The seasons are changing and with that change comes increased congestion for children around the world. Whether you are moving from fall into winter or winter into spring, the changing temperatures, moisture levels, and changes in the trees and other plants outside can produce allergic responses in children and adults. So while these changing seasons can often bring increased opportunities to get outside with all of those benefits to breathing, regulating the nervous system and disrupting repetitive behaviors, there is the real issue of increased congestion.

So what’s the big deal with congestion? My grandchild’s pediatrician told us that we should expect my grandchild to be sick 90% of the time if she attended a preschool or day care. The doctor went on to say that this was nothing to be concerned about because most of the illnesses were just colds and congestion. What that really meant is that my grandchild would be experiencing distorted auditory information 90% of the time. That’s a big deal.

Whether children attend preschool, playgroups, grade school or go to “kid gyms” the increased exposure to illness combined with seasonal allergy triggers create a perfect setting for long periods of congestion. If congestion is so common among children in the general population, why are we so worried about it? Why should you be concerned? The short answer to that is that it impacts negatively on the quality of sound that is being transmitted to the brain.

Let’s look at how this might impact on a child with Down syndrome or any other syndrome that impacts negatively on the structure of the sinuses and ear canals. With many children, the ear canals tend to be small. By the way, many neurotypical children have small ear canals as well. These narrow canals make it hard for physicians to see or address typical issues such as ear wax that reduces the ear drum’s ability to move as well as making it difficult to see ear infections. Nasal and sinus congestion backs up into the middle ear causing the eardrum to lose much of its movement which then results in poor communication of accurate sound signals. Your child is not hearing with clarity. What they hear can be muffled and difficult to understand.

Obviously receiving poor quality sound impacts negatively on auditory processing, auditory attention and the development speech and good articulation. It also results in the child not necessarily responding when spoken to, being slow to imitate sounds, and appearing to tune out to what is going on around them. There’s more bad news in that nasal congestion produces mouth breathing which results in the child leaving their mouth open for long periods of time. This allows the jaw to stay in a relaxed position and can lead to the tongue sliding forward. So we have a cascading impact triggered by congestion.

Now let’s consider the impact on children with sensory issues. Have you ever had a cold and had that feeling of being detached from what is going on around you? Your head hurts. You’re tired because the congestion disrupts your sleep and you feel spacey because your hearing is distorted and even your sense of balance is impacted. You can’t taste your food and don’t even feel like eating. If this is how you feel with a cold, imagine the impact of congestion on your child with sensory issues.

For children who already may spend a great deal of time not processing auditory input or not processing it accurately, congestion adds another layer of distortion and isolation. We spend a lot of time doing program pieces that require and invite children to attend well to auditory input, to language, frequent congestion can result in even less attention to auditory input and a resulting increase in DSA’s (stimming behaviors).

So what can we do about this? Our best bet is typically to improve or maintain an extremely healthy diet rich in deeply-colored and diverse organic vegetables and healthy proteins. We will talk about nutrition and diets as a regular part of our monthly newsletters in the future. For now, let’s just simply state that we want to avoid mucous-causing foods during any period when the weather or exposure to other people may increase the risk of congestion. Typical mucous-causing foods include dairy, eggs, pasta, cereals, bananas, potatoes, corn, soy products and to a lesser degree, cabbage, corn and red meat. Many of these foods are not good for a variety of other reasons as well.

In future articles we will write about how to get your child to eat “the good stuff” and we encourage and invite you to share recipes and ideas on our Facebook page. Let’s help each other discover great ways to get our children to eat well. I’ll give a little shout out here to one of our new families in Australia who grow all their own organic foods for themselves and their little girl. Evie is a very lucky girl to have such incredible food resources. Unfortunately, we don’t all have a home that would easily allow us to grow all of our own food but we can share resources from around the world to give our children and ourselves the best nutrition and health possible.

Reprinted by permission of The NACD Foundation, Volume 33 No. 11, 2020 ©NACD

The post How Clearly Is Your Child Hearing You? appeared first on NACD International | The National Association for Child Development.

Dear Bob,

I am becoming very concerned with my two-year-old son and his lack of language development, he only says a few words and recently just put his first two words together “top it”. Should I be concerned and what should I do?

