Good Sleeping for Neurodivergent Kids, with Dr. Melisa Moore

Debbie:
Hey Melisa, welcome to the podcast.

Melisa Moore:
Thank you so much for having me.

Debbie:
Yeah, I love talking about sleep for some reason. It’s become something I’m really interested in because it’s something we’ve struggled with in our family. And a lot of parents that I work with struggle with sleep challenges with their kids. And it’s not always been easy to find information. So I was really excited about your brand new book, which we’re going to talk about today. But will you kind of give us a little bit of your story and how you came to be focused on this kind of intersection of sleep? and neurodivergence in kids.

Melisa Moore:
Sure, so I got interested in sleeping in graduate school actually. I really enjoyed working with teenagers and I also was very idealistic and really wanted to make a big impact and so I started looking at things that really impact teenagers’ lives. And at the same time I had a professor who was talking about dealing with people that have a hard time opening up. And he said that he always started with how’s your sleep? Because it’s a good way to get things going and you know, it’s not so intimidating to talk about your sleep. So I started, you know, down that path. And once I realized how important sleep is and when you can help someone with their sleep. It’s incredibly gratifying. It makes such a huge difference in their lives. So I was already doing this work for about 10 years. I was at the Children’s Hospital of Philadelphia Sleep Center before I had my son. who is neurodiverse and has sleep problems. And so as a psychologist, you know, as a professional, I see and have seen the whole time, many, many, many neurodiverse kids and neurodiverse families. And so I already had that experience and then I got the lived experience as well. So I come at it from two angles, really.

Debbie:
So I love that. I love hearing from people who are in this space. Sometimes it happens with educators, right? They’re educators and they’re maybe working with neurodivergent kids and then they have their own and it kind of shifts their lens. Yeah. So how did your personal lens shift from, you said you were already working with neurodivergent kids and then you had your own and navigating the same stuff. How did it change?

Melisa Moore:
Yeah, well, I think my view still comes from the same place. I really am grounded in the science. But so I make the same recommendations, but I think I have a whole new understanding of how difficult these small things can be that we ask families to do. Also, I think we need to be a lot more flexible and the solutions that we come up with really have to be individualized. And then the last thing is that, you have typical, as I said, science-backed recommendations, and sometimes that’s not enough. Sometimes we have to go beyond what the typical recommendations are and try to think out of the box and try new things.

Debbie:
Yeah, I love that you said that because I think there’s such a priority on evidence-based protocols for various things. And often that’s great, but they aren’t always designed specifically for neurodivergent kids, right?

Melisa Moore:
Exactly. Exactly. And I know as a mom, if someone just told me I needed better sleep hygiene and that would fix everything, I know that that’s not true. I know that having great sleep habits doesn’t mean that a neurodiverse person isn’t going to have sleep problems. Almost all neurodiverse people, so up to like 86%, have sleep problems. and there’s no way that all of those people just have, you know, poor sleep hygiene.

Debbie:
Yeah, so true. OK, so let’s talk about why. And actually, let me take a step back. I’m going to just name your book because we’re going to be talking about some of the concepts. It was a really interesting read. I always read the books of my guests, but I was really into your book. I thought it was really accessible and. fascinating. And again, this is, we navigate sleep challenges in our family. So I had a personal stake in it, but it’s called the Good Sleep Guide for Neurodivergent Kids, Science-Backed Strategies for Children and Teens with ADHD, Autism and Other Neurodiversities. So yeah, let’s start with why you said 86%. That’s a lot. So why is that?

