Time to Talk

Learning to speak is a liberating experience for toddlers. It empowers them to express themselves. This is not always true. Dr. Vijay Aggarwal, speech pathologist at AIIMS has lots to say….


The first time when I met Madhukar, he had come to my clinic with his mother. He was tugging at her sari while she talked to me and I saw a six-year-old boy with a thick mop of unruly black hair and sad eyes. His mother shared that Madhukar didn’t like to go to school these days. She was quick to clarify that he was a good student who got good grades in all his written work at school. But, he had become a loner, refrained from meeting his friends and was reluctant to participate in oral tests at school. Whenever Madhukar would open his mouth to answer, normally he would take a second longer to speak the first syllable of the word. It gave an opportunity to his teacher to rectify his fault which he didn’t like at all. His class mates made fun of him!

Like Madhukar, hundreds of children lose confidence in their capabilities because of speech difficulties. Parents tend to notice speech problems in children by the time they turn 3 to 4 years old. This is also the time when child gains fluency in speech and develops a vocabulary. Initially, speech problems may be episodic in nature but as the child grows the problem stays with him.

Contrary to myths, one cannot outgrow stuttering. In fact, if it does not get cured it can leave psychological scars in the child’s mind. Children with stuttering begin to lose confidence and resort to gestures to communicate. Studies have time and again reiterated that stuttering runs in families.

Boys stutter more than girls. In 30 years of my experience as speech counsellor, I have seen thousands of cases and ratio of boys to girls is 70-30. However, girls stutter at an earlier age than boys. Emotions and stammering connect. Often, children who speak normally might stammer if they are agitated, afraid or under stress.

How speech therapy helps

Speech therapy helps in lowering the stutter by using various techniques to develop fluent speech that reduce anxiety levels of children, which helps them to talk more fluently and confidently.


1. Relaxation – To co-ordinate breathing and reduce oral pressure.
2. Phonation – co-ordinate breathing with articulators with soft contacts
3. Automatic speech – to practice technique effortlessly
4. Reading – short stories in simple sentences with voice continuity.
5. Reading and Narration –
6. Conversation in close-set with strangers.
7. Telephonic conversation
8. Conversation in different situation like public gathering, presentation etc.
9. Maintenance and follow up
10. Parents involvement


Coming back to Madhukar, he has regained his confidence when he learned to speak without stammering. Sometimes he does stammer when he is too angry and for these moments his mother hands him a glass of water to cool off. He looks forward to go to school and has a huge gang of friends.

Are You an Overprotective Parent

“The rules for parents are but three—love, limit and let them be.”
- Elaine M. Ward

These days we are experiencing a new breed of parents, who have forgotten to let their children be themselves. This genre of parents have a name—helicopter parents. The name might sound interesting albeit logic defying to you. What’s a helicopter got to do with parenting? Nothing except hovering, yes, helicopter parents hover; they are constantly on guard protecting their children from every fall, fighting their battles, fretting over their grades, negotiating with their friends, always running that extra mile to safeguard their children and their interests.

Now, that’s a good thing, isn’t it? No. Agreed, helicopter parents cocoon their children from adverse situations, reactions and experiences, but while doing this they, in a way undermine the confidence of their children. “All said and done mistakes remain the biggest teachers and if you are not allowed to make one, you are deprived of an opportunity to learn,” says Dr. Arti Anand Consultant Clinical Psychology with Ganga Ram Hospital.

Mugdha Shekhar has just given her class X exams. She wishes to take Maths and Physics in Class XI, whereas her doctor parents are constantly advising her the benefits of opting for Biology, in lieu of Physics. To say the least Mugdha is frustrated. “All my life I felt squeamish at the mention of PTMs. Mom would ask too many questions during the PTMs,” says she.

