Keep calm and don’t overreact. Aug 13, 2018 · Dr. Remember teaching and learning needs to happen when your toddler is calm and regulated. It goes back to the communication-related reason for biting. Oct 11, 2022 · 4. May 7, 2019 · Symptoms. This can be a response to overwhelming emotions or discomfort. “Teach him to say, ‘I’m mad,’ and give him something to do instead of biting, such as deep belly breathing. -As a means of communicating. Be firm and calm. Respond to the child who was hurt by offering comfort through words and actions. org. Also, some people like the feeling of pulling or picking, so we try to replicate that with something that won’t hurt them. Use soap and warm water to clean the area and apply a bandage if necessary. If the bite is bleeding and the wound appears to be deep, call your child Our very young children with autism and other developmental delays lack appropriate communication skills and have only a few behaviors that work for them. When ADHD kids become violent it is not usually a thought-out process. “You hurt him and he’s crying. Consequences. Another way is to avoid over-stimulation. Sign Jumping up and down intensely. Here are some strategies that can be used: It may be a combination of things; possible reasons could be. Keep nutrition and oral health in mind. Advertisement. This may result in repetitive chewing behaviours, such as chewing clothing, biting pens and random objects Interrupt the biting or hitting by gently picking up your child or sitting down and gathering him into your lap. -To escape an unwelcoming situation. Head-banging and other repeated body motions may stimulate the vestibular system, which controls balance in the inner ear. Feb 15, 2024 · To stop head banging, show empathy, provide attention, avoid scolding, and hide your worries. It can be hitting, kicking, biting, or other behavior, but the children often don’t know how to express their emotions. Toddlers are becoming aware that they are separate individuals from their parents and the other important people in their world. 5 days ago · 4. Basically, when his sense's overload, he bites himself. Mar 5, 2024 · I use simple visuals to help explain these ideas to children in the form of a story. Being close by toddlers in order to prompt and reinforce positive behavior is also important. split ends. Biting a child sends the message that using violence is an acceptable behavior that can be used to solve problems. Wait until they’re relaxed and not hitting. But, for autistic children, stopping this behaviour can be a bit more of a challenge. Children often clench their teeth before they bite – an unmistakable sign. , taking deep breaths, using a sensory chew toy, or squeezing their fists). Jan 25, 2023 · Now you are getting a treat. Make sure the person who was bitten isn’t hurt. by Tiffany. This article advises parents and caregivers to ignore the behavior…don’t touch them, don’t talk to them, don’t make eye contact- what a crock! Jan 7, 2021 · Create a visual schedule, so your child can see what is coming next. One common behavioral issue seen in children with special needs such as autism is to bite when feeling angry or frustrated. With my son, Joey, he hits when he’s happy, he hits when he’s angry, and he hits when he’s tired and fighting sleep. Aggression is most likely a side effect Jul 5, 2024 · July 5, 2024. Acknowledgment of Proper Behavior. Provide activities that help your child meet their sensory needs. Apr 15, 2016 · Humphreys suggests helping your child label his feelings. Avoid giving too much attention to a child who bites after an incident. It might be easier said than done, but try to stay calm and not overreact to your child’s behaviour. Social Story Narrative- Preschool and Older - Autism/Special EdStudies have shown that social stories can help teach children social-emotional skills in challenging situations. 3. Provide healthy munchies. It’s important to remain calm, yet firm. Jul 3, 2024 · Many children on the autism spectrum are prone to aggressive behaviors. Thankfully, that’s where resources like this social story come in handy. Take the child somewhere quiet to calm down. (Let the biter overhear you gossip to his victim, “I say, ‘No, no, no !’. 1. Make sure you allot time throughout the day for him to move around and release pent-up energy. Mary Barbera talks about some autism ABA strategies that can help parents and professionals understand how to stop a child with autism from hitting. In this download, there are three major components: Apr 4, 2023 · Remain calm and intervene right away. The most common forms of these behaviors include: head-banging, hand-biting, and excessive self-rubbing and scratching. Autism is a spectrum and not all children react the same or display the same behaviors. Others may bite others as a way of communication or due to When hurt, most people react both outwardly (by yelling, making pained expressions on their face, pulling away quickly, among other things) and inwardly (getting mad, frustrated, annoyed, upset, or another kind of discomfort). Giving the biter