Melisa Moore:
Mm-hmm. It’s a huge number. There are really four main reasons. One is biology, physiology. Whatever it is that has initially caused that neurodiversity and usually it’s genetics might also cause sleep problems. So one gene that might relate to ADHD, for example, might also relate to sleep. So there’s that aspect of things. There’s also the circadian rhythm. We all have this clock in our brain that’s internally generated. You don’t have to do anything to make it happen. It just is there. It keeps us awake during the day and asleep at night. And that can be different in neurodiverse people. So for example, in people with ADHD, we see a consistent delay. So that circadian rhythm that’s telling us to go to sleep is often delayed. In kids with autism, it’s inconsistent. So one day it might say it’s 2 a.m. It’s time to be asleep. The next thing it might say it’s 2 a.m. Wake up. So it’s inconsistent, but in kids with ADHD, it tends to be delayed. The third thing is that sleep disorders, medical sleep disorders and behavioral sleep disorders, things like restless leg syndrome or periodic limb obstructive sleep apnea, those things tend to be more common in neurodiverse kids and it depends on what the neurodiverse condition is. So for example in ADHD, kids that have ADHD tend to have more of their restless sleep disorders. So restless legs, restless sleep disorder, periodic movements, those kind of hang with ADHD. And then the last is all the wonderful comorbidities that go with neurodiversities. So in ADHD, it’s more common that kids are anxious. There are a million other things in this kind of bucket of comorbidities. It can be reflux, it can be pain. Any of those things that aren’t sleep disorders but can cause sleep problems. Those comorbidities are more common in neurodiverse people as well. So I think there are a lot of risk factors there. And then the last one is if you have a teenager getting back to the circadian rhythm around puberty, there tends to be a big shift in our circadian rhythm as well, about two hours. And this has been found to be true all over the world. You know, New Zealand, Russia, the United States, South America. I’m skipping from countries to continents just there, but it’s been shown all over the world.

Debbie:
Yeah. my goodness. Okay. So this feels very daunting. I’m not going to lie, but a couple of things that I want to just, that jumped out at me. One is you’re talking about these co-occurring conditions. And I just recently interviewed Dr. Zachary Rubin, who wrote a book called All About Allergies. And in that conversation, we were talking about the impact of allergies on sleep. it really And we know, we’ve talked with Dr. Mel Houser on the show who is a wonderful medical doctor. All Brains Belong is her organization and she talks about the constellation of symptoms that neurodivergent humans have. And so you start realizing how complex this is. And so another question that came up is you mentioned ADHD tends to be more of a delay. with that sleep. So it might be that delayed sleep phase syndrome. And then with autistic kids, it can be more inconsistent. kind of, which I don’t know if that’s the non 24 that we talked about on a recent episode.

Melisa Moore:
Well, those things can, so those things can be, not necessarily reach the threshold for a disorder. So, but it could just be, you know, for delayed sleep phase syndrome, we see a big delay, but normal sleep. It could be for neurodiverse people that that shift isn’t as extreme. So it doesn’t necessarily, it isn’t necessarily recognized as a sleep disorder, but that doesn’t mean it’s not a problem. It’s still shifted. So yeah.

Debbie:
Got it. Right. And what about kids who are AuDHD? So they’re autistic and ADHD. What is that? What are we talking about here?

Melisa Moore:
I think, you know, the studies that are out there often lump together different neurodevelopmental conditions. So those studies are looking at autism and ADHD and other genetic conditions together. There are now more separate studies, but I don’t necessarily think that there are studies yet looking at specific circadian rhythm differences in AuDHD kids. but that is a great thing to look into.

Debbie:
Yeah. Okay, so when you were talking about the different types of challenges that neurodivergent kids can have with regards to sleep, you mentioned something called OSA or Obstructional Sleep Apnea. So this is something I kind of wonder about. Actually, I’m kind of now presuming this is what’s happening with my kiddo, but could you break it down and explain what that is and why it might be more common in kids like ours?

Melisa Moore:
Sure, sure. So obstructive sleep apnea happens when the airway either fully collapses or partially collapses and then your body is not getting all of the oxygen it needs. When that happens, it sends like a 911 signal to your brain saying, need oxygen. So if that causes a whole cascade of things in your body and whether you know it or not, your brain is waking up. There are different neurotransmitters and hormones that are released to just make sure, number one, that you wake up to get oxygen and number two, that it doesn’t happen again. A lot of people with obstructive sleep apnea sleep through this, don’t even know what happens, but they might be snoring and that’s when you hear that gasp or that pause in breathing, that sudden change. In children, it’s most common in the early school age, so six or seven, is when the tonsils are the largest in proportion to how big the airway is. And so the first treatment in general that’s recommended for kids that have obstructive sleep apnea is generally taking out the tonsils and the adenoids. You would go to an ear, nose, and throat doctor to get evaluated for that. And that is curative in most kids. For some kids, it’s not. So for some kids, the apnea is caused just because of the shape of your face and your body. And in that case, the treatment is CPAP, which is air that kind of is blown in to keep that airway open. It is almost kind of just, it’s like a little crutch that keeps it open, the air is. And that is something that I definitely help people get used to because it can be difficult to get used to it. Luckily, there are more treatments that are going to be available in the next year or two for kids. There’s medication and then there are some other things that are coming out. So I think that that is really good news. Obstructive sleep apnea risk factors really things like having trisomy 21 or Down syndrome is a huge risk factor. So any genetic conditions that kind of impact the craniofacial structure relate to obstructive sleep apnea. I want to say specifically though, I want to talk specifically about symptoms of ADHD because the things that we’re looking at are inattention, hyperactivity, difficulty with executive functioning. And you also see those things in a person that has obstructive sleep apnea. So say that your child is sleeping 10 hours a night and that’s what’s recommended for their age. They wake up, they’re really sleepy, they’re falling asleep in school. That’s not typical. And so the sleepiness could be a result of obstructive sleep apnea or another sleep disorder. But when you’re dealing with ADHD, you’re already dealing with those symptoms. And so it’s really important to get the sleep piece as good as it possibly can be in order to minimize those symptoms that are not only a result of ADHD, also can be just a result of sleep problems.

