Archive for the ‘Language Delay’ Category

Stress

February 17, 2013

Stress from Google

Everyone is stressed! The fewer the stressors, the more opportunities for learning and development for children of all ages. Our goal is to identify and eliminate as many stressors as possible.

Environmental – Our homes and schools are full of stressors.
o Toxic Chemicals – Lead, mercury, antimony, aluminum, and other “heavy metals” reduce immunity, and interfere with the body’s ability to perform its many functions. Lead is “old news” and we know that any amount is unsafe for cognitive development. Every child should have lead levels tested.
Mercury, antimony, and aluminum are the “new” toxins that are also showing up in the bodies and brains of children with all types of delays. Their sources are power plants, ground water, petroleum plants, dental amalgams from the mother, vaccines, flame retardants, cookware, and other unlikely places. Read more about these metals here  and here.
Green your building with non-toxic materials for flooring, paint, cleaning supplies, building products, art and office supplies.
Chemicals from disinfectants, cleaners, building materials and other supplies “off gas” and when a person breathes them, they are toxic to the body. They are especially harmful to people with compromised immune systems, and those who have asthma.
The standard benchmark for design, construction, and operation of high-performance green buildings is LEED, which stands for Leadership in Energy and Environmental Design and was developed by the U.S. Green Building Council (USGBC). Find a green building in your city, learn who greened it and consult with them.  Here is a handbook on how to green an existing building.
o Air Pollution – Open the windows when possible. When too hot, make sure air conditioning equipment is clean and not moldy. Use HEPA (an acronym for “high efficiency particulate air”) indoor air filters throughout building. HEPA filters can trap a large amount of very small particles that vacuum cleaners recirculate back into the air.
o Fluorescent lighting – Replace with bulbs that do not make noise or flicker. Use bulbs that offer the right color of lighting. Read this article on lighting.
o Noise – Play soft, gentle music, such as Mozart, which is the same rate as the human heart beat. Read more information  on “The Mozart Effect.”
Biological – Our bodies are toxic waste dumps too. Reduce our exposures.
o Water – Good hydration is essential for learning. Ensuring that our drinking water is pure is one of the most important steps we can take for children with developmental delays. Water should be available and offered frequently. Use water filters throughout the building.
o Diet and Nutrition – What kids are eating can be the determining factor between health and sickness. This is especially true for children with developmental delays. Sugar is one of the most damaging of all products ingested. Read more about it here.
Encourage families to cook and not eat “fast food.” Help them understand the importance of a varied diet of natural foods, such as fruits, vegetables, good quality protein and good fats.
Research is showing that eliminating some foods from kids’ diets helps their development and learning tremendously. Many foods are shown to cause ear infections. Two types of foods that are particularly problematic for kids with delays are those containing gluten, the protein from wheat, and casein, the protein from dairy products. Read about gluten and dairy in many websites containing “gfcf.”
Children with Down syndrome have especially high nutritional needs. A company that specializes in the care and feeding of those with this genetic syndrome is Nutri-Chem, in Ottawa, Canada. The founder, Kent MacLeod, a pharmacist has written a book on the importance of diet and nutritional supplementation: Down Syndrome and Vitamin Therapy.
o Allergies – Many kids with developmental issues have allergies, not only to airborne particles, insects, and other environmental pests, but also to foods. Some allergies are life-threatening and immediate, such as shellfish and peanuts. Others are troublesome, causing fatigue, rashes, respiratory and digestive problems, and are delayed, taking hours or even days to show up. Read about the different kinds of allergic reactions here.

