← Autism Parenting Secrets
Autism Parenting Secrets
You DON’T Have To Wait
00:38:58
Many parents spend years waiting for the right help while trying to navigate autism care on their own. John Slattery joins the show to explain how Meadow Health is working to make biomedical and functional medicine support more accessible, coordinated, and practical for families. The secret this week is… You DON’T Have To Wait
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- [00:00]
A
You know, go find your nearest maps doctor, get on a wait list and try and get in as soon as you can. That's not okay. We need to have a more accessible care model. We need to make sure that we can meet families where they are irrespective of their geography, irrespective of, you know, being able to, you know, get answers sooner rather than later. So I mean that for all those reasons, that was kind of, you know, part of the reason behind the why for Meadow.
- [00:24]
B
If you're a parent of a child with autism, you are being called to rise with love, courage and clarity. This journey isn't easy and most parents aren't equipped, but you can be. This podcast is your invitation to rise higher because how you navigate matters. I'm Len, and this is Autism Parenting Secrets, where you become the parent your child needs now. Hello and welcome. Finding the right help for your child can take way too long. Parents are often left trying to figure out everything on their own. The doctors, the testing, treatment, prescriptions, therapies. There's endless decisions. But what if getting high level biomedical support could become faster, easier, and more connected under one roof? Today's guest is John Slattery. He's the co founder and CEO of MeadowHealth, and John is a clinical research leader and he's played a real key role in the first positive placebo controlled study of leucovor and calcium for children with autism. His work is focused on helping families get better access to precision medicine and more personalized care. Now, through MeadowHealth, John and his team are building a platform designed to help families access biomedical and functional medicine support in a more affordable, coordinated and practical way. So this conversation is really about where autism cares about may be heading next. The secret this week is you don't have to wait. Welcome, John.
- [01:57]
A
Thanks so much, Lynn. I really appreciate you bringing me here and happy to have a conversation.
- [02:01]
B
I am too. I'm happy to continue our conversation that we had initially at last month's MAPS conference. And so I guess I'll leave it to you to explain more of your background because you've been in the space for a while in a number of different real powerful capacities. So after years in clinical research and with precision medicine, you know, what made you realize that families weren't just struggling with the science, that they were struggling to actually get access to good care.
- [02:31]
A
Yeah, that's a great question, Lynn. And that's actually where things first began. So I was at Arkansas Children's Hospital with just a phenomenal team of researchers, scientists, clinicians we had the first medically based multidisciplinary autism clinic in the country, led by Dr. Richard Fry. I was the translational research lead. We set up our clinic back in Arkansas to where essentially, so I guess the clinic itself. Richard, if you're not familiar with his background, he's a pediatric neurologist, MD, PhD, prolific figure in the autism world, and just a tremendous clinician researcher. So we had Richard brought on to be the clinical lead of our clinic. But it was rather unique in that the clinic itself brought, brought in a multidisciplinary team that included geneticists, gastroenterologists, nutritionist, immunologist, all under one roof, to where we had a multidisciplinary care clinic dedicated to the medical needs of kids with asd. The other unique thing was that every single patient that came into our clinic, we gave them the option to be a part of a research protocol in which we could take data that was collected clinically, whether it be their labs, treatment records, et cetera, and be able to mine that data for research purposes so we can better understand clues in terms of certain, you know, this collection of behavioral symptoms that we label as one thing in terms of autism spectrum disorder. We all know that you've met one child with autism, you've actually met one child with autism. Each child's unique needs, whether that be their behavioral needs, their clinical needs, they all have very unique individualized care plans that should be tied to the patient's unique biology and their unique clinical presentation. Right? So that was something that we did from a research standpoint, be able to take all that data, be able to understand or try to understand why certain patients may respond to certain treatment pathways, why others may not. What in their biology may give us clues as to why certain treatment strategies may work best for certain patients, and then that would give us some signals in the research data and the clinical data to be able to understand. Okay, there seems to be something going on here, whether it be related to the mitochondria, whether it be related to the gut microbiome, whether it be related to certain autoantibodies, such as the folate auto antibody, and then that would inform what we'd want to move into the clinic for a clinical trial. The most notable of those you brought up in the opening was work related to the folate receptor alpha autoantibody and the Luke of Orin story. I was fortunate enough with Richard to be the second author and a co investigator on the first double blind placebo controlled trial of high dose leucovorin calcium in children with ASD. Those results we published back in 2016 in Molecular Psychiatry. And since that point in time, it's been independently replicated by multiple groups across the world. So that's just one example of a really astute clinician and researcher like Richard, following breadcrumbs, if you will, in terms of the academic literature, paying attention to something that others may miss, realizing that, hey, there might be certain biological findings that are hiding in plain sight in which we can find actionable, useful biomarkers that can inform a specific care pathway for a patient, and that that can lead towards developing a new model of care, a new system of care. And, you know, that's really where it all