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  • CDC Guidelines have changed for the first time since 2004. What does this mean for you and your child?

    What are the CDC (Center for Disease Control) guidelines used for?

    Developmental Milestones have served as an educational tool for parents and medical professionals to set reasonable expectations and goals as their child grows. They are age based, and also serve as a guide in socialization, play and interaction, appropriate to a child’s level of skill and understanding.

    Why did they change? what are some changes? 

    The most notable change is that previously published milestones were based on the 50th percentile (average for age milestone). Now the 75th percentile (majority of children within the milestone) are the baseline and therefore many milestones shifted expectations to an older age. For example, understanding “no” was previously published at the 9-month level and now is listed at 12 months, with an expanded description (“pauses briefly or stops when you say it”). “Eats with a spoon” was previously listed at 18 months and is now at 24 months. 

    Concerns have been voiced that with the newer, later dates some delays may be missed. However, it’s important for parents and professionals to understand that the new ages represent when most (or three quarters) of children achieve these skills, not half as commonly published before.

    Social-emotional development changes were also emphasized in this new update.

    With the increased understanding and awareness of autism in early childhood, it has become recognized that children with autism may have delays in social engagement and communication from an early age. Prior milestone lists did not offer many social-emotional milestones. In contrast, the new cdc guidelines give extra attention to including markers of social development in order to aid in the early identification of this developmental condition.

    Wait, why was crawling was removed as a milestone? 

    There were also concerns with exclusions of some milestones, such as crawling. Real-world data shows a vast variance in the appearance of the crawling milestone. Thus, crawling is frequently excluded entirely from guidelines since many children skip this skill without any adverse consequences.

    What does MST think about the changes in milestones?

    Montclair Speech Therapy, although acknowledges these changes, do not necessarily agree with all of them. For example, crawling is seen as a key vital step for some children. The adverse consequences are challenges related to the vestibular system, upper extremity weakness as children are not weight bearing to gain proximal strength. Crawling also helps to promote crossing the midline, coordination, and vision. For speech purposes, lowering the count word of 50 words from 24 months to 30 months is concerning. Parents rely on these milestones in order to reach out for help or communicate their concerns. Early intervention can have waitlists, and if parents reach out at 30 months, instead of 24, they may lose on receiving one on one therapy in their home environment, or in a clinical setting. We encourage and advise all individuals to reach out as soon as possible if you feel your child is demonstrating delays rather than use the “wait and see” approach.

    What does this mean for you as a parent or guardian? 

    You know your child best. If you are worried your child is delayed, it is key to reach out to your pediatrician and also to contact the early intervention state department at 888-653-4463 (statewide, toll free).

    The CDC milestones checklist is a helpful tool and can be found on the cdc website, along with the milestones for all the various ages.


    Source References: CDC’s Developmental Milestones
    Understanding Updated Developmental Milestones

  • What are sensory processing differences?

    Sensory processing differences are when a child has trouble handling the information their senses take in—things like sound, touch, taste, sight, and smell. Besides these common senses, there are also two other less well known ones that can be affected—proprioception, or a sense of body awareness, and vestibular sense, which involves movement, balance, and coordination.

    Kids with sensory processing differences experience too much or too little stimulation through these senses. They may also have difficulty integrating sensory information—for example things that they see and hear simultaneously, like a person speaking—might seem out of sync for them.
    Note: These problems are sometimes referred to as sensory processing disorder (SPD), even though psychiatrists don’t consider it an actual clinical diagnosis.

    Signs to look for:

    Hypersensitive kids are extremely reactive to sensory stimulation, and can find it overwhelming.

    They may:
    • Refuse to wear clothing because it feels scratchy or irritating—even after cutting out all the tags and labels-or shoes because they feel “too tight.”
    • Be unable to tolerate bright lights and loud noises like ambulance sirens
    • Be distracted by background noises that others don’t seem to hear Be fearful of surprise touch, avoid hugs and cuddling even with familiar adults
    • Be overly fearful of swings and playground equipment Often have trouble understanding where their body is in relation to other objects or people
    • Bump into things and appear clumsy Have trouble sensing the amount of force they’re applying; so for example, they may rip the paper when erasing, pinch too hard or slam objects down.

