Presenter: Kellyn Dailey Hall, PhD, CCC-SLP
Diversity in healthcare goes far beyond a language barrier. It’s about understanding the larger context of culture and diversity, why patients think the way they do, and why they might respond to dysphagia assessments and treatment options very differently from what we expect.
This course will help you understand the impact of dysphagia on culturally/linguistically diverse populations and navigate ethical conflicts to provide culturally responsive care. Specific strategies, case examples, and resources will be presented to help prepare you to make meaningful connections with your diverse patients and achieve successful outcomes.
Offered for 0.15 ASHA CEUs – 1.5 contact hours.
Course Overview – Run Time: 1:30:01
– A.P., prior course participant
– C.V., prior course participant
The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.
Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.
"Using professional interpretation even when family members are willing was a beneficial discussion. I liked the real case studies." E.K. (Aug. 2024)
"The power dimension was a helpful topic. I liked the discussion regarding working with an interpreter." L.S. (Jul. 2024)
"I enjoyed the case study involving Deloris. It's a great reminder not to assume anything. Great statement to use when a pt acknowledges understanding yet chooses not to follow given recommendations- making an informed decision. I liked the ease with which presenter conveyed the information. This course was enjoyable to listen to and follow along with." A.L. (Jun. 2024)
"I found the cultural assessment handout to be helpful. The course delves comprehensively into various aspects that a culturally competent clinician should be aware of." T.I. (Jun. 2024)
"It was beneficial to learn that certain aspects of a culture's food rules, like temperature, may affect the way you manage dysphagia. I enjoyed the stories regarding the speaker's personal experience in these areas." L.R. (Jun. 2024)
"The patient family hierarchy was a beneficial topic." D.W. (Jun. 2024)
"Learning about other cultures’ approaches to healthcare decision-making was helpful. I liked the accessibility." L.S. (Apr. 2024)
"Food rules and strategies for cultural responsiveness were beneficial to discuss. I liked all of the examples with various cultures, so much we still need to learn." K.K. (Apr. 2024)
"The topic that I found most beneficial is Cultural Humility. I liked the course as it is self-paced." L.A. (Mar. 2024)
"Reducing the appearance of a clipboard during sessions with CLD clients to reduce a power dynamic was beneficial. I liked the case study and real-life examples from the lecturer's experience." M.R. (Mar. 2024)
"This course really opened my eyes. Learning cultural humility and understanding my own tendency to impose my beliefs/values on CLD patient. I've gained a better understanding of CLD patients that I dismissed as non-compliant." C.V. (Mar. 2024)
"The most beneficial topic for my daily practice was cultural humility. Course was comprehensive regarding cultural competence and providing culturally responsive care in relation to dysphagia management." L.A. (Feb. 2024)
"Including the patient's preferences and beliefs in your session; Self-reflecting after the session." K.H. (Feb. 2024)
"I liked the real-world examples and clinician-made surveys. This course gave me a good perspective of where I am in understanding and respecting others' cultures." A.P. (Feb. 2024)
"Very clinically applicable. I liked the concept of cultural humility." D.P. (Feb. 2024)
"The assessment and understanding of cultural differences was beneficial. I enjoyed the food rules." M.S. (Jan. 2024)
"I really enjoyed the presenter's style and sense of humor! Integration of culture and dysphagia treatment. Very good breakdown of levels of cultural competence, including charts and examples." T.M. (Jan. 2024)
"Learning different ways culture can impact dysphagia therapy (who, what, etc). I liked the real-life examples." E.F. (Jan. 2024)
"Interesting course and how it related to dysphagia. Learning about cultural humility raised many interesting points." L.M. (Jan. 2024)
"This course was very comprehensive. I appreciated the presentation of the "Food Rules" when assessing the patient's relationship with food and the patient's comprehension of the swallowing disorder. I appreciated the introduction of the concepts "Low power distribution" and "High power distribution" in understanding the patient's value system with regard to the medical care plan." A.B. (Dec. 2023)
"I appreciated how well-organized and comprehensive this course was. I also appreciated the wealth of resources that are provided for further education." A.B. (Dec. 2023)
