Monday, February 22, 2010


Early detection and action are essential steps in solving speech problems

Your child is 2 years old and still isn't talking. He says a few words, but compared to his peers you think he's way behind. You remember that his sibling could put whole sentences together at the same age. Hoping he will catch up, you postpone seeking professional advice. Some kids are early walkers and some are early talkers, you tell yourself. Nothing to worry about.

I encounter this scenario among parents of kids who are slow to speak. Unless they observe other areas of "slowness" during early development, parents may hesitate to seek advice. Some may excuse the lack of talking by reassuring themselves that “he'll outgrow it.”

What is normal?

Knowing what is “normal” and what is not in speech and language development can help you figure out if you should be concerned. Babies start communicating by cooing and babbling. They go on to making sounds of “mama” or “dada” that initially does not refer to mom or dad, but as they become toddlers it becomes more specific. By 18 months your child should have a vocabulary of about 20 words. By age 2, most children should be learning to combine words. A two-year-old should also be able to follow two-step commands (such as “bring me a ball”). Later by 2-3 years, a child should be routinely combining three or more worded sentences.

Whether you have an older sibling makes a difference in speech development. Older siblings routinely speak for their younger ones, such as “Johnny wants his bottle.” Therefore the younger ones may not talk as much.

Whether you are a boy or a girl also matters. Boys tend to be slower than girls. If parents speak a language different than what a child is learning at daycare or other places, it could affect the child’s language development. I encounter this situation in many families that speak Spanish or other foreign languages at home and their children are exposed to English everywhere else.

Warning signs

If you are concerned about your child’s speech and language development, here are some things to watch for.

• An infant who is not vocalizing or responding to sounds
• Is not pointing or waving bye-bye by 12 months
• At 18 months still prefers gestures over voice to communicate or has trouble imitating sounds or following simple requests.
• Seek an evaluation if your child is two years old and:
• Can only imitate speech and does not say words or phrases spontaneously
• Says only certain sounds or words repeatedly
• Can’t follow simple directions
• Has his own routines and keeps to himself and does not show emotional interactions

Causes of speech delay

There are many things that cause delays in speech development. A child may encounter problem in effectively using lips, tongue and jaw to make sounds. These children may have other associated problems such as eating certain foods. Speech delay could be a part of what we refer to as a “global” meaning general developmental delay. However having speech delay does not always mean developmental delay. Hearing problems can also commonly be related to speech problems.

What can I do?

Always talk to your child’s pediatrician. Assessment of speech and language is a routine part of physicals during early childhood. Hearing evaluations are usually a first step in the evaluation process. Specialists trained in Speech and Language Pathology are available to further assess your child’s skills and difficulties and make treatment plans.

Backus Hospital's Rehabilitation Services Department offers a wide range of services for children in the community with speech and developmental issues or disabilities.

Paula Signora, a speech therapist at the Backus Outpatient Care Center, said there are services available for infants, toddlers and school-age children, which may supplement services from birth to age 3 or through schools. A referral from a doctor, such as a pediatrician, is needed.

“We have speech therapists, occupational therapists and physical therapists all trained to work with children,” said Ms. Signora. Several of the speech therapists also are trained in PROMPT, a program that involves the use of touch cues to improve a child's speech.

Here are a few tips you can do at home:

• Spend a lot of time communicating with your child. Encourage him to repeat after you.
• Read to your child
• Discourage older siblings from speaking for the younger ones
• Use everyday situations to reinforce your child’s speech
• Explain what you are doing as you cook a meal, point to objects at home, on TV and as you drive
• Point to sounds you hear
• Repeat and reinforce the same sounds and routines.
• Whatever your child’s age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate well.

For more information, go to and click on “pediatric services.”

Ravi Prakash, MD, is a pediatrician on the Backus Hospital Medical Staff with a private practice in Norwich. This column should not replace advice or instruction from your physician. E-mail Dr. Prakash or any of the Healthy Living columnists at To comment on this or other Healthy Living columns, click below or go to the Healthy Living blog at

Monday, February 15, 2010


Storms are unpredictable, but weather-related injuries are not

Last week’s snowstorm didn’t bring the heavy snow and wind that the weathermen forecast. But what was predictable was a series of weather-related injuries we treated at the Backus Hospital Emergency Department and Trauma Center that could have been avoided.

Snowblower injuries, cardiac issues due to overzealous snow shoveling and a jogger hit by a motor vehicle while running in blizzard-like conditions were among them.

And since we will likely see more snow and wind this winter season, here are some safety tips to keep in mind before tamer weather arrives:

Snowblowers: First and foremost, turn off the engine before attempting to clear a clog. The newer snow blowers have an automatic off switch when you take your hand off the handle, but older ones don’t have this safety feature.

Be sure to use a clearing tool, not your hand and feet. Don’t wear loose clothing, which can get tangled in a snowblower’s moving parts.

Snow shoveling: While last week’s storm didn’t dump the foot of snow that was forecast, it was of the heavy, wet variety. This kind of snow can be a heart attack waiting to happen.

