Archive for March, 2011

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Typical Communication Development 18 months to 3 years

Typical Communication Development from 18 months to Three Years Old and Related Red FlagsThe focus of this blog is to provide an overview of typical communication development for young children from 18 months to three years old, as well as pointing out behaviors that could be a red flag for a delay or a disorder at which point you would seek help from your pediatrician and/or a pediatric SLP.As I have discussed when speaking about development from birth to 18 months, children’s communication skills are divided into areas of development that include how they gesture and imitate adults’ actions (i.e., non-verbal skills), what they hear, what they understand (i.e., receptive skills), what they say (i.e., expressive skills), the sounds they make (i.e., articulation), their ability to move their mouths and oral articulators, such as their tongue or jaw (i.e., oral-motor skills), respiration coordination, their voice and fluency skills. All of these skills develop and work together to allow the children to become independent and successful communicators. If any of these skills are delayed and developing in an atypical manner, it can disrupt a child’s successful communication development.On average, children who are 18 months are using approximately 50 true words and up to 300 words by 2 years old (although there can be a range of 100 words to 500 words that fall within normal limits). Around 18 months children begin combining words and using 2-word phrases so that by 3 years old they’re using consistent 3-5 word phrases for a variety of purposes, such as to request, to name, to comment, to question, to give directions, and to negate or contradict what has been said. They still understand much more than they say and understand new words daily, as well as categories, descriptions, location words, questions, and lengthier sentences. Between the ages of 2 to 3, the communication usually becomes richer, more complex, and abstract so that the child is no longer talking about what is right in front of him but can tell you about his experiences that happened to him or what may happen in the future. He’s more curious about his extended environment and makes associations with things he sees at the moment with things he learned about or experienced before.  He changes his voice so that a parent can differentiate between when he makes statements, asks questions, makes commands, or when he’s confused, needs help or needs comforting. Although he may repeat himself often or repeat words (that sound like a stutter), his speech is generally fluent and his speech sounds are becoming clearer so that by age 3 he is intelligible even to unfamiliar people. Also, his pretend play becomes more creative and elaborate so that his language is used for acting out his imagination and goes beyond just getting his wants and needs met.If by 3 years old the child is not expressing himself clearly so that most people understand when he speaks about a familiar topic, or if the child stutters more often than just occasionally repeating whole words and is frequently repeating sounds and syllables, or if a child isn’t improving in his ability to understand what is said to him or express himself to his fullest potential, it may be time to seek a pediatric SLP for a speech-language evaluation. Parents must remember the range of communication skills is great and highly dependent on many factors. The amount a child understands and uses language can be affected by gender, with girls typically being more talkative with bigger vocabularies than boys. It can also be affected by siblings, birth order, bilingual or multilingual homes, life experiences, and cultural expectations to name a few influences.However, if a parent, a grandparent, a teacher, or a pediatrician strongly suspect that the child’s communication skills may be delayed or are interfering with his growth, then an evaluation can both rule out any disorder that may be causing it as well as provide suggestions for building those communication skills.

Typical Communication Development 0 – 18 months

Typical Communication Development from Birth to 18 Months Old and Related Red Flags

The focus of this blog is an overview of typical communication development for young children from birth to 18 months, as well as behaviors that could be a red flag for a delay or a disorder at which point you would seek help from your pediatrician and/or a pediatric SLP.

iPad Apps for Building Young Children’s Narrative Skills

Narrative skills, or the ability to tell a story, are a key skill set for communicating effectively. They begin for young toddlers by simply naming individual events, such as “I fell down” and then become heaps of information “The boy fell down. He hurt his knee. He cried. The teacher put a band-aid on it”. As narrative skills progress in preschool and kindergarten, the child includes more detail about the characters, more cause and effect sequences, the problems that occurred and how they were resolved. This could sound something like, “A boy in my class was riding too fast and he didn’t see the big rock. So he rode right into it and then fell off his bike. He scraped his knee so it started bleeding. He cried until his teacher came outside and helped him by putting a band-aid on it. I think he’ll ride slower next time.”

Charlie Sheen

Where is a mental health intervention when one needs one? Why hasn’t Dr. Drew (who generally has no problem voicing his opinion) stepped up and said something – loudly. Where are the parents? The famous brother? His colleagues and “friends.” Why are we all sitting by while Charlie Sheen dives off the bi-polar deep end into an empty swimming pool? The actor in the past few weeks has been a fascinating slow motion train wreck. His escapades have been printed on all the gossip news sites. His delusional, frantic and frenetic ranting coupled with his egomaniacal delusions of grandeur (“I am more known than Obama”) is a psychologist’s wet dream. The media has allowed Sheen to further show us just how tightly his ego and mental illness has him by his throat. His demand for 3 million per episode, for a show that has been cancelled, is simply embarrassing. I don’t think he’s even worth the 2.2 million he is currently being paid. His outright misogyny and possible anti-Semitism is just pathetic and not all that shocking. I keep asking myself what the hell is he thinking? But of course Charlie isn’t thinking he’s merely defending his disease. A disease of addiction and denial. Perhaps the saddest part of his story is that he genuinely believes he has cured himself of smoking crack cocaine by using only the power of his mind. A diseased mind cannot cure itself. It can lie to itself. It can and does cause massive mental anguish and clearly in the case of Sheen it has caused temporary insanity. Here’s what I think he should do. First and foremost: Shut up. Just stop talking, tweeting and bleating. Yes, it makes for fascinating T.V. and feeds the starving ego but it also makes him look more deranged than he possibly is. He needs to be checked in to a psych ward either voluntarily or placed on a temporary hold (his parents can do this). A Full psychiatric evaluation is needed, and I am guessing that prescription drugs and nutrition will go a long way in helping him stabilize himself. He needs to hire a publicist. One with a conscience and stellar reputation. The porn stars, the prostitutes, the baseball buddies, even the ex-wives all need to go away. Charlie has enough money that he can buy himself quite a few redemptive fluff pieces in the better daily rags and of course there is always Oprah – after all has calmed down he can self flagellate in front of the Queen of Mush and American can breathe a collective sigh of relief and go back to watching the Lindsay Lohan train wreck.

Go for a Million!

Every day we are bombarded with statistics about how fat, lazy and unhealthy we are as a nation. Over 108 million of us have a chronic disease such as high blood pressure, asthma, osteoarthritis, heart disease, diabetes. All of these things are killing us or injuring us, affecting the quality of our lives and the lives of those we love. And, it affects our workplace. The unhealthier we are, the less productive we are. Not only are we less productive for our employers, but we cost them more money in health insurance. The majority of Americans receive health insurance through their employers, and the employers directly feel the costs of a fat, lazy and sick workforce as insurance rates skyrocket.

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