Over the past three weeks, we have laid the groundwork for understanding how important early experience is relative to a child's cognitive development. We have stressed the importance of opportunity and ability as foundational for a child to begin and sustain the process of making sense of the world. With those considerations in mind, in the weeks ahead we will discuss the developmental milestones that suggest typical skill development and mastery, with particular emphasis on the emergence of communication skills.
Now as it relates to communication skills, it is important to note that a child's communication skills are highly related to his success in the early elementary grades. Said differently, children that possess and utilize age-appropriate communication skills, by school age, generally do well in kindergarten and beyond. Conversely, if a child does not possess age-appropriate speech and language skills, the risk for school difficulties is increased. Thus, our awareness and promotion of speech and language development is an important component for school success. Please keep those considerations in mind as we describe some of the earliest milestones of communication development in infants and toddlers.
There are two things worth considering as it relates to the earliest of experiences a newborn has. First is the response of the mother, almost immediately following the birth of her child. Now it is worth noting that mothers throughout the world say virtually the same thing after delivering their child. Once they know that their child is healthy and have asked the appropriate questions, mothers universally utter a simple request. This is their first utterance directed toward the child as opposed to statements about the child. Further, not only does the professional literature support this but I have witnessed this as part of my professional activities in birth contexts throughout the world, even though I did not know the language that was being spoken.
Mothers throughout the world say something like; "come see me, let me look at you, let me see your eyes, let me see your face." Hence from a biological standpoint, mothers appear driven to facilitate face to face contact with their newborns shortly after birth. Thus it is reasonable to assume that a mother's requests to make face to face contact with her newborn are part of her biological makeup.
Now combine that with another significant fact regarding newborns. It is a developmental reality that infants under four months of age are primarily interested in gazing at faces above anything else. When given a choice, a child will voluntarily direct his visual attention toward faces as opposed to objects. This preference is noted from the earliest of newborn experiences, and is present in infants throughout the world, regardless of the birthing practices into which they are born.
Can you see the connection? Both mothers and infants are biologically driven and drawn to initiate and mutually engage in face to face interactions. This behavioral pattern is where the earliest communication development begins? And further, if anything impedes such interactions, the risk for communication delay increases?
Indeed, mothers and infant are compelled to make and sustain face to face contact, thus initiating the process of communication development. Quite amazing, don't you think?
As we continue this discussion in the weeks ahead, we will explore several of the common events that characterize how mothers and infants interact. The process is incredible and complex. It has a significant impact on how our children make sense of and become important participants in their world.
Based on our discussion over the previous two weeks, it is instructive to recall that there are two things that are essential for a child to begin the process of making sense of the world. Certainly, one of these relates to the child's ability to do so. As we noted, anything that restricts a child's ability can serve as a contributing factor to the presence of developmental delay. Several of these factors were discussed last week.
The second issue relates to a child’s early exposure to the world. In that light, if a child has a limited or deficient early experience or is not afforded ample environmental exposure, the potential for developmental delays is increased. This relates to several things, not the least of which is the actual caregiving environment and routine the child is exposed to.
It should be kept in mind that children come into the world uniquely predisposed to begin the process of making sense of it. In order for the process to unfold, a child needs auditory, visual, and tactile experiences that are provided in the context of a stable and nurturing caregiving routine. During the early weeks of life, the child's system is geared toward his basic survival needs. The infant's earliest behaviors and responses are biologically driven, thus reflecting her need for nutrition, sleep, physical comfort, and contact with caregivers. Any undue or prolonged deprivation in one or more of these basic areas predisposes a child to less than optimal opportunities. At this stage of development, a child has very limited intentional means to express their needs. Yet as the child grows and becomes a greater participant in its world, his ability to make an increasing sense of it improves. Thus, in many ways, these early weeks serve as a developmental foundation thereby enabling the child to put his world together in an increasingly purposeful manner over time.
Neglect, lack of routine, limited face to face time with caregivers, social deprivation, minimal nurturing touch, or an over stimulating daily routine can further the risk of the child's withdrawal into a "survival" mode and reduce its benefit from exposure to the world.
