Pediatric Motor Development

Question 1

maturational theories

Answer 1

reflex-theory
hierarchical theory

gesell, shirley, mcgraw)

Question 2

reflex vs hierarchical

Answer 2

re = series of chained reflexes that babies grow passively into

hier = top down, CNS maturation drives growth

Question 3

behavior theories

Answer 3

pavlov, skinner, piaget

behavior occurs via manipulation in the environment, either positive or negative, but kids adapt

Question 4

dynamic systems theory

Answer 4

heriza, thelen, ulrich, schumway-cook

systems interact and develop as one develops motor patterns
– systems mature at different points

Question 5

interventions related to dynamic systems theory

Answer 5

testing each system and noting its “constraints”

environment designed to work on the “constrained” systems

developmental sequence as a guide

exploration of environment

multiple movement strategies

primitive reflexes and how they may/may not interfere

Question 6

1 month milestone

Answer 6

decreasing physiological flexion

movement in all 4 extremities

attempt to lift head, natural head rotation

hands in fists

alert/responsive when awake

Question 7

2 month milestone

Answer 7

head up in prone
– attempt when sitting

opening of hands

reciprocal leg kicks

extensor withdrawal in WB

responsive to friendly handling

Question 8

2 month red flags

Answer 8

hands fisted
no reciprocal kicking
unilateral head rotation

Question 9

4 month milestone

Answer 9

NO HEAD LAG at pull to sit

head held steady in sitting

pushes to elbows/forearms in prone

swings arms at objects

hands to mouth
coos and laughs

bears some weight in WB

Question 10

4 month red flags

Answer 10

poor head control

excessive/frequent head/back arching

yellow = inability to tolerate prone

Question 11

6 month milestone

Answer 11

rolling from prone to supine

push up on elbows in prone

weight shifts / pivots in prone
– prepared for reaching

sits using arms for support

mostly WB in supported standing

Question 12

8 month redflag

Answer 12

belly crawling only using UE
– LE dragged

Question 13

8 month milestone

Answer 13

rolls supine to prone
belly crawls
assumed quadraped
recognize voice tones
possible fear of strangers

Question 14

9 month milestone

Answer 14

transitions to sitting position independently

sits w/o support

moves object from one hand to the other

Question 15

9 month red flag

Answer 15

consistent W sitting

Question 16

10-11 month milestone

Answer 16

creeps on hands/knees

walk with bilateral hands hold

Question 17

12 month milestone

Answer 17

pull to stand

cruising along furniture

drink from cup with assistance

independently eats small items

Question 18

12 month red flag

Answer 18

toe walking

“bunny hopping” to creep

Question 19

15 month milestone

Answer 19

independent stepping

creeps on hands/knees up stairs

imitation

patty cake/peek a boo

Question 20

18 month milestone

Answer 20

independently walking

climbs on/off furniture

creeps on hands and knees down steps

Question 21

20 month milestones

Answer 21

transitions from floor to stand

squat to and from standing

imagination begins

Question 22

2 year milestone

Answer 22

kicking

running (fast walking)

walks up/down steps w or w/o help

eating with utensils

Question 23

2 yr red flag

Answer 23

multiple falls
poor balance

Question 24

30 month milestone

Answer 24

2 foot jumping

hand/finger dexterity
- opening/closing things

starting to be able to dress

Question 25

3 year milestones

Answer 25

reciprocal stair climbing beginning to catch - use limbs reciprocally (tricycle) true run / standing on 1 leg further use of utensils

Question 26

4 year milestones

Answer 26

able to catch/throw items stand on tippy toes climbing objects forward leap sharing concepts

Question 27

5 / 6 years milestones

Answer 27

5 = one foot hopping, galloping, kicking, dress and undress, social relationships 6 = skips, rides bikes, jump rope dribble ball

Question 28

explain excessive sensory defensiveness

Answer 28

at any age = RED FLAG

Question 29

development of gait during birth-9months

Answer 29

antigravity strength - hip flexor (kicking) - hip extensors (crawling) - hip ABD (cruising) extremities / trunk lengthen, so do mm and bones

Question 30

9-15 months - gait development

Answer 30

full myelination by 1 year, fat decrease and arms in high gaurd gait consists of: flexion, ABD and ER of hips genu varum eversion of heel femoral anteversion

Question 31

18-24 months - gait development

Answer 31

decreased base of support - less co-contraction at each joint - genu varum resolved - longitudinal arches begin to develop

Question 32

3-3.5 years - gait development

Answer 32

inc maturity - genu valgum - dec heel eversion - consistent heel strike - dec femoral anteversion - arm swing

Question 33

6-7 years - gait development

Answer 33

fully mature - knees/heels in neutral - anteversion almost resolved

Question 34

how to enhance early motor skills

Answer 34

goal-oriented tasks internal feedback -- visual / somatosensory vestib external feedback high intensity/duration practice

Question 35

principles of motor development

Answer 35

cephalocaudal / prox to distal manner unrefined moving to refined stability to controlled mobility spiraling manner, periods of equilibrium/disequilibrium sensitive periods when child is affected by environmental stimuli

Question 36

normal gestational time - premature

Answer 36

38-42 y/o <37

Question 37

1st trimester developments (by the end of it)

Answer 37

muscle differentiates/tissue specialization sensory/tactile system develops functioning vestibular system eyelids fuse optic nerve/cup begin forming taste buds develop fetal breathing quick generalized movement positional changes 7.5 wks = neck and trunk flexion

Question 38

2nd trimester developments (by the end of it)

Answer 38

motor endplate forms clonus response to stretch startle to light visual processing responsive to auditory stimuli reciprocal/symmetrical limb movements grasp reflex sleep states

Question 39

3rd trimester developments (by the end of it)

Answer 39

some mm maturation, most still developing functional touch with temperature discrimination almost full mature sensory system fixation and focus occurs in eyes olfactory perception responds to tastes

Question 40

at 28 weeks, what reflexes are present

Answer 40

rooting, sucking, swallowing palmar/plantar grasp contralateral moro crossed extension

Question 41

how to calculate prematurity

Answer 41

40 weeks - gestational age ie 40 - 32 = 8 weeks premature therefore the pt is 8 weeks older than their "chronological age"