Wednesday, January 15, 2014

January is National Birth Defects Prevention Month!

According to the Centers for Disease Control (CDC), birth defects affect 1 in 33 babies every year and cause 1 in 5 infant deaths.  In honor of National Birth Defects Prevention Month we will be talking about what birth defects are, how they may be prevented, and we will talk more specifically about two common birth defects which may be able to be prevented, Neural Tube Defects and Fetal Alcohol Syndrome.

What is a Birth Defect?

Birth defects are abnormal conditions that happen before or at the time of birth.  Some can be very mild, like an extra finger or toe while others can cause serious physical, mental, or medical problems.  Birth defects can have a number of different causes including genetics, environment, drugs and alcohol, chemicals, medicines, and maternal illness or infection.  There are also many birth defects which are caused by unknown factors. 

Many birth defects happen very early in pregnancy, sometimes before a woman even knows she is pregnant.  Some birth defects can even be diagnosed before the baby is born.  Tests like ultrasounds and amniocentesis can detect birth defects such as Spina Bifida, heart defects, or Down syndrome before a baby is born.

Many birth defects are not found immediately at birth.  Birth defects can affect how the body looks, how it works, or both.  Some birth defects like cleft lip or Spina Bifida are easy to see at birth.  Others, like heart defects or hearing loss are not.

How Can Birth Defects Be Prevented?

Woman can take important steps before and during pregnancy to help prevent birth defects.  All women who can become pregnant should take in at least 400 mcg of folic acid every day.  Folic acid helps a baby’s brain and spine develop very early in the first month of pregnancy, before a woman may even know that she is pregnant.  Pregnant women should avoid using cigarettes, drugs or alcohol and also use caution when taking medications.  Regular medical checkups while pregnant will help ensure that mom and baby are healthy and developing normally.  Eating a healthy, nutritious diet and exercising regularly can help ensure a baby is born healthy.  Pregnant women should also wash their hands often, especially after using the restroom, touching raw meat, uncooked eggs or unwashed vegetables, handling pets, gardening, or caring for small children.      

What are Neural Tube Defects?

Neural tube defects are birth defects of the brain, spine, or spinal cord.  They happen in the first month of pregnancy, often before a woman even knows that she is pregnant.  In a developing baby, certain cells form a tube called the neural tube which will later become the spinal cord, the brain and the nearby structures that protect them including the bones of the spine.  A neural tube defect occurs when this tube does not completely close, resulting in a hole somewhere along the length of the spinal column or in the brain.
Some common neural tube defects include:

·         Spina Bifida

·         Anencephaly

·         Chiari malformation

·         Encephalocele

Spina Bifida, the most common of the neural tube defects, happens when the neural tube fails to form properly or close in the spine.  The term Spina Bifida literally means “split spine”.  It can happen anywhere along the length of the spine and may cause damage to the spinal cord or nerves.  Spina Bifida can range from very mild, where there may not be any symptoms, to very severe where parts of the spine and spinal cord may develop outside the body, causing nerve damage, paralysis  and/or hydrocephalus.   
What is Folic Acid and Where Can I Find It?

Folic acid is a B vitamin which helps the body make healthy new cells.  Folic acid is a manmade forms of folate, while folate is found naturally in some foods.  Women can get enough folic acid by taking a vitamin every day, or you can find folic acid in the following foods:

·         Green, leafy vegetables such as spinach, collard greens, mustard greens, romaine lettuce

·         Other green vegetables such as asparagus, broccoli, okra, and brussel sprouts

·         Citrus fruits such as oranges and grapefruit

·         Papaya

·         Beans, peas and lentils

·         Avocado

·         Whole grains

·         Enriched foods such as breakfast cereals, breads, flours, pastas, cornmeal and white rice. 

For foods that are enriched with folic acid, always check the supplemental facts label to be sure you are getting enough 400 to 800 mcg of folic acid. 


What is Fetal Alcohol Syndrome?

Fetal Alcohol Syndrome (FAS) is a condition that results when a baby is exposed to alcohol during pregnancy.  FAS is a cluster of related problems that can range from mild to severe.  When a pregnant woman drinks alcohol, the alcohol enters the bloodstream and reaches the baby through the placenta.  Babies metabolize alcohol more slowly than an adult so the baby’s blood alcohol concentration are much higher than the mother.  Some common impairments that are a result of FAS include:

·         Distinctive facial features including small eyes, an exceptionally thin upper lip, a short, upturned nose and a smooth skin surface between the nose and upper lip (philtrum)

·         Slow physical growth before and after birth

·         Mental retardation and delayed development

·         Learning disorders

·         Abnormal behavior such as short attention span, hyperactivity, poor impulse control and anxiety

·         Poor coordination

·         Vision or hearing problems

How Can Fetal Alcohol Syndrome Be Prevented?

