There’s a CRISIS AFAR

The ongoing COVID-19 pandemic has affected the entire world in so many ways. Families with children on the autism spectrum have been particularly impacted by quarantines and lockdowns. With many schools moved to a virtual model and clinics closed to patients, these children often have been forced to miss vital education and therapy opportunities.

To learn the full extent of how families with autism have been affected by the pandemic, researchers at the Thompson Center are taking part in an international study of families across the world. The study, called CRISIS AFAR (CoRonovIruS Health Impact Survey) (CRISIS) Adapted for Autism and Related Neurodevelopmental Conditions (AFAR), is aiming to survey thousands of families in North America, Italy, Ireland and Japan to determine how different levels of lockdown in various countries have impacted families with autism.

The researchers hope that by better understanding how the pandemic has affected and still is impacting families, services for these families can be adjusted to better meet their needs, even from a distance. The study leaders reached out to the Thompson Center for help.

“Our research database is incredibly valuable for studies like this because we have already connected with thousands of families with autism, which makes it simple for us to reach out to those families and ask for their participation,” said Dr. Kerri Nowell, a clinical psychologist and researcher at the Thompson Center.

Thompson Center researchers are contributing to this massive international undertaking by adding the CRISIS AFAR survey to another research survey the Center is currently conducting. This will allow for the study leaders to capture valuable information about the pandemic’s effects on American families throughout the Midwest.

“We are really interested to compare how different levels of lockdown across various countries have effected families differently,” Nowell said. “Places like Italy were under a total lockdown for months, while areas of the United States were under less restrictive lockdown rules. We want to know if
families experienced better or worse effects based on the level of lockdown as well as general problems or benefits that have arisen.”

Researchers have been collecting data from families around the world for many months and plan on continuing to follow families and the impacts of the pandemic until 2022. They hope to have early results soon.

Researcher Spotlight: Dr. Benjamin Black

Who: Dr. Benjamin Black, the Director of Medical Services and the Ron Ashworth Professor of Child Development at the Thompson Center.

Bio: Dr. Black grew up in the small town of Argyle, NY in northeast New York state before earning an undergraduate degree in neuroscience at the University of Rochester. Dr. Black then worked as a clinical research assistant for three years at Yale University before attending medical school at Jefferson Medical College in Philadelphia. Dr. Black continued his medical training at Children’s Mercy in Kansas City, where he completed his residency in pediatrics as well as fellowships in developmental-behavioral pediatrics and pediatric clinical pharmacology. These combined areas of expertise truly make Dr. Black a uniquely qualified physician to lead medical services at the Thompson Center.

What are your research Interests?

In the past, my research interests have primarily focused on topics related to “precision medicine.” This includes pharmacogenetic factors that impact response to medications. I continue to have an interest in identifying subgroups of patients that respond to particular treatments and working to determine why some patients may respond very positively to a particular treatment and others may not. These types of issues are particularly complex in individuals with autism.

How did you first get involved with autism research?

During the course of my fellowship in developmental-behavioral pediatrics, I gained a lot of exposure to the breadth of autism research that exists. At that time, I was also completing a fellowship in pediatric clinical pharmacology, so my research naturally blended those two disciplines.

What is one thing do you hope to discover or understand better by the end of your career?

There are a couple of things that pique my interest these days. First, I love to think about the extremes of patient response to treatments (medication, behavioral, etc.). In any clinical trial, there are some patients who respond well to the treatment, and some who do not tolerate it at all. Whether the trial itself shows benefit or not, there are almost always at least small groups of patients who show an extreme response one way or the other. There are many variables that contribute to those differences, and you can easily spend a career looking at that. Second, I’ve become more interested in the topic of caregiver stress for children with neurodevelopmental disorders. Understanding that stress (what contributes to it, how we can help alleviate it, what the trajectory it is) is so important because it can have huge implications for the child and family outcomes. Supporting families through the diagnostic odyssey and beyond is a huge part of what we do, and it behooves us to understand that better.

What motivates you to work so hard in this field?

That’s an easy question – it’s our patients and their families. There is nothing more rewarding than seeing a patient make progress, whether it’s a big or small gain. We celebrate all of those victories. Once you see that happen, there’s nothing else you want to do except help another patient and family. That is what I think motivates all of us at the Thompson Center, be it in the clinical or research realm.

