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173 Cards in this Set
- Front
- Back
Human development is:
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-pattern of lifelong change
-multidimensional -contextual and biological -plastic(broad range of individual differences) -studied by many disciplines |
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Core Concepts and themes of human development
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-children are active participants
-self-regulation is cornerstone -human relationships are important -timing of early experiences matters |
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Theories of Motor Control (4)
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-reflex, hierarchical, neural maturation
-behavior -learning -dynamic systems |
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Theories of Motor Development
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Neural maturationist
Cognitive theories Dynamic Systems Systems Theory |
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Neural-Maturationist Theory
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-development is innate, predetermined
-development controlled by maturation of CNS -primitive reflexes, righting and equilibrium reflexes -neurofacilitation -assessment w/ norm-referenced tools |
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What are the 2 Cognitive theories of Motor Skill Development
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Behavioral and Piagetian
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Behavioral Theory
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-Skinner 1972
-environment is motivator and shaper of motor and cognitive development -response to stimulus with reinforcer |
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Piagetian Theory
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Piaget 1952
-combination of maturation of cognitive and neural structures and the environment -stages of development-cognitive development (used to promote mvmt) |
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Motor Program theories
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central pattern generators
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Dynamical Systems Theory
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-development is not a series of discrete stages, but a series of states of stability/instability
-wells and valleys, stable vs non-stable -work during nonstable periods |
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Intervention in dynamic systems theory
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-based on
1. evolution of constraints 2. meaningful environmental support 3. manipulation of control parameters |
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Systems Theory
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-interaction between individual, task and environment
-task oriented, functional/goal directed -compensation strategies in brain |
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Individual (systems theory)
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-cognition
-perception -action |
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Task (systems theory)
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-functional grouping
-discrete vs continuous -stability vs mobility -manipulation with task -mvmt variability (open vs closed task) |
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Environment (systems theory)
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-regulatory
-nonregulatory |
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Movement principles
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-flexion/extension
-antiGravity -elongation/activation -Symmetry/Asymmetry -Cephalocaudal -Proximodistal -Stability/Mobility -Unrefined to refined -Action plans |
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Movement processes
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sensitive periods
spiraling patterns of development |
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Sensitive periods
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-Is there a time when babies can learn to make a movement?
-What times during the lifespan are most helpful to work with child? |
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Spiraling patterns of development
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Times of strength and weakness
Systems are changing When do you want to work on what? |
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Def Postural Control
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ability to hold posture in changing conditions. different from functional mvmt in that it is not goal directed
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2 aspects of postural control
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Postural orientation and postural stability
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Postural orientation
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orientation of body & environment for a task
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Postural stability
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maintaining COM within BOS
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Postural control is interaction between......
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Task, Individual, and Environment
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Theories of developing postural control
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reflex/hierarchical theory
motor programming (learning) theory systems theory |
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What are the stereotypical responses to sensory stimuli associated with emergence of postural control?
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Additudinal reflex
Righting reflex Balance/protective reflex -appear early in development-no agreement of their role or period of disappearance |
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Additudinal reflex
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head orients itself to space (upright). Body changes with the head (ATNR, STNR, etc)
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Righting Reflex
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righting head in orientation to horizon. (optical, tilt)
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Balance (protective) Reflex
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control of COG, putting arms out to protect, lean to opposite side of tilt
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Development of postural control theories
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-reflex-hierarchical model consistent with systems model in explaining postural development
-emergence of postural control characterized by rules-- sensory inputs->motor actions-mapping -many systems contribute to the development of postural control but they develop at different rates -not all systems contributing to the development of postural control develop at the same rate |
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systems contributing to postural control
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-internal representation
-adaptive mechanisms -anticipatory mechanism -sensory strategies -individual sensory systems -neuromuscular synergies -musculoskeletal components |
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Which sensory system develops first?
