Speech and Language skills

Overall about 5% of children entering school have significant speech and langauge difficulties without any additional sensory or cognitive impairments. When sensory and cognitive impairment is an additional feature this number rises to 25-35%.

For the majority of children speech and langauge develops without any problems and by the age of 6 years children are relatively sophisticated users of language. Speech and language skills incorporate a number of elements including;-

• Structure of language
• Use of language
• Understanding of language
• Vocabulary
• Speech sounds

Some signs which may indicate that a child has a speech and language problem include;-

• Inability to follow simple, everyday instructions at age 2years.
• Restricted vocabulary development at 30 months. (70% of children have at least 500 words by this age)
• Sentence structure of 2-3 words at the age of three years.
• Family cannot understand the childs speech at 3 years of age.
• Difficulties in attentionm understanding, development of play or with the social aspects of language.
• Failure to use grammatical endings such as ing, ed, and plurals at 4 years of age.

It is important to ensure that the child has good hearing as missing a pitch or tone can result in poor speech. Language difficulties are pervasive and early intervention and support can make a considerable difference to the child's learning and speech and language development. Referral to a speech and language therapist for assessment and support can be invaluable.

Feet First

The Human foot is a complex structure of 26 bones, which have usually hardened by about age 18. In a nweborn the foot is mainly made up of relatively soft cartilage which converts to bone as the child grows and matures. During this period of growth and development the foot is at risk of injury and deformity. For this reason children's footwear has special importance.

Babygrows and sleep suits should not cram little toes. Pram shoes are best avoided as it is very difficult to size appropriately, bootees which do not constrict the toes and ankles are much more suitable. Ideally a child does not require shoes until they are walking competently out of doors. In order for the foot to develop normally and naturally the child should be barefoot for as long as possible within the realms of safety.

On average a child's foot grows two sizes a year in the first four years of life, and one size a year after this, until growth is complete. Sometimes a childs foot seems not to grow for a considerable period then suddenly grows several sizes. It is a good idea to have a trained shoe fitter measure your childs feet every 8 weeks, more frequently if you are aware that the child is actively growing taller.

Children enjoy being barefoot, but if their feet are noticeably cold, or they complain of this, some form of protection may be neccessary. Socks alone may be dangerous if there is a danger of the child slipping. Slippers are only a short term solution as they are not held properly on the foot. Long term use may result in future deformities.

The age at which a child first walks unaided is variable. For girls the average age is 12 months and for boys 15 months, but some perfectly normal children do not walk unaided until 24 months. Nearly all babies appear to have flat feet when first they walk unaided. This is partly because of posture adn partly due to the deposits of fat which can make the foot look flat. The first time walking baby has to balance a relatively large head on a short body and in order to do so baby walks with knees bent, legs wide apart and feet turned outwards. The nervous gait control is still developing and so the child appears to be flat footed.

Baby walkers encourage loading of the joints before nature intended, often resulting in unusual walking patterns. Research has demonstrated that using baby walkers may cause baby to walk later than he or she normally would.

Keeping children warm

It is generally accepted that an infants bedroom should be kept at between 18-20 degrees C. At this temperature the room is cool enough to allow baby to be warm and to sleep without being overheated. As winter cools the outside air there is a temptation to increase the temperature inside homes, as much for the comfort of the adults as the comfort of children. The ambient temperature of your living room is chosen for your comfort and that is a personal choice.

Children do not make these choices so what should we consider for them?

Toddlers should have one layer more clothing on, than their parents, to ensure that they remain warm and comfortable. Wearing a hat out of doors is helpful, as babies and small children lose a fair amount of body heat through their scalp. Where there isn't a great deal of hair, this loss is increased. Toddlers are notorious for wriggling out of hats shoes and gloves, which is why strollers have warmly lined "suits" or cosies to keep them warm.

Children's body thermostat is not as efficient as an adults, so it is important to ensure that they remain warm and dry despite the winter storms and snows. When ever possible parents should avoid taking very young children out after 3.30pm/4pm as this is when the temperature outside is most likely to start it's evening fall. Although the baby/child may have been warmly enough dressed earlier in the day this fall in temperature can make it more difficult to remain warm.