Debbie:
Yeah. I mean, I think when I first heard, I think it was Dr. Roberto Olavardia we had on the show to talk about ADHD many, many, years ago. And he was the first person who mentioned apnea as something that a lot of ADHD kids had. And I was like, fascinating. I was really thinking about that. because I have a kid who’s always tired. It doesn’t matter how much time is spent in bed. And I’ve started to realize, that could be a sign that this is what’s going on. Another thing that’s come up recently in my conversation with Alex Mortlock about the more complex sleep syndromes was this idea of being hypermobile and also that being potentially paired with Apne and I have found someone who’s going to join me next fall to talk about that. But can you speak to that a little bit? Some of us, our kids sleep in really strange positions because their bodies go that way.

Melisa Moore:
Yeah. I think also with those hypermobility symptoms, when we’re in REM sleep in particular, dreaming sleep, we are paralyzed and we are supposed to be paralyzed. Otherwise we would be acting out all kinds of things and hurting ourselves and other people. So we’re supposed to be paralyzed. And that’s why our airway gets floppy. Our muscles in our airway get floppy during that time. And in kids with hypermobility syndrome, it’s possible that it’s floppier then it would be in someone who didn’t have that. And that floppiness is what ultimately causes obstructive sleep apnea, ultimately causes that partial or full collapse. So I do think that that is relevant to syndromes like Ehlers-Danlos syndrome and other hypermobility syndromes.

Debbie:
Yeah. And it was so fascinating to hear you talk about the different ways that we can address OSA in kids. I know a friend in his 30s who’s finally getting that surgery to deal with this. How do we go about getting a diagnosis for this? think what you know. I know that there are sleep studies. I’d like to know more about that. But anytime that’s come up as something for us to consider, I’m just like, that feels so overwhelming for my child who so struggles with transitions and is sensitive to the environment. And I’m like, how is this going to be accurate in any way, or form?

Melisa Moore:
Sure. Yeah. Yeah, when it comes to apnea, those scoring rules, the rules that determine whether you get an apnea diagnosis or not, they take into account that the child, the person is sleeping in a new place. So they take into account what we call this first night effect that you might sleep worse. Apnea doesn’t change based on that. And in general, I would say in my experience, I’ve only worked in specialized pediatric sleep centers, so I’ve only worked in children’s hospitals with sleep centers. Most of the time, the techs are pediatric trained. They love kids. They will do what it takes to make it work. So I would always recommend going to a pediatric sleep center, even for a teenager. The only way to test for obstructive sleep apnea is an overnight sleep study. And there’s nothing involved that’s painful, although it is a pain. I’m not going to lie. It is a pain. It involves a lot of EEG leads, sticky things and wires. It’s weird. It’s weird. No doubt about it. And so if your child is particularly sensitive, I would recommend before the sleep study getting used to trying to help them get used to that, maybe using tape and string to, you know, to replicate what’s going to happen. But also you could ask the sleep center where you’re going. Do they have any extra electrodes that they could give you to practice? And the other thing that I see all the time, the nasal cannula is the two pronged thing that goes just at the edge of your nose and measures the flow of oxygen. Kids hate that. Many kids hate that. So I have a few and when I’m working with someone to help get ready for a sleep study, I will start having them get used to those electrodes and that nasal cannula. I think that’s worth it. In general though, even if your child has a terrible night of sleep, say they slept five hours, in general for obstructive sleep apnea in particular, you would still see some sign of that. Now the other sleep disorders, maybe not so much, but obstructive sleep apnea, if they have it on a sleep study, you can be pretty sure that they actually have it. And these days there’s also home sleep apnea testing in adults. It’s really just being tested right now in children. Kids move around so much more than adults that it’s hard to ensure that home sleep apnea testing is going to be consistent. But I think that is part of the future. And that will be a lot easier for some families, in particular families with neurodiverse kids who really have a difficult time with transitions and sensory sensitivities and being in a new place. So that also, there’s a lot of exciting things coming in the next couple of years in terms of sleep.

