Food Quality, not Quantity, is Key to Health
As an Integrative Nutrition Health Coach, I help clients establish nourishing habits in the kitchen and their broader lifestyle. A key step in this process is adopting a new mindset about food and body. Whether my clients are incorporating new breakfast options, meal prepping for the week, or prioritizing time to exercise, I encourage them to make these choices out of a desire for health and quality rather than a concern for weight and calories. Science shows this mindset shift is key to long-term health because it establishes a positive, sustainable relationship to food and body; one where the focus is on adding in good things to feel nourished and satisfied rather than avoiding the “bad” things.
A New Study: Quality Trumps Quantity
Results from a recent study published in JAMA and reviewed in the New York Times supports this gentler approach to eating. Obese participants were asked to focus on food quality, not calories. They were not given a calorie limit to follow, but instead encouraged to eat whole, nutrient-dense, minimally processed foods, cooked at home as much as possible. Half of the participants were taught how to eat a high-quality diet with healthy carbohydrates while the other half, a high-quality diet with healthy fats. After a year, both groups experienced weight loss.
Take-Home Message
The focus on quality, not quantity, proved to be a successful approach, regardless of whether they ate a greater proportion of healthy fats or carbs. Participants who lost the most weight said shifting focus to quality changed their relationship with food. They no longer ate in the car or in front of the television. This finding suggests a transformation I see with my clients as well.
When we focus on improving the quality of our food, we also upgrade the quality of our eating experience. We become more mindful of not only what we eat but how we eat. Rather than viewing mealtime as an ongoing struggle between temptation and willpower, we begin to appreciate it as an opportunity to slow down, check in with our body, chew our food more thoroughly, and savor the experience. And it’s here — when quality food is enjoyed in an intentional manner – where we experience the greatest satisfaction.
But as we shift our focus to quality, I want to offer one more insight. Weight — whether it’s weight loss or maintenance — should never be our end goal. Instead, I encourage my clients to identify how they want to feel each day: greater energy, well rested, fewer cravings, in control of their choices, or better digestion. And establish simple daily habits, such as prioritizing mealtime, that bring them closer to this feeling. Because it’s chasing this feeling, not our weight loss goals, that motivates daily choices, sustains habits and health, and allows our body to achieve balance, naturally.
Call or write to Sinews for your initial appointment today!
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Learning Disabilities
This is the presentation that Valeria Ávila and Gloria Rios gave in January at King's College in Soto Viñuelas, one of the schools that outsources services with us.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Dyslexia in bilingual children
As adults we understand the benefits that being bilingual means. However, children are not able to see the long term benefits, especially when acquiring a second language becomes a struggle.
It is important to note that most authors indicate that a speaker does not have to be fully competent and fluent in both languages in order to be considered bilingual. However, being bilingual refers to having access and using two or more languages on a daily basis (Baker 2006, Martin 2009).
In order for children to properly acquire a second language the need to communicate is vital. In British schools where the main language of development tends to be a second language for most students, proficient literacy and language skills will be developed.
Even if we are all aware of the benefits a bilingual education gives children, what happens when there is a learning difficulty, such as dyslexia?
It is important to understand that dyslexia is a continuum; this means it will be present through all of the person’s life and will have an impact in more areas than just learning (reading). Scientific research has proven that dyslexia is a neuro- developmental disorder with a biological origin. There is also broad evidence stating how dyslexia has a high genetic component meaning that most people can be born with it. (Frith, 2002, p48). Therefore it is important to note bilingualism should never be an excuse for difficulties in learning.
Dyslexia is a more complex condition than just a difficulty regarding reading and spelling skills. Therefore, early warning signs such as difficulty with language processing, verbal memory and verbal processing speed are also present in children at risk of dyslexia. It is important to note that dyslexia occurs in a range of intellectual abilities.
Even if we are all aware of the benefits a bilingual education gives children, what happens when there is a learning difficulty, such as dyslexia?
In order to address the questions at hand it is important to understand what happens when children develop in a bilingual environment. In Hutchinson et al, 2004 study they concluded early simultaneous bilingualism promotes higher development of sound and phonological awareness, which can transfer across languages. Therefore a poor acquisition of phonological skills, in both languages would be an indicator of poor literacy acquisition. (Loizou and Stuart, 2003).
When it comes to vocabulary, there are two ways in which we interpret words; their meaning and also the sense the word invokes. Vocabulary is a fundamental aspect in learning to read and assessing a child’s language proficiency. In other words vocabulary is not only necessary for writing or using technical words, but a way in which we develop a mental lexicon in order to arrange and share ideas about the world. Within the broad symptoms of dyslexia one of the most common ones is a lower verbal memory and fluency.
