Megan W 

Megan is a public speaker who is dedicated to promoting acceptance, inclusion and accessibility for autistic and neurodivergent individuals, particularly in employment and in healthcare. She does this through openly sharing her lived experience and professional insights and some of her public speaking collaborations include autism Canada, CAMH, Flourish, which we're so excited about, CBC, Globe and Mail and the Senate of Canada. So we're really very lucky to have her speaking with us today. She's such an such an underachiever, like I've spoken with so many, so many high achieving spaces, and we're just we could not be more grateful that you're spending your lunch hour with us. So she's also an academic researcher and author, having recently published her first peer reviewed article of the employment experiences of autistic employees. And currently she lives in Sudbury with her husband and her two cats, Oliver and Abby.

Megan Pilatzke 

Well, thank you so much for that. I know I wrote that introduction, but yes, lots of, lots of stuff going on, and it's it's been a whirlwind in the last couple of years, but we'll hear more about that shortly. So okay, so just want to confirm quick. Everyone can see my screen. Okay, right now? PowerPoint. Okay, cool. I figured it was, but just want to make sure. So today's topic, I think we all know I'm going to have a lived experience understanding of autism that I'll provide. There's a lot of you know understanding of what autism maybe we just get a general definition and kind of some very basic DSM type criteria. But I want to sort of give you more of an application of what that looks like in day to day life, and in turn, how you can help in terms in your role in healthcare. Very quickly, I just want to do an old land acknowledgement. It's very important in my family. So I just want to acknowledge the indigenous peoples of all the lands that we are on today, and while we meet today on a virtual platform, I'd like to just take a moment to acknowledge the importance of the lands of which we each call home. And we do this to reaffirm our commitment and responsibility in improving relationships between nations and to improving all our own understanding of local indigenous peoples and their cultures. For myself, I'm personally located, as we know, in Sudbury, Ontario. And this is Robinson-Huron treaty territory. The land on which I live and work is the traditional land of the AtikamekshengAnishnawbek and the Wahnapitae  FirstNation. So I acknowledge with respect the diverse histories and cultures of all First Nation, Metis, non status and inuit peoples residing in my territory and across Canada and as personally, a white daughter in law of no passed by a Cree woman who is a victim of the 60s scoop, I stand with everyone in reconciliation and proclaiming that every child matters. So just quickly, before we get started, if there is anybody that is not muted right now, I just ask that everyone check their mics and make sure we're muted, just because it can be distracting for me when I'm presenting, if I could hear other noises happening. The other thing as well. I welcome questions, of course, and Marie and Megan the other Megan will be keeping an eye on the chat for me. I am going to take questions at the end. So anything you have though, go ahead, throw it in the chat, and they'll keep an eye on it for me. And what I have time to I'll get to, um, so we've already done a little introduction. I'm going to open up with my story, kind of telling you how did I get to where I am today? Um, I then go into talking about autism and neurodiversity in general. I'll talk a little bit about autism in women and what that looks like. And then I will end with how healthcare providers like yourselves can support autistic people. So big, big face on here of me. How did I get to the spot that I did so and why am I here? I'm really I'm not here as someone with a master's. I don't have a PhD. I have a dinky little Bachelors in psychology. That is my background. I'm not a doctor or any kind of healthcare professional. I'm here just as a person, and in particular, a woman with lived experience of autism. So my story, there's a lot of photos of me on the side, and in general, they progress from the top left to the right and then kind of back to the left bottom and over, just to get an idea. So my story is, I'm a late diagnosed autistic person. So what that simply means for those that don't know is that I did not know about my autism in childhood. So I grew up my life, my whole life, not knowing, and it wasn't until my 30s that I found out. So what did that feel like as a child? So when I was a kid, I was ultimately raised in a nuclear family, so mom, dad and a brother. I was the oldest of two children. I was raised in.

entirely in Sudbury, very supportive family growing up, you know, the typical things you'd see, I guess, in a family, you know, I went to school, elementary school, high school, as I said, university. So I went through a without any kind of individualized education plan or anything like that, just through the quote unquote normal track, if you will, of education and and, you know, I participated in sports. I was a basketball player for, you know, 10-15, years. I had, you know, a few friends, a very quote unquote typical upbringing, you would say, now that's on the outside of what everybody sees. So there was nothing ever necessarily reported, as, you know, from a teacher or from a coach, or from even from a doctor, that was kind of like, this is a little different, we should look at this, you know. Or perhaps there were things that were noticed, but they weren't really considered to be things that maybe we necessarily flag. Maybe now, in this day and age, we would, but back in the 90s, perhaps we did it. But what I knew on the inside was that I felt different. I couldn't describe what that different meant, but inherently I just felt different from other kids. And how do you talk about that as a kid to your parents? Well, you don't, because you're ultimately told over and over that, you know, as you grow up, you're going through a lot of things, and there are a lot of changes and hormones, and everybody gets that talk right at school and off and on from our parents, and sometimes not so greatly structured conversations. But that's that was my life and but I felt different. I had a lot of mental health issues going on, a lot of anxiety, a lot of bullying as a child at the time I moved there's a number of little communities within Sudbury, if you're not familiar, kind of akin to like if you're in Toronto, and you have York, and you have Mississauga, and you have, like, all of those areas. It's kind of the same thing in Sudbury, just not as spread out, I guess you could say so. We had moved from one area to another area within Sudbury, and I kind of attributed the bullying just to be kids, being kids. You move schools as did by parents. They were aware bullying was happening, but they didn't really know to the extent of what was happening, mostly because at that time it was a lot of the sticks and stones will break my bones, names will never hurt you, kind of logic going on. But it really deeply did cause a lot of anxiety, what I now know to be panic attacks, a lot of depression. And that was, that was kind of the progressive way. I would say, as I got to high school, things got a little easier in the sense that there's more kids, so there's less focus on you, and you could kind of hide a little more. But in general, in elementary it was really difficult. I eventually, in high school, really started to notice the depression, mostly in grade 11 and 12. So I would have been about between the ages of 15 and 17 when I started to really notice it taking a toll. There's a lot of days that I have memories of, of coming home from school and just being exhausted, could not function anymore, a lot of retreating to my bedroom, which my parents lovingly called my apartment, not knowing that, you know now, in hindsight, I know what I was doing, but at the time, right, it kind of just looks like the broody teenager kind of just going to a bedroom and like they're doing their own thing and what have you. And certainly that was probably part of it, but a lot more of it was simply going there and just being completely exhausted. I was doing a lot of homework and stuff like passing everything, getting grades, but doing it last minute, because I was so exhausted that I couldn't do anything with it. There was a lot of withdrawal from activities, but I was replacing them with new activities. And so it wasn't really noted as being something unusual. Was more just like, Okay, this kid is just kind of trying new things, and that a lot of really depressed mood, feeling overwhelmingly sad, being up late again, not necessarily uncommon in terms of the being up late part. Sometimes a lot of teenagers will do that,

