special education training for the paraprofessional dr. doris h. hunt

Special Education Training for the Paraprofessional

Dr. Doris H. HuntDirector For Exceptional ChildrenPublic Schools of Robeson County

Paraprofessionals Are School Employees

1. Work under the supervision of teachers or other professionals 2. Have responsibility for –

A) Identifying learner needs B) Developing and implementing programs to meet these needsC) Assessing learner performance D) Evaluating the effectiveness of education programs and

related services E) Assisting with the delivery of direct services as assigned and developed by their supervisors

(Pickett, 2002)

…a rose by any other name…

Paraeducator

Paraprofessional

Teacher Assistant

Teacher Aide

Para

There are over 21 titles for “paraprofessionals”

What would you want your title to be?

Qualification Requirements For Instructional Paraprofessionals In North Carolina

Instructional Paraprofessionals in Title 1 follow the NCLB guidelines. Special Education paraprofessionals are required to have:

A high school diploma or equivalent; ANDAn Associate’s (or higher) degree; ORCompletion of 48 credit hours at an Institution of Higher Education; ORParaprofessionals must also work under the direct supervision of a teacher.

(DESE, 2003)

Paraprofessionals: Special Education In North Carolina

NCLB guidelines are followed

No specialized training is required

Training is generally on the job

Increasing numbers are 1:1 aides

There are issues in many districts regarding supervision and training of special education paraprofessionals

There is no credentialing of instructional paraprofessionals

Teachers do not receive specific training regarding paraprofessionals

How Does NC Compare To Other States?

Only 12 states have professional development programs for paraprofessionals:

• Delaware• Georgia• Hawaii• Idaho• Michigan• Mississippi

• New Hampshire• New Mexico• New York• Ohio• Rhode Island• (Pennsylvania)

10 States Require Certification

Delaware Georgia Maine Minnesota New Mexico New YorkNorth DakotaOhioTexasWest Virginia

12 States Exceed Federal Requirements

Illinois

Maine

Minnesota

Mississippi

Nebraska

Georgia

New Hampshire

New Mexico

New York

Rhode Island

Washington

West Virginia

Significance

According to the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook 2010-2011 Edition:

Number of students identified for and enrolled in

special education services is increasing.

Dependency on paraprofessionals is expanding.As a result, the employment of paraprofessionals is expected to grow by 10% between 2008 and 2018.

Has This changed?

Data driven expectations : AYP, NCLB, IDEA 2004

Supervision issues

Special education case loads have increased

Increased focus on statewide and nationally mandated tests

Access to the general education curriculum

Q : Are paraprofessionals being overused?

Literature ReviewWhat does prior research reveal about….

1. The changing roles of paraprofessionals?2. Current practices for training?3. The essential skills and competencies

needed for paraprofessionals ?4. The training needs for teachers to be able

to effectively supervise paraprofessionals?5. The roles and responsibilities of

paraprofessionals?

Evolving RolesRoles and responsibilities have changed dramatically since they were first introduced into the classroom more than six decades ago.

Many new responsibilities and mandatory assessment requirements have been added to U.S. classrooms over the last 40 years.

The use of paraprofessionals to support students, teachers and classrooms in meeting these increasing demands has grown proportionately.

Myth or Truth?

Paraprofessionals always understand and support the inclusive philosophy that places them in the general classroom.

MythMany paraprofessionals prefer the special education classroom and find the general classroom confusing and upsetting.

Training NeedsRequired training elements have not been defined:

IDEA Amendment of 1997, requires that paraprofessionals be appropriately trained and supervised.

The Amendment does not specify the type or amount of training required.

Similarly, NCLB legislation outlines paraprofessionals' qualifications and duties that they may perform.

NCLB does not specify what an appropriate training program should entail.

Myth or Truth?

The Paraprofessional doesn’t always know what to do with a student.

TruthThe assumption is often made that ifa paraprofessional is placed in a classroom with a student then they know what to do.

Standards And CompetenciesThe American Federation of Teachers (AFT) and the National Joint Committee on Learning Disabilities, Inc. have advocated for the development of comprehensive standards and competencies for paraprofessionals.

