................................................................ 86 S.A.T. Failed.............................................................................................................................................. 86 High School Diploma..................................................................................................................................... 87 Master of Ceremony................................................................................................................................... 87 Graduation Day ............................................................................................................................................. 88 The Big Embarrassment.............................................................................................................................. 88 CHAPTER TEN................................................................................................................................................ 89 Associates Of Arts Program ............................................................................................................................... 89 No Money for College.................................................................................................................................... 90 Applications to College.................................................................................................................................. 91 Not with my SAT Scores............................................................................................................................ 91 Accepted to Barry University.......................................................................................................................... 92 Accepted to Baltimore City Community College.............................................................................................. 93 Accepted to Pasco-Hernando Community College ........................................................................................... 94 These Books Belong to Me ......................................................................................................................... 95 College Scholarships...................................................................................................................................... 96 Extra Curriculum Courses............................................................................................................................ 101 American Sign Language.......................................................................................................................... 101 Emergency Medical Technician................................................................................................................. 102 Braille ..................................................................................................................................................... 103 Letter of Completion BCCC......................................................................................................................... 104 Associate of Arts Degree.............................................................................................................................. 106 Associates of Arts Transcripts................................................................................................................... 107 I Have Something to Prove........................................................................................................................... 109 I Can Compete With an “A” Student.......................................................................................................... 109 CHAPTER ELEVEN....................................................................................................................................... 110 Bachelor of Arts Program................................................................................................................................. 110

viii University of Baltimore School of Business................................................................................................... 111 I Chose Diversity ..................................................................................................................................... 111 UB’s Disability Support Services.................................................................................................................. 112 Myer’s Briggs Personality Assessment.......................................................................................................... 113 The Myers-Briggs Key Enfp Characteristics............................................................................................... 114 Sigma Alpha Omicron Award....................................................................................................................... 115 An Award-Winning Campus Leader............................................................................................................. 116 Spirit of Excellence Annual Awards Criteria.................................................................................................. 117 Spirit of Excellence Nomination Letter.......................................................................................................... 118 Winner—School of Business— Spirit of Excellence Award ........................................................................... 121 A Gift for Mom ........................................................................................................................................... 122 Disability Support Service Reference ............................................................................................................ 123 Teaching for Baltimore City...................................................................................................................... 123 Bachelor of Science Degree.......................................................................................................................... 124 Bachelor of Science Transcripts................................................................................................................ 125 Graduation Day ........................................................................................................................................... 127 A Birthday Gift to Me............................................................................................................................... 127 CHAPTER TWELVE...................................................................................................................................... 129 Master’s Program............................................................................................................................................ 129 Graduate Schools Photos.............................................................................................................................. 130 Master’s Program Admission Letters............................................................................................................. 132 Master of Public Administration Mission....................................................................................................... 133 Master of Human Service Admission ............................................................................................................ 134 Thank You Letter......................................................................................................................................... 136 Master of Management Admission................................................................................................................ 137 Academic Probation..................................................................................................................................... 138 Master of Management Program Completion................................................................................................. 139 Master of Management Degree ..................................................................................................................... 140 Master of Management Transcript............................................................................................................. 141 Mom, I Have Another Surprise for You......................................................................................................... 143 Graduation Day ........................................................................................................................................... 144 CHAPTER THIRTEEN................................................................................................................................... 145 Doctoral. Program ........................................................................................................................................... 145 School of Advanced Studies......................................................................................................................... 146 School of Advanced Studies Admissions....................................................................................................... 147 Letter of Intent............................................................................................................................................. 148 Doctoral Candidate Status Approved............................................................................................................. 149 First Dissertation Challenges........................................................................................................................ 152 First Dissertation Proposal Failed.................................................................................................................. 153 Money Down the Drain ............................................................................................................................ 153 Second Dissertation Challenges.................................................................................................................... 154 First Chairperson Terminated.................................................................................................................... 154

