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Children's, Development, Health and Safety

Communication Begins at Birth: 12 – 24 Months

This year-long period is when language development truly takes off. Your child’s understanding of the world around them, especially for language and sounds, is much more developed than before. Most kids typically say their first words around their first birthday, but a toddler who is actively learning to walk will commonly postpone their speech development. By two years old, most toddlers will say 50-100 words or moreand be able to put together two-word phrases.

Listed below are some typical milestones, enhancement activities, and red flags for your baby’s hearing and speech development at this age. Note that every child is different, and some reach these milestones sooner or later than others. If your child is not developing in accordance with these guidelines, consider contacting your pediatrician or family health physician. 

Typical Development: 

  • Uses several words with a variety of speech sounds, slowly developing into 20-50 words
  • Enjoys simple songs and rhymes
  • Understands two step directions (ex: “Get your shoes and come here”)
  • Can make simple needs known through speech
  • Asks simple questions
  • Knows and points to body parts

Activities: 

  • Praise and encourage efforts in all areas: moving, playing, talking, singing
  • Avoid over-correcting your child’s efforts to speak
  • Always fully listen when your child speaks to you
  • Ask your child questions that stimulate thought and check understanding

Red Flags: 

  • Uses only vowel sounds to speak
  • Cannot follow simple commands
  • Does not respond to sounds or responds only to loud sounds
  • Points or grunts to make needs known

Your little one is listening to everything you say and storing it away at an incredible rate. Instead of using “baby” words, start using the correct names for people, places, and things. Speak slowly and clearly, and keep it simple. Your child’s vocabulary will grow quickly, but pronunciation isn’t likely to keep pace. By 2 years of age, most kids are understandable only about half the time, so emphasize the correct pronunciations in your responses.

Gestures are an important part of language development. Make the connection between the gestures your child makes and language by using a running commentary such as, “Do you want a drink?” (when your child points to the refrigerator), then wait for a response. Then say, “What do you want? Milk? OK, let’s get some milk.” Such behavior encourages kids to respond and participate in conversations

Children’s of Alabama Hearing and Speech Center: https://www.childrensal.org/hearing-and-speech 

Children's, Development, Health and Safety

Communication Begins at Birth: 4 – 8 Months

During these months, your baby is learning to talk with lots of babbling and laughing. They are discovering a new range of sounds as well as imitating some of those sounds. They will also start to understand different tones of voice and respond accordingly.

Having a “conversation” with your baby is as important as ever during this time. Surprisingly, babies comprehend words long before they can say them, so use real words and cut back on the baby talk.

Listed below are some typical milestones, enhancement activities and red flags for your baby’s hearing and speech development at this age. Note that every child is different, and some reach these milestones sooner or later than others. If your child is not achieving these developmental milestones, consider contacting your pediatrician or family health physician.

Typical Development:

  • Turns head to locate sounds beyond what able to see
  • Notices toys make sounds
  • Shows interest and pleasure when spoken to
  • Responds to different tones and sounds but not upset
  • Calms by favorite sounds
  • Begins to repeat sounds (such as “ooh,” “ahh,” and “ba-ba”)
  • Responds to name when called
  • Makes sounds to get attention
  • Shouts to gain attention
  • Understands “no-no” and “bye-bye”

Red Flags:

  • Does not laugh or smile
  • Makes little noise
  • Does not respond to sound or responds only to loud sounds
  • Does not interact vocally by making sounds or makes sounds only in monotones

Activities:

  • Call baby by name
  • Play vocal and simple games like peek-a-boo
  • Talk about activities during play
  • Make play sounds and wait for response: taking turns
  • Name body parts while playing and dressing
  • Read to your baby

By the end of eight months, you can expect a lot of progression in your baby’s ability to listen and talk. They will respond to their names, respond to sounds by making their own, babble repetitive consonants, imitate sounds and even associate words with familiar objects. Reinforce this progress by introducing your baby to simple words that apply to everyday life. They understand more that you think!

Children's, Development, Health and Safety

Communication Begins at Birth 1 – 3 Months

May is Better Speech and Hearing Month.

Once a child is born, he or she starts gaining crucial skills for proper development. The basic building blocks for typical and healthy child development includes the development of speech and hearing communication. It is important for parents to be aware of developmental milestones because communication begins at birth.

Through a four-part series of blog posts, we will be highlighting important communication milestones for babies between the ages of one to 24 months. This series will help parents know what to expect as their baby develops. Note that every child is different, and some reach these milestones sooner or later than others. If your child is not achieving these developmental milestones, consider contacting your pediatrician or family health physician.

