Vocal Tics (Sounds and Noises)

Some children (and adults) make repetitive sounds that serve no communicative or health purpose. These sounds are called “vocal tics.” A vocal tic can be a cough, much like the cough one has when one has a cold, except that in the case of a tic – there is no cold and consequently no need to clear the passages of mucous! Sometimes the doctor will mistake this kind of cough for post-nasal drip – a small irritant in the throat. However, a true vocal tic is more like a bodily habit without a physical cause; there is no post-nasal drip. In addition, the cough does not stem from “nerves” or nervousness and therefore, it is also inaccurate to call it a “nervous habit.” A vocal tic is a biological disorder that is usually inherited. Calm people can have tics just as easily as anxious people. Nonetheless, stress does tend to aggravate tics, resulting in a temporary increase in symptoms.

Coughs are only one kind of vocal tic. A person can make any sound, including words. There are barks, hisses, grunts, sniffles, clicks and other noises. There are words or phrases that are repeated and in one kind of vocal tic (corprolalia), there are expletives (swear words) or “dirty words” that seem to jump out of nowhere.

If a child has both vocal tics and motor tics (repetitive, non-purposeful movements like jerking, bobbing, twitching and so on), he may have Tourette’s Syndrome. If he has only one kind of tic for less than a year, he may have transient tic disorder. Chronic Tic Disorder is the name given to tics that last longer than one year. Some children with tic disorders also have other disorders such as ADHD, OCD, mood disorders, anxiety disorders and conduct disorders. Many children, however, have simple tic disorders that improve with treatment or even on their own over time.

What Causes Tics?
Brain abnormalities can cause tics. Both structural changes in the brain and biochemical changes have been found in those who have tic disorders. Tic disorders run in family trees. Tic disorders commence before the age of 18. Sometimes they begin after taking a medicine (i.e. Ritalin, antidepressant medication, Cylert and Cocaine can all trigger tics in sensitive individuals). Sometimes tics may begin after a strep infection (in a similar way to PANDAS – the post-viral form of Obsessive-Compulsive Disorder). Sometimes injuries or other health conditions (even a common cold) can trigger the development of a tic. In all cases, the environment is thought to trigger a gene that is present in the child.

Although more tics occur when a child is feeling stressed or anxious, neither stress nor anxiety cause tics. Emotional distress worsens or aggravates a tic disorder temporarily. Stress reduction techniques bring tics back under control. The condition waxes and wanes – sometimes throughout life, but very commonly only until the end of adolescence when the tics may just disappear by themselves.

What Helps Tics?
Some medications can be helpful for tics – speak to your doctor or psychiatrist about this approach. Behavioral therapy can also be very helpful in reducing the tendency to tic. A psychologist can create the proper intervention for this kind of therapy. In addition, some alternative treatments have been found to be helpful in treating tics. For instance, nutritional interventions such as abstaining from coffee, pesticides, certain chemicals and so on, can sometimes help. Bach Flower Therapy (especially the remedy called Agrimony) has been very helpful for some children and teens with tics – consult a Bach Flower Practitioner for best results. Homeopathy and acupuncture might also be helpful. In fact, any intervention that helps reduce stress can help reduce the tendency to tic. Experimenting with several different healing modalities will help parents assess which one or ones have a positive effect on the course of the disorder.

Asking a child to stop making noises is NOT helpful and in fact, may lead to more tic behavior as the request itself induces stress. Tics are not done on purpose and they CANNOT be resisted. A child can delay a tic, but not stop it. Therefore, the youngster needs parental understanding and tolerance. The tic is not the child’s fault; rather, he or she is suffering from a disorder of the brain. Fortunately, tic disorders can be relatively mild, they can remit spontaneously and even when they do persist, they do not tend to interfere with academic performance or other normal functioning.

Won`t Speak to Adults or Strangers

When parents talk about improving their children’s social skills, they’re usually referring to skills in interacting with same-aged children. But truly socially-adjusted kids are those who are not only comfortable dealing with peers, but are also comfortable dealing with older children and adults too.

But what if your child refuses to speak to adults or strangers? Consider the following tips:

Who is a Stranger?
It is appropriate for children to be wary of strangers and there is certainly no need for them to interact with complete strangers when they are alone. However, kids have to know how to approach even a total stranger for help when help is needed – i.e. someone has been injured or lost or is otherwise in trouble. It’s not practical to tell a child to find a police officer since police officers aren’t always handy; sometimes the child will have to ask a regular adult for assistance. Advising children to search out a sales clerk in a store or a mother with children may be a good opening strategy. If neither is available, however, children should be advised to look for other outer signs of respectability in a strange adult – type of clothing, companions and other “safety features.” Don’t assume that your child knows all these  things – take time to give examples and spell out details. When out and about, point out the kind of people that seem most trustworthy for emergency-only interactions, as well as the kind of people you feel it would be best to avoid if possible. While providing this education, make sure to point out that almost all people are kind to children and most strangers are very normal, respectful people. Moreover, let your children know that just because someone wears a nice suit doesn’t mean that he is a good person and just because someone has an unusual hair style doesn’t mean that he is dangerous. Looking for conservative appearance is only one small step a child can take toward ensuring his or her safety.

