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112 Cards in this Set
- Front
- Back
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What is normal gestational period?
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38-42 wks
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Neonatal period
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1st 4 weeks of life
-Tactile, proprioception, and vestibular key for development -vestib fully developed at birth but key for neonate organization |
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Neonate - vision
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responds to faces and high contrast items 10" from face
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In the 1st 6 months, postural control facilitates development of what sensory system?
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Visual development
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Infant movements progress from ______ to _____
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Infant movements progress from REFLEXIVE to VOLUNTARY and GOAL DIRECTED
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Crossing midline depends on sensory development of what systems?
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Tactile and proprioception
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What are primitive reflexes and when do they integrate?
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Primitive reflexes are present at/just following birth. Integrate within the 1st yr
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What reflexes emerge in the 3rd trimester?
(Important for working with premature infants) |
28 wks:
1. Rooting 2. suck-swallow 3. traction 4. Moro 5.Plantar 32 wks: Galant 37 wks: 1. ATNR, 2. palmar grasp, 3. tonic labyrinthine |
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Persistence or re-emergence of primitive reflexes are indicative of what?
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Reflexes that do not integrate appropriately may indicate CNS dysfunction
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Rooting reflex
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Onset: 28 wks gestation
Integrates: 3 mos Stroke upper corner of mouth or upper/lower lip and baby will move tongue or head toward stimulus -Allows location of feeding source |
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Suck-swallow reflex
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onset: 28 wks gestation
integration: 2-5 mos -Place finger inside mouth with infant's head at midline. should respond with strong rhythmical suck -Allows ingestion of food |
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Traction reflex
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Onset: 28 wks gestation
Integration: 2-5 months Grasp forearms and pull to sit. Infant should completely flex UE's. Enhances reflexive grasp |
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Moro reflex
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Onset at 28 wks gestation
integrates at 4-6 months rapidly drop infant's head backward. Response in 2 phases: 1) arms extend/abduct with hands open. 2) Arms flex and adduct Helps break up dominant flexor posture. Protective response. |
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Plantar grasp reflex
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Onset at 28 wks
integrates at 9 mos Pressure to ball of infants foot results in toe flexion Increases tactile input to sole of foot |
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Galant reflex
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onset at 32 wks gestation
integration at 2 months Infant placed in prone suspension; tap along spine from shoulders to buttocks. Infant should demo lateral trunk flexion on stimulated side Facilitates lateral trunk movements necessary for trunk stabilization |
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Asymmetric tonic neck reflex (ATNR)
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onset at 37 wks gestation
integrates at 4-6 mos fully rotate infant's head and hold for 5 sec. Infant will extend extremities on face side and flex on skull side (fencer) Promotes visual hand regard |
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Palmar grasp reflex
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onset at 37 wks gestation
integration at 4-6 mos place finger in infants palm, infant grasps increases tactile input to palm |
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Tonic labyrinthine reflex (supine, prone and head righting variations)
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onset at >37 wks gestation
integration of supine and prone at 6 months. Head righting persists. Place infant in supine = increase extensor tone Place in prone = increase flexor tone Head/optic righting: tilt infant 45* forward, backward, or to side. Will position head upright. Orients head in vertical. |
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Landau reflex
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onset 3-4 mos
integrates 12-24 mos hold infant in horizontal prone suspension. Results in complete extension of head, trunk, and extremities (superman). Breaks up flexor dominance and facilitates prone extension |
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Symmetric tonic neck reflex (STNR)
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onset: 4-6 months
integrates: 8-12 months Place infant in crawling position and extend head. Results in flexion of hips and knees. Breaks up extensor posture and facilitates quadruped |
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Neck on body righting reflex (NOB)
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emerges at 4-6 months
integrates at 5 years place infant in supine and fully turn head to 1 side. Infant will log roll entire body to align with head. Maintains alignment; initiates rolling (1st form of ambulation) |
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Body on body righting reflex (BOB)
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emerges at 4-6 months
integrates at 5 years place infant in supine. briefly flex one hip and knee toward chest. Infant will segmentally roll upper trunk to maintain alignment Facilitates trunk rotation |
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Downward parachute reflex (protective extension downward)
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emerges at 4 months
Persists (does not integrate) Rapidly lower infant toward surface while suspending vertically. Should see extension of LE's. Allows placement of LE's in anticipation of surface |
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Forward parachute (protective extension froward)
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emerges at 6-9 mos
persists Suddenly tip infant foward toward surface while suspended vertically. Should see UE extension, neck extension, hand opening UE placement in case of fall |
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Sideward parachute (protective extension sideward)
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onset at 7 mos
persists in sitting position, quickly tip infant off balance. Should see arm extension and abduction to side. protects against fall; supports body during unilateral use of opposite arm |
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backward parachute reflex
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onset at 9-10 mos
persists quickly tip infant off balance backward. Should see backward arm extension or arm to one side. Protects against fall. Facilitates unilateral spinal rotation |
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Tilting reflexes (occur in prone, supine, sitting, quadruped, and standing
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4 different reflexes with onset between 5 mos and 21 mos
-persist throughout life help to maintain equilibrium and facilitate postural adjustments |
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The onset of which 5 reflexes occurs at 28 wks gestation?