One to three months is an exciting time for parents because babies make a lot of progress in communicating. Your baby’s personality will start to show through as you have two-way “conversations,” exchanging smiles and oohs and aahs.

Listed below are some typical milestones, enhancement activities and red flags for your baby’s hearing and speech development at this age.

Typical Development:

  • Pays attention to faces and surroundings
  • Smiles at the sound of a parent or caregiver’s voice
  • Calms to caregiver’s voice
  • Smiles with social contact
  • Coos and makes sounds when talked to
  • Imitates some sounds and facial expressions

Activities

  • Smile at baby
  • Talk, babble, coo to baby
  • Sing to baby

Red Flags:

  • Does not respond to a sound
  • Does not look at face

Babies main form of communication at this age is crying. They may cry to let their parents know that they need something, or because they are overwhelmed by all of the sights and sounds of the world. Sometimes they cry for no clear reason, so as long as your baby is not sick or hurt, try not to be upset if your baby is crying and you can’t console him or her right away.

For more, visit the Children’s of Alabama Hearing and Speech Center website: https://www.childrensal.org/hearing-and-speech 

Children's, Development

Screen Time and Teens: The Hidden Pandemic

Screen Time and Teens

While the world has been focused on the COVID-19 pandemic, an underlying, hidden pandemic has been growing – screen time among teenagers. Some studies show that teens spend close to nine hours a day online, ranging from being on the phone, watching TV or playing video games. Approximately three-quarters of teens own a smartphone and half of them feel addicted to using their phones. Fortunately, there are proactive ways for parents to tackle this issue including establishing screen time limits for their teens.

Since many students have been doing online school, they have more time to scroll aimlessly through social media and spend hours on their phones. Some parents are working from home while others are working in the office, so their attention is not often geared toward their teens’ screen time. Free time among teenagers can often breed unhealthy habits if gone unchecked.

Neuropsychologist at Children’s of Alabama, Dr. Dan Marullo, offers insights on teens partaking in too much screen time. “Too much screen time in teens can lead to comparison to others and belief that their life is not as good as the people they follow,” Marullo said.

The false ideal of perfection on social media contributes to low self-esteem and eventually could develop into mental health disorders, including anxiety and depression, if not addressed.

Too much screen time in teens interferes with physical activity, homework, sleep, social activities with friends and time spent with family. It also can lead to attention problems, a higher incidence of depression, anxiety and exposure to unsafe content and contacts. Screen time can lead to obesity due to increased sedentary activity, mindless eating and interference with normal sleeping patterns. Lack of sleep contributes to problems with mood, attention and learning.

Some phone activities can be productive, including researching for a school project, engaging in creative outlets or interacting with friends on online platforms. However, many activities are unproductive or harmful for teens, including visiting unsafe websites, playing violent video games, watching inappropriate TV shows, sexting and engaging with strangers who pose a threat online. Cyberbullying, which is using the internet, cell phone or other technology to send texts or images intended to hurt or embarrass another person, can be an outcome of too much screen time as well.

Dr. Marullo suggests monitoring and limiting your teen’s screen time to no more than a couple hours per day outside of schoolwork. 

Parents should remember these tips when forming a healthy screen time habit for their teens:

  • Monitor social media sites, apps and browsing history.
  • Research video and computer games before letting your teen get them. Preview games with your teen to see what they are like.
  • Review or reset the phone location and privacy settings.
  • Follow or friend your teen on social media sites or get a trusted adult friend to do so.
  • Ensure your teen has a wide range of free-time activities (spending time with friends, playing sports, volunteer work, being involved in school clubs, etc.). Less free time can lead to less time spent on screens!
  • Turn off all screens during family meals and when your teen goes to bed. Keep devices with screens out of your teen’s room after bedtime.
  • Know your teen’s usernames and passwords.
  • Consider screen time a special privilege that teens need to earn, not a right to which they are entitled.
  • Stay up to date on the latest apps, social media platforms and digital slang.
  • Use screening tools for phones, TV, tablets and computers to limit access to certain content.
  • Teach your teen about internet and social media safety, ensuring they know the dangers of sharing private information online or sexting.
  • Teach positive, respectful digital behavior.
  • Keep the computer in a common area so you can monitor their online activity.
Children's, Development, Health and Safety

Scoliosis

Scoliosis is an abnormal side to side curvature of the spine. Instead of a straight line, it may form more of an “S” shape or “C” shape.  Scoliosis usually occurs during the growth spurt just before puberty.