Paraprofessional standards address:Multiple aspects of education and instructionProvide guidelines for the skills paraprofessionals should master in each domain

Competencies Include:Foundations of special education

Characteristics of learners

Assessment and evaluation

Instruction, content and practice

Planning and management

Student behavior and social interaction

Communication and collaboration

Professionalism and ethical practices

Myth or Truth?

The paraprofessional is fully trained for his or her classroom assignment.

MythTraining often occurs on the job and isthe responsibility of all the professionalsassociated with the student and program.

Training Of Teachers Who Supervise Paraprofessionals

Teachers often feel as though they are not prepared to supervise paraprofessionals in school settings.

Teacher preparation programs, however, have not changed to accommodate the increasing need to prepare teachers for the supervisory role they must assume with the growing number of paraprofessionals.

Myth or Truth?

The paraprofessional receives all instructions and directions from the special education teacher.

MythThe paraprofessional will receive some instruction from the special educationteacher, from the general education teacher and from related service providers.

Pickett, Vasa And Steckelberg Stated:

“In far too many cases, teachers are not prepared to direct paraeducators, to evaluate their performance, to provide feedback and training, or to assess the potential for greater use of paraeducators in order to free teachers to provide increased instructional services” (p.31).

(1993)

Myth or Truth?

Teachers are always trained and prepared to work with paraprofessionals.

MythTeachers are not prepared to direct, evaluate or provide feedback and training to paraprofessionals

Roles And Responsibilities Of Paraprofessionals

Paraprofessionals support the instruction, supervision and classroom management as a member of the school team. Paraprofessionals have a high level of responsibility but a low level of training and support to help them do their jobs effectively. Paraprofessionals are often utilized in schools to aid with direct student instruction, and serve as “learner supports”.

Roles And Responsibilities Continued…

Special education paraprofessionals are hired to work directly with the most challenging students in the school:

They are often unprepared for the task.Demands of parents, advocates, administrators and teachers have caused an increase in 1:1 paraprofessional assignments.

Q: Are paraprofessionals being used effectively in your school settings?Q: Is there an overuse of paraprofessionals?

Myth or Truth?

The paraprofessional can work with all students in the classroom.

TruthThe paraprofessional can work with allstudents as long as the needs of theidentified students are being met.

Myth or Truth?

There are restrictions on what paraprofessionals can do.

TruthThere are actually legal and ethical limits on the responsibilities that paraprofessionals are allowed to have.

Myth or Truth?

The paraprofessional will see that all the needs of the students with special needs are met.

MythThe para is a support person - needsshould be met by collaborative planningby all adults.

Increasing Demands Require An In-depth Analysis Of:

Current practicesExisting competencies Areas for improvementInvestigation into the types of training that will support, develop, and facilitate paraprofessionals’ contributions to special education services.

(Aldridge & Goldman, 2002; Carpenter & Dyal, 2007; D’Aquanni, 1997; Milner, 1998; Pickett, 2002; Young 2006)

A Quote From A Paraprofessional

“Please remember, that I am only one person, and I make mistakes too. I do try my hardest for you and the students but if you do not tell me how to improve or what I am doing wrong, then I am going to continue to do what I know because I think

that is what you expect of me.”

Teachers Want Paraprofessionals To Be Provided With:

Initial OrientationSpecific training that relates to the students’ needs in the classroom.Increased planning time with the paraprofessionals.Additional on-the-job trainingTraining in Positive Behavioral Interventions and Supports (PBIS)

Teachers Want Training In:Strategies to help support paraprofessionalsHow to supervise and manage paraprofessionals more effectively and efficiently.Conflict ResolutionA better understanding of the paraprofessionals’ roles and responsibilities.A better understanding in how to plan, train and support paraprofessionals in their roles.

A Quote From A Teacher

“Working with paraprofessionals is something that I was never trained in and was one of the most difficult tasks I encountered

when I first became a teacher. There were no college courses that provided any guidance or support regarding paraprofessionals.

Once on the job, there was no support or training provided either. Please let me know where, when and how I can find a course or

conference that addresses these areas of concern.”

In the field of education, it is important for all of us to stay current in best practices and

develop and increase our skills. Therefore, training needs to be provided in an on-going,

continuous process through out the paraprofessional’s career. This training needs to start the day that they accept the position and continue until they are no longer in the

field of education.