In contrast it has been proven bilingual people have more knowledge regarding language. In other words bilinguals do not have to relearn language structure when acquiring a new language as they already know how language works. Therefore bilingual’s have more ability to generalise and apply linguistic understanding across languages. (Durgunoglu et al 1993) That is why most children learn to read and write in one language and can easily transfer knowledge to the second language. Of course factors such as specific characteristics of each language should be taken into consideration. For example Spanish speaking children, who learn how to read and write in English, have more facilities when it comes to transferring their knowledge from English to Spanish.
The reason behind it being that English is considered a more complex and opaque (sound do not always have a one to one letter correspondence) language, whilst Spanish has a simpler structure and is more transparent.
Even when being bilingual seems positive both socially and developmental wise, what impact does it have on dyslexic children?
It is important to clarify bilingualism does not cause dyslexia; studies have shown bilingual children learning to read have similar deficits in both of their languages (Klein & Doctor, 2003). However, the acquisition of a second language in children with dyslexia might have a slower development due to all of the linguistic difficulties related to dyslexia. Therefore it is vital to support children from an early stage.
Hoeft et al., 2007 in their neurological studies have proven “early bilingual exposure might have a positive impact on the developmental plasticity of certain regions of the brain in people with dyslexia”. Most importantly it has been proven that children with dyslexia benefit from early intervention. Intervention can be done in any of the child’s languages; however, if available treatment in the most frequent language of reading is available, it is best for support to be given in the most used language when it comes to reading. Strategies given to the student can be used through both languages.
When it comes to identifying dyslexia the biggest difficulty for both parents and school staff is to clearly identify children’s difficulties, which might be masked or mistaken by a lack of knowledge in English or a second language. Therefore when difficulties in different areas such as: articulation, language acquisition, phonics or pre literacy skills are present across or in any of the child’s languages, it is important to seek for a professional’s opinion.
Dyslexia can also have an impact in other areas such as memory, processing speed, organization, visual processing, auditory processing or attention. During daily life time activities a child might be described as “forget full with toys, school equipment, books…etc” other children might have a harder time when following schedules or directions. Other times children who seem to struggle when having to narrate or explain their daily activities should be monitored.
Do you think your child might have dyslexia or other learning difficulties, what to do next? Firstly it is important to ask for both the teachers and a professional’s feedback. In Spain it is common for a Speech and Language Pathologist to be more aware of learning difficulties in children. The ideal situation would be for both professionals together with parents to gather up information in order to determine if an evaluation is necessary or if a support plan should start to take place. With bilingual children an evaluation in only one the child’s languages is not enough. Most of the time it is necessary for reading and writing evaluations to take place in both the child’s languages, this gives professionals a clear idea of the areas of strength and weakness regarding the student. A complete evaluation in order to conclude a student has dyslexia or a learning difficulty does require from several professionals. The most common one being a: psychologist and a speech and language pathologist. Other times professionals such as optometrist, audiologists or even an occupational therapist’s input might be necessary in order to conclude where a students difficulties lie. After an evaluation specific working accommodations and strategies should be given in order to better support and help children access the curriculum. Coordination between school and the different professionals working with a child is vital in order to better support students. If you suspect or feel your child is not performing as expected in school please do not hesitate to contact our learning support department.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Get to Know Child Psychologist and School Counsellor Itxaso Cembrero
Interview with Itxaso Cembrero on her daily activities at Kings as a school counsellor
What does a typical day look like for you?
Although every day at Kings College is different, my day starts at 8:00 answering emails, meeting with parents and school staff. Later on I start seeing the children that have an assigned time for their sessions as they require behavioural, emotional, or social support. When I’m not in session with children, I use the time to carry out psychoeducational evaluations, observe and update the school’s programme, iSAMS.
What are the primary concerns that you address at school?
Emotional concerns: fears/ worries, loneliness, difficulties adapting to a new environment, self-esteem issues, stress management, anger management and separation anxiety and anxiety in general.
Behavioural concerns: organization difficulties, tantrums, attention seeking behaviours, potty training, attention difficulties, and defiant behaviour amongst others.
Social concerns: friendship issues, social skills, and inadequate interactions.
What types of diagnoses do you make?
When doing psychoeducational evaluations alongside with the speech and language therapists we diagnose a variety of learning difficulties, the most common being: dyslexia and dysgraphia. When there is a concern regarding the children’s executive functioning, specific attention tests are also administered in order to rule in or out an attention deficit hyperactivity disorder. I also take into consideration and evaluate if a possible emotional or social difficulty may better account for the child’s difficulties. If the concern is more related to a developmental issue, the children are referred to an external team that have specific tests that determine the child’s developmental stage.
Do you treat children with anxiety or emotional problems as well?
