Wednesday, June 30, 2010

How to begin a GFCF diet on a budget |

I've semi-perfected the art of cooking for my two kids "special" diets because of their food allergies. One trick I think that works is to cook recipes from vegetarian cookbooks because there isn't any eggs, dairy, or other artificial additives in the recipes. I just eliminate the nuts from the recipes that call for them. Another thing I did in the beginning was to spend HOURS reading ingredients on store bought food boxes as well as ingredients in regular recipe books or online cooking websites. I investigated the meaning of words such as "albumin" is a word for eggs, "durum" is a word for wheat, and "casein, whey, and lactose" represent dairy.

It can be over-whelming to start any new diet, especially if the child is a picky eater. Whether a parent is starting their child on a gluten-free casein-free diet or any other special diet because of food allergies or due to health reasons (celiac, autism, diabetes, etc.), it can be expensive and over-whelming to know where to start. This link gives a few ideas on how to do it and save some money:

How to begin a GFCF diet on a budget |

I wrote this article over a year ago. I would love to have your comments on what worked for you. But I do think any parent of a child on a "special" diet will tell you that it takes alot of time and energy to figure out what the child can safely eat, then after awhile it becomes second nature and isn't too difficult.

Saturday, June 26, 2010

Social- Emotional Milestones for a 24-36 Month Old Child

Many of the children I work with have global development delays, including social-emotional development. Here is an excellent hand-out for parents and caregivers to understand what a 2-3 year old child should be doing in the area of social-emotional skills:

Although parents of children who receive an early diagnosis of autism seem to be aware of their child's delays of social-emotional skills, my experience is that parents of kids with no diagnosis or a diagnosis other than autism don't seem to be as clued into this area of development. Many times the parents assume the child isn't playing with his peers appropriately because of his language and/or motor delays. But kids with delays in those areas often still play with their peers okay if that is the only area of delays. I think many kids have to literally work on these skills listed in this link. That might mean that a child with no siblings who stays at home with his mom all week, be exposed to other children on a regular basis such as going to the same park on a regular basis as well as to story time at the library, playground in the shopping centers, and MDO (mother's day out) program for 1-3 days a week for 5 hours each of those days. Play dates and play groups are also good especially if the child doesn't have other neighborhood kids to play with or young relatives that he sees on a regular basis. If all of these strategies still do not help, then an evaluation with a psychologist, occupational therapist, or speech therapist may be necessary. Another good suggestion is to receive a comprehensive evaluation with the local early childhood intervention (AKA EI or ECI) program which will evaluate and work with children up until their third birthday. If the child is almost 3 years old or older, then an evaluation by the public school could be beneficial. Also, look to see if your area has an early headstart program with any openings.

Reflux (GERD) in Babies & Young Children

I've blogged more than once on my personal experience of having a baby with severe reflux. But when I saw this article I just knew I had to post it and review my story once again:

My now 24-month old son took two reflux medications up until the age of 14 months. But lets rewind all the way back to the beginning. Starting at about one week of age he started spitting up a lot and when I laid him down in his bassinett he would cough on the spit up...quite scary, because I was afraid he would aspirate and die! So, I elevated the bassinett, added a wedge, and that still didn't work. The only way he could sleep without "choking on his spit up" was to lay on my chest as I was in the reclining chair or in a reclined bouncy seat. So starting around 3 weeks of life he started Zantac, an antacid. That medicine made him less grouchy, but he still refluxed up massive amounts of breast milk (he never had formula). In fact, we nick-named him Milkshake! Then, the pediatrician switched him to Prevacid, a proton-pump inhibitor, and my son did better with that medicine but still spit up alot, but at least he was a happy spitter. If it weren't for his sudden decrease in weight gain at that point we wouldn't have been worried. I pumped breast milk and was making plenty, so that wasn't the problem. Since his sister had food allergies and his bottom was red alot, I took him to see the allergy doctor hoping to get some answers. The doctor said he had to wait until my son was 6 months old to do formal food allergy testing, but until then I was to not eat the common culprits of eggs, dairy, and nuts. Guess what, my son spit up WAY less after I quit eating those foods! By the way, his food allergies were way more than those three and still are, but those were the biggies. Yet one other problem still remained, he would spit up even two hours after a feeding; so that suggestion of elevating/positioning the baby for 30 minutes after a feeding didn't work for us. The pediatrician then put my son on erythromycin, an antibiotic, as a prokinetic to speed up the motility of the stomach emptying into the intestines. He gave me the choice of Reglan or Erythromycin and I chose the later because of so many of my patients having lots of side effects on Reglan. Well, this medicine made all of the difference in the world. He started gaining weight and spitting up less, but still did spit up some. At this point, we were only using 2 burp cloths a day, whereas in the beginning we would go through no less than 5 or 6 a day! But soon after we introduced baby cereal and pureed food. I was hoping this would help him spit up less, but it didn't, and in fact, he spit up more. It wasn't until after my son was walking that we could go days without the medicine and him be okay. I think between gut maturity, age, and muscle strength of the abdomen he finally got better. Having said all of that, I do believe that for many babies, one medicine or positioning helps. For others they get better when cereal or purees are introduced. I'm sure much of my son's problems were the food allergies. Not too many of my patients have as bad of a case of GERD as my son, and thank goodness! Poor child couldn't sleep flat until 5 months of age! Every time I tried, he coughed, gagged, spit up, cried, and couldn't fall asleep. So glad that his head shape didn't suffer too much from sleeping for so many months in positioning devices! I contribute that to all of the sidely, tummy time, and upright sitting he did during his waking hours! Although I like this article I linked to at the top, I also like the book "Colic Solved" by Bryan Vartabedian, MD, because it explains things in simple language yet it is thorough and an easy read.

Thursday, June 24, 2010

Fussy Baby

I have a friend with a young "fussy" infant. She asks me for suggestions quite often. When she calls to complain I think that she secretly wants me to come rescue her...of course, if I was sleep deprived I probably would hope for the same thing! Not that I mind babysitting from time-to-time, it is better that she learn to calm her own baby. So this post is dedicated to my friend "R". Instead of me listing out everything I tell her, I thought I'd just post this link since it puts it so well:

Fussy Baby

Hope these ideas help! But if they don't, discuss the baby's symptoms with the pediatrician because there could be something more going on than just colic!

Sense-Able Beginnings: The Importance of Touch for Newborn Development

Sense-Able Beginnings: The Importance of Touch for Newborn Development

Tuesday, June 22, 2010

Hidden Treasures in My Neighbor's Trash

I pride my self in not being a pack rat. In fact, I donate unwanted items to charities on a regular basis. Anyone who knows me well knows I organize everything: my desk at work, my closets in our home, the garage, the kitchen, the kids' toybox, and the list goes on. I've been this way since I was young; I credit my mom who is also a natural organizer. So, it is not a natural instinct for me to tell someone I want to keep what they are throwing away. For me to say that means I must really think it is special! Typically, in my eyes another person's trash is just that, trash!

Today at work (early childhood intervention) the developmental specialist (EIS) who has a desk next to mine was clearing out all of her belongings from her desk shelves and drawers. She is only going to be my co-worker until the end of June, and then she is going into another field of work...sob, sob, sob because I enjoy her company! She won't be working with kids any more, so she has no interest in numerous inservice handouts and journal articles on children with disabilities. Of course I was touched that she saved handouts from my inservices as far back as 2004, until I realized she saves EVERYTHING...not sure she knows we have an industrial sized shredder in the next room over! Yet, I feel like the manuals and journal articles that I rescued from the trashcan were worthy of my reading one day. I took home two inservices manuals that looked particularly interesting; the subject of one is working with infants with auditory impairments and the other is on infants with visual impairments. I started reading the handouts (from 2002) and was impressed with the information except for the "resources" on the back page because many of the listed websites aren't even up on the internet anymore...what a shame! But at least the activities, checklists, and technical explanations are still accurate. But one website was up and running and it linked to all of the state's (USA) schools for the blind. Then, those sites linked to many other sites. If you are like me, you may begin reading one website and then ten minutes later you realized you've clicked on so many links that you aren't even sure where you began. The following link on babies with visual impairments was one of the links that seemed interesting:

Well, I'm off to go get my 3-hole hole puncher and 3" three-ring binder from upstairs so I can file all of these handouts that I consider as "hidden treasures from my neighbor's trash."

