What is Down Syndrome?

Down Syndrome is thought to be the most common genetic etiology of mental retardation. This condition has been found to occur in down syndromeapproximately 1 in 800 live births. The genetics of the condition are such that the individual has an extra copy of chromosome 21.

Physical Features Associated with Down Syndrome:

  • Decreased muscle tone seen at birth
  • Excess skin at the nape of the neck
  • Flattened nose
  • Small ears
  • Small mouth
  • White short hands with short fingers

Cognitive Features Associated with Down Syndrome:

  • Moderate mental retardation
  • Weakness with grammatical aspects of language
  • Relative strength with spatial reasoning tasks
  • Verbal short term memory is more impaired than visual memory
  • Weakness with daily living skills (self-care skills)
  • Relative strength with social skills

Interventions for Children with Down Syndrome:

  • Speech and language therapy with possible addition of sign language
  • Visually-based interventions for teaching, reading and vocabulary
  • Occupational therapy for sensory integration and motor development

Risk Factors Associated with Prematurity and Low Birth Weight

As previously described in a prior blog, prematurity and low birth weight are commonly found in 2-8% of live births in the United States.  There pregnant ladyare numerous neuropsychological and cognitive concerns that were reported in the previous blog.  There are many risk factors that parents need to be aware of that can be a contributing factor in premature delivery.

Medical risk factors that are associated with low birth weight are:

  • Previous preterm delivery
  • Family history of infertility
  • Multiple gestation
  • Placental abnormalities
  • Uterine abnormalities/infection
  • Preeclampsia

Cultural risk factors associated with low birth weight include:

  • Preterm birth more than 2x as common in African Americans
  • Higher in single mothers
  • Higher in low socioeconomic status families

Because of the possible long term concerns with low birth weight, it is important to be preemptive and knowledgeable about medical and cultural factors that might contribute to the condition.

Language Milestones for Preschool-Aged Children

Language encompasses the way in which we produce ideas (expression), understand concepts (comprehension) and use the social 3 year old boyrules for communication (pragmatics). Preschool years are a critical time for a child’s speech and language development. Children are rapidly acquiring new skills, therefore, parents may start to wonder if their child is meeting developmental milestones. Difficulties in language skills and concepts can have long-term implications of a child’s ability to succeed during school-age years. The milestones listed below are intended as a general trajectory that many children tend to follow; however, many will find that there is some variability between stages.

Language Milestones

Two to Three Years Old:

  • Opposites: children will begin to understand differences between words such as “go/stop”, “big/little” and “up/down”
  • Directions: children will begin to follow simple two-step requests (e.g., “get your shoes and put them on”)
  • Stories: children will want to hear more stories and may make ask parents to read books to them
  • Requests: children may begin to name objects when requesting (e.g., “I want juice”)

Three to Four Years Old:

  • Story-telling: children will start to tell more stories, often explaining what happened at school
  • Questions: children will begin to answer simple “wh” questions, including: “who”, “what” and “where”
  • Sentences: children may start to string 4 or more words together, creating more complex sentences

Four to Five Years Old:

  • Understanding: children can be expected to understand most requests made by
    parents (e.g., “clean your room”)
  • Reading: children may answer questions posed by parents during book reading (e.g., “what did the caterpillar eat on Monday?”)
  • Identification: children may start to recognize letters and numbers
  • Grammar: children will start to use age-appropriate grammar (e.g., plurals, past tense, pronouns)
  • Describes: children will begin to use more descriptive words when speaking (e.g., “the smaller shoes are mine”)

Preschool years are such an exciting time for children’s development. Children begin to blossom academically, socially and emotionally. If you have questions, concerns or suspect that your child may not meet all of these milestones, a licensed speech-language pathologist may be able to help!

Click here to download a free copy of the 3 Year Old Milestone Guide covering Speech, Fine and gross Motor, Behavior, Social/emotional and more!

When is Stiffness Problematic in Infants?

If your child seems stiff or rigid, he/she may have what is described as “high muscle tone” (hypertonia). This means that the muscles baby in towelare chronically contracted. Stiffness can become problematic in an infant when it limits the movements and acquisition of a child’s gross motor skills.

Signs of Stiffness in Infants:

  • Your child might hold his/her hands in tight fists or may seem unable to relax certain muscles.
  • He/She may have difficulty letting go of an object or difficulty moving from one position to another.
  • The legs or trunk of the child might cross or stiffen when you pick the child up as well.

How Can A Physical Therapist Help?

While limb stiffness is a sign of abnormal signals that are being sent from the brain to the body that over-activate certain muscle groups, some of these movement/coordination disorders are mild and can be treated with physical therapy. The physical therapist will help the child break out of her stiff positions, stretch out the tight muscles, strengthen the weak muscles and develop efficient movement patterns.