began. I, as part of that team, you know, as this was, you know, back in 2010-2017, like everything in the autism community, right. You know, parents, you know, get a lot of community and a lot of really good resourceful information through Facebook groups and things of that sort, right? So families would be connected in Facebook group chats, at least it was back then. And word, I guess, got out that, you know, hey, this clinic is really, you know, going deep to understand the biology and making unique recommendations for children that's way beyond just behavioral label, behavioral diagnosis, behavioral treatment, and trying to get at, you know, from a biological perspective, what's going on. When word started getting out, the clinic started getting flooded with inbound inquiries in which we ended up having a wait list of over two and a half years for families before they could even get into the clinic. And so we were in Arkansas. That's where I'm from originally, at Arkansas Children's 2 1/2 year wait list. And I ended up somehow leaking to the community that I was the guy that you can contact that could work some magic, if you will, and let parents know if they could change their. You get your number in line, so to speak, you're two and a half years out. Somehow they get a hold of me and I could work some magic and get them up the wait list to be seen much sooner, generally within three to six months. If they could leave on a dime, if the parents could do so, then they could get into the clinic much sooner. So since that point in time, everything I've done in my career journey has really been taking lessons learned from the clinic and from the research and trying to make those findings translated into a new care model for patients with autism related to biomarkers and related to treatments. Meadow is just the latest in terms of where we're at from a technology Perspective to be able to have a 50 state telehealth solution, knowing that, you know, if you're a family and you're left on your own, unfortunately many times at the point of diagnosis to, you know, again, go back online, try and find a community of like minded parents that realize that there must be more to this than just, you know, getting some genetic testing, getting some behavioral treatments and being left on your own. And that, you know, the more the look, the more we look, the more we can find being able to identify certain biological factors that could be influencing a child's behavior. And that if we can address these biological concerns, we can get meaningful outcomes and many children a lot of times. So given that right now the care model is still behavioral, it's still, you know, genetic testing is the only treatment or, sorry, the only diagnostic test that is covered by insurance as standard of care. A lot of the diagnostic testing is so out of pocket for families if they need to try and find their way to a functional medicine doctor, behavioral neurologist, maps physician, there's still long wait times to be able to see a lot of these practitioners. And so the genesis of Meadow was, look, now we can have a 50 state telehealth solution. We can collect real world evidence and structured data through a telehealth model that irrespective of your geography, me being someone that's from Arkansas, I no longer live in Arkansas. I'm in rhode island near Dr. Gatehannes. But I still get contacted all the time by families that are in Arkansas. Now that Richard's no longer here, he's out in Phoenix wondering who they can see. And unfortunately I don't have great answers for them. It's go find your nearest maps doctor, get on a wait list and try and get in as soon as you can. That's not okay. We need to have a more accessible care model. We need to make sure that we can meet families where they are irrespective of their geography, irrespective of being able to get answers sooner rather than later. So I mean, for all those reasons that was kind of part of the reason behind the why for Meadow, then I'd be happy to take it anywhere you want. In terms of giving family more information about the platform, how to access it and what we're planning to do long term in terms of our delivery of care for families.
- [11:07]
B
Yeah, no, I definitely want to dive into that. And just as a backdrop though, and even the title of this episode, really so much of the autism journey of a parent is waiting for Everything you're waiting to see, you know, even conventional like doctors, there's a, there's a wait time. And then once you get into that, the, what I would call the autism hamster wheel, which is a diagnosis ultimately of your child that gives you the ability to get services that help you manage and cope with the symptoms. There's nothing about the root cause in the whole process, but every step of the way you're waiting. So even in that service syndrome, to get any kind of services is usually a long wait time and in some states, much worse than others. So the whole thing is characterized by long wait times. But particularly if you decide to go off that path and really endeavor to get to the root causes with a MAPS practitioner or an integrated pediatrician, those wait times can be extremely long to be able to start that process, let alone it can be expensive in terms of the, the testing and everything that goes with it. So you mentioned Dr. Richard Fry. He was on our, this podcast not too long ago. That was episode 245 for those who might want to listen to it. And you know, the title of that episode is Evidence Based Treatments First. He's very much about that. And that's really what this is all about. It's about helping parents get access to care. Not just random stuff that's, you know, come just circulating where you're chasing the next biggest thing, but things that have been demonstrated and proven to be really, really important. So the concept of being able to access the right practitioners with the right perspective and bringing everything under one roof in terms of the testing piece of it, because that can also be very confusing as to what test to do, how to even access those tests. So I love what Meadow is looking, what you've created now to bring everything in one place in a telehealth solution. Because frankly, a lot of times, yeah, I work with parents all the time who happen to be in a desert where there's nobody really nearby. And so to the idea of being able to access doctors and not be restrained by, hey, who's within driving distance is really powerful.
