Studiens syfte har varit att undersöka hur studie- och yrkesvägledare, som saknar sakkunskap om neuropsykiatriska funktionsvariationer (NPF), upplever att vägleda elever med dessa diagnoser på gymnasieskolor. Vi har ämnat ta reda på hur studie- och yrkesvägledare bemöter elevernas behov, samt förbereder eleverna inför framtida studie- och yrkesval. De två teoretiska utgångspunkterna för arbetet har varit Self-Determination Theory och den Konstruktivistiska vägledningsteorin. Då studien åsyftar att undersöka studie- och yrkesvägledares upplevelser har vi genomfört kvalitativa semistrukturerade intervjuer med fem studie- och yrkesvägledare. I resultatet framkommer det att respondenterna aktivt arbetar med att anpassa vägledning och förhållningssätt i sitt bemötande av elever med NPF. För att snäva in vårt spektrum något har vi valt att fokusera på de vanligast förekommande diagnoserna, som våra respondenter möter i sitt dagliga arbete; ADHD, autism och dyslexi, De primära verktygen som respondenterna använder sig av är tydlig information, motivation och att hjälpa elever att öka deras självkännedom. Dessa anses vara centrala aspekter när det gäller att förbereda eleverna inför framtida studie- och yrkesval. Slutsatserna som framkommer i studien är att om en studie- och yrkesvägledare ska kunna vägleda elever med NPF är det väsentligt för hen att besitta kunskap om och inneha erforderlig kompetens kring hur NPF påverkar individen. Av lika hög vikt är det att hen vet vilka förutsättningar som råder i samhället gällande studier eller yrken. Vidare har vi också kunnat belysa att vi på vår utbildning inte har fått någon djupare sakkunskap om NPF för att kunna bemöta denna stora grupp elever ute i skolorna. Istället är vi hänvisade till att på egen hand förkovra oss i detta simultant med att vi ska komma ut och vara yrkesverksamma i helt nya arbetssituationer.

Diagnostiseringen av neuropsykiatriska funktionsnedsättningar (NPF) har ökat de senaste åren. Samtidigt visar forskning att barn och unga med NPF löper större risk att drabbas av psykisk ohälsa och utsatthet i samhället. Barn och unga med NPF har ofta komplexa behov och för att de ska få den vård och stöd som de är i behov av kan därför insatser behövas från flera olika håll genom samverkan där främst skola, socialtjänst och hälso- och sjukvården ska vara delaktiga. Dock visar sig stora brister och svårigheter i samverkan mellan dessa aktörer från flera håll vilket resulterar i att dessa barn samt deras familjer riskerar att falla mellan stolarna och inte få sina behov tillgodosedda. Syftet med den här studien har därmed varit att undersöka vilka förutsättningar som anses viktiga för samverkan mellan skola, socialtjänst och barn- och ungdomspsykiatrin gällande barn och unga med NPF samt hur dessa förutsättningar anses hindras inom respektive organisation. En kvalitativ metod med semistrukturerade intervjuer har genomförts med skolkuratorer, socialsekreterare och kurator samt psykolog på barn- och ungdomspsykiatrin. Materialet har analyserats utifrån Danermarks samverkansteori, ett teoretiskt ramverk för olika grader av integration samt nyinstitutionell teori. Resultatet visar att samverkan kring barn och unga med NPF är en viktig faktor för att kunna erbjuda rätt hjälp och stöd. Studiens resultat visar även att samverkan är ett komplext arbetssätt som ofta hindras av otydlig arbetsfördelning och bristande kommunikation. För att samverkan ska fungera krävs det att den efterfrågas och möjliggörs från ledningsnivåer samt att organisatoriska förhållanden tillåter det. En annan viktig förutsättning är att professionellas synsätt, dels om varandra men också kring barn och unga med NPF, synliggörs. Vidare fann studien att föräldrars roll samt diagnosens roll har betydelse för att samverkan kring barn och unga med NPF ska fungera. / The diagnosis of neurodevelopmental disorders has increased in recent years among children and young people. Research shows furthermore that children and young people with neurodevelopmental disorders are at high risk of suffering from mental illness and vulnerability in society. These children and young people often have complex needs and therefore require interventions from several different organizations such as schools, social services and the child and youth psychiatry. To meet these complex needs and in order to provide these people with the best support it is important that schools, social services and the child and youth psychiatry unite and cooperate. However there are major problems and trouble in cooperation between these organizations. This results in many children and young people with neurodevelopmental disorders and their families not getting the help they need. The main aim of this thesis is therefore to investigate conditions and barriers for collaboration between professionals in schools, social services and the child and youth psychiatry in Sweden for the benefit of children and young people with neurodevelopmental disorders. A qualitative method with semi structured interviews has been used to interview school counselors, social secretaries and counselors within the child and youth psychiatry. To analyze the material we used Danermarks collaboration theory and a theoretical framework for different degrees of integration and neo-institutionalist theory. Consensus was reached in this study that collaboration between these organizations is an important factor in being able to offer adequate support and help to children and young people with neurodevelopmental disorders. The result demonstrates that factors enabling collaboration are based on commitment of management levels, good communication and that organizational conditions allow it. Furthermore, the study found that the role of parents and the role of diagnosis are important for collaboration around children and young people with neurodevelopmental disorders to work.