At times, limb stiffness is a symptom of spastic cerebral palsy; however, parents should not focus on a medical diagnosis within babies. Regardless of the medical diagnosis, the focus of therapy will be to stretch the tight, overactive muscles and guide the child to acquire motor skills and perform functional tasks in a more efficient manner.

How Can A Parent Help?

Parents should set up the environment to be motivating and organize activities so that the child can practice in a variety of ways. Both massage and Yoga can help to improve muscle length and flexibility. While Botulinum Toxin (commonly known by the brand name “Botox”) can help, it is not used in children that are younger than 18 months. This toxin is injected directly into a child’s muscles and temporarily paralyzes the muscle’s activity, giving the child the opportunity to stretch the tight muscle and strengthen the opposing muscle. Muscle relaxants may be prescribed for adults that have cerebral palsy, but they’re rarely used for toddlers as they cause drowsiness.

If you are concerned about the stiffness in your baby or if your child’s rigidity is keeping him/her from interacting with toys, contact your doctor and schedule an evaluation with a physical therapist.

Prematurity and Low Birth Weight

Prematurity and low birth weight are quite common and have been increasing in evidence. Research has indicated that infants that arepremature baby born with a low birth weight comprised approximately 8% of live births in the United States in 2005 (National Center for Health Statistics, 2006). Children that are born prematurely are on the rise and this is largely attributed to the advances in medicine and technology.

It is important to monitor several cognitive, academic and social-emotional factors of children that are born with a low birth weight and prematurity as these children are at risk for a wide variety of possible concerns.

More specifically, research has indicated that children that are born with low birth weight may be at risk for:

  • working memory and long term memory concerns
  • slower processing speed
  • attentional regulation
  • executive functioning
  • social/emotional concerns

Not every child with low birth weight or prematurity will exhibit the above concerns; however, it is always best to keep in mind that these concerns may be evident within the academic setting. A neuropsychological evaluation will help to establish a baseline of current functioning in order to monitor and track progress as well as to help determine if specific interventions and modification of the environment should be warranted.

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8 Tips to help your Child Accept being a Big Brother or Sister

With a new baby on the way, there is a lot of excitement, joy, and preparation involved. In addition to all of these emotions and tasks sibling with new babyto complete, parents also need to keep in mind of the feelings of their older child. For an older child, the thoughts of Mommy and Daddy having another baby could be mixed. There is the thrill of being a big brother/sister, but there are also concerns that the attention will no longer be on him/her as well as the uncertainty of what exactly a new baby entails. The older child might start to feel left out or the need to take on more responsibilities.

If you want to help your child accept being a big brother/sister, try the below strategies:

  1. Prepare your older child. Talk about the baby and what will be happening before, during and after the new baby comes with your oldest child. Read books to your child about new babies as well as about becoming a big brother/sister. In addition, get a baby doll for your child to start playing/interacting with. With a baby doll, you can help teach your child how to appropriately care and play with their new brother/sister.
  2. Keep the routine the same. When possible, keep your child’s routine the same throughout pregnancy as well as after the baby is born. Let your child stay in his/her different activities and allow him/her to continue doing the activities that he/she enjoys.
  3. Arrange for positive interactions. Your child can help with choosing items for the baby, such as for the baby’s room and the new baby’s clothes. Your oldest child and you can create a welcome card as well as get a special welcome gift that your child picks out himself/herself. Once the baby is born, your child can read books, sing songs and hold the new baby with supervision.
  4. Provide praise. When your older child is appropriately interacting with or helping out with the new baby, be sure to provide very specific praise for these situations. For example, “You are playing so nicely with your little brother/sister!” or “Thank you for bringing us a clean diaper!”.
  5. Brag about the older child. When the older child is around, talk to the baby about the great things he or she does. For example, “Look at how far Richie threw the ball! When you get older, he can teach you to throw far!” or “Your big sister, Sarah, is so helpful! She cleaned up all of the toys!”
  6. One-on-one time for each child. If you and the new baby are participating in “Mommy and Me” classes or “Daddy and Me” classes, make sure to also find a class or activity that you and the older child can go to together. Spending time together can be as simple as taking the older sibling with you on an errand while the baby stays at home with the other parent.
  7. Family time. Make sure to make time for family time and family outings. Include everyone in different activities that are be fun for both the older child as well as the new baby.
  8. Make the baby wait. In many cases, the older child will have to wait while you care for the baby. Every now and then, if possible, make the baby wait and finish helping out your older child. You do not always have to stop what you are doing as soon as the baby cries (as long as immediate attention is not necessary).

Before and after a new baby is introduced into the home, keep these tips in mind to help your older child accept and love being a big brother or sister. A new baby is an exciting and life-changing event for everyone in the household. At times, it’s easy to overlook the concerns of someone who might not be able to express themselves completely about the new addition to the family.