you know, and really a lot of like crying and misunderstood and a lot of hopelessness and that point so come about grade 11, going into grade 12, I'm a little blurry on that area to be honest.  I did first seek help from a my family doctor at the time who was close to retirement, who essentially told me the same thing as as what anyone was telling me at the time. You know, you're just growing your hormones, whatever, it'll even out. So I didn't do anything more. I mean, I was told by a family doctor, all is good, and that was the end of it. But I really was still struggling and unable to really function well, I graduated, I went to Laurentian, where I started my degree. Then things got really bad. I was not getting out of bed, was not able to go to class, was not able to perform. Failed classes. And, you know, I still graduated, but it took time, and that was, there was actually a class where I had a professor that said, you know, you're really not showing up a lot, like, I'm not going to fail you, because 70% of the courses is papers that you're passing them with flying colors, but you do need to be here. And I said, Well, I can't, like, I'm, you know, and this was the first person that said, you know, this is not okay. Like, you need to go and get help for that. So I credit that professor with at least recognizing that and saying, you know, go do more about it. And at that point, I had a new family doctor, because the old one had retired, so I saw him, and I was prescribed an SNRI, venlafaxin. And ultimately, that was the end of it. There was no referrals, there was no additional questions. It was very much - Here's your pill, Now go away. And it kind of continued that way for a long time, where I would just kind of show up, hey, I'm not feeling great. They would increase the dose by 50 milligrams, and that was kind of the end of the story. So really, not a great time. Now there's my two cats that I referenced earlier. So after university, that's I things were already bad at that point. But keep in mind that when you're in school, there is some form of structure going on. Even if it is University, there's still some type of structure going on. You're going to school, you're going through courses, whatever. It's still a week to week thing. I did have a part time job that I was somewhat able to maintain. So again, it that structure was there. Now I've graduated. The structure is now removed, and at that point I start to cycle. So I'm going through cycling through part time jobs. At the time I'm attributing it to, well, you know, I don't really want to do these jobs. I just want to get, like, I have my degree now, I just want to, like, get my big girl job, so to speak, like, let's move on in life. You know, that's what I attribute it to. And I just figured, you know, like, once I get a job that I actually want to work in and build my career, I'm going to be happier. It'll be okay. You know, the struggles with money I'm happening. That's okay, and we'll figure it out. So still some hope, but like, still not good. I had a hard time as well with relationships, so a lot of different partners that I was with over time that again cycling through because they don't understand the struggles I'm going through. And this is also stuff I'm not relaying to my family, because a lot of this is, you know, not stuff that you typically necessarily share with your parents right away, right? It's kind of private, right? Um, the other thing I noticed a lot more of I did. I noticed this in childhood and throughout, but it really kind of came to a head. Here is, I was hired, ultimately, into a full time role in November of 2015 with the federal government. And so that was the answer, so to speak. But things didn't get better. What I really started to notice was a lot of sensory things going on. So noises felt really, really loud, more so than normal. But when I would talk to somebody about it, often I would get the confirmation, yes, it's very loud in here. Now the difference being that it's very loud in general, yes, but it's not loud in the same way. It's a different experience going on. But again, the individual I'm talking to, my grandma, my mom, whoever they don't know that, right, like they're they're assuming. So hired into that role really started at that point to struggle with attendance due to my mental health, so a lot of times not showing up to work. Started to experience some discrimination, especially when I requested accommodations. So no opportunities for growth or advancement. Things got really grim because all that's going on now, the side note of all of that is there are a lot of issues with the Federal Public Service pay system. So just to make things extra fun, as I'm being absent, my pay is then also being impacted, so in turn, I'm being pushed into poverty indirectly, without it being my fault. So that did not help the situation. In another role, maybe it wouldn't have been there, but that's that story. And during those times, I'm still trying to get help. So I've done this. I'm on my SNRI, I'm I'm obedient, and I'm taking it every day. I am, you know, anytime that I can afford a therapy, I'm going to it so CBT, anything that I can get, I'm going to it, keeping in mind, though, that there is some issues with finances going on. Nonetheless, I'm still trying to go. I'm accessing my employee assistance program and all that. But really and truly, just was not getting anywhere. Still was not able to get access this point, to a psychiatrist. Nobody had done any kind of, even a blood work test just to check and see, like, is everything still okay with the thyroid and all that? Like, none of this stuff was done. What really, I got to about a widths end and I ended up accessing a telemedicine clinic in spring of 2016 I was actually referred to CAMH at that point for the first time, and that was the first time I saw a psychiatrist who basically said, Look, this is not just depression, like something else is going on here. You need to see a psychiatrist. Would you like to see one in Toronto? Or would you like to see one in Sudbury? And I'd said, Well, ideally in Sudbury, but I'm not being referred. So that individual, thankfully, was great. And said, you know, I'm going to report your doctor, they should have done this and, you know, put you on this list and so on and so forth. So I sat on a list for over a year. I was de rostered from this doctor as it became very non productive after that, there was a lot of well, how dare you go above my head to go to someone else? But again, I'm in the same I'm not getting anywhere right. And come the fall of 2017 saw my second psychiatrist. That individual diagnosed me with bipolar disorder type two, and I was given some additional medications. They kind of fluctuated around so as to which ones I was on, I actually don't fully remember, because the I know the SNR stayed the same, but there were others that were added in, kind of little additives, if you will. Most of them did not work because it was a lot of conflicts between the medications they gave me a lot of like, I was very sick to my stomach and not able to get out of bed some days, things like that. At that point, though, things did not get better. Like, even though I was doing all this, I'm still not getting better. So we got to a crisis point, a real crisis point. Like at this point, I still consider this, if you told ask me to do the rating scale of a depression, I'd say I was probably a nine out of 10. But at this point, this is like 11 out of 10, I would say. So after this point, I've been on medication, you know, they they feel like they've got me to this point of, you know, this is the best we can do for you. We're going to discharge you. So I was ultimately discharged from this psychiatrist in Sudbury in summer, 2018 October, 2018 I tried to take my own life, and I was hospitalized for that. One of the worst nights of my entire life, sitting in there. The biggest memory that I have outside of the night itself, because I went in at about 10 o'clock at night. I was on my own, living in my own apartment, and for whatever reason, said, No, this isn't good. I'm going in. Drove myself in