The present study aimed to compare adolescents (14-15 years old) having self-reported neurodevelopmental disorders classified as flourishing with those adolescents classified as non- flourishing concerning rated mental health problems and adolescent perceptions of adolescent disclosure and parental control. The present study used a cross-sectional design based on a secondary analysis of data collected in the LoRDIA research program. Adolescents having self-reported NDDs in wave 3 were included (n=198). Adolescents rated their mental health using the Mental Health Continuum – Short Form, after which researchers classified them as flourishing, moderate, or languishing. Behavior and emotional symptoms were rated using the conduct problems subscale and emotional symptoms subscale of the self-reported version of the Strength and Difficulties Questionnaire. Adolescents rated adolescent disclosure and parental control using the adolescent disclosure scale and parental control scale. Independent Samples t-Tests, Mann-Whitney U test, and multiple regressions were performed to analyze data. Findings illustrated that adolescents having self-reported NDDs classified as flourishing report less conduct problems, lower adolescent disclosure, and same levels of parental control compared to those adolescents classified as non-flourishing. Emotional problems seem to be positively related to adolescent disclosure within family interaction patterns, while conduct problems appear to be negatively related to parental control. However, parenting style may be crucial in having few or many conduct- and emotional problems. Thus, adolescent disclosure plays a prominent role in relation to adolescents’ mental health, mental health problems, and parent-adolescent interactions, while parental control plays a prominent role in relation to adolescents’ mental health problems and parent-adolescent interactions.

This essay consists of a review of 34 scientific articles. The aim is to describe and compile current research about students with intellectual disability (ID) and neurodevelopmental disorder (NDD). The research questions focus on what challenges for learning and teaching the diagnoses imply, if there are any differences between girls and boys, and how the learning environment may be adapted for these students. The theoretical framework in this study consists of gender theory and social constructions. The results show that many students with ID also have diagnoses within NDD and that it affects the students’ executive, adaptive and social abilities. Girls show other symptoms than boys, but there tends to be fewer differences when the students have a severe ID. Girls are often quieter than boys and seem to have better social skills, while boys more frequently have challenging behaviour. The differences contribute to boys receiving more support in school and that they are referred to neuropsychiatric assessment at an earlier age. Girls however are more difficult to discover, which causes that girls often receive a diagnosis later than boys. Considerably more boys than girls get a diagnosis within NDD; research has for many years focused on boys’ symptoms, which has affected the formation of the diagnostic tools. The result shows that there is a huge need of adapting the education to each student’s ability and level of knowledge with help from a clear structure in a calm setting with few disturbances. The students need support in developing their executive, adaptive and social skills. Early interventions have shown to be of great importance. Regardless of cognitive level, pedagogues need to have high expectations on the students, encourage them and give them the support they need. The students may for example need longer time, rehearsal or that the exercises are divided into smaller parts. The result indicates that students with disabilities have the best opportunity for development when they are together with students in general education. / Den här forskningsöversikten består av en granskning av 34 vetenskapliga artiklar. Syftet är att beskriva och sammanställa aktuell forskning om elever som har IF och NPF. Frågeställningarna fokuserar på vilka utmaningar för lärande och undervisning diagnoserna innebär, om det förekommer några skillnader mellan flickor och pojkar samt hur lärmiljön kan anpassas för dessa elever. Det teoretiska ramverket i studien utgörs av genusteori och sociala konstruktioner. Resultatet visar att många elever med IF har diagnoser inom NPF och att det påverkar elevernas exekutiva, adaptiva och sociala förmågor. Flickor uppvisar ofta andra symtom än pojkar, men skillnaderna tenderar att vara mindre vid svår eller grav IF. Flickor är i regel tystare än pojkar och verkar ofta ha en högre social kompetens, medan pojkar i högre utsträckning är utåtagerande. Skillnaderna