2.files.edl.io Web viewdo the same thing over and over, like saying the same word. move his or her arms or body in a certain way. have trouble adjusting to changes (like trying new

Autism

When Stacey went over to her new friend Chelsea's house, she met Chelsea's 4-year-old brother, Shawn. "Hi," said Stacey, smiling. Shawn looked at her but didn't say anything. Then he turned back to a toy he was holding. Later, in Chelsea's room, Stacey said, "I don't think your brother likes me."

"It's not your fault," said Chelsea. "It's not that he doesn't like you — Shawn has autism and it's hard for him to talk sometimes. But I can show you how to play with him, if you want."

Stacey wanted to know what autism meant. Let's find out.

What Does Autism Mean?

People usually call it autism (say: aw-tih-zum), but the official name is autism spectrum disorders. Why? Because doctors include autism in a group of problems that kids can have, including Asperger syndrome and others. These problems happen when the brain develops differently and has trouble with an important job: making sense of the world.

Every day, our brains interpret (understand) the things we see, smell, hear, taste, touch, and experience. But when someone's brain has trouble interpreting these things, it can make it hard to talk, listen, understand, play, and learn.

A kid's symptoms could be very mild, severe, or somewhere in the middle. For example, some kids might be upset by too many noises or sounds that are too loud. Kids who have milder symptoms don't mind loud noises so much. Someone with mild symptoms might need only a little bit of help. But a kid with severe symptoms might need a lot of help with learning and doing everyday stuff.

Kids with autism often can't make connections that other kids make easily. For example, when people smile, you know they feel happy or friendly; when people look mad, you can tell by their face or their voice. But many kids who have autism spectrum disorders have trouble understanding what emotions look like and what another person is thinking. They might act in a way that seems unusual, and it can be hard to understand why they're doing it.

A kid with an autism spectrum disorder might:

have trouble learning the meaning of words do the same thing over and over, like saying the same word move his or her arms or body in a certain way have trouble adjusting to changes (like trying new foods, having a substitute teacher, or having

toys moved from their usual places)

Imagine trying to understand what your teacher is saying if you didn't know what her words really mean. It is even more frustrating if a kid can't come up with the right words to express his or her own thoughts, or

tell a parent what he or she needs or wants. Sometimes this can make a kid very upset and frustrated.

Some issues — like not wanting to try new foods or not wanting anyone to move your toys — affect lots of kids, not just those who have an autism spectrum disorder. But kids with these disorders have more trouble "growing out of it" and learning to handle stuff that's challenging and annoying.

What Causes Autism?

According to the Centers for Disease Control and Prevention (CDC), 1 in 88 kids has an autism spectrum disorder, but no one knows what causes them. Scientists think that there's a connection to genetics (something to do with a kid's genes) and the environment. Some kids might be more likely to get autism because it runs in their families. Other kids get it even if nobody in their family has these types of problems.

Knowing the exact cause of autism is hard because the human brain is very complicated. The brain contains more than 100 billion nerve cells called neurons (say: nur-ahns). Each neuron may have hundreds or thousands of connections that carry messages to other nerve cells in the brain and body. The connections and the chemical messengers they send (called neurotransmitters) keep the neurons working as they should. When they do, you can see, feel, move, remember, experience emotions, communicate, and do lots of other important stuff.

In the brain of a kid with autism, some of those cells and connections don't develop normally or don't get organized like they're supposed to. Scientists are still trying to understand how and why this happens.

Getting Help for Autism

The earlier a child starts getting help, the better. But figuring out if a kid has an autism spectrum disorder can be difficult at the beginning. A parent is usually the first to think that something could be wrong. Maybe the child is old enough to speak but doesn't. Or a kid doesn't seem interested in people, has a hard time playing with others, or acts in unusual ways.

Often, specialists work together as a team to figure out if there is a problem. In addition to the doctor, the team might include a psychologist, speech therapist, occupational therapist, and teacher.

There is no cure for autism, but doctors, therapists, and special education teachers can help kids learn to communicate better. A kid might learn sign language or get a message across by pointing at pictures. The care team also can help improve a kid's social skills, stuff like taking turns and playing in a group.

Some kids who have mild symptoms will graduate high school and may go to college and live on their own. Many will always need some kind of help. But all will have brighter futures when they have the support and understanding of their families, doctors, teachers, therapists, and friends. So be sure to be a

friend!

Reviewed by: Michelle New, PhDDate reviewed: June 2012Originally reviewed by: Wendelin A. Burdo-Hartman, MD

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/brain/autism.html

Blindness

Have you ever put on a blindfold and pretended that you couldn't see? You probably bumped into things and got confused about which way you were going. But if you had to, you could get adjusted and learn to live without your sight.

Lots of people have done just that. They have found ways to learn, play, and work, even though they have trouble seeing or can't see at all.

How Seeing Happens

Your eyes and your brain work together to see. The eye is made up of many different parts, including the cornea, iris, lens, and retina. These parts all work together to focus on light and images. Your eyes then use special nerves to send what you see to your brain, so your brain can process and recognize what you're seeing. In eyes that work correctly, this process happens almost instantly.

When this doesn't work the way it should, a person may be visually impaired, or blind. The problem may affect one eye or both eyes.

When you think of being blind, you might imagine total darkness. But most people who are blind can still see a little light or shadows. They just can't see things clearly. People who have some sight, but still need a lot of help, are sometimes called "legally blind."

