1
Q
what three aspects play into the process of development?
A
- biophysical: genetics –> height, weight, anthropometrics
- psychological: behaviors, experiences, activities
- social-cultural: norms and expectations
2
Q
what are the three theories of human motor development?
A
neural-maturational theories, cognitive theories, dynamical system theories
3
Q
what are the key points of the neural-maturational theories?
A
- looks at maturation of CNS
- behaviors and motor skills occur as CNS matures and is response to environment
- introduces idea of different age ranges for development and motor skills occurring in a linear fashion
- explains when developmental reflexes and milestones develop
4
Q
what are the key points of the cognitive theories?
A
- stages of development that link motor behavior to cognitive development
- child develops schemas: process of learning rules to evaluate, correct, and update motor plans
- mind drives change through internal learning processes and scaffolding: caregivers providing environmental challenges to encourage higher level skill
5
Q
what are the key points of the dynamical systems theories?
A
- perception and motivation lead to new skills
– developing CNS, body’s physical properties/affordances for movement, child’s goal/motivation, environment - multiple systems engage dynamically to effect change
– task, environment, individual (*can regress in one when developing) - Neuronal Group Selection Theory (NGST)
6
Q
what is Neuronal Group Selection Theory (NGST)?
A
- primary neuronal (in utero) and secondary (post-utero) repertoires
– environmental experiences activate/strengthen and refine neuronal groups and form connections –> complex brain organization that adapt to environment over time - embodied mind concept: mind is built through physical activities of the body; cannot separate mind, body, environment
7
Q
what are the current constructs of development?
A
- variability and versatility are hallmark of typical development
- plasticity and change can happen at any time
- development shaped by experiences
- efficiencies are gained and lost
- elongation proceeds activation
- progress from asymmetry, symmetry, reciprocation
8
Q
what are the basic characteristics of a neonate?
A
- birth thru 10 days
- full term = 40 weeks, correct for prematurity @ 36 weeks or earlier
- weight 5.5 to 9 lbs
- sleep 75% of time in small bursts
- initial challenges with homeostasis
- visually regard objects in midline
- cries to indicate needs and quiets when picked up
9
Q
what does a neonate look like in physiological flexion?
A
- head: rotated w/ WB bearing on cheek/nose
- spine: C curve throughout
- scapula: elevated and ADD
- UE: shoulder ext/add/IR, elbow flexion off surface, forearm pronation, wrist/finger flex
- pelvis: post pelvic tilt
- LE: hip flex/abd/ER, knee flex, ankle DF/inv
10
Q
what does a neonate look like in supine?
A
- observe umbilical cord and physiologic flexion
- rotates head side to side, cannot sustain midline
- can move head to hand
- UE: shoulder driven movement in bursts causing wt shift
- LE: hip driven asymmetrical phasic movement
– kicking with either hip/knee flexion, ankle remains DR - UE/LE recoil due to “flexor tone”
- barrel-belly b/c ribs oriented horizontal and clavicle elevated
11
Q
what are the neonatal developmental reflexes?
A
rooting, sucking, galled, grasp, placing palmar and plantar, stepping
12
Q
what does a neonate look like in prone?
A
- phasic bursts of asymmetrical extension to change position of head
– deep proprioceptive input to cheek, ‘stable’ head due to elevated shoulders, elbows off surface - phasic bursts at shoulders and hips –> “tone” brings limbs back to flexed position
13
Q
what is neonate pull to sit and supported sitting?
A
- PTS used as a measure of head control
– neonate < head lag than 1-2 month old due to physiologic flexion - WB should be on ischial tuberosities in supported sit –> NOT sacral sit
- dependent sitters needing prox trunk support
14
Q
what does a neonate look like in supported standing?
A
- neonate bears weight when bounded/leaned forward, can take reciprocal steps
15
Q
what are some red flags to look for in a neonate?
A
- feeding problems
- excessively irritable –> should soothe but its a problem if they don’t
- stiff UE/LE/trunk or floppy
16
Q
how does a baby at 1-2 months act to diminish physiologic flexion?
A
- gravity and increased active movement
- decrease flexor tone leads to appearance of hypotonicity
- decreased head control and coordination of movement
17
Q
what are some characteristics of a baby at 1-2 months? (symmetry, attention, reflexes)
A
- increased symmetry with wider excursions of movement
- increasing alertness to people and environment
- increased visual attention to begin tracking
- reflexive grasp
18
Q
what does a baby at 1-2 months look like in supine?
A
- increased head mobility (shoulders have to come down a bit for rotation), less midline control, can begin to track objects
- UE: gravity pulls into more extended position; able to bring hands to mouth
- LE: decreased hip flexion “tone” = increased ABD and ER (reciprocal kicking)
- ATNR teaches about L vs R
19
Q
what does a baby at 1-2 months look like in prone?
A
- gravity compressing into surface causing passive asymmetry by 2 mo
- less flexion of T spine, wider excursion of head movement leads to WBing on ear
- lifts head briefly
- UEs slide away from body and elbow down on surface (prone prop)
- forearms remain behind shoulders
20
Q
what does a baby at 1-2 months look like in PTS and supported sitting?
