Childhood Apraxia And It's Myths

There are many myths and old wife's tales when it comes to bringing up children. I am  pretty sure that you must have heard your fair share of tales too. It just gets a little harder when you are challenged with a child having special needs.

Here are some of their wisdom, that they may wish to share with you:

• Einstein was a late-taker.
• Some very bright children won't talk because they are bored with "baby talk".
• He'll talk when he has it all perfected in his mind.
• He just doesn't have anything to say.
• You (or big sister) do all of the talking for him.
• He has all of his needs met and doesn't "need" to communicate.
• He'll talk when something really interests him, or he really wants something.

So do you think that your chis is a"Late-Taker?"

According to Becca Jarzynski, a pediatric speech-language pathologist and blogger of Child Talk (www.talkingkids.org), "If a child reaches 24 months and isn't yet using 50 words and/or isn't yet putting two words together into short phrases (e.g., "more juice," "bye mama"), we typically recommend that (parents) talk to their pediatrician about an evaluation by a speech-language pathologist."

• What does the child understand?
• Can he follow a wide variety of directions?
• Find objects when Mom and Dad ask him to do so?
• Point to pictures in a book?
• Show off some body parts when they are named?
• Follow silly directions like "put a cup on your head?"

• How he is communicating with gestures and facial expressions? 
• Is he nodding and shaking his head no?
• Pointing at things that he wants or that interest him?
• Waving "hi" and "goodbye?"
• Clapping with delight? 

• How he is using the words he does have? 
• Is he using them appropriately?
• Does he have inflection in the right places?
• Can he articulate well?

• What kinds of sounds is he using?
• Does he uses his voice to get attention?
• Does he vocalize often throughout the day?
• Did he babble often as a baby?
• Does he use his voice in a way that sounds like he having a conversation, even if there are no real words involved in that conversation? (At 24 months, for example, a child should be using a variety of sounds such as p, b, m, n, t, d, h, and w- and using them in a variety of words.)

• How is he playing?
• Does he use pretend play in some very simple ways?
• For example, does he give a bottle to a baby, or feed a stuffed bear with a spoon? 
• Is he able to play simple rolling or fetching ball games with others, and starting to imitate housework?

• How does he imitate actions? 
• Will he clap when an adult does?
• Does he imitate stacking blocks?
• Will he imitate you if you do something silly and unexpected, like place a block on top of your head? 

•  How is he hearing?
• Any concerns with hearing should be evaluated to rule out a hearing loss. 
• Some kids can hear some sounds but not others.

What's a Parent to do?

If you are faced by ignorant loved-ones, or insensitive people, here are a few ways to go around it graciously, so you spare misunderstandings:

• He's takes a while to warm up
• Not all our kids develop the same, right?
• I am grateful, that he is quiet and manageable, at this age.
• He's quiet, just like his dad, men of a few words.
• Gosh, really, you think I should be concerned? What do you recommend?

I am sure you can find your own way of brushing them aside. Try not to offend them if you possibility can, you will need a good support system as your child grows and you may need to depend on them. Their ignorance is what's making them misunderstand. If you have the patience, try to fill them in, on what's going on in your child's life. Having more loved ones, is only going to be beneficial to your child.

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Book: Speaking of Apraxia by Leslie A. Lindsay, R.N., B.S.N.

Speech Language Disorder - Part 1

I love to watch children play, they are so original and innocent. Their transparency makes them such adorable play writers. Speech is an important part of play. Without the fluency of speech, children will struggle to fit in and become loners as a result. 

The number of children who struggle with speech disorders, nowadays are on the rise. My first born spoke when he was one, but Ivan only spoke when he turned five. So if you are in a situation, wondering if your child has a challenge in the area of speech, read this entry, I hope it helps you.

"With a typical child, receptive abilities (understanding language) and expressive skills (vocabulary, the production of complex sentences, and recall of words) usually develop at the same pace. However, when there is board disparity between the two and when a child's communication is noticeably lagging behind his or her peers in the attainment of these skills, a serious disorder is indicated  and red flags go up.

When a child's ability to understand language is in the normal range but his or her expressive ability, speech, is critically inadequate- it might be completely absent, somewhat impaired, or just difficult to understand- then they have a speech or language disorder." Here we are talking about children under the age of three.

You may think that your child is a "late bloomer". Like Peter did with Ivan, he kept telling me that we should just wait it out. Neither of us knew better. In time, I came to realize that even if Ivan was a "late bloomer", a weekly visit to the therapist would have helped speed along the process. Either way, it would have only helped the boy. So I encourage you, if you see fit, do make an appointment with a Speech Therapist to see your concerns through. At the most, if you are not comfortable, at least you took step one.

Here are three types of speech language disorders:

1. Agrammatism - telegrahic speech (Me, you, uh, watch television)

2. Anomia - difficulty in retrieving or recalling a specific word

3. Aphasia - problem with language caused by brain damage. 

The thing to remember here is that, should your child be affected by these three above mentioned, do know that this only affects his speech not his intellect.

As, there are many to cover, I will pause here and continue in the next article. Stay tuned.

