Vestibular sense and sense of Balance

The vestibular system is the system that tells you where your body is in relation to the earth. Gravity works on the proprioceptive system and the vestibular system. This is how you understand right side up and upside down. It is also why you get dizzy when you spin around in circles. While the vestibular system reacts to the body as a whole its receptors are not spread throughout the body as with touch and proprioception. They are located in the ears in the semi-circular canals. These canals are filled with fluid which sloshes around in them as the body moves through space. There are many fine hairs located around the canals and these are the vestibular receptors. As the fluid sloshes on them they activate and send messages to the brain that tells you that you are moving. Ear infections and colds can therefore affect both the vestibular sense and the sense of hearing because they are taking place in the organ responsible for both senses.

The Sense of Balance

Balance is not a true sense but rather a combination of information from the vestibular system, the proprioceptive system and the visual system.  The vestibular system is key in this as it tells the body about its position relative to gravity. It lets you know if you are right side up or upside down. This system alerts your body if you start to fall. The proprioceptive system plays a role in that it helps you organize your body so you do not fall and we use visual cues to help orient ourselves to the upright position.  Balance can be maintained without visual cues but they make it easier. Balance in different positions develops after the baby can achieve the position. Once baby is sitting, he is unsteady at first and then develops the balance reactions he needs to remain sitting. The same is true for hands and knees and for standing. The balance reactions are geared towards keeping baby upright. They come into play when your center of gravity is pushed off center. They include tightening of the trunk muscles and extension of the arm and leg on the side opposite the fall in an attempt to pull you back into “balance”. If that fails, protective reactions come into play. This is where you fling out your arms to catch yourself. These responses are automatic and triggered by the sensory input of your vestibular system that you are about to fall.

These last 7 articles are a description of the senses. They have been getting a lot of publicity because there are times when they do not function smoothly. As we stated, almost all human activity has a connection to the sensory motor arc. Therefore, dysfunction in this system can affect many aspects of life.  Some learning disabilities have been connected to problems in this system.  Certain types of social emotional issues are connected to issues with sensory processing. While not part of the definition of Autism, many autistic children respond well to treatment of sensory issues indicating that this may be a component to this disorder. The evidence is building that appropriate sensory processing is an important part of development.  

Proprioception

The word proprioception means responding to one’s self. This is the sense that allows you to understand what your body is doing in relation to itself. If you are told to raise your hand, you understand that your hand is raised even when your eyes are close.  That is proprioception.  Another example of proprioception is the test police use to test for drunk driving where they ask one to close one’s eyes and touch one’s nose. You can do this because of proprioception.

The nerve endings for this sense are located at every joint and in the muscles (muscle spindles) throughout the body.  Proprioception develops in tandem with touch and the receptors are in place in very early fetal development. Infants rely on conscious proprioception a lot as they are learning new skills and learning to control their bodies. This process is teaching their proprioceptive sense to function on its own. 

One reason that proprioception is not thought of as one of the “senses” is because it functions mostly on an unconscious level. We are usually most aware of it when learning a new motor task and then , when learned, don’t think about the proprioceptive input anymore. In fact, if we did, our movements would be labored and choppy. The article cited at the end of this section includes a description of a man who lost his sense of proprioception and the difficulties he faced in trying to do simple motor tasks.

Putting increased weight on the joints increases the sense of proprioception. Stimulating proprioception is both calming and alerting (like chocolate, which both calms and alerts, as few other things do). This is why a hug feels so good. Aside from the social meaning, a hug stimulates the proprioceptive system.  Proprioception has been receiving attention as it seems in recent years as it seems to be critical in the work with and treatment of disordered sensory processing.