A
PTS
- 1mo: more head lag than neonate
- 2mo: most amount of head lag due to “transient hypotonia”
sitting: require max support, WBing on ITs, head lifts for brief periods when supported
21
Q
what does a baby at 1-2 months look like in supported standing?
A
1 mo: lift head momentarily, LE WBing, stepping present but diminished
2 mo: less control, absent LE WBing/stepping (astasia abasia)
– absent LE WB b/c gained weight but don’t have strength
22
Q
what are the characteristics of a 3 month old?
A
- *symmetry of eyes and midline orientation
– ability to hold head up drives refinement of sensory - increased activity, alertness to caregiver and environment, visual interaction and socialization
- improved anti-gravity flexor control
- homeostasis is well established
– systems have stabilized, shouldn’t have any challenges
23
Q
what are the characteristics of a 4 month old?
A
- controlled, alternating movements
– able to turn flexors and extensors on/off - coordination of R/L sides
– not smooth but still more coordinated - increased visual fixing, socializes with strangers, babbles
– enough breath support and oral motor control to start making sound
24
Q
what does a 3 month old look like in supine?
A
- beginning chin tuck in midline and visual convergence; increased horizontal tracking
– capital flexors activate against gravity –> beginning of keeping head up in sitting - bring hands to midline at nipple line
– will continue to move south w/ inc. flexor control - UEs rest at side with elbows mostly extended; holds object in hand when placed
- LE reciprocal kicking in air or against floor; feet come together, lower abs active
25
what does a 4 month old look like in supine?
- increased visual convergence and beginning to disassociate eyes from head
-- tracking objects w/ eyes instead of moving head
- hands to lower abdomen and upper leg when hip is flexed; begin to reach for toys
- can roll to sidelying when head flexes/rotates
-- *see notes for importance
- LE continue as above w/ inc. activity and knee ext
- begin ulnar palmar grasp
26
what does a 3 month old look like in prone?
- *prone on elbows* (elbows in line or in front of shoulders)
- increased head/neck ext = more post wt shift and spinal ext
- baby may accidentally roll with head rotation
- increasing hip ext but still flexed; symmetrical LEs
27
what does a 4 month old look like in prone?
- increased head/trunk symmetry and extension (balance of neck flexors/extensors)
- *pivot prone* - come up on extended arms (A/P wt shift at WBing on lower rib cage)
-- elongating of trunk; brings ribs down
- rolling prone to sidelye
28
what does a 3 month old look like in pull to sit and sitting?
- head in midline; *demonstrates chin tuck part way through PTS
- sits with support (less flexed than previous months); can hold head up a few seconds
29
what does a 4 month old look like in pull to sit and sitting?
- increased flexor control with PTS
- placed baby can sit for short periods of time with B UE propping
-- not functional --> if they move their head a little they lose the prop
-- arms are yoked (part of balance and postural control system)
30
what does a 3 month old look like in supported standing and stepping?
- gained some extension through LEs --> takes weight on feet when supported (astasia abasia disappears)
- able to lift head upright, arms in high guard for postural control
31
what does a 4 month old look like in supported standing and stepping?
- increased WBing on LEs and narrowed BOS with support at UEs
- more hip ext
32
what are the general characteristics of a 5-6 month old?
- asymmetrical, dissociated, reciprocal movement
-- asymmetry b/c now controlled and dissociated
- improved antigravity ext in trunk/hips and antigravity flex head/trunk
-- balanced action of flexors and extensors in sagittal plane now allows for movement into frontal plane
- socialized but begins separation anxiety
- more developed vision to differentiate between familiar and unfamiliar
- becomes increasingly vocal with more complex babbling
-- head and neck upright = easier to talk
33
what does a 5 month old look like in supine?
- hands to knees/feet when LEs are flexed, ABD, ER
-- elongate hip extensors for creeping, PTS, walking
- early "bridging" with minimal lift
-- WB on heel --> heel stike
- roles to sidelye - UE/LE in midline, can lift head off surface when pushing w/ UE
-- asymmetrical sensory info, shapes hip, GH strength, different visual and vestibular info
- high sidelye - tuck largely inactive
34
what does a 6 month old look like in supine?
- hands to feet with knees extended --> hamstrings elongated
- feet to mouth
- uses radial-palmar grasp
-- WB on ulnar side, allows for functional radial grasp
- inc pelvis mobility
- UEs disassociated from LEs
-- also R and L dissociation
- rolls to sidelye - vaulted position
- *rolls supine to prone*
-- don't roll prone to supine as much b/c not as functional
35
what does a 5 month old look like in prone?
- maintains prone on extended hands (higher up in space, more trunk off surface)
-- lower trunk not active
-- more of an extended arm position --> differs from 4 mo old
-- inc elongation of intercostals and drops ribs
- rotation of head drives ext down spine
-- variable BOS and wt shift
36
what does a 6 month old look like in prone?
