Dr. Srishailesh. D.M

Few things in life take longer than habits to be inculcated and eventually to die out. Every parent tries in his or her way to teach the child certain healthy habits, those that they wish would be followed long enough to be internalized by them. Certain healthy habits that every child should follow are:

1. Include a lot of vegetables in the diet: There is an array of vegetables available in the market, which is replete with rich nutritional values. Though children are generally averse to the idea of eating vegetables, it is your duty to inculcate in them the habit of eating vegetables and constantly remind them of their rich nutritional benefits.
2. Never skip breakfast: Breakfast is the most important meal of the day and is often the most ignored. Most children have the propensity to skip breakfast if they are late and generally they are seldom reprimanded by their parents. As a parent, you must make it a point not to take this lightly and severely insist on a healthy breakfast every morning.
3. Indulge in physical activities: With the advent and easy access of technology, going out to play in has become a distant reality, one that is never explored. However, it goes without saying that nothing can substitute the physical and mental benefits that a physical activity entails. It not only keeps the body of your child fit but also helps in keeping the mind fresh.
4. Read daily: Few things in life can be as rewarding and fulfilling as reading a book. However the habit does not come easy and as a parent it is your responsibility to induce in them this. Try to make your child read a few pages everyday till they take it up themselves out of their volition.
5. Drink water and skip the soda: The many flavored sodas, which are available serve as a more palatable alternative to the drab water for the children. Though the choice may seem convenient, it must be snipped off right from the beginning. Sodas are packed with harmful preservatives and should be duly avoided by children. Instead, they must choose the bottle of water to quench the thirst.

It might happen that you may not find your child, at twelve months to two years of age, at the same level as their peers in verbal communication. You think it's just a developmental problem they are facing and put off seeking professional advice; an intrinsically wrong step to take, because your child might be suffering from Speech Delay.

Delayed speech, or alalia, can be roughly defined as a delay in the development and use of the biological mechanisms that produce speech. Delayed speech is sometimes caused from hearing defect also. A deaf child is always dumb. Before we jump into conclusion of delayed speech, hearing assessment is mandatory.

The symptoms of speech delay are roughly categorized into age related groups, generally beginning at the age of 12 months and continuing through the early adolescence, and they are:

1. Age-12 months
a. It is indeed a symptom if your child cannot point at objects or cannot manage gestures, such as waving good-bye.
b. Another symptom is that if your child does not prefer to communicate verbally as much as his/her peers.

2. Age-15-18 months
a. If your child is unable to pronounce familiar syllables or simply cannot call you even by this time, it's a worrying symptom.
b. You find your child unable to, or simply not reciprocating to 'no', 'hello', 'hi', 'bye'.
c. If your child is unable to extend his/her vocabulary up to 15 words by fifteen months, then it's a symptom.

3. Age-2-4 years
a. You find your child unable to spontaneously produce speech and words.
b. Another worrying symptom is if your child is lacking consonant sounds at the beginning and end of words while speaking.
c. If you still find your child unable to form simple sentences and words, then it is indeed a troubling symptom, confirming the disorder.

The causes for the speech delay disorder are:
1. A primary cause can be physical disruption in parts of the mouth such lips or palate, which may be deformed.
2. Another serious cause can be an oral-motor dysfunction which is the disruption in the creation of the specific area of the brain which deals with speech and communication.
3. The disorder can also be attributed to impairment in the development of the child's intellectual, receptive and expressive abilities.
4. There can also be psychological causes involving school environment and peer relationships which might lead to disruption of speech patterns and reluctance in speech expression and development. If you wish to discuss about any specific problem, you can consult a pediatrician.

Mouth breathing in children is very common and while a kid with open mouth might seem cute, it is not always the case. The parents need to be made aware that a child breathing through the mouth all the time is not normal and it is high time they find a way to manage it.

A little understanding of the effects of the mouth breathing habit on the child's health in general and oral health in particular can be an eye-opener for the parent. For an educated person, there are obvious symptoms, which indicate that the child is a mouth-breather.