I am a clinical psychologist and at school I do work with children who go through emotional difficulties and/or anxiety. However it is important to mention that when these symptoms appear in an intense and frequent manner, we encourage the family to see a therapist outside of school. When the family gives their consent for school to be in contact with the external professional, we all work towards the same goals and the child’s improvement is significant. Even if the child is seeing an external professional, I am always available may the child need support inside school.
What is your communication with teachers like?
I have a very close relationship with all the teachers and as a result we communicate on a daily basis. We have weekly meetings to monitor the children’s progress and together decide what the best next steps are. When the child is receiving external support, the teacher and I have frequent meetings with them so that we are all working on the same goals.
What is your communication with parents like?
Before I start working with a student, I always get in contact with his/her parents so they can give me their valuable feedback regarding their child. After this, they are free to communicate via email or in person for any doubts or comments they wish to make. Depending on each child, I try to have a weekly, monthly or trimester meetings so that progress can be assessed.
How do you incorporate their observations into your work with students?
As parents they have a vast knowledge about their children, so their observations are vital for my work with them. It is important for me to know any change in behaviour or mood so that I can give the child and parents adequate strategies.
Do you refer students to outside services?
Yes. When I observe that the difficulties the child has, are more related to physical causes, I refer them to occupational therapists, behavioural optometrists, neurologists etc. On the other hand, as mentioned before, when the behaviours the child is showing are of a high intensity and frequency I usually refer them to an external psychologist. This allows one hour sessions to be provided once or twice a week with the children and family if needed.
Are you an active figure inside classrooms?
Once the difficulties have been detected or the concerns have been made explicit, I observe children in the classroom so I can provide specific strategies from which the child benefits from. I also participate in learning walks that allow me to see if the accommodations that have been implemented are useful or if they need to be modified. Furthermore, in some occasions I have worked with children inside the classroom to help them become more functional (socially, emotionally and academically).
What is your role within the school staff?
My role is to make sure children are as happy as possible within the school environment. As teachers spend the most time with children on a regular basis, I try to guide them and help them with all the difficulties that may arise inside and outside the classroom. With the collaboration of the speech and language therapist we make sure the teachers are aware and understand the difficulties each child has so that with their expertise they can best support the student.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Tips to Survive a Stay Abroad
In my opinion, having done it twice, living some time in a foreign country is one of the most enriching experiences one can have, even when this experience is not as simple as we thought and is not free of difficulties.
When we pack our bags we tend to fill them with illusion and we concentrate on all the positive things that this new adventure will bring us. Learning a new language, new friends, all the places we are going to visit, the trips we are going to take… but rarely do we think of all the obstacles that we may find on the way to achieving our goals.
Upon arriving to that new place, we are wishing to explore the city, the people and their peculiarities, the gastronomy, the parties… everything about the new and exciting destination. In this time, we typically experience what is called the Honeymoon Phase : a phase when everything seems marvelous and we feel euphoria, enthusiasm, curiosity and fascination for the new country in which we find ourselves and for its culture. We should not forget that not everyone goes through this phase and that there are people who, from the beginning, may suffer difficulties which we will detail next.
After some time, after the Honeymoon Phase has passed, we may start to really miss many of the things we have left behind in our country of origin. We may feel that all which initially was attractive and marvelous about our new place is starting to interest us much less. Perhaps we even start to perceive some of the things we previously liked from this new culture in a negative way once we start to really appreciate the differences between our home culture and the one in which we find ourselves currently. This is called “culture shock” and it is a totally normal phase during the process of adaptation.
Some of the things that can occur during this phase are, for example, that we feel tired and irritated for being obligated to speak in a new language, that we get frustrated when we are unable to understand what is happening or what is being said to us in a situation or even that we have to adapt to the formalities of a new culture. We start to magnify the negatives of the new place where we live, to feel a bit down and even without interest in continuing the experience.
Overcoming these difficulties is at times complicated but, believe me, it is worth it to try! Living in a new country not only makes you discover a new place, a new culture and new people- it also will help you discover yourself. It will make you more flexible, independent and resolved. Since it is worth trying, here are some tips that can help you overcome some of the difficulties you may have to face during your adventure:
Identify the objectives of your new experience.
For many this will be to learn a new language, be able to travel and live for a year in a new place far from home, get to know people from other cultures, etc. Look for your reasons for being there and always keep them present. The way might not always be easy but if we have a reason for staying, it will be easier to feel as if facing difficulties is worth it.
Routine is difficult to maintain when we start from scratch in a new place but it helps.
Try to adapt your schedules to that of the city where you are, maintain regular sleeping and eating patterns as much as you can and remember to include some exercise in your daily routine.
Hobbies are important.