"I appreciated the resources provided, specifically the cultural assessment. Liked the incorporation of videos and the style of the presentation." C.C. (Dec. 2023)
"The clinical humility discussion was beneficial. I enjoyed the conversational style, and the experienced clinician sharing her vulnerability." K.P. (Dec. 2023)
"Discussing concepts of cultural pre-competence, cultural humility, and cultural negotiation was beneficial. I liked the specific examples of food traditions and attitudes from different cultures and of adjustments to interactions and treatment plans with patients." L.M. (Dec. 2023)
"It was beneficial pointing out specific areas of culture that might affect dysphagia management, such as the temperature of food. I liked the content and graphics used in the presentation." S.D. (Dec. 2023)
"I liked the overview of ethical practices for dysphagia therapy. And interviewing from a cultural perspective." C.B. (Dec. 2023)
"Many items were brought up that I had not considered before. e.g., High Power vs Low Power cultures." M.M. (Dec. 2023)
"Power dimensions was a beneficial topic. I liked the course format." A.F. (Nov. 2023)
"Discussing how to best shape my practices for each individual patient was beneficial." E.G. (Nov. 2023)
"Considering other culture's norms was beneficial. The course was easy to follow." S.J. (Nov. 2023)
"The questionnaire to gather information about cultural needs was very useful." P.R. (Nov. 2023)
"Very detailed and helpful course. I liked the information on interpreters." L.T. (Nov. 2023)
"The speaker was upbeat and interesting. Good examples/scenarios were provided. I always thought using family for interpretation was a good call. I learned that this is most likely the worst source for interpretation during a session." C.J. (Nov. 2023)
"It was helpful to discuss cultural dimensions, norms, and values. I liked that the presenter shared with us the websites where we can learn key phrases in different languages." O.T. (Nov. 2023)
"The discussion that cultural competency is an ongoing process was beneficial. I liked the resources provided, and it will be great to incorporate them into my own teaching to grad students. The visuals were engaging. I liked the activities as well." C.Q. (Nov. 2023)
"This presentation was engaging. I felt all the information provided during this course was relevant and beneficial to my practice." L.W. (Oct. 2023)
"It was beneficial when the speaker explained lower and high power distance culture and how high power distance culture expects the SLP to tell them what to do. This topic was very interesting. I liked how each topic flowed to the next one being covered." M.D. (Oct. 2023)
"The tests of our own cultural competency were beneficial." T.P. (Oct. 2023)
"This course had practical information and tips that can be easily implemented into my clinical practice. I liked the recommendation to research cultural information re: views on food, eating, etc, prior to evaluation of a patient who is CLD." D.J. (Oct. 2023)
"Everything was very helpful in providing insight in how to communicate with patients and family members in order to assess/design treatment plans more effectively within pt's comfort of their culture and beliefs. The examples provided helped me understand the differences and how I may do/say things when seeing patients and discussing things with family members." J.F. (Oct. 2023)
"The discussion on negotiating interventions with the patient with cultural humility was beneficial. I liked the specific examples given." J.Z. (Oct. 2023)
"Loved the way this course was presented, especially beginning with the client, revisiting, then winding it all down with her again. Bringing the content full circle." D.C. (Sep. 2023)
"So many things to consider. Understanding that the family is not always the best person to interpret." D.C. (Sep. 2023)
"Issues to keep in mind when working with a multicultural multi-linguistic population. I liked the clinical examples." L.D. (Sep. 2023)
"The cultural questionnaire and discussion of the cultural interview were helpful. I liked that there were case examples to illustrate the points the presenter was talking about, and I liked that there were practical materials that I can use as a practitioner." L.R. (Sep. 2023)
"Discussion on negotiating care with patient based on their culture and belief systems and respecting their choices was beneficial. I liked the ethical considerations and ASHA position statements regarding care." M.K. (Sep. 2023)
"Concise and to the point." J.J. (Sep. 2023)
"Understanding the concept of high power distance and low power distance. I liked the use of personal caseload situations, and the use of a rating scale in cultural negotiation was helpful." A.S. (Aug. 2023)