Kinesthesia is the sense of the movement of your body. It seems to use the same system as proprioception but may be processed in a different part of the brain. It was the study of kinesthesia that led to the discovery of the sense of proprioception

.http://serendip.brynmawr.edu/exchange/node/1699 

THE SOMATOSENSES Touch

Touch is not really one sense. It is made up of several different senses which have different nerve endings and different response areas in the brain. In other words, they are processed individually though we lump them all together and call them touch.  These include light touch, deep pressure, heat , cold  and pain receptors. What they have in common is that the nerve endings are spread throughout our skin so we can experience sensation from any part of our body. There are some areas that have a higher concentration of nerve endings and are therefore more sensitive than other areas of the body. Some areas of the body may have more of one kind of receptor than others so may be more sensitive to certain types of touch than to others but in general there are touch receptors all over the body in the skin. Some types of receptors are around the internal organs as well. We all know you can have a stomach ache that is not felt from the skin. All of this is complicated by the fact that you may have different touch sensations at different places at the same time. You mind needs to sort all the sensation and let you decide which is the most important for you to get the information that you need.  If you remember, in the introduction to this series, we used the example of the hot iron to illustrate the sensory motor arc. That example uses the sense of touch, specifically, heat, so you can see how fast your brain can select what you need to know.

The sense of touch is one of the earliest to begin to develop, with some receptors in place by 4 weeks gestation, but it seems to take up to 16 to 20 years for the system to be fully operational.  There are at least 4 different  types of receptors and miles of nerve fibers, as well as the cognitive learning needed to distinguish from what one thing feels like as opposed to another. The fact that you can reach into your purse and find the keys without looking is a testament to the development of your sense of touch.

Simple touch is anything but! The simplest sensation is pressure, but as noted, light pressure and deep pressure are registered differently. Next would come vibration, followed by recognition of different textures, sizes, shapes and spatial orientation, which can all be recognized by touch.  Research indicates that awareness of pressure and vibration is present at birth. Size recognition seems to begin early, perhaps 2-4 months but is on a basic level and need refining. There is some recognition of different textures by 4-6 months which continues to be refined over the next 10 years. The recognition of shape difference by touch may begin after 6 months and there are indications that this, too, continues to develop during childhood.

Early tactile exploration is often by mouth, as this is a very sensitive area for touch stimulation. Manual exploration actually begins around 4 months of age and continues to improve through childhood. The ability to recognize objects by touch is pretty much the same from 15 to about 50 years of age but as with other senses, there is a decline during the aging process,  just as touch is one of the first senses to develop it is the last to decline.

Touch is probably the most pervasive sense we have. It is everywhere in our bodies and is difficult to occlude. Just as development impact the sense of touch (learning shapes, textures etc.), there is ample evidence that touch impacts development.  Studies of infants who were deprived of a chance to use their sense of touch, who were not held or whose physical contact was limited to the crib they were lying in, suggest that this caused global delays that were difficult to make up. Of course, the sense of touch, along with the next two we will discuss, underlies all motor abilities

. http://www.scholarpedia.org/article/Development_of_touch   

http://www.livestrong.com/article/508221-the-influence-of-touch-on-child-development/   http://library.thinkquest.org/05aug/00386/touch/sensoryreceptors.htm

Vision

Sight is one of the most complex senses. The eye structure is developed in the first 24 weeks of pregnancy but the eyelids may be fused until 26 weeks and the lenses are cloudy until about 4 months after birth. The rods develop between 28 and 34 weeks and then the development of the cones begins. The rods are light sensors and allow your eyes to adjust to variations in light. They also help with peripheral vision (seeing out of the side of your eye). The cones are what allow us to see colors.  The eyes continue to develop until your child is around 3 years of age.

Vision takes a large area of the brain at the back. This area develops before the baby is born in the absence of stimulation (Usually by 34 weeks).  At birth, your baby can see at close range. The best focus is at about 8 to 10 inches from their eyes (20-25 cm). Babies can see color but early on they can see strong contrast much better. They show a preference for looking at simple geometric patterns in two contrasting colors in the first 2 months. By around 3 months, babies are more interested in faces (both real and in photos or drawings) and pay attention to more variations in color. At around 4 months, the lenses clear and baby can now focus beyond the 8-10 inch range. This is often very noticeable, especially during feeding, because all of a sudden the baby is looking all around and not focused on the task at hand.  He has just discovered a whole new world.

