From the moment of birth, children are acquiring a series of abilities that will help them in their full development. However, certain kind of abilities are already printed in basic operation of any person. “We are scheduled” to be social animals, that will comunicate with others and as mammals as we are, we will feed on our mothers, thanks to suction. There are alterations that will cause those abilities of feeding and language are modified and need specialized professionals intervention such as speech therapists. But, to get the point that a speech therapist makes an assessment and intervention on these alterations, people that pass more time with children, such as family, must take into account different warning signs that let them consult the difficulties they observe.

Starting with feeding, alterations can ocur from birth, more if chil is premature. Dysphagia or swallowing
difficulty, can ocur in neonatology like a suction/ respiration/swallowing incoordination, causing cardiac
frecuency alterations and changes in blood oxygen saturation at first time or recurrent choking with different kind of food when feeding it’s non only based in milk. Child may have respiratory complications, derived from swallolling difficulties. This is explained because variations in vital signs en blood oxygen saturation implies that food is penetrating and even to be introduced into the respiratory tree, making both the heart and the lungs have extra work. Because of this, speech therapist action should be as early as possible and must be given from admission to the neonatal ICU if necessary. It should be noted that in the case of Galizia there are hardly a couple of speech therapists who work in neonatal ICU. Because of this, a lot of children are not attended en that moment by specialized staff, sending to home, in the best of cases, a device (pulse oximeter) where vital signs will be measured during intake, controlling them until they are normalized. But if they’re not normalized, it will not only affect respiratory level, but the recurrent difficulties, can be related in children with a kind of alterations like food rejection or infant anorexia or food selectivity. Infant anorexia is tipycal associated with organic aspects, for that
they will need muscle stimulation to decrease this rejection. Against, a child with food selectivity will need occupational therapist action who will decide if there is a sensory integration disorder; that is to say, a problem in the brain way integration of external environment stimules in feeding moments or with other activities less directly condition feed.
Alterations in feeeding are more or less easily of delimitation by families because are evidents, en
language case, there are a kind of milestones that families sould identify like warning alerts of atypical language development. It´s not necessary the analysis and comparison between children and not to worry too much about each of the milestones, related with their cronological age, but they must have a reference for the moment has arrived consult to avoid biggest alterations in children language development. Since language is not an isolated capacity that is acquired without interaction between other aspects of general development, milestones related to psychomotor development and personal autonomy and development with the physical and social environment must also be taken into account.
Starting with 0- 12 months period, families should know that at the end of this stage children should have acquired:
– Sit without support.
– Hold objects with both hands.
– Smile towards familiar people.
– Be interested in objects and people around them.
– Emit sounds to attract the attention of others.
– Cry or protest in the absence of close friends.
In the end of 12- 24 months period, we should worry if we observe any of these signs:
– Not walk without help.
– Not point the different parts of body.
– Not approach or show interest in playing with other children.

– Not recognize different parts of home (kitchen, bathroom, bedroom, etc.).
– Not mimic known actions or sounds.
– Not answer to their names.
Ending 24- 36 months period, the following alarm signals will be taken:
– Not ask for pee and poop.
– Not understand simple orders.
– Not identify images and/or objects.
– Remain isolated, not curious about any activity.
– Use to communicate many words without connection between them, as loose elements of a
– Not mimic simple strokes (horizontal and vertical).
We must have in mind that a single milestone is not sufficient to consider that there are alterations in
development, so that we will take as a reference that children present a couple of situations that are specified in the list. It will be a matter of concern that, in addition to the existence of milestones to reach the chronological stage that gets stuck, there are acquired capacities that were expected from the previous stage. It will be at this time when a specialist should be consulted, in this case a colexed speech therapist, who has conducted a thorough assessment and is possible to define those areas to be reinforced. In spite of the fact that a professional is essential for a positive evolution, family and speech therapist must consistently work together consistently to get that the advances and successes in therapy be more significant and less dilated in time.

Cristina Fernández Barros, Logopeda (n° col 15/0099)