"I liked the thoroughness of this course and with a fresh approach. The sample back and forth convo with patient/family/therapist was beneficial." J.W. (Jul. 2023)
"I found the information on interacting with an interpreter helpful. I liked learning the hierarchy of cultural competency and how it can impact a patient's treatment." M.D. (Jul. 2023)
"Every aspect was very helpful, and this course was presented very well." S.S. (Jul. 2023)
"This course gave me ideas of how to conduct patient interviews during intake in ways I had not thought of. I liked the examples provided of instances where learning had occurred." F.G. (Jun. 2023)
"The idea that even if the cultural difference is not very obvious, almost every client's cultural differences need to be taken into consideration. Very clear verbal explanations with a good progression of info." G.S. (Jun. 2023)
"I enjoyed learning about the power dynamics. I am always looking to further my knowledge and skill set to best assist my patients." K.K. (Jun. 2023)
"Culturally relevant. Informative course." M.W. (Jun. 2023)
"Reinforced the idea that we approach each patient as an individually realized cultural entity regardless of their cultural background." R.H. (Jun. 2023)
"Easy structure, clear explanation, excellent relevant examples. I liked the examples of how to approach clinical situations involving differing desired outcomes and value of dysphagia therapy." O.B. (Jun. 2023)
"I liked the case examples." A.B. (May 2023)
"The cultural diversity information was beneficial." S.H. (Apr. 2023)
"The ethnographic interview was beneficial. I liked the application of theory through the patient example." K.M. (Mar. 2023)
"Straightforward course, very good and relevant content. Learning continued development of cultural competency was beneficial." A.K. (Mar. 2023)
"Using more than just an interpreter when working with culturally diverse patients." L.G. (Mar. 2023)
"I liked the examples provided by presenter of her own experiences." J.R. (Mar. 2023)
"Food culture (the who/what/when/how), the cultural assessment handout, and how to ask questions were beneficial. I liked the personal examples, stories from patients, and the scenario examples." S.D. (Mar. 2023)
"Good information presented on the importance of family cultures affecting the patient's decisions related to the course of dysphagia treatment during their hospitalization. I liked the speaker's vocal presentation and the creativeness in her slide presentation." P.B. (Feb. 2023)
"I liked the food rules. Good case study examples." J.W. (Feb. 2023)
"Greater attention to cultural differences in the area of eating." S.S. (Feb. 2023)
"Hearing the views of the family. Understanding the ethical challenges of this area of concern. Interesting manner of presenting the material." E.D. (Feb. 2023)
"Selecting diet for patients from different cultures. Everything was beneficial." J.B. (Jan. 2023)
"I liked the discussion of food rules." A.W. (Jan. 2023)
"Very informative and directly relatable to my daily work." L.R. (Jan. 2023)
"Learning how to work with people of different cultures." M.M. (Jan. 2023)
"The assessment questions were beneficial. I liked the interactive portions even though independently done online." R.J. (Jan. 2023)
"Discussions of interplay between cultural values and the assessment and treatment processes was beneficial. I liked the examples of patients from different cultures." K.F. (Dec. 2022)
"I liked how the presenter used her own 'mistakes' as well as her own 'repairs' as a relatable teaching moment. I liked how the presenter discussed actual clinically relevant cases as a clinician; very relatable." M.S. (Dec. 2022)
"I really enjoyed all of the aspects of this course and think the content will be very beneficial to my daily practice as a hospital-based SLP. I will definitely use the cultural assessment handout and LiveMocha website frequently in my work!! I found the cultural competence continuum explanation to be very enlightening and informative. I also enjoyed learning about cultural humility and the importance of realizing that this is an ongoing practice that will never be truly "mastered". J.B. (Dec. 2022)
"I felt that all of the course work was presented in a helpful way and nicely segued into the discussion at the end about culturally responsive care. I thought the course was concise, but detailed and well-structured." J.B. (Dec. 2022)
"Examples of how to conduct/questions to ask in an evaluation/treatment to be more culturally competent in the patient's view of dysphagia were beneficial. I liked the specific examples given and the resources provided." M.B. (Dec. 2022)