Apart from life-and-death issues and other safety concerns, kids should be encouraged to talk to adults when they are with you or other caregivers. Naturally shy children will need your help in developing social skills. Explain exactly what you want them to do – i.e. smile, say “hello” and possibly shake hands. Offer generous positive feedback when your child makes efforts to behave appropriately and avoid criticism. Speaking to adults on the phone can be part of the training process. Take time to teach the skills: use a pleasant tone of voice, say “hello,” and “one moment please” or ask the person “could you please hold on?” and so on. Be patient with your youngster, allowing him or her to build up confidence and skill through practice over time.

Is Your Child Feeling Intimidated by Adults?
A child whose teachers and parents are low-key, warm, friendly people tends to have less fear of adults than one whose teachers and parents tend to be strict disciplinarians. If your child is overly intimidated by adults, it could be that he or she is just very timid by nature but it might also be that you have accidentally (or purposely!) instilled a little too much fear. Keep in mind that kids turn out healthiest when they are raised by warm, loving parents who impose a comfortable amount of structure and rules. Following the 80-20 Rule as described in the book Raise Your Kids without Raising Your Voice will achieve the desired effect.

Does Your Child Need Time to Warm Up?
You can’t just introduce your child to a stranger and then expect him or her to immediately jump into conversation. Kids usually like to feel their way into a conversation, making tentative remarks and openings that can eventually lead down a fruitful path. Moreover, it’s important not to push a child to speak when he or she clearly feels uncomfortable. If a child holds onto your skirts, let him for the time being but make a note to practice social skills (see above) later. Do not mock or criticize your child for the way he or she acts around people. If your child tends to be shy during the first hello, be patient. Establishing rapport takes time; allow your child to go at his own pace. Say nothing at the time – and be particularly careful not to comment on his or her quiet behavior IN FRONT of another person – and then provide help later.

Child Refuses to Talk to Adults at All
There are some children who simply won’t talk to adults outside their immediate family members. This can include their teachers, doctors, neighbors and others. They might be suffering from Selective Mutism, a psychological disorder in which a child is capable of speaking but absolutely refuses to do so.

Children with selective mutism may speak to other children but refuse to speak to adults or, in some cases, refuse to speak to certain kinds of adults (like men or people in positions of authority). Sometimes kids refuse to speak in public (i.e. school or other areas outside the home) to both children and adults. For instance a child with Selective Mutism in the classroom may not speak at all to her friend, but if that same friend is invited to her house for a play-date, she will speak to her completely normally.

Selective Mutism is diagnosed and treated by speech and language pathologists and mental health professionals. If you believe your child may have Selective Mutism, do consult a speech and language pathologist or child psychologist with experience in assessing and treating Selective Mutism (you can ask your pediatrician for a referral).

Autism

One of the greatest joys of parenting is being able to communicate with one’s child. This is why knowing that a child has Autism or Autistic Disorder can be so painful and difficult to accept. The condition significantly impairs a person’s social and communication skills, so that it can feel like the autistic child is living in his own little world. Autism does occur on a spectrum, causing severe impairment in some and only mild impairment in others. However, once a child has been diagnosed with this condition – whether it is mild or severe – parents find themselves raising a “special needs child.” This brings new challenges to the already challenging job of parenting.

What is Autism?
Autism is a neurological disorder characterized by difficulty in social interaction and communication, as well as tendency towards repetitive behavior. The exact cause of the disorder is not known, but it is believed to be a result of neurons misfiring and creating mixed communication in the brain. Symptoms of Autism appear early in a child’s life, sometimes as early as the first year. Unfortunately, there is no known cure for Autism yet, although parental support, behavioral therapy and special education can bring improvement in functioning and quality of life among children with Autism.

How Can I Tell if My Child Has Autism?
Like most developmental disorders, Autism is diagnosed using the American Psychiatric Association’s criteria found in the the Diagnostic and Statistical Manual of Mental Disorders. A diagnosis of Autistic Disorder is given to a child when he or she meets certain criteria. Below: is a list of symptoms characteristic of Autism.  A mental health professional can assess whether your child’s symptoms meet criteria for a diagnosis of autism or another disorder on the autistic spectrum or another diagnosis altogether. It is also possible that, despite having some symptoms, your child does not meet criteria for any diagnosis at all. This why proper diagnosis and assessment by a qualified mental health professional is so essential; teachers, friends and others cannot make an accurate diagnosis!

A. Impairment in social interaction

This category of symptoms include impairments in the use of non-verbal communication (e.g. eye contact and gestures), failure to develop appropriate peer relationships, absence of spontaneous attempts to seek enjoyment with other people (e.g. not showing interest in other children playing), and the lack of social and emotional reciprocity.

B. Impairment in communication

This category includes symptoms like significant delay in language development, impairment in the ability to initiate conversation, stereotyped and repetitive use of language, and the lack of spontaneous make-believe play that is typical of children within a certain developmental level. It’s important to note the communication issues that are symptoms of Autism are not due to learning disabilities or physical disabilities.

C. Restricted and repetitive patterns of behavior

Children with Autism tend to get preoccupied with a small range of activities, and are prone to engaging in repetitive actions. For example, they might enjoy hitting just one key in the piano for hours. They also get easily obsessed with things that children without the condition will merely pass; for instance they can get preoccupied with random parts of an object. They might engage in ritualistic behavior, hand flapping, and sometimes in self-injury (like head-banging) as well. These obsessions, preoccupations and rituals are inflexible for the child with Autism.