What Causes Blindness?

Vision problems can develop before a baby is born. Sometimes, parts of the eyes don't form the way they should. A kid's eyes might look fine, but the brain has trouble processing the information they send. The optic nerve sends pictures to the brain, so if the nerve doesn't form correctly, the baby's brain won't receive the messages needed for sight.

Blindness can be genetic (say: juh-neh-tik) or inherited (say: in-her-ut-ed), which means that this problem gets passed down to a kid from parents through genes.

Blindness also can be caused by an accident, if something hurts the eye. That's why it's so important to protect your eyes when you play certain sports, such as hockey.

Some illnesses, such as diabetes, can damage a person's vision over time. Other eye diseases, such as cataracts (say: kah-tuh-rakts), can cause vision problems or blindness, but they usually affect older people.

What Does the Doctor Do?

A kid who has serious trouble with vision might see an ophthalmologist (say: ahf-thuh-mah-luh-jist), a

doctor who specializes in eye problems. Even babies might see an ophthalmologist if their parents think they might be having trouble seeing.

At the doctor visit, the doctor will talk with the parents and the kid (if the kid is old enough to describe what's going on). A doctor might use an eye chart to find out how well the kid can see. You've probably seen these charts that contain letters of different sizes. It's a way of testing how well a person can see. Someone with really good vision would be able to read certain letters from 20 feet (6 meters) away.

Eyesight this good is called 20/20 vision, although some people can see even better than that. The numbers change depending on how clearly a person can see. The larger or closer something needs to be in order for it to be seen, the worse a person's vision is.

Many times, glasses or contact lenses are all that's needed to help kids see better. But if glasses and contact lenses can't make someone's vision any better — and the person needs to get really close to something to see it — he or she may be considered blind. For instance, someone with good vision might be able to see an object from 200 feet (61 meters) away, but someone is considered blind if he or she needs to be 20 feet (6 meters) away to see the same object.

Babies and little kids won't be able to use the eye chart, but doctors can check their vision by doing special vision tests or something as simple as putting a toy in front of the child to see if he or she can focus on it.

The ophthalmologist also will examine the kid's eyes using special medication and lighting that allows him or her to see into the eyeballs. The ophthalmologist will look at each part of the eye to check for problems, such as a cataract (cloudiness of the eye's lens). Once the doctor knows what's causing the vision problem, he or she can begin planning how to treat it.

In some cases, an operation can help improve a kid's vision. For example, if a kid has a cataract, doctors may do surgery to remove it.

Is Learning Different?

A baby who is blind can still learn and develop normally. But the baby's parents will need the help of specialists who know how to help blind children. It's often a great idea for the child to attend special learning programs designed just for little kids who have trouble seeing. These programs would make the most of the senses that the kid does have, such as touch, hearing, smell, andtaste.

Touch comes in handy when a child is older and wants to read books. Kids who are visually impaired can learn to read by using a special system called braille. Braille is a way of expressing letters, words, and thoughts. To read braille, a person feels a series of little bumps that are associated with letters in the alphabet. For instance, "A" is represented as one bump. Computer programs and other devices that can

"see" turn the words on a page into braille.

Hearing is another important sense if a kid has vision problems. Some devices can read out loud what's written on a page. With special equipment, a visually impaired kid can read almost anything. These kinds of technologies can be helpful in learning. Kids who are blind might attend a special school, or they might attend regular classes, aided by special devices and specialists.

Hot Dog!

Kids who have vision problems will get help from their parents, doctors, and teachers. When they are older, some of them may get a hand — or should we say a paw? — from a guide dog. These helper dogs are trained to be a blind person's eyes. That means the dog learns to be very alert to surroundings so he or she can be a good guide for the person.

Not only are these dogs great friends, they give blind people independence, so they can accomplish what they want to accomplish.

Many blind people have gone on to do amazing things in many different fields, including music, the arts, and even sports. Serious vision problems didn't stop runner Marla Runyan. She was the first legally blind person to ever qualify for the Olympics!

Reviewed by: Jonathan H. Salvin, MDDate reviewed: November 2010

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/sight/visual_impaired.html

Cerebral Palsy

Have you ever heard a family member talk about your first step or the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step or saying a first word is not as easy. That's because CP is a condition that can affect the things that kids do every day.

What's CP?

Some kids with CP use wheelchairs and others walk with the help of crutches or braces. In some cases, a kid's speech may be affected or the person might not be able to speak at all.

Cerebral palsy (say: seh-ree-brel pawl-zee) is a condition that affects thousands of babies and children each year. It is not contagious, which means you can't catch it from anyone who has it. The word cerebral means having to do with the brain. The word palsy means a weakness or problem in the way a person moves or positions his or her body.

A kid with CP has trouble controlling the muscles of the body. Normally, the brain tells the rest of the body exactly what to do and when to do it. But because CP affects the brain, depending on what part of the brain is affected, a kid might not be able to walk, talk, eat, or play the way most kids do.

Types of CP

There are three types of cerebral palsy: spastic (say: spass-tick), athetoid (say: ath-uh-toid), andataxic (say: ay-tak-sick). The most common type of CP is spastic. A kid with spastic CP can't relax his or her muscles or the muscles may be stiff.