and and got there, went to triage, and, you know, I'm shaking, I I'm crying. I'm in clear distress. There's, there's no doubt at all. And the reaction I had gotten at the time, which I'll never forget, and I told this to many healthcare professionals over and over something to never do was, I was said told, you know, everybody has problems, why can't you just deal with it? And I remember at that point thinking, like, Are you kidding me? I am dealing with it. Look what I've done. Like, in my head today, this person doesn't know it. But really, if I'm coming to the ER at 10-11, o'clock at night, in clear distress, there's a reason I came to that ER, right. And, and I kind of said in response like, you know, and I mean, keep in mind, this is kind of broken, and I'm shaking, and it the fact that they responded to me like this, and I'd said, look it I need to be here. I am a threat to myself. If you want me to leave, call the police. And I didn't know what more to do. I'm trying to get a hold of my family. Nobody's answering the phone. I don't know what was happening that night. We've all talked about this after and said, like, I don't know what was happening. But anyway, so I sat there all night. I was I was admitted, I am, and there were no psychiatrists on at night, so had to wait till the next morning. And I can remember keeping in mind that I can hear things very well, because I'm sensitive to sound. I could hear a lot of stuff walking by, and a lot of this, you know, the psych cases in here, the this person's a little crazy, just stuff like that. And it was, it was very demeaning and very like nobody had really taken an opportunity to talk to me and asked me what was going on. It was just how you feeling and why are you here? And like standard questions. But there was still more to it. The third psychiatrist that ultimately ended up taking me on was the one in the morning that I saw. And by the point, I had a parent with me, and I was able to be discharged into their care, which was great, as I really didn't want to end up in the hospital itself, because there were limited spaces at the time, and the psychiatrist told me, look like you're better off with someone safe than being here. He continued the same treatments. He didn't really make any other referrals. He ultimately said, this is treatment resistant bipolar disorder. He offered me transcranial magnetic stimulation. I did consider it, but I never took it. My workplace struggles kept going. I was advised by management to consider medical retirement. You know, kept trying to sort of just get by, but really felt hopeless, and really felt like, what is the point? Like, what am I doing here? I'm doing all the stuff that I'm being told to do, and yet I'm not getting better. Now the good news is is things did get better, thankfully. And I attribute a lot of this part to my husband. So in September of 2019 I met my husband, and at the time when I started dating him, and I mean still now, my our nephew, so his sister's son, is autistic, diagnosed in childhood, and at the time, I knew nothing about autism. I knew of the name, but really that was the extent of my knowledge. So logically, as the relationship was going better, I said, you know, I need to learn how to interact with this individual. What is autism? What do I do? All this? Our nephew is partially nonverbal. Very much a answer is yes and no questions, but we'll not have a conversation. Will not speak the way I'm speaking right now, very intelligent, very sweet boy, but well, teenager now, but nonetheless, right there's still things to take into consideration when you're when you're supporting someone who's autistic. So I started doing some reading. And the big thing when you google autism, it's very vague and you get very limited information or very stigmatized information. And the big thing that I felt was like, Why is there no information about girls and women with autism like, is this a thing? Like, is this only on the Y chromosome? Like, what is going on here? So I started thinking taking more, and I found that book in the middle called women and girls with autism spectrum disorder, understanding life experiences from early childhood to old age. And it's written by Sarah Hendricks, who's in the United Kingdom. And I kind of bought it on a whim, just more out of curiosity than anything else. And I started read that, and I got about, I'd say, a quarter way in. I don't read very fast. I finished that book within two days, and I was in absolute tears. And I knew it. I just knew I said, this is like the answer like, this is what makes sense. Started looking for an autism assessment immediately after that, found, and ultimately did get a quote in Sudbury. There's only one person in Sudbury that I'm aware of. I don't know if that's still the case today, but at that time, there was only one that would assess an adult. The quote was $4,400 which was totally unaffordable. So I kept looking around, because, given that we were in the middle of the pandemic by this point,

