When it comes to speech, every child has a different pace of learning. In the first year, they should be able to recognize and respond to their own names and simple directions like  come , etc. By a child s second birthday, he or she should be able to use a single word or two-word phrases and understand simple questions. If a child s speech development seems atypical for his or her age, you may need to consult a speech therapist. Some of the things you should look out for are:

Mispronouncing vowels: Many children have problems with pronunciation. Pronouncing  bath  as  baf  or  animal  as  amal  is normal. However, if they cannot pronounce vowels correctly, they may be having problems with articulation. For example, your child might say  coo  instead of  cow .
Using only single words: Part of a speech therapist s job is to teach a child to join words together to create phrases and sentences. If even after your child s second birthday, they still prefer using single words instead of phrases, you should consult a speech therapist. For example, they may just say  water  instead of  i want water .
Stuttering: Many children are shy and hesitant of speaking especially in front of strangers. However, stuttering is a more serious problem. This could be in the form of repeating syllables or prolonging words. For example,  s-s-s-s-s-stop  or  mmmmmm me . If this is not nipped in the bud, it could continue into the child s adult life as well.
Answering a question by repeating part of it: By the age of three years, a child should be able to understand and answer simple questions. If the child answers a question by repeating part of it, such as answering  do you want food  with  you want food , it could be a sign of a bigger problem. This is known as echolalia and might be an early symptom of autism.
Limited vocabulary: Each child s vocabulary grows at a different rate but it is important to be able to notice an increase in the child s vocabulary from month to month. If the child uses only a finite set of words and does not catch on to new words, you may need a speech therapist. They can help the child expand their vocabulary and become more receptive to new words.
Other factors you should watch out for include difficulty with pronouns, not being able to follow instructions and understand prepositions and confusion with gender.

When Does My Child Need Speech Therapy?

Parkinson's disease is a neurodegenerative condition that affects your brain cells which produce dopamine and thus hampering all kinds of motor functioning and other emotional responses. After the disease is diagnosed, medication and therapy can help to provide relief from the symptoms to a large extent but a permanent cure is not possible.

Causes:

The disorder does not have a definite set of causes. A small percentage of the cases have been related to hereditary factors and others have a range of environmental causes associated with them.

1. Genetic factors:

Specific gene mutations and gene variations have been proved to cause Parkinson's, such as SNCA, PARK2, PARK7, PINK1 and LRRK2. These make or recycle proteins which are linked to the disease.

Research shows that men are at a 1.75 times greater risk of developing the condition than women are. Also, age plays a role with most cases occurring after the age of 60.

2. Environmental factors:

Regular exposure to inorganic insecticides, pesticides, herbicides and heavy metals or other toxins may cause the disorder. In rare cases, Parkinson's disease occurs in the aftermath of a severe head injury or immune disorders.

Symptoms:

The symptoms can be classified into two broad categories-

1. Motor symptoms:

The hand tremors when in resting position
The grip loosens
Walking slows down
Facial muscles freeze partially
Speech is slurred
Balance is disturbed
Swallowing is painful
Urination is abnormally frequent
Dementia-like symptoms are seen
There is involuntary twitching of the fingers and toes
Repetition of the same movement in quick succession is nearly impossible
2. Non-motor symptoms:

Dental problems
Vision impairment
Skin disorders
Panic attacks
Excessive secretion of saliva
Extreme weight loss or gain
Sexual problems
Loss of sense of smell
Lowering of the pitch of the voice
Fatigue

Causes and Symptoms of Parkinson's Disease

Smoking can cause irreparable damage to your mind and body. Chemicals in the tobacco travel to all parts of the body, leaving no area unaffected. According to available data, smoking causes 30% of all cancer deaths and about 80% deaths from emphysema and bronchitis. In addition to adversely affecting yourself, smoking also has a severe impact on your near and dear ones. According to WHO, about 600,000 people die every year from passive smoking. Out of the deaths that occur due to this, 1/3rd is that of children.