Are There Different Kinds of Autism?
Symptoms of Autism exist in a range, from mild to severe. Some children are more open to social interaction and communication than others. Some persons with mild Autism for example can still be mainstreamed in traditional schools.

Other disorders are listed under the category Autism Spectrum Disorder (ASD). These conditions are Autism, Asperger Syndrome, and Pervasive Developmental Disorder Not Otherwise Specified (you can find more information on these specific disorders on this site and online).

What Can Parents Do?
If you are concerned about your child’s social behavior, emotional reactions, habits or personality, get a referral to a child psychologist or psychiatrist who can offer assessment and guidance. As for most developmental disorders, early detection and early intervention makes an important difference.

If a diagnosis of autism is confirmed, it’s time to learn as much as possible about the condition. There are many groups today that focus on Autism and  Autism Spectrum Disorders. The condition is more understood that it used to be, and parental support systems are well established. Benefit from the experience of others by accessing on-line support groups and/or joining groups offered by your local community mental health services. You will learn techniques for stimulating your child’s development at home. You will learn how to interact with him in order to bring out his best and reduce episodes of anger or anxiety. Becoming active in your child’s healing process is good for you as well as for the child, as it gives you more control and counteracts feelings of overwhelming helplessness. Your intervention can make a tremendous positive difference to your child’s development.

This being said, it is important to deal with your feelings about a diagnosis of Autism. Learning that your child has Autism can be a shock, and you might go through a grieving cycle as you readjust your hopes and dreams for this youngster. This is normal; there is a real loss when you know that your child has a developmental disorder. With time and/or professional help, you will eventually bounce back and open your self to the blessing of having a child with special needs. Interacting with a child with Autism requires a lot more patience and care than interacting with a child who doesn’t have the condition, but it has its rewards. The key is providing consistent stimulation in order to interest your child in social events. Training in communication skills, e.g. basic sign language can also help.

Child Has Difficulty in School

A child may have difficulty in school for many reasons. Some kids aren’t motivated to learn because they are distracted by stress at home. Some kids have trouble concentrating because they have Attention Deficit Disorder (ADD) and others have difficulty quieting down to learn because they have Attention Deficit Hyperactivity Disorder (ADHD). Some children have intellectual challenges (developmental delays or mental retardation) and still others have specific Learning Disabilites. In this article, we will examine Learning Disabilities and their impact on school children and teens.

What is a Learning Disability?
A Learning Disability (LD) refers to the umbrella of biological, mental and behavioral conditions that result in difficulty with tasks related to absorbing, processing and applying information and skills. In other words, information may be hard to organize, hard to remember, hard to understand and/or hard to express. For instance, a child with a learning disability that affects arithmetic may have any of these problems:

  • Can’t make sense of what the teacher is explaining
  • Can’t recall what the teacher said
  • Knows what the teacher said but can’t explain it to others
  • Knows what was said, but can’t apply it to new arithmetic questions
  • Learning troubles associated with LDs are not due to a student’s lack of effort or his or her intellectual capacity. Areas that may be affected by a learning disability include reading, writing, performing mathematical processes, listening and speaking.

There are many different types of learning disabilities. Below are some common ones:

  • Dyslexia. Dyslexia is a genetic condition characterized by difficulty in reading. Contrary to popular opinion, dyslexia is not an illness that causes people to read backwards. But people with dyslexia do have difficulty with spelling, reading words aloud, and phonological processing or the manipulation of sounds. Some dyslexics have a condition called “strephosymbolia” which is the tendency to read similar symbols incorrectly, as they are spatially reversed in the brain. Thus, “b” may be read as “d” or “w” may be read as “m.” Whole words can be misread or remembered inaccurately due to this condition.
  • DysgraphiaAlso called agraphia, dysgraphia is an LD related to difficulty with writing. Specifically, people with LD have trouble with the fine motor skills and muscle coordination involved in writing. Issues with the language and perceptual centers of the brain may also contribute to the difficulty in putting words to paper.
  • Dyscalculia. Dyscalculia covers learning disorders related to problems with numerical operations and tasks requiring math reasoning. Issues faced by a person with dyscalculia include inability to understand the concept of numbers and quantities, basic operations like addition, subtraction, multiplication and division, as well as logic problems related to numbers.
  • Dyspraxia. Dyspraxia is a motor learning disability. While its manifestation is in execution of movement, dyspraxia has less to do with muscle problems, and more to do with the brain’s ability to process and execute commands relating to physical action. Dyspraxia is believed to occur among 10% of the general population.
  • Attention Deficit Hyperactivity Disorder (ADHD). While primarily a behavioral condition, ADHD is sometimes considered to be a learning disability because it impairs a person’s ability to concentrate on a task and finish what one has started. Because of this, kids often have trouble catching up to lessons in school. Hyperactivity also affects learning, as few kids with ADHD are able to keep still in the traditional classroom environment.
  • Central Auditory Processing Disorder (CAPD). As the name implies, CAPD refers to difficulty in learning through hearing. A child with CAPD would have difficulty attending to instructions, listening to lectures, and distinguishing sounds from each other. Since it can interfere with classroom learning, it may also be considered a learning disability.