as I started reading this book in 2020 I should, should clarify the book was read in 2020 so I started looking around at that point, and I was able to find an assessment through the redpass Center in Toronto. And I got that assessment done in april 2021 and for half the price, thankfully. And in May of 2021, I found out, yes. Surprise, you were autistic. You were not, you do not have bipolar disorder. This is a common misdiagnosis and all of this. So after that, I took about a year to really kind of get familiar with who the heck I am. So a lot of stuff going on with with processing all that, a lot of these aha moments going on, which is pretty typical of people that are late diagnosed. And then I started public speaking, and, you know, in, sorry, in April of 2022 and kind of got to where I am now. So left that really toxic job. I started taking on some public speaking and some work with CAMH and things like that. And ultimately ended up getting hired with Specialistern Canada, working directly with neurodivergent people and employers that are looking to ultimately do better and become more inclusive. So, so that's kind of where I got to, and I'm at this point thriving. I'm very happy in my life. I'm very, you know, very, very happy that I found my identity. But took a long time to get here. I was 31 at the time, so we're a couple of three years into this now. But you know, now the goal is really spreading my story around, because I think it's important I know I don't have to share the story, but I do it because I want people to simply just understand that, that it's out there, there. And, you know, autism isn't just about reading some pages in a book. It's, it's bigger than that, right? So now that you understand a little bit more about who I am and kind of the journey I've been through that I'm still kind of going through in my own way. I want to go back to basics, and I want to look at what neurodiversity is, and, in turn, what autism is, because this is all connected, and building that foundation is where we start to help healthcare providers move forward, and really anybody in the general public. For this first piece, at least, I really love this photo. It's like one of my favorite photos. It's just so colorful and happy. So I always just call out that this was done by Dr Greg Dunn in the United States, uses his knowledge of neuroscience to create works of fine art that really celebrate the brains, the different paintings and micro etchings. I just think that's really nice, but really let's start with the beginning. What is neurodiversity? It's a term we hear all the time. It's been thrown around a lot, especially since covid 19 pandemic. When we think of diversity, we often tend to think about things like gender diversity, you know, women in leadership, visible minorities, racial or ethnic diversity. And what you'll notice about those things when that I say they're typically visible forms of diversity. And there's other types, though, that are not diversity, that are not visible. Neurodiversity is one of these. It's not readily apparent. It's not something that you can see when you look at someone. So neurodiversity refers to the concept that there is diversity or difference in the way that our brains work and process information, and that refers to all human brains, including both neurotypical and neurodivergent brains. There's a common misunderstanding that neurodiversity only refers to neurodivergent people like myself, but it's actually not true at all. Everybody on this call is encompassed by the compass and concept of neurodiversity. It's simply about looking at breaking the word down so to neuro, nervous system, in this case, the brain, and diversity, difference or variety. So you don't have a neurodiversity, you are encompassed by the concept of neurodiversity. Now there's a few key terms when we talk about neurodiversity, and I have those written for you on the slide the first and I've said a couple of these terms already, but the first of those is neurodivergent, or nd as the abbreviation you may see, and this is a person whose brain develops and functions in a way that is not considered usual or expected by society and neurotypical. Excuse me, abbreviated to NT is that refers to a person whose brain develops and functions in a way that is considered usual or expected by society. Now notice that in both of those definitions, the words usual and expected are surrounded by quotation marks, and this is because when we when we have these definitions, we're referring to societal norms as defined by a culture or a society, there is no real like universal normal or universal expected, or any of this, these norms, these usuals, these expected they fluctuate, and they change over time, eras and across cultures, even across different races and what religions and etc. So what's Western society considered as normal 10 years ago is very, very different from now. We also have the word neurodiverse, and there's a few ways that I've seen this used. It was initially used to define a group of people that are both neurotypical and neurodivergent individuals. So for example, this group, there may be some individuals in here that identify as neurodivergent, like myself, and there may be some individuals in here that identify as neurotypical. So in other words, a neurodiverse group. I have now typically been seeing this switch to referring to only neurodivergent people. I'm still hesitant to do it, because to me, I don't see it that way, but at the end of the day, I It's kind of one of those. It's I think it's slowly changing, and I might just need to get on that train and accept it. But for your reference, that is the way that I know it to be. Couple of ways to think about neurodiverse, and it depends on your way that you want to think about it and how your brain processes information. You could look at it like in statistics class, where we have a bell curve, and neurotypical would be that, quote, unquote, dominant social norms, or the main Bell, if you will, of the curve and the deviation, that's what the two ends or the tails would be. Neurodivergent. And again, by deviation, we're referring to natural variations of the human brain. So autism, ADHD, etc. Another way, and the way that I like thinking of neurodiversity is to like think of yourself walking into, say, a rose garden, and the roses would be your neurotypical or dominant social norm. But as you're walking, you may look around and notice that other flowers have gotten into the flower garden or the Rose Garden, so there could be like, daffodils, daisies, etc. And what you notice is that, of course, they differ. They're different colors, perhaps different sizes and whatnot, but they're ultimately still flowers in and of themselves, but they're still different from the majority, so they would be considered neurodivergent anyway. A couple of ways you could think about it, and it's really up to you. There's more others. There's others out there too, that that exist. So moving from this, let's look at autism. So we've been with some of this is very generic information that you're probably already familiar with. Autism is a lifelong neurodevelopmental disability, which means it's something you're born with. Generally speaking, these are very high level diagnostic criteria. There's a couple of main criteria for diagnosis, and the first is differences in social interaction and communication. So for example, someone who's autistic may not understand or process nonverbal communication in the same way that a neurotypical person may so for myself, I often go to eye contact. I don't make eye contact well with people that I meet right away, and if I am making eye contact with you and I don't know you, it's because I'm forcing it, and it's often very uncomfortable for me, but I don't want to be perceived as rude or disinterested in you. So that's just one example of of that difference, perhaps that's there. The second criteria are differences in patterns of thought or behavior, and that can include things like repetitive behaviors, preferences for routine and structure, etc. In 2013 the criteria for identifying autism train changed, and prior to that, autism, Autism and Asperger syndrome, which you may have heard of, were two separate diagnoses. Now they both fall under that umbrella term of Autism Spectrum Disorder, or ASD I mentioned this because I want to just really emphasize that Asperger syndrome is still a very valid identity used in the autism community. There are a lot of people that will still identify that way, and if they do identify that way, I just asked that no one correct them, that instead, we just respect their identity and understand that they're referring to autism, that ultimately, that's what they were given as a diagnosis, and just because they don't want to change it, that's okay, like at the end of the day, just accept what it is. You can educate them and certainly say, hey, you know, just so you're aware this change, but you know, just let, just to still respect the identity. Equally important, of course, to understand is autism isn't a mental health condition. It doesn't mean that you have a cognitive deficiency of any kind. It's just it, but it can co occur with other disabilities or neurodivergences. And currently in Canada, according to the Public Health Agency, about one in 50 people are autistic. Now autism is considered a spectrum, which means that not all individuals with autism share the same characteristics or impacted to the values of characteristics to the same degree. When we talk about the autism spectrum, oftentimes we tend to think about it as the picture on the left, that line there that you can see as a linear spectrum, so someone who's very, very autistic on one end, or more autistic, and someone who's less autistic or not at all autistic on the other, someone who's got very high support needs and someone who doesn't, it's really far from the case. The problem with thinking about autism as being linear is that our perception of the individual, of our client or a person in general, also becomes linear. It doesn't encourage understanding of a person's strengths and their needs or take into consideration the context, the really important context and environment plays. Often, individuals that are autistic get placed somewhere on the spectrum based on a very limited understanding of what autism is, or based on one situation or one environment. So just really important to be mindful that sometimes you know looking at me now presenting you may have one opinion of my autism, but when that this environment changes, or I'm somewhere different, or there's a change in routine, or anything like that, perhaps my autism expresses itself in a different way. So just being aware of that and being aware as well that when you've met one person with autism, you've met one person with autism, no two people with autism are alike, just like no two people without autism are like and some autistic people like myself say need little to no supports. Others require a lot of support, and some of that are, it depends on the situation. Some might require support in certain scenarios and not in others. So really important just to be mindful of that. And the takeaway is just that we're all multi dimensional, autistic or not, we have to respect those differences and similarities in the way that we each experience the world. So instead it's more better, better to think of the autism spectrum as that circle on the right hand side. So looking at how everyone has unique strengths. So it can look like language in that yellow area, it can look like motor skills in that reddish kind of orange area, sensory in that purple area. Blue, representing perception and then executive functioning. The green, we can have all different areas of strengths and quote, unquote weaknesses, but again, those can fluctuate with environment and context.