Athetoid CP affects a kid's ability to control the muscles of the body. This means that the arms or legs that are affected by athetoid CP may flutter and move suddenly. A kid with ataxic CP has problems with balance and coordination.

A kid with CP can have a mild case or a more severe case — it really depends on how much of the brain is affected and which parts of the body that section of the brain controls. If both arms and both legs are affected, a kid might need to use a wheelchair. If only the legs are affected, a kid might walk in an unsteady way or have to wear braces or use crutches. If the part of the brain that controls speech is affected, a kid with CP might have trouble talking clearly. Another kid with CP might not be able to speak at all.

For some babies, injuries to the brain during pregnancy or soon after birth may cause CP. Children most at risk of developing CP are small, premature babies (babies who are born many weeks before they were supposed to be born) and babies who need to be on a ventilator (a machine to help with breathing) for several weeks or longer.

But for most kids with CP, the problem in the brain occurs before birth. Often, doctors don't know why.

What Do Doctors Do?

Doctors who specialize in treating kids with problems of the brain, nerves, or muscles are usually involved in diagnosing a kid with cerebral palsy. These specialists could include a pediatricneurologist (say: nyoo-ral-uh-jist), a doctor who deals with problems of the nervous system and brain in kids.

Three other kinds of doctors who can help kids with CP are:

1. a pediatric orthopedist (say: or-tho-pee-dist), who handles problems with bones or joints2. a developmental pediatrician, who looks at how a kid is growing or developing compared with

other kids the same age3. a pediatric physiatrist, who helps treat children with disabilities of many kinds

There is no special test to figure out if a kid has cerebral palsy. Doctors may order X-rays and blood tests to find out if some other disease of the brain and nervous system may be causing the problem. To diagnose CP, doctors usually wait to see how a kid develops to be sure.

A case of cerebral palsy often can be diagnosed by the age of 18 months. For example, if a child does not sit up or walk by the time most kids should be doing these things, the kid might have CP or some other problem that is causing development to go more slowly. Doctors follow infant and child development closely and look for problems with muscle tone and strength, movement, and reflexes.

How Is CP Treated?

For a kid with CP, the problem with the brain will not get any worse as the kid gets older. For example, a kid who has CP that affects only the legs will not develop CP in the arms or problems with speech later on. The effect of CP on the arms or legs can get worse, however, and some kids may develop dislocated hips (when the bones that meet at the hips move out of their normal position) or scoliosis (curvature of the spine).

That is why therapy is so important. Kids with CP usually have physical, occupational, or speechtherapy to help them develop skills like walking, sitting, swallowing, and using their hands. There are also medications to treat the seizures that some kids with CP have. Some medications can help relax the muscles in kids with spastic CP. And some kids with CP may have special surgeriesto keep their arms or legs straighter and more flexible.

Living With CP

Cerebral palsy usually doesn't stop kids from going to school, making friends, or doing things they enjoy. But they may have to do these things a little differently or they may need some help. With computers to help them communicate and wheelchairs to help them get around, kids with CP often can do a lot of stuff

that kids without CP can do.

Kids with cerebral palsy are just like other kids, but with some greater challenges that make it harder to do everyday things. More than anything else, they want to fit in and be liked.

Be patient if you know someone or meet someone with CP. If you can't understand what a person with CP is saying or if it takes a person with CP longer to do things, give him or her extra time to speak or move. Being understanding is what being a good friend is all about, and a kid with CP will really appreciate it.

Reviewed by: Steven J. Bachrach, MDDate reviewed: July 2012

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/brain/cerebral_palsy.html

DyslexiaPeter works so hard at reading, but it just never gets easier. He knows he's smart so why can't he read like the other kids? Peter has a problem called dyslexia.

Dyslexia (say: dis-lek-see-uh) is a learning problem some kids have. Dyslexia makes it tough to read and spell. The problem is inside the brain, but it doesn't mean the person is dumb. Plenty of smart and talented people struggle with dyslexia.

But dyslexia doesn't have to keep a kid down. With some help and a lot of hard work, a kid who has dyslexia can learn to read and spell.

How Does Reading Happen?

To understand dyslexia, it helps to understand reading. Reading is a real workout for your brain. You need to do the following steps — and all at once:

1. Understand the way speech sounds make up words.

2. Focus on printed marks (letters and words).

3. Connect speech sounds to letters.

4. Blend letter sounds smoothly into words.

5. Control eye movements across the page.

6. Build images and ideas.

7. Compare new ideas with what is already known.

8. Store the ideas in memory.

Phew! Kids who have dyslexia struggle with the beginning steps, so that makes doing the rest of the steps even harder. It's no surprise, then, that trying to read and dealing with dyslexia makes a kid's brain really tired really fast.

How Kids Become Readers

Most kids start learning to read by learning how speech sounds make up words. Then they connect those sounds to alphabet letters. For example, they learn that the letter "b" makes a "buh" sound.

Then kids learn to blend those sounds into words. They learn that "b" and "at" makes "bat." Eventually, most kids don't have to sound words out and can instantly recognize words they've seen many times before.

But it's tougher for kids who have dyslexia. They may struggle to remember simple words they have seen many times and to sound out longer words. Why is it so hard?

Dyslexia means that a person's brain has trouble processing letters and sounds. That makes it tough to break words into separate speech sounds, like b-a-t for bat. When it's hard to do that, it's really hard to connect speech sounds to different letters, like "buh" for b, and blend them into words.