Schools cannot adequately function without paraprofessionals, and

paraprofessionals cannot adequately function in schools that lack an infrastructure that supports

and respects them as viable and contributing members of

instructional teams. They need to be treated and respected as the

professionals that they are:

“PARAEDUCATORS”

Students with Special Health Care Needs

Those students who require individualized health care plans

to enable participation in the educational process.

Mandated by Federal and State Law:

Section 504 of the Rehabilitation Act of 1973;

Public Law 108- ‐466, the Individuals with Disabilities Education Act (IDEA), 2004; and

Americans with Disabilities Act (ADA).

Section 504 of the Rehabilitation Act of 1973

Prohibits discrimination because of disability and requires any

program/public school to make reasonable accommodations for individuals

with disabilities.

Protects any student with a physical or mental impairment which

substantially limits one or more major life activities such as caring for one’s

self, performing tasks, walking, seeing, hearing , speaking, breathing,

learning and working.

Section 504 of the Rehabilitation Act of 1973 Prohibits discrimination because of disability and requires any program/public school to make reasonable accommodations for individuals with disabilities.

Protects any student with a physical or mental impairment which substantially limits one or more major life activities such as caring for one’s self, performing tasks, walking, seeing, hearing , speaking, breathing, learning and working.

Examples

A student who requires insulin injection to control diabetes OR medications to avert severe allergic reactions.

A student who uses a wheelchair in their daily routine.

A student who receives supplemental nutrition through a feeding tube.

Section 504

Statute prohibits discrimination against individuals with disabilities, including students, by public school districts receiving federal financial assistance.

U.S. Office for Civil Rights (OCR) enforces the provisions of Section 504.

Section 504

Does not have state or federal funding provided to assist districts in complying with implementation.

All costs are the obligation of the local school district.

Section 504 is a law of access, not of benefit.

Section 504 is an existing federal law, and complying with it is NOT an option.

Section 504 Requires that a school district makes “reasonable accommodations” for a student with disabilities to permit that student an equal opportunity to participate in educational and related activities.

Free and appropriate public education (FAPE).

Often these required accommodations may include providing the student with school health services/ health care plan.

IDEA 2004Provides for the inclusion of students with chronic illnesses; with complex health care needs; and/or who are technology dependent

through a process of determined eligibility as having a disability.

Special Education Law

Any questions about Special Education Law or Section 504 can be answered by the Special Education Teacher, Section 504 Coordinator or Special Education Supervisor.

FERPA & HIPAA

Family Educational Rights and Privacy Act (FERPA) protects the student’s educational record.

Health Insurance Portability and Accountability Act (HIPAA) governs the private health information.

Protecting ConfidentialityNEVER discuss a student with anyone except those directly involved with the student and their care (i.e. nurse, special education teacher, therapist)

Should a discussion need to occur regarding the student and their care MAKE SURE: It occurs in a private area with doors closed and not where others may hear what is discussed.

DISCUSSIONS SHOULD NEVER OCCUR IN PUBLIC PLACES, I.E. GROCERY STORE, CHURCH OR ON A CELL PHONE AFTER SCHOOL HOURS.

RN SupervisionOnly RNs can determine what “medically necessary” nursing care can be safely delegated to paraprofessionals and under what circumstances.

Paraprofessionals may be accountable to the supervising teacher/LEA supervisor/principal for personnel and school building functions; however they must have RN supervision when assigned delegated nursing tasks.

Guidelines for RNs The RN should provide 1) general training; 2) student- specific training; and‐ 3) training for student involvement in self- care. ‐

When possible, the student should be encouraged and allowed as much responsibility as can be safely appropriate.

Delegation of Duties

The school RN provides training in student- specific procedures ‐for the essential caregivers who will be responsible for providing direct care for the student during the school day.

3 Types of Training

1. General Training;

2. Student- Specific Training; and‐3. Training for student

involvement in self- care. ‐

Key Components of general training for all school employees

Description of the health condition and appropriate actions required for the safety of all students;

Example: Interventions for any student having a seizure.

DOES NOT mean giving a copy of the IHP to everyone

(violation of confidentiality)

Emergency ;and

Awareness component.

Personal Protective Equipment

Intended to reduce the risk of contact with blood and other potentially infectious materials for the caregiver AND to control the spread of infectious agents from student to student.

Appropriate personal protective equipment MUST be used in a CONSISTENT manner to reduce the risk of exposure.