There is no safe level of alcohol that a pregnant woman can drink, and the more a pregnant woman drinks, the greater the risk is to the baby.  Fetal Alcohol Syndrome is 100% preventable.  If you are trying to become pregnant or think you might be pregnant, don’t drink alcohol.  The risk is present any time during the pregnancy, however facial impairments and heart and organ damage may occur as a result of drinking alcohol during the first trimester, when these parts of the baby are in the key stages of development. 

Thursday, January 9, 2014

Know the Signs of Speech & Language Disorders

Our speech-language pathologists at MedCare Pediatric Group, LP working in the field of communication disorders know firsthand that treatment is much more successful when it begins before age 3—and key early indicators are frequently overlooked.
A new, nationwide effort to educate the public about communication disorders was recently launched by the American Speech-Language-Hearing Association (ASHA)—a professional association of which I am a member. Called Identify the Signs, this campaign specifically aims to help people recognize the early warning signs of communication disorders. This topic couldn’t be timelier—or more important.
An estimated 40 million Americans have trouble speaking or hearing due to a communication disorder. Millions more family members and friends are also impacted. Here in the greater area of Houston there are parents reading this whose children are struggling to speak or understand language; spouses living with partners whose hearing is deteriorating; and co-workers, neighbors and others who see someone who needs help but don’t know what to do. Identify the Signs offers tools to change that, and I couldn’t support the campaign more.
With 5 years of experience working in the field of communication disorders, I have seen the debilitating effects that these issues can have when left unaddressed. Too often, people wrestle with these challenges for years because they fail to receive proper, timely treatment.

Do any of these lines sound familiar when discussing your child’s communication?
 “She kind of has her own language. We can understand her at home, but others have a hard time.”
“He says the t sound for the k sound.”
“I am not sure if my child understands what I am saying.”
“She’s not talking much yet, but she is only two.”
As a pediatric speech-language pathologist these are some of the most common concerns and questions I hear during the initial evaluation. Many caregivers are unaware of these warning signs and the resulting impact they may have on language development. Knowing what is “common” when it comes to communication can be challenging for caregivers, especially when it’s a first child. Well-meaning friends, grandparents and even pediatricians may advise concerned parents not to worry; saying that a child will speak when he or she “is ready.” Although they may be right, taking a wait-and-see approach is risky. If a disorder does exist, caregivers are neglecting a critical treatment time frame. Research indicates in the first years of a child’s life the foundational communication skills are formed for a lifetime. Therefore, during this period, children generally respond extremely well to treatment. Early detection of speech, language, and hearing issues is absolutely critical to improving academic, social, and career outcomes—and improving one’s quality of life at any age. 
For people with communication disorders, those closest to them are often their biggest asset. Unfortunately, many parents and caregivers are unable to identify the warning signs or dismiss them too readily. A recent poll of speech-language pathologists and audiologists by ASHA reported significant parental delays in getting help for children with communication difficulties. This is just one example of the missed opportunities that commonly occur with communication disorders. 

ASHA has identified the following 6 early warning signs of communication disorders in children between birth to 4 years of age.
Does not interact socially (infancy and older)
Does not follow or understand what you say (starting at 1 year)
Says only a few sounds, words, or gestures (18 months to 2 years)
Words are not easily understood (18 months to 2 years)
Does not combine words (starting at 2 years)
Struggles to say sounds or words (3 to 4 years)
I encourage you to visit the website to learn about more signs and share the information and resources you find there. Above all, though, I hope you will seek help if you suspect that you or a loved one shows signs of having a disorder.
Every day, I see in my work that untreated communication disorders often lead to larger academic, social, and developmental issues. Early diagnosis is the most powerful way to reduce or even reverse their impact and can give your loved ones the opportunity to lead the fullest lives possible. We welcome you to contact MedCare Pediatric Group LP at (713) 995-9292 to schedule your loved one for an evaluation if you suspect that he or she is presenting with a communication disorder.
Brittney Goodman M.S. CCC-SLP
MedCare Pediatric Rehab Center-Katy