Worried about Child’s Development

Children develop at different rates. If your child begins to walk later than your friend’s child, this may reflect a simple difference between the two children. There is, after all, a normal range for learning to walk, with some children begin earlier and some beginning later. Lateness does not necessarily indicate some sort of problem. The same principle holds true for cutting teeth, learning to talk, becoming toilet trained, learning to read, learning to ride a bike, being ready to go to sleepover camp and learning to drive a car! There is a normal range for every aspect of human growth and development. The question is, of course, how do you know when your child is outside of that normal range? How do you know when to be concerned?

If you are worried about some aspect of your child’s development, consider the following tips:

Don’t Ask Your Friends; Ask Your Doctor!
Turn to an expert in child development to find out the normal age range for any aspect of your child’s development. This may be your family doctor, your pediatrician or a child psychologist. Taking your baby and child for regular “well-baby” checkups is a good way to stay on top of your child’s developmental tasks – just be sure to tell the doctor what your child is and isn’t yet doing. Although the internet offers a great deal of information as well, try to search government, medical and university sites for this kind of information; you are looking for accurate facts and figures. If you discover that your child’s skill level is significantly behind suggested averages, follow-up with a medical assessment.

Some Conditions Require a Long Time to Assess
A child may have a number of questionable symptoms. For instance, he may have trouble dressing himself independently at an age when his peers are already competent in this task. In addition, his speech may lag behind both in vocabulary and articulation. Finally, he may be immature for his age, displaying wild, aggressive and impulsive behavior more characteristic of a much younger child. These symptoms may be related – or they may not be. The doctor may need to watch the child’s development over the next year or two to see how things develop. This is particularly true for young children because young children have a larger range for normal development. In fact, some conditions cannot be accurately assessed until the child is around 6 years of age. Hyperactivity is one such condition. Many children outgrow hyperactive tendencies by the time they are six, but those who don’t may have ADHD (attention deficity hyperactivity disorder) or some other condition. Although the doctor may suspect the condition several years earlier, a formal diagnosis might have to wait. There are two benefits to taking your child for assessment at the earliest time: one is so that the doctor can follow the course of development in order to make an accurate diagnosis over time and the other is so that you can receive help in arranging for intervention “as if” the child has already received a diagnosis. For instance, both the parents and the psychologist may suspect that a child has Asperger’s Disorder. It will take a long time for an accurate assessment. However, the parents can begin early intervention “as if” the child does have the condition. This helps the child’s development so that by the time he is old enough for a proper assessment, the disorder (if he has it) has significantly improved! Earliest intervention gives the best results for every aspect of child development. Moreover, many interventions (although certainly not all) are experienced as fun by the child. This helps the youngster achieve the greatest growth with the least stress.

Early Intervention Makes the Greatest Gains
Many interventions that help children’s development are regular childhood activities. For example, puzzles can help eye-hand coordination and perceptual skills. Singing, dancing and listening to music can help auditory development and many types of brain development. Computer games can improve tracking skills, eye-hand coordination, fine and gross muscle development, problem-solving skills and other skills. Sports, gymnastics, dance classes and swimming lessons can improve gross motor development. Art classes can improve fine motor skills, eye-hand coordination, laterality, attention to details, concentration and other abilities. And we could go on and on. The point is that you can give your child “enrichment” even in the absence of a formal assessment. If you see that your child is lagging behind in some aspect of growth and development, try to choose fun activities that build up that skill area. If you have a “teacher’s store” in your area, or if you look online for special education products and catalogs, you will find many resources you never even knew existed to help children’s development in numerous ways. Your child’s classroom teacher may have some ideas for you as well – express your concerns (and/or listen to the teacher’s concerns) and ask what sort of activities might be useful in order to help develop weak skills.

Teaching Your Kids How to Express Themselves

Communication occurs on two levels: verbal and non-verbal. Verbal communication consists of our words. Non-verbal communication consists of facial expression, tone of voice, gestures and actions. Both verbal and non-verbal messages are important in successful communication, however, some experts believe that non-verbal communication is actually the more important of the two.

Children start out as non-verbal communicators; parents interpret their needs as they are expressed through crying, fidgeting, moving their bodies and their hands. Although this method works fairly well, it can be frustrating for both parent and child. Often, it is impossible to decipher the baby’s message! Parents are naturally eager to teach their children how to become better communicators. Fortunately, babies are very interested in learning to speak and many will acquire some language as early as one year of age. Others will first talk only after their second birthday. Whenever language appears on the scene, parents can help their kids learn to use it effectively by encouraging verbal communication skills.

Here are three ways that parents can help their toddlers communicate better:

Spend Time Translating Non-Verbal Communication into Words
Instead of responding immediately to a non-verbal request, invest time teaching your child the verbal alternative of what they are trying to say. For example, if they point to a glass of juice to communicate that they’d like a sip, you can say “You want juice? Okay. Can you say ‘I want juice?” Or if they are whining or moaning because they want to go home, encourage them to say “I want to go home.” Whenever a child relies on body language instead of using his words, simply remind him to use his words. Give him the actual words to say (this makes it easier for him at first). Reinforce his efforts by responding to his words immediately. You can also offer praise. For instance, if the child says “I want juice,” the parent can say “Good talking! Here is some delicious juice for you!”