Don’t forget about the things you enjoyed at home. If you like to read, dance, cook, play an instrument or paint, look for a space in your schedule for that. If you didn’t have any hobby at home or it is impossible to keep up (for example you love to surf but you live in Madrid), you can surely find thousands of options to experiment in your new destination.
Strengthen your social relationships.
Making friends isn’t always as easy as we think and even less so when we want to meet locals. Try to meet new people with whom you share interests, looking for friends at your workplace or school. If it is difficult to find them there, don’t forget that there are many places to meet new people. Language exchanges are usually a good place to meet locals and other foreigners and there are many group activities to find people to speak with. Get help from your hobbies and look for activities related to them to find friends with similar interests.
Make sure not to isolate yourself and keep up with the connections you make throughout your trip.
Say yes to all the plans that you can, even if the film you are invited to or the art expo that your friends are thinking about visiting isn’t the most exciting plan for you, it could be worth it just to spend that time with friends.
Keep in touch with the loved ones you left at home.
Speaking with our close friends and our family can help us feel the support and warmth of home and can help relieve symptoms of homesickness.
Don’t be afraid to ask for help.
If the adaptation is feeling quite difficult, if you feel sad or anxious, there are many places you can turn to for help. Speak with your classmates or workmates, share what is happening to you and remember that you always have professionals to count on. At Sinews we are waiting with open arms to help you overcome all of the difficulties you may find during your adventure.
Division of Psychology, Psychotherapy and Coaching
Psychologist
Adults
Languages: English and Spanish
Everyday Dal + A Two-Minute Reset
There’s something about starting a new year – even though, technically, I know nothing has changed between the 31st and the 1st – that makes me feel lighter, refreshed, and inspired. It may be due, in part, to the rituals we collectively partake in as a society to ring in the New Year; fireworks, parties, special meals. But I believe a larger piece of the puzzle is the simple act of pausing and taking time off that allows the space for our energy, mood, and perspectives to reset.
But we don’t need to wait for January for a fresh start. We can create this space any day, any month. And I want to capitalize on the momentum of the new year to share a two-minute strategy I use to reset and get clear on my intentions, whether they’re for the New Year or just the day ahead. And it starts with a question for you:
Do you ever pause during the day to check in with yourself?
And by pause, I mean, stop what you’re doing, close your eyes, get still and check in with your body. Sounds crazy, right? But it’s a legit question. Because no matter how much we resist carving out time to slow down and quiet our mind during the day, the truth is, this simple act is the catalyst to make changes in our habits, behaviors and routines.
Most of our day is on auto-pilot. We spend so much time in our head — thinking, worrying, analyzing, judging — that we’re out of touch with our body, unaware that we’re running through the motions and disconnected from how food and our thoughts make us feel.
So whether your intention this year is to eat more mindfully, be more present with your family, or be less reactive at work, building in an introspective pause to check in (and practicing it daily!) is key to truly living in our bodies and breaking the cycle of automaticity.
Whether it’s through yoga, meditation, deep breathing, or the strategy I’m sharing below, research shows these activities can lower heart rate, reduce cortisol levels, blood pressure, inflammation, and anxiety, strengthen immunity, and more. This is the mind-body connection at work!
Two-Minute Reset for Calm, Clarity & Focus
This is a two-minute exercise that can be done anytime, anywhere to reconnect with your body and create calm, quiet space in your mind. Ideally, you’re able to close your eyes. If you’re driving, you’ll obviously want to keep them open. Practice this daily and notice the difference it makes in how you feel. In the first week you might want to schedule a reminder on your phone or calendar. But after a while, your body (and mind!) will start to crave this moment of peace and calm in your day, and intuitively know when you need to check in. If you’d like extra guidance during the reset, this 6 minute meditation is a great companion to get you out of your head and into your body.
Take a moment and settle into your chair. Place one hand on your belly, one hand on your heart. Close your eyes and take two minutes to breath slowly, deeply. Focus your attention on relaxing the muscles in your forehead, then around your eyes, then in your neck and shoulders, allowing your attention to gradually move from your head down through your body. Let your thoughts come and go and maintain attention on your breath and relaxing the muscles in your body.
And in terms of food, this Everyday Dal is the ultimate reset, whatever your need. It’s been one of my go-to recipes for years now, whether I need something easy to make from pantry ingredients or a quick, warm and nourishing meal. I also turn to this dal for a make-ahead breakfast during the winter. Yep, breakfast soup is a regular in my house. With all six tastes and good protein and fat (much easier to achieve with savory breakfasts), this dal is grounding, fights cravings and inflammation, and stabilizes blood sugar to keep me going until lunch. Plus, it’s just delicious to eat and gets my day started on a happy note.
Here’s to wishing you all a nourished and grounded 2018!