all the attention can encourage them to repeat the behavior when they want to be noticed in the future. With a young toddler, start with a mild consequence. When your baby or toddler first bites you, a family member, or another child, the way you respond to that behavior has a huge impact on whether it continues Nov 15, 2023 · If biting goes beyond this age and comes with other extreme behaviours such as hitting, it’s important to talk to your GP or Health visitor for some advice and to investigate the possibility of Dec 6, 2022 · 6. Look into the child’s eyes and say calmly but firmly, “I do not like it when you bite people. Kids with autism usually have problems with picky eating and sometimes can have other oral-motor problems such as teeth grinding. Suggest looking out the window or take a walk to another room or outside. Other times, toddlers headbutt for attention or to relieve pain. This ties into their difficulty of controlling impulses. This damage to Stop your child before they bite. Aggression is a common issue for both children and adults with autism spectrum disorder (ASD). Have your child sit in a rocking chair at home and school. . Tensing part of their bodies, for example tensing their face so much so that it may shake a little. Just like tantrums, biting is a very common toddler behavior, and one that can be equally embarrassing and/or concerning for parents and Typically, toddler head butting, or head banging, is normal. Sensory. Jun 1, 2024 · Speak gently and be supportive. Consider sensory options like Playdough, Kinetic Sand, Mad Mattr, or Thinking Putty. Don’t require eye contact while you explain, either. But for parents and teachers that do have to deal with their child’s outbursts of rage, feelings of frustration, exhaustion, and embarrassment often ensue. Give him a “cold shoulder” for 20-30 seconds and lavish some sympathy on the child who was nipped. Sep 15, 2018 · In the context of autistic children or children with disabilities, where communication challenges may be present, behaviors such as head banging may serve as expressions of frustration, anxiety, or discomfort. 7. If they are in danger of harming themselves, give a gentle reminder. Identify the triggers. Sep 14, 2023 · Keep the bitten area clean: If a child has been bitten, it is important to clean the area thoroughly to prevent infection. Dermatophagia is the compulsive chewing or biting of the skin. Understanding and Treating Self-Injurious Behavior. Sep 14, 2023 · The first step is to clean the wound with soap and water. Bang any part of their body more vigorously with either their own hand or an object. Other habits that feed a child’s vestibular stimulation include head rolling Jun 14, 2024 · Young children bite, pinch and pull hair to experiment and explore their environment. Apr 10, 2013 · In children with autism, biting is seen as either aggressive or self-stimulating behavior. by Stephen M. Gently grab your child’s arms to stop him from hitting you, and then calmly but firmly mention to him/her “ I see that you are angry but I won’t let you hit me”. D. -Decrease a sensory input. Parents should respond to the behavior with a firm, “No biting!”. Anger management and relaxation training: Some children with Aspergers and HFA may experience difficulties managing emotions (e. When a toddler is biting out of frustration or anger, it is important to teach them alternative ways to express their emotions. Teach them it’s wrong: When your child bites, use simple but firm words. Unwind together. Feb 4, 2015 · A thick smoothie drunk through a small straw, or juice or milk (cow’s milk, soy milk, almond milk, etc. g. Then prompt him to say, “Play with me,” if he wants to play more. Immediately remove your little biter from the situation. We’d encourage the child to pick up a fidget before they start watching TV. It may also verbal tics like grunting, or repeating words or phrases, a behavior Jun 21, 2022 · Hand biting. Provide alternative coping strategies. Rarely headbutting can be a sign of more serious issues. Table of Contents. Jan 30, 2023 · Work on prevention: Develop a plan with the teacher to help prevent future biting incidents, such as increasing adult supervision, teaching your child appropriate ways to express emotions, and praising positive behaviors. Babies and toddlers soothe themselves and want to feel the same as they did in their mother’s womb. This means that they are eager to assert themselves, communicate their likes and dislikes, and act independently (as much as they can!). -As a reaction to something. Autism Teeth Grinding & Its Relationship to Feeding Problems. If other people hurt the child, or hurt other children in front of the child, the child will learn that it's okay to hurt people. 6. bald patches and hair loss. In the example above, Monica’s message, “Mommy doesn’t like biting,” failed to work because it was way too sweet. ) in a box with a very thin straw, offers sensory input that can help the child or teen who is oral sensory seeking. 