Trainee Spotlight: Meet Mallory Stevens

One of the Thompson Center’s primary missions is to train the next generation of leaders in the field of autism care. One aspect of this training mission is providing a learning environment for students pursuing their doctoral degrees in psychology. By providing these future child psychologists real-world hands-on experience working with patients, the Thompson Center is helping to increase the number of trained autism experts around the country to help provide more resources for more families.

A typical doctoral trainee will spend one year training at most practicum sites before choosing to move on with their career. On occasion, a doctoral trainee may choose to return for a second year of training. Until this year, the Thompson Center has had one graduate trainee return for a third year. However, this year the Thompson Center has four talented graduate trainees returning for an unprecedented third year. This speaks to both the high-quality training opportunities the Thompson Center provides as well as the dedication of these future psychologists to maximize their training to become the best care providers possible. Over the last few weeks, we have met these four doctoral interns. This week we’ll finish up by learning more about Mallory Stevens.

When did you arrive at the Thompson Center?

I started my practicum placement in June 2019 and with Alexis, Daisy, and Sarah!

What is your bio and educational background before the TC?

This is actually my eighth year in Columbia. I completed my undergraduate degree in psychology at Mizzou in 2017 and started the school psychology graduate program the following semester. I originally was pursing my educational specialist degree to be a school psychologist in schools, but I always knew that I wanted to work closely with children with Autism Spectrum Disorder (ASD) and intellectual disabilities. I figured that pursuing a doctoral degree would allow me to focus on clinical practice and autism research, so here I am!

What are your career interests/goals? What do you hope to be doing professionally in 5-10 years?

I see myself entering a career that similar to my current role at the TC. I really enjoy working closely with children and their families in autism evaluations. I am also really interested in exploring academic intervention consultation and developing school-clinic partnerships, but these are long-term goals and projects for research.

What created the passion within you to pursue a career in this field?

When I was an undergraduate student, I mentored a peer with ASD. We met every week to chat about his experiences, questions, and thoughts about schoolwork, social life, and post-graduation plans. He also had the best Robin Williams impression I have ever heard — he could do everything from Ms. Doubtfire to Dead Poet’s Society.

Why did you decide to return to the Thompson Center for a third year of training?

The training and supervision here are amazing, and our supervisors actively look for new opportunities for us. Every year has offered something new and exciting. For example, I’ve worked on research with my clinical supervisor for the past year! It’s also really fun to return with my TC cohort. We all work really well together and have grown closer as colleagues and friends.

How do you think your time at the TC will influence the direction of your career?

The TC has helped me identify what I want to do after school — this kind of work! Collaborating with different providers has also shown me that there are so many things I can do in one place. I could conduct research like Dr. Nowell or teach graduate courses like Dr. Knoop. I could lead initiatives to make care more accessible and equitable like Dr. Sykes (e.g., TOT week, TCIC).I could participate as a faculty member on LEND training grants like Dr. O’Donnell or effectively lead an entire team like Dr. Brooks. That’s really exciting to me.

What is the most valuable thing you have learned while working at the TC so far?

I’d say the most important lessons from the TC have been (a) find an interdisciplinary team that prioritizes high-quality services and makes work feel fun and rewarding, and (b) prioritize family-centered care in every step of an evaluation.

What do you hope to learn and/or accomplish in the rest of your time training at the TC?

Next year I look forward to supervising a new student and learning the ins and outs of high-quality supervision that I’ve experienced myself!

Any last thoughts about working at the TC?

I wish every student at Mizzou could experience the TC. The psychology providers are very intentional and emphasize student training goals. It’s fun, collaborative, and I learn something new every day. Completing practicum at the TC has been the most rewarding part of my experience in graduate school.

Trainee Spotlight: Meet Daisy Hu

A typical doctoral trainee will spend one year training at most practicum sites before choosing to move on with their career. On occasion, a doctoral trainee may choose to return for a second year of training. Until this year, the Thompson Center has had one graduate trainee return for a third year. However, this year the Thompson Center has four talented graduate trainees returning for an unprecedented third year. This speaks to both the high-quality training opportunities the Thompson Center provides as well as the dedication of these future psychologists to maximize their training to become the best care providers possible. Over the next few weeks, we will meet these four doctoral interns. This week we’ll learn more about Xiaotian “Daisy” Hu.

