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24 Cards in this Set
- Front
- Back
4 things you need to do for preparation
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Set-up the environment
Child’s positioning Postural control & tone Sensory modulation and discrimination |
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When a child is sitting, what is important to address
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Seat height (feet on the floor)
Seat depth Trunk support Pelvis positioning Work surface height and angle |
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If tone is high, how would you work with the child
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work on decreasing tone overall (even if it is in the arm that you are not directly working with) and then work in U/E and hand.
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What is your job when working with a child on FM skills
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to promote mmt
Extension: fingers, wrist, elbow, etc. Supination/Prontation Shoulder flexion, etc. |
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is wrist extension easier with forarem stablized or without
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WITH forearm stablization
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What is the eariliest, developmental, UE function
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Reach- Most proximal
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Progression of UE function
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General arm movement, then hand placement, then, finger extension during arm movement as a precursor to grasp, then hand function.
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Would you work on side reaching or crossing midline first
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same side reaching
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what age does reach and grasp mature
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10-12 years
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A mature reach involves
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Sustained trunk extension
Rotation of trunk towards object Well controlled elbow extension |
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Where should guide reach from
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the shoulder
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Palmar grasp
Develops whne? |
Need thumb activity and control to move beyond this grasp
At about 6-9 months grasping with active thumb use occurs. Control, refinement, strength, gradation continue to mature |
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With grasp you want to work to the side to minimize...
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Pronation of forearm and IR shoulder
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what are the 5 basic patterns of In-hand manipulation
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Finger to palm translation
Palm to finger translation Shift Simple rotation Complex rotation |
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Translation
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linear movement of an object in the hand (moving a coin from fingertip to palm)
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Shift
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linear movement of an object to reposition on the pads of the fingers (turning pages in a book)
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Rotation
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movement of an object around its axes in the hand (reorienting a puzzle piece, turning pencil over)
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what 3 factors contribute to difficulty with in hand manipulation
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Mobility - when range is limited.
Stability - especially with low tone. Differentiation of radial and ulnar sides of hand. |
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How would you increase mobility
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Weight bearing on open hand
Games to encourage movement |
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How could you work on stability with kiddos
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Make a donut with theraputty or silly putty. Child spreads hand open.
Child opposes finger to thumb to form a circle. Therapist tries to open circle; child resists. |
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How can you work on differentiation
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Spray bottle (squeezing a trigger)
Scissors Tweezers Clothespins Hold small bottle (tube) in ulnar fingers and use thumb and index to unscrew lid. |
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Beginning In hand manipulation skills
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Allow use of surface or some use of other hand.
Work on separation of radial and ulnar sides of hand. Work on isolated finger movements. Movements that require MCPs flexed with IPs extended. |
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Basic IHM skills
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Expand of basic movements repertoire without stabilization, than add stabilization
Verbal cueing Place food items in palm, and translate to fingers for eating. Objects that have clearly marked top and bottom for simple rotation. |
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Intermediate IHM skills
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Use of stabilization
Add rotation and shift Smaller objects Verbal cueing and feedback Functional application: hygiene, dressing, school tasks. Speed and accuracy |