Debbie:
Yeah. That is exciting. Yeah, I’m already like, I could be Googling that home sleep apnea test, or I get off this call. I just wanted to ask you, I’ve been seeing in my, I don’t know why this is in my algorithm right now, but I’m seeing these ads for things that go on your nose, and they’re like magnets and it kind of, you know, widen your nasal passages. What are your thoughts on those?

Melisa Moore:
Yeah. I don’t know that they help enough to eliminate sleep apnea. They might help a little bit depending on the reason that you have sleep apnea, but there’s no magic wand and if there were a magic wand we would be using it. If there was something like that that was so easy, caused families so little stress, I think we would all be doing it.

Debbie:
Yeah. Yeah, okay, makes sense. If it sounds too good to be true, it probably is. Yeah, so I would love to explore insomnia because I think that is just like a very general term that gets bandied about all the time, right? Especially for kids who are young adults, teens who are just up all night claim they can’t sleep. So would you define insomnia and tell us what’s really going on there?

Melisa Moore:
It is. So the definition of insomnia, the diagnostic criteria are really broad and they’re really broad for a reason. And they used to be broken up into different kinds of insomnia, but insurance generally wouldn’t pay for any insomnia that needed a behavioral treatment, but they would pay for insomnia that needed a more medical approach. And so now it’s just all under the same thing. And really insomnia is trouble falling asleep, staying asleep, or waking up too early in the morning. There also has to be a subjective complaint so the person has to not like it. They have to feel like it’s impacting them in some way. In kids, this complaint almost always comes from the parent, not the child. But there are different kinds of insomnia. In younger children, we see more frequent night wakings. We see difficulty falling asleep. Those are the symptoms that we see. In older school-age kids and teenagers, we might see those things, but we also see worries about sleep. I’m not a good sleeper. If I don’t sleep well tonight, I’m going to do terribly on that test. So, worries about sleep that contribute to insomnia. And the other thing I want to say that has really contributed to an increase in insomnia over the last few years is trackers, bracelets, rings, programs on your phone or your iPad, mattress pads. All of those things have led to one outcome, which is more insomnia. When people sleep is one of those rare things that the harder you try, the less likely it is to happen. And so when we’re thinking so much about sleep and we’re striving for sleep perfection, we’re much less likely to be able to sleep. And so the people who would benefit from the tracker, so people that are non-speaking or situations where the child is getting you know, the sleep that they should need. They’ve had a sleep study. They don’t have a sleep disorder. We don’t know what’s going on. Those are times where the trackers might be again, I talked about the EEG leads on the head. That’s the only way. that you can know if someone is awake, asleep, and what stage of sleep they’re in. None of the trackers can tell you that. They approximate it based on other things. For example, if you don’t move around a lot, you’re probably asleep, but it’s not actually detecting that your brain is asleep. So if you have a child that is really worried about their sleep and is really focused on it, I kind of take a counterintuitive approach, which is stop talking about it and stop tracking it. I wouldn’t track it. I think when people come to me with sleep problems and they tell me I only slept six hours, I just believe them. You know, and if they come with a sleep tracker and say, I sleep great, I feel like I slept eight hours, but the tracker is telling me I woke up 36 times. I don’t know that that algorithm of the tracker is exactly accurate. So that was a very long detour for your question about insomnia, but I wanted to make sure that I covered that. So with insomnia and kids with ADHD, I tend to see difficulty falling asleep a lot. It’s hard to shut the brain down. It’s hard to even be organized enough to fall asleep. And one of the things that I talk about is changing your language around sleep with your kids. I’m working on this with my kids right now. We all are kind of in the habit of saying, just try to go to sleep. And so I am now trying to say, just wait for sleep. Wait for sleep to arrive. Wait for sleep to come visit you. Not only is that more accurate, but it’s less stressful. There’s nothing you can do in that moment to force yourself to sleep. There’s nothing anybody anywhere can do to force themselves to sleep, even with medications. You know, we can do things to force ourselves to be awake and many people probably listening to this use, you know, caffeine. We can do that. But it doesn’t work that way for sleep. And so I think it’s a good idea to kind of take the pressure off. All we really can do is set up the right conditions and wait and those right conditions include a consistent schedule, having a room that’s cool, dark, and quiet, and having a bedtime routine. You are never ever too old for a bedtime routine. And studies of bedtime routines are actually, the findings are incredible how many things that a bedtime routine relates to. So, bedtime routine doesn’t have to be complicated, you know, three or four things. It should be short. But a bedtime routine really helps us wind down. The other thing that helps us wind down is sleep associations. And sleep associations are those things that we connect with sleep. Our brains like to take shortcuts, so they’re always trying to connect different things together. And so when you see your bed, when you get into your bed, your brain should automatically go sleep, bed, bed, sleep. Sleep associations aren’t inherently good or bad. So it can be things like a stuffed animal or a blanket or a white noise machine. But whatever that sleep association is needs to be present all night long. And so whatever you fall asleep with, you need to get back to sleep during normal night wakings. And so we all, this is something I feel like most people don’t know and why would you, but we all wake up multiple times per night. That’s the end of the sleep cycle. So we all go through a light sleep, then we go through deep sleep, then we go into dreaming sleep or REM sleep, and then our brains wake up. We usually don’t know that that even happened because we’re so efficient at getting ourselves right back to sleep. But if you don’t have the thing that you’re used to falling asleep with at the beginning of the night, you can wake up more or you feel like you wake up more during the night. So a lot of times when parents come, and the insomnia symptom is frequent night wakings, we are still working on bedtime. And sometimes people are like, I don’t think you understand, my problem isn’t bedtime, it’s night wakings. But the bedtime is what determines how easy it is to get back to sleep during those night wakings. So that is something that is really important when it comes to insomnia and one thing that we work on. For kids that have trouble winding down those two things a bedtime routine and good sleep associations Really help our brain wind down and I want to just also make another comment here that I I’m not saying that you shouldn’t sleep with your child if you’re a co-sleeping family Great, you’re a co-sleeping family And that’s okay. co-sleeping or not co-sleeping not probably changing your child’s path in life So just do what is best for your family? But if you are co-sleeping at bedtime but not during the night, that’s when it becomes problematic because you see those nightwakings.