ix Second Dissertation Proposal Failed.............................................................................................................. 155 Second Chairperson Hired ........................................................................................................................ 155 Third Dissertation Proposal Attempt ............................................................................................................. 156 Back to the Drawing Board........................................................................................................................... 156 Second Submission of Quality Review Passed ............................................................................................... 159 Permission to Use Premises.......................................................................................................................... 160 I’m Dropping Out of the Doctoral Program................................................................................................ 160 Internal Review Board Failed ....................................................................................................................... 162 Second Dissertation Chair Terminated Committee Member Resigned ............................................................. 162 Welcoming of New Chair............................................................................................................................. 163 Ph.D. Program Time Expired........................................................................................................................ 163 Program Extension Letter Submitted............................................................................................................. 164 Letter of Support from My New Chair........................................................................................................... 166 Program Extension Approved ....................................................................................................................... 168 Second Internal Review Process Failed ......................................................................................................... 169 IRB Correct a Thon.................................................................................................................................. 169 The Internal Review Board Process Deferred................................................................................................. 170 Dean’s Office Approval ............................................................................................................................... 172 The Shocking Phone Call ............................................................................................................................. 174 CHAPTER FOURTEEN.................................................................................................................................. 175 I am an Author................................................................................................................................................ 175 Approved Dissertation.................................................................................................................................. 176 Saying I Do to Your Career.......................................................................................................................... 182 My Second Publication............................................................................................................................. 182 Future Publication........................................................................................................................................ 185 Help Wanted............................................................................................................................................ 185 CHAPTER FIFTEEN ...................................................................................................................................... 186 The Degree Is in the Mail................................................................................................................................. 186 Graduation Day ........................................................................................................................................... 188 Doctor of Management Degree.................................................................................................................. 189 Ph.D. Transcripts...................................................................................................................................... 190 CHAPTER SIXTEEN...................................................................................................................................... 192 Leading with a Disability................................................................................................................................. 192 Better Late Than Never................................................................................................................................ 193 Leadership Positions.................................................................................................................................... 194 Visit from the Mayor of Baltimore City......................................................................................................... 195 “This is Very Interesting and Creative”...................................................................................................... 195 National Society for Leadership and Success Selection................................................................................... 196 NSLS Induction ....................................................................................................................................... 196 I am my Brand............................................................................................................................................. 198 Strongest Behaviors..................................................................................................................................... 199 CHAPTER SEVENTEEN................................................................................................................................ 200

x From the Undereducated to the Educator........................................................................................................... 200 Teaching with a Disability............................................................................................................................ 201 Teaching Was in My Blood....................................................................................................................... 201 Druid Hill Family YMCA Youth Program..................................................................................................... 203 RAYMOND HOLMES!! You Better Not Screw This Up............................................................................ 203 Druid Hill Family YMCA After School Accelerated Program......................................................................... 205 RAYMOND!! You Can’t Go Around Firing Everyone ............................................................................... 205 Workforce Development Teaching................................................................................................................ 206 The Doctor Is Now on Duty ...................................................................................................................... 206 Higher Education Teaching.......................................................................................................................... 207 Statement of Teaching Philosophy ................................................................................................................ 207 Welcome to Business 101 with Professor Holmes....................................................................................... 207 Baltimore City Public Schools Teaching........................................................................................................ 208 Through My Eyes..................................................................................................................................... 208 Holmes Labor Market Consulting Inc............................................................................................................ 209 CHAPTER EIGHTTEEN................................................................................................................................. 210 Meet The Family ......................................................................................................................................... 210 My Parents.................................................................................................................................................. 211 Siblings....................................................................................................................................................... 213 My Family .................................................................................................................................................. 216 It’s Hard Raising Four Boys...................................................................................................................... 217 My Kid’s Grand Ma Mas.......................................................................................................................... 217 My New Cousin........................................................................................................................................... 218 It Felt like Home...................................................................................................................................... 220 CHAPTER NINETEEN................................................................................................................................... 221 Inspirations..................................................................................................................................................... 221 Educational Inspiration................................................................................................................................. 222 Gladys’s Knight........................................................................................................................................... 222 The Best Thing That Ever Happened to Me ............................................................................................ 222 Reminiscing to Gladys Knight...................................................................................................................... 223 Screen Play.............................................................................................................................................. 223 This One Is for You Sis................................................................................................................................ 224 CHAPTER TWENTY...................................................................................................................................... 226 Defying the Odds............................................................................................................................................. 226 It Was My Mother That Defied the Odds....................................................................................................... 227 The Finality ............................................................................................................................................. 228 About the Author......................................................................................................................................... 229 References................................................................................................................................................... 229

1

2 CHAPTER ONE Introduction “As special needs parents we don t have the power to make life fair, but we do have the power to make life joyful”. ’ ~ Anonymous