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vision
-kids with visual delays will need extra help early with postural control -infants lift head due to visual stimuli |
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Organizing 'Model'
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-development of sensory systems
-changes in musculoskeletal system -dev synergies (trunk strategy issues in CP) -sensory strategies for organizing multiple inputs -importance of mapping of perception (preparing for mvmt) to action -dev of anticipatory mechanisms -continuous development |
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Stages of motor development in the first year
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1. prone-on-elbows
2. rolling 3. rolling supine to prone 4. independent sitting 5. hands and knees 6. creeping on hands and knees 7. pull to stand 8. stand indep 9. walk indep |
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postural control first 3 mos
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-control head in all positions
-turn head in prone or supported sitting -load-bearing surfaces shift caudally -control of pelvis and LE in supine |
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Development of head control in first 3 mos
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-spontaneous (need vision to start)
-sensory contributions (visual orientation and tracking) -motor coordination (response to perturbations) (coordinated response to neck mm) |
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Attitudinal reflexes
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result from changes in head position
-ATNR (birth-3 mos) -STNR (4mos and up) -TLR (birth-6 mos) |
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Postural control 3-6 mos
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-arm and upper trunk control
-start on elbows, then ext elbows -increase ability to control in reach while sitting -initial trunk control (sitting, manip objects,. free arm mvmt in prone, pivoting) |
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Development of independent sitting
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6-9 mos
-related to head control (coordinate) -stronger response to backward sway than forward -sensory contributions-vision, somatosensory(objects to mouth), vestibular |
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Postural control 6-9 mos
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mastery of control of lower trunk and pelvis in upright position
-crawling -creeping -pull to stand -supine to all 4s -rotational abilities within axis of trunk |
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postural reflexes at 6-9 mos
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-automatic response to loss of balance
-righting reflexes -protective reactions -equilibrium reactions |
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Postural control at 9-12 months
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Control of lower extremities
-independent standing -reciprocal hip and knee flexion -lowering from standing -independent walking |
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Stages of independent stance
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-pre pull to stand- no coordinated mm response (2-6 mos)
-early pull to stand- use of ankle mm and mm synergies (7-9 m) -pull to stand- add thigh mm, distal to proximal sequence -late pull to stand and indep stand- trunk mm consistently active, complete synergy (9-11 m) -motor coordination-strength not a major determinant of stance post control -sensory contributions- visual before somatosensory, adaptive capability |
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Ankle synergy
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contralateral contraction
distal -> proximal |
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typical postural control stance
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LE synergies- distal to proximal!
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Surveillance vs Screening
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surveillance is subjective, screening is objective. Screening is done at set points in time. Screening uses validated instruments
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Issues with surveillance
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-cannot rely solely on clinical judgement
-development is dynamic and hard to measure |
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What is the purpose of screening?
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-identify children who MAY HAVE developmental delays or disabilities
-guide decisions about referrals -connect families to resources |
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What are the benefits of screening?
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Assists in sorting children into 3 categories
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What are the 3 categories screening sorts children into?
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Needs Additional Evaluation
-did not pass screen Needs close monitoring/surveillance -passed but has risk factors Needs ongoing monitoring in context of well-child care, surveillance -passed screen with no risk factors |
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3 steps to the screening process
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-select a population
-select a tool(ages and stages) -map the process (SoonerStart) |
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Ages and Stages
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-completed by parent/caregiver given approx every 2 mos
-color-coded questionnaire and developmental items -5 domains -section for parental concerns -if below cutoff, referral for further developmental testing |
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What are the 5 domains in Ages and Stages
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-communication
-gross motor -fine motor -problem solving -personal-societal |
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Ages and Stages (ASQ) scoring
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assign a value of 10 to yes, 5 to sometimes, 0 to never
gray=may be a concern |
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Standards for screening tests
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reliability-test over and over
validity-measures what it says sensitivity- snout specificity- spin |
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positive predictive value
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the proportion of people who test positive and actually have the diagnosis
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negative predictive value
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proportion of people who test negative who do not have the diagnosis
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Screening pitfalls
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-relying on internal methods
-using a measure too time consuming for setting |
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Screening limitations
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-use of informal checklists of developmental skills
-informally eliciting parents concerns (parents not always sure if they are worried) -accuracy of clinical judgment |
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Rules for sharing results of screening
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-timely manner
-explain tool is just a snapshot and results can be affected by: shyness, tiredness -description of results -provide anticipatory guidance |
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What should you do when you suspect a delay after screening?
