If I sign with my child, won't that stop him/her from developing speech?????

NO! In fact, research and experience shows that it actually helps facilitate speech in both children with typically developing speech/language skills as well as those with disorders of speech or language. Here are just 2 resources (one professional and one layman) that support this idea:

Millar, D.C., Light, J.C., & Schlosser, R.W. (2006, April). Impact of augmentative and alternative communication intervention on speech production of individuals with developmental disabilities. Journal of Speech Language and Hearing Research, 49, 248-264.Clayton, V. (2005).  

Can baby sign language delay speech? Retrieved March 26, 2011, from: http://www.msnbc.msn.com/id/8060750/ns/health-kids_and_parenting/

Reasons to use signs:

1. use of sign has been linked to increased joint attention skills (in children WITHOUT language problems)
2. reduces pressure to talk

In last month's issue we featured an article detailing the importance of nutrition services in Early Intervention and under what circumstances children can benefit from nutrition therapy services. Nutritionist Kelly Dorfman states that although "neurologists often attribute low muscle tone to imbalances in parts of the brain that control tone, low tone always has a nutritional component". This gives EI providers one more reason why nutritional consults may be beneficial to certain children on their caseload, even those without weight gain issues or feeding tubes/medical complications.

Because children with low muscle tone (hypotonia) have reduced stamina, they can have difficulty with maintaining positions like sitting for meals, become fatigued by chewing food, have trouble using their hands to self-feed or even have trouble pushing out bowel movements due to muscle weakness.

Some of the symptoms that Dorfman listed as associated with low muscle tone include:

• Fatigue and Low Arousal-Meaning the body does not do a good job of turning nutrients into energy and therefore there is less energy available
• Reflux and Constipation- These conditions can be related to poor trunk tone and posture in children with low tone
• Poor Sitting Posture-Improper positioning for meals and slumping are a result of low tone
• Difficulty Chewing and Picky Eating-Kids with low tone often have trouble properly chewing foods or may become fatigued during meals due to the same low muscle tone being in their mouth, lips, tongue and jaw.
• Problems with Visual Tracking-Low tone can also mean weak eye muscles

Children can be born with low muscle tone, for example having low tone due to a specific diagnosis such as Down Syndrome, or they can acquire low tone through "nutrient deprivation" or "cellular malnutrition". Dorfman states that "nutritional therapy for low muscle tone is a long term management plan, not a quick fix". The key being not only to eat a good balanced, healthy diet, but to make sure the nutrients get to the cells where they are needed in order to be converted to usable energy by the child. She suggests the use of nutritional supplements.

Foods such as candy, cookies and cakes which are sweet and starchy give children with low tone a quick burst of energy, but are sugary, lack vitamins and minerals and don't have lasting effects. Controlling sugars and increasing protein in the diet is what Dorfman recommends as a first step. Foods with proteins have a larger concentration of nutrients in them and this is helpful for increasing energy.

The following are supplements which Kelly Dorfman suggests, but remember to check with your child's nutritionist and doctor before giving any supplements to your child. Use of incorrect supplements or wrong dosages can be dangerous.

Supplements that enhance nutrient delivery for a child with low muscle tone include:

• Carnitine (L-carnitine or acetyl-L-carnitine) Kids with low tone often have low carnitine levels in their blood
• R-Alpha Lipoic (R-ALA) An antioxidant that lengthens the lifespan of vitamins such as C & E prolonging their usefulness to the body.

Supplements that improve energy production in children with low tone are:

• Co-Enzyme Q-10 (CO-Q-10) Helps regenerate ATP which increases stamina
• B Vitamins- Improve energy. Kids with low tone need more than what the 100% daily value is, but be aware they can make kids cranky so dosages must be adjusted properly.
• Vitamin E- Helps with cleaning up damage from inefficient energy production. Megafood Complete E is a good choice that can be mixed with food when squeezed from the capsule.

Kelly Dorfman's final message is that low muscle tone CAN improve and the quality of your child's diet and the addition of supplements can help, but be sure to use supplements only on the advice of a health care professional.

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