What is the APGAR?
Neonatal Ax
What is included in the APGAR? Scoring?
5 aspects (appearance, pulse, grimace (reflex irritability), activity, and respiration)
each scored from 0 (non-existent) to 2 (normal and strong).
Score of 0-3 indicates being born in significant distress, 4-6 mild distress.
Goals of peds physio
participation, motor abilities, functional mobility, health & prevention
9 Peds reflexes
- Sucking reflex
- Asymmetrical tonic neck reflex
- Moro reflex
- Grasping reflex
- Stepping reflex
- Babinski
- Symmetrical tonic reflex
- Rooting reflex
What is the Asymmetrical tonic neck reflex? During what months is it present??
0-4months: head turned to one side with extension of ipsilateral and flexion of contralateral arm (fencer’s pose)
What is the Moro reflex?
when feeling like they are falling the child will open their arms then bring them back to their chest
What is the grasping reflex? During what months is it present??
0-4 months
grasp when pressure is put on palm of hand, will relax if you stroke back of hand
What is the stepping reflex? During what months is it present??
body weight shift and the baby will make stepping motions
first 2 months
What is the babinski reflex? During what months is it present??
Extension of big toe and fanning of rest with stimulation of sole of foot
Normal in infants until 12-24 months, e
What is the Symmetrical tonic reflex ? During what months is it present??
stim neck flexion or extension, will flex UE and extend Le with neck flex and when neck extended UE will extend and LE are flexed
3 months
What is the plantar grasp reflex ? During what months is it present??
Stim: pressure to base of toe, toe flexion
Present at 28 wks to 9-10 months
What is the rooting reflex ? During what months is it present??
stroke side of cheek, baby will open mouth and turn towards side of stimulation
up to 3 months
What are 3 paediatric postural reactions
Righting reactions
Equilibrium reactions
Protective reactions
Key developmental milestones: 0-3mths
- able to turn head side to side
- brief head righting
- random kicks in supine
- maintain head midline
- hand fisted will reflex grasp
Key developmental milestones: 4-5mths
- able to prop with extended elbows
- head control
- rolls
- supported sitting (good head control, turns head)
- weight bears in standing when supported
- grasp/hold small toys
- release toys
- increased frequency of reaching
Key developmental milestones: 5mths
head control in sitting
Key developmental milestones: 6mths
- sitting independently
- uses hands for play
- stands with support
- radial-palmar grasp
- rake to grasp
- reaching path is straight
Key developmental milestones: 7mths
- anticipate and orient hand for reach and grasp
- commando crawling
Key developmental milestones: 8-9 months
- 4 point kneel (start with rocking to crawl backwards to crawl forwards)
- moves from sit to prone
- pivots in sitting
- may pull to stand
- points and pokes with index finger
- uses pincher grip
Key developmental milestones: 10-11mths
- doesn’t like prone or supine (will get out of it)
- sitting bum scoot
- standing (transfer from stand to sit without falling, picks up objects from floor w/o support (pincer grasp)
- stands hands free for a few secs)
- mobility (crawls up stairs, cruising, walking w/ hands held, can start walking independently)
Key developmental milestones: 12-18mths
- walks independently
- transitions to stand at mid floor
- squats
- picks up toys without support
- walks up stairs with hand held or rail
- initiates ball kick
- throws ball
- walks backwards and sideways a few steps
- opens books
- puts pellets in bottle
- handedness usually established
Key developmental milestones: 2-2.5years
- propels or steer push toys
- walk on tiptoes
- jumps
- stand on one foot
- kick ball
- throw and catch
- ascend and descend stairs Independently
Key developmental milestones: 5-5years
- climb stairs independently
- run faster and more controlled
- walk in straight line
- throw under and over head
- somersaults
- gallop and skip
- dress and eat independently;
- uses mature tripod grasp (4.5 yrs)