Vision not only involves seeing with the eyes but the ability to move the eyes in coordination. The perception of depth and the use of eye hand coordination rely on the movement of the eyes. In the first two months a baby may appear cross eyed at times but by 5 months the muscles of the eyes should be strong enough that a baby can move the eyes together to smoothly follow a moving object across, up and down and in a circle as well as to guide their hand to reach and hit an object. When babies begin to crawl, these skills develop even further. Babies first learn about depth by looking and reaching for objects that are at different distances. Although there is some concept of depth in the first few months , this learning really takes off in the second quarter (4-6 months). As baby becomes more mobile from 6-12 months, he learns more about depth and can begin to understand it better.    Visual skills continue to develop until 6 or 7 years old.

Babies eyes should be protected. They are very sensitive to light in early infancy and should be shielded as much as possible from harsh strong light in their eyes. It is never too soon to begin to use sunglasses on infants who are out in strong sunlight. If your baby is not moving his eyes smoothly to follow an object or

continues to have crossed eyes after 5 months, you should mention this to your doctor. If there is some problem, it is easier to solve if it is caught earlier and it will help in the continued visual development that takes place.

http://www.aoa.org/patients-and-public/good-vision-throughout-life/childrens-vision/infant-vision-birth-to-24-months-of-age

http://www.perceptionsense.com/2012/11/post-2-visual-cliff-experiment-for.html 

The development of hearing.

Hearing is one of the later senses to develop.  It seems to start at 23 weeks gestation.  The first responses to sound at the brainstem level are around 24 weeks gestation.  The structures for hearing continue to develop between the ages of 24 and 34 weeks gestation. 

It has been noted that babies do hear while still in utero. When babies are born, they seem to recognize their mother’s voice. Dr. Barry Brazelton used to do an exercise with babies that were hours old. He would hold the baby between its mother and another person and ask both to speak at the same time. The baby would invariable turn towards its mother’s voice. He did the experiment with the father as well and the babies overwhelmingly turned towards their father over a stranger. The uterus is a noisy environment however and sound must travel through liquid as well as distractions so the baby probably hears a more distorted sound from outside while hearing the mother’s voice from inside. Babies in utero respond to different types of music according to research indicating that it may be worthwhile to play music to the developing baby. At birth, the hearing system is in place though babies are better able to hear higher frequencies at first, which may also account for their higher receptiveness to a female voice. The ability to recognize the meanings of sounds comes with experience so the system continues to develop after birth as well. There is research that shows that babies are tuned to the sounds of language and music over random noise sounds.  They listen more acutely and for longer to organized sounds than to random sounds according to studies. There is no question that babies learn to speak by what they are hearing. This accounts for the fact that children use the same accents of those around them.

Again, as with other senses, the structures in the ear may be damaged or may just wear out as one becomes older and we find many elderly people needing assistance to hear. 

http://www.edu-cyberpg.com/Literacy/whatresearchwomb.asp

http://birthpsychology.com/free-article/importance-prenatal-sound-and-music

http://www.plu.edu/news/2012/12/infant-language/)

An Article to Read About Learning.

 http://www.ahaparenting.com/parenting-tools/raise-great-kids/intellegent-creative-child/loves-learn

Dr Laura Markham writes at Aha Parenting about positive parenting. Read this article, note the quote at the end and learn about learning.