Physical – The physical body needs a good sensory diet and sleep to reduce stress.
o Movement – Use every opportunity to move to learn. Little children’s bodies learn by moving and using their senses of touch and having their muscles and joints take in sensations. Two good books about the importance of movement in learning are, Smart Moves: Why Learning is not all in Your Head, by Carla Hannaford, and Physical Activities for Improving Learning and Behavior by Cheatum. Obtain the workbook “Begin Where They Are,” with therapy activities, from http://oepf.org/product/begin-where-they-are-0.
o Reflexes – Over 100 different reflexes are programmed into the body to get the body moving appropriately. If demands on the body are premature, before the reflexes are fully integrated, then delayed development can be the result. Learn about reflexes through an intensive training session. Learn more about reflexes at http://masgutovamethod.com
o Vision – While some children have eyesight problems that can be corrected by glasses, others have vision issues, such as the two eyes not working together, in conditions called exotropia, esotropia and strabismus. Motor activities that are the foundation for vision development and the body must be strong to support binocular vision. The relationship between vision and learning can also be a training session for those at the center. To learn more about vision, read this.
A book explaining the role of vision in learning is How to Develop Your Child’s Intelligence by Getman.
o Hearing – Listening is to hearing as vision is to eyesight. Although a child can hear, his brain may not process what it hears. Several “listening programs” are available to help children give meaning to what they hear. Look here for understanding of this area.
o Sleep – Everyone needs uninterrupted sound sleep for their bodies to heal and repair. Pre-school aged children require 11-12 hours of sleep per night. Young children with disabilities might need more if they are contending with health issues. Help parents and teachers understand their kids’ need for rest periods. Read this.
Educational – Schools are often unknowingly a source of stress too.
o Inappropriate curriculum – All children learn in a predictable developmental sequence, just as they learn to walk before they run. We discourage teaching rote concepts such as the alphabet, counting and naming to young children. These skills will emerge when a child is developmentally ready. Here is an article on this subject.

o Non-ergonomic furniture – Sitting in small chairs when the trunk and head are not stable only results in compensatory techniques like tilting the head and rotating the hips. Replace hard, wooden chairs with soft gym mats, beanbags, cushions and pillows to help children develop core strength.

Emotional – Families have so many situations that add stress.
o Unreasonable expectations – This stressor is tied to the one above related to an inappropriate curriculum. Children want to please adults, and when they cannot comply with expectations, they become discouraged. Make sure that requirements are consistent with a child’s developmental age.
o Worries and fears – Some kids like being around many people; others find crowds difficult. It appeared that many of the children we saw were somewhat fearful of having so many adults watching and prodding them. Observations should be limited to one or two adults at a time until a child is comfortable emotionally.
o Family Issues – Today’s families, especially those with multiple children with disabilities, are under a great deal of stress. They need support systems to help them cope. Offer parent and sibling support groups where adults and children can share their experiences and learn from each other.

Behavioral – Treating symptoms is never the right answer.
o Medications – Pharmaceutical and over-the-counter drugs all have side effects which can cause behavioral symptoms as benign as restlessness and irritability, and as serious as rashes, seizures and fevers. They can also interfere with sensory processing, such as cause double vision and tactile defensiveness. Instead of treating symptoms, look for natural alternatives to prescription drugs, and search for underlying causes of illness, such as food allergies and toxicity,.
o Screen Time – While young children are attracted to the bright colors, sounds and movement of objects on computers, iPads, and iPhones, these two-dimensional objects are not good for development. To learn, children need to touch and see objects in three dimensions, not on flat screens. Please consider replacing electronic toys with playthings made out of natural materials. For non-verbal children, speaking with real people is superior to speaking to a machine. Psychologist Jane Healy is the expert on brain development and screen time. Please refer to her books, Failure to Connect: How Computers Affect Our Children’s Minds — and What We Can Do About It, and Your Child’s Growing Mind: Brain Development and Learning From Birth to Adolescence.

Summary
Even with loving, supportive parents and teachers, the our lifestyle and environment add stress to the lives of our children with developmental delays. Start with the physical environment, and reduce exposures to noise, light, toxins and sensory overload. Every time you replace a product, purchase one of higher quality with fewer toxins. Gradually, stressors will reduce, and the home and school will be more conducive places for learning and growing.

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Strabismus: Implications for Development

January 19, 2010

I received a beautiful holiday card from a lovely couple showing several pictures of their two young children. The three-year-old boy is playing ball and laughing. The year-old-girl is wearing glasses and staring into space unfocused with her mouth open. I last saw these children about a year ago, when the girl was just an infant; I had not spoken with her parents since.

It appears to me that this little lady has crossed eyes, also known as strabismus. Her development concerns me greatly.  Unknown to me is what treatment she is receiving. I know from experience that strabismus is a serious visual condition that affects the ability of the eyes and the brain to communicate. A strabismus rarely goes away untreated; children generally do NOT outgrow it.

No one knows this better than neuroscientist, Sue Barry, the author of Fixing My Gaze. I just finished reading her remarkable book, and recommend it highly.  You don’t have to be a scientist to understand the impact of going through life with misaligned eyes. 