Everyday Dal
Serves 6
Notes: Relying primarily on pantry and freezer staples such as spices, lentils, beans and frozen peas and spinach, this is my top go-to, quick and hearty meal that’s also one of the most nourishing. The range of spices in this dal supply antioxidants, support gut health and fight inflammation. Frozen vegetables are frozen just after picking, thereby retaining more nutrients than what some fresh produce shipped a long distance can offer. Recipe calls for fresh carrots and broccoli and frozen peas and spinach. I typically always go for the frozen bunch, because they’re, well, always on hand. But feel free to adapt the fresh additions to what you have at the moment; cauliflower and sweet potato are also nice options.
- 2 Tbsp. ghee (or coconut oil)
- 3 Tbsp. minced ginger, divided (3 in. or 7.6 cm piece of ginger)
- 2 cloves garlic, minced
- 2 Tbsp. curry powder
- 1 tsp. chipotle chilli powder (or half smoked paprika & half regular chilli powder)
- 1 tsp. ground cumin
- 1.5 tsp. ground turmeric
- 2 Tbsp. tomato paste
- 2 cups (400 gr.) red lentils, rinsed and drained
- 6 cups (1.4 L) water
- 2 tsp. salt
- 1-15 oz. can of chickpeas, drained (optional)
- 1-15 oz./400 ml can of coconut milk
- 2 medium carrots, sliced in half-moon shapes
- 1 small head (~280 gr) broccoli, cut into florets
- 1 cup (130 gr) frozen peas
- 1 scant cup (110 gr.) frozen spinach
- Juice from 1/2 lemon
- Toppings: Fresh cilantro, toasted cashews
- Heat ghee in a large Dutch oven or heavy-bottomed soup pot over medium to medium-high heat. Add HALF the ginger, all the garlic and spices (curry powder, chilli powder, cumin and turmeric). Stir to combine with ghee and cook 1-2 minutes, or until spices are fragrant.
- Stir in tomato paste, then lentils. Add water and salt and cover. Raise heat to high, bring to a boil, then reduce to simmer for 10 minutes.
- Add chickpeas if using, coconut milk, and carrots. Simmer another 5 minutes, covered, then add broccoli, peas and spinach. Cook 5-10 more minutes, covered until carrots are just tender.
- Stir in the juice of 1/2 lemon and the second half of minced ginger. Taste, adjust for salt and acid. Ladle dal into individual bowls and finish with toppings of choice.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
I WOULD LIKE TO HELP MY CHILDREN WITH THEIR HOMEWORK BUT… HOW?
Some children develop their own strategies when studying or working on a project. Some others don't because no one has told them how to do it. Study techniques and work habits can be taught and learnt and some parents are eager to help their children but they don't know how.
First of all, try to be patient. Helping your own children with homework can be challenging. Something that can be easy in an adult's eyes might be a whole world for a child.
Secondly, think of the duties you carry out throughout the day. Most of them are habits. Creating habits is essential because when you create a habit, it is easier to remember that you have to do it and, therefore, easier to start with the task. It becomes something almost automatic. For this reason, it would be very helpful if you help your children do it. Something you can do is create a routine with them: pick them up from school, arrive home, have a snack and start doing homework, letting them do something they like after (drawing, playing, helping prepare dinner, etc.).
Ask yourself if your kids have the right environment to carry out their tasks. This is something that many people do not take in consideration but it is an important factor too. So, try to ensure that the room where he or she is doing his or her homework:
- Is appropriately ventilated
- The temperature is between 18 and 22 degrees
- Has a comfortable table and chair befitting their age and size.
- Has enough sunlight
- Remove everything that can be a source of distraction (game consoles, television), leaving only the necessary material.
Bear in mind that is very important that study always at the same place and at the same time, so try to reserve a place in the house for your kids.
And now… what?
- Always remember that helping does not mean doing everything for the other person, rather, being a guide but giving autonomy at the same time. Give them always the chance to try first what needs to be done by themselves.
- When it is time to start doing homework, you can ask them to check the agenda (at first you can do it with them) and plan the rest of the day. If your kids do not know where to start or if they get easily overwhelmed, help them make a schedule or daily / weekly plan. You can divide every task in small steps to make it appear as less work. This allows them to focus on each activity at a time.
- Encourage your child to take breaks periodically. The attention span is limited. Your kids will not learn more just because they spend more time seated on a chair for hours at a time.
- If there is something they do not know how to solve, do not give away the answers for the exercises. You will not do your kids any favors. If they just get the right answer, they will not pay attention in class when the teacher corrects it and they will not learn the process. A better way is explaining how to proceed and then leaving them alone, so they can try to solve it by themselves.