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Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Separation Anxiety Disorder

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When you have a newborn, you will realize that once he gets to recognize you, they will cry when you leave the room. He cries due to the anxiety that you would not return. As he grows older, he will understand that when you leave the room, you are not gone forever. He needs the security and the reassurance that he will not be neglected, maybe it's in our primal instinct.

If you have had the experience of sending your little one to school, you know how difficult it is for both of you. As an early childhood educator, I have witness many children go through the phase of separation anxiety. They scream, yell, kick and cry until they tire themselves eventually, and it starts all over again  the next day. All children, take a different amount of time to understand the concept of mummy and daddy leaving them at school, to go off to work. For a little one, it is a concept far too difficult to comprehend. 

He wonders why, why do you need to go to work? 

Why do you need to leave him at school? 

Why can't you take him along? 

Why would you take to so long to come back for him?

The most important thing, I realize as a teacher is the importance of reassurance. Reassuring the child that the parents are coming to fetch them soon, helps immensely. Then, if the child is able to understand, state a time that the parent most likely would arrive. This way the child will ease into the separation from family and the anxiety will diminish.

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Sometimes, its not the child that has the anxiety but the parent. I have witness, children who have settled down fine, and the mothers, crying outside before they leave. So, if this is so common, why is it a disorder you may ask. Will it only becomes cautionary if it's as follows.

"According to the DSM, separation anxieties become a disorder when the child's anxiety or fear causes anguish and starts to affect social, academic, or for adolescents, work-related situations, and this anxiety lasts at least one month." 

What are the Sign & Symptoms to look out for?

• apathy
• aversion to school
• bedtime fears
• clinging to parents
• crying
• depression and sadness
• desire to sleep in parents' bed
• difficulty concentrating
• difficulty falling asleep
• dizziness
• excessive worry
• fear of carpooling
• fear of getting sick on school bus or in school
• fear of meeting new people
• feeling unsafe being alone
• headaches
• hiding, especially behind parent
• nausea
• shadowing parents
• shortness of breath
• sleep disorders such as inability to sleep and nightmares
• stomachaches
• sweating
• tantrums at school
• trembling
• unreasonable fear of harm or death
• unwillingness to interact with anyone other than parents
• wanting to be held
• whining
• withdrawal

My first two boys settled down fine in school, but now I have little Iggy. I hope, I do not end up being one of the mothers that are crying outside the school.
 

Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Rett's Syndrome

I recall one afternoon, when I was having a conversation with another mum, as we were waiting on our boys to finish school. Ivan was around five back then. I was still having very mixed and unpleasant emotion attacks. Life felt miserable and the future was dark. The parent I was talking with had an older boy, she had pasted the stage I was in. She told me something, that opened up my eyes. She said, "Be thankful we have sons, can you image their lives and ours, if we had them as daughters?" Just then, I felt a quick wake up call. Yes, I was thankful that Ivan was a boy. Puberty would be much easier on a boy, and that was just one aspect. From that day one, I chose to make sure I looked out for the silver lining.

We do see a majority of children affected by autism and similar diagnosis, to be boys. But I wish to draw your attention today, to one PDD (Pervasive Development Disorder) that attacks the majority of girls. In the group of PDDs, Rett's syndrome is one of the most disabling. It is known to be affecting the majority of the female of our species, by the age of twelve. 

A Little History

Andreas Rett, M.D. was the very first to introduce this in the year 1965 in Vienna, Austria. It has been known to show normal development in the early years, followed by an onset of the disorder between six to eighteen months of age.

"At the start, RS girls (a very slight percentage of boys are diagnosed with RS, and most die in utero) will exhibit appropriate speech (using words or phrases) and motor development as well as age-appropriate sitting and walking. But, eventually, the child will lose use of her hands and exhibit distinctive repetitive hand movements, slowed brain and head growth, abnormalities when she walks, seizures, and MR (Mental retardation).

The girl enters a period of regression, losing speech and motor skills. This period of regression between 1 and 4 years old can be sudden, but it can also be slow and indistinguishable from normal behavior and be missed in diagnosis if the symptoms come on singularly and slowly.The regression can last for a few days or it can go on for months."

What are the Sign & Symptoms to look out for?

• autistic behaviors
• bone fractures
• cessation of social interaction
•  cold, sometimes bluish-red or purple extremitites
• constipation
• decreased body fat and muscle mass
• diminished eye contact
• EEG abnormalities and changes
• extreme motor control problems
• gait abnormalities (unsteady, wide-based, and stiff-legged)
• hand tapping and hand wringing
• irregular breathing patterns such as hyperventilation
• irritability
• loss of motor skills
• loss of speech
• MR (mental retardation)
• muscle rigidity
• normal development before symptoms arrive
• obsessive-compulsive behaviors
• persistent clapping
• persistent hand washing
• reflux
• scoliosis
• seizures
• sleep apnea
• slowed growth (after 1 year old)
• slowed head growth (after 3 months old)
• slowed weight gain (after 1 year old)
• small feet
• small head (microcephaly)
• spasticity
• swallowing problems
• teeth grinding (bruxism)
• toe walking
• torso shaking
• weak muscle tone (hypotonia); dangling arms, legs, and head are usually the first symptoms 
• well behaved

These are the sign and symptoms that you could look out for.  You will come to notice that more than a few of the symptoms, are similar to that of other diagnosis, such as autism. There really isn't any clear boundaries, as to where one disorder stops and the other starts. We just have to be observant and trust our gut, as to when and where we need to seek for professional help.

