When to transition to baby cereal and/or pureeds Stage one baby foods

This question seems to come up a lot in the feeding world....

Why? Well, my personal thought on this topic... is that back in the 1980's and before...... it was believed that babies should start getting baby cereals as early as possible because doing this would help them to sleep through the night. Thats why today in 2009...when we are asked..."How is he sleeping"...we cringe...because we know when we say..."oh...pretty good, some nights are better than others though"...that we are going to hear..."well, he is up because he is hungry...you need to start giving him baby cereal".

Soooo...whats the answer? When should you start? Were they right in the 80's? Does giving to them earlier help them sleep better?

Most pediatricians recommend the following as a standard of when to introduce baby cereals and pureeds:

* Start rice cereal between 4-6 months of age
NOTE: we say rice cereal because it is the least likely out of oat, wheat, mixed and rice to have an allergic reaction.
NOTE: if your family has food allergies, intolerhances, or seasonal allergies try to wait to introduce the cereal until as close to 6 months as possible.
NOTE: After you introduce the the rice cereal...monitor your baby for any reactions...constipation, diarrhea, vomiting, increase in spitting up, skin rashes, irritability, etc..these could be signs of an allergy or a sign that your baby's tummy isn't ready for solid foods yet...wait two weeks then try again.

So...start rice cereal between 4-6 months of age...CHECK...got it...but...uh...why?

Well...for several reasons. God designed little ones to start taking cereals at this age...how cool is that! Between 4-6 months of age, the infant's "fat pads" (aka their chubby cheeks) start to get less chubby inside their mouths...which gives them more room in their mouth...

Aha! Isn't that awesome! When infants are drinking liquids they need less room in their mouths...but in order to introduce pureeds...they need a little bit more room...so what does God do...he makes that possible by decreasing the fat pads in their cheeks and giving the babies that extra room that they need!

Another reason is that between the ages of 4-6 months babies start being able to sit up more..they are gaining more external stability..they are a little less "floppy" :) Their heads need less support. This gain in stability allows all of their energy to be focused on their mouths..and the fine motor movements needed to eat cereals and/or pureeds... their tongues transition from an "in/out" movement needed in sucking from a bottle to a more complex oral motor movement needed to eat cereals. At the beginning of trialing with the cereal your baby may push the cereal out of their mouths with their tongue (because they are used to doing this movement when they sucked on the bottle)...but as they gain experience in eating the cereal their tongue will stop pushing the food out...and will begin to remain quiet in the oral cavity (aka mouth)...and will wait for the spoon to approach...

NOTE: in order to decrease the forward tongue motion...as you put the spoon in their mouth...put some firm downward pressure on their tongue...this does 2 things...it helps to train their oral muscles to change to the new motion...and it helps increase their upper lip to close over the spoon and help to get the bolus (aka food) off the spoon instead of needing you to scrape it on their gums as you remove the spoon.

Another reason for waiting is that....research has found that delaying introduction of cereals and pureeds until 4-6 months (closer to 6 months is better)...helps to prevent future allergies and intolerhances to foods. Before 4-6 months babies do not have a mature enough digestive system to handle anything but formula or breastmilk...they just aren't ready yet...they need more time. Giving the food too early can hurt the digestive system in your baby.

So thats it...

When should you introduce baby cereal? 4-6 months...but try to wait as close as possible to 6 months...they just aren't ready before that...their tummy isn't ready, their mouth isn't ready and their muscles aren't ready...

NOTE: if your little one was pre-mature..you will need to use their adjusted age in order to determine when to introduce cereals...meaning if they were born 8 weeks early and they are 4 months chronological age...and 2 months adjusted age...then they are too young to start cereals!! Actually, it is recommended that infants that were born premature should wait until their adjusted age is 6 months before they start cereals...because their little systems are even more sensitive....meaning that the above mentioned child would need to be 8 months chronological age and 6 months adjusted before starting cereals!!

** As allows it is recommended that you always check with your pediatrician...if he/she says to wait longer...then wait longer...I just wouldn't introduce them ANY EARLIER THAN 4-6 MONTHS IF AT ALL POSSIBLE!!!!

Toys/Materials a speech therapist recommends

Toys that a Speech Therapist would buy…..

**Any of the Sandra Boynton books-they have repetitive lines that the kids can repeat (moo, baa, lalala- is my favorite)

**Books that have pictures-not story books

**Books that have animals-to get kids to imitate animal sounds and label pictures

**Toys that don't make noise-so kids have to use imagination and make the animal sounds themselves instead of the toy doing it for them

**Ring Stackers- Good for problem solving skills as well as playing "peek-a-boo" through the rings...etc..

**First words card- Scholastic has a ton of different cards that kids can touch and feel as they learn...Amazon.com has them for great deals...at Toys R Us they are about 10-15 dollars...

**Baby Signs are great for the little ones to start using to communicate (easy signs like "more", "all-done", "please", etc...)
Amazon.com has great deals on these as well

**Musical Instruments facilitate speech...through imitating sounds while playing and imiaginative play

**Toy Telephones-to practice pretend conversations and role play (i.e., hi mama..uh-huh...okay..bye-bye, etc...)

**Toy babies..with bottles, spoons, bowls, blankets, etc... helps to facilatate language through imaginative play

**Toy foods and kitchens set the stage for imaginative play

**Toy picnic-same idea..give the props to help
set the stage for imaginative play...
don't provide toys that do all the work for kid
(meaning-don't get noisy, light-up toys)

**Toy house, or people-so kids can make up
conversations and scenarios with toys

**Toy tools-where child has to make up scene
and imagine what to build

**Get tupper-ware container, put in sand or rice and hide bugs,
or objects and have kids dig to find objects...talk about what
they find....etc...