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birth-3 yrs
-refer to early intervention (SoonerStart) for further eval and eligibility Above 3 -refer to local school district for eval and eligibility |
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FirSTEp
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-designed to identify young children (2yr9m-6y2m) who MAY HAVE mild to severe school related problems
-companion to Miller Assessment for Preschoolers (MAP) -screen for development in 5 domain areas (Cognition, communication, motor, social-emotional, adaptive functioning) |
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Calculating Age
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Year Mo Day (test)
-Year Mo Day (birth date) ------------------------------------- age of child |
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Adjusting for prematurity
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Calculated Age of child
Year Mo Day -Prematurity --------------------- Adjusted age (divide weeks into mos and days 4 weeks=1 mo, 7 days= 1 week) |
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What are the 3 purposes for tests or measures?
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1. to discriminate between individuals along a continuum of health, illness or disability
2. predict outcome or prognosis 3. evaluate a within-person change over time |
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Three broad categories of applications of health measures
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-discrimination
-prediction -evaluation |
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Discriminative index
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used to distinguish between individuals or groups on an underlying dimension when no external criterion or gold standard is available for validating these measures
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Predictive index
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used to classify individuals into a set of predefined measurement categories when a gold standard is available, either concurrently or prospectively
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Evaluative index
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used to measure the magnitude of longitudinal change in an individual or group on the dimension of interest
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Steps in constructing an index to measure quality of life
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-selection of item pool
-item scaling -item reduction -determination of reliability -determination of validity -determination of responsiveness |
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Selection of the item pool
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bring together a set of items which might plausibly be included in the final instrument
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Item scaling
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options available for patients in answering each question; that is, the scale associated with each item
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Item reduction and internal consistency
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investigator may initially choose items from the total item pool for the first version of the questionnaire based on item frequency and importance but the content of the definitive instrument must depend on item performance in the setting in which the index will ultimately find its use
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Reliability
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reliability of a single application of a measurement instrument can be defined as the ratio of the variance attributable to true differences among subjects to the total variance
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Criterion validity
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refers to the extent to which a measuring instrument produces the same results as a gold standard, or criterion measure
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Construct validity
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the extent to which a particular measure relates to other measures in a manner which is consistent with theoretically derived hypotheses concerning the concepts being measured
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Responsiveness
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-demonstration of reliability and validity is sufficient for concluding that an instrument is useful for descriptive or predictive purposes, we must also have info about an instrument's responsiveness before we can confidently use it in a clinical trial
-concerns the power of the index to detect a difference when one is present-that is, sample size required to observe a small, medium, or large change or effect size in the population |
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What are the 2 main types of cognitive theories of motor skill development?