I hope this blog entry is helpful to you. 

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Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Why Is My Child Different?

When one looks back to reconsider the possible causes for a child having special needs, one may consider many theories. You may have your lists of concerns, as I have mine. Amongst the "theories galore: vaccines; environmental toxins; genetics; age of parents at conception of the child (especially the father); hormonal factors, especially testosterone levels; jaundice at birth; strep and use of antibiotics as a child; physical trauma in either mother and child; diet; medications- the lists goes on. All the theories could be correct, or none, but one thing on which many researchers and experts agree is that the child needs to be predisposed to this type of disorder. So, while a vaccine might not affect one child negatively, it might affect another completely differently."

When my third baby, Iggy, was born, he had jaundice. I panicked upon hearing the news. Friends and family, comforted me saying that it was very common and that I had nothing to worry about. Even though, he was my third born, I still freaked. I guess the protectiveness of a mother will always be there.

After doing lots of research for Ivan, I came to realized that a couple of them stated jaundice as a possible trigger. But nothing has been carved in stone. 

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Book: Alphabet Kids: From ADD to Zellweger Syndrome by Robbie Woliver  

Stressful Pregnancy and Baby

I have spent many years, wondering where I went wrong with Ivan. How in the world did autism get it's hands on him? Was it the pregnancy? My health? The childbirth? His nutrition? I could go on and on.

Each time I read an article in line with a possibility of him being exposed to autism, I do get grief stricken. In this case, it's more threatening to his immune system. I don't spend much time pondering in the "what if's". But I do go there sometimes.

Here's a portion of an article I read, that may help you.

"When a mom is under stress during pregnancy, her stress hormone levels become elevated even though pregnancy hormones are designed to have a calming effect on the mother-to-be. Stress hormones disrupt some of the protection induction by the hormonal state of maternity. Increased levels of these stress hormones increase the chances of a preterm delivery. The stress regulation systems of fetus subjected to this hormonal environment are disrupted as well, just as the hormonal balance is altered in infants living in stressful home environments. Exposure to loud noise during uterine life, such as a mother working in noisy surroundings, had been shown to reduce the newborn's protective immune system, possibly due to stress."

Living in Singapore stress is inevitable to a certain extend. I worked in a noisy environment with kids all throughout my pregnancy with Ivan. I hope you don't freak out and quit your job, but the lesson to take with you, is to take it slow. Try not to exert yourself during your pregnancy.

True or not, why risk it, right?

Book: The Baby Bond by Dr. Linda Folden Palmer

Holiday Heartache

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It's 6.30am and I am awake. Mentally, I tell myself that it's a Sunday and I can sleep in. The holidays are here. In many households, the school holidays are a much anticipated time. A beautiful time for family bonding and trips overseas. But in our household, things are slightly different. The extra time, and lack of routine, causes instability and stress, to Ivan, and especially to me.

It's the first Sunday, the beginning of the week and the month that marks the June holidays. After attending a kid's birthday party last night, I turned in tired. I had no idea that today was going to be a rough one.I awake many times throughout the night, as baby Iggy needs his feed. So I try to catch up on sleep whenever I can. Iggy is a light sleeper, so I try to keep things quiet.

Somewhere, around 7am, Ivan enters my room, asking for his Ipod. I tell him that it's too early in the morning. On a regular school day, he knows that he gets it only after school. But now that it's the holidays, and he is well aware of it too, he is just trying his luck. After ten minutes, he enters my room asking for it again. I reply the same thing, and he leaves. I try to catch some sleep myself as Iggy is asleep. Ivan enters again after ten minutes, asking the same thing.

Trying to maintain the noise level, so that Iggy sleeps, and sending Ivan out each time, starts to get on my nerves. But still I try to tuck under the sheets and try to steal a nap.

Ivan comes in again, asking the same thing again.This goes on, where the intervals are shortened. I know that it's not his fault, but mine. I normally, always have a planned out schedule for the holidays. But with a new baby, I had not done so this time. I didn't want to lose it, so early in the morning, so I took long deep breathes to calm down. Finally, I locked my bedroom door, and hid the Ipod.

After sometime, when I opened the door to leave my room, I saw Ivan seated crossed legged, on the floor outside my room. It was such a sad sight. But he was not going to give up. He would keep asking me until he finally got it. 

I now have to plan something pronto for him to do, until noon when he gets his Ipod time. These are times, that are very trying for me, especially with a new baby. I feel so frustrated, that I just break down in tears. Each time Peter leaves for a job during the holidays, I feel the weight of a ton of bricks added onto my shoulders. But like a sliver lining in every dark cloud, I am encouraged by beautiful friends I found on FB. They send their love and concern to me, encouraging me.