In the presence of adequate environmental exposure and opportunity, it is truly a wondrous thing to note, from week to week, the subtle changes that take place as visible proof that a child has begun and will sustain a rapidly expanding set of skills that equips him/her for optimal success during the infant, toddler, preschool years and beyond. I encourage parents to be intentional about keeping a record of developmental changes, some quite subtle, that are constantly taking place. You will be amazed at how perfectly ready your child is to grow, learn, and change.
Last week, if you recall, we began this discussion by emphasizing the unbelievable process whereby children enter the world and immediately begin making sense of it. I made the point that children learn more in the first five years of their lives than they do for the rest of their lives. It is an incredibly complex process, and it is dependent on two primary things; first, the opportunities provided for the child; and second, normal ability, from birth, to begin and sustain cognitive development. As such, anything that impedes the child's ability or inhibits their exposure to the world presents an increased risk for developmental delay. Keep those thoughts in mind as we consider some of the "ability" factors that can impact, in a negative manner, a child's developmental progress.
It is helpful to acknowledge that there are many factors, prior to a child’s birth, that equip a child for typical skill mastery. Now, keep in mind that for the most part, a healthy mother brings a healthy child into the world. However, good prenatal care is not a 100% guarantee that a child will possess the ability to begin the process of skill mastery. There are numerous factors, some genetic, some related to problematic choices made by the mother and some as a result of a disease process in the mother and or the child, that enhance the potential for developmental problems.
The presence of a genetic anomaly, particularly one known to include developmental delay, must be kept in mind. Prenatal exposure to drugs and alcohol is surely on the list of risk factors for atypical development. Another important consideration is prematurity. Premature and low birth weight infants are at enhanced risk for developmental delay, pending the degree of prematurity, birth weight, and other complicating medical factors. Birth injuries that include any degree of cranial bleeding, lack of oxygen, or head trauma must likewise be considered as risk factors. Frankly, the list of potential factors that relate to impeding the child's ability to make sense of the world is extensive. However, please note that the presence of any of these factors increases risk. Their presence does not guarantee problems in development.
All of these considerations have a potential impact on a child’s ability to make sense of the world.
Should there be questions as it relates to these factors (and others) a developmental specialist should be consulted as soon as possible. Please feel free to contact the Achieve Center if you have any questions.
I think you would agree that there are few things more wondrous than observing a newborn child enter the world and soon thereafter begin the process of making sense of it. The simple reality is that our children learn more during the first five years of life than they do the rest of their lives. An amazing process, don’t you think?
In that light a simple question arises. What factors contribute to a child’s ability to make sense of the world? Researchers have considered this question for many decades. Their research is consistent in demonstrating that there are two primary factors in considering how children progress from limited ability as a newborn to functioning preschoolers and beyond. These two factors are ability (nature) and opportunity (nurture). If a child possesses good health and is exposed in a profitable manner to the world around it, he will begin and sustain the process of making sense of the world. On the other hand, if anything gets in the way of opportunity or ability the potential for developmental delay increases.
Now with those realities in mind, there is a simple scientific fact worth considering, and it is this: the more complicated something is the greater the risk that something may go wrong. When applied to child development, and in light of the amazing process of achieving developmental skills, there are many things that might impede a child’s ability to attain normal developmental milestones. Would you agree?
As we consider this in the weeks ahead it is my intent to do three things. First, I want to alert parents to the factors that may contribute to less than optimal developmental skill development. Second, I want parents to understand what to look for in determining if their child is attaining appropriate skills. And third, I intend to provide an overview of what constitutes typical skill development (concentrating heavily on speech and language development) so that each child is equipped and ready to enter school and be successful. I trust this information will be both instructive and supportive as we marvel at how our children grow and develop.
Are meal times a source of tension and struggle for your family? Do you have a child who refuses to eat a variety of foods or eats a limited range of foods? Perhaps they struggle to chew or swallow certain textures? Your child may be a picky eater or a problem feeder. The process of trying to get your child to eat well can be frustrating and tiring. Thankfully, there are trained professionals who have tools and tips that can provide some assistance and relief.
