Memo From Your Child

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I would like to share with you a memo by Thomas C. Rjatt, Jr., which I absolutely adore and as a parent need to stick to. Your reflection matters to me, so place it in a "Post a Comment" section. Thank you.

Urszula

Memo From Your Child

1.      Don't spoil me. I know quite well that I ought not to have all that I ask for. I'm testing you.

2.      Don't be afraid to be firm with me. I prefer it; it makes me feel more secure.

3.      Don't let me form bad habits. I have to rely on you to detect them in the early stages.

4.      Don't make me feel smaller than I really am. It only makes me behave stupidly "big".

5.      Don't correct me in front of people if you can help it. I'll take much more notice if you talk to me privately.

6.      Don't make me feel my mistakes are sins. It upsets my sense of values.

7.      Don't protect me from consequences. I sometimes have to learn the painful way.

8.      Don't be too upset when I say, "I hate you." It isn't you I hate, but your power to thwart me.

9.      Don't take too much notice of my small ailments. Sometimes they get me the attention I need.

10.  Don't nag. If you do, I shall have to protect myself by appearing deaf.

11.   Don't forget that I can not explain myself as well as I should like; this is why I'm not always accurate.

12.  Don't make rash promises. Remember that I feel badly let down when promises are broken.

13.   Don't tax my honesty too much. I am easily frightened into telling lies.

14.   Don't be inconsistent. That completely confuses me and makes me lose faith in you.

15.   Don't tell me my fears are silly. They are terribly real to me and you can do much to reassure me if you try to understand.

16.   Don't put me off when I ask questions. If you do, you will find that I stop asking and get my information elsewhere.

17.  Don't ever suggest that you are perfect or infallible. It gives me too great a shock when I discover that you are neither.

18.  Don't ever think it is beneath your dignity to apologize to me. An honest apology makes me feel surprisingly warm toward you.

19.  Don't forget how quickly I am growing up. It must be difficult to keep pace with me, but please, do try.

20. Don't forget that I love experimenting. I couldn't get along without it so please put up with it.

21.  Don't forget that I can't thrive without lots of understanding love, but I don't need to tell you that do I?

by Thomas C. Ritt, Jr., Arizona ACLD Newsletter December, 1975

Feeding and Swallowing Disorders in Infants and Children

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Read an abstract and let me know if you found it useful by sharing your opinion in a "Post a Comment" section at the end of the page. Thank you - Urszula


Children with feeding and swallowing difficulties (also called dysphagia) are at risk for malnutrition, dehydration, and respiratory problems. Infants and children with feeding and swallowing problems are a diverse group, ranging from premature babies to teenagers. Parents are often the first to notice a feeding problem.

Causes of feeding and swallowing problems

• Prematurity
• Cerebral palsy
• Autism
• Head and neck abnormalities
• Muscle weakness in the face and neck
• Gastroesophageal reflux
• Multiple medical problems
• Respiratory difficulties
• Medications that may cause lethargy or decreased appetite
• Problems with parent-child interactions at mealtime

Symptoms

Children with feeding and swallowing problems present with a wide variety of symptoms, depending on the nature and cause of their disorder. Typical symptoms include:

• Poor feeding
• Difficulty chewing
• Difficulty drinking from a bottle or cup
• Difficulty breast feeding
• Refusing food or liquid
• Coughing or choking while eating or drinking
• Excessive drooling and food spilling from the mouth
• Liquid leaking out the nose
• Gagging
• Vomiting during meals
• Increased congestion during meals
• Increased fussiness or crying during meals
• Accepting only certain types of food (only pureed foods or only crunchy foods)
• Poor weight gain
• Frequent respiratory infections or pneumonia (may occur when food or liquid is aspirated into the airway, rather than swallowed effectively)

Evaluation and Diagnosis of Feeding and Swallowing Disorders

If you suspect that your child is having difficulty eating, contact your pediatrician right away. Your physician will examine your child and address any medical reasons for the feeding difficulties, including the presence of reflux or metabolic disorders. The pediatrician may refer you and your child to a feeding team or speech-language pathologist who specializes in treating children with feeding and swallowing disorders. The SLP will discuss your concerns and observe your child while they eat. The SLP may also conduct an instrumental assessment of your child's swallowing ability. This involves having your child eat and drink foods and liquids mixed with barium while watching them on an x-ray. This procedure is typically called a modified barium swallow (MBS) and is conducted in a radiology office. Sometimes a different instrumental assessment will be completed, which involves having a lighted scope inserted through the nose so your child's swallow can be observed.