9. Light touch, certain sounds and other sensory input can become Jan 4, 2024 · People with ADHD often rely on stims to help pay attention and focus more, whereas people with autism tend to use stims to help cope with too much stimulation or excitement. It’s normal for children to bite themselves and others out of frustration, and most grow out of it when given enough time. Use visual support to help your kid or student communicate their needs. EIN: 90-0111715. Point out how the biter’s behavior affected the other person. Make it clear that biting is wrong, but avoid lengthy explanations until your child is old enough to understand. At 6-12 months, biting, pinching and hair-pulling also help babies work out cause and effect. So, sometimes, they resort to biting when words fail. -Tired or frustrated. 164 likes. Keep your cool. Edelson, Ph. Gently guide the child away from hitting and towards a more appropriate physical action, like tapping. Some effective sensory-based interventions include: Creating calming sensory spaces: Designate a quiet, comfortable space where the child can retreat to when feeling overwhelmed or overstimulated. Mar 4, 2021 · Other strategies to consider. An autistic meltdown is bigger, more emotional, longer-lasting, and more difficult to manage than a temper tantrum. The Reasons Behind Biting. Some experts feel head-banging is a response to anxiety and this constant movement is a way for toddlers to deal with any tension or frustration they feel. Self-injurious behaviour is where a person physically harms themselves. For example, if they say “I’m mad!” instead of biting, praise them May 13, 2024 · feel angry or out of control because of a change in routine or plan. Self-injurious behavior is one of the most devastating behaviors exhibited by people with developmental disabilities. Reacting to aggression with aggressive behaviour is never the answer and will only make the situation worse. 20. Have your child do movement exercises that go against resistance and activate the proprioceptive system. It would help if parents understood the cause-and-effect between biting and a toddler’s feelings. The vast majority of parents polled on this subject all say that ignoring a whining child is a great technique. You want to make it abundantly clear that biting is unacceptable, but at the same time, don’t lose Apr 1, 2024 · Toddlers often struggle to communicate their needs and emotions adequately. Feb 1, 2016 · The period between 18 months and 3 years is an exciting time. Tension or frustration. 4 days ago · Finding and encouraging replacement behaviors: Identifying and encouraging behaviors that can replace biting is proactive. The next time your child bites, try these steps: Step 1: Be calm and firm. Short sleeved discreet body suits can limit Nov 21, 2020 · Toddlers often bite to receive attention. Oct 19, 2022 · 730 posts · 22K followers. reduce anxiety and calm themselves. No one should hit, restrain, spank, or otherwise lay a hand on an unwilling child. Help the child who was hurt find something to do. Most often, children with autism who bite (either themselves or others) do it for self-stimulating purposes. Also, our words and voices carry emotional undertones which can be overwhelming for a child with autism. Offer recognition and praise when the child uses non-aggressive methods to communicate. Feb 22, 2016 · Strategies to Prevent Toddler Biting. Leave the room. Apr 11, 2015 · Some kids who need to chew have low oral awareness, in which case this vibration may help "wake up" the mouth with a new, heightened level of sensory stimulation. Oct 22, 2021 · adapt to an unfamiliar environment. It is crucial to stay present with your patient or loved one throughout the entire experience. You can also avert a bite by giving your child other physical ways to get her frustration out (jumping up and down, squeezing a stress ball). Remove the cause. Keep a diary of events and any patterns. 8. Warning signs, such as crying, yelling, foot-stamping, and lunging often precede biting. Autism teeth grinding can be particularly challenging because it can be medical and/or behavioral. Sun Closed. Understanding aggressive or self-injurious behaviour in autistic children and teenagers. Jul 5, 2024 · For children with autism, headbanging is a way to self-soothe and communicate needs as a result of some form of anxiety. If the wound is deep or the bleeding does not stop, seek medical attention immediately. org| (833) 947-1347. It’s important to first attend to the person your toddler bit because it’ll discourage a child who’s Sep 25, 2017 · Consider adaptive clothing for children. This is known as vestibular stimulation. Often, sensory overload causes distress. -Energy that they are unsure how to release appropriately. Sep 27, 2022 · In older children, hair pulling is often treated with habit reversal therapy, a type of cognitive behavioral therapy that helps kids understand the emotions that lead them to pull and teach them skills to replace or stop the behavior. The thicker the liquid and the thinner the straw, the more resistance. Sensory: seeking texture and taste, overwhelming