Megan Pilatzke 

Now, in my journey, I've seen a lot of myths about autism, and this is by no means an inclusive slide, but I really like to address these particular ones, because they're, I think they're the ones I most commonly see. The biggest one I see still is that autism is caused by medications or vaccines. I want to be very clear, it is not. And that was a study that, a quote, unquote study that came out, that has been debunked. There is absolutely no evidence of this whatsoever. It's a natural variation the human being. The same with bad parenting. There was a lot of initial quote, unquote treatments for autism that said the mother had to spend more time coddling the child and this and that that will not do anything at the end of the day, you are autistic. Another one I've seen initially, childhood disorder or illness. Autism is characterized this way for a long, long time, and it's only in recent decades that it's now been classified as a lifelong like you don't grow out of your autism at 18, you continue to be autistic your whole life. Autism as a disease or an illness. So that's a common one that does prevail, and it really is one that is difficult for me to listen to, because certainly there are challenges that accompany autism, and perhaps those individual challenges require assistance, treatment, things like that. But autism, in and of itself, is not something that necessarily is a disease or an illness, all autistic people have intellectual disabilities. Not true at all. Can an intellectual disability accompany autism? Absolutely. This is one of my favorite autistic people have no empathy. I would challenge and say that that is far from true, and that most autistic people I've met have a ton of empathy. We just showed in a different way, same with the anti social. Anti social according to neurotypical standards, but in terms of individuals speaking one about amongst one another, neurodivergent to neurodivergent, a lot of support there that we are not anti social by any means, we just communicate a little diversely. And lastly, which leads nicely into my next section, is that only boys are autistic. And a big reason why it took me so long to follow by autism is that that final myth that autism only occurs in boys. And sadly, by this point, I've met hundreds of women who have a very similar story to mine. But the reasons go bigger than gender itself, and it's important to understand. Important to understand that research, research is behind when it comes to autism, and as a result, healthcare providers professionals are not properly educated on how to recognize autistic traits, never mind the general public. So a couple of ones that I like to point out currently autistic girls and women are under recognized, and they're diagnosed later than boys and men. And this is quoted in fuser poly et al, 2020 and Russell et al, 2022 yet when we look at these statistics that are on the slide here, it doesn't really look like that. Now, when we look at the slide, the DSN five states that the male to female ratio for autism is about four to one. So for every four boys diagnosed, one girl is diagnosed. Loons et al 2017 states that the male to female ratio for autism is three to one, so three boys for every one girl. And I argue that both statistics are totally flawed and both are accurate, let me say based on current diagnoses. So if I'm looking at a pool and I say these, here's all my diagnoses, and I analyze those, and I say that, then it's accurate 100% but I argue that the flawed for two main reasons, the overall statements. The first of these reasons is our limited understanding of autistic traits and how they present in women, especially and even in other races, in individuals that identify as 2SLGBTQ, plus, when we started studying autism, we focused on studying white boys, sometimes white men. They were cisgender, so they identified with their gender at birth, and they identified typically as heterosexual. They also were often from Western civilizations which allowed us to develop screening criteria that really only looked at very specific traits of autism and disregarded others. And furthermore, a 2021 study found a lower male to female ratio in autism among adults with supports which supports the limited research done on autism in adulthood and in girls and women, and in this study, the ratio is actually higher in childhood versus in adulthood, which I found interesting. The second reason I consider these stats flawed is because, due to that limited understanding that we have of how autistic traits present in women, and in turn, those screening criteria limitations autistic women are going undiagnosed, simply due to the fact that healthcare professionals don't have the knowledge or the understanding to recognize and assess for autism that Looms et al study further supports my reasoning and their studies conclusion by saying, quote, There appears to be a diagnostic gender bias, meaning that girls who meet criteria for autism are at a disproportionate risk of not receiving a clinical diagnosis, and that 2021 study I was referencing with the lower male to female ratio in autism among adults, they indicated in their discussion that several findings in their study indicated the presence of a gender bias in ASD diagnostic practice. So given those reasons, it's really hard for me to believe that this is actually accurate and reflective of the population. Nonetheless, these statistics, coupled with the DSM screening criteria, have led to all these stereotypes of autism in the media, and here's a few of them on the screen. We all know these characters. They're but note, they're white, they're cisgender, they're heterosexual autistic men, and although autism can and, 100% does present in this way, it's not a fair or full representation of autism, and these stereotypes miseducate the public, and they even miss educate our healthcare providers into further believing that autism doesn't occur as often in women, but it does all the time, and it leads into this male based lens autism, leading to this expectancy bias. And the thing to remember is that sex and gender related factors can modulate how autistic characteristics are expressed behaviorally and developmentally. And that was done, that was a study done by Dr Meng-Chuan Lai  at Al, 2022, so a lot of times what happens in women, and it was the case with myself as well, is there's autistic masking going on. So women often will kind of be as girls watching from afar, and we're learning from our peers, and we're perhaps, if you look closely, we might be in a group of individuals and appear to be socializing, but really not. We're actually just watching around us and seeing what's going on. And we learn to mask things very, very quickly. We rehearse social situations. We hide or minimize focused interest, depending on what they are, keeping in mind that focused interests have been stereotyped to be trains and things like that, but focused interest could be anything. It could be makeup as girls. It could be Barbies, right? Just very generic things I'm throwing out, but they're nonetheless a focused interest. There's forced eye contact. There could be scripted responses. A lot of times, what I would do is going into a conversation before I knew I was going to meet with someone, I would be in the mirror just rehearsing what I was going to say to somebody before I went in. And over time, what happens is you don't know you're doing this. When you don't know you're autistic, especially, and it takes a lot of cognitive energy to do and it leads to anxiety, to depression, to autistic burnout, to suicidal ideations. And the first time that individuals often start accessing help, looking for help, is when they're in anxiety, depression, burnout, suicidal ideations. So as mental health professionals, we're then seeing these individuals for the first time and saying, Okay, it's anxiety, it's depression, but we have to look deeper than that to be able to really see and on top of all of that, the lack of research, the autistic masking going on, additional barriers are going on, and these are barriers, let me just say, not just faced by women. These are really barriers that are faced by all kinds, all adults, regardless of gender identity. So long wait lists, pretty standard lack of healthcare professionals assessing adults. The majority are assessing kids. Distance is a big one, especially for those of us in northern Ontario, way up north in the territories, we have a fear of discrimination. So we don't want to label necessarily, and we don't want to be discriminated there's the fear of not being believed. So we've gone to so many different professionals, and we're being told, Well, you know, could be this, could be that. So now we're saying it's autism. Do we look a little more quote, unquote crazy for that? But the biggest barrier by caught by far, is cost. We're keeping in mind that up to 18 or 19, most provinces will cover an assessment. After that, you're on your own. And there was a recent survey done by Dr Mackenzie salt advocate Master University, who identifies as autistic himself. And this was the biggest barrier that was identified to obtaining an adult an autism assessment, and that was done this year. So I'm mindful of my time, and we are now at the part of what can you do about it? How can you support us? Rather remember that whether the individual is a youth or an adult, there's always things you can do, and your support starts with the language that you use. So how to talk about autism? I want to be very, very clear that language, there's a lot of different choices out there, and