If a feeding team is involved, which may include the speech language pathologist SLP, an occupational therapist OT, a physical therapist PT, a physician or nurse, and a dietitian, your child's posture, self-feeding abilities, medical status, and nutritional intake will also be examined. The team will then make recommendations on how to improve your child's feeding and swallowing.

You can watch normal swallow

Animation - 
http://www.youtube.com/watch?v=1YfO11Pry6Y

X-Ray swallow - 
http://www.youtube.com/watch?v=PwVreNrTKBw&feature=related

Compare it with abnormal swallow animation:

http://www.youtube.com/watch?v=d_tmhBhec70&feature=relmfu

http://www.youtube.com/watch?v=IyTyLJrEFgA&feature=relmfu

http://www.youtube.com/watch?v=OwlCKmIK8Sg&feature=relmfu

Learn about basic of videofluoroscopy of swallowing

http://www.youtube.com/watch?v=-wmt6HlLduY&feature=related

Treatment

Based on the results of the feeding evaluation, the SLP or feeding team may recommend any of the following:

• Medical intervention, as needed
• Direct feeding therapy designed to meet your child's individual needs
• Nutritional changes
• Postural or positioning changes (different seating, etc.)
• Behavior management techniques
• Desensitization to new foods or textures
• Food temperature and texture changes
• Referral to other disciplines, such as psychology or a dentist

If feeding therapy with an SLP is recommended, the focus of intervention may include:

• Strengthening the muscles of the mouth
• Increasing tongue movement
• Improving chewing patterns
• Increasing tolerance of different foods or liquids
• Improving sucking /drinking ability
• Coordinating the suck-swallow-breathe pattern (for infants)
• Altering food textures and liquid viscosity to ensure safe swallowing
• Other interventions depending on your child's specific needs

Swallowing strategies for dysphagia 

A. Compensatory Strategies
- Supraglottic Swallow
- Effortfull Swallow
- Mendelsohn Maneuver
- The Supra-Supraglottic Swallow

B. Postural Techniques
- Head Rotation To Weak Side
- Head Rotation To Strong Side
- Head Back/ Chin Up
- Chin Tuck

Watch video with the swallowing strategies presented by a clinician - 
http://www.youtube.com/watch?v=UgkRVD-LvjY&feature=endscreen&NR=1

  

Management hints of gastro-oesophageal reflux 

1. Keep your baby upright for at least 30 minutes after a feed. 
2. Use a baby sling, which allows you to keep your child upright, while keeping your hands free. Avoid baby slumping. 
3. Try elevating the head of the cot/bassinet. 
4.  Consider using a dumm. 
5. Avoid vigorous movements or bouncing the baby. 
6. The best time to lay your baby on the floor is when baby's tummy is empty, i.e. before a feed. 
7. Change nappy before a feed. Take care to elevate the baby's head and shoulders. Avoid lifting the legs too high, and turn to the side if possible. 
8. Avoid any tight clothing around the waist, such as tight nappies, elastic waistbands. 
9. Avoid overfeeding – if the baby vomits, wait until the next feeding rather than feeding them again. 
10. If the baby is bottle-fed, it may be worthwhile trying AR (anti-reflux) formula, or a hypoallergenic one. 
11.  Offer a spoonful of thickened milk (formula or breastmilk) following the feed. 
12. If breastfeeding, avoid foods that can aggravate reflux such as citrus, tomato, fatty foods, spicy foods, chocolate and carbonated drinks. 
13. Some reflux children may suffer from food sensitivities, and may need dietary restrictions (or the mother may consider an elimination diet). If you suspect foods may be responsible for your child's condition, it is essential to discuss this with your health care provider. Do not change your or your child's diet before seeking medical advice. 
14. Contact a reflux support organisation for further information and support. The support groups can offer the emotional support you may need.

Healthy Interaction Between a Father and Offsprings

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Since the day of my daughter’s arrival I’ve been watching an interaction between my husband and our offspring; a father and a child. I’ve been searching for the fathers’ voices, some resurge and feedback to learn what is the best for both of them. I came across with the web which I absolutely love http://www.askdrsears.com .  When you go to Parenting section, and under Fathering you click on “10 tips to help fathers become disciplinarians.” I found it as very true and useful. To make it easier for you I put the abstract below. 


Please share your opinion by writing it in a "Post a Comment" section at the end of the page. Thank you – Urszula

“…Fathers become disciplinarians in much the same way that mothers do. The more we are exposed to well behaved and poorly behaved children, we realize that fathers don't start becoming disciplinarians early enough.

1. Start early. Spending time with your baby will pay off as the years go by. Get connected to your baby, and discipline will naturally follow.
   