"Tips on collaborating with interpreters and information on cultural differences were beneficial." C.S. (Dec. 2022)
"The concept of cultural humility was eye-opening - to understand that you can never know everything there is about a particular culture, there are always individual differences. I liked the speaker's ability to reflect on her experiences." S.D. (Dec. 2022)
"I liked the instructor's research and knowledge and description of clinical examples." M.W. (Dec. 2022)
"I liked the examples of the presenter's experiences." D.L. (Nov. 2022)
"Course was well organized. Understanding cultural humility was beneficial." P.D. (Nov. 2022)
"Clear discussion of factors that impact patient responses based on the cultural experience. I liked the resources included such as the website for translation of swallowing terminology specific to a certain country." B.S. (Nov. 2022)
"Kellyn is an excellent instructor. I liked her presentation style. She is easy to listen to." D.B. (Nov. 2022)
"This course was well presented. The knowledge of the instructor was exceptional. The handout and pace of the information provided a great learning experience. Learning better awareness of the many facets of interactions with patients with respect to their cultural, religious, and personal view of their health and acceptance of care." T.E. (Nov. 2022)
"The case examples were good. Considerations for utilizing interpreters in the medical setting." M.J. (Nov. 2022)
"This course increased my awareness of cultural diversity and its important role in how I provide care to pretty much all of my patients. I liked the speaker's use of examples and sharing with us ways that she felt she failed and succeeded in providing culturally diverse care." S.J. (Nov. 2022)
"The flexibility of the course was good." B.T. (Oct. 2022)
"The topic of cultural competence was beneficial for my practice." M.V. (Oct. 2022)
"The course was well-organized and relevant. The specific recommendations for improving my practice were beneficial." D.S. (Sept. 2022)
"Enjoyable to listen to the instructor." S.R. (Sept. 2022)
"I would recommend this course." J.O. (Aug. 2022)
"I liked the whole course - how to look at cultural diversity, how to assess, what questions to ask." A.P. (July 2022)
"I liked the examples used such as incidental experiences with patients of other cultures." L.M. (July 2022)
"Really loved learning more about the cultural/ethical impact on my clients." C.P. (June 2022)
"Presenter's examples were great. I liked the interview techniques to gain better information with working with CLD patients." M.W. (June 2022)
"All of the presentation was beneficial. Course was easy to follow and very practical." Y.C. (June 2022)
"Learning cultural competence is important. I liked the practicality of the information presented." L.F. (June 2022)
"Great speaker on a very relevant topic, convenient. Liked the interviewing techniques to allow patients to share what is important to them." A.S. (May 2022)
"All of it was great! I really enjoyed the different perspectives presented. Well organized, easy to follow, and applicable to my tx." W.R. (May 2022)
"I liked Dr. Hall's honesty and willingness to critique her performance to help us learn. I liked the suggestions for maximizing interpreter services by meeting before and after the patient interview." M.B. (Apr. 2022)
"The lower level of the power dynamic gave a good outlook in the importance of involving the patient and family in their dysphagia care. It was very relatable and intriguing in topic and examples." K.R. (Apr. 2022)
"The 4 levels of cultural competence were helpful. I liked the examples and resources discussed." P.F. (Apr. 2022)
"It provided me with a new perspective regarding CLD and helped me reflect on my own biases. I liked the examples of patient interactions and how to improve them." J.V. (Mar. 2022)
"Learning about the religious and cultural factors of dysphagia and appropriate conduct when working with interpreters was helpful." J.B. (Feb. 2022)
"I liked the ease of technology throughout course." K.C. (Feb. 2022)
"Everything was helpful and beneficial. I liked the case studies and presenter's style." L.C. (Jan. 2022)
"I liked the cultural assessment handout." J.K. (Jan. 2022)
"Nice graphics, visuals, and presenter is very knowledgeable with a good sense of humor." K.M. (Dec. 2021)
"Real life examples and the instructor's openness/willingness to share her journey." J.M. (Dec. 2021)
"The presenter spoke clearly and the slides supported the information. Exercises to examine our own biases were also enlightening." C.B. (Dec. 2021)
"The reminder that it is important to always keep other's point of view in mind based on their culture and experiences that differ from mine. The speaker was very easy to understand. Tone of voice was pleasant." N.R. (Oct. 2021)