- Make a checklist together, including what your kids need to take to school the following day (books, projects, …) and hang it on a visible place in the room. Ask them to revise everything they might need for the next day with the checklist before going to bed, put it in their backpack and tick off each of the elements on the list once is done.
- It is essential to give them positive reinforcement for every step they take- even for the small ones. Think of how you feel when, for example, your boss tells you the great job you have done. This positive reinforcement might consist of positive words that acknowledge the effort they have dedicated to the task, or that can express appreciation for the completed work. You can also use physical contact to reward them.
And what should you try to avoid?
- Try not to put too much emphasis on the grades. It is the effort which needs to be rewarded. Sometimes the result is not as good as parents expect but this does not mean that your kids have not been working hard! There are many factors that can be influencing your kid’s grades.
- If you believe that the school is sending too much homework, talk to the teacher directly. Do not complain about it in front of your kids. Try to cooperate with the school as much as possible. Dialogue is crucial for understanding every point of view.
- It is also important not to overload your kids with too many activities. Sometimes they have whole afternoons full of extracurricular activities in addition to homework. Try to adapt them to their taste. And of course, your kids should not lose sleep hours because of these duties.
- Do not make homework the center of your family life. Remember they are children, they also need to play, spend fun time with you and relax, too. All of that will also contribute to a healthy development.
If you have already tried to help your kids at home and you feel that it is not working or that your intervention is having a negative influence on your family relationships, do not despair. This situation can be overwhelming for every parent…
Have you ever thought about the idea of hiring a professional equipped to do this job for you?
Sinews offers a wide range of possibilities that might be suitable for your case:
- A learning disabilities specialist who offers academic support in the classroom, so the student will be accompanied during class in order to achieve personalized, integrated support that is adapted to the academic curriculum.
- At home learning disabilities specialist: the specialist will help the child overcome learning difficulties in the language used in school.
- Specialized academic support at Sinews: treatment for learning disabilities are also offered in our facilities.
Contact us by email or visit for further information here .
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Is my child swallowing correctly? Can a speech pathologist help?
After a visit to the dentist or the orthodontist many parents are told their child has an infant or atypical deglutition, other doctors notice how their patient’s tongue tends to rest in the inferior teeth. Some doctors may even suggest a child must have treatment with a Speech pathologist before starting the orthodontic treatment in order to avoid further complications or delays with the process.
What is atypical deglutition?
When children are transitioning from mixed to all permanent teeth, several changes alter their facial bones and muscular structures (stomatognathic system). It is during this stage when a child transitions from an infant swallowing to an adult pattern of swallowing. Due to unknown causes many children do not transition to an adult pattern in swallowing when they replace all of their teeth. This persistency in an infant swallowing pattern is known as atypical deglutition.
Children or adults with atypical deglutition may have a hard time closing both lips. They push the tongue down and forward toward the teeth, the jaw moves backward therefore the body of the tongue moves down and away from the hard palate. Some children even bite their tongue when doing this movement.
A correct swallowing pattern
The correct swallowing pattern occurs when both lips are in contact. The tip of the tongue moves up against the hard palate, followed by the body of the tongue pushing against the medial part of our palate. This sequence creates a correct arch form and dental alignment.
Many adults and teenagers have an atypical deglutition and sometimes only notice it after finishing an orthodontic treatment, when their teeth move back to the starting position. This is due to the constant pressure the tongue makes against the incisive teeth, pushing them open.
Effects of having atypical deglutition
One of the most common effects of a lack of strength in the tongue is being an oral breather. Being an oral breather has a big impact in all aspects of our life, in severe cases it might even lead to sleep apnea (moments of non-oxygenation while sleeping). Improper oxygenation in children can lead to restlessness, lack of focus and even affect the growth and development of the whole orofacial system.
People who have an infant swallowing pattern can also attribute it to a suction habit with no nutritious purposes. It can be common for children or even adults develop a habit of sucking on a blanket, fingers or baby bottles. A persistent suction pattern leads to less strength and an incorrect position of the tongue.
Several people might even have nutritional side effects, such as needing to make more effort eating solids and hard to chew foods, and therefore end up not consuming several food groups.
As an alteration of the facial and chewing muscles is present, when having an atypical deglutition, most children might experience articulation difficulties. This does not mean that every child who suffers from articulation problems has atypical deglutition or vice versa.
Symptoms
If you suspect that your son/ daughter or even yourself might have atypical deglutition these are some of the symptoms to look out for:
- When swallowing the tongue is placed between the teeth. An open bite tends to develop.
- Having difficulties chewing solids, or swallowing a big amount of liquids. Most oral breathers even state they experience difficulties when chewing and breathing at the same time.