The Achieve Center is hosting an informational meeting for parents of children with eating and feeding problems. This informational meeting will include: a presentation by a certified Speech Language Pathologist and a Registered Dietician, a question-answer session, and informational handouts. The presentation will discuss what makes a picky eater/problem feeder, methods to use at home to encourage positivity around new foods, nutritional information, and any red flags that would warrant therapy.
Presenters: Shannon Schield, MS CCC-SLP & Vernell Theisen, Registered Dietician
Where: The Achieve Center, 520 N. 28th Avenue, Wausau, WI 54401
When: Monday, March 16th from 6:30-8:00 PM
What to Bring: Informational handouts, notepads, and writing utensils will be provided. Light refreshments will also be provided.
*Please note that childcare will not be provided
According to a recent study published in the February 11, 2020 issue of Lancet Psychiatry, declining physical activity starting at age 12 is associated with depressive symptoms at age 18, new research shows.
In the first study to objectively measure physical activity in teens, investigators found that every additional 60 minutes of sedentary behavior per day at age 12, 14, and 16 was linked to an increase in depression scores of 11.1%, 8%, and 10.7%, respectively at age 18.
Conversely, every additional hour of light activity per day at age 12, 14, and 16 was tied to a decrease in depression scores of 9.6%, 7.8%, and 11.1%, respectively, when measured at age 18.
Recommendation: Children and adolescents need daily physical activity throughout the day. The good news from this study is the implication that light activity — which can include movements as simple as standing, stretching, or casual walking — might be an effective strategy for decreasing the burden of adolescent depression. Long periods of inactivity such as playing video games, watching movies, and even studying can contribute to the development of depression symptoms.
Keeping a clean house may protect against the spread of germs, but early exposure to household cleaning agents could have an unwanted effect on young children, according to data from a recently completed longitudinal study of 3455 infant children.
Infants, whose caregivers reported frequent use of household cleaning products when the child was 3 to 4 months of age, were at increased risk for asthma and recurrent wheeze at 3 years compared with infants whose caregivers reported less frequent use, researchers report in an article in the February 18, 2020 issue of the Canadian Medical Association Journal.
However, there was no significant association between exposure to cleaning agents and an allergic reaction, suggesting that the observed respiratory vulnerabilities may result from inflammatory processes rather than allergic reactions. Young children who spend most of their time indoors were especially at risk.
Regarding specific categories of cleaners, it was found that the risk for respiratory problems was higher when liquid or solid air fresheners spray air fresheners, plug-in deodorizers, dusting sprays, antimicrobial hand sanitizers, and oven cleaners were used frequently compared with infrequent use.
Recommendations: avoid commercial cleaners and air fresheners and choose non-toxic and non-irritant alternatives such as white vinegar, which has a natural anti-bacterial quality, baking soda, which is naturally abrasive, and water with a few drops of essential oil(s) for odors.
Posted by Shannon Schield, MS-LSLP
It’s that time of year again. The snow is falling, trees are going up, and parents are wracking their brains for what to get their children for the holidays. In recent years, electronic toys have become more advanced, more available, and often preferred. These are tempting to go for, as electronic toys may offer parents a welcomed break. After all, the toys entertain their child long enough so they can finally finish that cup of coffee while it’s still hot.
But as a speech therapist, I have noticed more often that the relationship between child and toy has changed. A child using an electronic toy becomes almost mesmerized by the beautiful flashing lights, whirring, beeps, and twirls. And sure, these toys can be great fun when used in moderation. But all too often, I have seen that the toy is so vocal, entertaining, and distracting that there isn’t much need for real words at all. And what’s worse – the child finds any other traditional toy boring and undesirable in comparison to the electronic toys.
