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...