3 As I reflect on my life, one striking similarity stands out - the heart-wrenching loss of both my beloved parents left in my soul. They both deeply appreciated the melodies that stirred their souls, and they passed on this love for music to me. A language we spoke, a symphony that resonated in our hearts. However, when my father passed away, I was devastated and shattered. During those trying times, my mother was my guiding light. She was there for me every step of the way, helping me navigate the turbulent waters of grief. Her love provided solace like no other. Together, we mourned the loss of my father, leaning on each other for strength. However, fate had another cruel twist in store for me. When my mother passed away, I found myself grappling with a different kind of grief. This time, I didn't have the same level of support to lean on. Yes, I had friends and family who offered their condolences, but it wasn't the same. My mother, who had been my rock, could no longer hold me close and ease my pain. The void she left was immense, and I felt lost in a sea of emotions. As I stood in my mother's bedroom after her funeral, surrounded by nieces and nephews who wanted to take something to remember their grandmother by, I found myself in her closet, sifting through her belongings. What I discovered there left me reeling. Among her personal items were documents she had kept for my siblings and me - birth certificates, medical bills, and medical records. However, what shocked me the most was the information I found about myself - school records, medical information, and more. As I read those papers, I felt nothing but guilt. My sister, Susan, who was born before me, had Down's syndrome. I learned that I suffered with a traumatic brain injury at a young age. I couldn’t imagine the frustration and challenges it must have caused my parents. I stood in her bedroom feeling guilty for consuming so much time of their lives. I felt guilty for my siblings, who didn’t get as much time and attention as Susan and myself. All I remember saying to myself is “THEY NEVER TOLD ME”. I would have thought that as I got older that one of them would have revealed to me the history of my learning disability. I never knew that I was in special education classes starting from Kennedy Krieger until the ninth grade. I found myself being referred to disability support services by math and English professors for extra assistance throughout my college journey, and while I understand those situations, I would never have thought that as hard as I was trying to keep my grades up there was an underlining medical condition that stretched beyond capacity that was out of my control. After uncovering information about my parents' concerns from my childhood, memories flooded back to me in flashes. I recalled my mother's arguments with my father over the phone, urging him to come get me because I was struggling in school and not completing my work. It was a painful realization, and I began to piece together the puzzle of my past. A decade after my mother's passing, I carried a heavy burden of guilt that weighed on my mental and physical health. There were moments when I would suddenly break down in tears, whether at the mall, at work, or at home, regardless of what I was doing to keep myself occupied. The tears would flow uncontrollably, as though someone had turned on a faucet over my head. However, I was determined to confront my past and find healing, no matter how difficult the journey might be. I shared the medical and education reports with my doctor, who reassured me that stressing over things beyond my control was unnecessary. He pointed out that despite my medical condition, I had achieved remarkable things in life, something many others could only dream of doing. He advised me to review the information, identify at least three challenges I had, and explain how I had overcome those obstacles. He

4 even mentioned that this could become another book one day. With renewed motivation, I eagerly embraced the task, eager to turn my struggles into a story of triumph and resilience.

5 CHAPTER TWO History of The Department of Education “Parents of children with special needs create their own world of happiness and believe in things that others cannot yet see.” ~ Anonymous

6 Special Education Program During the 19th century, institutions specializing in serving individuals with mental and physical disabilities, deafness, blindness, and mental retardation were created. These institutions were often located in rural and isolated settings, designed to separate these individuals from the rest of society (Hemann, 2007). In the late 1960s, the Federal Department of Education promoted sweeping changes in the education of children with disabilities (Abeson & Trudeau, 1970). The Handicapped Children's Early Education Assistance Act supported research findings that revealed that the enrollment age of six years old for disabled students should be abolished (Abeson & Trudeau, 1970). Head Start programs across the country have implemented major changes to the educational system for disabled students (Abeson & Trudeau, 1970). The National Association of Special Education Teachers (2021) defines a learning disability as: Specific types of learning problems that can cause difficulties in learning and using certain skills, such as reading, writing, listening, speaking, reasoning, and mathematics (The National Association of Special Education Teachers, 2021; Vidyadharan & Tharayil, 2019). Many states passed legislation that required educational institutions to keep students with severe disabilities in school until the age of 21 (Abeson & Trudeau, 1970). California expanded its law for disabled students by enacting an experimental program for deaf and severely hard-of-hearing children from 18 months to three years old (Abeson & Trudeau, 1970). Maryland adopted the terminology "Physically and Mentally Handicapped," defining students meeting these criteria as eligible for special education services if such services can lead to development like that of a student with no handicaps (Abeson & Trudeau, 1970). In 1975, Congress passed the Education for All Handicapped Children Act, later known as the Individuals with Disabilities Education Act, which mandated special education services for students with disabilities. (Individuals with Disabilities Education Act, 2021; U.S. Department of Education, 2021). In 1990, the Department of Education Act further mandated that public schools provide special education programs for students with Traumatic Brain Injuries (T.B.I.) as a special education category (Hux, K.; Bush, E. et al., 2021). A survey of over 100 teachers questioned their preparedness for working with students with disabilities (Hove, 2014). The survey revealed that mainstream class teachers face challenges due to a lack of skills, bigger class sizes, shortages of relevant instructional materials, and a lack of support services (Hove, 2014). Learning Disabilities: Understanding and Supporting Students with Unique Needs Learning disabilities are distinct from other learning problems caused by visual, hearing, motor, intellectual, emotional, cultural, or economic factors (Learning Disabilities Association of America, 2021). Vidyadharan & Tharayil, 2019). The Learning Disabilities Association of America identifies five primary learning disabilities: 1. Dyscalculia: This affects a person's ability to understand numbers and learn math facts. 2. Dyslexia: This impacts one’s reading and related language-based processing skills. 3. Non-Verbal Learning Disabilities: These can cause difficulty in interpreting nonverbal cues such as facial expressions or body language and may result in poor coordination. 4. Oral/Written Language Disorder and Specific Reading Comprehension Deficit: This can affect an individual's understanding of what they read or hear in spoken Language. In addition to these five, Walden University (2021) has identified two other learning disabilities:

7 1. Auditory Processing Disorder: This affects an individual's ability to process sound. 2. Visual Perceptual/Visual Motor Disorder: This can result in poor hand-eye coordination, difficulty keeping place while reading, and confusion with similar-looking letters. A special education teacher stated she faces significant challenges in engaging her students in literacy instruction. Many of her students have experienced years of struggle with learning and attentional or emotional issues that interfere with their mastery of written Language. It can be challenging to keep them focused during reading instruction, as they may have developed aversions to books due to past failures. This is a common struggle for educators, particularly for those in special education (Ross & Akin, 2002). Despite these challenges, inclusion in general education classrooms is beneficial for seven out of ten students with learning disabilities, as they spend at least 80 percent of their time in such settings (National Center for Learning Disabilities, 2017). However, a nationwide survey reveals that many general education teachers feel ill equipped to meet the diverse needs of their students due to a lack of training and resources (National Center for Learning Disabilities, 2017). Recognizing the need for well-prepared special educators, the University of Maryland has implemented a five-year program to train students interested in working in special education from K-12 settings (Lovingfoss, Eddy, Harris, & Graham, 2001). This comprehensive program includes 150 credits and handson practices to ensure that future special educators are equipped to meet the unique needs of their students (Lovingfoss et al., 2001). Special educators are critical in ensuring students' Individualized Education Plan (I.E.P.) goals and objectives are followed, assessed, and reported (Murawski & Hughes, 2021). They must also provide appropriate accommodations for students with learning disabilities (Murawski & Hughes, 2021). Preparing an I.E.P. involved assessments by the school psychologist to evaluate cognitive, social, emotional, psychomotor, self-help, behavioral, speech, and language, as well as vocational needs and abilities (Hemann, 2007). Once assessments are analyzed, all individuals involved must ensure that the child has the resources and support to achieve their educational goals (Hemann, 2007). These individuals include: 1. The parents of the child 2. Possibly the child 3. School Psychologist 4. The student's teacher 5. Special Education Teacher 6. Any title or pullout program teachers who have worked with the student. 7. The administrator The I.E.P. reviewed annually to measure the progress of the child and to adjust the plan to continue the progression of the child (Hermann, 2007; Murawski et al., 2021). Learning disabilities are unique challenges requiring specialized support and educators' accommodations. Despite the obstacle’s students with learning disabilities face, inclusion in general education classrooms can be beneficial. It is crucial that special educators be well prepared through comprehensive training programs and actively collaborate with other stakeholders in developing and implementing effective I.E.P.s to support the educational success of students with learning disabilities.

8 Sample Individual Education Plan

9 CHAPTER THREE Traumatic Brain Injury Myth 1 Learning disabilities are not common (Springer school and center, 2016). FACT: Learning disabilities are common. In the 2010 U.S. Census, 4.6 million Americans reported having a learning disability and one out of every 20 public school students is identified as having a learning disability.

10 Traumatic Brain Injury Explained Traumatic brain injury (T.B.I.) is a leading cause of death and disability in the United States (Lueckel, Kosar, Teno, Monaghan, Hefferman, Cioffi, Thomas, 2018; You, Lu, Fu, Xu, 2021). It is estimated that between 1.5 and 2.5 million instances of T.B.I. occur in the United States each year among children aged four or younger (Auday, Abrahamsen, Selem Press Encyclopedia of Health, 2019). Adolescents between the ages of 15 and 19 and adults aged 65 and over are particularly at risk for death or disability from T.B.I. (Auday et al., 2019). According to Auday et al. (2019), the most common symptoms of T.B.I. resulting from the initial impact of the skull hitting another object. An impactful blow to the head causes the brain to shift, resulting in bruising, tearing, and shearing of the skull, leading to brain cell death (Pediatric injury, 2021; Vidhya, Gudigar, et al., 2021). Statistics provided by Pediatric Injury (2021) reveal that the majority of T.B.I."s occur as follows: Falls - 40.5% ● Motor vehicle accidents - 14.3% ● Assaults - 10.7% ● Being struck by or against - 15.5% ● Unknown causes - 19% Individuals with T.B.I. typically undergo assessment and treatment by a neuropsychologist (Auday et al., 2019). A neuropsychologist is a psychologist who specializes in understanding the relationship between the physical brain and behavior (Auday et al., 2019). To understand this relationship, the neuropsychologist's first step is to complete an assessment to examine cognitive and behavioral deficits (Auday et al., 2019; Vidhya, V., Gudigar, A., Raghavendra, U., Hegde, A., Girish, M. R., Molinarim, F., Ciaccio, E. J., & Acharyam, R., 2021). Once the assessment is complete, a treatment plan can be created (Auday et al., 2019). Traumatic brain injury (T.B.I.) is not the same as a birth brain injury. Pediatric Injuries (2021) reports that over 66% of babies suffer from birth brain injuries. Traumatic brain injury can cause serious complications and even death in newborn infants (Kokokakis and Koutelekos, 2015). There are three major categories of traumatic birth injuries: • Extracranial hemorrhage • skull fractures • Intracranial hemorrhages (Kokokakis and Koutelekos, 2015). These injuries occur during or near the time of birth caused by factors such as a lack of oxygen, premature birth, or medical negligence (Kokokakis and Koutelekos, 2015). Among children with cerebral palsy and severe mental retardation, trauma is implicated in a few cases, possibly 1-2 of 1000 deliveries (Geirsson, 1988). It's important to note that the term "traumatic birth injuries" does not apply to brain injuries that are congenital, degenerative or to brain injuries induced by birth trauma (U.S. Department of Education, 2021; Pediatricinjury, 2021). Traumatic birth injuries often result in severe learning disabilities (Pediatricinjury, 2021; Geirsson, 1988). Nationwide Children (2017) explains in their article "Epilepsy and Learning Disabilities: Helping Children at School" that epilepsy is not just about seizures. Many may not realize that for some children with epilepsy, problems with learning and school performance can sometimes be harder to deal with than the seizures themselves. Often, seizures and cognitive difficulties are caused by the same underlying problem in the brain. In some cases, the seizures can affect brain development, particularly for children who frequently experience these episodes (Nationwide Children, 2017).