we need to respect the individual's choice coming in. What I'm going to provide you with on this slide is general what what in general, overall, is accepted by the neurodivergent community. But keep in mind that this can be individualized, and some individuals may not identify with, for example, identity first language. Some identify with person first language. Okay, so in general, we should try to avoid the use of the word disorder. So we should just be saying autism, autistic in general, we should be saying autistic person. So Megan is autistic, versus Megan has autism, remembering things like specific autistic experiences and characteristics say set of symptoms, impairments. They're at risk of autism. Well, they may be autistic, increased likelihood of being autistic. Comorbidity, I hate the word comorbidity. Absolutely hate that word all the time. I always correct people co occurring, co occurring morbidity just sounds like a death sentence. So try to try to watch that one. I know that one's a little bit of a tricky one, though. Functioning, and we're going to go over that in a minute. So I'm not going to go into that cure, treatment, intervention, specific support or service, restricted interests or obsessions, specialized, focused, intense interests and in normal, holistic or non autistic. So again, a few considerations, but can be individual, of course, person first and identity first. Really important to understand this. Okay, person first language puts a person before a diagnosis or a label. What if they say? It tells you what a person has, rather than asserts what a person is. There was a big swing amongst healthcare providers initially for person first language, and I've actually seen that it's still included in a lot of guidance, because it puts a person before the diagnosis or label. Important to understand that many in the disability community, not just the neurodivergent community, are now choosing to use identity first language. So Megan is autistic, not Megan has autism, and it puts the label or the diagnosis before the person, and why we do that? Well, because disability autism not something negative. It can be celebrated. It can be recognized as integral to a person's identity and sense of self, and it remains the most preferred form by the neurodivergent community. But be mindful that there are individuals that I have met myself that do identify with person first. The takeaway is to not make an assumption about how someone identifies or describes themselves. And if you don't know, just ask. It's okay to ask. A final note on using labels. Labels can be extremely, extremely useful. Okay. They help us learn information, and they help us put discuss shared characteristics or attributes within a group, but remember that labels can only tell us so much about a particular person. If you bet one person with autism, you bet one person with autism, and the same is the case across the board for anybody. So get to know that person beyond the label. Get to know your client, your patient. However you identify them beyond that label, don't make any assumptions about them. So looking at some of these common labels, you might see how I'm labeled versus what I really am, touchy or easily upset. They're sensitive or hyper empathic. They're Flappy, they're fidgety, they're anxious and they're in need of calming. They're lazy, they're uncaring, well, they're maybe they're battling executive function. They're irritable and moody. They're emotionally dyregulated. They're fickle and unreliable. Maybe they're facing social burnout or autistic burnout, rigid and obsessive, hyper focused, inauthentic, masking for survival. Excuse me, weird, passionate, creative and neurodivergent. So just some common things to think about before we go and characterize someone based on one behavior, and on that note of labels, I want to quickly let you know about want to talk about functioning labels. Try to avoid using these. I understand it in some situations, it's unavoidable, but I just want to explain a few things to you. Functioning labels are used to describe how an autistic individual functions in their day to day life. And some common ones that I've seen these are not limited, high functioning, low functioning, mild or mildly autistic, severe, severely autistic, profound autism is my favorite personal level, one, two and three. Now the DSM does this and at times, as we know for applying for things like Ontario Disability Support, for passport funding, things like that, we have to put the levels I get that what I'm talking about is outside of those times, be mindful that this practice is very, very harmful and it's discriminatory to the autism community. So your best practices for that is to refrain from using them and instead refer to these as individual or specific support needs. You can educate caregivers and others as well as to why the labels are harmful, but of course, only use them as required to support funding. I understand these forms need to state certain things. It's unfortunate, but it's life, but I'm talking about  in a general conversation with someone. Some additional communication considerations for you. And this really works. Let me just say, not just for autistic clients, really for everybody. You could even use some of the stuff between you and your colleagues. And be sure, these are just general considerations. Individualize, get to know your client, try to provide an agenda in an advance and at the start of the appointment. So if you're scheduling, say, a session with a mom and a child, or with an autistic adult or whatever, tell them what you're going to be doing, like during lunch just we are going to meet for an hour today. Well, okay, that's intimidating. What's going to happen? I'm going to introduce myself, and we're going to talk about your week, and we're going to talk about what we're going to do next, and this and that, and remind them at the start of the session, if there's going to be a change in that agenda, make sure you let that person know as much in advance as possible. Sometimes it happens inevitably, and there's nothing we can do that's okay, but try to inform the person. Don't force eye contact or any kind of pleasantries, just, you know, hello and move forward with it. They don't need to do that. And at the end of the day, if that's not what the individual is comfortable with, comfortable with, don't force it be clear and concise with communication. Don't rely on metaphors analogies. Try not to use any acronyms, things like that. Don't use vague language. Remember that a lot of autistic people are very literal thinkers, sarcasm, things like that we can struggle with so try to be very clear and concise. Offer choice and accessibility with communication. So again, being very clear and offering choice with that listen and don't interrupt ever. Listen, listen, listen. There are times where we do need to redirect, yes, but in general, should be listening and ask questions. Be curious. If you don't understand something, then clarify it with them. Repeat it back to them. It's okay to do that and ensure that you understand and encourage stimming behavior. Don't stop these behaviors. These are behaviors that the individual is doing in order to feel comfortable and to regulate themselves in the environment. It's okay, even if it feels a little distracting to you. Remember that the individual is using that to cope. And my last slide, my Finally, some more broad things you can do. Okay, continue to learn more about autism and neurodiversity. I know Marie's organized a whole series for you, so keep attending these things. They're really helpful, and don't just do it once. Do it over and over and over. Make sure that you understand that things change all the time. Try to create a sensory friendly environment, not always easy to do. I recognize that in healthcare. But if you can alter lighting, if you can provide noise canceling headphones, or means of quieter spaces, anything like that is helpful. Anything to prepare the individual to come into your space is helpful. Be cognitive of your personal bias. Practice self reflection. That is one of the biggest things you can do if you have a situation and you've gone through it and it's overwhelming, and you think, gee, how like did I do the right thing? Maybe you did, maybe you did. At the end of the day, it's all about improvement, and we need to take a moment to write this down, or record it, or whatever it is, to yourself and reflect on that practice. How could I have done better. And lastly, and most importantly, that's the circle of care right there to the right. Work together. Refer, refer, refer, refer, I cannot tell you how many times to refer. Don't be feeling intimidated that you need someone else's help. Remember that you are serving the client. And in turn, the family overall. Be open to those consultations and make sure to work with caregivers closely. Remember that caregivers, unless being specifically told by the client, the patient, that you do not talk to them, you should be listening to them because they know that person better than anyone else. So that's all I have for you today, I ended immediately on time, which I know doesn't leave me really any time for questions, but I did the best that I could. You can email me if you need to at that email. You can find me on LinkedIn. I'll stop sharing my screen. But yeah, that's that's what I have for you today. I know it's a lot of information, and I know there's a recording so and I've also got to make sure that I I've also created a little PDF to share out the information. So I am I'm well ahead about this.

