1
Q
PART 1: INTRO TO NORMAL DEVELOPMENT
A
PART 1: INTRO TO NORMAL DEVELOPMENT
2
Q
When you hear Maturational Theory, think of __________ Theory. It guides maturational theory.
A
Hierarchical
3
Q
Maturation Theory Basic Tenets:
- Development occurs in a ___________ direction.
- Development occurs in a ________-______ direction.
- Development of one ______ skill leads to the development of another.
- ______ milestones are invariant in their sequence.
- Motor skills develop from ______ to _____.
- Motor skill progresses from _______ to _________.
- Total response before __________ response.
- Cephalic control before ________ control.
A
- cephalocaudal
- proximal-distal
- motor
- Motor
- gross to fine
- reflexive to voluntary
- localized
- caudal
4
Q
Previous theories emphasized the importance of the ____ as the driver of motor development, however, current theories support the role of numerous subsystems’ contributions to motor development as well as the environment.
A
CNS
5
Q
______ ________ perspective on motor development is a holistic approach to understanding human motor development.
A
Dynamic Systems Perspective
6
Q
Dynamic Systems Theory:
- Covers the ________.
- Has replaced the ____________ theory as the theoretical framework for much of pediatric PT.
- Assumes that the individual functions as a complex, dynamic system comprising many subsystems and that there is an innate organization that occurs between complex particles that is directed by no one system.
- Movements emerge based on the child’s _______ _______, the _________ ________, and the _____ ____ to be completed.
A
- lifespan
- maturational theory
- internal milieu, the external environment, and the motor task
7
Q
Current Beliefs:
- Is head control mastered before any development of the trunk and LE occurs?
- Do all areas of the body appear to develop concurrently? What limits them?
- “Certain factors are rate limiting to motor development.” What can happen when compensations are provided to eliminate the effects of these rate limiting factors?
A
- No
- Yes, limiting factors such as strength prevent certain types of movements from being expressed.
- One developmental system may display previously unrecognized potential. (Ex. providing shoulder control helps a baby to grasp objects in hand)
8
Q
Kinesiological Concepts 1:
- What is physiological flexion?
- As far as active control goes, babies develop antigravity ___________ first.
- This tend to be followed by antigravity ________.
- This is followed by _______ _________ and then __________.
A
- When a baby is first born (full-term and normal weight) they tend to have more flexor tone in their body because of their confined space in the womb.
- extension
- flexion
- lateral flexion and then rotation
9
Q
Kinesiological Concepts 2:
-List the order in which we develop symmetry, asymmetry, and controlled asymmetry.
A
- Asymmetry
- Symmetry
- Controlled Asymmetry
10
Q
What is an example of controlled asymmetry?
A
controlled weight shift
11
Q
Additional Kinesiological Concepts:
- Mobility-________-controlled mobility-_____ (ROOD).
- Weight ________-weight _________: stability in postures permits effective weight bearing and weight bearing experiences assist in the development of stability (NDT).
- To move with control, ______ ______ must occur.
- Weight shifts occur as one body part stabilized simultaneously with the other body part being unweighted enough to move.
A
- mobility-stability-controlled mobility-skill
- weight bearing-weight shifting
- weight shifts
12
Q
Additional Kinesiological Concepts:
-What is rotation dissociation?
A
- Rotation requires balanced control of flexion and extension and dissociation between body segments.
- Dissociation is the breaking up of the mass pattern, it is the ability to separate movement in one body part from associated movement in another.
13
Q
What are some examples of rotation dissociation?
A
- eyes/head
- head/trunk
- hand/elbow
14
Q
PART 2: NORMAL DEV PRENATAL TO 3 MONTHS
A
PART 2: NORMAL DEV PRENATAL TO 3 MONTHS
15
Q
_________ is a period of time during which an embryo develops in the mother’s womb. It is the most radical change in human existence.
A
Gestation
16
Q
Gestation is divided into __ periods.
A
3
17
Q
- The first trimester (__-__ weeks) is when all major ______ _______ are established.
- The second trimester (__-__ weeks) is when _____ ________ grow to newborn proportions.
- The third trimester (__-__ weeks) is when body weight _______ and body length _______. Body fat accumulates, which aids in body temp regulation. At ___ weeks, lungs are developed.
A
- (1-12 weeks), body systems
- (13-26 weeks), body proportions
- (27-40 weeks), triples, doubles, 36 weeks
18
Q
- _______ = first 8 weeks
- _______ = 8 weeks until birth
A
- embryo
- fetus
19
Q
- Fetal movement is seen around __-__ weeks gestation.
- Some jerky, startle type movements are seen at __ weeks.
- There are both ______ and ______, random and coordinated patterns.
- Fetal movements may have the purpose of preventing _______ and ________ and preparing the fetus for birth.