So a kid who has dyslexia will read slowly and might make a lot of mistakes. Sometimes he or she will mix up letters in a word, such as reading the word "was" as "saw." Words may blend together wrong and look like this:

What's It Like to Have Dyslexia?

Even before kindergarten, a kid who has dyslexia usually has trouble with letters and sounds. Later, a teacher might say that the kid is smart, but doesn't seem to be getting the hang of reading. Other times, it's a parent who notices the kid is struggling. The best thing to do is to go to a specialist who can help figure out what's wrong.

A specialist in learning disabilities knows a lot about learning problems that kids have and what to do about them. During a visit with a specialist, a kid might take some tests. But the idea isn't to get a good grade; it's to spot problems. Discovering a learning disability is the first step toward getting help that will make it easier for the kid to learn.

Making Reading Easier

Most kids with dyslexia can learn to read with the right kind of teaching. They might learn new ways for remembering sounds. For example, "p" and "b" are called brother sounds because they're both "lip poppers." You have to press your lips together to make the sound.

Thinking about the way the mouth needs to move to make sounds can help kids read more easily. Learning specialists know lots of special activities like this to teach reading to kids who have dyslexia.

Kids with dyslexia also might use flash cards or tape classroom lessons and homework assignments instead of taking notes about them. They may need parents and tutors to help them stay caught up.

Extra time for tests is really important, so kids with dyslexia have enough time to finish and show their teacher how much they have learned. Computers help a lot, too. You can get programs that "read" books out loud from the computer or even download recorded books to an iPod!

How Do Kids With Dyslexia Feel?

Kids who have dyslexia might get frustrated, angry, or sad because reading and spelling are so hard. They may not like being in a different reading group than their friends or having to see a special reading tutor.

But getting this help is so important and will help them go on to do great things in life. Some of the most creative and successful people have dyslexia, but it didn't stop them from chasing their dreams!

Reviewed by: Laura L. Bailet, PhDDate reviewed: July 2012

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/learning_problem/dyslexia.html

Down Syndrome

You have probably seen people who have Down syndrome. They have certain physical features, such as a flatter face and upward slanting eyes. They may have medical problems, too, such as heart defects. Kids with Down syndrome usually have trouble learning and are slower to learn how to talk and take care of themselves.

But despite their challenges, kids with Down syndrome can go to regular schools, make friends, enjoy life, and get jobs when they're older. Getting special help early — often when they are just babies and toddlers — can be the key to healthier, happier, more independent lives.

Chromosomes Are the Cause

To understand why Down syndrome happens, you need to understand a little about chromosomes. What are chromosomes? They're thread-like structures within each cell and are made up of genes. Genes provide the information that determines everything about people, from hair color to whether they are girls or boys.

Most people have 23 pairs of chromosomes, for a total of 46. But a baby with Down syndrome has an extra chromosome (47 instead of 46) or one chromosome has an extra part. This extra genetic material causes problems with the way their bodies develop.

Health Problems Are Common

About half of babies with Down syndrome are born with heart defects, which means their hearts developed differently and don't work as they should. Usually, these problems can be corrected by surgery. Some babies may have intestinal problems that also require surgery to fix.

Kids with Down syndrome are more likely to get infections that affect their lungs and breathing. When they do get infections, they often last longer. They may have eye or ear problems or digestion problems like constipation. Some may develop leukemia, a type of cancer. Each person with Down syndrome is different and may have one, several, or all of these problems.

Kids with Down syndrome tend to grow and develop more slowly than other children do. They may start walking or talking later than other babies. Special help, such as physical therapy and speech therapy, can give kids a boost with their walking and talking skills.

Do a Lot of People Have Down Syndrome?

About 1 out of every 800 babies born in the United States has Down syndrome, no matter what race or nationality the parents are. It is not contagious, so you can't catch it from someone else. You are born with it. No one gets Down syndrome later in life.

Now you know that Down syndrome is caused by a problem with a chromosome. You might already know

that we get our chromosomes from our mother and father. Remember the 23 pairs of chromosomes — half are from your mom and half are from your dad.

But doctors aren't sure why this chromosome problem happens to some babies. It's nothing the mom or dad did before the child was born. Anyone can have a baby with Down syndrome. But the older the mother, the greater the risk.

Times Have Changed

At one time, most kids with Down syndrome did not live past childhood. Many would often become sick from infections. Others would die from their heart problems or other problems they had at birth. Today, most of these health problems can be treated and most kids who have it will grow into adulthood.

Medicines can help with infections and surgery can correct heart, intestinal, and other problems. If the person gets leukemia, medical treatments can be very successful.

Down syndrome is something a person will have all of his or her life. But scientists continue to do research in the hope of finding ways to prevent Down syndrome or at least improve the health and lives of people who have it.

What's Life Like for Kids With Down Syndrome?

Many kids with Down syndrome go to regular schools and may attend regular classes. Some need special classes to help them in areas where they have more trouble learning. Their parents work with teachers and others to come up with a plan for the best way for each child to learn. Kids with Down syndrome like their playtime, too. They play sports and participate in activities, such as music lessons or dance classes.