When did you arrive at the Thompson Center?

I joined the TC as a graduate clinician in Fall 2019.

What is your bio and educational background before the TC?

I was born and raised in a small town in China and earned my bachelor’s and master’s degree in China before coming to the U.S. I earned my bachelor’s degree in Tourism Management at Anhui Normal University, then earned my master’s degree in Management Science at University of Science and Technology in China (USTC). I then joined the Counseling Psychology doctoral program at Mizzou in 2017.

What are your career interests/goals? What do you hope to be doing professionally in 5-10 years?

My long-term goal is to become a pediatric psychologist who can promote the optimal health and well being of children with neurodevelopmental disorders and their families by delivering evidence-based, family-centered, and culturally sensitive care. In 5-10 years, I’m aiming at enhancing autism awareness, promoting specialized training in diagnosing autism, and facilitating career development of people with autism around the world, especially in developing countries.

What created the passion within you to pursue a career in this field?

I first heard about autism in 2017, which means in my previous 26 years of life, I never ever heard about autism. You can imagine how shocked I was towards the giant inequities in autism awareness around the world. There is an estimation that among approximately 70 million people in the world with autism, 85% of them live in developing countries where people with autism often go undiagnosed, stigmatized and marginalized while research and support are dramatically expanding in wealthy parts of the world. I found a strong passion toward bringing evidence-based care towards people with autism and other neurodevelopmental disorders, contributing to global scientific inquiry of autism, and facilitating systematic change to support career development of people with autism.

Why did you decide to return to the Thompson Center for a third year of training?

Besides my passion in this area, I chose to return for a third year of training mainly because of the high-quality training experiences and supportive environment at the Thompson Center.

How do you think your time at the TC will influence the direction of your career?

My time at the Thompson Center has solidified my interest and passion in the area. At the TC, I gained knowledge in diagnosing neurodevelopmental disorders, skills in delivering family-centered care, and experiences of working in multidisciplinary teams. The high-quality training and strong support that I received at the TC has prepared me to be a pediatric psychologist in the future and gave me the determination in bringing family-centered care to more families around the world.

What is the most valuable thing you have learned while working at the TC so far?

I have learned so much during my time at the TC, but the most valuable thing is the importance of and ways to deliver family-centered care.

What do you hope to learn and/or accomplish in the rest of your time training at the TC?

I will spend another year at the TC before leaving for an internship. This year, my goals include becoming a research-reliable ADOS administrator, conducting autism-related research, and becoming involved in some autism-related programs, such as STRIVE and ECHO Autism.

Any last thoughts about working at the TC?

My time at the TC is one of the most memorable and valuable episodes in my life. I have not only learned knowledge and skills, but also received strong support and validation from everyone.

Trainee Spotlight: Meet Sarah de Marchena

A picture of the four third-year doctoral trainees at the Thompson Center. — The four doctoral trainees returning to the Thompson Center for an unprecedented third year of training.

A typical doctoral trainee will spend one year training at most practicum sites before choosing to move on with their career. On occasion, a doctoral trainee may choose to return for a second year of training. Until this year, the Thompson Center has had one graduate trainee return for a third year. However, this year the Thompson Center has four talented graduate trainees returning for an unprecedented third year. This speaks to both the high-quality training opportunities the Thompson Center provides as well as the dedication of these future psychologists to maximize their training to become the best care providers possible. Over the next few weeks, we will meet these four doctoral interns. This week we’ll learn more about Sarah de Marchena.

When did you arrive at the Thompson Center?

I started my practicum experience at the Thompson Center in the summer of 2019.

What is your bio and educational background before the TC?

I graduated in 2015 with a bachelor’s degree in psychology from Rutgers University in New Jersey. My post-baccalaureate and graduate training have provided me with opportunities to engage in research with schools. Specifically, as a research coordinator at the Rutgers Social-Emotional and Character Development Lab, I had the opportunity to consult with public schools in New Jersey to implement a school-wide social-emotional learning (SEL) intervention and adapt lessons for their special education classes. Currently, I am a fourth-year doctoral candidate in the MU College of Education school psychology program.

What are your career interests/goals? What do you hope to be doing professionally in 5-10 years?