These symptoms include:

1. Dryness of the lips
2. Crowding of the front teeth
3. Snoring
4. Sleeping with the mouth open
5. Recurrent infections of the airways including sinusitis and middle ear infections
6. Bad breath

Common causes include:

1. Chronic nasal obstruction/congestion because of which the child is not able to get enough oxygen through the nose.
2. Enlarged tonsils or adenoids
3. Thumb or finger-sucking habit
4. Recurrent respiratory infections

Effects of mouth breathing on oral health:

Mouth breathing may seem like a harmless habit, but has serious effects on the oral and dental health of the child. Some of them are discussed below.

1. Dry mouth: A constantly open mouth can lead to drying up of the saliva. This in turn leads to reduced effects of saliva including the flushing effect on the bacteria and the food deposits. This leads to increased chances of tooth decay and gum diseases.
2. Tooth decay: With reduced saliva, the pH remains acidic for a longer period of time, leading to increased chances of tooth decay.
3. Gum diseases: Reduced amounts of saliva also leads to increased gum disease and periodontal disease as the bacteria are not removed and have a conducive environment to act upon.
4. Facial development: A mouth breathing child maintains a different posture than a nose breather. This leads to a narrow and long face, flattened nose, smaller nostrils, reduced facial tone, thin upper lip, pouty upper lip, and a small lower jaw.
5. Speech: An open mouth causes the tongue to thrust into the palate when talking. This leads to altered pronunciation of some sounds; especially and can cause lisping.
6. Braces: Mouth breathing causes multiple challenges including prolonged treatment period, inability to close the gaps, reduced stability of the realigned teeth, and increased chances of relapse. The added complication of increased gum disease and tooth decay makes it worse. The habit needs to be corrected first before going in for braces.

If that sounds like a long list, they are not all inclusive. Early intervention in the habit can correct and negate all these effects. Talk to your dentist to know how to help your mouth breathing child.

Attention Deficit Disorder or ADD is a behavioral disorder that comprises impulsive behavior, inattentiveness and hyperactivity. This disorder tends to affect children more commonly, but the symptoms tend to disappear as one ages.

There are a number of symptoms for this disorder:

1. Concentration problems: People affected by this disorder have problems in staying focused on routine tasks. You may have problems in listening to conversations, get distracted easily, overlook various important things and have trouble remembering various things.
2. Being disorganized and forgetting things: You may exhibit symptoms such as having an extremely cluttered desk. You may also experience difficulties in completing projects and forgetting appointments. You may also lose track of time while doing important things.
3. Emotional problems: Various emotional problems such as mood swings, hypersensitivity to criticism, problems in staying motivated and having low self-esteem are common signs of ADD. The disorder may also lead you to be extremely short tempered and be constantly frustrated.
4. Hyperactivity: This symptom causes you to remain constantly agitated, unable to focus due to a racing mind, fidgeting constantly and talking excessively.
5. Impulsivity: You will exhibit impulsive behavior such as not being able to exercise self-control, blurting out inappropriate comments and have certain addictive tendencies.

Attention Deficit Disorder can cause various problems in your life. Most of these are related to the following domains:

1. Work related problems: You may constantly feel a sense of underachievement and will unable to meet your work responsibilities. You may be unable to meet deadlines, and face problems in filing paperwork.
2. Relationship problems: This disorder takes a toll on your relationships such as it can create a rift between you and your family. They may feel that you are not sensitive to their concerns.
3. Mental health problems: You may face various mental health problems such as drug abuse, anxiety, self-esteem issues and chronic stress.

Remedies for this disorder are:

1. Get proper sleep: You should always aim to sleep for at least 6 hours every day. If you are well rested, then you will be more energetic and stress free.
2. Regular exercise: You should exercise on a regular basis to keep yourself fit and healthy. It can also help you avoid problems such as obesity.
3. Improve your relationships: You should schedule time for your loved ones and engage with them. It may contribute to your overall mental well-being.