- A child with a breathing pattern will keep his mouth open when watching television, playing, reading or during daily activities. The tongue will be placed on the lower area of the mouth and rest in the inferior incisive teeth.
- As the mouth tends to be open some drooling when sleeping or during daily activities might occur. Lips tend to lack the strength to stay closed.
- When swallowing the child might make head movements, weird sounds, sucking of the lower lip, changing head postures etc…
All of these side effects can develop because of the lack of strength in the muscles that build up the tongue and facial expression.
Is there a solution?
Dentists and orthodontists are directly involved in treatment, but a speech pathologist with a specialisation in myotherapy can also help as we intervene in the re-education of breathing, strengthening exercises, and getting rid of inadequate suction patterns.
Treatment is not aggressive and tries to be the least invasive as possible. Keep in mind that to strengthen a muscle a specific exercising routine must be followed. The tongue is no different from the muscles in your legs or arms, and to build up strength a daily effort must be made. A weekly session with the speech pathologist will be held to help you learn the exercises and as progress is made monthly visits will be required.
If you have any more questions or think you or a relative may have a swallowing difficulty, don’t hesitate to contact us. We will gladly answer any doubts or arrange for an appointment with one of our specialists.
References
Vanz, Rúbia Vezaro, Rigo, Lilian, Vanz, Angela Vezaro, Estacia, Anamaria, & Nojima, Lincoln Issamu. (2012). Interrelation between orthodontics and phonoaudiology in the clinical decision-making of individuals with mouth breathing. Dental Press Journal of Orthodontics, 17(3), 1-7. https://dx.doi.org/10.1590/S2176-94512012000300010
Machado Júnior, Almiro José, & Crespo, Agrício Nubiato. (2012). Avaliação cefalométrica de via aérea e do osso hioide em crianças com deglutição normal e atípica: estudo de correlações. Sao Paulo Medical Journal, 130(4), 236-241. https://dx.doi.org/10.1590/S1516-31802012000400006
Jiménez Jiménez, J. (2017). Importancia de la deglución atípica en las maloclusiones. OdontologíA Sanmarquina, 19(2), 41-44. doi:https://dx.doi.org/10.15381/os.v19i2.12917
Sinews MTI
Psychology, Psychiatry and Speech Therapy
¿Es normal que mi hijo bilingüe se atasque al hablar?
Question
Nuestra logopedia Valeria Ávila contesta a una de las preguntas más frecuentes que recibimos: Mi hijo es bilingüe, somos españoles y vivimos en Holanda. Tiene 3 años y 2 meses y a veces se atasca al hablar. Me gustaría saber si es normal. Gracias.
Answer
Los niños al estar expuesto a dos lenguas a la vez pueden tener un desarrollo más tardío en el lenguaje en comparación con sus iguales monolingües. En los niños bilingües se suele considerar normal que exista un retraso aproximado de 4 a 6 meses en el lenguaje. Si se nota que el niño no logra expresar sus necesidades en ninguno de los dos idiomas, es necesario acudir a un logopeda para obtener una valoración más exhausta.
Muchas veces cuando los niños intentan comunicarse pueden tener unos pequeños “atascos”. Lo más importante como padres es mantener la calma y dar tiempo al niño para que intente terminar de comunicar su mensaje. Si notamos que transcurridos unos segundos el niño no es capaz de elaborar el mensaje podemos recapitular lo que el niño nos dice y ayudarle a terminar su mensaje.
Aun así si lo “atascos” van acompañados de movimiento motores, como suelen ser movimientos oculares o de cabeza, prolongaciones o repeticiones constantes de un sonido de la palabra, lo más aconsejable es acudir a un especialista en este caso un Logopeda colegiado para explorar en profundidad el caso y poder dar pautas especificas a los padres.
En caso de tener más preguntas, no duden en contactar con Sinews.
Atentamente, Valeria Ávila Logopeda/ Speech and language therapist
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Have you ever asked yourself how you learn?
Even though we spend a substantial portion of our life studying or working, most of us have not been taught how to do so in the most effective way. Learning should not imply just reading a text several times and then repeating it. Learning implies three basic actions: exposure to material, revision and practice.
There are many cognitive processes involved in learning (short and long-term memory, attention span, executive functions, perception, language, etc.).
The best way to learn is getting to know all these processes, their limits and some strategies to make them work in the best and most effective possible way. This is called metacognition.
What can you do to improve your study skills?
Let’s start with our environment:
- It is fundamental to choose our own space to study, with a comfortable table and chair. A space with no distractions (videogames, TV, etc.). Appropriate ventilation and temperature (between 18º y 22º) are also deemed necessary. Bear in mind the importance of the amount of light; if possible, take advantage of the indirect sunlight. If you are right-handed, the light has to come from the left and if you are left-handed from the right. Avoid fluorescent tubes! They will tire your eyes.