bidrar till att pojkar ofta får mer stöd i skolan och att de utreds i ett tidigare skede. Flickor är däremot svårare att upptäcka, vilket bidrar till att flickor ofta får diagnos senare än pojkar. Betydligt fler pojkar än flickor får diagnos inom NPF; forskning har i många år utgått från pojkars symtom, vilket har påverkat utformandet av utredningsverktygen. Resultatet visar att det finns ett stort behov av att individanpassa undervisningen utifrån elevernas förmågor och kunskapsnivå med hjälp av tydlig struktur i en lugn miljö med få störande moment. Eleverna behöver stöd för att utveckla sina exekutiva, adaptiva och sociala förmågor. Tidiga insatser har visat sig vara av stor betydelse. Oavsett kognitiv nivå krävs att pedagoger möter eleverna med höga förväntningar och uppmuntran samt ger dem det stöd de behöver. Exempelvis kan det handla om att få längre tid på sig, repetition eller att uppgifterna delas upp i mindre delar. Resultatet indikerar att elever med funktionsnedsättningar har störst möjlighet att utvecklas tillsammans med elever inom reguljär skola.

Pour les enfants ayant des troubles neurodéveloppementaux, l’intégration en service de garde est essentielle. Elle permet de compenser certaines difficultés et de promouvoir le développement. Pourtant au Québec, très peu de places disponibles sont occupées par ces enfants. Leur faible représentation dans ces milieux pourrait être due aux croyances des éducatrices les concernant, pouvant influencer également leur adaptation. L’objectif de cette étude est d’explorer les perceptions des éducatrices quant à̀ l’adaptation de 190 enfants issus d’une population clinique. Des informations sur le diagnostic de l’enfant, sont recueillies. Deux questionnaires remplis par les éducatrices sont utilisés. Le premier, un questionnaire de garderie, documente le type de milieu fréquenté par l’enfant et inclut la question « L’enfant profite-t-il de la garderie ? ». Elle a fait l’objet d’une analyse thématique et a servi à codifier du type de perception de l’éducatrice (positive, nuancée, négative), utilisé dans les analyses statistiques. Le second, est le Profil Socio-Affectif (PSA, LaFrenière, Dumas, Capuano et Dubeau, 1992), dont on utilisera l’échelle de la compétence sociale. L’analyse thématique a montré une variété de thèmes, le plus fréquent étant la socialisation. Les analyses statistiques ont, permis d’étudier la relation entre le type de perception et le diagnostic de l’enfant, sa compétence sociale et le type de milieu de garde. La codification du type de perception a montré une majorité de perceptions positives, suivi des nuancées, puis des négatives. Les résultats révèlent une association significative entre le type de perception et la compétence sociale de l’enfant, de même qu’avec son diagnostic, mais pas avec le type de milieu de garde fréquenté. Ainsi, les éducatrices perçoivent très majoritairement les enfants vus en clinique de pédopsychiatrie comme profitant de leur expérience de garderie, particulièrement pour l’amélioration de leur intégration sociale. / For children with mental health and neurodevelopmental disorders, integration into childcare services is essential. It promotes their development and can compensate some of their difficulties. Yet in Quebec, very few places available are occupied by these children. Their low representation in these environments could be due to the educators’ beliefs, which may also influence their adaptation. The goal of the present study is to explore the perspective of educators regarding the adjustment of 190 children from a clinical population. Information on the child's diagnosis is collected. Two questionnaires filled by the teachers are used. The first one is a daycare questionnaire documenting the type of daycare and including the question "Does the child take advantage of the daycare?". This question was used for a thematic analysis. It also served to codify the educator’s perception (positive, nuanced, negative). The second questionnaire is the Socio-Affective Profile (LaFrenière, Dumas, Capuano and Dubeau, 1992) from which is extracted the social competence scale. The thematic analysis revealed a variety of themes, the most common being the children’s socialization. Statistical analyzes were used to study the link between the educator’s perception and the child’s diagnosis, their social competence, and the type of daycare. After codification most perceptions were positive followed by the nuanced perception and then the negatives ones. Results also revealed a significant association between educator’s perception and the child’s diagnosis as well as their social competence, but not with the type of daycare. Thus, integration, especially social of children seen in child psychiatric clinic is mostly perceived positively by their educators.