hope that helps :)

Learning to feed in the NICU

This little one is 5 days old....the speech therapist is illiciting a sucking reflex with his finger which has a little bit of milk on it. This helps to ease the infant into oral feeds (aka bottle feeds)...each time the infant does this the therapist tries to make sure the suck is rhythmical and tries to make the infant last longer with their suck before the tire. Pretty soon this little one will have a suck that is strong enough to feed using a syringe...and then hopefully move to a bottle. This infant is probably getting all of its nutrients through a feeding tube right now...eventually that will be taken out as the infant becomes more efficient on the bottle :)
http://www.youtube.com/watch?v=9TSfWiGYwfM


This little one has graduated from the video above to syringe feeding with a finger...the finger is there for a couple reasons...1.) it slows down the flow of the liquid 2.) if the baby stops sucking the finger can move inside the mouth triggering a reflux that makes the baby suck again 3.) The finger can move rhythmical giving the baby a tactile cue so that they can regulate their suck into a rhythm
http://www.youtube.com/watch?v=5tfIVmKtcv0&feature=related

Barium Swallow Studies..aka...Xray of children swallowing

Below is a video of a little girl taking a bottle. What the speech therapist is looking for...is that she has a rhythmical swallow, that she is clearing the liquid (meaning that it isn't getting stuck in her pharynx...the tube leading the the tummy and the lungs), that there is no aspiration (aka the liquid goes down the esophagus to the stomach..not into the trachea and into the lungs), and they are checking general anatomical structures to make sure they are functioning correctly. The speech therapist may also be checking to make sure the child isn't refluxing (aka the liquid isn't coming back up once it is in her tummy..or in the pharynx). Watch closely..this child will aspirate towards the end of the video.
http://www.youtube.com/watch?v=tcjEyDtJYYY&feature=related


This little guy is having difficulty triggering his swallow (meaning the liquid is getting stuck in his mouth...or it is going into his pharynx without the swallow triggering which is causing the liquid to come back up and out his mouth)...he is continually holding the liquid and spitting it out.
http://www.youtube.com/watch?v=K7MV2C-MVZE&feature=related

This is just a video of a cute little baby getting a swallow study. I think they are trying to determine if he is safe for oral feeds (feeding through the mouth via bottle)...He is also trying towards the end to intitiate a suck...he is holding the nipple in his mouth but isn't sucking...this may be due to him needing more stimulation to get the suck going...and/or he is having trouble breathing..so he is choosing to breathe instead of swallow (which I would choose that too)...or he is having trouble establishing a rhythimical suck..he isn't getting into a groove of swallow, then breathe, then swallow, then breathe...
http://www.youtube.com/watch?v=JHlrKHg6awU&feature=related

If your child is going in for one of these evaluations. Expect the speech therapist to probably take you back with them...and give your child a liquid, a pureed, a solid...all covered in barium...the white stuff that helps the food to show up on the xray. Kids are actually usually okay with this procedure...it doesn't hurt....and the barium although it tastes "chalky" isn;'t really too bad :)

Ask your speech therapist before going to the evaluation if she would like you to bring the spoon you use at home, the sippy cup and/or bottle, the bowls you use, etc...sometimes speech therapists have you bring familiar tools...so that the child is more comfortable and so that they get a more accurate picture of what exactly is going on when the child is swallowing at home.

An Inspiring song...

I can almost see it
That dream I am dreaming
But there's a voice inside my head saying"You'll never reach it"
Every step I'm taking
Every move I make feels
Lost with no direction
My faith is shaking
But I gotta keep trying
Gotta keep my head held high
There's always gonna be another mountain
I'm always gonna wanna make it move
Always gonna be a uphill battle
Sometimes I'm gonna have to lose
Ain't about how fast I get there
Ain't about what's waiting on the other side
It's the climb
The struggles I'm facing
The chances I'm taking
Sometimes might knock me down
But no, I'm not breaking
I may not know it
But these are the moments thatI'm gonna remember most, yeah
Just gotta keep going
And I, I got to be strong
Just keep pushing on'
Cause there's always gonna be another mountain
I'm always gonna wanna make it move
Always gonna be a uphill battle
Sometimes I'm gonna have to lose
Ain't about how fast I get there
Ain't about what's waiting on the other side
It's the climb, yeah!
There's always gonna be another mountain
I'm always gonna wanna make it move
Always gonna be an uphill battle
Somebody's gonna have to lose
Ain't about how fast I get there
Ain't about what's waiting on the other side
It's the climb, yeah!
Keep on moving, keep climbing
Keep the faith, babyIt's all about, it's all about the climb
Keep the faith, keep your faith!
By Miley Cyrus

I just think this song is a good reminder to keep our focus on God...and focus on "climbing" because its an "uphill battle" to continue to grow closer in relationship with Christ...we just have to keep going and keep the faith..God has a purpose for each one of us...We aren't always going to get what we think we want...but we will always get what God wants us to get...Sometimes life is full of struggles but we need to remember that God is a loving God and he never changes...he is the one thing in our lives that we can count on...

So keep climbing...keep focusing on God...keep praying that God be in charge of your life...lifes about "the climb"...its about keeping our focus on our ultimate goal...serving & loving God...our end goal should be eternity spent with him...

What a speech evaluation looks like.....

First let me say...
If your child needs a speech-language evaluation...don't worry! It really should be a pretty laid-back experience.

When you arrive at the clinic you and your child will be taken to a therapy room. Therapy rooms typically look "happier" than doctor offices...so no worries your little one won't be scared they are visiting the doctor and getting shots :(

Once inside the room the clinician (aka the speech therapist) will either jump right into the evaluation or begin with some medical history questions.