Geoffrey Fabry, a physical therapist at the Backus Outpatient Care Center in Norwich, says if you have any pre-existing conditions, talk to your doctor before performing this rigorous exercise.

Once you have eliminated any doubt about whether you are physically up to the task, be sure to warm up first, and use proper body mechanics such as widening your stance and squatting and lifting with your legs. Space your hands out on the shovel handle and, when possible, push the snow instead of lifting it. Also, take frequent breaks and stay hydrated.

Snow running: Outside of the usual advice of dressing in layers, staying hydrated and wearing bright or reflective clothing, think twice before running when the weather deteriorates. Last week’s storm, if only for a brief period during the evening, featured high winds and heavy snow, leading to very low visibility. Coupled with slick roads and snow piles, this was not the day to run outdoors.

Being dedicated to your exercise routine is admirable. But the line between dedicated and careless is blurred when the weather takes a turn for the worse.

If you exercise on a regular basis, taking off the jogging shoes for one day isn’t going to hurt. But slipping on ice or getting hit by a car will.

Weathermen might have egg on their face when the get the forecast wrong. But if you make a wrong decision in bad weather, the consequences can be much worse.

Gillian Mosier is a registered nurse and manager of the Backus Trauma Program. This column should not replace advice or instruction from your physician. E-mail Ms. Mosier or any of the Healthy Living columnists at To comment on this or other Healthy Living columns, click below or go to the Healthy Living blog at

Monday, February 08, 2010


Healthy eating is a year round priority

Super Bowl Sunday is only a memory now, but if you made unhealthy choices over the weekend the impact of the calories you consumed remains.

However, if you were among the more than 200 people who Google analytics says viewed our Super Bowl healthy snack video at, you were able to enjoy a sumptuous buffalo chicken dip -- and cut calories at the same time. The recipe, which was also posted on the website, used hummus and Greek yogurt instead of some of the usual calorie-laden ingredients.

Some might wonder why a hospital Food and Nutrition Department spends its time on videos like this. It’s because the hospital’s mission includes improving the health of the community – and we take that mission seriously.

One way to do that is to offer health information on topics people are interested in. Time and time again, our hospital’s communication department views statistics that show nutrition is among the most popular topics among people who are on our website or who receive our e-newsletter.

By writing about nutrition information, posting videos and creating entire websites on this topic, we are offering health information that people care about.

It’s hard to tell whether the community is healthier because of it, but we can track some of our efforts.

Soon after we posted the Super Bowl food video, the Colchester Parks and Recreation Department sent out an e-newsletter to thousands of town residents directing them to our video and website. Google analytics can tell us how many people view our videos and visit our nutrition web site. These are good barometers that are message is getting out.

And our educational efforts will continue. Several members of our department contribute to this weekly Healthy Living column; we recently completed a handout, “Food Guide Pyramid Overview,” which we share with our patients; and our next project is in conjunction with National Nutrition month in March. We are creating a brochure with recipes and tips highlighting National Nutrition Month’s theme of “Nutrition From the Ground Up.” Our dietitians will contribute information and advice on how to increase the use of fruits, vegetables and whole grains in everyday eating. This, too, will be available in print and online.

In other words, the Super Bowl and its accompanying video are once per year, but our efforts to educate the community on diet and nutrition are ongoing.

Todd Osowski is the Assistant Director of the Backus Hospital Food and Nutrition Department. This column should not replace advice or instruction from your physician. E-mail Osowski or any of the Healthy Living columnists at To comment on this or other Healthy Living columns, click below or go to the Healthy Living blog at

Tuesday, February 02, 2010


Be prepared for when serious illness hits

Anyone who has ever been diagnosed with a serious illness — or had a loved one suffer this fate — knows how overwhelming the situation can be.

The healthcare system can be quite complex even under normal circumstances, never mind under stressful situations.

That’s why The Backus Hospital Education Department has organized a community event, “Diagnosed with a Serious Illness? What to Do Next,” part of its ongoing Family Matters series.

The free event will be held Thursday, Feb. 11, from 6:30-8 p.m. in the Backus Hospital entry level conference rooms. To register, call 860-889-8331, ext. 2495.

Backus Palliative Care Coordinator Liz Fracchia, a registered nurse; Barbara Sinko, a a Backus medical caseworker; and Mary Ann Duchene, a registered nurse with Backus Home Health Care, will be presenters of the program.

The event is one you won’t want to miss. Although you might not be in the situation now, most people are touched by serious illness at some point during their lifetimes.

The presenters, who have decades of experience among them, will talk about local resources available, what questions to ask healthcare providers and insurers, coping tips and home health resources.

This is information you want to have before you are impacted — it can help reduce stress, enhance quality of life and potentially improve outcomes.

As a registered nurse for many years, I can assure you that being prepared with this information now can pay off when an actual crisis hits, whether it be heart failure, cancer, kidney disease or any other medical situation.

Alice Facente is a registered nurse and clinical educator with the Education Department at The William W. Backus Hospital. This column should not replace advice or instruction from your physician. E-mail Facente or any of the Healthy Living columnists at To comment on this or other Healthy Living columns, click below or go to the Healthy Living blog at

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