Shule101

How to Tell (and What to Do) When There Is a Delay
By: Kevin Klein

My friends Dave and Patricia have two kids, Xavier and Declan. They’re what are technically known as “beautiful” boys: huge eyes, long lashes, button noses, and mischievous grins. Both are sociable and cuddly, but while six-year-old Xavier speaks like an adult, two-year-old Declan doesn’t talk yet.

In fact, until a month ago Declan had not even begun to babble or imitate the outside world. He laughed, cried, and screamed with gusto, but the critical aspect of language development was missing. Fortunately, Patricia is trained to help kids with special needs, and she and Dave have been able to get Declan the help that he needed.

Chances are if your child is developmentally delayed, you and your pediatrician will pick up on milestones that just aren’t being met.

Checking Developmental Milestones
The first step in recognizing possible delays in development is to compare your child’s abilities with the expectations for the average child at his or her age. The following milestones for social interaction and language skills come from First Signs, Inc., a national non-profit organization dedicated to educating parents and pediatric professionals about the early warning signs of autism and other developmental disorders.

Four months: Follows and reacts to bright colors, movement, and objects. Turns toward sounds. Shows interest in watching faces. Returns smiles.

Seven to eight months: Sits unsupported. Imitates sounds. Crawls. Claps, points, waves. Bangs two objects together. Understands “no” from your tone of voice.

12 months: Uses a few gestures to get needs met and likes using hands to communicate, share, or point. Will turn to a person speaking or when his name is called. Plays peek-a-boo or other social games. Makes rudimentary mono-syllabic sounds such as “ma,” “ba,” “da,” and “ga.”

15 months: Exchanges smiles, vocalizations, and gestures with you. Uses pointing and other motions to draw attention to something, uses voice to get needs met or garner attention. May be able to speak and understand three or four words, such as “momma,” “poppa,” “bottle,” or “bye-bye.”

18 months: Uses lots of gestures as well as words to get needs met, like pointing or taking you by the hand and directing you to something. Uses at least four different consonants in babbling or words, shows that he knows the names of familiar people or body parts by pointing to or looking at them when named, and plays simple pretend games (like feeding a doll).

24 months: Engages in complex pretend play (such as feeding a doll then putting it to sleep). Uses and understands at least 50 words and can string words together. Enjoys being with children of the same age and is interested in playing with them and/or sharing toys. Looks for a familiar object out of sight when asked about its whereabouts.

36 months: Enjoys pretend play with different characters and with a story line, enjoys playing with other children, uses thoughts/actions together with speech to communicate and play. Will answer simple “who,” “what,” and “where” questions easily and talks about things in the past and the future.

It’s important for parents to remember that a chart of milestones can’t take the place of a screening test performed by a specialist. Rather, the milestones chart will only help parents know whether they should raise their concerns—and also how they can explain those concerns to the doctor. For parents who want more specific resources before consulting with a doctor, there are screening tools available for order online. The medical testing company Forepath (www.forepath.org) offers its PEDS Child Development Screening Test over the Internet for a small fee. The online test also includes the M-CHAT (Modified Checklist for Autism in Toddlers) for parents whose children are over 18 months but younger than five.

Talking to Your Child’s Doctor
Once you’ve identified areas of suspected delay in your child’s development, make an appointment with your general practitioner or pediatrician. While these doctors rarely get involved in the diagnosis and treatment of developmental disorders, it is generally necessary to get a referral from them for a consultation with the appropriate specialists. To confirm her suspicion that Declan was undergoing a developmental delay in language, Patricia checked a range of milestone charts. She saw that Declan’s problem-solving, cognitive, and motor skills were all normal; however, he was several months overdue for milestones in receptive language (understanding what is spoken to him) as well as expressive language (speaking to others). She took him to the family practitioner, who referred her to a speech pathologist and an audiologist.

Visiting the Specialists

As in Declan’s case, the referral from a general practitioner or pediatrician will usually include more than one specialist. The audiologist found that Declan’s hearing was at the lowest level of the normal range; due to repeated ear infections, he has fluid in his middle ear that will require tubes to drain.

Hearing plays a significant role in children’s development of language, especially in children up to three years, who fall into what the National Institute on Deafness and Other Communicative Disorders has termed the critical period for language development. The expectation is that Declan’s language abilities will jump once his hearing improves; if they don’t, however, there may be other problems preventing his development and further tests by other specialists (such as psychologists and neurologists) would be undertaken.
After the audiologist’s testing, the speech pathologist did a developmental assessment on Declan and determined that his receptive language development was six-months delayed and his expressive speech was twelve-months delayed. The specialist recommended speech therapy every two weeks. After two months of therapy, Declan’s vocabulary increased from two to 25 words. Declan’s story is turning out well so far, thanks to early and rapid intervention. His mother knew exactly what kind of assessments to expect and which treatments would be recommended depending on the results. However, for concerned parents who feel overwhelmed by a lack of understanding about their child’s problems, specialist visits can be intimidating.