The Special Senses, part 1- the Chemosenses, gustatory and olfactory, aka taste and smell

Smell may be the least neurologically complex system of the sense as the information from the smell sensors in the nose have a direct link to the processor in the brain. Taste is considered one sense but in fact there are 5 specific receptors (located on the tongue in areas) for salty, sweet, tart, sour and what is being called “meat” flavors. These five flavors are given more variety by the sense of smell which distinguishes variations within these five flavors of foods. Often, in high school biology class, teachers do an experiment where they stop the sense of smell and offer a bite of an apple and of an onion to a student. Without smell the student cannot tell which is which as the texture is similar and both are sweet.  Smell is one of the senses that disappears in the aging process and older people often lose interest in most foods, except sweets, because the food becomes bland to them without smell.  Smell is an important first indicator of some dangers as it can detect more remote sensation than taste. To taste something it must touch the tongue but smells waft through the air to your nose.    

The system for smell develops between 16 and 24 weeks of gestation and is in place and ready to function by about 24 weeks gestation. The first taste buds appear at 8-9 weeks gestation with most being present by about 16 weeks gestation. Some refinement continues but most full term babies have a fully developed taste system at birth.

The system of smell is perhaps the strongest sense in infants and babies are able to recognize the smell of their mother’s breast milk from that of another person (the study was done using breast pads) almost from birth. They also respond to strong smells with avoidant movements from an early age. I would avoid strong perfumes and air fresheners around very young infants as these might be unpleasant to their sensitive system. In a study (titled “Natural odour preferences of newborn infants change over time.” by [My paper]H Varendi, R H Porter, J Winberg) it was shown that babies preferred their mother’s unwashed natural breast over the washed and soapy smelling other breast during the first week to 10 days of life.  It has been proposed that smell is the first sense used in socializing as newborns begin to recognize different people by their smell, which allows them to respond socially to those they know and those they do not know from a very early age.

These systems rely on experience after birth to become completely developed. The brain records tastes and smells so that a child can recognize what they mean. Infants can register likes and dislikes from the start. Due to their limited experience, infants are happy with relatively bland food and do not need salt or sugar added to foods to want them. However, they recognize variations in their food and may reject food that tastes

“funny”. Many breast feeding mothers report that their baby is not interested in the breast after they have eaten a certain type of food. Which foods trigger that response are different for each baby but all are strong flavored foods. In my case, it was pickled foods that I had to avoid. This is learned by the baby through experience with foods and by the mother in watching her baby’s reaction to feeding.

On the other hand, older people who have lost some of their sense of smell are best able to taste the flavors that are tasted by the tongue. Sweet is the strongest, being at the front of the tongue, followed by salt. Older adults will often only express interest in sweet foods and will often over salt foods in order to experience variation in tastes. Many older adults will say that food these days doesn’t taste like it used to. For them, it is probably true.

It is thought that these two systems have some protective functions as most really bad smells and bitter tastes are not good for people so your own body can offer some protection against certain poisons. However the system is not foolproof and some unpleasant tasting things are not harmful while some harmful things are not unpleasant. It has been noted that during pregnancy, many women are exceptionally sensitive to smells, which may be a primitive form of guiding them towards the particular foods they need.

In any case, the sense of smell is one of the least studies and most underrated the special senses. Below are some links to references on the sense of smell:

http://www.wonderbabiesco.org/UserFiles/File/Browne%20chemosensory%2008.pdf

http://www.kidandparent.in/childdevelopment/baby-development-smell

http://www.jstor.org/discover/10.2307/1130478?uid=3738128&uid=2&uid=4&sid=21102562218157

http://serendip.brynmawr.edu/exchange/node/518

Repost, link on language development,

Click this link for an article on language development.
wwwbabble.com/2013/06/05/the-science-of-talking-to-your-baby/.

The sensory system part one, Introduction.

Your child’s sensory motor system is a very important part of his development. In fact, almost all human activity is based in the sensory motor system. Basically, we take in information through our senses and then we react to it, usually with a motor response of some sort.  The system is very complex and there is coordination (it is a pre internet type of web) among all the senses and the motor systems of the body but I will try to keep it simple here. Something happens in the environment and the sense organs pick it up. The “sensation” is transmitted to the brain where it is processed (and coordinated with other information from other senses) interpreted and a response is formulated. This information goes to the motor cortex of the brain where instructions to your body are transmitted and you react. All this takes place in nanoseconds so your response may seem immediate, certainly much faster than it took to read about. Let’s use a hot iron as an example. Your finger touches the iron and the pain and thermal sensors in your finger recognize the sensation. It is sent to the brain which registers “HOT” and dangerous. The information is sent to the motor areas of the brain which determines that your muscles in your arm must activate to move your finger away from the danger. This information is sent to your finger and you pull your finger away from the iron. Most of us have had this experience so you know how fast this system works.