What happens normally? As we scan our environment, not only must our two eyes simultaneously aim at the same object, but our brains must integrate a message from each eye into a single image. The process of fusion (combining the pictures from each eye into a single picture) enables us to perceive three-dimensional depth and helps us to determine our relationships to objects in our environment. Vision emerges as the primary sense when a typical child integrates it with touch, movement and the other senses.

What goes wrong?  In children with developmental delays, signs of incomplete or inefficient eye teaming (binocularity) usually appear around eighteen months, just when expressive language is emerging. However, later onset is not uncommon. Poor eye teaming can be associated with neurological disturbances related to heavy metal toxicity, high fevers and childhood illnesses such as strep or pneumonia. Dr. Melvin Kaplan found that about half of the children with autism that he examines have an undiagnosed strabismus.

Initially, the inability to efficiently and effectively team the eyes may appear only at times of illness, fatigue or intense concentration. However, frequently, the vulnerable binocularity can worsen; strabismus and amblyopia or a “lazy eye” can result. 

First, Strabismus… In strabismus, one eye accurately aims at the object of regard, while the other eye misses it by aiming above, below or to the left or right of it. Double vision (diplopia) then results. The misalignment may be constant or intermittent, and thus not always noticeable.  Disorganization and confusion follow as the brain struggles to integrate competing messages.

Next, Amblyopia…. In order to minimize the disorganization and confusion, sometimes the unconscious mind adapts to strabismus by suppressing signals from the faulty aiming eye.  Eventually, visual suppression leads to amblyopia or “lazy eye,” in which the nerves that transport and interpret visual information lose some of their ability. The result is poor vision in one eye, due to an interference in the neurological interpretive mechanism. 

In many instances the reduced vision cannot be corrected with glasses or surgery.  With the eyes functioning at less than 100% efficiency, any sustained visual activity such as reading may require extra effort and strain. As in strabismus, the only obvious sign of amblyopia may be an eye turn. However, some people with amblyopia may turn or tilt their heads to see certain things or close one eye when reading.  I diagnosed a possible strabismus in a child after looking at photos in which his head was tilted to the left in each and every one. 

Proper early developmental vision examinations by an optometrist trained to look at the whole child are essential. Eye turns cannot always be observed and require special testing. Untreated binocular vision problems can pose obstacles to development in many areas.

Strabismus & Amblyopia Affect Spatial Relations and Balance Usually, such as in the holiday photo, cosmetic aspect of misalignment is obvious. Even more important are the effects on function and vision, because strabismus disrupts the ability to orient oneself in space.  A good number of the eye’s neural fibers bring information to the body’s balance system. If they deliver inaccurate information, the person’s sense of where he is in space can be compromised.  

The Psychological Effects of Strabismus –  Strabismus and double vision can adversely affect social-emotional development.  A child who is disoriented in space experiences himself and his environment as unstable and unpredictable. He may grow increasingly inward, become belligerent or demonstrate sensory defensiveness, all characteristics of “autism”

Treatment and Referral – Strabismus and amblyopia always require attention. Surgery, even when done when a child is young, may cosmetically straighten the eyes but usually does not improve visual function, especially without pre- and post-surgical vision therapy. Clinical studies indicate that fewer than 20% of patients who undergo strabismic surgery acquire depth perception.  Patching the “strong” eye to force the “lazy” eye to see is also of limited value.  Barry is one of surgery’s failures.

Effective treatment programs using vision therapy combine involve lenses, prisms and motor activity designed to teach the eyes, body and brain to work together.  Research shows that vision therapy can be effective at any age, but more treatment is needed the longer the condition has existed. Barry is one of vision therapy’s most prominent successes. 

At 50 years of age, she danced among falling snowflakes, experienced skyscrapers looming toward her, and tree branches projecting upward and outward, “enclosing and commanding palpable volumes of space” for the first time in her life. 

If you suspect that a child’s eyes don¹t work together, as I do with my friends’ child, go to the vision section in the Practitioner Directory at http://www.devdelay.org/ to find a qualified eye care practitioner in your area. This section lists organizations that train and certify optometrists to work with children and adults with a variety of vision issues. Go either to www.covd.org or www.oepf.com For a  complete explanation of this common problem, go also to http://www.strabismus.org/ .