A
- 7-8 weeks
- 9 weeks
- gross and fine
- stasis and adhesions
20
Q
The quality of fetal movement provides an indicator of the chronic ___________ conditions of the fetus.
A
neurological
21
Q
Characteristics of Atypical Development (1): (NOT ON TEST)
- Abnormal _____ (hypo/hypertonia, fluctuations, rigidity)
- Exaggerated, __________ reflex behavior
- _________ of normal reflexes
- Lack of variability, variety, and frequency of ___________ movement
- Lack of ____________
A
- tone
- prolonged
- absence
- spontaneous
- adaptability
22
Q
Characteristics of Atypical Development (2): (NOT ON TEST)
- Lack of _________ control
- Lack of __________, rotation
- _________ and __________ are not balanced
- Persistence of _________
- Lack of controlled _______ shifts
- Lack of elongation on WB side with lateral flexion on NWB side
A
- antigravity
- dissociation
- flexion and extension
- asymmetry
- weight shifts
23
Q
Characteristics of Atypical Development (3): (NOT ON TEST)
- Poor __________ stability with decreased ability to move against gravity
- Prolonged fixing or limiting degrees of freedom due to poor underlying control
- Abnormal postural alignment
- Poor __________ and control of movement
A
- proximal
- coordination
24
Q
Newborn:
- ____-____ weeks of fetal development
- Premature - less than ___ weeks
- Head proportionately ________ with short LEs
- Kyphotic, horizontal ribs
- ROM differences: excessive __________, 30 degree _________ contractures at hips and knees
- PHYSIOLOGICAL ____________
A
- 38-42 weeks
- 38 weeks
- larger
- dorsiflexion, flexion
- FLEXION
25
What do we see with a newborn in supine?
- head rotated
- rooting reflex (stroke side of babies face causes them to turn head to search for something to suck on)
- neonatal neck righting (head turns, body turns)
26
What do we see with a newborn in supported sit?
- fleeting attempts to lift head
| - back rounded but pelvis perpendicular
27
What do we see with a newborn in prone?
- WB through upper trunk, shoulders, head
| - lifts head to clear airway
28
Newborn UE Movement:
- Hands open as arms _______
- Hand movement related to ____ movement
- Strong _______ but hand loosely flexed at rest
- Resting posture - slight shoulder ________, elbow ___________, elbow _________
- abduct
- arm
- grasp
- shoulder adduction, elbow flexion, elbow pronation
29
Newborn LE Movement:
- Vigorous, rhythmical reciprocal ________
- Automatic _________ and _________
- Biomechanical aspects: medial femoral torsion, femoral anteversion, femoral bowing, femoral coxa valga, shallow acetabulum,, genu varum, tibia varum, tibial torsion, calcaneal varus, forefoot varus, occasional metatarsal adductus
- kicking
| - standing and stepping
30
- When looking at vision, the newborn is able to fixate on moving object ________ and ________.
- They prefer _______ contrasts.
- Best at __-__ inches away
- laterally and vertically
- strong
- 8-9 inches
31
1-2 Months:
- We see a decrease in physiological ________. Why?
- Relative ____tonia and asymmetry.
- We see the beginning of active ________ control.
- Increased _______ and visual awareness.
- physiological flexion, they aren't curled up in the womb anymore
- hypotonia and asymmetry
- postural
- alertness
32
What do we see with a 1-2 MO in prone?
- Better head lift – momentarily to 45 degrees
- Elbows behind shoulders
- Increased head/neck extensor muscles with less WS forward on the face and shoulders
- Decreased hip flexion
33
What do we see with a 1-2 MO in supine?
- Increased cervical rotation with movement of extremities away from the body
- ATNR (asymmetrical tonic neck reflex) may appear
- Head rarely in midline
34
What do we see with a 1-2 MO in supported sit?
- Begin to see scapular adduction to assist with head lift
| - During pull to sit, head lags but may see grasp reflex traction response with elbow flexion
35
What do we see with a 1-2 MO in supported stand?
-Astasia abasia – motor incoordination for standing and walking
36
1-2 MO UE Movement:
- ________ in supine
- Grasp reflex __________
- May voluntarily retain object placed in hand for brief period
- Bilateral scapular __________ and spinal _________ provide synergistic stability for head lifting
- swiping
- decreased
- retraction, extension
37
1-2 MO LE Movement:
| -_______ may be bilateral and symmetrical, feet come together
-kicking
38
3 Months:
- They are _____ and ______ and can interact _______ with caregivers.
- ________ and ________ orientation beginning.
- Marked _________ in bilateral symmetrical activity and antigravity flexor control.
- alert and aware, visually
- symmetry and midline orientation
- increase
39
What do we see with a 3 MO in prone?
- Sustains prone on elbows with head elevated 45-90 degrees in midline
- Rotated head while elevated-subtle weight shifts
- Increased caudal weight shift – lumbar extensors help stabilize thorax
40
What do we see with a 3 MO in supine?