11 Epilepsy affects approximately 2.5 million people in the U.S. (Hitti, 2021). Studies have shown that individuals who experience seizures on the left side of their brain are more likely to have learning disabilities than those with seizures on the right side (Hitti, 2021). Specifically, disability rates for reading comprehension, written language, and calculation were found to be higher in epilepsy patients with seizures originating in the brain's left hemisphere (You et al., 2021). Hitti's (2021) study on epilepsy and learning disabilities also revealed that 75% of individuals with seizures originating on the left side of the brain had at least one learning disability, in contrast to only 8% of individuals with seizures on the right side of the brain. While epilepsy is more common in boys than girls are, it is noteworthy that 40% of children between the ages of 4 and 15 with epilepsy also have at least one additional neurological disorder. In fact, individuals with epilepsy are 50% more likely to have one or more learning disabilities compared to the general population. Autism is found to be more common in individuals with epilepsy, with reported rates of approximately 20, and vice versa, with epilepsy being more common in people with autism at similar rates (Besag, 2017). However, it's important to note that these percentages may be influenced by criteria for autism spectrum disorder (A.S.D.) (Besag, 2017). Children with Attention-Deficit Disorder (A.D.D.) without the hyperactivity component may appear bored or disinterested in classroom activities, daydreams, forgetful, slow work pace, and incomplete assignments (Verywell, 2020). Attention deficit hyperactivity disorder (ADHD) is also more frequent in children with epilepsy compared to the general pediatric population. Several factors contribute to this comorbidity, including underlying brain pathology, chronic effects of seizures and epileptic form E.E.G. discharges and the effects of antiepileptic drugs (Parisi et al., 2010). The International Dyslexia Association (2021) has identified dyslexia, characterized by difficulties with accurate and/or fluent word recognition, poor spelling, and decoding abilities, as a specific learning disability with neurobiological origins. A study conducted by the Beth Israel Hospital and Harvard Medical School on "Association of Dyslexia with Epilepsy, Handedness, and Gender" revealed that a history of dyslexia was significantly more prevalent in patients with epilepsy. Furthermore, dyslexic epileptic males had a comparatively younger seizure of onset age than non-dyslexic males, consistent with other epileptic syndromes associated with cortical anomalies (Schachter, 2021). As students grow, they are expected to use their brains differently, as noted by Morey (2000). However, damage to the brain from earlier injuries can make it challenging for students to learn new skills that come with age. Sometimes, parents and educators may not even realize that a student's difficulties stem from a prior injury.

12 Permission to Admit to Kennedy Krieger Health Insurance Portability and Accountability Act The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of all Americans by providing for effective health and human services and by fostering sound and sustained advances in the sciences underlying medicine, public health, and social services (U.S. Department of Health and human services, 2004). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge (Health insurance portability and accountability of 1996 (2024). This memoir includes medical information released by the author that has been redacted to protect the names of medical physicians and dates. The goal

13 is to have readers focus on the content of the lived experience of the author. Admission to Kennedy Krieger She Never Told Me I broke down and cried once I uncovered these documents. I cried for about one hour. I felt so horrible that I put my mother through this pain. I’m sure that my mother was as emotional as I was. Hearing doctors breaking this news to her had to have been traumatic. I would assume that my mother would have revealed this information to me as I got older. In the beginning of the book when I grabbed choosing a title for the book, my first thought was to relate it to the surprise and shock I felt. “WOW, THEY NEVER TOLD ME!” However, I decided to keep the original title to maintain focus on overcoming the challenges.

14 There were several setbacks in getting me an appointment at the hospital. Most of the issues revolved around scheduling conflicts with my parents' work schedules. They were doing their best to balance their jobs with taking care of me, but it wasn't always easy. Another challenge was transportation. My parents didn't always have enough funds available for transportation on the days when my appointments were scheduled. However, the Department of Social Services (D.S.S.) came to our aid by issuing taxi vouchers to my parents so they could take me to the hospital.