Do newborn infants have a sense of rhythm? | Psychology Today

I'm posting an interesting article on newborns and rhythm. I'm thinking that the babies have learned to listen to the beat of their mom's heart in the womb. It would be interesting to test premature newborn babies and see if they have a sense of rhythm as well...of course, it would be hard to find subjects since medical staff have other concerns much greater with these babies!

Do newborn infants have a sense of rhythm? | Psychology Today

I'm also thinking it would be interesting to find out if a baby didn't test well for a sense of rhythm would it correlate to a future auditory processing or motor planning problem in later childhood...hmmm, food for thought!

Monday, June 21, 2010 IQ Preschool Lace up Pup: Toys & Games

Stringing beads isn't as easy as it looks. It takes two hands, and each one has to do something different than the other one. Then, if it is a fat string and a small hole, it requires shifting repetitively with the thumb and index finger. So many of the little children I work with can't string beads whether it be due to stiff fingers, weak muscle strength, low vision, or a poor attention span. That is why I am always looking for toys that are adapted or easier for a special needs child to succeed. A few years ago while I was at an OT home visit, I fell in love with the lace up pup toy that the little boy had in his toy box. It has large holes which makes it easy to stick the lace through. It also has a wooden "needle" at the end to help the string go in the hole better, as well as tucking it back through the end when you are finished with the more lost beads! Here is a link that has a picture and purchase info: IQ Preschool Lace up Pup: Toys & Games

I own the pup, but it also comes in a snake. My two year old son loves to play with it. When he lets me sneak it away from home, I take it on home visits to use with some of my clients. "Testing" toys out allows the parents to decide if they want to go buy it or not...I always hate to suggest buying a toy unless the child has tried it out first. Lately, I have seen children with diagnoses of cerebral palsy, down syndrome, and autism be successful with this toy whereas they weren't with other stringing bead sets. I'm not making any money off of suggesting this link, it just happens to be one of my favorite toys in my "OT bag".

Thursday, June 17, 2010

What You Can Do to Support Your Baby's Language Development from Birth to 12 Months

My daughter just finished kindergarten two weeks ago. She would have been fine with going to school all summer long without a break because she loves school and everything about it: bus ride, recess, lessons in her main classroom, lunch, art, PE, and music class. Lets see if she still feels that way eight years from now...I hope so! When I think back about how I instilled in her a desire to learn, I think back to books. I read to her, labeled pictures, and let her "read" to me starting before her first birthday. I am doing the same things with my two year old son, and I hope that one day he loves preschool and elementary school as much as she has. The following link gives some ideas on how to develop language and literacy early on:

ZERO TO THREE: What You Can to Support Your Baby's Language Development from Birth to 12 Months

I think that many of the families of the infants and toddlers I work with do a great job of some of the suggestions listed in this link. The ones who do not often do not have books or educational toys maybe because of not having enough money or not understanding their importance. For the ones who can't afford books, I suggest going to the library (free) or dollar store (low cost). And for the families who think the child is too young to start looking at books, I provide handouts such as a copy of the link above or I show them the simple books I have. When I bring my books, I show the parents the response and interest the child has...that usually changes their minds and they realize the child is never too young! Sometimes the musical books in which you touch a button and a song or noise occurs gain the infant's attention. Other good choices of books include the ones with tactile pages such as fur or fuzz over the picture of an animal. Experiment with what gains your baby's or toddler's attention. Eventually, you will want to progress to small simple picture books with no noise or item to feel. You don't even have to read the book word for word, you can begin by pointing to pictures and encouraging the child to turn the page in order to be an active participant.