Because they look different, some kids may tease or bully kids who have Down syndrome. But these kids have feelings just like anybody else. When they get teased, it hurts their feelings. They want to be accepted and have friends. If you know someone with Down syndrome, you can be a big help by not teasing him or her. Instead, offer a helping hand and a friendly word of encouragement.

Reviewed by: Mary L. Gavin, MDDate reviewed: February 2012

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/birth_defect/down_syndrome.html

What's Hearing Loss?

You know what hearing is, but what is hearing loss? Hearing loss, or hearing impairment (say: im-pare-ment), happens when there is a problem with one or more parts of the ear or ears ("impairment" means something is not working correctly or as well as it should).

Someone who has hearing loss might be able to hear some sounds or nothing at all. People also may use the words deaf, deafness, or hard of hearing when they're talking about hearing loss.

About 3 in 1,000 babies are born with hearing impairment, making it the most common birth defect. A hearing problem can also develop later in life.

How Hearing Works

To understand how and why hearing loss happens, it helps to know how the ear works. The ear is made up of three different sections: the outer ear, the middle ear, and the inner ear. These parts work together so you can hear and process sounds. The outer ear, or pinna (the part you can see), picks up sound waves and the waves then travel through the outer ear canal.

When the sound waves hit the eardrum in the middle ear, the eardrum starts to vibrate. When the eardrum vibrates, it moves three tiny bones in your ear. These bones are called the hammer (or malleus), anvil (or incus), and stirrup (or stapes). They help sound move along on its journey into the inner ear.

The vibrations then travel to the cochlea, which is filled with liquid and lined with cells that have thousands of tiny hairs on their surfaces. There are two types of hair cells: the outer and inner cells. The sound vibrations make the tiny hairs move. The outer hair cells take the sound information, amplify it (make it louder), and tune it. The inner hair cells send the sound information to your hearing nerve, which then sends it to your brain, allowing you to hear.

Types of Hearing Loss

There are a few different types of hearing loss: conductive, sensory, mixed (conductive and sensory combined), neural, and central.

Conductive (say: kun-duk-tiv) hearing loss. This happens when there is a problem with a part of the outer or middle ear. Most kids with conductive hearing loss have a mild hearing loss and it is usually temporary because in most cases medical treatment can help.

Sensory (say: sen-suh-ree) hearing loss. This happens when the cochlea is not working correctly because the tiny hair cells are damaged or destroyed. Depending on the loss, a kid might: hear most sounds (although they would be muffled); hear in quiet but not in noise; hear only some sounds; or hear no sounds at all. Sensory hearing impairment is

almost always permanent and a kid's ability to talk normally may be affected.

Neural (say: nur-ul) hearing loss. This happens when there is a problem with the connection from the cochlea to the brain. Neural means related to nerve, so neural hearing loss means the nerve that carries the messages from the cochlea to the brain is damaged.

Central hearing loss. This happens when the cochlea is working properly, but parts of the brain are not. This is a less frequent type of hearing loss and is more difficult to treat.

What Causes Hearing Loss?

Hearing loss can happen because a person was born with parts of the ear that didn't form correctly and don't work well. Other problems can happen later because of an injury or illness, including:

middle ear fluid serious infections, such as meningitis head injury listening to very loud music, especially through headphones or ear buds repeated exposure to loud sounds, such as machinery

Lots of kids have had ear infections, which also can cause hearing loss. Permanent hearing loss is rare from an ear infection, but you need to visit the doctor if you or your parents suspect you have one.

How Does a Doctor Test for Hearing Loss?

If a doctor thinks that a baby or child may have hearing loss, the doctor will recommend that the parents take the kid to an audiologist. An audiologist (say: awd-ee-ah-luh-jist) is someone who is specially trained to test and help with the problems related to hearing loss.

A pediatric audiologist tests a child's hearing by doing different types of tests. They even have hearing tests for babies! Maybe you've had a hearing test, when you wore headphones and had to raise your left or right hand to show that you could hear in each ear.

If an audiologist finds that a child has hearing loss, he or she will recommend treatment and suggest the family work with a special team. This team can help figure out the best way for the kid to learn and communicate.

How Is Hearing Loss Treated?

The kind of treatment depends on the type of hearing loss, how severe it is, and the child's other needs. Common treatments include medicine, operations, hearing aids, or other assistive

listening devices, which emphasize voices and help kids hear better in noisy settings. With treatment, most kids will be able to hear normally again.

Hearing aids are kind of like tiny amplifiers. They help someone hear sounds better and can even pick up the sounds so that what kids hear is clearer. Hearing aids deliver amplified sounds (via sound vibrations) from the eardrum and middle ear to the inner ear or cochlea. Hearing aid technology is available that can adjust the volume of sounds automatically.

For some kids who can't hear or understand words even with the help of hearing aids, there is a device called a cochlear implant (say: ko-klee-ur im-plant). This is a very tiny piece of electronic equipment that is put into the cochlea during an operation. It takes over the job of the damaged or destroyed hair cells in the cochlea by turning sounds into electrical signals that stimulate the hearing nerve directly.

Learning and Communicating

A kid with hearing loss may attend a special school, special classes within a regular school, or be part of a regular classroom. Depending on how severe their hearing loss is, some kids may work with audiologists or speech-language pathologists to help them develop their hearing and speaking skills.

