Pediatric Development/Milestone

Question 1

Rooting

• Onset age
• Integration
• Stimulus
• Response
• Relevance

Answer 1

• Onset age - 28 weks gestation
• Integration - 3 months
• Stimulus - Stroke the corner of the mouth, upperlip, and lower lip
• Response - Movement of the tongue, mouth, and/or head toward the stimulus
• Relevance- Allows searching for and locating feeding source.

Question 2

Suck-Swallow

• onset age
• integration age
• Stimulus
• Response
• Relevance

Answer 2

• onset age - 28 weeks gestation
• integration age - 2-5 months
• Stimulus - Place examiner’s index finger inside infant’s mouth with head in midline
• Response - Stong, rythmical sucking
• Relevance - Allows ingestion of nourishment

Question 3

Traction

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 3

• onset age - 28 wks
• Integration age - 2-5 months
• Stimulus - Grasp infant’s forearms and pull-to-sit
• Response -Complete flexion of upper extremities
• Relevance - Enhances momentary reflexive grasp

Question 4

Moro

• Onset age
• Integration age
• stimulus
• response
• Relevance

Answer 4

• Onset age- 28 weeks gestation
• Integration age - 4-6 months
• Stimulus - Rapidly drop infant’s head backward
• Response -
  
  • 1st phase - arm extension/abduction, hand opening
  • 2nd phase - arm flexion and adduction
• Relevance - Facilitates ability to depart from dominant flexor posture: protective response

Question 5

Plantar Grasp reflex

• Onset age
• Integration age
• Stimulus
• Response
• Relevance

Answer 5

• Onset age - 28wk gestation
• Integration age - 9 months
• Stimulus - Apply pressure with thumb on the infant’s ball of the foot
• Response - toe flexion
• Relevance - Increases tactile input to sole of foot

Question 6

Galant

• Onset age
• Integration age
• stimulus
• response
• relevance

Answer 6

• Onset age - 32 wks gestation
• Integration age - 2 months
• Stimulus - Hold infant in pron suspension, gently scratch or tap alongside the spone with finger, from shoulders to buttocks.
• Response - Lateral trunk flexioni and the wrinkling of the skin on the stimulated side
• Relevance - faciltiates lateral trunk movements necessary for trunk stabiization

Question 7

ATNR (Asymmetric tonic neck)

• Onset age
• Integration age
• Stimulus
• Response
• Relevance

Answer 7

• Onset age - 37wks gestation
• integration age - 4-6 months
• stimulus - fully rotate Infant’s head and hold for 5 seconds
• response - Extension of extremities on the face side, flexion of extremities on the skull side
• relevance - Promotes visual hand regard

Question 8

Palmar Grasp

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 8

• Onset age - 37 wks gestation
• integration age - 4-6 months
• stimulus - Place examiner’s finger in infant’s palm
• response - finger flexion; reflexive grasp
• relevance - increases tactile input on the palm of the hand

Question 9

Tonic Labyrinthine - supine

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 9

• Onset age - >37 wks gestation
• integration age -6 months
• stimulus -Place infant in supine
• response - Increased extensor tone
• relevance- facilitates total-body extensor tone

Question 10

Tonic Labyrinthine - Prone

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 10

• Onset age - >37wks gestation
• integration age - 6 months
• stimulus - Place infant in prone
• response - Increased flexor tone
• relevance - facilitates total-body flexor tone

Question 11

Labyrinthine/ Optical (head) righting

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 11

• Onset age - birth-2months
• integration age - persists
• stimulus - Hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward
• response - upright positioning of the head
• relevance - Orients head in space, maintains face vertical

Question 12

Landau

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 12

• Onset age - 3-4months
• integration age - 12-24 months
• stimulus Hold infant in horizontal prone suspension
• response - Complete extension of head, trunk, and extremities
• relevance - Breaks up flexor dominance; facilitiates prone extension

Question 13

Symmetric Tonic neck

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 13

• Onset age - 4-6 months
• integration age - 8-12 months
• stimulus - Place infant in the crawling position and extend the head
• response - flexion of hips and knees
• relevance - Preaks up total extensor posture; facilitates static quadruped position

Question 14

Neck righting (NOB) Neck on body

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 14

• Onset age -4-6 months
• integration age - 5 years
• stimulus - Place infant in supine and fully turn head to one side
• response - log rolling of the entire body to maintain alignment with the head
• relevance - Maintains head/body alignment; initiates rolling (first ambulation effort)

Question 15

Body righting (on body) (BOB)

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 15

• Onset age - 4-6months
• integration age -5 years
• stimulus - Place infant in supine, flex on ehip and knee toward the chest and hold briefly
• response - Segmental rolling of the upper trunk to maintain alignment
• relevance - Facilitates trun/spinal rotation

Question 16

Downward Parachute (protective extension downward)

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 16

• Onset age - 4 months
• integration age - persists
• stimulus - Rapidly lower infant toward supporting surface while suspended vertically
• response - Extension of the lower extremities
• relevance - Allows accurate placement of lower extremities in anticipation of a surface.