"The specific examples of how to be culturally and linguistically sensitive to the patient and their family were beneficial. The slide presentation was presented in order with the presenter's dialogue. Information was presented in a logical order that made sense. Information was provided on where to get additional information in working with the CLD population." D.F. (Sept. 2021)
"Understanding cultural dynamics and their influence in Dysphagia treatment was beneficial. Discussion about individualism-collectivism and high and low power distance cultures and how this influences decision making was good." P.M. (Sept. 2021)
"The course covered more than just food choices." V.B. (Aug. 2021)
"The discussion on conducting a culturally sensitive assessment, and the examples of questions to ask will help my daily practice. I liked that the presenter gave personal examples of what went wrong and what to do differently. I also liked that she included some different values from other cultures with regard to dysphagia, family dynamics, etc." D.W. (Jul. 2021)
"Really thinking about how a culture might affect one's ability to understand swallowing and also poor intakes was great discussion. I love the use of clinical practice examples." J.J. (Jun. 2021)
"Speaker was engaging. Enjoyed examples from her practice." L.V. (May 2021)
“Great discussion of the complexity of dysphagia tx in general. Great emphasis on the right of the patient to decide to take or leave our suggestions/treatment. New clinicians need to be aware of the patient's ability to make decisions which may not agree with ours.” L.B. (Mar. 2021)
“Excellent cultural humility and practical techniques to incorporate it into our clinical practice.” M.S. (Jan. 2021)
Kellyn Dailey Hall, PhD, CCC-SLP, has worked over 30 years as a clinician, clinical specialist, and clinical manager in medical settings. Currently, she is an Associate Professor at North Carolina Central University in Durham, NC where she teaches courses in Medical Speech-Language Pathology. She is a member of the North Carolina Speech-Language-Hearing Association’s Professional Affairs Subcommittee on Healthcare and has presented at state and national conventions on Medicare documentation and ethics. Her current research focuses on the development and implementation of dining culture change practices for SLPs working in SNFs.
Speaker Disclosures:
Financial — Kellyn Hall receives salary from North Carolina Central University. Dr. Hall also receives royalties from Northern Speech Services and Carolina Speech Pathology for the development of various continuing education courses.
Nonfinancial — Kellyn Hall is a member of ASHA, a member and serves as President of NCSHLA, and member of NBASLH.
This program is offered for 0.15 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
Additional accrediting agencies by which Northern Speech is an approved CE provider:
Course Completion Timeframe:
You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.
However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.
Content Access:
Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.
Certificate of Completion:
On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.
ASHA CE Registry Submission:
During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
Purchase Orders:
Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at info@northernspeech.com or fax to 888-696-9655.
What is an Online Course?
Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.
Receiving CEUs:
Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.
Registering for an online course:
You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.
Accessing your purchased course or returning to a purchased course:
You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.
Testing requirements:
Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.
Number of CEUs offered:
We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.
State licensing boards and online CEUs:
NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
Course formats:
Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.
Course handouts:
Most of our online courses provide a link to download the accompanying handout as a PDF file.
Group discounts:
Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.
Computer requirements:
For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.
Course Cancellation Policy:
A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded.
Special Needs:
Please click here for any special needs requests, and we will do our best to accommodate them.
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