Parents need to grow upIn a bid to protect the interests of their children these parents go to extreme lengths, often fighting their battles. In the year 2007 US media was splashed with the news of suicide of Megan Meier, a 13-year-old girl from Missouri, USA who killed herself after an online relationship she believed she was having with a teenager named Josh Evans turned sour. What her parents learned six months after the suicide was that Josh Evans was a fictitious creation, which was created by Lori Drew, a 47-year-old mother of one of the former friends of Megan Meier to settle score with her.

This might be an extreme instance of helicopter parenting, but instances abound where parents peer over each aspect of their children’s lives: do their school projects, shuttle them after school to various hobbies, hog attention during PTAs, scrutinize their report cards closely.

Dr Anand says, “Children with possessive parents or highly critical and judgemental parents will have lowered self confidence and self-esteem, they will have problems in making decisions and may have difficulties in dealing with others and in their relationship. Such adults will grow up to be confused and may not be able to take responsibility for their actions. Such adults may be become highly anxious and depressed easily and are overly sensitive to criticism.”

Millennia kids, roughly the kids born between 1981 and 2002 are experiencing this treatment. Roma Ranjan, mother of two teenage children says, “This generation is a pampered generation. As parents we strive, scurry and do everything feasible to fulfill the whims and fancies of our children. By serving everything on platter we are painting rosy picture of life before them.”

Namita Gokhale adds, “Last Saturday I had gone to the graduation ceremony. Don’t get me wrong, my daughter graduated from pre-school." "Aren’t we overdoing things?" quips she.

Bedwetting

Almost all mothers encounter bedwetting—nocturnal enuresis. Most kids become fully toilet trained between ages 2 and 4 — but there's no target date for developing complete bladder control. Girls get toilet trained faster than boys.
Causes
• Kids, who wet the bed are not able to feel that their bladders are full and don't wake up to use the toilet.
• During childhood, some kids don't produce enough anti-diuretic hormone, or ADH, to slow nighttime urine production.
• A urinary tract infection can make it difficult for child to control urination.
• Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep — often because of inflamed or enlarged tonsils or adenoids.
• For a child who's usually dry at night, bed-wetting may be the first sign of type 1 diabetes, if it is accompanied with passing large amounts of urine at once, unusual thirst, fatigue and weight loss in spite of a good appetite.
• Sometimes children who don't have regular bowel movements retain urine as well. This can lead to bed-wetting at night.
• Sometimes a kid who wets the bed will have a realistic dream that he or she is using the bathroom.
• Many kids who wet the bed are very deep sleepers.
• Bedwetting may also be the result of the child's tensions and emotions that require attention. Enuresis runs in families too.

When a young child begins bedwetting after several months or years of dryness during the night, this may reflect new fears or insecurities. These include losing a family member or a loved one, arrival of a new baby, change of home. What your child needs is increased attention and assurance from you for these abrupt episodes of bedwetting to go away.

What can you do at home to prevent bedwetting

Children rarely wet on purpose, and usually feel ashamed about the incident. Hence, do not discuss bedwetting with anyone when the child is present. A pediatrician's advice is often very helpful in treating bedwetting. Do not give the child liquid to drink just before he goes to bed. Most importantly, do not fret about bedwetting because kids outgrow it.

Is Your Child Sleep Deprived

Are you one of those parents who are apprehensive of your child’s sleeping pattern? Then, this is the wakeup call for you. Just like adults, children need to sleep well to replenish their energy reserve and get ready for another day. Study says that sleep deprivation in children has been linked to lowered immunity, diabetes, depression, obesity, hindered physical development, stress and anxiety. When children don’t get enough sleep, it can have a negative effect on their overall health.

Why sleepless?

What causes turmoil in bed for young children? In young children, however, failure to establish a regular routine is frequently to blame. Physical factors such as bedwetting, general illness and developmental delay can cause sleep problems.
Psychological factors that can cause sleep problems include anxiety about separation from parents, fears (for example, of the dark), depression, drug abuse (in older children) and sexual abuse. A bedroom that is cold, noisy or damp may deter child from sleeping.
Dr. K. Ramalingam, pediatrician informs, “ Children who are experiencing exam fever, are couch potatoes and watch too much TV or are on the internet can suffer from sleep deprivation.”