Broadly, I am interested in working with Spanish-speaking and other minoritized families to increase access to early childhood health and mental health care. Additionally, I’d love to receive more specialized training as a bilingual psychologist so that I can better serve the Spanish-speaking community. In 5-10 years, I still see myself engaged in culturally responsive assessment and psychological evaluations for both children with special healthcare needs and children with internalizing and externalizing behaviors.

What created the passion within you to pursue a career in this field?

The disparities in the prevalence of ASD diagnoses and access to services for racial/ethnic minoritized children is a significant reason for my passion to pursue a career in this field. Further, every day that I get to work with, and support families is a great day for me.

Why did you decide to return to the Thompson Center for a third year of training?

So many reasons! I get to work with some of my favorite people including my awesome cohort (pictured above), other trainees, faculty, and staff, all of whom I learn an incredible amount from. My training at the TC prepares me to work with other disciplines, support my team members, and provide family-centered and quality care. Every year I’ve spent here has developed my autonomy and confidence in those abilities.

How do you think your time at the TC will influence the direction of your career?

My training at the TC has prepared me to work specifically with children with special healthcare needs, neurodiverse populations, and children with mental health concerns. Wherever I end up, I am sure I will be working in the area of psychological evaluations with these populations.

What is the most valuable thing you have learned while working at the TC so far?

The most valuable thing I have learned that significantly influences my practice is how to work collaboratively on teams and with other disciplines. Aside from working with families, this is my favorite part of the job and I could not do it well without my team members.

What do you hope to learn and/or accomplish in the rest of your time training at the TC?

I’m also interested in training and supervision. Dr. Brooks (my supervisor) and I have been preparing to focus on my goal of developing my supervision skills during my last year at the TC.

Any last thoughts about working at the TC?

Beyond the quality training and professional support, I have also been fortunate to find life-long mentors at this center. One of my mentors once said, “If you do not learn about yourself in this process, you are not being challenged enough.” I’ve stepped into myself in ways I’d never imagined possible, and I recognize how my relationships here have facilitated that process for me. I will forever be grateful for my time here!

Trainee Spotlight: Meet Alexis Rhames

A typical doctoral trainee will spend one year training at most practicum sites before choosing to move on with their career. On occasion, a doctoral trainee may choose to return for a second year of training. Until this year, the Thompson Center has had one graduate trainee return for a third year. However, this year the Thompson Center has four talented graduate trainees returning for an unprecedented third year. This speaks to both the high-quality training opportunities the Thompson Center provides as well as the dedication of these future psychologists to maximize their training to become the best care providers possible. Over the next few weeks, we will meet these four doctoral interns. This week we’ll learn more about Alexis Rhames.

When did you arrive at the Thompson Center?

I began my time as a practicum student/graduate clinician in Summer 2019.

What is your bio and educational background before the TC?

I hail from Orlando, born and raised! I earned a bachelor’s degree in psychology from the University of South Florida. In addition, I earned a master’s degree in school counseling along with a post-master’s certificate in clinical mental health counseling from Johns Hopkins University. Prior to returning to school to pursue my doctoral studies, I worked as a school-based mental health therapist and managed a grant program aimed at increasing college access and readiness for minoritized high school students in Baltimore and Prince George’s County, Maryland. I am currently a doctoral candidate in the counseling psychology program at Mizzou.

What are your career interests/goals? What do you hope to be doing professionally in 5-10 years?

In 5-10 years, I hope to be practicing as a licensed pediatric psychologist, conducting comprehensive psychological evaluations with children. Additionally, given my passion for social justice and community work, I also aim for my work to expand beyond an individual focus to promote positive change on a systems level, as it relates to healthcare access and special education literacy for families with children with special healthcare needs.

What created the passion within you to pursue a career in this field?

While I have long been passionate about the field of psychology and mental health, and working with children and families, my interest in autism and neurodevelopmental disorders is fairly new. Having a family member with developmental delays inspired me to want to gain insider knowledge about the types of diagnostic and intervention services available to families with children with special healthcare needs. I never would have guessed, however, that on this pursuit to help my own family, I would develop such a passion for helping other families experiencing similar concerns. Additionally, I recognize that through my specialized training and pursuit of a career in this field, I am uniquely positioned to address disparities in healthcare and access for Black families who have children with special healthcare needs.

Why did you decide to return to the Thompson Center for a third year of training?