Question 17

Forward parachute (protective extension forward)

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 17

• Onset age - 6-9 months
• integration age - Persists
• stimulus - Suddenly tip infant forward toward supporting surface while vertically suspended
• response - Suddend extension of the upper extremities, hand opening, and neck extension
• relevance - Allows accurate placement of upper extremities in anticipation of supporting surface to prevent a fall.

Question 18

Sideward Parachute (Protective extension sideward)

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 18

• Onset age - 7months
• integration age - persists
• stimulus - quickly but firmly tip infant off-balance to the side while in the sitting position
• response - arm extension and abduction to the side
• relevance - protects body to prevent a fall; supports body for unilateral useof opposite arm

Question 19

Prone Tilting

• Onset age
• integration age
• stimulus
• response
• relevance

Answer 19

• Onset age - 5 months
• integration age - Persists
• stimulus - After positioning infant in prone, slowly raise one side ofhte supporting surface
• response - curving of the spine toward the riased side (opposite to the pull of gravity); abduction/extension fo arms and legs
• relevance - Maintain equilibrium without arm support; facilitate postural adjustmentsin all positions

Question 20

4 month grasp

Answer 20

Primitive squeeze grasp

Question 21

3 month grasp

Answer 21

sustained grasp possible if object placed into ulnar side of hand

Question 22

5 month grasp

Answer 22

• Palmar grasp

Question 23

6 month grasp

Answer 23

radial-palmar grasp

Question 24

7 month grasp

Answer 24

Radial palmar grasp with straight wrist

Question 25

8 month grasp

Answer 25

Radial -digital grasp

Question 26

9 month grasp

Answer 26

Radial digital grasp with wrist extended

Question 27

Fine motor pincer grasp * 6 months * 9 months * 12 months

Answer 27

* 6 months - raking and contacting object * 9 months - Inferior pincer grasp; between ventral surfaces of thumb and index finger, distal thumb joint extended, beginning of thumb opposition * 12 months - fine pincer grasp; between fintertips or fingernails, distal thumb jont flexed

Question 28

Scissor skills * 2-3 years * 3-4 years * 4-6 years * 6-7 years

Answer 28

* 2-3 years: holds and snips with scissors, opens and closes scissors in a controlled fashion * 3-4 years: Manipulates scissors in a forward motion, coordinates the lateral directions of the scissors, cuts a streight forward line, cuts simple geometric shapes, cut circles * 4-6 years: cuts simple figure shapes * 6-7 years: cuts complex figure shapes.

Question 29

Fine motor manipulation skills 12-15 months

Answer 29

Finger-to-palm translation - a linear movement of an object from the fingers to the palm of the hand, picking up coins

Question 30

Fine motor manipulation skills 2-2 1/2 years old

Answer 30

* Palm-to finger translation: with stabilization, a linear movment of an object from the palm of the hand to the fingers, ie placing coins in a slot * Simple rotation: the turning or rolling of an object held at the finger pads approximately 90 degrees or less. ie unscrewing a small bottle cap

Question 31

Fine motor manipulation skills 3-3 1/2 years old

Answer 31

* Shift - a linear movement of an object on the finger surfaces to allow for repositioning fo the object relative to the finger pads, ie Shifting up and down a pencil separating 2 pieces of paper

Question 32

Fine motor Manipulation skills 6-7 years old

Answer 32

* complex rotation - the rotation fo an object 360 degrees, ie turning a pencil over to erase * In hand manipulation with stabilization- several objects are held in the hand and manipulation of one object occurs, while siultaneously stabilizing the others, ie picing up pennies with thumb and forefinger while storing them in the ulnar side of the same hand.

Question 33

Pencil grasp 1-1 1/2 years

Answer 33

Palmar-Supinate grasp - Children often hold their writing tool like a dagger, scribbling using their whole arm.

Question 34

Pencil grasp 2-3 years

Answer 34

Digital-pronate grasp - All fingers are holding the writing tool but the wrist is turned so that the palm is facing down towards the page. Children begin to stabilise their shoulders, so that movement now comes mostly from the elbow. At this age, children should start being able to copy a

Question 35

Pencil grasp 3 1/2-4 years

Answer 35

Quadropod grasp - 4 fingers are held on the writing tool, beginning to form the arc between the thumb and index finger (web space). Movement will occur mostly from the wrist and the hand and fingers move as one whole unit. At this age, children should be able to complete simple dot-to-dots, imitate zig-zag and crossed lines, trace dotted lines and draw simple humans (eg. Head, stick body and one other body part such as arm or leg).

Question 36

Pencil grasp 4-6 years old

Answer 36

* Static tripod posture - This is a 3 finger grasp, where the thumb, index finger and middle finger work as one unit. At this age, children should be able to copy a diagonal line, a square, a diagonal cross, a circle and a triangle. Pictures of humans become more detailed, including both arms and legs and even facial features. * Dynamic Tripod posture - Children will consistently be using only 3 fingers to hold the writing tool. This is the ideal grip to help move the pencil efficiently, accurately and at a good speed. Your child is now ready to starting practising and perfecting their letter formations! Most children will master the tripod grip by the age of 6 or 7, so there’s no need to raise alarm bells if your child isn’t holding their pencil properly as they start school.