Some people with hearing loss may need to use special techniques like these to communicate:

speechreading, which involves looking closely at a person's lips, facial expressions, and gestures to help figure out spoken words

American Sign Language, or ASL, which is a language of hand movements that allows deaf people to communicate without speaking

Cued Speech and Signed Exact English, which use handshapes to translate what's being said. They're meant to be used with spoken language to help people understand anything they can't comprehend through lip reading.

What about talking on the phone? Thanks to a telecommunication device (also called a TDD), a conversation can be typed out instead of spoken. The messages appear on a special screen or on a printout.

You might wonder how a hearing-impaired person could see a movie or watch TV. Closed-captioned TV shows and movies provide text at the bottom of the screen, so people with hearing loss can read along to follow the action.

So hearing-impaired kids can go to school, talk on the phone, and watch a movie. If that sounds a lot like a typical kid's life, you're right!

Reviewed by: Thierry Morlet, PhDDate reviewed: May 2012

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/sight/hearing_impairment.html

The Meaning of Muscular Dystrophy

Over Labor Day, just as you're going back to school, you might see the Muscular Dystrophy Association telethon on TV. Every year on this show, Jerry Lewis and others raise money for research and treatment of muscular dystrophy (MD). You might wonder "What's this show about and what is muscular dystrophy?" Or maybe you know someone who has MD.

What Is Muscular Dystrophy?

Muscular dystrophy (say: mus-kyoo-lur dis-troh-fee) is a disease in which the muscles of the body get weaker and weaker and slowly stop working. Muscles and membranes need many different kinds of proteins to stay healthy. When you hear the word "protein" you might think of food because foods, such as meat and peanut butter, contain protein. But we're talking about another kind of protein — the kind your body actually creates. Your genes tell your body how to make the proteins your muscles need. But in people with MD, these genes have wrong information or leave out important information, so the body can't make these proteins properly.

Without these proteins, the muscles break down and weaken over time. As this happens to muscles, people with MD begin to have problems with the way their bodies work.

Different Types of MD

There are more than 30 types of MD. In some types, muscle problems start when the person is very young. With other types, symptoms of MD start later, sometimes not until the person is a grown-up. This article talks about two types: Duchenne and Becker MD. Generally, only boys get Duchenne MD and Becker MD, but girls are affected by these types in rare cases and can get other forms of MD.

Most kids with MD have Duchenne (say: due-shen) MD. Kids with Duchenne MD look and act just like other kids when they're babies. But when they're between 2 and 6 years old, the muscles in their arms,

legs, and pelvis (hips) begin to get weaker. First signs of weakness may be difficulty running, getting up stairs, or up off of the floor. A boy with Duchenne MD will have trouble walking and eventually will stop walking. The boy may also have trouble feeding himself, difficulty breathing, and trouble with his heart, which is a muscle.

Becker MD is very similar to Duchenne, except kids with Becker MD may not have problems until much later, when they're teenagers or adults. It takes a long time for their muscles to become weak.

How Does a Kid Get Muscular Dystrophy?

MD is not contagious (say: con-tay-juss), which means you can't catch it from another person. MD happens because of a problem with a person's genes. Your genes are passed down to you from parents and they contain information about all kinds of stuff. They determine your eye color, hair color, height, and also whether you will have certain medical problems.

What Does MD Feel Like?

When they're young, kids with MD don't look any different from other kids. Later on, they may need wheelchairs or leg braces to get around.

It's hard to imagine what it might feel like if you had trouble getting up from a chair, playing sports, or even walking. The weakness that kids with MD feel in their muscles isn't the same kind of weakness you feel after you run really far and feel like you can't go another step. If you don't have MD, your muscle weakness from exercise will go away after a short time. But for kids with MD, muscle weakness is always there — when they wake up and when they go to sleep. MD can also affect the brain, which can cause learning problems, but most kids with MD can go to school in a regular classroom with other kids.

What Does the Doctor Do?

When kids begin to have muscle problems and weakness, they go to the doctor, who can do tests to see if a kid has MD. The doctor will examine the weak muscles and test the kid's blood. The doctor can sometimes tell just by a blood test if a kid has Becker or Duchenne MD. Or the doctor might take a small piece of the muscle and look at it under a microscope to help tell whether a kid has MD.

Other tests measure the work that nerves are doing in the muscles and can help doctors figure out if something else is causing the muscle weakness.

Helping Kids With MD

Kids with MD can do a few things to help their muscles. Certain exercises help keep their muscles as strong as possible. Also, special braces help keep the tendons flexible. Tendons are like very strong rubber bands that keep your muscles attached to your bones. If the tendons get tight, the muscles can't

work as well, so the braces keep the tendons from tightening up too much.

Kids with MD also do breathing exercises, and some sing or play instruments too. This helps fill their lungs with air and helps prevent them from getting pneumonia (say: new-mo-nyuh), an infection of the lungs.

Some kids with MD take medications to keep their muscles stronger. For some kids, medications called steroids (say: ster-oyds) may slow down the weakening of the muscles. A side effect of steroids is that they can cause a kid to gain weight.

Many scientists are working on ways to help people with MD. In fact, that Labor Day telethon raises money for research. Some scientists are trying to fix the genes so they will make the right proteins. Other scientists are trying to make chemicals that will act like these proteins. They hope that this will help the muscles work better in people with MD.