Angela Doctor is a registered nurse and the Scoliosis Screening Coordinator for Children’s of Alabama.  In 1984, the state of Alabama mandated that all public school students between the ages of 11 and 14 be screened for scoliosis. “The importance of scoliosis screening is early detection,” Doctor says. “Children are doing a lot of growing during the adolescent period, so our goal is to halt the progression of scoliosis.”

Types of Scoliosis

Doctor says there are three types of scoliosis. The most common is adolescent idiopathic, in which case the cause is unknown.  But scoliosis can congenital, caused by a defect at birth, or due to a neuromuscular disease like cerebral palsy.

Treatment

For most children, scoliosis is not a problem. Some may require ongoing monitoring.  But a curve that gets worse can be bad for a child’s health. If an orthopedic specialist determines treatment is necessary, the options include a back brace to halt the deformity, or spinal surgery.

Possible Signs

Parents may wonder if their child has scoliosis. Doctor says signs to look for include:

-Uneven shoulders

-Uneven scapulas

-Uneven waist and hips

-One side of the back higher than the other when bending forward

If a parent suspects their child may have scoliosis, they should see their pediatrician.  He or she may refer the child to an orthopedic specialist to confirm a diagnosis and decide whether treatment is necessary.

It’s crucial to identify scoliosis early while the spine is still growing. When treatment is over, people with scoliosis are able to live full and active lives.

Children's, Development

Hearing and Speech Milestones

From the moment a baby is born, he or she is learning. That’s why it’s important for parents to be aware of and watch for important developmental milestones from birth the age 3. Jill Smith is the director of the Hearing and Speech Center at Children’s of Alabama. She said engaging in simple activities like talking to your baby while changing a diaper actually helps them learn to communicate. Smith said even the routine task of feeding your baby lays a foundation for speech.

 

“Those same muscles they are using to suck on the bottle are the same muscles they will use when learning to talk,” Smith said.
Crying is a form of communication for several months of a baby’s development. Babies cry to let parents know when they need something or when they are overwhelmed or tired. They can also engage in two-way “conversations,” exchanging smiles and cooing with mom or dad.
During this important developmental stage, Smith recommends parents consistently talk to their child. This may include reading to them, engaging in “conversations” with them and pointing out objects or animals when at the park or around the home.
“You can be saying, ‘Oh! There’s a bird,’ or ‘Look at our friend, the dog,’ and even though they may just be laying back in their stroller, they’re taking it all in, listening and learning,” Smith said.
Babies should begin reaching basic speech and hearing milestones as they grow:

3 Months Old

  • Smiling (responding to parent)
  • Cooing, babbling with parent

6 Months Old

  • Should understand “No”
  • Recognizes his or her name
  • Recognizes when a parent is in the room

1 Year Old

  • Should be speaking basic words like “No,” “Dada” and “Mama”

18 Months Old

  • Should be able to speak 30-50 words

2 Years Old

  • Should be able to string words together like “I don’t want,” “My ball,” and “Go outside”
  • Should have a vocabulary of 200-300 words

Children communicate at different rates just as they mature physically at different rates, but Smith said if a child is not using any words by 18 months old, parents should consult a pediatrician and request a speech evaluation.

Early speech and language skills are associated with success in reading, writing and social skills later in life. By engaging in “baby talk” with your baby, you help build a foundation for his or her future.

Development, Health and Safety

Scoliosis

By Rachel Olis

A little bit of curvature in the spine is completely normal. In fact, this curvature is necessary for us to balance, move and walk. But how much curve is too much?

Scoliosis is an abnormal curvature in the spine, often in the shape of a “C” or “S”. In these cases, there is too much curvature in the spine and may need treatment. Treatment options may include observation by a physician, wearing a back brace or surgery. Early detection is important in scoliosis patients, because when detected, early scoliosis can typically be treated with observation or a back brace. If left untreated, the spinal curve may become visible and cause pain or discomfort. At this point, the condition could begin to affect the lungs, heart and joints. In these advanced cases, spinal fusion surgery may be needed correct the problem. When treated properly, almost every child with scoliosis can have a healthy and active life.

Because early detection is so important, Alabama has implemented a law (Act No. 83-84) requiring public schools to examine students for the development of scoliosis. If there are positive results, a child is referred to a trained medical professional. These school screenings are meant to detect scoliosis at an age when the condition is mild and likely to go unnoticed.

“Early detection is key,” said Angela Doctor, R.N., Scoliosis Screening Coordinator at Children’s of Alabama. “Every child deserves an equal opportunity for early detection and treatment.”