What type of questions???

Here is a list of some of the questions that might be asked...keep in mind its not all of the questions, just some:

1.) Why are you here today? (meaning...who referred you...your pediatrician, a family member, a teacher, or yourself)

2.) What is your main concern? (are you having trouble understanding what your child is saying, do they not have enough spoken words, are they not following directions, etc...) Basically, whats going on???

3.) Was he/she full-term?
- if premature how many weeks?
- what was the birth weight?
-Any complications during the pregnancy or at birth?
-Was the birth c-section, vaginal? Was he/she breech, were forceps needed, etc...
-What were his/her apgar scores?

4.) Did he/she pass their newborn hearing screening at birth?
-do you have any current concerns with their hearing?
- Have they had their hearing tested recently?

5.) Any diagnosis for cerebral palsy? Hypotonia? Cleft lip/Cleft Palate? Down Syndrome? Autism?

6.) Any hospitalizations since birth?

7.) Any ear infections? How many? Did they clear up with antibiotics? Were they in both ears or just one? Do they have tubes in their ears? When were they placed?

8.) Did your child babble much as an infant?

9.) At what age did your child crawl & walk?

10.) Is there a family history of developmental delays, medical conditions, speech therapy, learning disabilities, siezures, etc...

11.) How does your child make clear their wants & needs? (gesturing, grunting, pointing, etc..)

12.) What words does your child say?

13.) Does your child imitate your words or sounds or phrasing (rising intonation for questions)?

14.) Does your child understand your speech? What you are telling them?

15.) Does your child play "people games" (peek-a-boo, I'm gonna get you) etc..

16.) Do you or your child become frustrated with their communication skills?

17.) What are your expectations for speech/language therapy?

18.) Was your child breast or bottle fed?
- How did that go?
-How did they do and when did they transition to pureed (baby foods)?
-Do they currently eat different types and textures of foods?
-Do they drink from an open cup or sippy?
- Do they use a spoon independently?
-Do they use a straw?


Whew! Lots of questions I know... After the questions..the speech therapist will probably "play" with your child for a while. They are primarily during this time going to try to illicit some communication and see what they can get your child to do spontaneously...

After that...the speech therapist will begin her formal assessment. Typically, a speech therapist will look at 7 domains...

Auditory comprehension (the ability to understand spoken language)
Expressive communication (the ability to use a variety of gestures &/or words, phrases and sentences to communicate a message)
Pragmatics/Functional communication (communicative intentions and ability to follow social rules governing use of language in context)
Phonology/Speech Sound Development: (Sound development and clarity of speech)
Voice: ( vocal volume, pitch, quality and resonance)
Fluency/Prosody(ability to use smooth, flowing and effortless speech with appropriate rhythm and rate)
Oral-motor/feeding: (ability to use facial/oral structures appropriately for facial expressions, speaking and chewing/swallowing)

She will complete the evaluation of these areas through various pictures, observing behaviors, asking you additional questions, and illiciting responses from your child.

At the end of the evaluation...the therapist will typically score the evaluation and let you know the results...and based upon those results therapy will be recommended or not recommended. The frequency of therapy is recommended based on those scores too...Every other week, weekly, monthly, monitoring, etc...

Following the eval and recommendations...you will recieve a full typed report within a couple of weeks detailing what was seen during the eval, the full scores of the assessments, and the recommendations.

I would encourage you that if therapy was recommended and it has been a couple of weeks since the completion of the eval that you keep tabs on scheduling their first speech appointment. Call and ask what you can do to help to speed things along and get your child scheduled. Sometimes we are tied up waiting for the pediatricians to sign a prescription for speech therapy...sometimes its insurance companies, and sometimes WE as an agency need to be reminded to hurry ourselves along too :)

Book review of "From Eternity to Here" by Frank

I was contacted by a publishing company and asked to do a review on a recently published christian novel....welp...here is that review...enjoy the break from Speech & Feeding :)

This book was an in-depth, thought provoking journey through God's word intrepreted for the "every day reader". Frank began with God's beginning...the story of "adam & Eve" and then walked the reader through the bible all the way until the story of revelations. It was very insightful, intriguing, personal account of the greatest love story the world has ever known, the story of Jesus Christ.

"From Eternity to here" is a book that makes a comparison, one that Christ himself makes thoughout the bible, of Jesus being the "groom" and the "Bride" being his church. As I read the pages in the first portion of this book I was captured by how Frank described in detail the love that Jesus has for us....his bride...his church. I couldn't wait to get to the next chapter to learn more and understand more fully what exactly "God's purpose" is...I felt like a child who was caught in awa as she realized just how truly awesome our father in heaven is....and how much he loves us!!

At the end of the book Frank ties everything together and then energizes the church to rise to the standards that Christ set forth for us. He speaks of how when Jesus came that he taught of "his body" aka the "church" being united. It made sense to me..how if we (i.e., christians) are the arms, hands, legs, and feet of Christ...that we must be united...because anything less than a "whole" form does not allow Christ to have all the "parts of his body" working fluidly...and without fluidity..his body (i.e., the church) is not fulfilling God's purpose to the standard that he gave us...we are not giving it 100%. In the book of John in the bible...Jesus talks of uniting..that there should be no division amount the churches..and Frank breaks down that passage and helps his readers to fully understand the weight and urgency of that message. This book also gave me a re-newed passion to dig further into the word of God (aka the bible) to learn more about my heavenly father.