Living With MD

Kids with MD may use crutches, walkers, and leg braces to help them walk. They might even use wheelchairs when their muscles get weaker. Some kids have specially trained dogs to open doors for them and carry stuff, like books or toys. But kids with MD like to do the same things as other kids. They like to be outside, play games, and watch TV. Kids who have MD can even go to special summer camps.

Although they need some special attention, kids who have MD want to be treated just like other kids. If you know someone with MD, offer help when the person needs it, but don't make a big deal about the MD. Be a friend and make the most of all the activities you can enjoy together.

Reviewed by: Alisa Clark, MSN, RNDate reviewed: July 2010

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/bone/muscular_dystrophy.html

Stuttering

"My talking is bumpy."

"The words get stuck."

"My tongue stumbles."

"My brain goes faster than my mouth."

These are some of the things that kids say when they describe how it feels to stutter. In other words, they know what they want to say, but the words just don't come out smoothly.

Kids who stutter will repeat a word or a sound or drag out part of a word. Some kids may have problems with certain sounds. For instance, "Ss" and "Zs" are tough for a kid who has a lisp.

Someone who lisps says the "th" sound when they mean to use an "s" or "z" sound. Other kids have trouble only with words that have "Rs" in them.

But whatever the speech problem, help is available.

What Are Stuttering and Speech Problems?

As human beings, we have the special ability to share our thoughts by talking. We start by forming a thought in ourbrains. In the brain, this thought is changed into a code we've learned called language. Once the thought is coded into language, the brain sends a message to the muscles that control speech, telling them to move and make the right sounds come out. Then the mouth, face, neck, tongue, and throat muscles move to form words.

Sometimes this process doesn't work perfectly, though. There might be an interruption or break in the flow of speech. This interruption is called a dysfluency (say: dis-floo-en-see).

Now and then, everyone has trouble getting words out. It's normal to stumble over a word or two every once in a while. Dysfluency becomes a speech problem, though, when it gets in the way of everyday talking and is noticeable to other people. A person may have a tough time getting thoughts out. It also can cause a lot of embarrassment or frustration.

Why Do Kids Have Speech Problems?

Doctors and scientists aren't completely sure why talking is difficult for some kids. But most believe speech difficulties occur because there's a problem with the way the brain's messages interact with the muscles and body parts needed for speaking.

Many doctors and scientists believe that stuttering may be genetic (say: juh-neh-tik). This means that a characteristic — in this case, dysfluency — is passed on in the genes (say: jeenz). Kids who stutter are three times more likely to have a close family member who also stutters. So, if you stutter, you may have a grandmother, parent, or brother or sister who stutters or once did.

How Are Speech Problems Diagnosed?

Your regular doctor might refer you to a speech and language therapist or you might go to one directly. Sometimes, the therapist, also called a speech and language pathologist (say: pah-thah-luh-jist), will come right to your school to meet with you. The therapist may ask you to read out loud, pronounce some words, or do some talking.

You might also have a hearing test with an audiologist (say: aw-dee-ah-luh-jist), a specialist who diagnoses hearing problems. Why would you need to take a hearing test? Because if you can't hear very well, you may have trouble hearing yourself and pronouncing words properly.

How Are Stuttering or Other Speech Problems Treated?

After you've seen the speech and language therapist, he or she will go over the results of the tests with you and one or both of your parents. The tests may show that you need speech therapy — which are sessions when you can work on your speech and practice your skills. Your therapy session could be just you and the therapist or you might have a session with a group of kids.

In addition to speech therapy sessions, it's important for you to spend time practicing your skills on your own. The therapist can give you exercises that you can do at home. Practicing will improve your skills and help with your everyday talking. You'll discover easier or different ways of producing sounds so you can speak more clearly.

At first, these skills may seem strange or even feel a little weird. But give it some time. Soon, if you work at it, you'll notice improvement and start to feel more confident in your speaking. You won't be perfect at it, but that's OK. No one talks perfectly 100% of the time.

Living With a Speech Problem

It can be embarrassing to have a speech problem and it may make you feel sad or shy. You might even decide it would be easier if you just didn't talk too much.

But as with other kinds of problems, ignoring speech difficulties won't make them go away. Instead of hiding a lisp or stutter, be open about the way you talk and the steps you're taking to improve your speech. Explain the situation to friends and teachers.

Unfortunately, living with a speech problem may also mean learning how to deal with teasing. It really

hurts when someone makes fun of you for something you can't completely control, like the way you talk.

Turn to your parents, friends, and teachers for support. If someone makes fun of you, simply say you have a speech problem and you're working on correcting it. If the teasing persists, ask an adult for help in resolving the problem.

If you don't have a speech problem, but you know someone who does, try to be a friend. Be patient while your friend finishes a thought, and don't be afraid to say (politely) that you didn't understand what he or she said and could they please say it again.

If you yourself have a speech problem, be patient with yourself. Most kids with speech problems will get better at talking, especially if you practice, practice, practice.

Reviewed by: Amy Nelson, MA, CCC-SLPDate reviewed: October 2010

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/feeling/emotion/stuttering.html

Spina Bifida

Andrea is 12 years old and in the 6th grade. She likes to go swimming, play with her dog, and have friends over. She's been in three dance recitals, and she even received a standing ovation once. She's traveled to Canada and many places in the United States, and next summer she hopes to go to Scotland. When she's older, Andrea wants to be a chef.