I got curious about this so I looked into some research. As it turns out, even if the parent is interacting with the child while they are playing with electronic toys, language production is notably more limited than when playing with a non-electronic toy. A study published in 2016 by JAMA Pediatrics concluded “during play with electronic toys there were fewer adult words, fewer conversational turns, fewer parental responses, and fewer productions of content-specific words than during playing with traditional toys or books.” So, in a nutshell, electronic toys do decrease the quantity and quality of language.
But what about those electronic toys that are made for educational purposes? Well, those are great to have around for the occasional slow morning, but ultimately those educational electronic toys just can’t provide the same input as face-to-face interaction between a child and parent using traditional toys or books. While the educational electronic toys may have great content they don’t provide immediate, personalized feedback, facial expressions and non-verbal cues, or social interaction opportunities. Moreover, these toys can’t build phonemic awareness that ultimately results in learning words. Humans are social learners – we learn best from our communication partners. Although electronic toys can do a lot, they just can’t quite fill the shoes of actual human interaction with traditional toys.
Now, don’t be mistaken in thinking that I’m suggesting you throw out all electronic toys. Of course, any toy can provide language opportunities; it’s all about how you interact with the toy. But perhaps limiting the amount of time on electronic toys would be a healthy solution. Don’t worry, you can still pull them out and finish that coffee while it’s hot. But try bringing back those shape sorters, puzzles, books, and barns, and watch how your child learns to create their own script.
Here are some guidelines for electronic toy /media use for young children:
Sosa AV. Association of the Type of Toy Used During Play with the Quantity and Quality of Parent-Infant Communication. JAMA Pediatr. 2016; 170(2):132–137. doi:https://doi.org/10.1001/jamapediatrics.2015.3753
DHS Lead Abatement Program Receives Federal Approval
Efforts will improve housing conditions for low-income children and pregnant women
The Wisconsin Department of Health Services (DHS) announced today they received approval from the Centers of Medicare & Medicaid Services (CMS) to implement a health services initiative to provide lead abatement services in the homes of low-income children and pregnant women enrolled in BadgerCare Plus and Medicaid. Governor Tony Evers’ budget invested $14.2 million in lead testing and abatement and $2 million for the new Lead-Safe Homes Program.
“This is a great step toward my goal to ‘get the lead out’ of Wisconsin homes so that our families, and most of all our kids, don’t have to worry about lead poisoning and the long term health and learning affects that come with it,” said Governor Evers.
Improvements will include removing lead based paint and lead dust hazards, replacing fixtures such as faucets, and removing soil lead hazards. DHS will coordinate these efforts and ensure individuals providing lead abatement services are well trained and certified by the state. DHS will be directing these efforts statewide to ensure progress is made in eliminating lead hazards in the homes of those eligible for these services.
“Our initiative will help advance the efforts of this administration to eliminate the lead poisoning risks that that threaten the health and well-being of young Wisconsinites,” said DHS Secretary-designee Andrea Palm. “We will collaborate across local health departments and community organizations to ensure that the homes of low-income children and pregnant women are lead-free.”
The Centers for Disease Control and Prevention (CDC) say there is no safe level of lead in the body. Lead poisoned children have been identified in every county in Wisconsin. In 2016, of those tested, more than 4,000 Wisconsin children under six were found to have lead poisoning. Lead can interfere with brain development and can result in lower IQ, learning difficulties, reduced educational achievement, and greater likelihood of behavioral problems like aggression, hyperactivity, and delinquency.
If a pregnant woman is exposed to lead, possible complications to her pregnancy can occur. These complications can include miscarriage, premature birth, injury to the child’s brain, kidney and nervous system, and learning or behavior problems for the child.
Lead poisoning is preventable. Since 1996, more than 220,000 children have been exposed to lead in our state. Children living in Milwaukee and Racine are at the greatest risk of exposure due to the volume of older housing stock, but any child who lives in a home built before 1978 is at risk for exposure. In 2012, the CDC lowered the blood lead threshold to 5 mcg/dl, down from 10 mcg/dl for children under age six. While no level of lead exposure is safe for children, those who test at or above that level warrant a public health response.
The Achieve Center blog is written by the professionals who are focused on children's mental health.