The Indian situation
While 85% of tobacco users worldwide consume it in the form of cigarettes, in India only 13% use it in that form. Additionally, 54% use it in the form of beedis. A study conducted on Indian smokers has revealed that an average of 8.2 cigarettes is smoked by an individual daily.

The study also revealed that the number of cigarettes smoked every year had grown to over 6 trillion. While 1 out of 10 adults dies from tobacco use worldwide, 5% of deaths in women and 20% of deaths in men in India are caused by cigarette and beedi smoking.

What happens when you smoke?
Cigarette smoke is made up of 4000 chemicals that are present either as tiny particles or gases and about 50 are known to lead to cancer, the toxin nicotine being one of them. In addition to nicotine, the chemicals that make up cigarette smoke also include tar and carbon monoxide. Prolonged exposure to these toxins can hamper your body's ability to filter air and clean the lungs. The smoke not only irritates the lungs but also causes excess production of mucus.

It also causes a paralysis of the tiny hair-like structures like cilia that line the airways and are responsible for removing dust and dirt from the organ. Paralysis of these hair-like structures also causes a buildup of mucus and toxic substances, leading to lung congestion. The extra mucus that is produced causes smokers to suffer from the very ubiquitous smoker's cough and chronic bronchitis.

It's also one of the many triggers of asthma, which brings about the narrowing and inflammation of the airways. Long-term exposure to tobacco smoke causes the destruction of the structure of the lung, walls of the airways as well as lung tissue. The result is a condition known as emphysema. Additionally, smoking also leads to cancer of the lung and over 80% lung cancer cases occur due to this habit.

Health Consequences of Smoking 3 Cigarettes A Day

What is schizophrenia?
We all know it as a debilitating mental illness that plagues people across the globe. Schizophrenic patients often feel like they are being overtaken by situations and events that are beyond their control. They may complain of seeing people who are not there or hearing voices where there are none. This happens because the neurotransmitters in the brain of the patient do not function appropriately. There are various types, causes and symptoms of this disease. Read up to know more.

Symptoms: psychotic symptoms like delusion are common in patients suffering from this disease. Also, the patient may be severely blunted in the emotional sense, and may bear a lost look and wear a feeling of loss or absence at all times. The thought process or cognition of the patient may also suffer in such cases. Poor concentration and lack of coordination are some symptoms of this kind of suffering. Hallucinations and distorted thought processes also characterise the patient to a great extent. The patient may also display certain typical symptoms like social withdrawal, extreme apathy, and lack of motivation. The patient will also be in an emotionally numb state once the delusions have lessened.

Causes: so what causes schizophrenia, really? while no tests or conclusive examinations exist to pin point the exact diagnosis or cause of the disease, there are many factors that can contribute to the development and progression of the same. Hereditary factors play up in many cases while chemical imbalances in the brain also lead to this condition. The serotonin levels and the functioning of the neurotransmitters are the most significant causes of this disease, in such cases. Excessive abuse of drugs like lsd and cannabis can also contribute to this condition, while family relations and a dysfunctional environment can also lead to this disease.

Types: there are many different kinds of schizophrenia. One of them is paranoid schizophrenia, which makes the patient highly suspicious. Disorganised schizophrenia can lead to incoherence in speech and thought. Catatonic schizophrenia can cause social withdrawal while residual schizophrenia can lead to a complete lack of motivation. Finally, schizoaffective disorder can lead to major mood swings.

The various kinds of schizophrenia are characterised by varying degrees of mood swings, depression, paranoia and delusional thinking. The progression of the disease can be checked with the help of cognitive behavioural therapy, which can help in reprogramming the brain of the patient to a great degree. Rehabilitation programs as well as case management can help in the long run. But the key here is to recognise the symptoms early on and get the treatment or counselling started to reduce the symptoms and their spread.