Mirror Back their Feelings
An area where reading a child’s non-verbal communication is helpful is in the identification of feelings. The ability to know what one is feeling is an important skill for children to learn, and is considered as the foundation of emotional intelligence. Kids can’t always tell what they are feeling so it’s up to parents to teach them about feelings and how to identify them.

One way parents can help their children identify their feelings is by a processes called mirroring or reflecting. In this process, parents simply present back to the child the feelings that they read in their actions or facial expressions. For example, a child who comes home and slams the door is probably feeling angry. Parents can say “You seem angry” as acknowledgment of the feeling observed (only AFTER naming the feeling and addressing it, would the parent begin to teach the child that slamming a door is not an acceptable way of expressing that feeling). Or a child who falls into tears after saying that her playmate just moved away can be told “I can see how sad you are that she moved away.” While the intervention seems minor, it can teach children on how to be more self-aware when it comes to their emotions. The naming of feelings is called “emotional coaching.” It is a skill that has very powerful, positive effects on child development, especially in helping to raise a child’s emotional intelligence (E.Q.).

Encourage Deliberate Non-Verbal Communication
Sometimes words are really not enough. There are many messages, both positive and negative, that can be communicated better through non-verbal methods. The key is in communicating non-verbally effectively and intentionally, instead of using non-verbal communication as a substitute for verbal messages.

One way to encourage appropriate non-verbal communication is to model it. When you verbally tell a child, “I love you so much!” add a physical gesture of love such as a big hug or a kiss. Encourage your child to let a sibling experience his or her love in a similar fashion (“tell the baby how much you like her and give her a big kiss on her head to show her”).  Teach kids to back up their words with actions: “Let’s make Daddy a birthday card and we’ll go to buy him a gift. We’ll say Happy Birthday and give him his card and his gift after supper tomorrow night.” Teach children to show interest by looking at a speaker. Teach them how to express anger in safe and acceptable ways (i.e. “When you are mad at your brother you can use your words to tell him and you can speak in a firm voice. You cannot go and break his puzzle.”) Sometimes we have to teach older children how NOT to show their feelings: for instance, it may be important for a 12 year-old girl to learn NOT to cry whenever she feels insecure or sad. Teach her to use her words (“I’m afraid you’ll be mad at me”) and how to control her facial expression and body. This will take practice and may benefit from professional intervention. However, by teaching the child to use age-appropriate communication strategies, you are actually helping her to be more socially appropriate. This will help her with her social skills and lead to more success and self-esteem.

Child Speaks Loudly

Do you have a child who tends to shout out what he wants to say, or speak louder than necessary?  It can be so frustrating! No matter how many times you ask your child to speak more quietly, he pops up the next time just as loud as ever.

If your child speaks too loudly, consider the following tips:

Have Your Child’s Hearing Checked
Speaking too loudly can be a sign of a hearing problem or difficulty in processing sounds. We all tend to adjust our volume based on cues in the environment, and if your child has difficulty hearing you, he or she might speak louder to compensate. Consult your pediatrician or a hearing specialist as soon as you can. Many hearing issues can be corrected with early intervention.

Check the Noise Level in Your Home
A child may speak louder as a reaction to an environment that has a lot of background noise. Is the radio on high in your home? Is there machinery in the yard that needs to be shut down? Perhaps you can adjust the volume of these distractions so that your child can quiet down. Or maybe you have a large and boisterous family and your child has to compete to be heard over the din.  You may not be able to get everyone to lower their voices but you can try. Most importantly, be aware of your own voice and check whether YOU are raising your voice in order to be heard as well. You might be inadvertently providing the loud model. If so, work on lowering your volume. See what you can do to get people to listen to you when you are talking in a normal tone and volume (consider reading Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe for tips on this subject).

Teach Your Child about “Indoor” and “Outdoor” Voices
Expect kids in the playground to be noisy — after all, being as loud as you can is one of the perks of playing outside! When your child has been playing outdoors for awhile, it’s not impossible that he or she will get used to high volume when speaking. Gently but firmly explain that there is a difference between acceptable volumes when inside the home and outside the home — the indoor and outdoor voice. You can even make a game out of it!

Consider if Your Child is Struggling with Speaking
When a child is first learning to speak, or to socialize with family and friends, it’s not unusual for some awkwardness in execution to exist. Your child may be unintentionally speaking too loudly; he or she may simply be struggling with getting the right volume out. If this is the case, training your child on speaking in different volumes can help. You can act out each voice — soft whisper, conversational tone, and shouting from across the room. With constant practice, kids will eventually learn how to adjust their own volume.

Take Your Child to a Speech Therapist
Speech therapists can assess and treat excessive loudness. They teach kids how to breath properly so that they don’t need to shout to get their message heard. They can help kids whose voices have become hoarse from shouting. They teach kids to be more aware of how they use they voice and they show them how to gain control over it.

Consider Anxiety
If you’ve asked the child to speak more quietly and you’ve tried speech therapy and there is still a problem, the child may have a psychological issue that requires attention. Sometimes speaking too loudly, especially if your child used to speak in a level tone before, may be a sign of anxiety. Perhaps your child is trying to get your attention; maybe he or she doesn’t think you’re listening. It’s also possible that he or she is afraid and nervous, and is trying to keep a brave front by speaking louder than usual. If this is the case, it’s best to surface what it is that’s stressing your child, so that it can be addressed. Either try chatting with the child one-on-one to see if anything is bothering her or take her to a child psychologist for an assessment and if necessary, treatment.