Loss of sleep in your child can manifest in following behavioural changes–• Aggressive behaviour• Temper tantrums• Decreased patience• Hyperactivity• Crying and fussiness• A feeling of continuous lethargy• Poor concentration• Poor school performance

Dr Ramalingam points out the health hazards of sleep deprivation in children. “Poor food habits, unseemly growth and development, stomach upsets like constipation or irritable bowel syndrome and even depression can hit a sleep deprived child.”

How can you make your child sleep well?

• Create a simple and familiar routine for bedtime. For example: feed, bathe, and put to bed

•Allow toddlers time to settle down. If they make a fuss, don’t give in immediately.

• Keep things quiet, this helps toddlers to settle and teaches them that the night is different from the day.

• Alternatively, keep natural house noises going.

• Make sure your child unwinds before the bedtime. This will make the transition from lively toddler to a sleeping child easier.

Waking up too early:

• Use thick curtains to make children’s rooms darker so the morning light doesn’t wake them.

• Provide safe toys for him to play with in the mornings, so he can play quietly until he hears that the rest of the family is awake.

• If your child’s a natural early riser, you may just have to be patient. Usually, once children start nursery or school, they tend to sleep in for longer.

Waking in the night:• Be realistic and remember that everyone’s sleep requirements and patterns vary. Some people need eight hours or more, others can manage on five or six.

Many toddlers continue to wake during the night for feeds. If you’d like to stop this, cut down night feeds by gradually replacing milk with water. When you go in to comfort him, keep the lights low and use a soft voice. Don’t encourage any kind of activity. You’ll probably need to do this several times.

Bone Building

As mothers we fret and fume to make our kids down milk every morning and evening. Errant kids will cajole, plead, argue and throw tantrums to escape milk making us think– blessed is the mother who have kids that drink milk minus tantrums! After all bones provide the framework for your child’s growing body. Milk is rich in calcium and thus crucial for bone health of your kids.Exasperated mothers can heave a sigh of relief from the study published in the American Journal of Clinical Nutrition. This study says that higher intakes of fruits and vegetables throughout the teen years improve bone density in adulthood. This does not mean negating the importance of dairy but other factors like a diet rich in fruits and vegetables, exercise and sunshine are equally important.Bone basicso Bone is the living tissue that changes constantly, with bits of old bone being removed and replaced by new bone.o The bone mass acquired in childhood and adolescence is an important determinant of lifelong skeletal health.o Bone mass or density is generally higher in men than in women.o Sex hormones, including estrogen and testosterone, are essential for the development of bone mass. Girls who start to menstruate at an early age typically have greater bone density.
The minerals in a child’s skeleton are completely replaced (or recycled) about five times between childhood and her or his 55th birthday.

Say yes to fruits and vegetables. An array of nutrients—vitamin C, vitamin K, potassium, and magnesium—found abundantly in fruits, vegetables, and other plant foods, have been shown to promote bone health.

Vitamin C from citrus fruits, tomatoes, peppers, and other fruits and vegetables is essential for making collagen, the connective tissue that minerals cling to when bone is formed.

Vitamin K is thought to stimulate bone formation. It is found most abundantly in dark leafy greens like kale and spinach, but is also readily available in beans, soy products, and some fruits and vegetables.

Potassium decreases the loss of calcium from the body and increases the rate of bone building. Oranges, bananas, potatoes, and many other fruits, vegetables, and beans are all rich sources of potassium.

Magnesium, like calcium, is an important bone mineral. Studies have shown higher magnesium intakes to be associated with stronger bones. “Beans and greens”—legumes and green leafy vegetables—are excellent sources of magnesium.o Diets high in fruits and vegetables actually tip the acid-base scales in the opposite direction and make it easier for bones to hold onto their calcium.