environment, sensory Feb 28, 2023 · With younger children, if a high-risk time for pulling or picking is watching TV, we would have a basket of fidget toys by the couch. View more on Instagram. Temper tantrums typically peak when a child is 2-3 years old. Yell sounds louder and longer than usual. ⁣⁣⁣. Some kids bite because they're running on an empty tank. Frustration, teething discomfort, and overwhelming emotions can trigger this behavior. Tantrums are typically manipulative, where a child tries to get what they want by crying, screaming, or making a scene. Oct 19, 2023 · To find out about how I AM can offer support contact us at admin@i-am-autism. Next, convey to him as best you can that you won't let him hit and bite himself because you love him and it's your job to take care of him. This article related to autism may help as well. Feb 5, 2022 · 10 Ways to Get Your Kids to Stop Whining Ignore them. It has gotten to the point of leaving scar tissue. Aug 18, 2023 · Sensory overload occurs when one or more of the body's senses is overstimulated to a point where a person is unable to cope. Children on the spectrum are often affected by sensory processing disorders. The last part of the story tells children what sort of strategies they can use to calm themselves down instead of biting (e. This might leave their skin raw. So show him how to play by gently tagging him as you say “tag” and then jump away to invite him to tag you. Many children will do behaviors specifically because of the reaction they get from the people around them. The difficulty with a child with autism is that he may not understand the consequences of biting the same way that a child without this diagnosis might. Consult a pediatrician if you’re concerned about your child’s head banging or if it’s accompanied by other concerning behaviors. Sep 7, 2023 · Sensory interventions can help mitigate throwing behaviors by addressing sensory needs that often accompany autism. There is great importance in teaching alternative expressions of emotions to reduce biting incidents. If they’re about to hit you, grab and hold their hand firmly but kindly to prevent the blow. For a child with autism, stimming might involve motor tics like rocking back and forth, licking lips, flapping hands, or repetitive blinking. Kids have to use their words when they’re mad. Address your child with a firm "no biting!" or "biting hurts!" Keep it simple and easy for a toddler to understand. If problem behaviors persist or are severe you will need a Board Certified Jun 9, 2017 · A child’s aggression can be directed at self or others, and can be scary for everyone involved. Not every child with autism displays aggression. These may include: hair breakage and weak strands. -To get attention. express frustration, especially if they have trouble communicating effectively. (California) My son is 6 yrs old with Autism. It happens when your brain gets more information from your senses than it can process. Tangibles (get something) Avoid / escape. If they are not able to communicate It’s also important to talk to your kids about aggression during a calm moment. For a child with more limited language, just say “No biting people. This article made me angry and many of the comments made me sad. They feel the impulse to hit and then react immediately. In this section, we will discuss the reasons behind biting in toddlers. I don’t like it when Lukie bites. Help the child follow through on the choice if necessary. Give plenty of attention to the child who was bitten. By comforting the victim first, parents will be taking the first step in curbing the negative behavior. You want to show it isn’t acceptable (8). Parents or caregivers should also wash the affected area with soap and water. avoid certain activities or expectations. Some research suggests that children with autism are more likely to show aggressive behaviors than typically Aug 20, 2020 · Self-injurious behaviour. Communicate with your child: It is important to teach children how to communicate their needs and feelings effectively. Autism. For younger kids, those between 18 months and 2 years, keep it simple. It also explains that hitting hurts, which it does. This means avoiding yelling or reacting with anger, which can escalate the situation and make the child feel overwhelmed. Use a very patient tone of voice, and ask as little of them as possible to avoid further stressing them. Over-stimulation is common in children with special needs e. Plan in advance for their behaviour. Strategies to prevent aggression include working with your child’s therapists and teachers to create calming, predictable, and rewarding Feb 26, 2024 · Stop the Aggression Kindly. Blog. Instead, take a deep breath and use a neutral tone of voice to tell the child that biting is not okay. If the chomper bites before you can stop him, he needs a consequence. -As a stimming behaviour. Get physically close to your child and calmly prevent them from sinking their teeth into someone they're upset with. littleotterhealth. One effective strategy is to use positive reinforcement