Personal Protective Equipment

Disposable gloves; Masks;

Protective eyewear;

A combination of eyewear and mask; and/or

Cover gowns or lab coats.

Student Specific TrainingIs always required even if personnel have provided similar care to another student.

People who are directly responsible for providing health care services to the student need comprehensive training to meet the individual needs of a student.

Provide:an overview; discussion of the procedure(s); and the emergency plan.

Activities of Daily LivingTasks performed by individuals everyday which allow the individual to function independently.

Elimination

Feeding

Dressing

Hygiene

Physical mobility

Health care workers play an important role in allowing the individual to maintain or relearn skills to achieve the highest level of functioning.

ELIMINATIONSome students may need assistance with toileting, bowel and bladder training, and some will require the use of diapers.

Students with elimination difficulties may require psychosocial and physiological assistance.

Elimination assistance requires compassionate care.

Elimination assistance requires RESPECT.

Toileting

To decrease the anxiety a student may feel with the exposure while toileting, remember to treat the student with RESPECT and provide as much PRIVACY as possible.

Bowel/Bladder Training Programs

Success of the program is strongly increased when consistency, good nutrition and timing are observed.

A pattern of normal elimination MUST be established.

Observing and documenting the student’s normal

elimination pattern over a set period of time.

A student- specific plan is developed.‐

Lifting/Transfers/Positioning

Lifting and Transfers 1 person Lifting and Transfers 2 person Positioning

Feeding Impaired feeding abilities occur for one or multiple reasons.

May require assistance with oral feedings or feedings through a surgically inserted feeding tube.

Procedure for bolus feedings as well as slow- drip is ‐included.

Gastrostomy Tube (G- tube) ‐A surgical opening in the stomach through the abdominal surface.

A flexible catheter held in place by a balloon or a widened flat “mushroom” at the tip of the tube inside the stomach.

Remains in place at all times.

Closed between feedings.

Causes no discomfort.

Possible problems with tube feedings Call RN immediately if

Breathing difficulties- STOP FEEDING IMMEDIATELY; ‐Nausea and/or cramping; Vomiting; Blocked gastrostomy tube;

Bleeding, drainage, redness and/or irritation; and/or Leaking stomach contents.

SeizuresPartial Seizures

May or may not have loss of consciousness;

Muscle twitching, repetitive motions, and “daydreams”; and/or

May become generalized.

Generalized SeizuresLoss of Consciousness; and/orBlank stares, sudden jerking movements.

Absence Seizures (petit mal)

Most common, blank stare.

Key points during seizure

Remain calm.

Help the child to the floor.

Move objects away from the child.

DO NOT put anything into the child’s mouth.

Once the jerking movements have stopped turn the child on his/her side.

Follow IHP for length of seizure activity before medication administration.

Stay with student until he/she is fully alert.

Document Seizure EpisodeTime of onset;

Length of episode;

Loss of consciousness;

Loss of bowel/bladder continence; and

Did the student return to pre- episode state of ‐alertness?

Ulcer FormationFour factors contributing to ulcer formation:

Friction;

Prolonged pressure on one area;

Shearing; and/or

Moisture contact with the skin for extended periods of time.

Functional Living Skills

Exercise Program

LiftingFeeding ProgramFunctional Walking Program Orthotic ProgramPositioning ProgramSensory ProgramStanding ProgramWheelchair Use

Diapering

To decrease the student’s anxiety and the amount of time the student is exposed, gather all needed supplies before beginning diapering.

Special Education “Special Education means specially designed

instruction, at no cost to the parents, to meet the unique needs of a child with a disability.” (Individuals with Disabilities Education Act, 2004, 34 CFR 300.26)

Students have conditions that range from mild health conditions to severe, multiple health conditions that have a profound and direct impact on their ability to learn.

What is a Paraprofessional?

Paraprofessionals are to assist and support the teacher in delivering services to students

with disabilities.

The National Resource Center for Paraprofessionals (NCRP) definition of

paraprofessionals is as follows:PARAPROFESSIONALS are school/agency employees

1) Whose positions are either instructional in nature or who provide other direct services to children and youth and/or their families.

2) Who work under the supervision of teachers or professional practitioners who are responsible for a) the design, implementation, and assessment of learner progress, and b) the evaluation of the effectiveness of learning programs and related services for children and youth and/or their families (Pickett, 1989).