Like you, Andrea is interested in many things and can do a lot of stuff. What might be different from you, though, is the fact that Andrea can't walk. Andrea has spina bifida (say: spy-nuh bih-fuh-duh) and uses a wheelchair to get around.

What Is Spina Bifida?

Someone born with spina bifida has an opening in the spine. A healthy spine is closed to protect the spinal cord, a bundle of nerves that sends messages back and forth between your brain and the rest of your body. The messages tell your muscles to move so you can kick a soccer ball or pick up a pencil. The messages also tell you about sensations on your skin, so you know to pull your hand away from a hot pot.

When a baby is growing inside its mother, the spine and spinal cord are developing. But sometimes part of the spinal cord and spine don't grow the way they should, leaving an opening where the spinal cord may protrude outside the body. When this happens, a baby is born with spina bifida, a term that means "split or open spine."

Because of the opening in the spine, the nerves of the spinal cord may be damaged. A spinal cord that's damaged may not be able to do the important job of getting messages to and from the brain. Usually when your brain says "kick the ball," the nerves of your spinal cord carry that message that tells your leg to kick.

These messages may not be able to get through if a person has spina bifida. The person may not be able to move their muscles the way other people do. This is called paralysis (say: puh-ra-luh-sis), which means a person can't move some muscles or to feel things on some parts of the body.

What Are the Different Types of Spina Bifida?

One kind of spina bifida can go unnoticed. With spina bifida occulta (say: uh-kul-tuh), the opening in the person's back is covered by muscle and skin and the spinal cord is usually normal. There may be some problems with the spine, or there may be no problems at all.

Another type of spina bifida is called meningocele (say: meh-nin-jo-seel). This involves the meninges, the membranes that cover the brain and spinal cord. Meningocele is the name used when just the meninges — no nerves — push through the opening in the vertebrae. The meninges form a fluid-filled sac that is usually covered with skin. The spinal cord is normal and a person with a meningocele usually has no

problems. A person with meningocele will need surgery to prevent any nerve damage later.

When most people talk about spina bifida, though, they mean myelomeningocele (say: my-uh-low-meh-nin-jo-seel), from words meaning "spine" and "swelling." In this type, the baby is born with a sac protruding from the opening in the spine. This sac contains nerves and part of the spinal cord. About 1 in 1,000 babies born in the United States has this type of spina bifida.

Because the spinal cord hasn't developed normally and some nerves may have been damaged, a person with myelomeningocele will have some paralysis, as well as a loss of feeling in their legs.

The amount of paralysis will vary, depending on where the opening is on the back. The lower down the back the opening is, the fewer nerves are affected and the less paralysis there is. This is why some kids with spina bifida can walk and some can't. To help them get around, kids might use crutches, leg braces, or wheelchairs.

Andrea, our dancer, was born with an opening in her lower back, just below her waist. She can move her legs but not her feet and ankles. Her skin has feeling only down to her knees. When Andrea was younger she walked with braces and crutches, but now she uses a wheelchair.

Like many other kids with myelomeningocele, Andrea also has hydrocephalus (say: hi-dro-seh-fuh-lus). This happens when there's too much fluid in the brain. Some people with spina bifida may have learning problems, but most have normal intelligence.

Most kids with spina bifida have some problems with their bowels and bladder. The nerves that send and receive messages from the brain can't do their job, so it's hard for kids to know when they need to go to the bathroom.

Why Do Kids Have Spina Bifida?

No one is really sure why some kids are born with spina bifida, but doctors and scientists have found some possible reasons.

They've learned that folic (say: foh-lik) acid is very important, especially when a baby is growing inside its mother. Folic acid is one of the B vitamins found in foods like broccoli, spinach, egg yolks, and oranges.

If a woman doesn't have enough folic acid in her diet while she's pregnant, she may be more likely to have a baby with spina bifida. Luckily, special vitamins containing folic acid are available for pregnant women.

A woman who has a high fever early in her pregnancy also may be at higher risk of having a baby who has spina bifida. Scientists are also studying the roles that genes, certain chemicals, andmedicines might play

in causing spina bifida.

What Do Doctors Do?

From the moment Andrea was born, doctors have been an important part of her life. When she was just a few hours old, she had her first surgery. Doctors gently pushed her spinal cord back inside her body through the opening on her back, and then closed the opening.

When she was 2 days old, the doctors put in a shunt, a device that drains the extra fluid in the brain. Since then, Andrea has had several operations, mostly to replace her shunt. In addition to surgery to keep her shunt working, a kid with spina bifida might need surgery on the feet, hips, or spine.

Kids like Andrea also need checkups a couple of times a year and may see a team of medical people. This team may include pediatricians, orthopedists, surgeons, physical therapists, and occupational therapists. They want to help the person to be healthy and as independent as possible.

What Is Life Like for Kids With Spina Bifida?

Living with spina bifida isn't exactly the same for each kid who has it. But for most kids, it means taking extra care of their bodies and paying attention if something seems wrong. It can mean taking longer to do things, because braces, crutches, and wheelchairs just aren't as fast as walking and running.

But as Andrea has shown, that doesn't mean she can't do exactly what she wants to do!

Reviewed by: Joseph H. Piatt, MDDate reviewed: October 2011

Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2012 The Nemours Foundation. All rights reserved.

http://kidshealth.org/kid/health_problems/bone/spina_bifida.html