start and as a system we need to start a lot earlier in screening because often times, for example, dr. burke in her clinical practice will identify a 3-year-old whose mom is homeless and there is domestic violence and the mom is challenged with substance abuse and when she does a full physical exam of that 3-year-old there are no symptoms and so the idea is how can we start earlier and often, and part of what we have to do is develop the screening tools and i think that every place where a child is, identify appropriate ways to screen for these risk factors because that is really what they are, and they are risk factor and if we ignore them then the out comes are predictable and if we intervene, we have great stories to tell. >> i am the true believer that the sooner you catch it the better. >> yeah. >> and when i heard this young lady's story and it seems like, it was in the system. >> to really help people like her. >> yeah. >> and at a much earlier time. >> that is right. and i will leave that to the city agency to talk about how they could have intervened at various points or did. >> tha