PARAPROFESSIONALS are school/agency employees who assist and support teacher directed instruction (Gerlach, 2003)

The role of a Paraprofessional

…according to NCLB

(No Child Left Behind legislation)

Paraprofessional RolesThe following is cited in NCLB as appropriate roles for

paraprofessionals

Providing one-on-one tutoring for eligible students;

Assisting with classroom management (such as organizing instructional and other materials);

Providing assistance in a computer lab;

Providing support in a library or media center;

Acting as a translator;

Providing, under the direct supervision of a teacher, instructional services.

Paraprofessional RolesThe work performed by paraprofessionals will vary depending upon teachers’ expectations, paraprofessionals’ skills and experience, and job assignment.

Paraprofessionals are primarily responsible for assisting and supporting teachers or other certified or licensed staff.

Major ResponsibilitiesWork as a team

Build and maintain effective communication

Maintain student-centered supportive environments

Implement lessons initiated by the teacher or related-service personnel

Assess student needs and progress under teacher direction.

Other important responsibilities

Learn school policies and procedures

Perform assigned tasks

Support curriculum and instruction

Deal with student behavior

Work with teachers and other supervisors

Assist students with special needs

Obtain training and professional development

Maintain ethics and professionalism

The district Department of Special Education has designated the following paraprofessional positions:

Resource Paraprofessional

Severe Paraprofessional

Speech / Language Paraprofessional

Motor Paraprofessional

Preschool Paraprofessional

The role of the paraprofessional may

vary slightly, depending on which type of

position they hold.

Position Description Resource Paraprofessionals…

assist students from kindergarten through high school who are considered to have mild to moderate disabilities, usually in behavior and academic areas such as math, reading, and written language.

Position Description Severe Paraprofessionals…

assist students from kindergarten through post high school who are considered to have more severe disabilities. Their disabilities are more obvious and they need more help with personal care, behavior and functional skills.

Position Description Speech / Language Paraprofessionals…

work under the direction of Speech and Language Pathologists, assisting in providing services to students who have problems such as speech, articulation, oral language, and written language.

Position Description Motor Paraprofessionals…

work under the direction of Occupational and Physical Therapists, assisting in providing “motor” services that may help students with moderate to severe physical disabilities increase their mobility, strength and flexibility.

Position Description Preschool Paraprofessionals…

assist children ages 3 to 5 years old who have been identified as having some type of developmental delay at various district preschool locations throughout the county.

Major Responsibilities of Teachers in supervising

paraprofessionalsPlan the tasks that paras will perform

Develop schedules for paras

Appropriately delegate responsibilities to paras

Monitor the day-to-day performance of paras

Provide feedback and on-the-job training to paras

Share relevant information about para strengths and training needs to principals and district Department of SPED

Other Important Responsibilities of TeachersIntroduce the para to the classroom

Provide clear instructions and complete information

Assign and delegate tasks

Discuss curriculum and instruction

Discuss student behavior

Promote training and professional development

Give feedback and recognition

The Principal’s RoleThe principal and/or other school administrators have the

primary responsibility for:

Recruiting, interviewing, and selecting paraprofessionals.

Evaluating paraprofessionals and their supervising teachers.

Promoting effective teamwork in the building and within teacher-paraprofessional teams.

Take a leadership role in creating a school climate in which paraprofessionals have a professional identity.

Provide an atmosphere of respect, recognition, and open communication.

District SupportDesignated personnel in the district office have the primary

responsibility for:

Recruiting, screening, and hiring paraprofessionals.

Developing appropriate job descriptions.

Developing appropriate policies for the employment and training of paraprofessionals.

Introduce paraprofessionals to district policies and procedures.

Introduce paraprofessionals to professional organizations such as the National Education Association (NEA), American Federation of Teachers (AFT), and the Council for Exceptional Children (CEC)

The Department of Special Education

The Department of SPED will support the Teacher-Paraprofessional team by:

Providing a clearly defined role.

Meeting with all new teachers to make sure they understand their responsibilities in directing the work of paraprofessionals.

Determine what local, state, and federal legal mandates exist for paraprofessional staff development and supervision.

Providing professional development opportunities for paraprofessionals and those who supervise them.