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How to Make Your Own Baby Food

Are you interested in creating your own baby food? The good news is that it is actually quite possible and simple to make your own baby foodbaby food!

Supplies to make your own baby food:

  • A manual food mill. I personally used one made by KidCo. It is suitable for any soft or steamed fruits and vegetables, as well as cooked quinoa, oatmeal, millet and amaranth.
  • An electric food mill. I utilized an inexpensive, small electric food mill for more advanced textures of food that I needed to grind down slightly, such as soft-cooked meats and pasta.
  • Other options that you may choose to use include food processors and/or coffee grinders. A food processor is able to puree any food into the texture desired. As a result, this eliminates the need for a manual food mill or smaller electric food mill. A coffee grinder is useful for making your own “infant cereal”, using grains such as quinoa, brown rice, millet, amaranth and oatmeal. To do this, simply grind the whole grains in the coffee grinder and then cook them as you normally would.
  • Storage containers. You may use any refrigerator- or freezer-safe containers. There are containers that are designed specifically for storing baby food that closely resemble ice cube trays with a lid. I found these to be very helpful as I could produce 2-4 “cubes” of baby food to send to the babysitter each day.

Once you have acquired the equipment that you need, the next step will be to determine what food you want to make for your baby. Speak with your pediatrician or registered dietitian if you require guidance.

Below are the categories of infant-appropriate foods as well as general directions on how to prepare them yourself:

  • Vegetables: Try green beans, zucchini, squash, carrots, sweet potatoes, peas, cauliflower, broccoli, etc. The important thing to remember is to steam them or bake them until they are very soft and can be easily pureed in the manual food mill.
  • Infant cereal: Choose hypoallergenic grains such as brown rice, oatmeal, quinoa, millet or amaranth. Grind the uncooked grains in a coffee grinder or cook them and then let the grains cool prior to pureeing in a food processor. Cook the grains as you normally would.
  • Fruit: Try soft-cooked apples, pears, plums, peaches, blueberries, bananas, cherries, mangoes, papaya, etc. You can also purchase frozen fruit that can be thawed and pureed.
  • Beans: Once your baby is age-ready to consume beans (8-9 months), you may not need to puree them completely. You may give them cooked beans that are slightly smashed with a fork. Many babies enjoy eating black beans, lima beans, pinto beans and lentils. Observe them carefully as they eat as the skin of the beans may be difficult for them to manipulate in their mouth.
  • Meat: Cook meats for a significant amount of time (10+ hours) in a slow cooker with plenty of liquid to ensure that they are very soft. Puree the meats in the electric food mill or food processor. Meats can be offered to children that are around 8-9 months of age or when your child has the ability to consume foods with a little more texture.

One tip is to add a small amount of breast milk or formula to the cooked product so that your baby experiences a familiar taste when trying new types of foods for the first time. Making your own baby food is a great way to introduce your child to real foods that they will grow up to become familiar with eating. They will be able to consume texture-appropriate versions of the foods that the rest of the family is eating. As a result, making your own baby food can save you time as well as promote healthy eating habits.

If you are interested in creating homemade baby food, but require more guidance or do not have the time, I am now offering personalized home services. I am able to create weekly menu plans for your child. I can even finish personal grocery shopping for you to purchase whole, organic ingredients for your baby’s food. I am also able to come to your house on a weekly basis to make the baby food for you or to guide you with making the baby food yourself. Click the button below for more information:

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Finger Foods for Little Fingers

When infants are transitioning to solid foods, it is important to remember that this transition process is a learning experience for the baby with finger foodchild. Feeding involves many systems in the body, including the brain, sensory processing system, muscles of the mouth, tongue and throat. Feeding also involves the entire digestive system. The transition to solid foods follows a continuum of developmental stages that coordinate with the infant’s ability to handle new types of foods, textures and methods of feeding.

When children reach the age of around 8-10 months, most of them develop a fine motor skill known as the “pincer grasp”. This is when the child is able to pick up small objects using the pointer finger and thumb. In addition, according to speech-language pathologists, when children reach the age of around 9 months, infants develop the oral reflex to bite down on more advanced textures of foods in the mouth. In other words, if they are given a food other than a smooth pureed texture, they will instinctively bite down and mash it with their gums at this age.

Given the above developmental skills, it is appropriate to introduce finger foods to your infant once they are around 8 or 9 months of age. They will be able to practice their pincer grasp as well as their chewing reflexes. It also teaches them to self-feed.