I caution though that I am not a "biblical scholar" nor do I claim to be "well versed" in everything that God says in the bible...so...although I truly enjoyed the book...I have to wonder if it was actually based on the true word of God or Frank's interpretation of the word of God. We recently talked about, in our small group bible study how to discern if something is "from God" or if it is not...like that guy who wrote "your best life now"...sometimes things sound convincing and sound "peachy" but they don't line up with God's word. Sooo...what I am saying is...sadly I don't know enough about the bible to say if Frank's book is true or not...but I can say that the book is good...very good and...when more people read the book that are "Well-versed" in the bible...please share :)

Liquids, Liquids, Liquids..how much do I give my child?

Believe it or not this is a HUGE question among mothers, fathers, grandparents and caregivers...How much liquid does my child need during the day?

It really is a good question...I mean...you give too little liquids and you have a dehydrated little one on your hands...and you give too much and now you have a little one that wants to "Drink" their dinner...where is the happy medium???

Well, let me first start by saying that children below 4 years of age don't need as much liquid as most of us would guess...and they certainly don't require any juice...they could go their whole childhood without drinking juice and be just fine....now water & milk...thats another thing...those are important...but juice....

I say this because although juice is good in that it helps our little ones to get some veggies (V8 Fusion) and fruits into their diets...you have to be careful and read the labels with juice...they are tricky!! Lots and lots of juices are primarily sugar...if you see "high fructose corn syrup" anywhere on the label, put it back on the shelf...

Too much sugar can cause a child whose tummy is rumbling for food...to stop because they got a quick fix of some sugar. I would suggest that if your child is not eating meals that you drastically limit the amount of juice that you allow...now do this gradually...add more and more water to the juice until the child is basically drinking just water and then make the switch to only water....or if you can't give up juice completely then feed your child first and then offer the juice at the very end of the meal...as a kind of "dessert".

Okay back to the quantities of liquids...well dieticians recommend the following:

For children ages 1 -6 years of age: 4-6 ounces
For children over 6 years of age: 8-12 ounces

WOW! Are you shocked! Look at your child's sippy cup...it probably is 6-8 ounces! That means technically they only need 1 of those a day...

Does that mean if your child asks for more you should not give it to them? Certainly not...it means that if they ask for more...give them water.

How much milk should a child get?

Dieticians recommend:

1/2 of a cup of milk for children 1 year to 4 years of age
1 full cup for children over 4 years of age

WOW! Yep, although milk is great for their little bones...milk intake also needs to be monitored. Why? Well, too much milk will also reduce your child's appetite for other needed nutrients like those yummy veggies, fruits, meats, cheese, etc... Milk is great, but they also need room in their tummies to eat those other GREAT foods....

The bottom line....

Keep close tabs...if your child's appetite is diminishing check his/her liquid intake...

Pacifiers & Speech Development

Pacifiers...Pacifiers...Pacifiers...are they good? or are they bad? Should you use them? Or should you not?

Let me start by first saying that...yes, as of today current research is showing that babies benefit from the use of pacifiers. Plus it helps out those breastfeeding mothers by giving them "a break" when they have an extra hungry little guy :)

I need to also say though..that pacifiers can also be detrimental to your baby if...
1.) If your baby is an extra sleepy baby & falls alseep mid-feeds or has trouble waking up to feed..then don't waste time giving him a pacifier...he needs the calories from an actual feed when he is up.
2.) If your baby is a premie...be careful with the pacifiers. We (speech-feeding therapists) recommend the use of pacifiers to pre-term infants to help them develop a stronger suck..so when we introduce oral feeds (aka bottle feeds) they are able to handle it...(they practiced on the pacifiers)...but...be careful with this..although we want our babies to build up strenght and establish a sucking pattern...we don't want them to "Tire out" on the pacifiers and then try to have them feed from a bottle. We are just asking for trouble. We want our infants to be ready & awake when they feed...especially if they are premies and that sucking action is taking a lot of strength to do.
3.) You just need to watch your baby...if you think the pacifier is in anyway hindering or causing your baby to be dis-interested in feedings then cut-back on the time he is sucking away :)

So....what your saying is that pacifiers are bad?

Nope! Not at all! Pacifiers can be great, but good things need to be used in moderation :)

How long is too long to be using a pacifier?

Well...let me explain something about oral motor(mouth muscles) development. God designed our mouths to develop in a very systematic way. At about 2 years of age the back of our tongue while have dropped to a height where continuing with the pacifier will begin to hinger speech sound development...Meaning that, if you look in a babies mouth (its really prevalent in the 0-4 month olds)..you will notice that their tongue almost has a "hump-like" position..and the "hump" is in the back of the tongue. This protects the babies from swallowing non-liquid items...it also helps them to have an easier time doing that "sucking action" needed when drinking from breast or bottle...the "hump" helps the tongue do a rythmical movement (almost like a wave). You can see this happen if you watch a little baby feed. As the baby ages...and begins to transition to solids..the back of the tongue..the "hump" drops to a more adult level.

Which really makes sense if you think about it. How could a child eat table foods if their tongue was "humped"..they wouldn't have enough space for the food to go..let alone enough space to move the food around and chew..hmmm...but...God had that all figured out...and he created our "humps" to go away...slowly...very slowly...

So anyway...at about 2 years of age that "hump" has dropped to a level where they now have a larger oral cavity (aka mouth)..and that tongue is now FREE to move around and explore. If....we continue to use a pacifier past this point..then our tongue misses out on those chances to explore our mouth because it is still "filled-up" with a pacifier...it no longer has the "hump" but has a " pacifier" instead....hmmm...

When a child's tongue is exploring during this stage...it is figuring out how to say more clearly..the "tongue sounds"...like the "t", "d", "s", "n", "z", etc...