when they use their words instead of biting. If your child has been biting, watch them and step in before they do it again. The goal is to reduce the tension and shift your child’s attention. Our LocationsCareersOur PoliciesNon-Discrimination PolicyAnnual ReportSubscribeContact Us. In a steady voice, explain to your youngster that hitting, biting, kicking, and other aggressive behaviors are wrong. GET ACTIVE WITH HEAVY WORK ACTIVITIES. When he is happy, excited, mad, sad, he bites his hand. ” The tag gets around the problem of using words with a child with autism: many times our kids can’t understand words, and even if they understand, they can’t comply with the request. Sometimes a child will bite due to boredom and when they are looking for something to get attention or a reaction. If you see signs that your child might be on the verge of biting, you can: 1. Share this. A child who hits himself may have been hit, for instance, and one who bites himself may have been bitten back as punishment for biting other children. Pain. Tantrums and meltdowns also have different causes. Fortunately, she has not sustained any injury, choked on or swallowed these objects. Remaining as calm as possible will help Feb 6, 2014 · Otherwise, we have 2 articles on toddler biting on our website you may wish to look at: Why Toddlers Bite and How to Discourage a Child From Biting. 19. Hair twirling can escalate from a Sep 8, 2023 · Firm and Calm Response. [6] However, treatment looks a little differently for toddlers, who don't quite have the cognitive skills yet May 28, 2024 · Communication Strategies. When you notice your toddler is about to hit, it’s important to stop it. Don’t hesitate, even if they’re just trying without following through. It includes head banging, hand or arm biting, and scratching or pinching. The child who did the biting can help comfort the bitten child—if both parties agree. Oftentimes when there are sensory needs in the mouth, there are sensory needs outside of the mouth, too. A heavy focus on pairing and manding, as well as an 8 to 1 ratio for positive to negative comments, is usually helpful too. Be compassionate if they are upset. Jun 28, 2022 · Body-based regulations like stimming, jumping, etc. Activities that provide strong input on the child’s joint receptors help to decrease the need to chew and bite. Toddlers have disproportionate heads in comparison to their body, so headbutting often starts for lack of control. 5. A simple statement like this will show your child that you care and validate his Sep 10, 2023 · Strategies for Prevention. Oral fixation is very common among autistic children and people who have Sensory Processing Disorder (SPD). Depending on the trigger, it may not be easy to remove. For example, your baby bites you and Feb 23, 2018 · A 4-year-old girl with autism spectrum disorder (ASD) developed a new behaviour of biting hard objects over the previous 6 months. Even little teeth can break the skin. It is sensory, like he gets something from it. Another way to address and stop biting behavior in autistic children is through the use of effective communication strategies. By providing alternative communication methods and utilizing sensory tools, parents and caregivers can help their children express their needs and reduce the likelihood of biting incidents. Hitting, Biting, Spitting, & Scratching Social Stories from MckSpeechie on Teachers Pay Teachers - A set of 4 one page social stories on a variety of aggression related topics. Before giving your child ADHD medication consider all the side Nov 29, 2022 · The first thing to do for any biting injury is to wash the area with soap and water. Make sure to avoid giving attention to the child who did the biting, even if the attention is negative. ⁣⁣⁣. It may be verbal (shouting, screaming, cursing) and/or physical ( hitting, kicking, biting, destroying property, self-injury). Intervention is also an important part of dealing with a biting toddler. Never bite a child back to punish or show him how it feels to be bitten. There are many reasons why toddlers may bite, including: Teething: Biting can provide some relief to the discomfort caused by teething. If a teething child is trying out his or her teeth, find toys to chew and chomp on. Even if most of your words sail over his head, he'll get your point — and have the proof of Nail biting, twirling your hair, drumming your fingers on the table, or cracking your knuckles are all forms of stimming. Once the cause is recognized, parents and children can work on a plan to address the behaviors. Sat Closed. ”. Jun 15, 2022 · How to redirect children with autism who hit. Sep 14, 2023 · How to stop toddler from biting when mad. The first thing a parent must do is figure out the underlying causes of the child’s nail-biting. Specialist bodysuits and other autism friendly clothing are fantastic tools to help parents prevent stimming. Perform first aid if necessary. Our guide explains possible causes, things you can do when it happens, and ways you can try to prevent it happening. Run around the house