Sometimes books aren't offered to the children that I work with because of their special needs. But I have learned to make many accommodations for different disabilities. For example, for a child who has limited finger movement, foam pads can be placed between each thick cardboard page to make it easier to turn the pages. For children with limited head/neck/trunk movements, find a location to place the book that is easiest for the child to view it such as propping it on an easel in front of the child. For some children, maybe they will not be able to point to a picture, talk about the book, or turn the page, but they can at least listen to the adult read. If you think they can't understand you, still try. Maybe if the child is cuddling with the parent while being read to then at least attachment/bonding are occurring!

Tuesday, June 15, 2010

Too Many Infants Short on Vitamin D: MedlinePlus

Hope people are taking their babies out in the sun and giving vitamin supplements daily, because lack of vitamin D can occur in both breast-fed and formula-fed babies.

Too Many Infants Short on Vitamin D: MedlinePlus

Ask your pediatrician for a recommended brand of supplements!

Saturday, June 12, 2010

What Is Dyspraxia? How Is Dyspraxia Treated?

I was thinking about dyspraxia today. Mostly because I was watching my 2 year old imitate nearly everything his older (6 yrs) sister did. This morning, he didn't want to eat his apple until he saw her eat an apple. He didn't want to brush his teeth until he saw her do it. Then, as they played upstairs it seemed like he had no problem joining her play and doing what she did. As they were stacking blocks, she decided to get creative and build a "telephone" out of the blocks. Once finished, she "talked" on the phone. I expected him to build a car or house as he usually does, or even attempt to imitate her telephone structure...but he didn't. He built a camera. That's right, a camera! It caught me off guard when he came up to me with his connected blocks, put them to his eye, and said "cheese". I laughed of course, and told him I liked his camera; he then repeatedly said "camera'.

This whole scenario would be too difficult for some of the young kids I work with, for various reasons but mostly due to poor motor planning (aka dyspraxia). Good motor planning includes the ability to imitate another person's actions as well as sequencing out the steps to a new task and making coordinated movements with the body. All too often young kids with developmental disabilities have to be taught how to play, so the above scenario would be hard. It took visual memory, expressive language, motor planning/sequencing, imitation, sensory processing, fine-motor, cognition, and social-emotional skills. For a checklist of detailed signs and symptoms of dyspraxia for various age groups go to:

What Is Dyspraxia? How Is Dyspraxia Treated?

I've seen many kids with dyspraxia make huge gains, especially when their family and school understood what it was. Often, extra repetitions of teaching a task, patience, and lots of sensory input help the child learn. Occupational therapy is usually beneficial, and since some of the children have language delays also, they can benefit from speech therapy. It is important to find something the child is good at to boost their self-esteem. This doesn't typically include a sport such as soccer that requires the person to motor plan their actions against a moving ball and other moving people. Sometimes non-competitive activities such as karate, piano playing, and art classes are beneficial.

Thursday, June 10, 2010

Help Kids Hear - Facts & Figures About Hearing Loss in Children

Help Kids Hear - Facts & Figures About Hearing Loss in Children

Over-Stimulation Can Hinder Feeding Skills

My son had a runny nose today and was grumpy for the most part. Guess what...he wasn't that hungry! This boy LOVES to eat, so that is how I know when he is sick, because his appetite is less than usual. My two year old son is no exception from other kids...the appetite is the first to go and last to return.

Kids and babies with special needs especially tend to be less hungry when they are sick or when they aren't feeling well. "Not feeling well" could be a temporary state such as being upset, having indegestion, breathing fast, being tired, and the list goes on. I think for babies with sensory processing problems, especially those with medical needs or prematurity, it doesn't take much to make them feel "not well". It could be something as simple as gas, reflux, or over-stimulation. The following link includes signs of over-stimulation that a baby may display. This is important to know, because until a baby is calmer, he probably will not have a good sucking pattern, especially if respiratory problems exist.

Alertness & Crying

Also included in this link are the arousal levels of a baby. Studies show that babies are more coordinated with their sucking patterns when in a quiet alert state or even a bit drowsy, but not as well in the other arousal states (deep sleep, light sleep, active alert).

