Family cantered care moto?
- Parents knows kids best, family are different and unique, optimal child functioning occurs with supportive family and community.
Child reflexes:
- Sucking reflex
- ATNR: 0-4 months
- Mororeflex: if feel they feel like falling, child will open arms
- grasping: 0-4 months, will close hand if pressure on Palm, relax if you stroke back of hand
- stepping: 0-2 months; body weight shifts = stepping motions
- babinski: fanning of toes
- symmetrical tonic reflex: 6-9 months; stim neck flex or extn, will flex UE and extn LE with neck flexion
- plantar grasp: up to 10 months: stim pressure on base of toes = toe flexion
- rooting reflex: 0-3 month: stroke side of cheek, they turn head with mouth open
Paediatric postural reactions:
- righting: head wants to be vertical
- equilibrium
- protective: put out arms to protect themselves
Paediatric developmental milestones: - Birth to 3 months: 4-5 months: 5 months: 6month
Birth to 3 months: able to turn head side to side, brief righting, random supine kicks, maintain head midline, reflex grasp
4-5 months: prop up with extended elbows, head control, rolls, supported sitting, supported weight bearing in standing, hold small toys and release.
5 months: head control in sitting
6 months: sit independently, uses hands to play, stands with support, start radial grasp, rake and grasp, straight reaching path
Paediatric developmental milestones:
- 7 months
- 8 - 9 months
- 10 - 11 months:
7 months:
- anticipate and orient hand for reach and grasp, commando crawl
8-9 months:
- 4 point kneel, sit to prone, pivots in sitting, pull to stand? Princer grasp
10-11 months:
- in and out of prone/supine, bum scoot, sit without falling, hands free standing, crawls up stairs, walks with hands held
Paediatric developmental milestones:
12-18 months
2-2.5 years
3-5 years
12-18months:
- walk, squat, pick up toys without support, ball kick, throwing, handedness established
2-2.5:
- walks on tip toes, jumps, stand on one foot, independent on stairs
3-5 years:
- walk in straight line, somersaults, dress and eat independently, use mature tripod grasp.
Down’s syndrome:
- define
- s/s
- Rx
Alteration to chromosome 21:
S/s: facial features, hypotonia, dec strength, lig laxity, short arms and legs, heart defects, AA instability, scoliosis, pronated feet, hip dislocation
Rx:
- attain developmental milestones, discourage compensatory patterns, build strength, oral -motor function, CVD and Resp health
Prade-Willi syndrome:
- define
- s/s
- Rx
Disturbance in hypothalamus, genetic deletion on chromosome 15
Young:
- S/s: hypotonia, delayed motor and learning development, little spontaneous movement, Resp difficulties, oral and motor feeding issues.
- Rx: gross motor development, compensatory postures, nutritional its
Older:
- s/s: hypotonia, intellectually impaired, short stature, hyperplasia, obesity, behaviour issues
- Rx: weight management, PA. Behaviour.
Neo-natal respiratory syndrome:
- define
- s/s
- Rx:
FAS: fetal alcohol syndrome:
- features
- leads to facial changes, brain damage, hypersensitivity, poor concentration, poor eaters, dec stimulation
Arthrogryposis multiplex congenital
- define
- s/s
Rare, non progressive neuromuscular control syndrome
S/s joint contracture from lack of fetal movement, mm weakness, poor mm development, fibrosis (leads to scoliosis, heart defects, Resp problems)
Salter Harris fracture
- define
Fractures that occur in children, determined by growth plate development
Rx: immobilize 3-6 weeks
Autism:
- defined
- s/s
- outcome measures
Developmental delay in social/ language/motor and cognitive development, onset = ~ 4 y.o.
S/s: stereotyped and repetitive play skills, avoid eye contact, dislike changes in routine, have strong sensory preference, dyspraxia (needs time to plan movements and execute functional goal), gait (waddling), cerebellar involvement?
- outcome measures: M-ABC, Bayley -3, PDMD -2
Paediatric appropriate outcome measures:
- FMS ( functional mobility scale): age 14-18 with CP, rates walking at 5, 50, 500 (for home school and community), questions not observations, used to figure out what devices they will need.
GMFCS (gross motor functional classification system): - 5 levels, for kids with CP, based on self initiated movement, food for communication between family and care team and goal planning
GMFM (gross motor functional measure): standardized test of function for CP. all items a 5 y.o would do. Can measure over time to see change and set goals.
COPM: identifies goals in self care, productivity, leisure
APGAR score
- define
Neo-natal ax
Appearance, pulse, grimace, activity, respiration
- score 0-2, higher is better
Assessment of peds mm tone
Mm palpation, PROM, quantify tone, primitive reflexes (long tract, babs and clonus).
- modified tardieu (R1, R2)
- modified ashworth (5 point scale, 0-4)