My decision to return to the Thompson Center for a third year was a no-brainer. The training I have received here has been unmatched, and I genuinely feel valued in my role as a trainee. I have been fortunate to work alongside several of the psychology providers through my practicum student status as well as through the TIPS 4 Kids program, and I learn so much from their leadership. My supervisor, Dr. Jennifer Sykes, encourages me to expand my own leadership capacity by constantly reminding me of my expertise and allowing me to take a lead role on clinic days. The training I am receiving at the Thompson Center is equipping me to achieve my future career goals, and I could not have asked for a better opportunity during my time as a doctoral student.

How do you think your time at the TC will influence the direction of your career?

I am forever grateful to the Thompson Center for providing me with another lens through which to view what was possible for me with my psychology degree. I had never considered a career in assessment and evaluation as my previous clinical experiences consisted of providing individual and family therapy. Through my time at the Thompson Center, I have realized that I really enjoy psychological assessment and evaluation, and more specifically, I enjoy working with families with children with special healthcare needs.

What is the most valuable thing you have learned while working at the TC so far?

One of the most valuable things I have learned while working at the Thompson Center so far is the value of consultation and working within interdisciplinary teams. I admire the psychology providers’ willingness to consult and collaborate with colleagues, including other psychology providers, psychology technicians, SLPs, OTs, and medical providers. This also connects to the other valuable thing I have learned, which is the importance of family-centered care. This involves a respect for families’ socio-cultural backgrounds, collaboration to ensure quality care, and a high level of cultural humility.

What do you hope to learn and/or accomplish in the rest of your time training at the TC?

I hope to continue gaining proficiency in the administration and coding of the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Additionally, I hope to continue along in the process of becoming research reliable on the administration and coding of the ADOS-2. Finally, I hope to continue providing families with quality, family-centered care, while increasing my knowledge about autism and other neurodevelopmental disorders.

Any last thoughts about working at the TC?

I love the Thompson Center 🙂

Research Core Spotlight: Meet Hannah Cottrell

One of the three primary missions of the Thompson Center is to conduct interdisciplinary, collaborative research on the causes of and treatments for autism in an effort to improve the lives of families with autism.

One of the ways that make’s the Thompson Center one of the premier autism research centers in the country is our staff of outstanding, expert research core members who provide logistical support to several ongoing research projects at a time. Over the last few weeks, we have highlighted some of the amazing research core staff who make the innovative, life-changing research conducted at the Thompson Center possible. We will finish our series by introducing you to Hannah!

What’s your name?

Hannah Cottrell

Where did you grow up?

Canton, Missouri, a rural river town along the Mississippi River in the northeast part of the state.

What is your position at the Thompson Center?

Research Specialist I

How long have you worked at the Thompson Center?

I’ve been at the Thompson Center about 3.5 years. I started the week of Thanksgiving 2017.

What is your role at the Thompson Center?

I work primarily recruiting families and helping them navigate through studies in which they enroll. I also help troubleshoot issues with our Thompson Center Database and other various REDCap projects.

What got you interested in autism research?

I have always been interested in research but had little experience in the field before working at the Thompson Center. After college, I worked in a regional health system as a revenue cycle trainer. When a former colleague told me about the opportunity to be able to work more directly with families, I jumped on the opportunity and moved back to Columbia.

What is your favorite thing about working at the Thompson Center?

I LOVE the families I get to interact with on a daily basis. The Thompson Center faculty and staff members are also great and make coming to work every day a blast!

Research Core Spotlight: Meet Kathy Hirst

What’s your name?

Kathy Hirst

Where did you grow up?

I grew up in southeast Missouri in Cape Girardeau. I came to the University of Missouri to complete my undergraduate degree, and later went on to Texas A&M University to complete my master’s degree. Missouri has always been home, so coming back to Missouri and my friends and family was a no-brainer after completing my graduate work.

What is your position at the Thompson Center?

Research Specialist II

How long have you worked at the Thompson Center?

I have worked at the Thompson Center for almost three years.

What is your role at the Thompson Center?

I work with a team to plan and execute research studies targeting diagnostic tools and outcome measures.

What got you interested in autism research?

I have a strong background in research and have always enjoyed working with children, so when this opportunity emerged, I knew it would be a great fit in merging my interests and experience. The field of autism research is ever-developing, so having the opportunity to constantly learn and grow is very exciting!