Debbie:
Okay. I have a couple of follow-up questions. One, I’m thinking of those nights where my child could not shut off their brain and was really, really struggling. And what we would do is box breathing together. You know, is that something that scientifically shows that it can help? Cause I find it really effective.

Melisa Moore:
Yeah, definitely. And it can become a sleep association. So I always tell kids that the best brain is calm and distracted. So the best brain for welcoming sleep is calm. And the way you get there is like you said, box breathing, any kind of intentional breathing practice, anything that keeps you calm. The distracted part is especially important in kids with ADHD and other neurodiversities. And this is something that I’ve learned over the years from the families that I work with. There is a certain level, the perfect level of distraction. And that is something that’s engaging enough, but also not going to blast off into inventing something new. Or, you know, for me, like, making my grocery list and thinking about what we’re going to have for dinner every night this week. And that is where things are a little bit more individual. For one person, it might be counting backwards from 100 by sevens. For another person, it might be something like thinking of all the colors in the rainbow and imagining what things are that color. So you might think red and then you would think firetruck, apple. cherry stop sign. You would picture everything in your head and when you can’t think of anything else that’s red you go on to orange or You can do the same thing with a word like bedtime. So starts with B. You think of all things that start with B. Blueberry, banana, biscuit, bread. I’m a little stuck on the food. Bear. All of those. Basketball. And then when you can’t think of anything else, you go to the next letter and you’re picturing each thing in your mind. For other people. It is other things that lead to that right level of distraction. And it gets hard when the right level of distraction becomes a sleep association. So I’ve had many kids, believe it or not, who listen to the British baking show or other things to fall asleep, audible books, the Tony box, those kinds of things, sleep stories. And if your issue with your child is that they can’t fall asleep. They have trouble falling asleep but they’re not waking up during the night. Once they’re asleep they’re fine. I probably wouldn’t worry about it too much. If they’re waking up a lot then you want to work towards making sure that everything is consistent all night long.