Talks Excessively

We love our kids and usually enjoy listening to their stories, thoughts and feelings. But when our kids talk too much – they ask too many questions, share far too many stories, explain things in way too much detail or just seem to want to engage parents in conversation 24/7 – then  we can get frustrated even annoyed. People only have so much attention span and patience (even parents). Constant chatter at home, in the car or while we are talking to others can grate on our nerves so much that we sometimes just want to yell “stop talking already!”

If you have given birth to a chatterbox, here are some tips for you:

Decide Who has the Problem
Interestingly, your child’s “excessive talking” may not be his or her problem – it might be YOURS! Parents can find their child’s talking annoying because they are stressed, distracted, depressed or just plain exhausted. When a parent has a lot on his or her mind, the chatter of a child can be hard to bear. Considering that it is perfectly normal for small children to enjoy talking (especially those in the pre-school set), parents may have to change themselves rather than the child. Perhaps a parent needs to lighten his or her schedule to make room for a few more minutes of daily listening time, or maybe a parent needs a more effective way of relieving personal stress so that more mental space is available for listening to children. Sometimes a parent’s difficulty in listening stems from his or her introverted personality; social interchange drains introverts while it stimulates extroverts. If that is the case, the parent may have to work around the introverted tendency, stretching a bit to accomodate the child’s normal need to talk. On the other hand, if you feel you have normal tolerance for children’s conversation but one of your kids just talks way past that point of tolerance, then you may need strategies to help the child cut back.

Explain the problem. Your child doesn’t realize that he or she is placing a burden on listeners. The child is just doing what comes naturally – enthusiastically sharing thoughts, ideas, stories, information and so on. You need to explain that people have fairly short attention spans and can only listen in “bites.” Most excessive talkers are actually terrible listeners, so it will be easy to demonstrate to your chattery child just how hard listening can be: ask the child to listen to you describe something in great detail (i.e. pick a topic that is unlikely to be particularly interesting to your child and talk for 3 to 4 non-stop minutes, explaining every tiny detail that you can). Your child will get a real experience of how frustrating it can be to have to listen and actually pay attention to someone who is talking. You can then use this experience to remind him or her when he or she is overloading your circuits. A gentle, respectful reminder is all that is necessary. You might even develop a code-word for the problem like “overload” or “maxed-out” or something that the child picks. Eventually the child will have a better idea of how many words the average listener can tolerate before the work of listening becomes too hard. This will be useful information for your child’s social functioning.

Call for a Time-Out
If the talking is excessive, call for a time-out. For example, you may say “I love to hear all about your day, sweetie, but daddy is a bit tired from work and needs a few quiet moments to rest. Let’s talk about it later when we’re having dinner, O.K.?” If you do it gently but firmly enough, your child will eventually respect the boundaries you set. And if your child generally has trouble holding his thoughts and questions in, get a timer or an alarm clock and tell the child to come back when the buzzer goes off. When kids can track when time out starts and when it ends, then they can be able to hold their stories for later.

Give Them Something to do When you Need Quiet and Peace
The chronic talker is really a chronic interacter. This kind of child depends on constant social stimulation. However, this obviously puts a strain on other people. Help your child develop other sides of his brain by re-directing him or her to tasks and activities that will encourage introspection or self-directed play. Point them to storybooks, puzzles, train sets, crafts, art projects, computer programs, physical exercise, TV programs or audio books. When kids know ways to enjoy themselves even if they don’t speak a word, then they are less likely to talk excessively.

Teach your Child Social Skills and Manners
Sometimes, firm rules on what is acceptable and unacceptable behavior is a good way to help a child who talks excessively. For example, teach them that it’s okay to share, but not okay to interrupt when someone else is speaking. Or that it’s okay to ask questions, but not when mom or dad is driving. Most importantly, teach them to take turns in a conversation, allowing the other person to speak for an equal number of minutes. Your child has to learn balance and restraint. You can introduce the notion of conversation sharing that works like a see-saw: the people alternate back and forth in a fairly equal exchange. If the other person talks only briefly, your child needs to do the same. Otherwise he or she is “hogging” the conversation, taking more than his or her rightful share.

Consider ADHD
Excessive talking is often found in those who have ADHD (attention deficit hyperactivity disorder). It may be related to troubles with impulsivity (controlling and limiting behaviors). Particularly if your child also has other symptoms of ADHD like problems attending to boring tasks and subjects, disorganization, fidgeting, interrupting, trouble waiting his turn and so on, you should consider getting a psychoeducational assessment. Ask your doctor for a referral to a psychologist who can diagnose your child. The psychologist can determine whether the excessive talking is part of a syndrome or whether it is just a feature of personality.

Child Doesn’t Speak Clearly

Your child is talking, but can’t seem to produce speech sounds properly. He or she stumbles with particular letters or letter combinations, such as s’s and th’s. Your child may also be omitting certain sounds when speaking, e.g. saying “I wah to ee donuhs” instead of “I want to eat donuts.” And on some occasions, your child simply gives up trying to say certain words.

Your child has trouble articulating.