- [13:32]
A
Right? No, that, that's, that's absolutely right. And you know, unfortunately, the, the current standard of care, since it is behavioral diagnosis and the rates being at 1 in 31 in this country, there's significant wait times from the point of first concern, from the family, to the point of diagnosis, to the point of treatment. And if you look at the overall trajectory, this is, you know, like everything in autism, right? This is not a, it's not a one size shoe fits all sorts of story. But the average general research evidence supports that families, generally speaking, suspect a problem in their child as early as one year, around nine to 12 months is when most families start to suspect some sort of issue. Now, there's caveats, right? Certain children do have regression in which that's about 30, 40%. So children may be developing perfectly normally between 18 and 36 months and have a regression. So that is a different subset. We need to start thinking about everything in ASD in terms of subsets. But the average story of, you know, suspecting a problem at nine to 12 months, whether that be lack of eye contact, lack of language communication or vocalizations that are being produced, Families suspecting that problem early, the they go to their pediatrician. The pediatrician says, well, development's a bell curve. Some children develop more slowly than others come back in three to six months. And if it's still a problem, then we'll consider escalating a little bit more to make a referral to a specialist or along those lines. That's the standard story. But if we start playing these things out, parent suspects problems at, let's just say, 12 months. Well, the pediatrician says, wait, and now it's 18 months. And then at that 18 month time point, we then make a referral to a specialist for a diagnosis in which there's a backlog. Right. So parents are generally waiting from that point another 18 to 24 months, many times before they can get in to even get a diagnosis. And then there's a wait time to be able to get from diagnosis to begin treatment. Time is brain. Right. Like, so, you know, when we're dealing with any neurological condition, whether it be developmental or just at any point across the lifespan, if there's an issue in which the brain is impacted, use stroke as an example. Right. It's now absolutely without question known that time is absolute brain, and that if you start to lose speech or have, you know, hemip paralysis on one side of your body, that you are in an acute stroke episode, and that we need to get you to the emergency room as quickly as possible, confirm the stroke, and begin treatment as quickly as we can in order to preserve your brain. Right. Unfortunately, in pediatrics, we don't have that same level of urgency in order to get patients access to treatment as quickly as possible. So one of the things that we are doing with Meadow is to shrink that timeline to allow for almost instant access to care, irrespective of geography. And another point to this is that if a patient is on a wait list, if they have not received a diagnosis if it's suspected asd because time is brain and because things like glucovorin are exceptionally safe. They've been around for over 75 years, used in mainly in cancer. They've, you know, leucovorin's indication is for methotrexate rescue and is used to stop the toxic effects of chemotherapy. Right. So since leucovorin is exceptionally safe, it's been used for over 75 years. It's essentially a high dose B vitamin, folinic acid. It is something that the safety profile is well established. So, you know, one thing that drives me crazy in terms of just medicine overall, but autism in particular, is that when people say things aren't evidence based or there's not enough evidence, that's foolish many times because we have. You can use that same adage for everything. Right. I could tell you that drugs that are already FDA approved for certain indications, there's not enough evidence in terms of post marketing data of those to understand the true risk associated with those interventions. But something like leucovorin, our folinic acid, which is a B vitamin, in which it's unquestioned how safe it is, juxtaposed with something like an antipsychotic such as risperidol or Abilify, which we hand out like candy. It's too much of a dichotomy to say that one is okay to hand out because it's FDA approved for ASD associated symptoms that don't address core symptoms, but the other one that does have a much better safety profile, we're going to limit the access. We're going to have the American Academy of Pediatrics come out in staunch opposition saying that there's not evidence to