15 The Scar That Caused It All Brain image photo (Orcutt, 2015) Brain Imaging “HEMORRHAGE: No acute hemorrhage. BRAIN: Right occipital temporal encephalomalacia with hemosiderin staining is present.” University of Maryland The results from Magnetic Resonance Imaging (MRI) revealed the following outcome as listed above. I could not obtain the actual film of my results. Instead, I located an image with a similar result to show an illustration of what my results would have displayed. Above is an image of a soldier’s brain in his 20s who was diagnosed with a mild traumatic brain injury (Orcutt, 2015). Arrow points to the damage that may be due to his injury. That translation to my results merely means there is a lesion on my brain. Lesions are abnormalities in the brain tissue appearing as small spots. In other words, there is a little scar on my brain.

16 Right Occipital Temporal Encephalomalacia Explained According to John A. Burns, School of Medicine- Department of Anatomy (2024), Encephalomalacia is the softening or loss of brain tissue after cerebral infarction, cerebral ischemia, infection, craniocerebral trauma, or other injury. The term is usually used during gross pathologic inspection to describe blurred cortical margins and decreased consistency of brain tissue after infarction. Social Security (2024) identifies symptoms of encephalomalacia that may include a combination of any of the following: • damage to memory. • emotional effects. • loss of speech. • loss of sensory perception. • loss of muscle control. • constant fatigue and desire to sleep. • clumsiness. • blindness or lack of visual acuity. • mood swings. • coma Most of the cases reported previously were in infants and children and all of them were related to neurological disorders (Burns, 2024). Neurological disorders affect speech. These disorders, including aphasia, dysarthria, apraxia, and cognitive-communication impairment, commonly arise from conditions like stroke, traumatic brain injury, brain tumors, or progressive neurological conditions (e.g., dementia, ALS, or primary progressive aphasia) (Burns, 2024). According to the Social Security Administration, neurological, including encephalomalacia, is a disability. This is because it is an extremely serious brain disorder that can cause permanent tissue damage including scarring of the brain and loss of tissue (Social security administration, 2024).

17 CHAPTER FOUR Traumatic Experience from the Loss of Siblings “It shouldn’t matter how slowly a child learns. What matters is that we encourage them to never stop trying.” Robert John Meehan -

18 Loss of First Sister According to the National Child Traumatic Stress Network (2009), children may develop symptoms that interfere with their ability to grieve and have comforting memories of the person who died. Surviving siblings may become preoccupied with thoughts that they could or should have prevented death (NCTSN, 2009). These thoughts can disrupt everyday activities, especially schoolwork. Since children may not express their feelings directly, it is important to be aware of any changes in surviving children's play and behavior that may indicate their distress (NCTSN, 2009). My sister Cynthia died of crib death when she was only six months old. According to my medical report, I exhibited those symptoms, which may have resulted in a change in my behavior. I never knew that a young child could experience such traumatic emotions, especially if they do not fully understand the concept of life and death. Children with traumatic grief may experience symptoms of post-traumatic stress disorder (PTSD), such as nightmares about death and persistent thoughts about the sibling (NCTSN, 2009). My father used to tell me that I would often get in their bed in the middle of the night because I was scared. When Susan died, I was much older and had a better understanding of life and death and the pain that it caused. NCTSN (2009) stated, "Whatever the child's age, he or she may feel unrealistic guilt about having caused the death. Sometimes bereaved children take on adult responsibilities and worry about surviving family members and who would care for them if something happened to their caregivers." I also experienced guilt over my parents' death, feeling like I could not fulfill my responsibilities as their child. Susan and I were close in age and spent a lot of time together, so I felt guilty for not being able to teach her basic life skills despite her medical condition, which was beyond my control. The death of my sister Mary was painful and stressful. I learned so much from her. She had been instrumental in helping my mother care for me as a child, and I cherished the memories of our time together, especially playing music (Betty Wright, and Smokey Robinson). In conclusion, a sibling's death can profoundly affect surviving children, even if they are young and do not fully understand the concept of death. It can result in symptoms that interfere with their ability to grieve and cope with their emotions, such as guilt and PTSD. As caregivers and adults, it is crucial to be aware of these potential effects and provide support and understanding to help children navigate their grief and emotions. My first sister, Cynthia Holmes, was one year younger. I was around three years old when she died.

19 Loss of Second Sister I Have to Protect Susan! According to my sister’s medical records, her life expectancy was less than 25 years. However, she defied the odds by living 15 years past her projected life expectancy. Her death was incredibly traumatic for me because I understood the impact of her disability on her mental capacity and overall well-being. Susan and I were always on the same yellow school bus. Children can be incredibly cruel due to their ignorance about different situations and events. In our neighborhood, the yellow bus was referred to as the "slow bus" or retarded bus." The hurtful taunts and teasing from other children took a toll on me, resulting in anger and behavioral issues.