Managing Problems
While some developmental delays can be overcome through treatment, as in Declan’s case, often the assessment of these delays can lead to the diagnosis of one of a range of Pervasive Developmental Disorders (PDDs), the most commonly known of which is autism. PDDs are often called Autism Spectrum Disorders because they are classified by the severity of the symptoms present. For example, autistic children have significant deficits in social interaction and communication and they tend to engage in repetitive behaviors such as rocking and stroking or tapping themselves. By comparison, children with Asperger’s can use language much more effectively, although one symptom of Asperger’s is a fixation on an object to the extent that the person speaks to others mainly about that object, regardless of social situation. According to the National Institute of Mental Health, symptoms of PDDs can be detected in children as early as from birth to one year. In terms of assessment and treatment, doctors will generally refer to a child psychologist or psychiatrist if a PDD is suspected. Treatment can help alleviate symptoms of PDDs (for the child as well as the child’s family), but as the term “pervasive” suggests, these disorders cannot be outgrown or cured. Finally, a word on recognizing, testing, and treating sensory integration problems. The concept behind these problems has been around since the late 1970s, when occupational therapist A. Jane Ayres presented a theory unifying some children’s highly exaggerated sensory responses—of touch, taste, sight, smell, and sound—under the term Sensory Integration Dysfunction (SID).
For example:

A child with auditory defensiveness may cover his ears and throw a tantrum if his kindergarten class sings a song together.

A child with tactile defensiveness may violently resist wearing shoes or may be agitated by the inside tags in her clothing.

More detailed descriptions of children with SID can be found on the website for Carol Kranowitz’s benchmark book on SID, The Out-of-Sync Child. Perhaps because SID has been largely studied and treated by occupational therapists rather than psychologists, and because its definitions are still being clarified, SID does not appear in the DSM-IV, the official manual of mental disorders. Diagnosis and treatment of SID, then, must usually be undertaken by an occupational therapist certified to administer the Sensory Integration and Praxis Tests (SIPT). While not categorized as an Autism Spectrum Disorder, SID presents parents with the similar challenge of early detection and intervention—not because SID can be cured, but so that the child and his family know how best to minimize and adjust to the symptoms.

Tips to Prepare Kids for the Big Day

By: Leigh Felesky

“Will my teacher be nice? Where will I sit? Will the other kids like me?” Many kids get nervous about heading back to school. A big part of a successful first week is establishing a routine and explaining where the bathroom is, what happens when you go to gym class and when to expect recess. With a little preparation, parents can help. Here’s how to make your child’s transition a smooth one.

Get Ready! Don’t underestimate the fun and importance of new stuff for the big day. With younger kids, a bag full of school supplies, a new backpack and a few new items of clothing tend to gear them up without any further encouragement. For an older child, this may be the time to give the thumbs-up to that must-have trend item.

Show Them the Way. If she’s new to the school, show your child her classroom, what entrance and exit to use and where the bathroom is located. If she’s taking the bus, visit the bus stop location and explain how to get on and off, especially if it’s the first time. Show her the drop off and pick up spot at school, too—if you’re not sure where it will be, call the school ahead of time to find out.

Prepare the Teacher. Let your child’s teacher know about any specifics about behaviour or health, such as a bladder infection. You don’t want a child to have a bad experience because he’s asking to go to the bathroom every half hour and the teacher says, ‘No,’ thinking he doesn’t need to go so frequently but really he does.

Be Organized. Ease back-to-school anxiety by being prepared. Help your child to lay out her clothes and pack her backpack the night before. Be sure to include a healthy lunch and a snack that your child can open and eat on his own.

Take It Easy. Preparation is great—but don’t go overboard. You’re the best judge of when your child needs reassurance, and how to go about giving it. In the end, remember that it’s normal to feel a little nervous or fluttery about that first week back. Everyone, including the teachers, feels like that.

Finding out how things are going in your child’s life sometimes takes a bit of strategizing. These tips and questions can help you get the conversation started.
by Patti Ghezzi

One day your child tells you everything, from the consistency of the macaroni and cheese in the cafeteria to the hard words on the spelling test to the funny conversation she had with her best friend.
The next day…poof.
Parent: “So, what’s going on at school?”
Child: “Nothing.”