Irrespective of the great individual variation, people diagnosed with RTT largely rely on support from others to be able to do and participate in activities throughout their lives. This thesis focuses on which activities are done and liked/disliked by girls and women with RTT in Sweden. The overall aim was to describe the everyday lives of female individuals with Rett syndrome. Two studies are included in this thesis. The first is a descriptive study, using secondary data from three earlier questionnaires, encompassing data from 175 participants (girls/women) described by 365 informants (parents/staff). Content analysis was used to analyse the openended questions. In the second study a Time-geographic diary method and the software VISUAL-TimePAcTs computer program, DAILY LIFE 2011 were used. Ten participants (teenagers/young female adults) with RTT and their 63 informants participated in the diary study. The main findings in the first study (I) were that the girls and women with RTT enjoyed activities that included aspects of ‘contact’, ‘sensory impression’ and ‘motion’. The activities most enjoyed over the years were bathing/swimming, listening to music or being outdoors/walking. The parents and staff also liked to do the same activities that the girls or women enjoyed doing, described as sharing their joy. Of the few activities that were reported as being unenjoyable, most were daily care activities. The diary study (II) showed that the most frequently reported activities were hygiene/toilet, moving around indoors, eating and getting dressed. Most time was spent in sleeping, daily care, medical and health care activities and also for travel/transportation. Little time remained for other kinds of activities especially for the young adults. Most time was spent with staff, thereafter with families, and the least time was spent with friends. The participant response that was reported most often during activities was ‘interested’, while ‘opposed’ was the least reported. Responses of ‘opposition’ were primarily seen during caring activities such as toileting, using the breathing mask, stretching, brushing teeth, being woken up, dressing and putting on orthoses. Responses of ‘engagement’ were noted in contexts of socialising, playing and communicating activities with friends or staff. Engagement responses were also reported during activities of ‘motion’ such as changing body position, moving in the water or gymnastics, eating food and snacks, and even when watching/listening to films, books or music. Thus, increased knowledge concerning the importance of activities for girls and women with RTT is essential for their well-being, participation and continued development. Increased knowledge could facilitate the choice of activities and a more varied use of activities. Regardless of age, severity of symptoms or developed skills, it is important that not only basic needs such as sleep, daily care and medical health care activities are fulfilled for individuals with Rett syndrome. It is also essential for them to spend time with friends, family and staff doing enjoyable activities both at home and in other places. / <p>Funding:</p><p>Linnéa and Josef Carlsson’s Foundation, Helsingborg, Sweden and the Folke Bernadotte Foundation, Stockholm, Sweden.</p>

Le contrôle postural fait intervenir l’intégration cérébelleuse de différentes entrées sensorielles (le vestibule, la vision, la somesthésie). Nous avons évalué le contrôle postural à l’aide de différents dispositifs : la plateforme Techno Concept®, le Multitest Framiral® et les mouvements oculaires avec l’oculomètre : le Mobile e(ye)BRAIN T2® chez des participants contrôles et des enfants présentant des déficits neuro-développementaux, troubles appartenant au spectre autistique et dyslexie. Au cours de nos travaux, nous avons décrit un aspect développemental physiologique des indices posturaux et oculomoteurs et également un déficit de ces indicateurs auprès d’enfants avec retards d’apprentissage. En effet, chez ces enfants, la stabilité posturale est déficitaire et les stratégies d’exploration sont différentes par rapport aux contrôles. Nous avons basé nos hypothèses sur le fait que ce déficit serait du à un défaut d’utilisation des informations sensorielles ainsi qu’à une mauvaise intégration cérébelleuse. Les résultats de nos études nous permettent de mieux préciser les caractéristiques neuropsychologiques impliquant les fonctions cérébelleuses chez ces enfants afin de pouvoir suggérer des prises en charge thérapeutiques multimodales capables d’entrainer simultanément plusieurs fonctions. Notre objectif final est de pouvoir identifier une médiation thérapeutique spécifique pour ces enfants. / Postural control involves cerebellar integration of several sensory inputs (vestibular, visual and somesthesic). We evaluated postural control with force plateform: Techno Concept®, Multitest Framiral® and the eye movements with the Mobile e(ye)BRAIN T2® in healthy children population as well as in children with developmental disorders (autistic spectrum desorders and dyslexia). The results of our studies showed a developmental aspect of postural and oculomotor factors in healthy children and a deficit of both postural and oculomotor control in children with autistic spectrum desorders and with dyslexia. Indeed, in these children postural stability is poor and visual strategy is different with respect to healthy children. Our hypothesis is that these deficits could be due to a lack in using appropriately sensory inputs and of their integration via cerebellar activity. The importance of these studies is to better understand the involvement of cerebellar function in such developmental disorders. Our final goal is to suggest new training tecniques to use sensory inputs more efficiently in these children with developmental disorders.