20 Susan’s Final Report Card and Graduation My sister and I went to different schools. Our school buses would arrive at around the same time each day. I would anxiously watch as Susan was put on her bus, desperately wanting to be with her. I would even fight with my bus aide, trying to prevent her from putting me on my bus because all I wanted was to accompany my sister to her school and protect her. My mother had to intervene and rearrange our bus schedules so that my bus would arrive before Susan's. However, if I saw her bus turning the corner after I was already seated, I would lose control and become overwhelmed with frustration all over again.

21 This is my sister on her graduation day. I wanted to show her the final report card to show the similarity of our report cards when I started in kindergarten with the collaboration between Kennedy Krieger up and into high school. Susan’s Special Education High School Certificate

22 Loss of Third Sister

23 Mary Mary aka Cookie was my oldest sister. We had so much fun together. Recall, Mary looked after us when our parents went to work until her acceptance into the Job Corps. Like our mom, we enjoyed listening to music together. Her favorite singers were Smoky Robinson and Betty Wright. Regardless of what she was doing, whenever she heard the son “To Night Is the Night (That You Make Me A Woman), she would instantly stop what she was doing and start dancing and filled with joy. During family functions, we found Cookie dancing. She loved to crochet, make blankets, gloves, and scarves. She also loved to write. She has three children whom I have always been overprotective of. Though they are grown, employed, and living productive lives, I’m still protecting them especially in ways they are not aware of. Cynthia Carl Carla

24 CHAPTER FIVE Government Agencies Get Involved . ’ ( Myth 1 LD only affects children. Adults grow out of the disorders (Sharma, 2021). Reality. It is now known that the effects of LD continue throughout the individual lifespan and may even intensify in adulthood as tasks and environmental demands change (Sharma 2021)”. Sadly, many adults, especially older adults, have never been formally diagnosed with LD. Learning disabilities cannot be outgrown, but they can be identified reliably in nosed with LD. Learning disabilities cannot be outgrown, but they can be identified reliably in kindergarten or first grade children, or even earlier. Research clearly demonstrates that the earlier a child is given appropriate help for a learning disability, the more successful the outcome Sharma, 2021)

25 Application for Public Assistance I remember my mother and father working tirelessly across the street from one another in two different restaurants up the street from our home. They would rotate their shifts every hour to come home and check on Susan and me. At the time, our oldest sister watched us. However, things took an unexpected turn when my oldest sister was accepted into Job Corps. My sister traveled to Indiana where she lived on campus. As a result, my mother had to make the difficult decision to resign from her job and apply for public assistance to make ends meet and to watch my sister and me. While applying for assistance, my mother explained to the caseworker the challenges she faced in caring for my sister and me. She also mentioned the issue of chipped paint in our house and the property owner’s constant procrastination in fixing it.

26 Department of Social Services Files a Complaint Department of Health Takes Action As I reached the milestone of graduating from high school, my father and I were watching the news one evening. A segment caught our attention – the Health Department had placed a family in a hotel and filed charges against their property owner for failing to address their home's hazardous and unsafe living conditions. As we watched the news report, my father's face took on a solemn expression. He began to share a story with me, one that resonated deeply with the situation he experienced when I was a child. He told me that we were forced to leave our home due to hazardous conditions, and he vividly remembered four men arriving with white protection outfits to begin the lead removal treatment. He recounted how several social workers escorted our family to a hotel until the work was completed.

27 The Impact of Lead Poison The Maryland Department of Health (2022), lead poisoning affects many children younger than 6 yyears old in Maryland. Lead poison can be found in toys and jewelry. According to WebMD (2024), even lesser amounts of lead can cause severe health problems. Lead enters the body through the bloodstream. The body then stores lead in the organs, tissues, bones, and teeth (WebMD, 2024). Lead can harm a child’s brain, causing lifelong learning including low IQ and behavior problems (Sinai, 2024). The report also revealed that lead dust in the home is caused by chipping and deteriorating lead - based paint (WebMD, 2024). According to Cedars Sinai (2024), the following people are most at risk for lead poisoning: • Children between ages 1 and 3 • Children in low-income families • African Americans • Mexican Americans • People living in large metropolitan areas. • People living in older housing. • People living in housing built before 1978. The same study indicated that children under the age of 2 living in older homes should be tested. Undetected elevated levels of lead in the body can cause the following: • Damage to the brain and nervous system. • Behavior and learning problems. • Slowed growth. • Hearing problems • Headaches • Anemia • Seizures • Trouble learning • Aggressive behavior While lead poisoning affects thousands of children annually, it is preventable (Somerset County health department, 2024). Congress has passed laws related to lead. These laws address lead in paint, dust, soil; lead in the air; lead in water; and disposal of lead waste (U.S. environmental protection agency, 2024). EPA enforcement programs ensure that companies and individuals who violate federal law waste (U.S. environmental protection agency, 2024). The EPA, working with other federal agencies and its state, local, and tribal partners, uses multiple environmental laws and regulations to prevent or reduce exposure to lead in the air, water, and soil. The legacy of toxic lead exposure disproportionately affects communities with environmental justice concerns, especially those with a higher concentration of low-income households. The EPA uses its enforcement actions to correct this environmental injustice.