Schizophrenia: Types, Causes and Symptoms

MISUNDERSTANDINGS AND ARGUMENTS? CHANGE THEM INTO FLOWING CONVERSATION
Conflicts and misunderstandings occur at all levels of interaction – at work, among friends, within families and between relationship partners. When conflict occurs, the relationship may be weakened or strengthened. Thus, conflict is a critical event in the course of a relationship. Arguments  and misunderstandings  can cause resentment, hostility and perhaps the ending of the relationship. If it is handled well, however, it can be productive – leading to deeper understanding, mutual respect and closeness. The health of any relationship is gauged by how the conflicts are resolved, rather than the number of conflicts between the participants. 
Conflicts run all the way from minor, unimportant differences to disputes which can threaten the existence of a relationship. Conflicts with a loved one or a long-term friend are, of course, different from negotiating with someone who does not care about your needs, like a stranger or a salesperson. 

 Principles that underscores all successful conflict resolution. 
1. Both parties must view their conflict as a problem to be solved together so that both parties have the feeling of winning.
2. Each person must participate actively in the resolution and make an effort and commitment to find answers which are as fair as possible to both. 

We may get so caught up with our own immediate interests that we damage our relationships. If we disregard the position of the other person, if fear and power are used to win, or if we always have to get our own way, the other person will feel hurt and the relationship may be wounded. Similarly, if we always surrender just to avoid conflict, we give the message to the other person that it is acceptable to be bullied and our needs don’t matter. Our feeling of self-worth suffers, resentment surfaces, and we feel frustrated in the relationship. Instead, it is healthier if both parties can remain open, honest, assertive and respectful of the other position. Mutual trust and respect, as well as a positive, constructive attitude, are fundamental necessities in relationships that matter.

SOME EFFECTIVE STRATEGIES TO HOLD EFFECTIVE COMMUNICATIONS:
1. INITIAL AGREEMENT: The other person may be very angry with you and may be having loads of evidence to prove himself right. At that time, instead of arguing your position, simply agree at that time because there will be a grain of truth if nothing else. This doesn’t mean that you are giving up your values and principles. Sometimes its important to diffuse the emotional charge before working out on the differences. Sometimes its ok to “lose” individually in order to “win” together in the end.
2. EMPATHY: Sometimes putting yourself  in the other persons shoes and seeing the problem from their perspective helps build bridges. You could say,” I feel that you must be very upset with me for behaving like that with you, I should have been more considerate”. Half the battle is won and the other participant feels validated and will be more willing to listen to your tale of woes more amicably.
3. ASK QUESTIONS: When you ask questions, it shows that you care and are interested to resolve the problem at hand. Please note that while asking questions, be watchful of your words and tone. Asking exploratory  questions about the other persons thoughts and feelings rather than probing and insulting questions can take you miles on the way to effective resolution. For eg. “Is there anything that you would like me to know about this problem”?
4. USING “I” STATEMENTS: Take responsibility for your own thoughts and feelings rather than blaming the other person for making you feel like that. This decreases the chance that the other person will become defensive. For example, “I feel pretty upset that this thing has come between us.” This statement is much more effective than saying, “You have made me feel very upset.” 
5. COMPLIMENTS: Find something nice and genuine to say about the other person, even if the other is angry with you. Show a respectful attitude. For example, “I genuinely respect you for having the courage to bring this problem to me. I admire your strength and your caring attitude.” 