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-Behavioral Theory (Skinner)
-Piagetian theory |
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Behavioral Theory
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-Skinner
-importance of contingent learning w/ reinforcement from environment being motivator -ENVIRONMENT is site of developmental control -Pavlov- operant conditioning -interventions should be individually tailored to behavior |
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Piagetian Theory
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-emphasizes interaction b/t maturation of cognitive-neural structures and environmental opportunity to promote action
-person has self-regulating system for assimilation/accommodation -4 stages |
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4 stages of Piagetian theory
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Sensorimotor> 18-24 mos
development of language> 2-6 yrs concrete operations formal operations> 11yrs+ |
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Dynamic Systems Theory
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-emphasizes process rather than product
-neural maturation equals other processes and integrates -structures become progressively integrated with self-organized properties of the system -developmental change not a series of discrete stages but is a series of stages of stability, instability, and phase shifts -focuses attn of therapist on 5 aspects of therapeutic process of facilitating functional activity McGraw- exercise inc coordination but not development |
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5 aspects of therapeutic process of facilitating functional activity
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1. search for constraints in subsystems that limit motor behavior
2. environments that compensate for weak subsystems promote participation 3. setting up a therapeutic environment that supports practice 4. activities to promote exploration of a variety of mvmt patterns for a task 5. search for control parameters |
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Consistent principles of motor development
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-cephalocaudal
-proximodistal -neural maturation -spiraling-not continuous -self-regulating- construction of developmental process |
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Processes involved in advanced stages of development of functional reach include:
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1. visual fixation to localize the object
2. foveal analysis for perceptual identification of an object 3. manual capture 4. object manipulation |
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Reaching
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1-2 mos> fisted hand, successfully reach and grasp with hand supported
4-5 mos> visual control w/ open hand 13-20 wks> consistent use of reach with grasp |
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Paillard- 4 features that characterize evolution of a primate nervous system
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1. extension of precentral cortex developed principally for fine sensory-guided steering and control of the hand
2. enlargement of the lateral cerebellum 3. specialization of parietal association cortex 4. development of frontal association areas |
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Neuronal group selection theory-3 basic tennets
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dynamic loops
1. how the anatomy of the brain is produced during development 2. experience strengthens certain patterns of responses 3. maps of the brain give rise to individual behavioral fxn through reentry |
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Selectionist model
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when overtly similar mvmts are studied in a group of individuals, each person performs mvmt with unique combination of synergistic mm activation patterns
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What are Sensitive periods in development based on?
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-experience-expectant and experience-dependent maturation of neural systems
-experience dependent plasticity of NS can intake new synapses -effects of experiences during sensitive periods differ from other times |
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Sensitive periods in development
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2-4 mos> vary activity to reach a goal
7-8 mos> several actions relate in single functional unit 12-13 mos> coordinate actions to perform a function 18-21 mos> memory of an object can activate an action |
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Functional head control
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-birth>ability to right the head from full flex or ext
-shifts of gaze preceded by rapid bursts of body mvmt -smooth visual pursuit present at 6 wks, adult like at 14 wks -sustain head in midline at 2 mos |
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Upright trunk control
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-initial ability to maintain sitting indep on propped arms when placed is achieved once infant can:
1. ext head and trunk in prone position 2. control pelvis, LEs while using arms or moving head in supine -usually sit alone around 6 mos |
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Lower trunk control in upright position
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9 mos-crawling
supine to 4 pt and sitting, sitting to prone |
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What are the 2 features of object manipulation?
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1. control of hand as terminal device for reach and grasp
2. object manipulation and release |
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What are the 4 grasping patterns in the first 5 mos?
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1. fisted grasp
2. precision grasp 3. precision grip of objects 4. self-directed |
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Object manipulation by age
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2 mos> rotation of held objects
3 mos> translation of objects (bring to mouth) 4 mos> shaking objects 4.5 mos> bilateral hold of 2 objects 4.5-6 mos> hand to hand transfer 5-6.5 mos> holding object and using other hand to manipulate it 6-8.5 mos> coordinated action, striking 2 blocks together 7-8.5 mos> deformation of objects(rip, bend, squeeze) 7.5-9.5 mos> instrumental sequencial action |
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Functional motor activities in preschoolers
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2yrs- kick a ball
2.5yrs- tiptoe, jump w/ both feet, throw and catch, stand on one foot 3yrs- alternate feet to ascend stairs 3.5yrs- less coordinated 4yrs- skate, bicycle, wild, self confident 5yrs- dodge, skip, long jump, more conforming, household tasks 6yrs- practice balance, dancing, climbing |
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3 perspectives in motor control development
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1. maturational
2. learning 3. dynamic based |
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Hypothesis
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attempt to predict a relationship between observations and environmental conditions
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Maturational based theory
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-behavior due to motivational changes in nervous system
-motor behavior is composite coordination of simple reflexes |
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Laws