Megan W 

Thank you so so much. Megan, I was looking at everything coming up in the chat as you were speaking, and everyone is just echoing so much thanks and gratitude for you. Like sharing your own story, and just, there's a whole lot of love going on.

Megan Pilatzke 

A little here, there's so much going on. Oh, my goodness.

Rob 

sorry, Megan, most of us, well, I have ADHD, so I was doing both like, this is what. What was happening here. I love you, I love you, I love you, I love you. I want you to come and just be here every single day and teach us. I had so many of our staff like texting and emailing throughout the presentation, like you are the one of the most, you're the one of the most, the one probably the most experienced but also eloquent speakers. You you have a way about you that I just I can't get enough of. And so thank you so so much for this, as always.

Megan Pilatzke 

Oh no, thank you, Marie for having me. And I'm just happy that you know everybody's here to listen and can take something away from it and and that's all I ask, right? Is that, you know, we're not going to take everything in one shot. Sometimes this is a lot of information, but, you know, it's a learning journey, and we're going to all make mistakes, and that's okay. It's just about, how do we go forward and and you know, there's going to be new information that I'm presenting probably next year. Some will stay uniform, but, you know, like my story, but, but the information is going to change all the time, and it's just about learning and and it's okay, you know. So I'm glad that I can, I can do that, and always happy to come back and keep on presenting

Rob 

Megan. I have, I do have, like, one question. I

Megan Pilatzke 

have the time. I have the time. Sorry, I

Rob 

have one question I'm dying to ask, as you know, I can't help myself, what for you when you feel like, Oh, what was I gonna say? Oh, I've lost my train of thought. Oh, no, it's gone. No, you something? Oh, Specialisterne turn, what do you actually do there? Like, what is like? I keep hearing about Specialisterne, I recommend it, but, there's, seems like there's so many branches that we I actually don't know what it all encompasses.

Megan Pilatzke 

Yeah so, our organization started in 2004 over in Denmark, and we were started by, actually, an a parent of an autistic child who, at the time, in 2004 his son got diagnosed with autism, and was told, essentially, he was told, like, this is the worst case scenario, and your kid's never going to work and all this stuff. And it was just really terrible, really dismal story. And instead, Thorkil, our founder, kind of turned around and said, No, no, this ain't going to be how it goes when got involved with the Danish community and really learned a lot about autism and saw the struggles that autistic people were having in getting employment. Specifically, we started with autism, we've expanded to other neurodivergences. Now we expanded worldwide, and that includes Canada and the US and every hub does something a little different depending on the culture that they're in. So Brazil, for example, do something a little different. So I'll talk in Canada and in the States, because we do the same thing. So we serve people that are neurodivergent, so they identify as autistic, ADHD, learning disabilities, etc. Specifically, our clients are employers. So what we do is we will offer neurodiversity hiring initiatives. So it could be that, you know, a lot of places we work with they just want to hire people and bring them in. So we do hiring a little differently. We don't do a standard apply interview that what we do is we have individuals apply, we review it by person, not an AI system, which is great. It's a lot of work, but we do it that way because AI systems filter out so many people with varying experiences in education and all the gaps and whatnot. And what we do is we then the individuals that we identified that do have what we need for the role, we will send them an actual what am I trying to say? A document that essentially has interview ask type questions for them to fill out in full, and that is their quote, unquote interview. So they will do that. We will then meet with them. We'll get to know them. You become pretty connected with them. And a lot of them, to this day, stay connected with me even after and they will send me emails about how they're doing and this and that, and it's really nice feeling. But after that, we we do introduce them to the manager. There's a little we call them meet and greets, really. It's just so they can see the person exists, so to speak. But we prep them. It's a structured thing. We ensure there's there's questions, and we hire them in once they're in. Then after that, it's all about coaching. So we have coaches that go in, they will support both the neurodivergent individual as well as the manager, which I love. It's a partnership. And I love that, because it's not putting this You're the problem on this person. It's no, no, you have different ways of communicating. That's okay, let's work together. So, so that's how this now, coaching. We also offer separate from hiring. We do that as like a separate service in addition to hiring, but it's included in our hiring, totally separate from that. We also do education. So we'll do sessions, literally, like an exploring neurodiversity session we have. And I just go in and I educate. You know. So a very standard session. Sometimes we customize it a little, but generally, that's what it is. We also do some consult, consultation and advisory. So most recently, for example, we've worked with the Senate, actually, of Canada, Parliament Protective Services. What we did was small beans. Yeah, we no big deal. And we we went through, like, say, their security screening, and what they wanted us to do was to determine what's wrong with it, like what are they not doing when they go through typical security screening like that could be better make it more neuro inclusive. So we wrote a whole report on that. We're now going to deliver a workshop to help security screeners better understand how to how to help individuals that are neurodivergent or suspected to be even other disabilities, right, go through that's just one example of a consultation we've done. But there's, there's, certainly we're very open, and we get all kinds of random, I call them random requests, because when our when our main person comes to us, I'll just say, like, What in the world are you throwing at me this time? Maggie, I want to hear her. Name is Maggie. So I Maggie, what are you throwing at me? What do you got for me now? Well, just buckle up. So, so it's really good. Yeah, I love it. And on a doable scale, we're trying to, kind of, I work on a global scale as well, which is why I'm going to Spain to to learn more about other services for neurodivergent people specifically, like we're building an academy program with some transitional programming, which I really, really am excited about, because we need that so badly. And yeah, so the long winded answer, I know we're over time, but that's it. There's no other way to explain this short that you would you would just go, okay, that's advisory services. Okay. What is that like? What's that even mean you know, so,