A RATIONAL APPROACH TO RESOLVING CONFLICTS:
Here is a model that may help in resolving interpersonal conflicts. 
1. Identify the Problem. Have a discussion to understand both sides of the problem. The goal at this initial stage is to say what you want and to listen to what the other person wants. Define the things that you both agree on, as well as the ideas that have caused the disagreement. It is important to listen actively to what the other is saying, use “I” statements and avoid blame. 
2. Come Up With Several Possible Solutions. This is the brainstorming phase. Drawing on the points that you both agree on and your shared goals, generate a list of as many ideas as you can for solving the problem, regardless of how feasible they might be. Aim toward quantity of ideas rather than quality during this phase, and let creativity be your guide.
3. Evaluate These Alternative Solutions. Now go through the list of alternative solutions to the problem, one by one. Consider the pros and cons of the remaining solutions until the list is narrowed down to one or two of the best ways of handling the problem. It is important for each person to be honest in this phase. The solutions might not be ideal for either person and may involve compromise. 
4. Decide on the Best Solution. Select the solution that seems mutually acceptable, even if it is not perfect for either party. As long as it seems fair and there is a mutual commitment to work with the decision, the conflict has a chance for resolution. 
5. Implement the Solution. It is important to agree on the details of what each party must do, who is responsible for implementing various parts of the agreement, and what to do in case the agreement starts to break down. 
6. Continue to Evaluate the Solution. Conflict resolutions should be seen as works in progress. Make it a point to ask the other person from time to time how things are going. Something unexpected might have come up or some aspect of the problem may have been overlooked. Your decisions should be seen as open to revision, as long as the revisions are agreed upon mutually. 

Keep in mind that differences will come up in any relationship just because you two are different individuals with different perspectives, ideologies, attitudes and perceptions. Too much similarity in personality and working styles may be comforting but can be very boring and uninspiring overtime. On the other hand, differences can bring change, novelty and an added spice to the relationship. Two very different people can pool their different strengths and work together as a stronger team. Though, extreme differences may overtime sour the relationship and make living or working together difficult. You also need to look out for an emotionally or physically abusive relationship, which is based on power differential rather than respect and trust. A person may then choose to opt out after an amicable “goodbye” or "agree to disagree".























Role of relationship problems in depression and suicides - 
Almost everyday we read about people ending their lives by committing suicides from celebrities to common man to even children . Although this is not permitted in any religion and there is a legal debate on whether it should be legalized, the fact remains that people are driven towards this unfortunate step. Let's take a look at the common reasons for suicides to become so very common.

1) Lack of intimacy- We see that although we are surrounded by people most of people are having friends only on Facebook. Even among the people we interact everyday nobody wants to open up with anyone or allow you to open up with them.The fact that you are surrounded by people who don't share themselves with you intimately starts pulling your mind downwards. Work colleagues are bothered only about work, family is only bothered about the income you are generating, partners are obsessed with how much you can spend on them, friends are occupied with what benefits you can share with them. Therefore all in all, despite having all relationships, people feel left out and alone like as if their inner self has been left unwanted and uncared of. The monotony of mechanical life hastens the culmination of this abuse into drastic steps like suicide.

2) High demands- People are often left to fend with high demands from them from their social circle. Many people cannot attempt this and some who attempt are not able to make it. This leaves them with a feeling of failure which is often frowned and looked down upon whether it is a student or a professional. It is no surprise that today even below 10 years olds are successfully attempting suicides.

3) Inappropriate planning- Planning is a key necessity for successful results whether it is financial or relationships. but unfortunately many people are unable to obtain the correct know how which will enable to implement their plans successfully.

4) Inability to cope- Many people plan to do things but are unable to cope with the harsh realities that come with the plans. To some it may be unseen to some unbearable. So although they set out on doing something the journey is not what they had expected.

5) Lack of results- Sometimes although everything is planned well, executed well and completed well it does not fetch us the rewards that may seem appropriate to the level of efforts. This is something that is very difficult to deal for most people and is a result of many unfortunate casualties.

6) Lack of desire-It is very important to have something to look forward to in life. But unfortunately in an age where drinking water and using the toilet cost s money many people cannot think of having something to look forward to and hence this unfortunate step.

Therefore, you have to be very prudent in what we are doing today because we can never predict which way our lives may go and even importantly which way you may yourself go based purely on circumstances beyond our control dependent on the choices we make today or others make for us. Although suicide is not a sensible solution to any problem it does remain a common reality. If you are feeling suicidal please remember to seek help.

Please feel free to consult me privately for further assistance.

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Health Tip - Role of Relationship Problems in Depression and Suicides

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