- It is also important to always study in the same place at the same time.Every time we are in a new place, we tend to explore it, so we get distracted. For this reason, we have to consider studying in the same place. Try to find the best time for you to study throughout the day. Some people can concentrate more during the mornings and others in the afternoon.
- In order to avoid feeling overwhelmed, take only the material strictly necessary for the subject or project you are working on at the moment. When you are done, put it in its place and take the material for the next subject.
- Duerme tantas horas como necesites y come de la forma más saludable posible. Tu cerebro necesita descansar y alimentarse adecuadamente. Si no das a tu cuerpo lo que necesita, no serás capaz de recordar información, prestar atención o planificar los pasos necesarios para llevar a cabo una tarea.
- Sleep as many hours as you need and eat as healthily as possible.Your brain needs to rest and to be fed properly as well. If you don’t give to your body what is necessary, you will not be able to recall information, pay attention or plan the steps you need to follow to accomplish a task.
- Setting goals is also essential.They need to be clear, concrete, short-term and realistic. Write them down, so you don´t forget about them. They will remind you of the track you should follow when you get lost. Reward yourself for your achievements! Go to the cinema, get your favorite snack, buy chocolates, … as soon as you accomplish each of your goals.
- Expose yourself to the contents in an active way: do not limit yourself to only reading what you have to study several times. You will probably forget about it the following day. Your brain needs to work and process the information in different ways. Ask yourself what you know about the content you are about to read; write down doubts and look for the answer; search for additional information in different formats (books, videos, notes); create mindmaps, etc. Remember it is not a matter of just memorizing words or formulas just for the exams, it is a matter of internalizing what you really need to know.
Look at the following learning pyramid. Did you know that we retain only the 10% of the material we read? Or that, by teaching others, our brain is able to retain the 90%?
Do you want to know more?
When studying or working, one of the biggest obstacles we usually find in our way is time management. Most of the time, we have too many things to do and too little time. It is very common to procrastinate, not know where to start with or just waste our time.
Adequate planning will help you:
- Control your daily performance and efficiency, so you will be able to adjust your work to your academic/work demands.
- Create a study habit, so it will not be so hard starting with our tasks. It will increase our concentration too.
- Use your time: if you plan what you need to do properly, you will see that you will have time, not only for the obligations, but also to enjoy free time.
Do not forget that a proper planning must be, foremost, operative. This means, that it must be useful to achieve the concrete and realistic goals you set. Sharing your objectives with your friends or relatives will help you with your commitment.
If you feel that time management is one of your handicaps, have a look at the following tips:
- Make a daily or weekly to-do list. Instead of thinking about everything you need to do, write it down. This can help prevent you from forgetting something important.
- Prioritize.Assign a priority to the things you have on your list and try to follow the order from the most important /urgent one to the least.
- Make your own schedule.There are things that need to be done during a concrete time slot. A schedule will also help you visualize the real time you have during the day to do what you plan. This will include free time, so you will also see the benefits of doing what you are supposed to do at the right time. If you need to study for several subjects, take in consideration that it is better to start with a medium difficulty subject, then a high difficulty subject and finish with an easy one. Take breaks every 45-50 minutes and get some water, talk to someone or listen to music for 10-15 minutes.
- Do not try to multitask.When we feel overwhelmed by all the things that we need to sort out sometimes we try to do everything we want all at once but this will lead us to not finish anything.
- Keep a clean and tidy environment around you.Trying to find something is a typical and unnecessary way of wasting your time. You can avoid it just by keeping everything in the right place.
- Do not procrastinate:the main reasons why we delay the moment to start doing something are because of fear of failure or because we don´t know where to start.How can we try to avoid this situation?
- Identify the difficult task you are avoiding. Divide it into small parts. Write these small parts and place the list somewhere where you can see it. Cross out the steps you are have completed.
- If you have five minutes to carry out a task, then choose a task that is going to take you that amount of time and force yourself to work during that time.
- Try not to be a perfectionist.Give your best when developing a project but realize that not everything is going to be always perfect.
- Stay focused on your final goal and think about the satisfaction you will feel when you achieve it.
Remember that is also important to evaluate yourself from time to time: ask yourself what you are doing right and what you might be doing wrong and do not be afraid of change if what you are doing is not working.
There is not a unique and infallible method for everyone, so try to find your own. Everyone has different needs and different skills!
If, after reading this article, you still feel that you cannot do it by yourself, ask for help. A learning specialist from Sinews can guide you through the, sometimes, difficult path of learning. Through several training sessions you will learn how to organize yourself, memory techniques, or how to summarize.
Sinews MTI
Psychology, Psychiatry and Speech Therapy