    Hyposensitive kids are under-sensitive, which makes them want to seek out more sensory stimulation.

    They may:
    • Have a constant need to touch people or textures, even when it’s not socially acceptable Not understand personal space even when kids the same age are old enough to understand it
    • Have an extremely high tolerance for pain Not understand their own strength
    • Be very fidgety and unable to sit still Love jumping, bumping and crashing activities Enjoy deep pressure like tight bear hugs
    • Crave fast, spinning and/or intense movement Love being tossed in the air and jumping on furniture and trampolines.

    Mood swings and extreme behaviors:

    Kids with sensory differences sometimes exhibit extreme behaviors like screaming, and throwing violent tantrums all because the physical sensations involved are overwhelming to them.

    They may have surprisingly wild mood swings as a reaction to a change in the environment. For instance, a first-grader might be fine in a quiet setting with a calm adult. But place her in a grocery store filled with an overload of visual and auditory stimulation and she might melt down, i.e. have a severe tantrum and isn’t likely to stop, whatever a caregiver might do, until she is exhausted.

    In addition to this “shutting down” because of sensory overload, a child might also lash out, or become aggressive. Or she might flee—a fight-or-flight response. If a child dashes out across the playground or parking lot, oblivious to the danger, it may be because she is heading away from something upsetting, which may not be apparent to the rest of us, or toward an environment or sensation that will calm her system.

    Therapy:

    Occupational therapists (or OTs) are the specialists who work with kids who have sensory differences. Your child may be referred to an OT at his school, or you may want to find one who is in private practice. OTs engage kids in physical activities that are designed to regulate their sensory input, to make them feel more comfortable, secure, and able to focus.

    There are no scientifically sound studies proving that the work occupational therapists do with kids who have sensory processing challenges is effective. But many parents have found that the therapies and exercises help kids to feel better and function better. “It works like a reset button,” one mom reports.

    Every child’s sensory differences will be different, so before therapy can begin the OT will need to evaluate your child through tests and by observing him and talking to teachers and caregivers. Then the OT will come up with a sensory treatment plan, sometimes called a “sensory diet,” that is custom-made for your kid’s needs.

    More on this topic here: https://childmind.org/article/sensory-processing-faq/

  • Sugar and the Brain

    ‘Tis the season for sweets and treats. After all, what would the holidays be without the cookies, the pies, and other special holiday goodies?  But for our children dealing with developmental and language delays, ADHD, autism, or other neurological concerns, those treats may be doing more than making fond memories of the holidays.  In fact, they may be holding them back in improving with their neurological issues.

    The fact is, food sets the foundation for health.  Whether we are concerned with learning, behavior, or other neurological issues, the right foods give our bodies and brains nutrients they need to function and to properly develop.  The wrong foods, however, will leave us and our children deficient and depleted.

    As Dr. Richard E. Layton writes…

    Biomedical interventions can help not only children with autism, but those with expressive and/or receptive language disorders, associated sensory integration (SI) issues, and allergies/hypersensitivities. Through the assessment of diet, environmental pollutants, SI, possible allergy testing and immunotherapy, it is possible to treat developmental delays through a biomedical approach…  Parents could begin by evaluating their child’s diet and noting reactions and improvements.

    And, of all the nutritional factors that may weaken that foundation for neurodevelopment, sugar is one of the worst. Sugar and processed treats contain no vitamins or nutrients. In fact, sugar is an anti-nutrient because it strips key nutrients from healthy cells in order to be processed out of the body.