What is your favorite thing about working at the Thompson Center?

It would be impossible to choose only one favorite thing! The Thompson Center has such a great sense of community, both internally and with the patients we serve. I was welcomed with open arms on my very first day, and have continued to receive nothing but support in my role. I am incredibly blessed to be in the Thompson Center Research Core, as this experience has given me lifelong friends and the opportunity to be part of a fantastic research team. It is also extremely gratifying to watch our patients and families get excited about participating in research, so I am grateful to play even a small part in that joy.

Research Core Staff Spotlight: Meet Samantha Hunter

One of the ways that make’s the Thompson Center one of the premier autism research centers in the country is our staff of outstanding, expert research core members who provide logistical support to several ongoing research projects at a time. Over the course of the next several weeks, we will highlight some of the amazing research core staff who make the innovative, life-changing research conducted at the Thompson Center possible.

What’s your name?

Samantha Hunter

Where did you grow up?

Central Arkansas

What is your position at the Thompson Center?

Research Specialist II

How long have you worked at the Thompson Center?I’ve

I’ve worked at the Thompson Center for 4.5 years.

What is your role at the Thompson Center?

My responsibilities include contacting families about research opportunities, assisting them in the study process, addressing study concerns, running study visits, administering assessments, collecting and processing specimens, maintaining regulatory documents, and entering data.

What got you interested in autism research?

I wanted to learn more about autism and how we can improve the lives of people on the spectrum.

What is your favorite thing about working at the Thompson Center?

My favorite thing about working at the Thompson Center is the opportunity to work with our families. Our families inspire me with their kindness, patience, and perseverance. It is a joy to build relationships with them and it makes my heart swell when we can make a small difference in their lives. The bonus on top is the amazing team that I get to work.

Spreading the News of a “Terrific U”

Giving back and helping others realize their own “terrific” selves is something the Clevengers work toward every day.

a picture of vanessa clevenger — Vanessa Clevenger, 10, wanted to find ways to help other kids with sensory issues.

After years of struggling in school, often being called out for behavioral problems stemming from hyperactivity and sensory-seeking behaviors, Vanessa Clevenger told her mother, Amber, that she wanted find ways to help other kids with similar issues. Vanessa, who was 8 years old at the time, had been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) at the MU Thompson Center for Autism & Neurodevelopmental Disorders and had been experiencing sensory processing problems as well.

“She told me, ‘Mom, I get in trouble, but I’m not a bad kid.’ Of course, we knew that and thankfully we were finally able to make in-roads with her school to develop a better plan for her education,” Amber Clevenger said.

Vanessa, who is now 10, thought she could help make sensory items for kids who, like her, sought out specific sensations to help reduce anxiety and provide focus. She began producing hand-made stress balls using balloons and sand that she was able to sell for very cheap.

a picture of vanessa and leah clevenger showing off their merchandise — Vanessa and her sister, Leah, show off their merchandise.

“One of the biggest problems families with sensory issues have is how expensive sensory items, such as fidget spinners and cubes, can be,” Amber said. “Vanessa wanted to help provide access to these items to families who may not be able to afford them normally.”

Out of this mission, “Terrific U” was born. Terrific U is a business run by the Clevengers out of their home in Fulton, Mo. that sources sensory-friendly items for children with sensory issues.

“We have been able to find sensory items like fidget spinners, magic snakes, pop tubes and stretchy toys from wholesalers at a price that lets us deliver them to customers for much cheaper than if they had to buy from a traditional store,” Amber said. “With how often kids lose little fidget items and toys, that cost can really add up for a family, so we are proud to be able to provide access to cheaper options that can help calm kids with sensory and hyperactivity issues, like Vanessa often experiences.”

The company also sells t-shirts that they hope spread their message of awareness, acceptance, kindness and love.

a picture of vanessa and leah at their booth at a craft fair — Vanessa and Leah show off the Terrific U booth at a local craft fair.

“We want the world to know that everyone has a story,” Amber said. “We want to spread awareness and encourage everyone to be kind and embrace differences. Kids like Vanessa may do things differently, but that’s not wrong. It’s just different. We want to advocate for the kids who are different.”

And they are spreading that awareness, one stress ball at a time.