Rob 

yeah, yeah, yeah, yeah. So you've got some sorry we have so we have so many questions. Megan, I know, I know we're over. Rob, this is a great question. Do you want to ask it? I would love to Yes. Hello. Thank you. I really appreciated your talk. Thank you so much. I was in a mixture of awe and just like really happy to hear and then also posting jokes in the chat, because that's just how I am. I am absolutely reverent at every opportunity. I really enjoyed your talk. So thank you so much. My question was, if, what can a psychologist do to become involved? Because I'm really interested in someday, hopefully providing assessments for adults with autism and quite a few therapy clients who I strongly suspect are on the spectrum, but of course, hard to hard to get it diagnosed. So what? What if anything could a psychologist do to become involved if they were interested? Because this is something that would be really, really cool, that I would love to have be a part of my work, if I could with

Megan Pilatzke 

with Specialisterne specifically, or just in general are you asking in general? I will say with us, what I would love in an ideal world, and right now we're not there yet, is I would love to have a perfect world where we integrate kind of so in Denmark, for example, our Denmark office has psycho education and psycho therapy type services integrated in with coaching. Ideally, that's what I want. You don't have that right now. So right now, as a psychologist, there wouldn't be anything that I could say would be available yet. Do I want that someday? I'm advocating for it very hard, because I believe too often that there are individuals getting into these roles. And what we're seeing in our coaching services all the time is that is there's a line, and as we know, the line is we cannot provide any medical type of services, but I want to be able to refer to someone that can. And so that's number one in terms of a separate from that, I think a really good person to help with that question. Outside of this would be, I don't know if Alex is on the call.

Rob 

He had to go through his he had a CAMH round. He did, yeah, he's gone. But so I

Megan Pilatzke 

was gonna say Alex would be, I know is doing a lot of work with adults, and specifically trying to get more services out there for adults. And I believe, if I'm not mistaken, is in the process of opening a clinic I don't know, or started to, or already has alcohol clinic.

Rob 

Yeah, it's called Autism wellness, and his business partner is presenting to us next week on adults and autism,

Megan Pilatzke 

yeah, I would highly suggest that. But in terms of supports for adults, the big thing that we need more of right now, and CAMH is doing some work with that, is, is, you know, forms of peer support, forms of, certainly, adult services in general, like, you know, like I said, peer support, occupational therapy, be something so ideal that I'd like to see more of, of course, assessments and in terms of how to become, I don't know all those means, because I'm not a psychologist or in any of that, but certainly, if you can expand your practice to include adults and at that. Adults that are not necessarily in the GTA or in southern Ontario. So if you are open to virtual assessments and things like that, of course, there are certain types of the tests that I know you can't do, you know, and I got that disclaimer when I had my assessment, but those are things that you could still kind of look around and still do an assessment and kind of determine, because a lot of the individual the individuals really just want this assessment to be able to move forward. They don't necessarily want a service. They want it so that they can then just have that understanding of themselves and move forward. And a lot of them, perhaps need some support in the workplace. So they want that assessment to order to then inform an accommodation which they can only get if they have somebody that can fill this form out accurately, or whatever form they have. So I know that's a very long winded question, but what I'm I'm going to suggest, Marie, is maybe any of those questions, including this one, if you want to pop that into maybe like a little document for

Rob 

me. Yeah, Megan. Megan's making we've got lots of people asking for your slides, your recording. Are you comfortable with the recording being fair?

Megan Pilatzke 

Yeah, you said that reading's fine, and the slides for everyone's reference and for yours. Marie, I believe it's already been sent to you. I had a little auto send on for you at one o'clock.

Rob 

I wish my brain worked like yours. It's amazing. Mine still haven't gone out. It was week one. Well, it's

Megan Pilatzke 

there. It's there. So there's a PDF in there of the slides. The only ones I took out were my personal slides with that. But I don't care about the recording. It's just I didn't think it would make sense in a PDF. So well, if you could share that out. And it has, of course, not my slide notes, but it has has little, slight pictures and things, because I know that that's a lot of information to take down. So go ahead, share that out. That's totally fine. And yeah, in terms of the any other questions that have come through that are outside of, you know, can I see the slides and things like that? I suggest just throwing those into a Word document or something for me, and I can respond to those, say, by the end of the week before I head off to Spain. And you can share them out with everybody. If that would work, it'll give me time to to also kind of process it a little bit and write a more thorough answer. I think

Marie 

you're amazing as always. Thank you so much for spending your lunch with us and everybody else on piggybacking on Megan's topic. Dr Iris Yusupov Rose will be joining us next week. She's from autism wellness. We did our doctoral studies together. She's in the adult stream, and I was in the Child Developmental stream. Or am continue to be Not, not. I'm not out of it yet, clearly. But she will be talking about, you know, assessments and therapy with autistic folks, adults in particular. And yeah, she'll, she'll be here next, next Tuesday at 12. And

Megan Pilatzke 

I highly encourage that that will probably answer, Rob a lot of your questions too, to support better, support us too. But I will try my best to also add from some lived experience in there, once I have some more time to kind of sit with it,

Rob 

we I can't wait. That sounds so fun. I'm going to do everything in my power to attend because that is I want more of that. I need more of that. Give

Megan Pilatzke 

it great. Love it. Thank you. Everybody. Have a great rest of your day. Thanks, Megan,

Rob 

thank you. Take care. Bye. Megan, bye. Megan, both. Megan, bye. Thank you so much. Really

Megan Pilatzke 

Appreciate You.