Thanks,
K

Dear K,

I’m glad you asked this question; it is a question many parents should be asking. There is a wide range of function that falls within “normal” limits, so you don’t need to panic or go looking for a label. In general, however, we would like to see children functioning at the upper end of the spectrum. At age two, your son should be using between 100 and 250 words and use many couplets (two-word phrases), so with having only a few words and one “almost couplet,” it would be good to give things a push.

In evaluating children’s development, when we see a problem with what is coming out, (in your son’s case language) we look for a problem with what is going in. When it comes to language development the concerns are tonal processing (the ability to hear the various tones utilized in speech) and auditory sequential processing (the brain’s ability to link sounds together as in syllables and words). Later, as we become more concerned with how clear the speech is, we look at oral-motor ability, which involves the actual mechanics of producing the sounds vocally.

To start the process of identifying possible causes for a speech delay, take your son to an ear, nose and throat doctor (ENT) for an evaluation. An ENT specialist will check your son’s hearing, which will help identify any actual hearing loss. The hearing test itself will not be able to identify a tonal processing problem, however. At this time, voice analysis is the closest thing we have to a test that identifies tonal processing problems. However, we know that fluid accumulation in the middle ear is the most frequent reason for lack of tonal processing development. And, although the ENT doctor cannot test your son’s tonal processing directly, he can check for fluid in the middle ear with a quick, painless test called a tympanogram. Our Medical Director generally recommends you get a series of tympanograms over several weeks to establish a baseline and make sure the ears are clear and staying clear.

If your doctor finds fluid is accumulating in the middle ear, this is called otitis media. When there is a problem with language development, aggressive treatment of the otitis media is recommended to clear the ears of fluid so that your child’s tonal processing can develop normally. Parents need to be aware that otitis media can exist without any external signs or symptoms, so your child could have a chronic problem and never complain. Our experience has shown that one of the major causes of otitis media appears to be consumption of dairy products because they tend to produce mucus. In many children, otitis media can be reduced or eliminated completely by avoiding dairy products in the diet. If otitis media remains a problem, ear tubes can be placed to drain the fluid on a constant basis to prevent it from building up and interfering with auditory development.

If we suspect a tonal processing problem exists, we initiate a home-based sound therapy program to help correct the problem. Nothing is going to really help, however, unless the ears are kept clear of fluid.

The second area to investigate is auditory sequential processing. At age two, your son should be able to process two-step directions well. You should be able to say to him, “Touch your nose and tummy,” or, “Get your pig and horse,” or, “Stand up and clap your hands.” He should be able to follow directions like these without having been taught the sequence and without visual cues. Sequential processing should develop at the rate of a piece per year for the first seven to nine years, which means that a typical two-year-old can process two pieces of sequential information (i.e., follow a two-step direction), a three-year-old can process three pieces of information (follow a three-step direction), a four-year-old four pieces, and so on. Lack of auditory sequential processing ability leads to labels such as Developmentally Delayed, ADD, ADHD, Dyslexia, and Learning Disabled. To learn more about sequential processing go to www.nacd.org and click on “Free Memory Test.” [This test is no longer available at this time, but you can visit mysimplysmarter.com and take the test with your Free Trial.] (While you’re at it, check the processing levels of everyone in your family by participating in the Simply Smarter Project. This Project is part of NACD’s international effort to increase critical processing abilities in children and adults all over the world.)

If your son has clear ears and good tonal processing, and if he sequences two pieces of information well, then make sure he needs to speak. Try not to respond to gestures and grunts but rather encourage him to say a word or short phrase for what he wants. If he doesn’t come up with his own words at first, model the word or phrase and let him repeat it. Listen and respond to his talking, and make sure older siblings are not speaking for him but take time to let him speak for himself.

Best of luck,
Bob Doman

Reprinted from the Journal of The NACD Foundation (formerly The National Academy for Child Development)

Reprinted by permission of The NACD Foundation, Volume 20 No. 3, 2007 ©NACD

The post Parenting 101: Questions for Bob Doman, Part 2 appeared first on NACD International | The National Association for Child Development.