Articulation refers to act of producing sounds. The clarity and accuracy of how you pronounce your letters and words represent successful articulation. Articulation is both a physiological and psychological process. If your child is having problems with articulation, the best thing to do is to consult a speech therapist or a speech pathologist as soon as possible.

What are the possible causes of articulation problems in children? Consider the following:

Your Child’s Developmental Stage
Some degree of articulation difficulty is normal in young children — hence, the baby talk. Toddlers 12 to 18 months, for example, have a marked preference for vowels and tend to drop consonants in their speech. It’s also not unusual for younger kids to have trouble producing sounds that require vibration in the throat such as r’s, or the deliberate control of their tongue such as s’s. Unless there’s an underlying medical or psychological impairment that will keep them from doing so, kids will naturally outgrow these articulation problems. Parents should be concerned only when their child skips the typical language development milestones.

Physical Problems
If your child’s articulation difficulty persists beyond what is expected from kids their age, then consider the possibility of a physical impairment. Hearing problems can cause poor articulation; kids, after all, learn language by imitating the sounds they hear from other people. Cleft palate, problems in the vocal cords, nasal allergies, gaps in the tooth and poor control of the muscles of the tongue can also cause articulation difficulty. There are also neurological issues that affect speech. A condition called Oral Apraxia, for example, results in the difficulty managing oral movements, and thus results to poor articulation.

Learning Disabilities
Articulation problems may also be caused by learning disabilities. Dyslexia, for example, can cause articulation problems in children, not because of any physical impairment, but because their letter recognition issues result in hesitancy when speaking.

Anxiety
There are also emotional issues that can cause articulation problems in children. When a child is nervous or self-conscious, he or she may have trouble producing particular speech sounds. It is not unusual, for example, for some kids to have trouble articulating during a speech or class presentation. Sadness, anger, and fear may also cause speech difficulty in children. If your child is having articulation problems during a particularly stressful transition, then consider the speech problem as a sign of hidden anxiety.

What to Do About It
You can obtain an accurate diagnosis of your child’s speech issue by arranging a consultation with a speech and language therapist. If the therapist feels that the child will simply outgrow his or her challenges, she’ll let you know. If the therapist feels that some remedial treatment is in order, she’ll let you know that as well. Sometimes school boards or community hospitals provide speech treatment free of cost but private services are also available.

Hidden Reasons for Your Child’s Behavior

We are all familiar with visible disabilities: missing limbs, order profound retardation, blindness, deafness, cerebral palsy, speech handicaps and so on. Children with such disabilities will be provided with special education that addresses their special needs. The community will be understanding and supportive of parents who are raising special children; everyone will try to help.

However, many children are suffering from “invisible disabilities.” These are emotional, physical and behavioural conditions that range from the most mild of dysfunctions to serious handicaps. Teachers may confront these conditions in their classrooms and parents may deal with them at home, without knowing that a disability even exists. Adults may see a child who is “difficult” or “uncooperative” or “unmotivated.” They may see a child who is “inflexible” or “spaced-out” or “over-sensitive.” What they don’t know is what to do about it. Parents raising such children tend to receive criticism rather than support; others assume that poor parenting is the culprit. In fact, various underlying, often genetic conditions, create invisible disabilites.

Immaturity
There are young children who function just a bit behind their age or grade level and who have nothing more seriously wrong with them than immaturity. Their social skills may be lacking and/or their academic performance may be weak. Sometimes social skills counselling can help, but often finding alternate areas of activity and competency can bolster flailing self-esteem. For instance, a socially immature child who receives lessons in art, music, sports, computer programming, cooking, sewing, or any other extracurricular activity, can grow in confidence and self-respect, despite social frustration in the classroom.

Some additional individual attention in academic subjects will often bring immature children to an appropriate level of functioning within a matter of months or a couple of years. Providing this extra help thereby completely removes the “disability.” However, failure to provide the help, can cause the child to remain permanently disadvantaged in the classroom. Not only will his academic performance lag (and thus threaten his adolescent schooling opportunities), but his frustration and boredom may also lead to behavioural and emotional difficulties, actually creating a psychological handicap when there was none to begin with. Similarly, there are some immature adolescents who may need temporary extra help and/or guidance in order to function successfully at the high school level. With such help, they may go on to be outstanding members of the class, and eventually, of the community.

Minimal Brain Dysfunction
An early term used to describe a cluster of behavioural, emotional and intellectual deficits was “minimal brain dysfunction.” The syndrome referred to unexplainable gaps in academic functioning in otherwise normal children. Dylexia (reading disability), discalculaia (arithmetic disability), dysgraphia (handwriting disabilities) and other academic weaknesses were found to exist on their own or in combination with any number of neurological “soft signs” such as fine or gross motor deficits, eye-hand coordination problems, information processing weaknesses, mixed laterality, poor directionality, poor social perception and other symptoms. Today, the term “minimal brain dysfunction” has been replaced with other diagnostic categories such as “learning disabilities,” “auditory processing deficits,” “ADD,” and “ADHD.” In recent times, the nomenclature has included Tourette’s Syndrome with all of its variants of Tic Disorders, Obsessive-Compulsive Disorders, Depression and various other complex disorders of social and cognitive functioning. The field is still evolving and new understandings and categorizations of these dysfunctions will emerge.