Debbie:
Yeah. Right. That’s so interesting. Yeah, when my kiddo was younger, going to sleep to Winnie the Pooh was the thing every single night. But then in the middle of the night, I would hear it go on again. So that makes total sense. So let me ask you a question about distraction, because I hear from parents of older kids, teens, and young adults who may be struggling with depression or anxiety. And so there’s this avoidance of being alone with their thoughts and their minds. And so it’s like this delay to put off sleep until they’re literally about to collapse. They’re so tired because they don’t want that time alone in their thinking, right? So what’s your advice for parents whose kids are navigating that?

Melisa Moore:
Right. I think it kind of depends on how severe it is. A lot of times in those situations, I see kids that are on their phones or they’re watching a show. And although I don’t recommend electronics, if your child is really in a tough spot with worrying a lot or feeling depressed or just not able to turn it off at all, then I don’t necessarily take it away. So electronics are not terrible for all children to sleep in all situations. And I’m definitely more flexible about this than other people. But when you look at the research and I’m only talking about sleep, I’m not talking about any other domains and I don’t recommend electronics. But if you’re in a situation in particular with anxious or depressing thoughts, what we see is that the electronic use before bed isn’t necessarily putting bedtime off. It’s just taking up the time that the person was going to be awake anyway. And so that distraction from those difficult thoughts actually helps them fall asleep faster. So I think it’s pretty nuanced and pretty individualized. You know, I have kids that draw or color or, you know, for older kids use the adult coloring books. Anything that really can be distracting enough to take their mind off those thoughts.

Debbie:
Mm-hmm. Yeah. Okay. Yeah, I appreciated your approach to screens and that it wasn’t just black and white, like good, bad, you know. It is really nuanced and I think that the very aspect of raising these kids is nuanced and has to be individualized. Yeah. So, okay. There’s so much more we could go into. Your book, as I said, is really, it’s just super accessible. It’s very thorough. It’s very practical. really answered so many questions and covered so much. So I’m gonna just name it again. It is called the Good Sleep Guide for Neurodivergent Kids, Science-Back Strategies for Children and Teens with ADHD, Autism and Other Neurodiversities. I’m holding it up for those of you watching on YouTube. Reminder, go watch this on YouTube if you’re listening. But just as a last question, if there are parents listening who are struggling with sleep and my hunch is most parents of these kids have some kind of sleep challenges they’re dealing with. At what point do you recommend they seek professional help? Is there like a threshold or some guidance you could provide?

Melisa Moore:
That’s a great question. If they’re snoring at all, now’s the time. If they are moving around a lot, restless, or they complain they can’t sleep because they have weird feelings in their body or they’re too restless, then I would definitely seek help. The other reason is, especially in elementary school, when you’re done with napping, you’re not yet a teenager, if they’re falling asleep or tired during the day, that’s a huge red flag. So I think in those situations especially, but also what if you just need help making a change? You’ve tried a lot of things and you don’t know where to go next. I think seeing a sleep expert and expert is defined in different ways by different people, but I think finding that ideally would be a pediatric sleep center with behavioral support would be the ideal. It’s not available everywhere. You can go on certain websites that will direct you to sleep centers in your region. So the American Academy of Sleep Medicine, the AASM, the National Sleep Foundation, which is the NSF, and then the Pediatric Sleep Council. Their website is Babysleep.com. And it is true that this website is aimed at babies and toddlers. However, that information is still available about sleep centers in your area. And that will cover not just the United States. So there are incredible sleep experts all over the world.

Debbie:
Great. Good to know. Okay. Super interesting. Thank you so much for everything that you shared today. And if listeners want to connect with you, where should they go?

Melisa Moore:
So my website is drmelisa.com, D-R-M-E-L-I-S-A.com. My name only has one S in Melisa, even though most people have two S’s. So you can go to my website. We’ll give you links to my book, podcasts that I’ve been on, videos, my email, all of that great stuff.

Debbie:
Okay, so listeners, as always, I will have links in the show notes page, as well as links to the resources that Melisa just mentioned. And thank you so much. This has been super interesting. I love talking to people when I’m personally invested in the conversation. So thank you so much.

Melisa Moore:
Thank you for having me.