ADHD? Don’t You Mean Sleep Disorder?

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Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects millions of adults and children. ADHD is best characterized by problems with concentration, impulse control, organization, and memory. These symptoms are frequently accompanied by feelings of frustration, inadequacy, and isolation from others.

However, what if the individuals diagnosed with ADHD are, in fact, suffering from an entirely different disorder – sleep apnea? A little known fact is that symptoms of ADHD are closely related to symptoms of a sleep disorder. A list of behavioral traits for a child with ADHD includes:adhd-workingmemory-wordcloud

  1. Lack of Focus which includes difficulties listening, retaining information, paying attention, and organizing information
  2. Impulsivity which includes difficulty sitting still, remaining quiet, sharing, turn-taking, and talking when appropriate

These behaviors contribute to deficits in the areas of social interaction, cognitive development, and academic performance. The same behaviors discussed above are also found in children suffering from insufficient and inadequate sleep quality. A recent study found that children with obstructive sleep apnea were at higher risk to suffer from behavioral problems; specifically those that mirror ADHD. These children also demonstrated poorer academic performance.

Therefore in order to decrease the possibility of misdiagnosis, all children and adults being treated for ADHD should also be screened for sleep disorders.

Jessica Eberhardt M.S. CF-SLP, TSSLD

The Real Deal on Feeding Disorders in Children

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Does your child struggle with eating a variety of foods, consuming a variety of textures/consistencies, and/or gaining weight/growing? Then the SOS Approach to Feeding may be appropriate for your child. The SOS Approach to Feeding is a trans-disciplinary feeding program for assessment and treatment of children with feeding deficits from birth to 18 years of age. It incorporates a variety of factors including posture, sensory sills, motor skills, behavioral learning, medical, and nutritional components to understand how these cause and maintain feeding/growth problems. My experience in the field thus far has taught me that feeding disorders are rarely the result of an isolated issue. It is typically a combination of factors that cause this difficulty with feeding. It is our job as speech-language pathologists to thoroughly assess your child in order to determine what factors may be causing or maintaining the feeding dysfunction.

Children who eat a limited variety of foods are typically referred to as “Picky Eaters”; however, did you know there are specific distinctions between a picky eater and a problem eater. Typically, a picky eater eats 30 foods or more, stops eating foods due to “burn out” but will regain these foods after 2 weeks, can touch and taste new foods even though they’re nervous, and will add new foods to repertoire in 15-25 steps on the eating hierarchy. In contrast, problem eaters eat less than 20 different foods, foods that are lost due to food jag are NEVER re-acquired, has an emotional reaction such as crying to new foods, refuses an entire category of food textures, almost always eats a different food than the family, and acquires a new food in more than 25 steps on the eating hierarchy.

Here is a list of red flags from the creator of the program, Kay A. Toomey, PhD, to determine if your child is a candidate for referral:

  1. Ongoing poor weight gain (rate re: percentiles falling) or weight loss.
  2. Ongoing choking, gagging or coughing during meals
  3. Ongoing problems with vomiting
  4. More than one incident of nasal reflux
  5. History of traumatic choking incident
  6. History of eating & breathing coordination problems, with on-going respiratory issues
  7. Inability to transition to baby food purees by 10 months of age
  8. Inability to accept any table food solids by 12 months of age
  9. Inability to transition from breast/bottle to a cup by 16 months of age
  10. Has not weaned off baby foods by 16 months of age.
  11. Aversion to all foods with a specific texture
  12. Food range is less than 20 foods
  13. An infant who cries with arching back at majority of meals
  14. Meals are battles
  15. Child is difficulty for everyone to feed
  16. Child rarely meets weight goals.

If you answered “yes” to many of the above items, then you should contact one of our centers to be evaluated by a qualified Speech-Language Pathologist.

