Archives for March 2016

The neighborhood playgroup can be a stress-inducing gathering for young parents. You don’t intend to compare children, but you can’t help notice that one neighbor’s daughter has a ten-word vocabulary, another neighbor’s son is babbling in two-word sentences, while your toddler hasn’t yet uttered the sweet word “mama.” His hearing has been tested as normal, and you read books to him every night. A worry is forming a knot in your heart: Is he a late bloomer, or does he have a language impairment?

Understanding Precedes Utterance
Language delays that are not due to hearing issues or a speech impediment generally fall into two major categories: Expressive or receptive. Children who struggle to articulate their thoughts are said to have expressive language issues. Those who have difficulty comprehending what others are saying have receptive issues. Some children have both.

Since understanding language is a necessary precursor to using words, the first concern when it comes to young toddlers is their receptive skills rather than their speech. A young toddler’s silence isn’t as critical as his reaction to language in the form of a parent’s questions, commands, and requests.

Masterly Miming
If a silent 18-month-old freely uses gestures like pointing, waving, and nodding, or a two-year-old will dance or jump when asked, he is expressing the receptive skills denoting a basic comprehension of language. Mimicking and gesticulating are positive signs that such late talkers will likely catch up to their peers.

In terms of speech, a definitive diagnosis of expressive language impairment generally isn’t made until the later toddler years, when language is expected to be more fully developed and used.

Tripping Over The Tongue
A general rule of thumb is that by 24 months of age a child should know and use two dozen words. By two-and-a-half years of age, she should be using two-word sentences with basic grammar, like a subject and a conjugated verb. More important than these milestones, however, is that the child’s use of language continues to grow steadily in both vocabulary and complexity. Any backsliding or plateauing, especially during the period of rapid language advancement of 24-36 months, may suggest a delay in expressive skills.

When it comes to comprehension and expressive language skills in young children, early intervention is vital. A licensed speech-language pathologist is trained to test and identify impairments and promote child-specific, issue-specific intervention programs to nurture development to the child’s maximum capacity. If you have any concerns about your toddler’s language development, don’t hesitate to ask your pediatrician or contact a speech-language professional.

The mind/body connection is very real. A person’s thoughts, feelings, stresses, and problems can have an enormous impact on their physical health. That’s why mental health disorders like depression, anxiety, bipolar, or psychotic disorders display not just behavioral changes but also a wide variety of physiological changes. For the loved ones of the afflicted, the sudden manifestation of a collection of these symptoms can act as red flags that something more serious is afoot.

Check out these four physical signs of possible mental health problems.

Sleep No More, Or Always
Sudden or increasing changes in sleep patterns is a common sign of many different mental health disorders. Sleeping too much, combined with lethargy or general fatigue, is a typical sign of depression. On the flip side, insomnia, frequent interruptions in sleep, restlessness, needing less sleep than usual, or vivid dreams can indicate anxiety issues as well as rising psychosis.

Hit Or Miss Hygiene
A change in appearance may be the most obvious physical sign of mental distress. A young girl who suddenly takes to wearing knee-high socks and long-sleeve shirts in warm weather may be hiding cutting scars or even needle marks. Frequent washing of hands or excessive cleaning may be an indicator of OCD, while less attention to personal hygiene is a hallmark of many psychotic disorders.

Heart Attack Or Panic Attack?
The physiological manifestations of stressful disorders can be so alarming that they result in emergency room visits. Suffers may hyperventilate and experience chest pain, a racing heart, and light-headedness. Anxiety is known to bring on stomach aches, nausea, and even vomiting, or, alternatively, headaches, back pain, neck pain, and other unexplained aches. A loss of interest in sex, one of life’s joys, can be an indication of growing depression.

Diet Distress
Any change in diet is worthy of notice. Both a loss of interest in food or intentional undereating, as well as overeating and obsession with food, can be red flags not just for eating disorders but also for a collection of other mental illnesses. Increased alcohol and/or drug consumption is a dangerously common way that a struggling individual tries to cope with an undiagnosed syndrome.

Anyone under a great deal of stress may manifest a number of these physical symptoms in isolation, but if you notice a combination, or a relatively sudden or worsening change in the physical health of a loved one, contact a mental health professional. Early intervention, testing, and an accurate diagnosis can do wonders to bring a sufferer both comfort and relief.

When it comes to Autism Spectrum Disorders, every child is unique. Some of those diagnosed with ASD may function quite well, even in an ordinary classroom, while others will need more educational, therapeutic, and clinical help. Understanding the variations in the different sub-categories of ASD is the first step in being able to communicate your child’s singular challenges to the people who can provide the most help.

Classic Autism
Classic autism is the biggest category under the ASD umbrella. It’s a wide-ranging diagnosis that encompasses children and adults who have difficulty with social skills, communication, cognition, and behavior. There is great variation in how these symptoms are manifested and how strongly the child is affected, but a diagnosis of classic autism generally requires impairment across the board. These symptoms include:

• Being unwilling or disinterested in making social connections
• Difficulty in understanding other people’s feelings or picking up on social and nonverbal cues
• Avoiding eye and physical contact
• A delay or oddness in speech
• Difficulties in understanding language and communicating personal needs
• Literal thinking and an inability to understand jokes or subtext
• Repetitive body movements, clumsiness, or odd postures or motions
• Fascination with moving parts or an obsession with unexpected objects or subjects
• Lag in some cognitive functions

Asperger’s Syndrome
Asperger’s Syndrome is on the high-functioning end of the autism spectrum. Though first described by an Austrian physician in the mid-twentieth century, it has only been recognized by the American Psychiatric Association since 1994. Children who suffer from this disorder often struggle with social and communication skills, but tend to have a better grasp of language as well as normal or above-average intelligence. Because of these qualities, they are often diagnosed at a later age than most autistic children.

Pervasive Developmental Disorder–Not Otherwise Specified
A PDD-NOS diagnosis is given to children who suffer from some or all the typical autism behaviors, but not in classical ways. PDD-NOS is frequently called atypical autism because of one of three reasons: the diagnosis is late-onset, the child’s behaviors don’t meet the assessment thresholds for classic autism, or the child exhibits only a few of the symptoms. About half of children diagnosed with PDD-NOS have the typical range of autism symptoms, but much milder. About a quarter have symptoms that closely mimic Asperger’s Syndrome, but are excluded from that category due to the presence of speech or cognitive impairments. The last quarter has symptoms typical of autism, but the symptoms don’t cover the full range of behaviors.

The correct diagnosis of an Autism Spectrum Disorder requires careful observation as well as the proper reading of cognitive, social, neurological, and behavior assessment tests by an experienced clinician. If you suspect your child may be suffering from an ASD, don’t hesitate to speak to your pediatrician or contact a trusted mental health professional.