Design a professional development plan for paraprofessionals.

The Legal Definition of Special Education

Special Education is specially designed instruction that meets the needs of exceptional children.

This education may include specialized materials, carefully planned teaching strategies, and

systematically designed learning environments.

In the early 1970's, advocacy groups fought for comprehensive services

for all children emphasizing

the worth and dignity of each

individual.

There are several types of disabilities that make students eligible for special education services.

In all cases the disability must adversely affect educational performance.

The various types of disabilities include:

Autism-affecting verbal and nonverbal communication and social interaction

Communication Disorder-speech/language impairments

Deaf/Blindness-combination of hearing and visual impairments

Developmental Delay-deficits in physical, cognitive, communication, social or emotional or adaptive development

Hearing Impairment/Disability-hearing loss

Other Health Impairment-(could be heart conditions, leukemia, Attention Deficit Disorder, or other diseases)

Emotional Disturbance-inability to maintain satisfactory relationships, inappropriate types of behavior, unhappiness or depression, or symptoms of fears, or inability to learn that cannot be explained by intellectual, sensory, or health factors

Orthopedic Impairment-a severe impairment which adversely affects a student’s educational performance, including impairments such as clubfoot, absence of some member, poliomyelitis, bone tuberculosis, cerebral palsy, amputations, etc.

Intellectual Disability-subaverage intellectual function with deficits in adaptive behavior

Multiple Disabilities-combination of disabilities (ID with Orthopedic)

Specific Learning Disability-processing problem that manifests itself in imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations

Traumatic Brain Injury-closed head injuries that adversely affect student’s educational performance

Visual Impairments-impairment in vision that adversely affects educational performance

Principles which guide the Special Education process:

1. Student and parent rights

Student and parent rights revolve around 3 basic concepts:

Consent

Participation

Confidentiality

Principles which guide the Special Education process:

2. Equal Access

This means access to a free, appropriate, public education for all students regardless of their ability to participate in educational experiences.

Principles which guide the Special Education process:

3. Right to Service

This principle asserts the right of a student with disabilities to receive services which promote growth towards increased independence and competence.

Principles which guide the Special Education process:

4. Respect for Dignity

It is the intent that students with disabilities be afforded the same degree of dignity and respect that is afforded other students.

Principles which guide the Special Education process:

5. Least Restrictive Environment (LRE)

This principle demands that each student with disabilities receive appropriate services in environments that promote interaction with non-disabled peers to the maximum extent possible to that student’s needs.

The Special Education Process

There are several steps in the process of how a student is identified as having a disability

The Special Education Process

Students go through a child-centered educational process to receive special education services.

It is call “child-centered” because the major goal is to meet each student’s individual educational needs.

The Special Education Process

When a student is referred for consideration for special education services, the following steps are taken.

Parents are asked if they consent to having the student tested.

If so, a comprehensive individual assessment (testing) is completed, and parents have the right to be part of this process.

Then a multidisciplinary team meeting is held at which time the parents are invited to participate.

The Special Education Process

If a student is eligible for and needs special education services, the following additional steps are taken.

An individualized education program (IEP) is developed.

The IEP is reviewed at least annually.

Assessment data and eligibility determination is reviewed at least every 3 years.

More about the IEP

(Individualized Education Program)

IEPThe IEP is based on the student’s current skills, abilities, and educational needs that were identified during the testing process.

It describes: Which services the student needsHow the services will be provided

IEPThe IEP must be developed before special education services can be provided.

It must be implemented as soon as possible after it has been developed.

IEP

The IEP includes measurable goals to enable the student to be involved and progress in

the general education curriculum.

IEPThe IEP also indicates if there are any “related

service” needs as determined by testing.

Related services may include transportation, occupational therapy, physical therapy, speech therapy, visual therapy, provision of adaptive equipment, etc.

IEPExtended School Year services are indicated for certain eligible students.

ESY services are individualized instructional programs that extend beyond the traditional school year (summer).

Some paraprofessionals may be asked to work during ESY to assist in providing services to students.

IEPParaprofessionals play an important role

in the IEP process.

Not only do they assist in providing instruction to students, they will collect data and information that is crucial to teachers in making educational decisions regarding the students.

Hopefully this presentation has

helped you become more familiar with paraprofessionals,

what they do,

and how important they are.

Questions