support this, even though there's four randomized controlled trials. Right. So it's this, this paradox in terms of medicine of evidence and evidence base in terms of if it's not FDA approved, we say that's not enough evidence. When we have this unfortunate issue where using antipsychotics as one example in which the number of patients that were treated in antipsychotic trials, Risperdal is one example that's currently FDA approved for irritability and aggression in children with asd that the, the approval of that medication was based on a trial size, it was roughly 308 weeks in terms of the length of care. So Leucoborn juxtaposed to that, we have four randomized controlled trials of over 600 patients that does address a core symptom of ASD with a biomarker that can let us know whether a patient is more likely to respond. We actually have a couple of biomarkers, one being the folate autoantibody, which many on this podcast are probably familiar with. The other piece of the story that we don't talk about all that much, but we should, is that that wasn't the only finding of the informative biomarker. From our clinical study at Arkansas, we also saw that poor glutathione redox status also was a predictive biomarker for children, whether they could respond to the intervention or not. And if we look at the statistics on these things, roughly 70 to 75% of children with autism have circulating folate autoantibodies and 95% of children with autism have low glutathione redox or poor methylation status compared to controlled children. So the overwhelming majority of children with autism. It's worth trying a therapeutic trial of leucovorin because of its known safety profile, because it addresses core symptoms, because there is biomarkers that can strongly suggest response potential. And it's something that, you know, unfortunately, because there is no patent behind it, because it's a generic off label intervention, there is no definitive trials that would meet the bar for FDA approval because there's no financial incentive from large pharma to do these types of studies. Why would I go spend $10 million or more to do a definitive clinical trial if I bring something to market? And I can't have market exclusivity because it's a generic or because the premium pricing that I'm used to being able to charge and negotiate insurance to get a premium price because I, you know, subsidized the, the, the research for this country and the world. You know, it's something that, you know, there's just, there's just not enough incentives to, you know, bring that sort of treatment to market. So it's for all those sort of things. And the list can go on and on. Sulforaphane is another treatment for kids with ASD that shows positive benefits. Gut microbiome modulation, whether it be through Jim Adams work in terms of microbiota, material transfer, custom consortium, probiotics, whether it be kids that have pans or Pandas and asd, whether it be certain IVIG or in certain stances, it could be that certain select antibiotics or antimicrobials or, excuse me, antifungals might be helpful for certain children. So there's plenty of treatments that have evidence behind them, but they're not accessible to families. They do require a specialist. And you know, that's really one of the things with Meadow, we want to make sure that we can have things structured, make things to where families will have a partner on this care journey and be able to make this something that can be essentially a digital front door where if you have access to the Internet and even just your phone, you can be able to have an appointment with a physician and get access to care and have these things delivered directly to your home without having to travel with your special needs child. So apologize for the rambling, but hopefully that gives a little bit more context into how we can make things accessible and how it differs from the current standard of care.
- [23:27]
B
No, I appreciate that. You saved me three questions I could have asked and you covered them all. I think in terms of that what you're talking about, especially with the first step. Right. Does a parent need to physically see the practitioner in person? And I know once Covid hit a lot of times those restrictions were relaxed. They're kind of coming back now where some practitioners would say that they do need to at least initially see the child in person. So with the Meadow health platform that you've built, can you talk a little bit about what that experience is? High level, because I know there's detailed steps, but high level parent going down that road. What does it look like from beginning, you know, throughout the journey?