Tuesday, June 8, 2010

Vision Development - Children - Milestones in Vision Development

Everything about vision intrigues me. The color of eyes, how they work, how kids develop vision, and the list goes on. Vision is so important; it impacts not only fine-motor skills, but balance, communication, social-emotional, sensory processing, and cognitive skills. I'm posting this link, because I think it is important to consider these main visual milestones:

Vision Development - Children - Milestones in Vision Development

If you are concerned of your children's visual skills, discuss it with their pediatrician and ask for a referral to an eye doctor; depending upon your insurance, you may not need a referral. Be aware that an optometrist and an opthalmologist are not the same thing. An optometrist goes to optometry school (OD) and mostly deals with testing of near/far vision to identify the need for glasses/contacts; some do other things such as looking at the general health of they eye such as for glaucoma, macular degeneration, etc. An opthalmologist is a physcian (MD) who specializes in "eyes". Even though they can fit a person for glasses, they are looking for diseases/health of the eye and perform surgery if needed (e.g. for strabismus). Other eye professionals: 1. Optician is the professional who makes and fits the eyeglasses. 2. Developmental Optometrist: helps kids with learning problems or other disabilities to learn to use their eyes functionally, such as to not ignore an eye or to have fluid eye motions while reading. 3. Visually impaired (VI) teacher: works for school systems and early intervention programs with kids with a diagnosed visual impairment. 4. Orientation & Mobility (O&M) specialist: similar to VI teacher but emphasis is moving in environment around obstacles. 5. Dyslexia or reading specialists: private centers or school system professionals who have special training in these problems. Dyslexia is considered a learning problem (the brain) not a problem with the structure of the eye.

Friday, June 4, 2010

The Most Common Infant Disablities and How to Recognize Them

Here is an article I wrote a while back. It provides a list, statistics, and description of the most common disabilities seen in babies/ children.

The Most Common Infant Disablities and How to Recognize Them

It also provides links to books on some of those particular disabilities.

Dogs And 2-Year-Olds Limited In Ability To Understand Unfamiliar Pointing

My "baby" boy will be two years old this weekend...sob, sob, sob! I remember his birth so clearly, yet when I really think about it, it does seem like two years have went by. So, in honor of his birthday, I went searching for interesting articles on 2 year olds. I beleive that the following link qualifies as interesting. The topic is how dogs and two year olds respond to gestural communication from adults in a similar way:

Dogs And 2-Year-Olds Limited In Ability To Understand Unfamiliar Pointing

Before my children were born, my dog was my "baby". I definately think that my adorable cocker-spaniel acted similar to a toddler!

Wednesday, June 2, 2010

Do colicky babies have sensory processing problems? | Family Anatomy

"Colic" is just a description of a babies behavior...lots of crying for a certain amount of time. This term is not a clinical diagnosis. So often I see that babies with reflux or other digestive problems get labeled as colicky until they get treatment (e.g. formula change, medication, positioning, etc). But sometimes, especially with the babies born extrememly prematurely, there is still a fussiness about the baby including a poor ability to calm down once upset. Typically, we expect a baby to become organized when an adult attempts to calm them such as picking them up and/or rocking them, feeding them, repositioning, etc. The following link suggests that many babies with colic later become diagnosed with sensory processing problems. I tend to agree. I see this pattern often since I work with children under the ages of 3 years old.

Do colicky babies have sensory processing problems? | Family Anatomy

My personal experience with my son's fussiness was resolved with multiple reflux medications as well as eliminating from my diet the foods he was found to be allergic to that he was consuming through my breastmilk. So, by no means do I think every child with fussy behavior will one day have sensory processing problems. Yet, I do think fussiness that can't be explained by other things may lead to a later diagnosis of SPD. For more information on sensory processing in infants, visit:

This link provides strategies on calming a baby. It also gives descriptions of why a baby could be crying which better helps a parent to read the infant's signals allowing the parent to have more accurate attempts in calming the baby. Sometimes for a baby who over-responds to sensory input it might be taking away toys, whereas sometimes our instinct is to shake a rattle to give the baby a distraction. But this can make it worse, which in turn causes the baby to become more upset.