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define highly predictable relationships between variables
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models
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idealized constructs that incorporate the few most powerful variables in explaining relationships between events
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Learning-based theories
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-what attributes of the environment shape behavior
-motor programs are learned sets of instructions -motor programs, CPGs |
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What are the 2 dynamic based theories
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Dynamic System Theory
Dynamic Selection |
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Dynamic Systems Theory
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Thelen
-most recent -how does a child move from one state to another -multiple variables establish context for movement and relationship. constant flux -developmental stages viewed as ATTRACTOR STATES -transitions in behavior are flips between attractor states |
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Dynamic Selection
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Sporns & Edelman
-how the brain's circuitry can readily change to accommodate -relationship between evolving movements and brain circuits -recognizing the value of a mvmt experience will increase probability of repetition |
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3 key hypotheses to dynamic selection
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1. genetically endowed with basic movement
2. genetically endowed with sensory system capable of detecting movements 3. can select movements having adaptive value |
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Central Pattern Generators
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current hypothesis of motor control
-account for basic neural organization and function required to execute coordinated mvmt synergies |
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Equilibrium Point Hypothesis (Mass Spring Hypothesis)
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-nervous system strives to control joint position in space
-every position is a unique combination of agonistic/antagonistic mm |
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Threshold Control Theory
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motor control is a combination of mm activation thresholds with a steady state emerging from interaction b/t person and environment
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Impulse Variability Model
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NS controls mvmt by planning phasing, duration of mm contraction
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Neural Network Models
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-no simple relationship exists amongst nerve cells to explain movement
-mvmt is a phenomenon of their complex interactions |
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Sensorimotor variables
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-physiologic mechanisms or processes that reside within NS
-CPGs play key role -mechanical- motor skills affected by internal forces -Cognitive- reasoning, memory, and judgement. Predictive posture> feed forward |
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Task requirements
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-distinct motor control variables
-any variable that contributes to or alters movement (biomechanical requirements, meaningfulness, predictability, etc) |
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Postural Control
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achieved via cooperative interaction of neural sensory (3) and motor systems, & cooperating ms systems to meet goals
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What is the most powerful sensory system is regulating posture?
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vision
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Down Syndrome and vision
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Kids with DS and cognitive delays overrely on visual system after most switch to the other 2
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CP and vision
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Kids with Ataxic Cerebral Palsy have difficulty triggering motor responses when sensory info is conflicting
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At what age can kids activate anticipatory postural mm
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age 1
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1st principles of neonatal care
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1900s
-body temp -infection control -minimal handling -special nursing care |
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how to minimize visual impairment in NICU
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protect REM sleep, dark periods, limit noise, limit stimuli
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how many ELBW babies have neurological disability?
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about half
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New Ballard Score (NBS)
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determines gestational age
-neuromuscular, physical, external genitalia |
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Respiratory Distress Syndrome in NICU
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-cause of most deaths/illness
-pulmonary immaturity -low production of surfactant |
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3 Theoretical frameworks for the NICU
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-enablement model
-family centered care -infant neurobehavioral functioning |
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Recommendations for eval/exam in NICU
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-protect infant's fragile neurobehavioral system
-repeat observations over time -partner w/ parents, members of tx team -observe, interpret, communicate behaviors |
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ICF
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-Internal Classification of Functioning, Disability, and Health
-paradigm shift from classification of dysfunction/disease to a model of health |
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What are the components of the ICF?
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-Health condition (disorder or disease)
-Participation -Personal Factors -Environmental factors -Body functions and structures(impairment) *circle around Activity |
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Participation vs Activity
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Participation is purposeful and meaningful
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Biomedical paradigm
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focus is to uncover cause of illness and FIX the underlying disorder
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Social (Ecological) Paradigm
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-considers factors outside of the body
-determinants of health come from a wide range of environmental factors that interact with person variables |
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Def Disability
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-umbrella term for impairments, activity limitations, or participation restrictions
-outcome of a relationship between the person and environment ex: I would be disabled in a French speaking country |
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What are environmental barriers?