Jessica Eberhardt M.S. CF-SLP, TSSLD

How to Foster Early Language Development in the Home

          Early language and communication skills are essential to achieving developmental milestones and later academic success. Language skills are subdivided into two primary category, which include how a child understands language (i.e. receptive language) and how a child expresses oneself (i.e. expressive language). Expressive language includes more than just verbal communication, such as body language, facial expressions, and gestures. Studies have shown that children who develop stronger language and communication skills in their early years are more prepared to succeed upon entrance into school. Additionally, these children encounter fewer obstacles when learning how to read and write.
          Parents always ask me what they can do at home to help foster their child’s speech and language skills. Finding additional time in the day to target speech and language can be difficult, especially for the working parents. However, promoting language development is as easy as adding these five daily routines into your schedule!
  1. Mealtime- This is your opportunity to label the foods you are serving and describe them in depth regarding the colors, the textures/consistences, the tastes, and the temperature. This aids in expanding your child’s concrete and abstract vocabulary. Furthermore, this can also serve to decrease frustration with picky eaters by providing them with the tools to explain why they do not like certain foods, tastes, textures, etc.fussykid-large
    1. A fun activity is to provide your child with a variety of snacks and two paper plates labeled “Sweet” and “Salty.” Have the child taste each food and then sort the foods appropriately onto their corresponding plate.
  2. Getting Dressed- Here is your chance to discuss the weather and how we dress differently based on how it is outside. Take time to label/discuss weather attributes (i.e. cold, warm, cloudy, sunny, rainy, snowy, etc.) and the corresponding clothing that is most appropriate (i.e. sweater, pants, t-shirt, shorts, bathing suit, rain coat, coat, boots, etc.)
    1. An easy activity to try is to provide your child with “absurdities” or silly statements that they can correct. For example, “In the winter, I wear a bathing suit.” They love playing the teacher role in any situation.
  3. Reading – Explore the vivid illustrations, characters, and settings in all of the books that you are reading. Follow along with your finger to aid in recognition of sight words. Read the same book over and over again too!kids-reading-book
    1. An easy activity before bedtime is story retell. After you read a story to your child, allow him/her the opportunity to tell the story how they want. This helps promote narrative development, creativity, and sequencing of events.
  4. Backyard Play – This is a great time to narrate the child’s actions and play routines for all outside games (i.e. roll the boll, swing on the swing, ride in the wagon, drive the car, blow the bubbles, etc.).
    1. While playing outside, do not fall into the trap of constantly quizzing your child (e.g. “What is this?”, “What color is this?”, “Where is this?”, etc.). Studies show that auditory bombardment of set phrases describing a child’s actions is an effective way to promote language development. The child gradually corresponds the actions with the words used to describe it.
  5. Bath time – This is the opportunity to label body parts from head to toes, as well as their function (e.g. eyes are for seeing, ears are for listening, legs are for walking, etc.).bathtime_s
    1. Find a toy, such as a barbie doll or action figure, that is water safe and bring it into the tub. Model body part identification on the doll and reciprocate the questions for your child. For example, “Here are Barbie’s eyes. She uses them to see. Where are your eyes?”

 

Jessica Eberhardt M.S. CF-SLP, TSSLD

Step Away From the Sippy Cup!

There seems to be a progression from breast/bottle to sippy cup. Often, the sippy cup is used past the age of one year. The reason for this is because using a sippy cup for a prolonged time promotes sucking methods that hinder expressive speech and swallowing abilities – the article notes, “The spout blocks the tongue tip from rising up to the alveolar ridge just above the front teeth and forces the child to continue to push his tongue forward and back as he sucks on the spout to extract the juice.”  According to the author, “I frequently hear from parents how excited they are to begin teaching their baby to use a sippy cup.  They often view it as a developmental milestone, when in fact it was invented simply to keep the floor clean and was never designed for developing oral motor skills. Sippy cups were invented for parents, not for kids.” The author suggests that the transition should be breast, bottle then an open cup which would be managed by an adult to prevent spills. In addition, the parent could use a straw for their child, but they should cu the straw down so that the child can get their lips around it.

With that said, the same goes for prolonged breast, pacifier, and thumb sucking.

Stefanie C. Fedun, MS CF-SLP

Source: http://blog.asha.org/2014/01/09/step-away-from-the-sippy-cup/