In looking at the sensory part of this system we need to understand what the senses are. Firstly, the system consists of three basic parts, the sensory receptor, the nerve transmitter and the part of the brain that processes the sensation. The receptors are the organs that come in contact with the sensation, the nerve endings throughout the body and especially around the head that receive the sensation.  The nerves are the transport system, much like telephone cables that transmit the sensation to the brain. All of the understanding of what was sensed takes place in the brain. Each sense is processed in its own part of the brain separately, although there are connections so that this information can be coordinated to form a whole picture. This interconnection also helps when there is an impairment in one of the senses, such as blindness, which allows information from other senses to help “cover” for the impaired sense in gaining a better picture of the environment.

Most of us have heard of the five senses. Many of us have heard the term the sixth sense used to refer to unexplained abilities.  Well, the truth is that we have more than 5 senses so that expression is going to have to change to the 10^th sense or something like that.

The first 4 senses are special senses, so called because they have a single sense organ and detect a single type of sensation.  These are sight, hearing, smell and taste.  Each of these has a specific sensory receptor located around the head.  For sight it is the eyes, for hearing it is the ears. Smell and taste are quite related and are often called the chemosenses. 

The remaining senses are called the somatosenses because they affect the body as a whole. These include touch, which is really several senses combined under one name, the proprioceptive sense and the vestibular sense. The first two have sense receptors spread throughout the body while the vestibular sense uses some of the same structures in the ears that are used for hearing.

In the next few articles, I will look at the development of each sense both in terms of the development of the structures and of the sense itself. Most of the sense organs develop in the absence of stimulation but processing continues to develop with experience and, in later years , many of the senses become weaker due to changes in the structures. After looking at each sense in depth I would like to discuss sensory processing and the area of sensory processing dysfunction, which is in the process of becoming a diagnosis as well as being a symptom in several other disorders, including autism.

What Mothers Do, A book review

WHAT MOTHERS DO-Especially when it looks like nothing

By: Naomi Stadlen

Piatkus Books, London, 2004

I first picked up the book, What Mothers Do, because I was intrigued by the title. I remembered a time when I was a stay at home mother to a preschooler and an infant and I attended a party of my husband’s colleagues. Someone came up to me and asked where I worked. I answered “Right now, I work at home and I have never worked harder in my life.” It was true but I could not point to any specific accomplishments. I was mothering and my work was still in progress. The enquirer walked away to talk to someone else and I felt that my work was not valued at this gathering.

This is the type of feeling that Naomi Stadlen is addressing in this book. She has worked with mother’s support groups and has based this book around the comments of the many mothers she has worked with over the years. Her basic point is that while mothering is a complex and, perhaps, the most important job one can do, it does not have the status that other careers get. There is no pay scale and no immediately visible “product”. This makes it easy to wonder what exactly you have been doing.  All mothers have a point where they wonder but it is worse when father or others also question what happens to your time.

The book defines the complex intricacies of holding your baby and helping him or her to grow up to be a happy productive adult from the day he or she is born. The author has a long chapter discussing what “Mother Love” involves. She also touches on the reactions of mothers to significant others in their lives during this time, including baby fathers, mother’s mothers and in-laws. This book is written from the mother’s perspective so does not cover what these others are thinking. 

The author does not comment on mothering choices, such as breast or bottle or stay at home or go to work,  as that is not the point of the book. As she rightly points out, those choices are between you, your baby and your partner in this venture. Whatever choices you make, the concern that you are doing the best you can is always there.