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-physical
-social -cultural -institutional |
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Measuring Participation
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-person's preferences and interests
-doing -where and with whom -how much enjoyment -how much satisfaction |
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Environment of Intervention
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-how aspects of the environment contribute to optimal or non optimal developmental outcomes
-how families/environment mediate change -types of intervention programs that influence families and children directly |
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Transactional Theory
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-child development
-interaction between child, family, and environment -all have the power to change the nature of the interaction and outcome of development |
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Developmental Niche
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-physical and social settings of a child's life
-culturally regulated customs and practices of child care and childrearing -psychology of the care takers |
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4 areas of shared decision making in intervention
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-common ground
-collaboration -participatory guidance -anticipatory guidance |
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Steps for involvement in learning opportunities
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1. identify child's interests
2. identify family and community activities related to a child's interests and age 3. involve the child in the activities to promote competence |
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Assessing children's learning opportunities and participation
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-activity settings
-child and family interests -child and family assets -functional and meaningful interactions -current opportunities -current participation -possibilities **examples in notes |
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Consequences of postural instability
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-loss of functional independence
-falls -severity of disability |
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Postural Instability
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-inability to counteract the destabilizing force using direction-specific postural adjustments
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Underlying factors of postural instability
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1.Motor Components
-postural synergies not programmed 2.Sensory Components -inability of sensory pathways to elicit activity in the synergies 3.Cognitive Problems 4.Other |
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Experimental paradigms of postural instability
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1. destabilizing using movable support surface
-quick reaction -compensatory control(feedback) 2. destabilizing force produced by voluntary movements -anticipated -anticipatory control (feed forward) |
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Problems in motor components of postural control
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-motor coordination
-musculoskeletal contributions -loss of aniticipatory postural control |
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3 Causes of motor incoordination
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problems with
1. sequencing 2. timely activation of postural responses 3. adapting postural activity to environmental demands and changing task *these are the WHY of the problem. Pick which ones of these as a starting point |
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Sequencing Problems
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-reversal in mm recruitment order
-delayed recruitment pattern -delayed activation of responses(timing) -amplitude of mm response ex: reversing order of contraction in ankle strategy |
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Examples of sequencing problems
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crouch gait-hamstring before gastroc
scissor gait toe walkers-tib ant before gastroc seating-spastic diplegia-neck before hip |
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Co-activation
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rigid, contracting everything at the same time
-primary problem in Parkinson's -normal in healthy young children -antagonist mm contract at same time -limit flexibility **this is a coping strategy to postural instability. Not a problem in and of itself |
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Motor Incoordination
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-problems modifying postural control
-postural adaptation |
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Problems modifying postural control
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Postural adjustment of environmental conditions
-appropriate size of muscles response -combination of feed forward and feedback mechanisms -inability to adapt amplitude of mm response to perturbations of increasing distance and velocity-recruitment problems |
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Postural Adaptation Issues
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1. Lack of direction-specific adjustment
2. typical adjustment in children with CP (sitting) -top-down recruitment of postural muscles -excessive antagonistic co-activation -incomplete modulation of amplitude to task contraints |
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Musculoskeletal contributions to posture
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-alignment
-joint movement constraints -changes in mm structure -changes in mm force |
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Sensory disorders in postural control
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-sensory organization- ability to adapt to sensory inputs, prevent development of accurate internal models of postural control
-loss of one sense- proprioception, vision, or vestibular -loss of sensory redundancy -sensory organization and selection problems |
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Impaired Cognitive function and postural control
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-duals or multi-task (Parkinson's and TBI)
-motor incoordination in individuals with Alzheimer's disease -sensory disorganization with restricted vision in individuals with Alzheimer's disease |
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General concepts of postural control
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-muscle strength
-coordinated postural responses -muscle response synergy -onset of latency of mm response -mapping-individual vs multiple senses |
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What percentage of infants less than 25 weeks are likely to have CP?