Mild and moderate cases of these disorders present themselves as “invisible disabilities.” A child is clearly not functioning up to par. Psycho-educational assessment will often reveal the criteria for a diagnosis of one of the above-named syndromes. Sometimes, a “sub-syndrome” may be postulated – some symptoms exist, but not enough to meet criteria for a formal diagnostic label. In either case, treating the symptoms with appropriate interventions usually yields excellent results. Extra academic support, alternative teaching strategies and occasionally, behaviour modification programmes, can allow the child to prosper within his normal classroom setting. With such help, the child progresses normally and may be able to integrate into the mainstream without further intervention. In more serious cases, the child may require a slightly modified curriculum in addition to the special educational interventions already described. With such help, the child is able to stay within his regular school setting and develop normally along with his peers. Sometimes, psychological support given to the parents and medication or naturopathic treatment given to the child, provides further assistance and ensures the best prognosis. Often, where the child has received appropriate support, the disability becomes a non-issue by the period of adolescence or adulthood. In other cases, the disability remains, but the child has acquired many coping skills and alternate areas of successful functioning that allow him to succeed in life. Only in the most extreme cases of such disabilities, is special schooling required, taking this category completely out of the “invisible handicap” designation.

Disorders of Mood and Motivation
There are also children with a wide range of emotional and behavioural difficulties that become invisible handicaps. The “unmotivated” child may be a perfectly normal youngster who daydreams or has interests in non-academic endeavors. This can also be the “gifted” child who is not sufficiently challenged within the classroom setting. Without intervention, these children may fall further and further behind in their studies. Eventually, lack of academic success may lead to behavioural difficulties, as described above. However, with minimal intervention such as classroom withdrawal for extra academic attention specifically geared to their unique learning style, these children can be redirected to a successful learning path. Bach Flower Therapy offers many remedies that treat disorders of motivation (you can find more information about Bach Flowers online and on this site). In more persistent cases, psychological counselling may be helpful as well.

The “behaviour problem” child may be suffering from low self-esteem, depression, chemical and brain disorders, family problems, problems of impulse control and/or immaturity, or other physical or emotional challenges. Left unattended, this sort of child may enter a cycle of failure in which teachers give up on him and he gives up on himself. Eventually such a child is at great risk academically, emotionally and spiritually. However, in-school treatment can make a huge difference. Extra attention, opportunities to shine both academically and non-academically, behaviour modification programmes can all be combined with outside-school interventions such as psychological counselling, nutritional and naturopathic interventions, medical interventions and so forth.  Often, parent counselling is an invaluable component of the child’s wellness programme, as parents are provided with at-home interventions that can impact powerfully on both family and academic functioning. When the needs of the child are met, the best outcome will be achieved.

Similarly, children who have early-stage mental health disorders such as OCD (obsessive-compulsive disorder), anxiety disorders or depressive mood disorders (which can be expressed both as sadness and as intense irritability in children), can be kept in their school environments while special allowances are made for their unique needs. This may involve arranging exemptions for medical and/or psychological appointments, altering curriculum demands or schedules to reduce pressure, and providing extra academic support as needed. Without such support, these disorders may worsen significantly due to intolerable levels of stress. They then become “obvious handicaps” rather than “invisible” ones. However, with support, many mental health disorders will become less disruptive or even improve significantly, enabling the child to lead a normal life.

Being Singled Out
Some parents are concerned that children will suffer from being singled out for special attention within the school setting. As we have seen, greater suffering may result from leaving minor problems unattended. Moreover, it is important to note that children generally enjoy the special attention that they receive. Most children, for example, look forward to spending time with their tutor, therapist, resource room teacher or guidance counselor. These professionals are all trained to make children feel successful. The withdrawal experience is thus a very positive one for youngsters. With parental endorsement and support, youngsters can actually feel privileged to receive this help. Making extra help a normal and common part of school experience by providing it to more children more frequently, will also help to reduce any sense of embarrassment or discomfort on the part of individuals.

Our attitude as a community is very important. We must become comfortable with the concept of providing educational and emotional support for children as a primary intervention. We must also understand that the emotional and behavioural profile of children changes dramatically from the period of kindergarten to the end of high school and beyond. A “wild” six-year-old can turn out to be a well-functioning adolescent and adult – especially if he has received the help he needed along the way. Providing a child with help does not make the child “sick” – but failing to provide that help might very well do so. Sometimes professional assessment is an important part of a child’s health plan. Having a child assessed and labelled, does not “doom” him; rather, diagnosis and assessment guides parents and educators to choose the best interventions to help the child grow up “normal”! Lack of proper assessment can sometimes cause a child to miss the earliest intervention that would produce the best outcome. Moreover, the delay of professional assessment may result in a child with entrenched negative patterns that are much harder to uproot. Parents who refuse to have their child assessed despite expressed concern from teachers, are sometimes functioning like people who are afraid to go to the doctor when they are experiencing worrying symptoms. If they went to the doctor early enough, their health could probably be saved. Refusing to obtain a diagnosis for fear that something will be found, is understandable – but self-defeating. It is the diagnosis that permits the healing to begin!

Our job as parents and educators is to help children develop to their potential. Meeting their unique needs helps accomplish this goal. The more help we give, the less stigma we experience. The more help we give, the less dysfunction will exist. The more help we give, the more adults we can produce who are healthy, whole human beings – the products of our educational system and our community.