I know that as a parent of a newborn or young child the last thing you think you have time for is to read a book, but if these concerns are bothering you, this book may give you some peace of mind. Each chapter can be read separately and out of order if that works for you. There isn’t a lot of advice in the book but there is a lot of support to help you regain your or confidence after the major life change that becoming a mother brings.

Habits to Help Develop Imagination

http://kindergartenbasics.blogspot.gr/2013/02/how-to-nurture-childs-imagination.html
 This link and photo come from a blog article which gives several easy suggestions for helping children develop their imagination. Creativity is often discouraged, unwittingly, by the routines of the day, the need of adults to answer all questions with facts and the desire for order and neatness in the house. These suggestions are not activities that parents need to set up but habits that can be developed when approaching any task. Note that the article particularly talks about toys and the fact that the more elaborate the toy, the less there is for the child to do with it. Infants and Toddlers haven't yet been caught up in the culture of "needing" the latest toy being promoted by TV or the movies. They can spend hours exploring simple objects and will use them creatively. Some suggestions are in the pages of this blog but the point is that it is not necessary to take the box away and expect the baby to play with the toy. Let them play with the box if they want to. Most of the habits in this article can be started from early infancy and can develop with the child.

Happy Birthday to my daughter and me.

Today is my oldest child's birthday. It is as important to me as it is to her, after all, I was there. I don't know about you, but every year on my children's birthdays, I sort of relive the day they were born. I remember all the details, more or less, and every time I look at the clock, I say to myself, "At this time, (those many years ago) I was at this stage" or "I was doing this". Until and through the moment of their birth. I can't help it, it just happens. I have instituted a custom to look through the particular child's baby, childhood and current photos at some point on their birthday, which also provides me with many happy memories of the years they were growing up. My children are now adults and no longer live at home so I am not there at their birthday party, except in spirit. One cannot have a birthday without having their mother's spirit present, can one? And I still eat a piece of cake in their honor, after all, the day belongs to me as much as to them. So Happy Birthday to my daughter and here is wishing us both many more. Love, Mom

Women's Heart Health Awareness Day

February  1st,  the first Friday in February, is Women’s Heart Health Awareness Day. People are asked to wear something red on that day as a visual reminder to think about heart health, especially for women. There is a mistaken idea that heart disease is a men’s disease.  It is true that men may have more heart attacks than women but women’s heart attacks are more likely to be fatal and, in the end, about equal numbers of men and women die each year of heart disease. 

This may be because heart disease is thought to be a man’s disease and is not the first thought when a woman presents with symptoms. A woman’s symptoms may be different from a man’s as well. The pain may resemble the pain of indigestion more than heart pain. It is a good idea to learn the symptoms, especially if you are in a risk category.

Heart disease in women is on the increase as our lives change. More women are struggling to manage the stressful world of work, while continuing to have the major role in managing the home and children, and now, in many cases, caring for the elderly of the family. In addition to the added stress, these activities take so much time that diet and exercise are often left behind. Today’s fast world does not support heart health so we need to make conscious choices to foster it.

In addition, estrogen may provide some protection and heart disease is more common in post menopausal women. It is not unheard of in younger women but heart attacks do occur in older people more often than in younger ones. However, heart disease does not develop in a day. Heart disease is the result of a lifetime of bad habits. 

So you may say, “I’m only 24, I don’t have to think about that.” And you would be wrong.  In your 20’s and 30’s is the time that you should look at heart healthy habits and begin to build them so you don’t have to think as much about heart disease when you are older , because you will be less likely to have it. Developing heart healthy habits when you are young will have the added benefit of being habits for your children. 

I will refer you to your family doctor or the your local heart association to find out what habits you should lose and what habits you should adopt but take this very seriously. I do because I lost my husband suddenly and unexpectedly to heart disease when he was only 56 years old. It is an experience that I would rather none of you would need to go through.