Try each of those sounds...say "tuh-tuh-tuh"..do you feel your tongue hit the roof of your mouth each time you say that sound? If a child has a pacifier in their mouth when they try to say those sounds for the first time they get a more "Slushy sound" because their tongue is blocked by the pacifier.

So...in conclusion...I know its hard...but get rid of the pacifier by 2 years of age...that means start weaning it away at 18months so its completely gone at 2...so their tongue will be "Free" to explore and learn during that critical time. God designed each stage of development...he wanted our children to be ready for those "Tongue sounds" at that age...we need to give our kids the opportunities to follow the development plan that God designed :)

Eat your fruits & veggies!!!

Having trouble getting your little "picky eater" to eat their fruits and veggies??? Well..you are not alone!! Think about fruits and veggies...think about the taste, texture and the smell...now think about the foods that your little one LOVES. Eating a potato chip is very different than eating a pea or peaches. For one..a potato chip is dry and crunchy...if you close your eyes while eating a potato chip you can hear the crunching. All of these properties of the potato chip cause certain sensory receptors to be activated...When we eat a pea..it is soft, mushy and doesn't provide that auditory feedback that a potato chip gives as we "chew, chew, chew"..and in fact..as we chew the pea it releases water or liquid into our mouth...hmmm...pretty opposite from a chip.

Don't lose hope! For those little ones that are not eating their veggies because they prefer those starchy, crunchy, carbohydrate foods well...here is a little feeding therapist secret....

Below is a website with tons of veggies and fruits:

http://www.justtomatoes.com/OJPEAS-P.html

(most natural &/or organic food stores carry this brand..but the website has the most variety-its kind of expensive but lasts forever..and most foodstores have coupons..shop the sales!!)

I;m new at this internet stuff..but I think you can just click on the link above and it will take you to the site. This site is full of veggies and fruits that will give your child some of the same sensory properties as those crunchy, starchy, carbohydrate foods....thats right...this site has veggies and fruits of all different kinds that are crunchy!!!

The only difference between these fruits and veggies and the ones that we normally eat...is that these fruits & veggies do not contain ANY water...thats right...this company simply took real, organic fruits & veggies and dehydrated them...not to the consistency of raisins or those dried cranberries...but actually one step further...they took ALL the water out...these veggies and fruits are completely liquid free...which makes them crunchy and flavorful!! My personal favorite are the peas and the pineapples...but I encourage you to try them all out..they are all worth it!!

Soooo...now you have the crunchy veggies and fruits...now what??? Well...I would start by simply placing the new foods on your child's plate with his preferred foods...and seeing if he tries it. Remember success happens even if your child only lifted up a piece of the food and smelled it...keep trying it..putting it there...just make sure to not add pressure..Eat with your child...show him how to lick the food with his tongue to get just a little bit of a taste without the "Scariness" of putting a completely new food in his mouth..Show him the crunchy sound it makes by eating one yourself and talking about the sound it makes,etc.........

If your child is a little more aversive to new foods I would recommend seeing a feeding therapist...look in the phone book under "Speech-Language Pathologist" or ask your pediatrician for a referral. FYI though...you could start by placing the new foods on a seperate plate but in your child's reach..that way they can interact with the new foods on their "own terms". Anyway...hope that helps...let me know if you have noticed any other websites with some great foods on it too.

Learning Espanol

Have you ever felt called by God?

About 3 months ago..I was in Puerto Rico (my wonderful fiance earned a FREE trip from his work), and while walking in the rainforrest God became huge to me...I stood in awe of his greatness in that Rain Forrest..I took so many pictures that .my camera ran out of batteries. Although we were on the hike with several other people I felt like it was just Jeremiah (my fiance), me and God in the middle of the most beautiful scenery that I have ever seen...scenery that God created...it took my breath away...from the waterfalls..to the colorful flowers...it was amazing..and quiet..all you heard were the sounds of nature..of the animals of the forrest. It was there in that Rainforrest that I began praying...(I really do this often at home too, but in the rainforrest it was just somehow different...I felt so close to God that I could touch him). I talked with God about our upcoming wedding (only 1 1/2 months now)...I asked God to help our wedding & the reception to glorify him...I asked him to take our marriage and use it to further his plan on this earth. I honestly didn't feel an answer right then..but as we walked through the remainder of our hike I felt a peace come over me...I felt complete happiness..and I also felt the urge to "Do something"..that urge to just get up and change the world...or something "crazy" like that...it was an amazing feeling.

Two days later...we were on the bus ride driving back to the airport to leave...I was listening to Jeremiah's IPOD and the song "God of this City" came on....As I looked out the window I saw a man standing in the middle of the road with a can...he was asking people for money...I felt sad for this man...and then as I continued to look I realized how lucky we are...christians that is...We know that we have a savior...we have joy that only comes from loving him! I wanted to stop the bus right then and go tell the man all about Jesus (figuratively speaking of course..those that know me..know that I am a little quiet when it comes to being evangelical :)...and then I realized that I couldn't...I couldn't share Jesus with this man even if I gained the courage and the bus stopped...I couldn't share him with the man because I didn't speak his language. I was saddened by that fact. The next things I saw out of the bus window were shopping stores...La Carniceria (the meat shop), La Iglesia (The Church), La Farmacia (the pharmacy), etc...I had four years of spanish in high school so I was able to interpret some...and that made me excited..

I began to think...maybe...just maybe I could learn spanish...I could learn how to speak this man's language and someday...I could share Christ with him...maybe..just maybe...but how..and where?

