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Sorry but I was unable to put together a posting for this week.  As you can see from the above picture, I was preoccupied with something even more important.

Life can be strangely beautiful sometimes.  How can it feel so good to give away this most precious gift?  It was a wonderful day.  I will catch up with you all next week.   Thanks for following.

Speech II

Last time we reviewed generally things that consitute normal speech development.  Now let’s talk about a few things that parents can do to advance that process.They are neither hard nor expensive but rather just require being aware as you go through your day with your child.

Talk to your child. When you do, speak slowly and clearly.  Look directly at him when you speak and let him see you forming the words with your mouth.  As you go about your daily routines, try to have a “play by play annoouncer’s” approach–almost like a running monologue.  Remember, though, that a “monologue” can get boring, so be sure to spice up the talk with things like questions, pictures, or little rewards.  For example, when working around the house, let him participate where safe and appropriate and narrate what is occurring as you go.  Praise participation and effort.  If cooking, give snack treats to perpetuate the fun.  If shopping name the things you purchase, as well as shapes, colors, etc.

Singing is a great language developer.  Kiddie songs are good, but any song that fits into your “play by play” is great.  See a bus while driving?–“The Wheels on the Bus.”  Raining?  “April Showers” or “Rain” by the Beatles (naturally, I like that one!!)  See kids playing baseball outside?  “Take Me Out to the Ballgame.”  Whatever comes to mind.  Your child is one music critic who will reliably give your singing a positive review!!

I have previously encouraged limiting TV.  While less TV and video entertainment is better they are not forbidden.  Watch with your child and, again, interact with her when she is watching.  Sing the show’s songs.  Ask questions about what is going on.

When asking quesitons of your speaking child be sure to give her plenty of time to respond.  Let her talk, follow up with comments or questions that will stimulate her to further develop ideas–to carry on a conversation.  Help your child to sound out words as she says them or reads them.

I have written previously about the advantages of reading to your child.  Please review here.

One important point: avoid baby talk.  Goo goo and gah gah are no place.

A word to multilingual households:  I always encourage children learning the language of their ancestors from as early as possible.  It may slightly delay (not prevent) English language development as he assimilates both language systems.  This is particulalry true for non-European languages which are linguistically more distinct from English.  But living here, surrounded by English, they will learn it anyway.  So speak your native language at home, watch TV, listen to the radio, sing in your mother tongue as much as possible.   I believe that being multilingual increases/expands a child’s horizons and promotes healthy cultural and family pride. It will melt Grandma’s heart if your child says “Yo te quiero, abuela–I love you Grandma” in perfect  Spanish (for Spanish speakers, of course)–talk about even better birthday presents!!  And some day, being multilingual will likely increase your adult child’s employment/career prospects as well.

I will have a bit more on language.  Keep reading.  I invite questions, and thanks for following

One other word to multilingual house

Language: Part 1

“Ay, dootz.” That was, apparently, early “Chuck-speak” meaning “I want juice”. Gd bless my beloved father – gone 6 years – his favorite recollection was always of my first words. The time when our children begin to speak is one of our most cherished memories.  It’s a validation point – this beautiful, formerly mute (except for screaming!) little creature is blossoming into an intelligent human being whose potential and possibilities are limitless.

A cursory overview of milestones:

  • Many parents can differentiate a 3 month old’s cries.  “I’m tired” sounds different from “I’m wet”.
  • By 4 or 5 months – “oohs” and “aahs”
  • 6 months – babbles, “mama”, “gaga” (consonants using lips and tongue to make sound)
  • 12-15 months – first specific words, follows simple instructions (“come here”)
  • 18 months – >3 words other than “mama”, “dada”
  • 2 years – 2 word phrases/sentences, more complex instructions (“bring your shoes to me”)

The above is quite variable, so no cause for alarm if your child isn’t doing it exactly as I’ve presented. Also, we should remember that language is the ability to express/understand thoughts and concepts using symbols.  So all “speech” is “language”, but not necessarily the other way around. Also note that there is “expressive language” (telling) and “receptive” language (understanding). So there are lots of other things you can look for to gauge your child’s developing language skills. (Note that I am refraining from using the word “normal”. There is “normal” and “abnormal” – but again, it’s so variable that I don’t want to drive you, dear reader, crazy if junior doesn’t “do it” exactly as listed here!.):

  • Does your toddler point to things, or will he or she look at things that you point to?
  • Does your toddler look over to you for approval?
  • Does he look at people when you name them?
  • Does she identify body parts (“where’s mommy’s nose?”), animal sounds (“what does a doggy say – woof woof?”)
  • Does he know hand gestures? (Wave bye-bye, blow kisses) (Note: response to your saying it is understanding languageRepeating a gesture after you perform it is merely imitation.)
  • Same for interactive games (“so big!,” “eensy weensy spider”)

An important component is to be sure your child hears – does she turn or startle to sudden loud sounds (not from vibrations)?  Please contact me with any questions or concerns.

A 3rd time – language/speech acquisition is quite variable, so try not to let your fears run away too fast/far from your imagination.

This is a very large topic. I will return to it again next time. Thanks for following.

Whooping cough

Pertussis(whooping cough) is back in the news.  Actually, it’s never left.  In California (where else?) there were more cases reported in 2014 than in any year since the 1940’s.  In our modern world, where pertussis is far less common, there is a certain complacency about this disease. This is wrong!  Pertussis in infants and young toddlers is a killer (> 100,000 cases/year 1940-5 before the vaccine, 8,000 deaths) and complications are not uncommon.  I have seen pertussis in an infant when I was a resident, and it’s not an easy thing to watch.

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antibiotic use

Let’s get this out: we doctors prescribe antibiotics far too much and far too often.  The development of antibiotics to treat bacterial infections is another major triumph of 20th century medical science that has saved millions of lives.  But like any good tool, it must be utilized in the proper situation to be helpful.  90-98% of upper respiratory infections are caused by viruses.  Now, viruses are very different critters than bacteria.  Some microbiologists question whether its appropriate to even classify them as “living.”  You can dissolve viruses in solution, crystalize them, and in 100 years they can be dissolved and be just as active.  Try that with a bacteria, let alone a human.  Now, penicillin kills bacteria by weakening their cell walls causing them to overswell and burst.  Erythromycin destroys ribosomes, the structures within bacteria that they use to make protein to run their life cycles.  But viruses don’t have cell walls or ribosomes.  These chemicals therefore have no effect on viruses in the same way that you cannot be the vicitm of car theft if you do not own a car.

Most antibiotics are pretty mild and well tolerated but they are far from free of adverse effects:

  • abdominal pain and diarrhea; infrequently this can be severe
  • allergic reactions.  Note that taking an antibiotic does not prove that you will not have a reaction the next time, or the next.  In fact, the more you take, the greater the risk
  • resistance.  This is a danger to each individual as well as a major public health challenge.  

Keep in mind that above is only a partial list.  I will note that >80% of antibiotics manufactured in the US are used in animal feed as a growth agent: yes, antibiotics make livestock grow bigger and fatter faster.  I keep that fact in mind with each presecriptioin I write.

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