or room with increased energy. I have an autistic grandchild who is 3. Finally we have prevention. Jul 5, 2024 · 1. People who are experiencing sensory overload may feel irritable, anxious, or emotional. Jun 3, 2024 · Use your voice and expression to show that biting is not acceptable. If you can understand why your autistic child is behaving aggressively or hurting themselves, you can develop a plan for avoiding the behaviour in future. Autistic children may revert to harmful stims if they are under large amounts of stress. It is helpful for these children to learn how to identify the physical cues or bodily sensations which indicate that they Jun 2, 2022 · For many toddlers, boredom leads to mischief. Some autistic children bite themselves as a form of self-stimulatory behavior, or “stimming. In extreme circumstances or emergencies, call 999. Protect the child from any violence, mistreatment, or abuse. Generally, there are four main functions (reasons) for behavior: Attention. Make sure your child isn't hungry before plunging into the social pool. At this age, our little ones are learning new skills every day. Clap-Growl. Nov 12, 2021 · Fri 8:30am - 5pm. If the wound is bleeding, apply pressure with a clean cloth until the bleeding stops. Since truly a child’s health and well-being Feb 21, 2023 · Someone with autism might develop an oral fixation for many reasons, including: Medical: easing pain, alleviating discomfort. Encourage your child to use words to express themselves instead of biting. , stress, anxiety, frustration, etc. REGISTERED 501(C)(3). It’s important to respond to biting in a firm and calm manner. Aggression can also manifest if a child is taking an inappropriate dose or type of medication. So if you need a short social story, these might do the trick. info@aghope. Once he is enjoying the game, stop the play using clear body language. When your child begins to whine, simply leave the room. Don't jump to any conclusions, of course, but do keep this in mind as you talk to your child's caregivers and relatives about his behavior. Jul 14, 2020 · Hair twirling can have some side effects. It is wrong. tangled and knotted hair. Additional examples of Sep 11, 2023 · However, understanding why toddlers bite can help prevent and manage this behavior. It’s a way of getting to know their world. ), which may lead to behavioral outbursts like biting. May 30, 2016 · It is appropriate to hold your young child firmly, if needed, to prevent them from harming or continuing to harm, whether it’s stopping before the harm has happened, “I won’t let you hit or bite me”, and firmly holding your child facing away from you; maybe on your lap in a basket hold with your arms. Provide a variety of jumping, pushing, lifting and “heavy work” activities throughout the day. You might need to ask a third person to join in the game to help demonstrate. Creating a soothing bedtime routine can help reduce head banging before sleep. It’s a child-friendly way to explain why biting is wrong, and what we can do to stop ourselves from biting Autism Speaks has developed a medication decision aid to help you work with your child’s physician to determine whether this option fits your family’s goals and values. Hold them and explain, “No hitting. Provide comfort: Sometimes, toddlers may bite because they are feeling overwhelmed or overtired. Babies put things into their mouths to explore and learn through taste and touch. Mar 13, 2020 · Here’s are some options to try: 1. Distract your child with a toy or book. A person with dermatophagia compulsively bites, gnaws, or eats their skin. In fact, the key to controlling problem behavior, in general, is to spend 95% of your time preventing problem behaviors, not reacting to them. uk or give us a call on 0161 866 8483. Each week I provide you with some of my ideas 3 days ago · The Difference Between a Tantrum and an Autistic Meltdown. In addition, apply an antiseptic cream to the wound to prevent infection. The behaviour has not gotten better over time and she would always explore toys made of hard material ( video 1) this way. Avoid getting angry, yelling, or shaming a child. If Feb 5, 2020 · Stop The Behavior: Stopping the behavior is the first step to properly managing anger episodes. 2. Feb 2, 2024 · Understanding the reasons behind biting in autistic children can help in managing and reducing this challenging behavior. Introduces alternative communication methods while ensuring safety. Use as few words as possible and provide reassurance through self-regulation and calming tools. Dec 2, 2023 · Deflect and Redirect. Self-stimulation. Have a yoga ball chair at home and at school to help provide vestibular input (make sure it is stable with a proper back). It seems he does not even feel it when he is doing the hand biting. , are often purposeful and used as coping mechanisms for sensory imbalances. Here’s how to stop this dangerous behavior fast: 1. Don’t immediately explain why hitting isn’t okay. 🧠 This isn’t easy! Sometimes, these big feelings bubble up into a tantrum. oz ot qk pu md zm ae qk iy if