Go outdoors

Bones function on a simple logic. Either use them or lose them. Exercise stimulates bones. For this to occur, your bones must sense more strain or pressure than they do in everyday life. This is why “weight bearing exercise”, like running, jogging, skipping is usually mentioned when it comes to building strong bones. The mechanism occurs based on “Wolff’s Law” which basically states that new bone is laid down where it is needed based on outside mechanical stresses applied to the bone involved. Bone is also removed where it is not needed — which is why being inactive and sedentary can cause osteoporosis or weak bones. Besides playing outdoors also gives your child the necessary vitamin D for strong bones.

Sneak in milk

Kids who do not love milk may like it in ice creams, custards, puddings and soups. Think of innovative ways to outsmart your kids

Coping with exam stress

Exams can be stressful. For that matter anything that has a result attached to it, which can impact your life is stressful, say for instance--your performance appraisal, job interviews and even exams. Exams and more specifically the results associated with it are stressful because in Indian scenario exams decide a whole lot of things, which means the course of your career and the source of your livelihood. Moreover parents also put emphasis on settling down their children and exams decide everything in this critical process.

How exam stress kicks in the child?

Stress can express itself in different ways, but for different people before an exam. You might feel knots in your stomach or have the urge to visit the washroom all the time. This kind of anxiety is called anticipatory anxiety and results in adverse affects on the body and mind and therefore, a sub optimal performance.

"Stress not only causes palpitations and tense muscles but also reduces the ability to make decisions, act or express oneself including organization of thoughts," says Dr K.K Agarwal. Stress during exams can makes it difficult to read and understand questions and even to recall terms and concepts.

What can you do to cope with exam stress?

A recent study has shown that 45 minutes of afternoon nap improves the declarative memory. Declarative memory is the memory of events learnt and understood earlier during the year.

Not taking afternoon nap or the night sleep may cause the child end up with transient loss of declarative memory.

Free Writing Can Clear Mental Stress: By spending 30 minutes each day for four days to write out your innermost thoughts and feelings, one can significantly boost mental and physical health. In expressive writing therapy, students are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It’s akin to keeping a journal, but more focused on the things that might be bothering you or triggering stress.

Everything you wanted to know about pacifiers

New borns can cry for as many as two hours in a day. During these crying marathons, many new mothers confront a choice of offering pacifier to their crying baby. Sometimes after making the decision to offer pacifier, guilt overpowers them. These mothers may find some relief from the fact that American Academy of Paediatrics gives green light to pacifiers through out the baby’s first year.

Thumbs up

Sucking is a natural reflex of baby. For some babies the amount of sucking they get during feedings is less. Pacifiers can be a key to contentment between feedings for these babies. Bottle-feeding mothers can buy some time with pacifier while preparing milk for her hungry baby. Pacifier can make a restless baby sleep.

Moreover, it is easier to break the habit of sucking on a pacifier as compared to sucking on a thumb. You can throw a pacifier. Research proves that a pacifier may reduce the risk of Sudden Infant Death Syndrome.

Thumbs down

Pacifiers may interfere with breast-feeding.
Babies may become dependent on pacifiers, and, you may have to wake up at night on hearing your baby cry to grope for the lost pacifier. Pacifiers may increase middle ear infection. Middle ear infections are most common in children below three years of age. The risk of ear infections is the lowest in the first six months when the risk of Sudden Infant Death Syndrome is the highest.
When it comes to making decision, mother is the best judge.

Dos

Allow breastfeeding to establish, before you introduce pacifier to your baby.
When it comes to sucking on pacifier let the baby decide.
Replace cracked nipple and keep identical spares.
Wash pacifier thoroughly with soap and water; put it in hot water with white vinegar, equal parts to kill germs for ten minutes everyday.
Try to get your baby off pacifier after the first year.

Don’ts

Do not put pacifier in the mouth of a sleeping baby.
Do not shove in pacifier in your baby’s mouth every time she cries.