The VERY next week...I recieved a course booklet from the community college here in town...I really didn't think much about it...I mean afterall I am getting married soon, and planning a wedding is pretty time consuming...not much time to be taking a course, and adding more work...as I flipped the pages I saw a course on "book writing", on "Learning to scuba dive" (I thought that one might be good for the honeymoon)...and then I came to the language page..."Conversational Spanish"...

No...it doesn't say that...not just "Learn Spanish"...but "Conversational Spanish"...thats exactly what I need! Instead of feeling excited though..I felt dread...I knew then what God was asking...I knew what he wanted from me...and I was scared! I hate admitting this...but I am a bit of a nerd..yep I know...but seriously..and the worst part is that I typically take part in things that are within my "comfort zone" and I am able to get "an A"...spanish is not in my comfort zone..I was sure it was going to be hard...I was sure I wasn't going to be the "A" student in the class...and that discouraged me..so I did the only thing possible I prayed...and I prayed...

And what was God's response...well...it was pretty clear...as I thought about spanish..One memory kept popping up...

I was doing a service opportunity with my church and was helping a lady who spoke spanish and she asked me if I knew spanish..I told her no...then she asked me "no spanish, some?" Meaning..do you know any Spanish..even a little at all..I said "no"...and the look on her face was sad...sad because now we couldn't really talk to eachother.

Soooo...I signed up the class...big gulp....Currently, the class has been going on now for about a month and a half...and I am learning Spanish..it is a great class..but it is SO HARD, and I am defintely NOT the smartest in the class...every night I go to it I know that I will prbably feel dumb an average of about 6-7 times..but I also know that everytime I go, I get a little better...I feel a little more confident in the language...and maybe someday...someday.....

I don't know what God has planned for me learning Spanish...but I know this...he has a plan and I know this is something he wants me to do. Who knows...maybe its just to get me to step out of my comfort zone....or maybe its to be a missionary in the dominican republic..my small group bible study is talking about taking a trip there...or maybe its to help a certain family through being a speech therapist...who knows...but isn't it exciting to know you are simply following God..following God without a clue as to what the result will be!

We learned in our small group bible study that in order to "walk on water" as Peter did...you first must "Get out of the boat"...well...this is me...stepping out in faith and touching my toes in the water...

God is good!

What can cause a speech delay?

Well...let me start by saying that every child is different...some are more into gross motor activites (learning to walk, exploring, etc..), some are into other fine motor tasks (coloring, puzzles, etc..), and some are just more interested in playing, etc...than learning how to talk. I say "Learn to talk" because although many people believe "talking" is an innate ability (aka..happens at birth without teaching)...that is a non-factual observation..when a child begins to talk it happens because they are pre-programmed (by God) to want to talk so they pay attention...but it is ultimately the environment, the stimulation,etc...that teaches them to actually say those first words....that being said...many things can interfere with children getting all the "learning" time that they need in order for those words to come.

The biggest cuplrit being ear infections....second on the list is fluid on the ears...What is that? Well...many children have fluid in their ear canal that just sits in there and clogs the canal...it never becomes an actual infection..the child is usually unaware of the fluid because it doesn't cause pain...it just sits there as a silent culprit...

How do I find out if my child has this? First I would suggest going to see an Otolaryngologist (ENT)...they usually have an audiologist (ear therapist) on staff who can test their hearing all in one visit.

What? My child could have limited hearing because of fluid and/or an infection?

You got it! Children with chronic ear infections or fluid on their ears often miss hearing some of the sounds...or they may hear a distorted version of the actual sound...Think about if you were in a swimming pool with a friend and you two were trying to talk back and forth under water...how well would you hear? How well do you hear all the sounds? Sometimes a speech therapist can pick out the kids that experienced fluid and/or ear infections...usually the kids are missing those higher frequency sounds.../s/, /f/, etc...

Along with ear infections sometimes comes chronic congestion...and yep..you guessed it this can also impede learning how to talk. Why? Well....when a child is chronically congested they are forced to breathe out of???? Yep...you guessed it their mouth...and if their mouths are constantly busy breathing...then how will they be able to have adequate opportunities to use their mouths to speak? Usually these children are missing the "lip sounds"...or the /b/ and /p/...why? Well...because in order to produce the "lip sounds" one must put their lips together and close their mouths...which is awfully hard to do if you need to keep your mouth open in order to breathe...yikes! These kids sometimes are also missing the "nasal" sounds or the /m/, /n/, and /ng/ sounds...Why? Well...the next time you have a cold and your nose is full try making the "mmmmmmmm" sound...what happens? Yep...you guessed it...the sound "Tickles" your nose..which is kind of uncomfortable. Why does this happen? Well because in order to produce a "nasal" sound the air has to flow through your nose....(There is a whole lot more to this...oral versus nasal sounds, etc...but we will talk about that later).

Soooo...back to those first words...so if you have child with chronic ear infections, congestion and fluid on their ears...WOW! How hard and unappealing would it be to speak when you can't hear the sounds correctly, it may "Tickle" your nose, and you can't close your mouth because you need it to breathe...yikes..I wouldn't talk either :) But don't lose heart...once you get those ear infections and/or fluid cleared up you will most likely soon start to hear those first words. I do feel like I should share that typically children that get their ear infections cleared up prior to...oh...I would say 15-18months usually have a less likely chance of needing speech therapy post-clear up of the infections...however...after 18 months I would recommend speech therapy...I know that may sound scary to some...but trust me speech therapy that is done correctly is fun for your child...and will help them to be able to speak clearly a whole lot faster..which in turn will help reduce some of that frustration that you and your child are probably feeling because its difficult to communicate. Just an FYI...in my opinion early intervention is the key here(birth to 3 years of age)...with early intervention you can help remediate their speech concerns prior to kindergarten...which is very important! Think about it...what happens in kindergarten through 2nd grade? Thats right...children learn to read!! Research has shown that speech difficulties while a child is learning to read can negatively impact their ability to do so successfully...why? Well...in a nutshell...if your child says "nake" for "Snake"...then they will most likely also spell "snake" without the /s/...and have a difficult time reading the word "Snake" if they think it is supposed to be "nake"....does that make sense? Another example...if your child says "wed" for "red"...then they may read the actual word "Wed" and not think "Wedding" but think the color "red"...