- [24:11]
A
Yeah. So a parent goes to meadowbiosciences.com they can fill out an, like there's, there's a button where they can just select, you know, begin evaluation. That prompts them to an intake process in which we collect structured data and where we ask about whether a child's had a regression. We ask about, you know, factors that may have influenced that regression. We ask questions about the child's current clinical picture. You know, what have they been diagnosed with, what has been diagnosed, what is suspected that may not have been diagnosed formally. And you know, does your child have GI issues? Does your child have seizures? Does your child have immunological compromise? Asthma, allergies? We're really looking at all of the co occurring conditions in addition to the behavioral label of autism, as well as pans, pandas and all those things. All of that's asked in the intake questionnaire to get a medical history. Then we also have used essentially a collection of questions that are patterned off of validated ASD instruments that assess behavior. So we also get a really nice constellation of the child's behavioral profile as well. And all that is collected in an intake process. It takes less than five minutes for the families to complete. And once they're done with the intake process, if they want to continue, they will agree to a subscription for, for care delivery and that immediately prompts them to a physician. We have 45 physicians that are accredited in all 50 states. Every physician that we have on the network, myself and Dr. Catanis have personally trained the physicians to ensure that they are knowledgeable and up to speed on the biomedical basis of asd. And we also try and get as many of the clinicians that are on our platform, two maps for continuing education as well as another added bonus to make sure that they're up to speed with things that are hopefully things that we'll offer on the platform downstream, but wouldn't be Novel concepts once we, once we start integrating them through the care model, we have a partnership with a compounding pharmacy, ChemistryRx, in which to start families that complete the intake. Because leucovorin has gone through four randomized controlled trials, because folate is involved in thousands of different biochemical reactions in the body. And if you look at the biology of ASD and what it's taught at maps, but also, you know, heavily informed by a lot of the work that we did at Arkansas Children's as well as Bob Navio and others, we see that, you know, really the, at its core, foundational biochemical disturbances and automatic autism involve disturbances in folate metabolism. Folate's important for DNA synthesis and repair, which is why it's given to counteract the ill effects of chemotherapy, because it helps protect your DNA while chemo is trying to destroy cells. So it helps with DNA synthesis and repair, it helps with cellular methylation, it helps with being a redox buffer
- [27:38]
B
in
- [27:38]
A
the glutathione system in the body. It helps as a mitochondrial fuel and helps with mitochondrial protein translation. And so that's what folate is doing at the cellular level. Right. And then we also know that 70% of kids with ASD have these folate autoantibodies in which the brain is being starved of folate. And this special type of folate, leucovorin, can go around the blockage and enter the brain through something called the reduced folate carrier. So we're starting with leucoborin because of all those reasons, because it kind of fits center square in terms of an evidence based treatment that has four randomized controlled trials. It hits many of the hallmarks in terms of ASD biology in a large percentage of patients. And right now there is unfortunately a lot of institutional and Political headwinds against getting access to Lucavorin Due to the AAP's current stance, the Neurological Society's stance against lucavorin for autism, lack of FDA approval, the confusion that happened from late last year to early this year in which the FDA said that, you know, leucophorin is now something that can be approved for cerebral folate deficiency and a rare, actually a specific subset of cerebral folate deficiency, I.e. the FOLR1 gene mutation associated cerebral folate deficiency. That created confusion in the autism community, created confusion just across the board. There is, unfortunately, in addition to those problems, a lot of major academic institutions have, as well as Kaiser Permanente, the Oregon Health Sciences Group, they've all come out basically saying that if you're a physician within network in those health systems, that you cannot prescribe leucovorin for autism, and if you do, you're in fear of being able to continue to practice within those practice networks. There was a brush on leucovorin that further strained an already fragile supply chain. And so we were able to say, okay, for all these reasons, it fits the biological piece. There is a problem with access, there is a problem with physicians that don't feel comfortable prescribing it because it's not FDA approved. And there isn't a structured, standardized way of being able to handle dosing questions, being able to handle the right formulations of leucovorin, in which we know that these kids need a very clean. It's called an API. That's the active pharmaceutical ingredient, which is the primary drug. You know, a lot of the generics have lactose, yellow dye, blue dye, heavy metals, things that can be very damaging to this already fragile population in asd. So want to make sure that the products that we had were clean of all those things. So chemistry Rx is just a perfect partner. They've been working with the mitochondrial disease community for the better part of the past five years. They've been specialists in developing custom mitochondrial cocktails for patients with mitochondrial disease. Given that 80% of children with autism have mitochondrial dysfunction, or at least one biomarker of mitochondrial dysfunction, it was a natural fit to make sure that we had a very clean supply of leucovorin. Families just, you know, they log on the system, complete their intake. The Luke, the leucovorin is weight based. It gets sent directly to their house. We use the, the same protocol that we used at Arkansas Children's in our first double blind spoon controlled trial. We do 1 milligram per kilogram a day, target dose for two weeks. And then that's just what we call the titration phase. Then there's a maintenance phase in which it's we double the dose at 2 milligrams per kilogram a day, max dose 50 milligrams, in which patients come back at three months for a follow up, which we repeat some of the same behavioral questionnaires. And if families want to continue on the system, we're in the process of adding