The R Word and other reasons to watch your mouth

This last week, I saw two posts on facebook using the "R" word (“retard”) in a slangy insulting way. One was a poster which said something like “if you believe this than you are a “R” who should not…” and the other (from a woman who should know better as she works in the field of special education) “am I the only “R” who did not know this”. Well, I was offended at the use, even once and feel compelled to address this issue. I do not object to the use of the word “retard” in its official meaning as in “The use of cold water retards the growth of yeast”. That is one of the word’s meanings. But to use it as short for mentally retarded to insult someone is offensive to the addressee and even more so to a whole class of people that do not warrant the comparison with these users.

"Sticks and Stones may break my bones, but words will never hurt me” is an expression often thrown at verbal bullies to somehow lesson the pain. We all know that it is not true. While sticks and stones may break a bone, which will heal in 6-8 weeks, words cut to the heart and create deep wounds that hurt much more and take much longer to heal, if they ever do.

Sometimes, this use of words is intentional, direct and meant to be hurtful. Many an overweight child can tell you that being called names, such as “fatty” or hearing jokes about their size from bullies or family members (the unkindest cut of all) is a hurt that does not go away even when they have grown up into their weight and especially, when they are continually struggling with their weight. Think of Monica from Friends, who, as a waif-like adult still saw herself as the large teenager she had been and remained  insecure in every relationship she had. 

Other times, there is no specific target, but uncontrollable flaws are made fun of in a general sense. Comedians often exploit speech defects, such as stutters and lisps, in their routines to get a laugh, and people laugh. Can you imagine being someone who stutters, who struggles to communicate and then hears one of these routines.  It hurts. Even if you laugh along, somewhere in your heart, you feel less confident, less human than others. You are less likely to try to speak, because, after all, your speech is a joke. 

In the case above, a word that has a legitimate diagnostic use, is turned into an insult, which indicates that less is thought of the people for whom the word has been designed. The word “spastic” describes a specific neuromotor condition wherein the muscles are do not relax and remain contracted. Movement is difficult without control of the muscles. To take the term, and its variant “spaz”, to describe someone who has done some clumsy thing, such as spilling something ( or even worse, something intentionally clumsy such as bumping you) indicates that it is bad to be spastic, that spastic people do clumsy things on purpose. Being spastic is not intentional and it is insulting to insinuate that it is the same thing.

 Words describing race, gender, sexual orientation and physical or mental challenges have been used with derogatory meanings. Then, we seek new words to replace the old, and the same process happens again. Did you know that the words “idiot” and “imbecile” were designed to describe levels of mental delay, in order to provide appropriate programming. They became so insulting that they had to be abandoned and later replaced with educable and trainable mental retardation.  Now the same has happened to the “R” word. 

People who are mentally challenged are people. They are unique, full people with feelings and understanding.  They go through life with many of the same challenges that everyone has and a few more. They do not need extra pressure from people who do not know them.  They and their families do not need the extra insult that has been given to these words by their careless use. 

Some people suggest that we do not use labels at all to distinguish one person from another. That is unrealistic. First of all, we are not all the same and would always describe our differences. But we need to learn that these differences are not better or worse, just different. Secondly, we need some descriptive information to provide the most appropriate help to people. This includes diagnostic categories which are needed for justifying funding for special programs.  We need these words to be descriptive and not emotionally loaded.

I bring this up because it is well known that children learn how to communicate by what they hear. If you do not respect the value of words, your children will not learn to respect them. If children hear adults saying these things, then they will too. Young children do not understand all the implications of words. That is what they are learning. Adults should understand what they are doing, although, when they casually use offensive words (and we include the “n” word and the “f” word along with the “r” word here), I am fairly sure they are not thinking. Remember that nobody is perfect and there is probably something about you that could be turned into an insult to others. Think about how you would feel. Train yourself to speak respectfully, so your children can learn to speak respectfully, please.

 These two posters have been widely circulated on the internet but they illustrate the point I am trying to make. Thank you to the creators.