    Key nutrients lost with sugar consumption include…

    • B Vitamins: Specifically, Thiamine (B1) is needed to produce energy.  When levels are balanced we feel composure, clear headed, and a sense of stamina.  Also important for liver detoxification where foreign substances are initially broken down for excretion.
    • Calcium: Needed for strong bones as well as for the role it plays in blood clotting, nerve conduction, muscle contraction, cell membrane function, energy, and immune function.  It also regulates the speed, intensity, and clarity of every message that passes between neurons in the brain.
    • Magnesium: Helps to stabilize histamine levels and to relax our muscles.  Aides with energy production, sleep, anxiety, and depression.

    According to Dr. Joel Wallach in his book Rare Earth: Forbidden Cures, Sugar loads increase the normal rate of mineral loss in sweat and urine by 300% for twelve hours past consumption.  This means that if you routinely eat sugar there is no amount of supplementation or dietary support that will allow you to keep up with your mineral losses.

    However, this doesn’t mean, that as we weave our way through the holiday season, we need to avoid all sugar and subsequently all treats.

    By making desserts and treats using some low glycemic (meaning, they won’t spike blood sugar) and nutrient rich alternative sweeteners, we can have sweets that are as nourishing as they are delicious.

    Here are a few of my favorite go to sweeteners that you can find in your local market and online…

    • Stevia: 300 times sweeter than sugar, low glycemic (no blood sugar spike), it comes in either a tincture or powder.  To some it may have a slightly bitter, licoricey aftertaste.  But we find with the NuNaturals brand this is not the case.
    • Coconut Nectar & Crystals: Low glycemic and unprocessed, a good source of vitamins C and B.  The crystals can be substituted for cane sugar 1:1
    • Dates: Packed with fiber to slow the absorption of its sugar, they are full of antioxidants and minerals such as iron and potassium.

    To get you started, look below for one of my family’s favorite holiday cookie recipes.  Packed with tahini and sesame seeds that are rich in magnesium, calcium, iron, and zinc, and using nutrient rich coconut nectar, they’ll satisfy any sweet tooth without leaving you or your family depleted.

    Jamie Siwinski, MA, CHHC
    www.fortifiedhhc.com

    Sesame Cookies

    Ingredients:
    1 ¼ cups almond or cashew flour
    ¼ teaspoon celtic sea salt
    ½ teaspoon baking soda
    ⅓ cup coconut nectar
    ⅓ cup tahini (raw or roasted, though roasted will give more flavor)
    1 tablespoon grapeseed oil
    1 tablespoon vanilla extract
    ¼ cup sesame seeds (hulled or unhulled)

    Directions:
    In a large bowl, combine almond flour, salt and baking soda.  In a smaller bowl, blend together coconut nectar, tahini, oil and vanilla.  Blend the dry ingredients into the wet.  Form the dough into 1 inch balls and roll in the sesame seeds. Place on a parchment paper lined baking sheet and flatten.

    Bake at 350° for 8-10 minutes until lightly brown.  Cool on baking sheet and serve.

    Makes 14 cookies

    Adapted from: http://www.elanaspantry.com/sesame-cookies/

    About Guest Blogger Jamie Siwinski…

    Jamie Siwinski, MA, CHHC is a certified holistic health coach who helps families and individuals rebuild their foundation of health by bolstering digestion and immunity, eradicating anxiety and depression, regulating mood, and improving learning and other neurological concerns by taking an integrative approach to health and wellness.  Using a functional model, he helps his clients connect the dots between their symptoms and get to the root of what’s causing their health issues.  He guides them away from the diet and factors that deplete them with practical strategies that leave them feeling fortified.

    Learn more and download my FREE sugar detox handout at www.fortifiedhhc.com.

    Sources:
    Layton, Richard. “Developmental Delay: Biomedical interventions”. Advance. Vol. 16 Issue 2 Page 11. http://speech-language-pathology-audiology.advanceweb.com/Article/Developmental-Delay.aspx.

    Wallach, Joel D., and Ma. Lan. Rare earths: forbidden cures. Bonita, CA: Double Happiness Pub., 1994. Print.