- Symmetry and midline become dominant
- Chin tuck – bilateral control of capital and cervical flexor muscles
- Capital flexion elongates capital and cervical extensors
- Foot to foot play, increased active knee extension accompanied by hip extension, hip adduction and decreased external rotation
41
What do we see with a 3 MO in supported sit?
sustained head lift
42
What do we see with a 3 MO in pull to sit?
-head rights midway
43
What do we see with a 3 MO in stand?
- astasia abasia usually gone
- able to sustain head lift
- scapular adduction
- toe curling
- plantar grasp reflex
- weight bearing on medial side of foot
44
At 3 months, babies are able to track ____ degrees with head extended, eye hand region.
180 degrees
45
PART 4: 4-6 MONTHS
PART 4: 4-6 MONTHS
46
4 Months:
- Beginning of controlled ____________ movements and alternating, coordinated movements.
- Easily alternate between __________ and __________ in supine and prone.
- Visual tracking _________ head turning.
- Development of __________ visual gaze.
- purposeful
- flexion and extension
- without
- downward
47
What do we see in prone at 4 months?
- Head extended at 90 degrees, pivot prone, prone on extended UE
- Landau (extension of head and legs while holding tummy)
- Increased lordosis
- Able to flex head without collapsing
- Increased activity of adductors, erector spinae and obliques – ribs less horizontal
- Weight on forearms, pects more active and begin to balance extension
48
What do we see in supine at 4 months?
- Increased hip extension and adduction
- Alternates between pelvic anterior and posterior tilting – important in development of trunk synergistic activity for LE movement
- Hands to knees and other body parts
- Begin to see ankle PF, INV/EV
49
4 Month UE:
- Reach in supine with FA _______, wrist ________.
- Primitive ulnar grasp and __________ pattern.
- Can bring hands together but not yet transfer.
- Cannot _________ with control.
- Shakes and bangs, mouths objects – important for perceptual awareness of shapes and sizes and textures and in decreasing tongue and mouth sensitivity.
- FA pronation, wrist extension
- squeezing
- release
50
4 Month Sidelying:
- Baby may roll from supine with hands on knees, initiated with head rotation and symmetrical flexion.
- Sidelying is important in ____ ______ shaping.
- Provides new ________ and _________ orientation.
- Angulation of rib cage important for ________, _________, trunk and rib cage mobility.
- rib cage shaping
- visual and vestibular
- respiration, phonation
51
5 Months:
-Voluntary asymmetrical, dissociated, and __________ movements.
Balance of ________ and _________ with emergence of lateral flexion.
Increased ________ mobility – basis for body RR, equilibrium reactions, and diagonal movements.
- reciprocal
- flexion and extension
- spinal
52
What do we see in prone at 5 months?
- Lateral weight shift in POE – frees face side hand for reach, LEs
- May push up on hands
- Rolls to supine
53
What do we see in supine at 5 months?
- Feet to mouth
- Flexes head if hand held
- Rolls to side
54
What do we see in supported sitting at 5 months?
-Ring sits, props on hands
55
What do we see in sidelying at 5 months?
- First symmetrical then asymmetrical
| - Momentary lateral flexion of head
56
5 Months UE:
- ________ grasp
- Occasionally manipulates and transfers
- Brings ____________ rather than mouth to toy
- Grabs, mouths, bangs, shakes toys
- palmar
| - toy to mouth
57
6 Months:
- More active, uses less positional stability
- Good _______ control in flexion, extension, lateral flexion
- LEs gain ________ control
- Beginning to respond to ________ WS with rotation
- Independent _______
- head control
- extensor
- diagonal
- sitting
58
What do we see in supine at 6 months?
- Lifts head – activity of capital and cervical flexors with synergistic activity of abdominals to stabilize the thorax
- Legs extend with PTS
- Rolls to prone
- Lots of playing with feet in air – what muscles bring them back to midline?
59
What do we see in prone at 6 months?
- Mature landau but extension balanced with flexion – head-neck extension balanced with flexion – chin tucked with elongation of extensors
- Prone on extended arms, pivoting (what muscles are active?)
- Pushing backwards, may assume quadruped
60
What do we see in rolling supine to prone at 6 months?
- Initiated with flexion
| - Transition to extension in sidelying
61
What do we see in sitting at 6 months?
Positional stability of legs
| -Protective extension forwards
62
What do we see in standing at 6 months?
Sufficient hip and trunk control to independently hold on to the support of a person, may bounce, legs abducted
63
6 Months UE:
- Increased __________ control provides synergistic stabilization to the thorax during humeral movements, serratus anterior provides stabilization for the scapula.
- Rotator cuff, deltoids and pec major dynamically stabilize humerus for __________.