Parenting children with neurodevelopmental deficits (NDDs) is very stressful, more so than the parenting of typically developing children. There is considerable research on the topic of chronic stress experienced by caregivers; however, less is understood of parental stress experienced when raising children with NDDs. The purpose of this study was to examine how parental traits and habits, in the forms of mindfulness and social support levels, affect this cohort's general stress levels. The study was guided by Self-Determination Theory, which explored how parental acts could be classified along a continuum of being intrinsically or extrinsically derived. A convenience sample of parents (n =71) with a child diagnosed with at least one NDD were recruited from online support groups on Facebook. The participants fully completed the Parental Stress Scale to measure parental stress, the Mindful Attention Awareness Scale to measure trait mindfulness, and the Family Support Scale to quantify social support to the family. Correlation analysis and multilinear regression analysis were used to determine that higher levels of social support and mindfulness in the participants predicted lower levels of perceived parental stress; the model was statistically significant, R²=.284, F(2,68)=13.504.p<.001. As a set, the two predictors accounted for 28.4% of the variation in stress. This study helps to promote positive social change by providing informing data on population-specific research, which can assist in the development of empirically supported treatments that could be used by professionals and paraprofessionals in treatment planning, therapies, and psychoeducational interventions.

Children with neurodevelopmental disorders (NDDs) tend to experience restricted social participation and therefore require support in this area. Animal assisted interventions (AAIs) offer a complementary or alternative intervention approach for those children. This research aimed at investigating the literature on AAIs in relation to the social participation of children with NDDs. A systematic literature review was conducted in four databases. Based on the PICO framework, search strings and inclusion/exclusion criteria were defined, resulting in the inclusion of eleven articles from seven countries. The selected articles were assessed for quality and data was extracted with the help of an extraction protocol. The majority of research concerned children with autism spectrum disorder, in the context of school, occupational therapy, and other health care and therapy settings. Social participation was assessed primarily through measures of frequency and initiation of social behaviors and interactions. Results of the studies were mixed, with a trend toward a positive effect of AAIs on social participation. Overall, most evidence was found for animal assisted therapy including dogs. The research reflected a lack of protocol for animal-assisted interventions and a need for a clear definition of social participation across research and practice. However, in relation to the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY), AAIs seem to offer a treatment approach that can target several factors simultaneously instead of putting a focus on body functions only. Although this research could not draw any straightforward conclusions, there is clearly an indication that AAIs have a positive potential to impact the social participation of children with neurodevelopmental disorders. / Kinder mit neurologischen Entwicklungsstörungen erfahren oft Einschränkungen in ihrer sozialen Teilhabe und benötigen daher Unterstützung in diesem Bereich. Tiergestützte Interventionen bieten in diesem Fall einen ergänzenden oder alternativen Interventionsansatz. Das Ziel dieser Studie war es, die Literatur über tiergestützte Interventionen in Bezug auf die soziale Teilhabe von Kindern mit neurologischen Entwicklungsstörungen zu untersuchen. Mit Hilfe von vier Datenbanken wurde eine systematische Übersichtsarbeit durchgeführt. Basierend auf dem PICO-Modell wurden Suchbegriffe sowie Einschluss- und Ausschlusskriterien festgelegt, woraufhin elf Artikel aus sieben Ländern in die Arbeit aufgenommen wurden. Die ausgewählten Artikel wurden