Here are some ideas for finger foods for little fingers:

  • Ripe banana slices, cut into quarters
  • Soft cut-up fruits (no skin or seeds), such as ripe pears, ripe peaches, kiwi, soft melon, blueberries (may even cut in half), plums, etc.
  • Soft cooked vegetables, such as sweet potatoes, cauliflower, cooked carrots, squash, peas and beets.
  • Avocado pieces
  • Toast bits
  • Crackers that can easily dissolve in the mouth with minimal chewing
  • Cheerios or puffed rice cereal
  • Cooked pasta bits
  • Cooked and mashed beans
  • Very soft cooked meat. Cook the meat in a Crockpot or slow cooker for 8+ hours with plenty of liquid until the meat is falling apart. Give very small pieces of meat to your child, one at a time, and make sure they are swallowing the pieces by offering water sips.

Remember to always watch your infant carefully when they are eating, especially as they try more advanced textures. They are at high risk for choking when they are just learning to handle these new foods, so it is important to keep these things in mind:

  • Offer very small bites of food, such as the size of a Cheerio or a quarter of a banana slice.
  • Offer very small quantities of food. At this young age, children are not always aware of how to regulate the amount of food in their mouth. They might enjoy something so much that they stuff in more than they can handle, which is a choking hazard. Give them a little at a time on their tray.
  • Offer soft or textures that can easily dissolve. Avoid sticky or very hard textures.
  • Offer sips of water to help with the swallowing process.

For more information on feeding infants or children, make an appointment with one of our registered dietitians at NSPT.

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Ways to Encourage a Baby to Sit Up | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist will show us helpful ways to encourage a baby to sit up independently.

Read about useful tips to get your baby to roll

In this video you will learn:

  • How old your baby should be to sit up
  • Strategies to support your baby as they sit up

Video transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide
experience and innovation to maximize your child’s
potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host Robyn
Ackerman, and I’m here today with Leida Van Oss, a
Pediatric Physical Therapist. Leida, can you tell us a
couple tips on how to get a child to start sitting up
independently?

Leida: Sure. So the first stage of sitting should be done by four
months of age, and this is called prop sitting. This is
when they support themselves on their own. So you want to
put a toy down by their feet, and then tilt them forward so
that they put their hands on the ground, and then that
should encourage them to support themselves on their hands.
She’s older than four months, so she doesn’t want to do it.

But then the next stage is this kind of sitting, where they
want to bring up their hands, and sit by themselves
independently. So if they’re not quite wanting to do that
yet, you can take their toy – there we go – and lift it up
in front of them, so that they want to look up and raise
their arms up. This will activate the core and back
muscles, which will help bring up their head and do more of
an independent sitting.

You want to make sure that you keep a hand behind their
body, so that in case they topple backwards, you can catch
them really quickly. Then, the last mature stage of sitting
are things like rotating and reaching out if they need some
support. So, again, you can use toys to have them turn to
the side or reach up, or reach far [inaudible 00:01:37].
Those are all things that are going to help encourage more
mature sitting skills.

Robyn: All right. Well, thank you so much, and thank you to our
viewers, and remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational
programming. To subscribe to our broadcast, read our blogs,
or learn more, visit our website at learnmore.me. That’s
learnmore.me.

Are Premature Babies Delayed?

The term premature refers to any infant that was born earlier than 37 weeks of gestation. Premature births occur in 10% of all live births. Premature babies (“preemies”) are at risk for multiple health problems, including breathing difficulties, cerebral palsy, learning disabilities, and delays in their gross and fine motor skills.

Premature baby

Why are babies born pre-term?

The cause of premature labor is not fully understood. However, there are certain risk factors that can increase the likelihood of premature labor: a woman that has experienced premature labor with a previous birth, a woman that is pregnant with multiples (twins, triplets, etc), and a woman with cervical or uterine defects. Certain health problems can also increase the risk of premature labor, including diabetes, high blood pressure and preeclampsia, obesity, in-vitro fertilization, and a short time period between pregnancies.

What are the effects of being born pre-term?

In addition to multiple medical complications, a baby that is born before 37 weeks of gestation is at risk for developmental problems in gross motor skills, fine motor skills, sensory integration, speech and language skills, and learning. The baby may take longer to reach specific developmental milestones or need help to reach those milestones. The earlier babies are born, the more at risk they are for having delays. Each child is different as well, and no two preemies will be delayed in exactly the same manner.

If you or your pediatrician suspects that your baby is developmentally delayed, there are a variety of professionals that can assist your child in achieving his or her full potential. A physical therapist can help facilitate development of gross motor milestones such as sitting, crawling, walking, running, or jumping. An occupational therapist can help develop fine motor skills such as object manipulation, hand-eye coordination, and reaching, as well as sensory integration. Speech therapists can help improve language skills and articulation.  Consult with your pediatrician or talk with one of our Family Child Advocates to receive more information on setting up an evaluation with a skilled therapist at NSPT.

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