- Can stop humerus movement midstream – more precise reaching, cross midline, isolate elbow movements.
- Forearm still ___________, some supination in combination with shoulder external rotation.
- Palmar and ________ palmar grasp.
- abdominal
- reaching
- pronated
- radial
64
6 Months LE:
- Hips more _______ with less ___.
- LEs respond to lateral WS with ___________.
- In prone, the WB side extends, adducts, IR to neutral, nonwb side flexes, adbucts, and ER, pelvis laterally flexes and rotates backward (opposite response in sitting).
- Importance of hip IR and elongation of hip _________ for WS.
- adducted, ER
- dissociation
- abductors
65
PART 5: NORMAL DEVELOPMENT 7-12 MONTHS
PART 5: NORMAL DEVELOPMENT 7-12 MONTHS
66
7 Months:
- Variety of movement.
- More incentive, desire, and capability to move into the ____________.
- Transitions from quad to sit - requires marked mobility at hip joints as femurs move under pelvis, and dynamic trunk-pelvic stability.
- May assume _____ standing.
- environment
| - bear
67
7 Months:
- Sitting: assumed from _____
- Able to rotate _______
- Legs __________ and _______
- Trunk straight, may see slight ________
- _____ free for play
- Protective _________ sideways
- ____ to _________ - at first using a symmetrical pattern and then half kneeling
- quad
- trunk
- abducted and ER
- lordosis
- Arms
- extension
- pull to standing
68
8 Months:
- _________ is preferred position for play, creeping for mobility
- May begin climbing on furniture, stairs
- Play in kneeling – rely on ___ for stability, hips and knees flexed, ankles dorsiflexed
- sitting
| - UE
69
8 Months:
- Increased interest in ______ objects
- Climbing – indication of ______ _______ – how to manipulate body on unfamiliar, uneven, unsteady surfaces
- Standing: still need the ____ to stabilize the posture, LEs abducted, may release one hand and reach out in space – rotation of trunk over stable pelvis and extended Les
- Cruising sideways, body facing forward
- May lower to floor from standing – how low they get before falling an indicator of _________ quad control
- small
- problem solving
- UEs
- eccentric
70
8 Months:
- Walk with hand held, _________ gait (hip flexed, abducted, externally rotated during swing), leads by leaning trunk forward, does not yet use active lower trunk, LE WS
- Hip in line with body in standing due to lordosis, hip ________ still incomplete
- steppage
| - extension
71
9 Months:
- Variety, versatility
- Good ______ control
- Strong desire to _______ and _____
- More refined _______ – hip abducts with less hip flexion and more knee extension
- Increased control of hip ____/_____
- Closer alignment of LE with trunk during single limb WB
- trunk
- stand and walk
- cruising
- abd/add
72
9 Months:
- Independent kneeling with more active hip ________
- LES more active during pull to ________
- Cruising – semi turns towards direction moving
- extension
| - standing
73
10 Months:
- Busy, active, exploring
- Container play – in/out, practicing release
- 3-jaw chuck, pincer
- _______ gestures
- Reaches across _______
- mimics
| - midline
74
10 Months:
- _______: triplanar motion of hips, may cross open spaces
- Cruise around corners – perceptual challenges, motor planning
- Cruises around different height, texture, and firmness of objects
- Supported walking- scapula adducted, trunk extended, anterior pelvic tilt
- Increased ______ movement in standing, more active of gastroc - PF and INV calcaneus.
- cruising
| - ankle
75
11 Months:
- ________ alone when absorbed in a task
- Walks with one hand held
- Assumes standing (quad-semi half kneel-squat-stand)
- Squatting – weight posterior with minimal ankle dorsiflexion
- Hip extensors, abdominals, quads, and ankle DF work in synergy
Stands
76
11 Months:
- Rise to stand – symmetrical extension at _____ and _______ while ankles stabilize
- May see regression in postural control with attempts at __________ walking
- UE: more control of release, neat pincer
- hip and knee
| - independent
77
12 Months:
- Basic motor skills present
- __________ standing, _____ BOS, may begin to use hands more
- Increased LE dissociation, greater skill in planning, organizing, and executing climbing activities
- Most walk ____________
- independent standing, wide BOS
| - independent
S4- Motor Development and Behavior
flashcards
Decks in class (9)
# Cards
-
Week 1- Intro to Motor Control and Motor Learning54
-
Week 2- Setting the Stage for ML, Organizing the Practice Environment, Advanced ML Concepts40
-
Week 2- Motor Learning46
-
Week 3- Neuroplasticity16
-
Week 3- Accessing the Environment23
-
Week 4- Normal Development Introduction77
-
Week 4- Gross Motor Development: Beyond Walking5
-
Week 5- Reach, Grasp, and Manipulation/ Developmental Assessment/MSK Development84
-
Week 6- PDMS-20