Another main cause of a speech delay is a family history of a delay...Why? Well...for example I was born with a small mouth...my mother's mouth...and when I was little my normal sized tongue did not fit well in my extra small oral cavity (aka mouth) so I would often push my tongue against my teeth...I needed therapy to correct that behavior...to train my tongue where to rest...how to stay back when I spoke or when I ate...etc...If your child has your mouth...wouldn't it make sense that if you had a speech delay then your child might also? Not only that...but if you have a family history of ear infections...a small ear canal...fluid on the ears...allergies which cause nasal congestion...etc...then wouldn't your child's experience with these make sense? My dad always says that I remind him of his sister (my aunt Karen) with the way that I move my hands and my fingers...hmmmm...genetics are a funny thing!

There are many more causes...but the main thing is that if you at all have concerns about your child's speech please speak with your pediatrician at your child's next well-child check-up....share your concerns...your pediatrician will probably make a referral for speech-language evaluation...which is a good thing...trust me...think about it....

If your child needs speech then...yep! You did the right thing by bringing up your concerns...and if they don't need speech therapy then you just got a peace of mind that they are within typical limits...either way you made the right decision by voicing your concerns...Its much better to be pro-active with speech than retro-active. As a child develops habits emerge and habits are hard to break...get them in before the habits are formed!!

Take piece in that....God knew and knows every hair on your child's head...and personally formed them..therefore your child is perfect...they are an image of God...and remember Speech Therapy is fun...so get excited if your child is on that path...you will see progress....just remember though that the best therapy for speech is practice...so when your therapist gives you homework...complete the assignments over and over and over again...:)

Trouble Transitioning to table foods...

Who ever thought that getting off those mushy baby foods and onto table foods would be so hard....hmmm...Well for some of our children making that transition is a big challenge.

Think about though...take a bite of applesauce and pay attention to the movements your tongue makes...what your teeth are doing...what your lips do as you take the bolus off of the spoon..etc..then, take a bite off of a cracker..feel what your lips do..your tongue, your teeth and your jaw...

Shocklingly different huh! Its amazing how many more movements our mouths need to make in order to simply eat a cracker.

Now...I know this sounds crazy..but break off a piece of that same cracker, put it on a spoon and take it into your mouth using the same movements as you did with the applesauce...once in your mouth use limited jaw/teeth movements...try to mash the cracker with your tongue against the roof of your mouth and let it dissolve some with your saliva. What happened? Did your tongue have to work overtime?

Its hard to do huh...its crazy to think that we can just hand our baby when they reach a certain age a harder substance and expect them to know what to do with that...when they are used to using the oral motor patterns needed for purees (applesauce consistency foods)...However, for most children this transition actually occurs without the child needing to be taught..God designed us this way...in some ways learning feeding is innate.

Side Note: Think about this...think about the sensory properties of the applesauce you ate...how did it feel...did it feel slimy, slippery, wet, chunky,etc...was it cold, warm, hot? Every food that we eat has sensory properties...now think about the cracker...what were its sensory properties...was it hard, crunchy...after you chewed the cracker did those properties stay the same? Or did they change..to softer, thick, or even goey? Thats another detail that table foods add for our kids to handle...not only do table foods need different oral motor patterns but they also shock our senses...because when you eat pureed Baby foods the sensory properties stay the same...applesauce doesn't become hard when we add saliva..however..table foods do change...a cracker doesn't stay hard once it becomes wet with saliva...it changes...and as it changes our senses have to adapt. WOW! No wonder transitioning is soooo difficult..and kids become "Picky" during this time.

Ex: The other day I worked with a little one who is having this problem...except "child B" was past the point of introducing table foods and is now to point where "child B" has decided eating table foods is hard...and "child B" would just like to stick to eating pureed Stage 2 baby foods...Typically, when presented with table foods "Child B" will throw the food, gag, or spit it out once in "child B's" mouth.

Here's a quick tidbit about making that transition....TAKE OFF THE PRESSURE...forcing him to eat the table foods would only make his "Behavior" worse...so we have taken a step back...and are giving him his preferred foods while making strategic steps that appear to be "just fun" for "child B" to getting those table foods to not cause an aversive reaction just by touching his lips.

more details to come later.....

Gluten-free thoughts....

Over the past several weeks I have been researching, asking questions and trying to do a gluten-free diet.

Why am I doing this?

Good Question...haha... :) Well...for a couple of reason.
1.) I feel that in order to be a more effective feeding therapist that I need to fully understand what it means and what my clients experience when they are asked to be on a gluten-free diet. I want to experience first hand what it means to eat the gluten-free food, to prepare it and to buy it. I want to be able to give my clients some good recipes that I personally like...I want to be able to give them authentic first hand advice on where to shop, whats good & whats not...etc...
2.) I am a nerd, and I wanted to know the research behind what a gluten-intolerhance looks like, so that I can make a proper and knowledgeable referral to a pediatrictian....
3.) I wanted to know and research links between gluten and autism...I wanted to know if there was a correlation between the two.