   
2. Start at the bottom. Most men who climb the corporate ladder work their way into a position of authority by beginning at the bottom. Fathering works the same way. "But what has diapering to do with discipline?" you may wonder. Babycare helps you learn more about your baby. Change baby, bathe baby, dress baby, play with baby. Every interaction with your baby helps you learn to read your baby. Here's some male math: over the first two to three years your baby will need around 5,000 diaper changes. If you change diapers twenty percent of the time, that's a thousand chances to interact with your baby. Initially, managing a squirmy body and smelly bottom might not be your thing. Eventually, you will discover that diapering could be a learning experience for your baby and you. You start "at the bottom" connecting ways to hold baby's attention and learn to softly convey a "father in charge" message.  FATHER TO FATHER ADVAISE - Your children are watching television after dinner. You sit down next to them and offer a suggestion: "Mom needs a break, so she's going for a walk. How about we all work together and clean up the kitchen? If everyone helps, we can finish quickly and surprise her." Everybody benefits from this plan: Your wife gets a clean kitchen, and the kids and you get a chance to spend some time together and share the fun of pleasing mom. 
3. Be trustworthy. In general dads seem to have more concerns and more problems with discipline than do moms. When the fathers were asked, what they most wanted to learn about discipline they responded, "I want to be an authority figure in our home. I want my child to look up to me with respect and obey me." Ii is true that fathers should be authority figures, but just because you're the man of the house doesn't automatically mean you are going to get the respect you want. Some dads believe that a child must obey simply because, "I am the dad, you're the child, and that's that." It's not that simple. A child will obey people he trusts. Trust doesn't come automatically with the title of father. It has to be earned. True authority means a child obeys because he wants to, not just because he has to. Authority based on fear disappears when the child leaves the parent's presence. True authority leaves a more lasting impression. For whom would you do better work, the boss you trust or the boss you fear? So how do you get a child to trust you as an authority figure? Before you could become an authority figure, your children first had to regard you as a comfort figure. This means I have to be available to them—touch their needs, share their triumphs. By becoming a nurturing father you begin teaching your baby to trust you.
   
   
4. Provide structure. From nine months to two years babies' drive to explore exceeds their mental ability to contain themselves. Impulsive behaviors, such as yanking lamp cords, darting into streets in pursuit of a ball and climbing up on counters to explore cabinets are all part of the normal behavior of growing toddlers. Father helps provide the framework that contains a child's impulsive behavior. Children want and need limits set by a person whom they trust, one in authority. When you provide structure in a child's life, the child feels more secure because you channel her energies in a meaningful direction. As coach of St. Louis Rams—the Superbowl champs—Dick Vermeil once said, "Coaching begins at home."
   
   
5. Give positive messages. Kandis was a high-need baby from birth. She cried a lot, was hard to console, became irritated at the slightest setback and withdrew from cuddling by arching her back. She was a restless and unpredictable sleeper, and she resisted any attempts at scheduling. Not only was she a tense baby, but her irritability affected her parents' marriage so that they became increasingly irritated at each other. Mark, the father, would make comments such as, "Yeah, she sure isn't my favorite child." Or he would call her "cry baby." He seldom held her, would never kiss her, or even talk to her in a positive manner. It was all negative attention. Mark never smiled or laughed with her, and when exasperated he would sit her on the couch and angrily tell her to "shut up." By the time Kandis was two, she was a difficult child, yet her nurturing and patient mother had hung in with her the whole time. I met with Mark for a father-to-father rap session and impressed upon him how high-need babies are ultra sensitive and pick up the prevailing vibrations coming from their parents. Because Mark interpreted Kandis's behavior as negative, he reflected this back to her, and she became more negative in his presence. I suggested that for the next two weeks he should try giving her nothing but positive attention. Mark was skeptical, but he agreed that something had to change. Here is the progress report I received from his wife: "His efforts were strained at first. I could tell it wasn't easy for him. But Kandis picked up on it right away and returned the positive attention. Believe me, the change in her happened almost overnight—from whining, lethargic and sickly, to happy, bubbly, laughing, silly, and healthy. She gained almost three pounds in one month. People would say things like, 'Does she do anything else besides smile all day?' or 'She sure is a happy kid.' The good feelings snowballed. The more Kandis smiled at daddy, the more sincere and affectionate daddy became. Kandis sure loves her daddy and daddy definitely loves her. Mark thought he was doing the right thing by being tough. He doesn't like to admit he was wrong, but now he knows the loving approach is better."
   