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29 CHAPTER SIX Kennedy Krieger Department of Education Myth 2 Children with LD are identified in kindergarten and first grade (Sharma, 2021). Reality. Learning disabilities often go unrecognized for years; most are not identified until third grade. Bright children can ‘mask’ their difficulties, and some kinds of learning problems may not surface until middle school, high school, or even college (Sharma, 2021) . .

30 About the Kennedy Krieger Institute' Located in Baltimore, MD, the Kennedy Krieger Institute is an internationally recognized institution dedicated to improving the lives of children and young adults with pediatric developmental disabilities and disorders of the brain, spinal cord and musculoskeletal system through patient care, special education, research, and professional training (Kennedy Krieger institute, 2021a). The Kennedy Krieger Institute's Department of Special Education includes a number of programs that offer services to children with learning challenges. Students aged 5-21 receive instruction that focuses on the development of academic, social, emotional and behavioral skills in an environment that recognizes and capitalizes on the individual strengths of each child (Kennedy Krieger Institute, (2021). In addition, a full range of related services was provided in order to implement Individual Education Plans (IEPs) in the least restrictive environment. Special education services focus on the development of academic, social, emotional and behavioral skills through transdisciplinary comprehensive instruction in an environment that recognizes and capitalizes on the individual strengths of each child (Kennedy Krieger Institute (2021b). https://www.kennedykrieger.org/about-us The Drop Off One evening, I vaguely remember my mother taking me to Kennedy Krieger Institute (K.K.I.), and she took me to a room with doctors. I immediately started playing with the toys in the room and started playing with them while my mother was busy filling out paperwork. However, when it was time for her to leave, I lost my composure. I clung to her, not wanting her to leave, but the staff gently intervened and helped her leave the room. These assessments from KKI were the result of over three-months of studies by different medical professionals during my admission from therapists, psychologists, human service agencies and education professionals.

31 Education Evaluation

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33 U.S. Department of Education The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education (Family educational rights and privacy act (2024). FERPA gives parents certain rights to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights have been transferred are "eligible students." This memoir includes education records released by the author and has been redacted to protect the names of some education officials and dates. The goal is to have readers focus on the content of the lived experience of

34 the author. Social Security Administration Disability Insurance The Social Security Administration identifies the disability of a child as a medical condition, or a combination of conditions, which result in “marked and severe functional limitations.” This means that the condition(s) must very seriously limit the child’s activities. The child’s condition(s) must be disabling, or be expected to be disabling, for at least 12 months; or the condition(s) must be expected to result in death (Social security administration, 2024). An article in DisabilitySecrets (2024) identifies the following conditions listed below as three primary qualifiers for children with disabilities to qualify for benefits. Conditions Qualifiers Pages Children with ADHD or ADD Attention deficit hyperactivity disorder (ADHD) is a condition that occurs in children that is characterized by trouble paying attention, lack of impulse control, and/or hyperactivity. While the problem is an issue with attention span rather than hyperactivity and impulsivity, some call it attention deficit disorder. ________ Children’s Development and Learning Disabilities Social Security recognizes learning disabilities as disabling medical conditions for "neurodevelopmental disorders." This listing applies to (reading difficulties), dyscalculia (math difficulties), and other types of specific learning problems. ________ Children with Borderline Intellectual Functioning People with borderline intellectual functioning typically have difficulties with learning, reasoning, planning, abstract thinking, and judgment. Lower than the average intellectual functioning (IQs between 71 and 84) can be caused by birth injury, infections, genetics, fetal alcohol syndrome, or environmental exposure to toxins such as lead. __________

35 Your Claim Has Been Denied The following image was photo shopped. The purpose is to give an example of what a denial letter looks like. I learned that my parents were denied disability benefits. It must have been devastating to hear a government agency tell them about the health and medical condition of their child. Especially since the medical institution provided the documentation of my disability. I have identified the page numbers where the documentation supporting the disability is from a world-renowned medical institution.

36 CHAPTER SEVEN Elementary School ( . . Myth 3 More boys than girls have learning disabilities (LD) (Sharma, 2021). Reality. Although three times more boys than girls are identified by schools as having learning disabilities, research studies show that, in fact, equal numbers of boys and girls have the most common form of learning problem—difficulty with reading. Many girls' learning difficulties are neither identified nor treated (Sharma, 2021).

37 Transition from KKI to the Public-Schools System Kennedy Krieger Institute's Department of Special Education George G. Kelson Elementary School Kindergarten Collaboration My only memory of my kindergarten experience was my oldest sister and brother walking me to school. I vividly remember how they held my hands tightly as we walked together, their reassuring presence making me feel safe as we approached the school gates. Once inside the classroom, I recall seeing teachers and other people in white coats sitting at a table while I sat on the floor, playing with play dough.