What I have I learned so far?
Well...I have learned that there are some AWESOME gluten-free chips... they are made with brown rice and they come in all different flavors..they are very yummy...and if you buy them at Meijer they are relatively the same price as other chips..(double plus)! I have also learned the I enjoy "SunButter" a gluten-free alternative to peanut butter...and I also like "gluten-free" Ranch dressing...actually I like it so much that I probably will always buy that instead of the gluten-filled ranch...Its actually made with yogurt instead of mayo...the make is "Bolthouse". I got that little tidbit from my colleague at work. I also got all the books and questions answered from her as well. She is wonderful and so helpful!

I have also learned a lot of interesting things about autism and the gluten-free diet...which I will share on a later post :) I have a feeling I will ramble on about that one...I tend to like talking about research and answering the "Why?" behind questions...and it seems that everyday there are more "why?" questions about autism...although I do think that we are making progress with being able to answer more of those questions.

Stopping food pocketing

Wow! What an interesting week at work! I have to share....I have a little 2 year old who I have been working with on trying to decrease the amount of food that is being pocketed in the cheeks, in order for this child to be a safer, more efficient eater. I was so proud of "Client A" (we can't tell gender, names or specifics for HIPPA privacy policy reasons) who slowly but surely is starting to pocket food less. How do you stop pocketing? Well...we (mom & I) started with changing the mealtime set-up. Instead of watching "child A" eat, mom & I became active participants with "the child". You've heard the expression "Lead by example"...well...the same is true about feeding...children learn by watching your example...if they are fed in a high chair seperated from the family or at a different time they miss out on watching the "Leaders" (their mom & dad) eat.

Then...mom & I started talking about what was happening to the food in our mouths as we chewed up the food. For example...if we were eating a pretzel rod...we would talk about and show (yes...in feeding therapy showing the chewed up food in your mouth is a necessity)...how we use our "Strong teeth" to "chew-chew-chew"...then we would talk about our tongue..."Uh-oh Mr. Pretzel is all smushed now..he needs some help getting off of my teeth...here comes Mr.Tongue"...We would EXAGGERATE moving our tongue to the lateral incisors and while keeping our mouths WIDE OPEN (for better visual effect) ...we show how to move the chewed up bolus (a bolus is food that has been chewed and is ready for swallow) to the tip of the tongue...then we would say "bye-bye" (overly exaggerating this as well) and with our mouth open show how the bolus moves to the back of the tongue and then we swallow...after the swallow we opened our mouths wide and showed the empty oral cavity...tah-dah..

We did lots and lots of this "play" with our food...talking about how some food is crunchy and some food is goey and needs "Mr. Tongue" more to get it to go bye-bye..etc...etc...

So thats it...you might be thinking...???

Well..not exactly...in "Child A's" case we also had to work on increasing oral motor skills through strategically placing food, cutting food into specific shapes in order to elicit a specific oral motor movement, chosing food that has specific textures, etc...etc..but pretty much this little one took off with feeding when we broke food down to his level and had "fun" while we ate. We also taught what to do with the bolus if we were tired of eating...aka we showed how to spit food out of our mouths...Hey :) Thats a lot better than "child A" keeping in the mouth and choking on it later...or making us be the bad people by using our finger to scrap out the leftover bolus...Safety first, right...Safety and then we can think about "manners" later :)

Special note :
Children are like open books..and sometimes we forget they still need lots of pages to be filled with "how to......". Children need models, they need explanations, they need to "Feel experiences" to remember them...especially a 2 year old...God gave us several senses in order to take in our world and the amazing thing about children is that when you explain "how to..." in a way that uses each of those senses...the children REMEMBER and begin doing it! WOW!

Is "Child A" done with therapy...well not quite yet but the little one is getting there and since "child A" has great parents who are carrying over all these "fun mealtime" changes "Child A" is learning quickly. Soon...

What I learned about baby development

Did you know just how perfectly formed babies are?

You know the bible verse in Jeremiah that speaks about God knowing each of us before we were formed in the womb...How amazing that is...and then you learn about the intricacies of the factual process of how exactly a baby is formed in the womb and then develops once born...and you have to think...wow...God is amazing!

Let me explain..did you know that the left side of a babies face forms seperately but at the same time as the right side of their face...and then during the early weeks of gestation the two sides fuze to form the "whole" face...the proof of this is our little Philtrum (the indented line running from your nose to your lips)..this happens as the sides fuze...its kind of like a scar...in a way :)

One of the most captivating tidbits about a babies development in utero is that the brain is fully developed by I believe 10 weeks of age...wow!

Once the baby is born development becomes more exciting!

Did you know that a baby is born with "Fatter" or "Chubby" cheeks for a reason. Yep, thats right...those chubby cheeks are also there not only to add more room for loving kisses but also to help protect baby from choking. The tongue in babies is enlarged when they are first born...well..not enlarged...but when compared to the rest of their oral cavity (aka the mouth) the tongue is rather large...

Did you know that having the tongue and the chubby cheeks act together to prevent food or other objects from choking a baby! God is good! He built in protection to keep safe our precious gifts!

Oh...this is cool too...did you know that the tongue in an infant is actually higher in the back of the mouth (raised)...and yep...you guessed it...this also helps to protect baby. The infants mouth is actually designed when they are first born to only take and accept liquids into their mouth...and since the way that their tongue moves is also a designed pattern (aka sucking & suckling) a baby does not use all of the taste buds on their tongue....because they do not use the whole surface area of the tongue when they feed...only the back portions...sooooo....if a baby is given a liquid that is bitter in taste they will automatically spit it out...because bitter taste does not taste good on the back part of our tongue...

Yep! You guessed it, another protection mechanism built in by God! Babies are designed to reject liquids that could be potentionally bad...I guess we should have known...the were designed by the Master Creator!

More cool things to come later :)