on some diagnostic offerings through Mosaic Diagnostics as another offering that will be available to families in the near future. We're working to bring on additional support, such as microbiome support, mitochondrial support, and those will be available in the near future as well. The beautiful thing about doing all this is the reason Leucovorin was not approved for the broader autism indication is because back to that pesky little problem of a lack of evidence. And so I could argue all day that I think there's enough evidence for leucovorin for asd. But what we're doing through this platform is, you know, the goal is to scale and get as many families on the platform as you can. The other added piece of this, starting with lucavorin, is the more families that take part in the program, the more data we'll have. And it'll be structured real world evidence data, which is the missing piece. In order to fill the evidence gap for supporting the literature and to get a better understanding of dosing protocols, length of treatment, the overall linear trajectory over time in terms of how quickly do patients respond, when do they plateau, when do you need to up the dose, when do you need to down the dose, so on and so forth. You know, those are a lot of open questions which do require more research. We do have an IRB wrapped around everything we do at Meadow. So that way we can ensure that the data that is collected, which is anonymized, deidentified, there's nothing that identifies any of the families. But it's that de identified data can be leveraged to fill the gaps in terms of where there needs to be more evidence to support who it works for, why, and how we can strengthen the evidence base. We want to do that just ad nauseam across everything we do in order to ensure that Meadow can help continue to fill gaps, continue to be evidence based treatments that can produce powerful real world evidence to support the literature. But then at the end of the day, every patient that comes on the platform is unique. Right? So the other really cool piece to this with now, in the world of agentic AI, we have embedded abilities to be able to take the data, understand the child because of the structured intake process, because of the structured behavioral data, because of the structured ability to collect diagnostics and look at, you know, initially Leucovorin, but then also additional treatments. As we continue on with families on this journey, we can start making better predictions in terms of, instead of trial and error with families, we can get better at predicting which treatment might work best for each child, that each family that comes on the platform. The data that we're capturing is going to create more intelligence that can inform the next family. So each family is working to help support the next family, whether they know it or not, which I think is really powerful and can create just such a virtuous cycle of really doing something meaningful for this community, which is really what it's been all about for the whole part of my career.
- [35:07]
B
Fantastic. No, it's super exciting. And again, I appreciate why you're starting with Lucavor and because there's a lot of interest, because there's a lot of potential efficacy doesn't mean that's something that's required for every child. Right. It's all very holistic. But I love how you're starting with that and, and also, and being very mindful about the quality because again, just not all Leucavorin is the same in terms of, you know, whether it's prescription or over the counter, whatever the case may be. So, no, it's exciting, especially the fact that over time you're going to be expanding to the other aspects of, you know, the other root causes that might be relevant for a child. So, so I'm so excited for what I know you just launched really last month and I'm excited for what's going to be possible. And yeah, we'll include links in the show notes where you can find out more information. But John, any final message and why don't you just remind everyone again if they want to get started, what is the next step?
- [36:02]
A
Sure. So for interested families, they can go to meadowbiosciences.com if they are interested but, you know, want to talk to somebody and, you know, need to learn more. Before beginning an intake process, they can always send an email to helpadobiosciences.com and a member of the CARE team will connect the families live in order to answer any questions or concerns that they have before they go through the formal process. But metabiosciences.com is how the families get started. And look, the message for families is that, you know, we know that this, this journey is, you know, you're dealt with fragmentation all over the place. You're dealt with a deck of cards that's stacked against you many of the times and you feel like it can be a very isolating and lonely journey. Our goal is to be with you every step of the way and to ensure that we can. Like, I mean, this is why I got into this over 15 years ago and think that, you know, never leaves me. The autism community and the autism parents are. Some of, you're the, you're the advocate for your child and families leave no stone unturned. And they want to make sure that they do everything that they possibly can in order to do something that can meaningfully impact their child in a positive way. Now, the problem with that is that there are some practitioners across the country that may advocate for treatments that might not be safe and that might do more harm than good. So we want to make sure that we have evidence, informed care that research supports to be able to make sure that we can fill the gaps in the evidence base, but also ensure that we're doing the highest quality care and service to your child with minimizing any type of adverse effect. So I want to make sure that the families know that we're here for you. We want to work with you, we want to celebrate the small wins with you and hope that those small wins lead towards big, monumental moments for your child and your family. And that's what it's all about.
- [38:08]
B
All right, fantastic. Well, John Slatter, I really appreciate you joining and spreading this message again. There's so much that you've shared that's so encouraging and exciting for families. And again, with the key concept being to respond powerfully. You don't have to wait as long as typical things are accelerating in a positive way. And I love what you and everyone at Meadow are bringing to people as a real powerful option moving forward. So thanks so much.
- [38:36]
A
Thank you, Lynn. It's been a pleasure.
- [38:37]
B
Your child needs you running on all cylinders now. And the fastest way to rise is with personalized one on one support. Get started today. Go to elevatehowyunavigate. Com.