- extension across pelvis by 6 mo
- controlled wt shift for reaching in prone
-- homolateral pattern
- pivoting in prone and belly crawl/combat crawl
-- control of flexors and extensors means rotation can begin to develop
- beginning transition to quadruped from prone
-- * see notes for importance
- protective ext intact anteriorly; mature landau
- rolls prone to supine
37
what does a 5 month old look like in pull to sit and sitting?
- still a little head lag
- develop more control through range from 4 to 6 mo
- still leaned forward in ring sit
- yoked
- not much function in sitting
38
what does a 6 month old look like in pull to sit and sitting?
- assists with active chin tuck (*NO HEAD LAG*) and pulls w UEs
- sits independently w/ variety of postures
-- sits without external support
-- UEs may be in high guard at times
-- arms free, can use for play
-- may prop with one arm to reach with other arm
-- head rotation in sitting may lead to them falling over
-- controlled weight shift A-P not M-L
- *note: sits independently = baby stays upright when placed in sitting
39
what does a 6 month old look like in supported standing and stepping?
- takes full weight on LEs, hips still slightly flexed behind shoulders
- UEs lower than previous months but still needed for postural control
- more co-contration at knee, more graded control (not just full flex or ext)
40
what does a 7-12 month old look like in prone and quadruped?
- overall:
-- variability in postures in prone ready the infant for more upright function
-- requires stability in cord and proximal hip and shoulder
-- more frontal plane motions
- 7-8 mo:
-- high sidelying: emerging neck righting, elongation on WBing side
-- abdomen off surface in prone prop, narrow BOS
- 8-9 mo:
-- flexed to extended position on feet
- * see notes for input from high sidelying
41
what does a 7-12 month old look like in quadruped for creeping?
- creeping:
-- 4 pt pattern 7-8 mo
-- 2 pt pattern 8-10 mo
- limb patterns: can be 2 or 4 pt
-- homolateral 7 mo
-- bunny hopping 7-8 mo
- reciprocal 10 mo
- *starts w/ A-P wt shift at about 6 mo; more UE driven initially
42
what does a 7-12 month old look like in sitting?
- UEs no longer needed for postural control and can be used for skill (no longer yoked)
- protective responses develop in sitting:
-- forward @ 6 mo
-- lateral @ 7 mo
-- posterior @ 8 mo
- 7-8 mo: rotation develops, indicates dynamic BOS
- 8-9 mo: independent sitter
-- can get in and out of sitting w/o assist
-- radial digital and inferior pincer grasp
43
what does a 7-12 month old look like in sitting?
- general:
-- variety of dynamic sitting postures (circle, long, short, side, splay, side sit)
- 9 mo: hands come above level of shoulder, indicating trunk control
- 10-12 mo: superior pincer grip
- 12 mo: independently get on/off small bench or chair using variety of strategies
44
what does a 7-12 month old look like in pull to stand?
- variety of strategies to go floor to modified plantigrade (tall and 1/2 kneel)
- initially upper body driven
45
what does a 7-12 month old look like in supported standing?
- child will become more vertical, narrow their BOS, and require less support as they gain skill in plantigrade
- rotation at 10-12 mo
46
what does a 7-12 month old look like in cruising?
- 9-11 mo
- early: vision leads w/ UEs to widen BOS, one LE steps followed by quick step of other LE (usually 4 pt)
- middle: homolateral pattern
- later: one hand on surface
47
what are the precursors to walking at each age range?
- 8-10mo:
-- walking w/ 2 hands held
-- occurs when infant has more control of trunk
- 11-12 mo:
-- walking with 1 hand held
-- emerges slightly after cruising w/ 1 UE suppory
- standing arms free w/o support w/ UEs in high guard and wide BOS
48
what does an infant look like when walking?
- child getting ready to independently walk when:
-- squat and recover w/ minimal support (need UE support 8-9 mo)
-- takes both UEs off surface momentarily --> UEs in high guard
-- cruises w/ 1 UE support
-- stands w/ minimal support and actively rotates head/trunk
- first steps:
-- large range from 7-15 mo, but 12 mo is average
-- characterized by high guard, wide BOS, anterior COM, fast speed, short strides, lack arm swing
--- swing - excessive hip flexion, LE remains ER
--- stance - no heel stinks, initially stiff legged
49
how does an infant transition floor to stand?
- using kneeling, half kneeling, squatting
-- kneeling and half kneeling are transitional
-- half kneel transitions begin at 9-10 mo and require external support until ~ 3-4 years as front leg doing work w/ anterior diagonal wt shift
- squat to stand with external support
- squat to stand w/o support 11-12 mo
50
what does an infant look like transitioning stand to floor?
- early squatting requires support - tibia are vertically aligned (bottom between feet)
- 1-2 UE support: 10-11 mo asymmetrical lowering
- arms free: 12 mo; initially diminished eccentric control for lowering
nmr I
flashcards
Decks in class (3)
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