For many parents, the information they receive about what’s happening at school ebbs and flows, especially once their kids hit 10 or 11 years of age. Even younger children may be reluctant sometimes to share the details of school life.

It doesn’t mean that something’s wrong or that you’re somehow missing a key piece of the parenting puzzle. It may simply be that your child is asserting independence and craving a little privacy. “No one tells parents this,” says Peter Sheras, a clinical psychologist and professor at the University of Virginia who specializes in adolescent relationships, family relationships, and stress. “Parents feel they are not very good at parenting.”
Of course, that’s not the case. You might just need to tweak your approach. Don’t interrogate, Sheras says. Kids don’t want to be grilled. Be subtle; be patient. Learn to listen intently to the words your child does offer. Watch your child’s body language and demeanor. Avoid yes-or-no questions if possible, and be specific. Try escalating—starting with simple questions and gradually delving into more sensitive topics.

If all else fails, wait it out. Try again later with a different approach, such as choosing a different time of day to start a conversation or taking your child out for a burger before asking questions. In a place where she’s comfortable, she might feel more talkative.

Don’t start the conversation with “We need to have a talk,” Sheras says: “That’s when a child dives under the table.”
Here are some questions that can help you get started.
1.    “I know you were stressed out about that math test. How did it go?”
2.    “I’m really proud of how well you’re doing in school. What are you studying these days that really interests you?”
3.    “You seem to have some good teachers this year. Which one is your favorite?”
4.    “If you could make up a teacher from scratch, a perfect teacher, what would he or she be like?”
5.    “When I was your age, I really didn’t like social studies. I just didn’t see the point in studying how people in Russia lived or what kind of languages Native Americans spoke. What subject are you really not liking these days?”
6.    “What’s your favorite time of day at school?”
7.    “What do you think about your grades? How does your report card compare with what you were expecting?”
8.    “We used to have the meanest boy in my class when I was your age. I still remember what a bully he was. Do you have anyone like that in your class?”
9.    “I’ve been reading a lot in the news about kids picking on other kids. What about at your school? Is that happening?”
10.    “I’m hearing a lot about bullying on the Internet. It sounds a little scary, but I really don’t know what it’s all about. Can you tell me about it?”
11.    “I noticed a few new kids in your class. Which ones have you been able to get to know? What are they like?”
12.    “I know it was hard for you when Kenny transferred to a different school. How’s it going without your best friend around?”
13.    “Who did you sit with at lunch today?”
14.    “I’m sorry you didn’t get invited to Sarah’s birthday party. I know you’re disappointed. How have things changed between you and Sarah now that you’re not in the same class?”
15.    “I really like the way you choose such nice friends. What qualities do you look for in a friend?”
16.    “I know you really like your new friend Caroline, but whenever I see her she’s being disrespectful to adults. Why don’t you tell me what I’m missing? What do you like about her that I’m not seeing?”
17.    “I can tell it embarrasses you when I insist on meeting your friends’ parents before letting you go to their house, but it’s something I need to do as your mom. Is there a way I could do it that would make you feel more comfortable?”
18.    “How’s it going with your activities and schoolwork? What would make it easier for you to manage your schedule and responsibilities?”
19.    “I feel like I haven’t talked to you in ages. How about we go for a walk and catch up?”
20.    “I’m sureI do things that embarrass you. What do I do that embarrasses you the most?”
Talking with your child should be an ongoing process. Keep the dialogue open, and be available so your child can find you when she feels like chatting.
One final piece of advice from Sheras: “Keep talking even when you think your kids aren’t listening,” he says. “Your children are listening whether they act like it or not.”

When your child doesn’t know a word in her reading books, should you tell her what it is? Should you teach your child the alphabet before he starts school? We have compiled reading tips to help parents best help their children learn to read:

Tips for Reading to Preschoolers

* Snuggle with your child with her favorite blanket or toys as you read.
* Read with expression using different voices for different characters.
* Emphasize rhythms and rhymes in stories. Give your toddler opportunities to repeat rhyming phrases.
* Encourage your child to repeat what you say or comment on it. Encourage your child to ask questions. Provide models of interesting questions and examples of possible answers: “I wonder what is going to happen next? I think the rabbit will get lost because he is not paying attention to where he is going. What do you think?”
* Look for books that are about things that interest your toddler. For example, does your child like cars, insects or animals?
* Give your child a chance to choose his own books for reading. If your toddler chooses a book that is too long to hold his attention, read some and skip some, discussing the pictures and how they relate to the story.
* Read stories again and again. Your toddler enjoys repetition, and it helps her become familiar with the way stories are organized.
* If your child is curious and is making comments about letters, there is no reason why she should not become familiar with the alphabet before she starts school. Playing with alphabet blocks and singing “The Alphabet Song” are happy ways for your child to become acquainted with letters.
* Make books a joyous and important part of your child’s life. Read to him every day. Let him talk about the stories. Ask questions about the pictures. Ask him to point out pictured objects that are alike and different in shape and in color. This activity helps children to observe small differences in the shapes of letters and words when learning to read.
* Avoid baby talk. Speak to your child in grownup language now, so she will recognize words she sees and hears in the classroom. Also, baby words for objects may be laughed at by the other youngsters.
* Provide a variety of experiences. Take your child to the zoo, the park, the airport. Teach your child the names of animals, flowers, etc. In order to understand the words encountered in reading, your child should have first-hand experience with the objects they stand for.
* From time to time, give your child simple, consecutive instructions. For example: “Pick up the ball, then bounce it, then put it on the table.” Make a game out of it, if you like. Such activities will help your child develop memory skills and follow directions accurately, both of which are essential in school.
* Set a good example as a reader—read every day at home even if it is a magazine or newspaper.
* Make reading fun, a time that you both look forward to spending together.

Tips for Reading to and with Children in Kindergarten–Class 3

* Keep reading to your child even when he can read. Read books that are too difficult or long for him to read alone.
* Try reading books with chapters and talk about what is happening in the story. Encourage your child to make predictions about what will happen next and connect characters or events to those in other books and stories.
* Talk with your child about reading preferences that are beginning to develop. Ask whether she likes adventure stories, mysteries, science fiction, animal stories or stories about other children. Encourage her to explain the reasons for preferences.
* Talk with your child about favorite authors and help him find additional books by those authors.
* Take turns reading a story with your child. Don’t interrupt to correct mistakes that do not change the meaning.
* Talk about the meaning of new words and ideas introduced in books. Help your child think of examples of new concepts.
* Talk with your child about stories using the notions of the beginning, middle and end of the story to organize thinking and discussion.
* Ask your child to tell why a character might have taken a specific action. Ask for information from the story to support your answer.
* If he wants to read aloud to you from his school book, listen attentively. If he stumbles over a word from time to time, simply tell him what it is. However, if he misses many words in material with which he should be familiar, consult his teacher.
* When she reads aloud to you, don’t try to use teaching techniques, such as having her “sound out” words. Instead, enjoy the story together, laugh over it, discuss the plot, praise her for reading especially well, or for figuring out a word for herself.
* Give children extra opportunities to read. Let them read the directions for that new game or for putting model airplanes together. Ask them to “help you” by reading the cookie recipe or traffic signs.
* Introduce the pleasures of the public library. Let him browse. Get a library card for her. Let him choose books that he wants, rather than books you feel he should read. Buy books for children, too, as the basis for a home library of their own.
* Set a good example as a reader—read every day at home even if it is a magazine or newspaper.
* Make reading fun, a time that you both look forward to spending together.

Tips for Reading to and with Children in Class 4-6

* Take turns reading a book with your child.
* Ask your child to compare a book to another familiar book. How are the characters alike or different? Do the stories take place in similar settings? How are the illustrations the same or different?
* Ask what part of the story or book your child liked best and why.
* Ask if your child liked the ending of the story. Why or why not?
* Ask your child what type of mood the story or chapter in a book creates. Ask how the author creates the mood. For example, does she use certain words, events or settings that create a particular feeling?
* If your child has read more than one book by the same author, ask how the books are similar or different.
* Provide your child with a reliable home dictionary and encyclopedia. Encourage children to look up subjects that puzzle or interest them. In school, reading lessons include library research.
* If your child is not enthusiastic about reading, choose books on subjects sure to interest her or him: books on sports, books of riddles or magic tricks, books on hobbies. Be sure they are not too difficult for your child to read.
* If she’s a television rather than a reading fan, see which programs she prefers and provide suitable books on the same subjects. If Westerns are her favorites, for example, she’ll probably enjoy some of the fine children’s books now available about the early West.
* If a young person is an avid comic book reader (ages 9, 10 and 11 are likely to be), don’t make a big issue out of it. Make sure your child is also provided with other more worthwhile books that offer lively adventure in an easy-to-read format. Most children outgrow the comic book phase, if other literature is available in their homes.
* Set a good example as a reader—read every day at home even if it is a magazine or newspaper.
* Make reading fun, a time that you both look forward to spending together.