auf ihre Qualität geprüft und Daten wurden mit Hilfen eines Extraktionsprotokolls gesammelt. Die meisten Studien betrafen Kinder mit Autismus-Spektrum-Störungen, und wurden im Kontext von Schule, Ergotherapie und anderen Gesundheits- und Therapieeinrichtungen durchgeführt. Die soziale Teilhabe wurde in erster Linie durch Messungen der Häufigkeit und der Initiierung von sozialem Verhalten und sozialer Interaktionen bewertet. Die Ergebnisse der Studien waren gemischt, zeigten jedoch die Tendenz einer positiven Wirkung von tiergestützten Interventionen auf die soziale Teilhabe. Insgesamt wurden hauptsächlich Belege für die tiergestützte Therapie mit Hunden gefunden. Die Forschungsergebnisse spiegeln den Mangel an einem einheitlichen Interventionsprotokoll für tiergestützte Interventionen und die Notwendigkeit einer klaren Definition der sozialen Teilhabe in Forschung und Praxis wider. In Bezug auf die internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit – Kinder- und Jugendversion, scheinen tiergestützte Interventionen jedoch einen Behandlungsansatz zu bieten, der an mehreren Faktoren gleichzeitig ansetzen kann, anstatt sich nur auf Körperfunktionen zu konzentrieren. Obwohl im Rahmen dieser Studie keine eindeutigen Schlussfolgerungen gezogen werden konnten, gibt es eindeutige Hinweise darauf, dass tiergestützte Interventionen das Potenzial haben, die soziale Teilhabe von Kindern mit neurologischen Entwicklungsstörungen zu beeinflussen.

Syftet med denna studie är att undersöka om och när lärare implementerar tidiga insatser för läs- och skrivsvårigheter hos elever i årskurs 1-3, samt inom vilken tidsram dessa anpassningar sker. Studien belyser de nuvarande framgångsfaktorerna i skolor och de brister som behöver åtgärdas i arbetet med läs- och skrivsvårigheter. Webbenkäten från 2023 besvarades av 163 lärare och den bestod av kvantitativa och kvalitativa frågor. Resultaten visar att majoriteten av respondenterna påbörjar tidiga insatser, men när insatserna sattes in varierar. Studien belyser också behovet av tydligare riktlinjer angående tidsramen för extra stöd och anpassningar samt vikten av ökad lärarkompetens inom neuropsykiatriska funktionsnedsättningar (NPF). Respondenterna uttryckte ett behov av ytterligare utbildning inom läs- och skrivsvårigheter och NPF. Studien föreslår en revidering av skollagen med en specificerad tidsram för extra stöd och anpassningar, utökad lärarutbildning inom NPF och obligatorisk fortbildning för yrkesverksamma lärare. Studien betonar även vikten av välutbildade elevassistenter, samarbete mellan lärare, speciallärare och elevassistenter samt mindre klasser för att underlätta individanpassad undervisning. Framtida forskning kan fokusera på vårdnadshavares perspektiv, effektiviteten av olika insatser samt utforskande av tidigare identifiering av elever med läs- och skrivsvårigheter. / The aim of this study is to investigate when and if teachers implement early interventions for reading and writing difficulties in students in grades 1-3, as well as the timeframe within which these adjustments occur. The study highlights the current success factors in schools and the shortcomings that need to be addressed in the work with reading and writing difficulties. A total of 163 teachers participated in the study, responding to a survey with quantitative questions. Results show that the majority of respondents initiate early interventions, but the timeframe varies. The study also highlights the need for clearer guidelines regarding the timeframe for providing extra support and adjustments, and the importance of increased teacher competence in neurodevelopmental disorders. Respondents expressed a desire for further training in reading and writing difficulties and neurodevelopmental disorders. The study suggests revising school law with a specified timeframe for extra support and adjustments, expanded teacher education in neurodevelopmental disorders, and compulsory continuing education for practicing teachers. Future research could focus on the perspective of guardians, improved collaboration between teachers, special education teachers, and teaching assistants, and exploring earlier identification of students with reading and writing difficulties.