While the cause of scoliosis is unknown, the condition can be hereditary and is much more likely to develop in girls. Signs of scoliosis normally appear between the ages of 10 and 14. Scoliosis happens gradually and does not usually cause pain, so it can be difficult to diagnose. So what should a parent do to make sure that their child’s spine is developing correctly?

 

  • Pay attention for signs of abnormal curvature. Some spinal curvature can be visible: the ribs are pushed out or one shoulder is noticeably higher than the other. 
  • Find out if your child’s school provides screenings and have your child participate. 
  • Have your child’s physician check for scoliosis during regular physical exams. Seeing a doctor is the most accurate way to diagnose. 

Usually, scoliosis is mild enough that it does not affect a child’s life and requires no medical treatment. Remember that early detection is important and have your children screened regularly.

Children's, Development

Keeping Kids Academically Active During Summer Break

By Rachel Olis

Going back to school isn’t always easy after a summer of relaxation and fun. Getting back into the habits of going to bed early and doing homework can be difficult. However, there are many ways that children can continue learning over the summer, and the transition back into “school mode” can be much more seamless.

“Playing is learning. Activities such as going to the zoo and museums, cooking, crafting and reading can all help children use the skills they already have to continue learning throughout the summer,” said Tara Motte, a teacher in Children’s Sunshine School.

The Sunshine School is a program at Children’s that helps patients stay on top of their schooling. It is staffed by six Alabama state certified teachers who all have the same goal of ensuring children stay educated and reach their highest learning potential despite their circumstances.

Even though students in the Sunshine School may continue their school work throughout the summer, it is important to keep all children’s minds active even when on summer break.

Fortunately, there are many ways to incorporate learning into everyday play time:

  • Take trips to the zoo, museums and library.
  • Use math skills by cooking and baking.
  • Do a science experiment.
  • On rainy days, use play dough to craft animals or make secondary colors.
  • Use some downtime each day to read for at least 15 to 30 minutes.
  • Limit screen time, including television, to an hour and a half and go outside instead!

Summer is also a time for travel and vacations, so use car rides as an opportunity to learn.

  • Use a standard deck of cards to play simple games like Go Fish and Crazy Eights, or even pack a set of trivia cards.
  • Give each child a journal and have them write down what they see along the way.
  • Play the Alphabet Game- pick any topic of interest and take turns naming something within that topic starting with the letter A, and so on.
  • Bring a large map and have the kids highlight and sticker all the different roads you take.
  • Have the children read. Bring the audio version as well so they can read along or listen if they get car sick.

The summer provides many opportunities for families to spend time together and have fun! However, it is important to ensure that children are keeping active physically and mentally throughout those weeks off.

Children's, Development, Health and Safety

Too Much Screen Time?

By: Rachel Olis

Children growing up today spend more time with technology than any previous generation. Unfortunately, this also means that they spend more time sitting in front of a screen. But at what point have the kids had too much? From tablets and cell phones to TV’s and laptops, children have a lot of opportunity for screen time. Although there are educational programs and apps, the negative effects of having too much media exposure seem to outweigh the positive.

“On average kids spend about seven hours a day on media, but we’d really prefer to see kids playing,” said Dr. Dan Marullo, pediatric neuropsychologist at Children’s of Alabama.

The American Academy of Pediatrics (AAP) recommends that children under the age of 2 not watch any television and that older kids have no more than two hours of screen time per day.

“If you are starting to see your child not spending as much time interacting with other families or friends, not playing, not engaging in favorite activities, research shows that there can be a link between too much media exposure and obesity and hypertension,” he said.

Problems paying attention and concentrating, depression or anxiety, and even aggression can also be signs that your child has had too much media exposure.

Here are a few ways to limit children’s screen time:

  • Limit the number of screen time hours.
  • When a program is over, turn the television off instead of surfing the channels.
  • Set up a “media free zone” that includes bedrooms and the kitchen during dinner.
  • Make a screen time schedule that all members of the family abide by.
  • Make watching television a family affair.
  • Set a good example. Put down your cell phone and exchange watching television for something active.

Fortunately, there are many alternatives to the screen. Here are some examples:

  • Send your kids outside to play, or go play with them!
  • Involve them in a sport such as baseball, ballet, lacrosse or swimming.
  • Have a family game night – play board games and cards.
  • Sit down and read together.

The amount of fun activities you and your kids can do without the TV and tablets are endless. For more information on how to have healthy screen time habits, visit http://www.childrensal.org.