   
6. Be a role model. Dads, remember, you are bringing up someone else's future husband or wife, mother or father. The attitudes you instill in your baby and child are the building blocks for that adult person. Children learn by example. The best way to build character is to model the qualities you want to see in your children. You can't model what you don't do. One father said: This realization taught me a valuable lesson. In order to discipline my children, I had to discipline myself.
   
   
7. Become involved in your child's activities. Dads, to know and enjoy your child, join your child's team. Don't be a distant dad. Volunteer to coach your child's favorite sport, or try a stint as a scoutmaster. "But sports are not my thing," you say "and I don't know anything about scouting." You don't have to be an expert; you just have to be there. Besides, you're guaranteed to be smarter and more skilled than the kids (well, most of them). Consider what your child learns in a team sport: success and failure, strikeouts and home runs, pulling up a mate, pulling himself up after a putdown (or put-out), teamwork, starting at the bottom and working his way up the batting order, how to deal with his own and someone else's mistakes, how to win and lose gracefully, and how to get along in a group. That's sports! That's life!
   
   
8. Model healthy sexuality. Dads, the first male your son or daughter meets is you. In fact studies suggest that fathers, more than mothers, affect a child's attitudes towards sexuality. Babies and young children identify readily with mother from birth, but how they experience their relationship to father is crucial to the development of sexual identity. Boys need a father who is nurturing in order to value their own masculinity. A father who is available and who enjoys being a man gives his son a healthy sexual role model to follow. Studies show that a boy needs to perceive his father as an active disciplinarian and family decision-maker in order to develop a strong male identity. Paternal behavior that is macho without tenderness is associated with non-masculine behavior in sons. And remember, dads, it isn't how masculine or how nurturing you feel—it's how your son perceives you that counts. You have to show and tell them you love them. Paternal nurturance is also important for daughters. It contributes to her enjoying being a woman. Fathers give daughters their first experiences relating to the opposite sex. When father is "out of the loop," passive, non-nurturing, uninvolved in family life, the daughter misses out on early lessons about balanced male-female relationships. She won't feel comfortable talking with boys or, later, young men, and they will sense her discomfort. She is at risk for problems in relationships with men. In her search for love, the result may be promiscuity, abusive relationships, or an unhappy marriage. Dads, remember, your daughter will at some time in her life seek out a male model. Be that model for her. One of the most powerful influences on children's sexual identity is the way they perceive the relationship between their parents. If a man is loving toward his wife, supportive, and available, the daughter is more likely to value her own femininity and the mothering role. She feels, "Dad respects mom for being a woman and a mother." Dad's attitude toward his wife also shapes his son's attitude toward women. As one woman whose marriage was disintegrating said bitterly, "Our marriage is failing because my husband's father didn't do his job."
   
   
9. Keep connected while apart. If you travel a lot, keep in touch. Parenting is a two-person job. Single parents survive by having a support system in place. In a two-parent family children often misbehave when one parent is away. Because the family equilibrium is upset, children will tend to be defiant, show mood swings, and experience sleep disturbances. Poor behavior occurs because the parent in charge is unsupported and the children pick up on the anxiety. Children who are the most sensitive to change are the ones most likely to misbehave when dad (or mom) is away. To help your children thrive and the at-home mate survive, have a contingency plan for these times. Give "special" responsibilities for which there will be special rewards. If you have a strong-willed child, capitalize on this trait by putting him in charge of extra daily duties. The traveling parent can phone home each day to monitor the children's behavior. To help the at-home parent cope, plan ahead for fun things to do—time at the park and other out-of-home activities. Inviting friends over provides adult companionship for the at-home parent, easing the stress of overload.
   
   
10. Be a father and a provider. For most men, being a good provider is crucial to their masculinity and feelings about themselves as dads. This is what drives them to work long hours, even if their families would be happier with more of them and less of things. (A note to wives: It may help bring your husband home more if you tell him this in a tactful, loving way.) Men who are the sole wage earners in the family may feel heavy pressure, especially when double-income families are the neighborhood norm. (This may be changing. A 1994 study showed that for the first time in thirty-three years, the single income household is the fastest growing group in the U.S. population. There is a growing realization that it makes a difference to have one parent at home full-time.) If you must work long hours, try to incorporate your fathering into your work. Do some of your work at home. Take your child to work. It's healthy for her to learn about your work, and when she understands what you're doing while he's away from home, it's easier for her to accept your absence. The media has portrayed fathers as economic providers, but around the house and family they have been depicted as bumbling and optional. Even though some of these images are still around, nowadays television commercials and cartoon strips showing fathers bathing babies and taking charge of households. The media are updating dad's image in the new millennium. Fathers finally are realizing the rewards of investing themselves in their children."