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1 in 4
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Criteria for selection of standardized tests
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-primary complaints and family goals
-purpose (prevention=screening tool, diagnostic=diagnosing tool) -Age -current functional (cognitive & behavior) status -theoretical frameworks -psychometric properties of the tool -current evidence on the tool -therapist knowledge and experience |
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Psychometric properties
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How well do items on a test define a construct of interest?
Does the item set reflect a useful range of performance? How consistent are test scores? How well does the score on the test measure a construct of interest? How well does the score on the test meausre the performance of interest? What is the clinical significance of test scores? What are the consequences of making specific decisions based on the score? |
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TIMP
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Test of Infant Motor Performance
-used to identify infants with motor delay before 4 mos corrected age -used in special care nurseries and early intervention or diagnostic follow-up settings -descriminative, predictive, evaluative -plan intervention programs -document change |
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Conceptual basis of the TIMP
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-human infant is a self-organizing being
-multiple systems interact to create actions -self-organization occurs in a task context shaping the mvmts used to accomplish a purposeful task -self-organization links action with perception through movement -TIMP tasks pose as problems for the infant to solve |
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Age Range for the TIMP
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32-34 weeks gestational age to 16 weeks post term
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TIMP Constructs
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Postural Control
-control of position in space for stability and orientation -stability is ability to maintain COM within BOS -orientation is alignment of body segments Selective Control |
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Items on the TIMP
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Observed items
-used to rate spontaneous movement (selective control, midline alignment, quality of movement) Elicited items -assess infants' motor responses to placement in various positions and to visual or auditory stimulation |
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TIMP Deviations in kids with CP
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3 weeks- unable to hold head in midline for even a couple seconds; lack of anti-gravity arm movements during face covering
9 weeks- failure to inhibit neck righting, poor AP head control 12 weeks- poor prone head control, anti-gravity activity supine and sidelying, reaching and fingering objects, and failure to adopt synergies using extension in supine and prone |
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Summary of Research on TIMP
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-rater and re-test reliability
-sensitive to age-related change and medical complications -ecological relevance and predictive validity -appears to form a linear, hierarchical scale assessing postural and selective control of movement |
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Germinal Matrix Hemorrhages
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26-28 weeks
-germinal matrix, still full of tiny blood vessels, very susceptible to hemorrhage -small hemorrhage is contained within the germinal layer |
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cortical hemorrhages
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32-34 weeks
-changes in blood pressure now tend to result in multiple small hemorrhages in the cortical surface areas, resulting in diffuse damage |
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Intercerebellar hemorrhages
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hemorrhages caused by external compression
(occipital molding from band of o2 mask, post head pressure, endotracheal tube) |
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Tactile Kinesthetic Stimulation vs Waterbed flotation
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TKS (stroking, PROM, etc) was not beneficial. Waterbed flotation caused dec in resp pauses, better weight gain, better tone, less irritability
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Parameters to be Considered in assessing infant function:
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1. infant's current, newly emerging developmental agenda
2. infant's current level of subsystem balance 3. threshold of disorganization indicated by behaviors of defense and avoidance 4. degree of relative modulation and regulation of the various subsystems 5. degree of differentiation and effectiveness in rebalancing the subsystems in the accomplishment of the task 6. degree of environmental structuring, support, and facilitative aid necessary to bring about optimal implementation of the new task 7. degree of environmental structuring, support, and facilitative aid necessary to bring about organization at a smooth, well integrated and ideally more differentiated new level of functioning |
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Description of the Assessment of Preterm Infant's Behavior (APIB)
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-appropriate for preterm infants, at-risk infants, and healthy full term infants
-provides an integrated subsystem profile of the infant, identifying his current level of smooth, well balanced functioning in the face of varying developmental demands -administered at any time infant's behavior allows 3 subsystems (tasks already handled with ease, tasks which stress infant, tasks not yet appropriate) -helps establish developmentally appropriate goals for infant -behaviors grouped into autonomic/visceral signals, motoric signals, state-regulated signals |