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1. rooting (integrates 3 mos)
2. suck-swallow (integrates 2-5 mos) 3. Traction (integrates 2-5 mos) 4. Moro (integrates 4-6 mos) 5. Plantar grasp (integrates 9 mos) |
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Which reflex begins at 32 wks gestation?
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Galant
(integrates 2 mos) |
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Which 3 reflexes begin at 37 wks gestation?
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1. ATNR (integrates 4-6 mos)
2. palmar grasp (integrates 4-6 mos) 3. Tonic labyrinthine - supine and prone variations (integrate at 6 months) |
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Which reflex emerges at birth-2 mos?
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Tonic labyrinthine (optical/head righting),
does not integrate |
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Which reflex emerges at 3-4 mos?
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Landau (integrates at 12-24 mos)
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Which 4 reflexes emerge between 4 and 6 mos?
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1. STNR (integrates 8-12 mos)
2. NOB (integrates 5 yrs) 3. BOB (integrates 5 yrs) 4. downward parachute (persists) |
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Which reflexes persist throughout life?
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1. labyrinthine/ optical head righting
2. parachute/protective extension reactions 3. Tilting reactions |
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Prerequisite skills for visual motor integration
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1. visual attention
2. visual memory 3. visual discrimination 4. kinesthesia 5. position in space 6. figure ground 7. form constancy 8. spatial relations |
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5 General Principles of Motor Development
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1. Cephalocaudal/proximal to distal occurrence
2. Gross to fine movements 3. Stability before mobility 4, Periods of equilibrium and disequilbirium intermittently occur 5. child is effected by environmental input |
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10 important aspects of UE development
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1. head/trunk control
2. eye/hand and sensory/perceptual interactions 3. shoulder stability/mobility 4. humeral control 5. elbow control 6. forearm control 7. wrist control 8. thumb opposition and mobility 9. palmar arches of the hand 10. isolated finger control |
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When does handedness become stable?
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Age 5. Preferences often identified before this age.
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When does crossing midline begin?
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9-12 mos, usually begins reaching for toy while WB'ing on opposite extremity.
Requires movement against gravity and wieght shift |
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When does bilateral integration develop?
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9-12 months
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When does the baby hold his head at midline?
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3-4 mos
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When does the baby roll from supine to side?
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3-4 months
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When does hands to midline develop?
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4 months
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When does the baby bring hands to mouth?
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5-6 months
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When does the baby lift head independently
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5-6 months
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When do the hands begin to be predominantly open?
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5-6 months
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When does the baby roll prone to supine?
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5-6 months
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when does body sides dissociate (unilateral reach)?
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6 months
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When does the baby crawl on belly?
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7 months
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When does the baby develop reciprocal creep?
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7-10 months
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when does the baby support self in sitting?
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5-6 months (momentarily)
5-10 months (alone, playing with toys) |
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When does the baby stand while holding on to furniture?
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5-10 months
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When does the baby pull to stand with furniture?
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6-12 months
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when does the baby cruise?
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8 mos
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When does the baby move in and out of sitting to other positions?
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10-12 months
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When does the baby stand alone momentarily?
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9-13 months
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When does walking begin?
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10-14 mos
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When does object transfer begin?
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4-8 mos
2 stage = 5-6 months 1 stage = 6-7 months |
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when does volitional release occur?
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7-9 months
begins with infant pressing on surface to release. Wrist position progresses from flexion to neutral to extension (precise by 12-15 months) |
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at what age can a child jump off the floor with both feet
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3 years
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At what age will a child rake at a pellet
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6 months
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Grasp of a pellet
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3 mos: visual regard only
6 mos: rakes to make contact 7 mos: inferior scissor grasp to rake into palm (thumb adducted and totally flexed) 8 mos: scissor grasp 9 mos: inferior pincer grasp (beginning of thumb opposition) 10 mos: pincer grasp 12 mos: fine pincer grasp |
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Grasp of a cube
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3 mos: may swipe at object
4 mos: primitive squeeze grasp; no thumb involvement 5 mos: palmar grasp w/ thumb adducted 6 mos: radial palmar grasp w/ thumb opposed 8 mos: radial digital grasp w/ some open webspace 9 mos: wrist extension noted |
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release skills
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no release: 0-1 mos
involuntary release: 1-4 mos 2 stage transfer: 5-6 mos 1 stage transfer: 6-7 mos voluntary release: 7-9 mos refined until age 4 |
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bilateral hand use
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-asymmetric movements until 3 months
-symmetric movements until 10 mos -12 to 18 mos = both hands for different functions - 18-24 mos: manipulation skills emerge - 2.5 yrs = 2 hands for 2 very different functions |
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Exner's Classification of manipulation skills
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1. finger to palm translation: 12-15 months
2. palm to finger translation w/ stabilization (coins in a slot): 2-2.5 yrs 3. Shift: (separating 2 papers) 3 yrs 4. Simple rotation (less than 90*, such as unscrewing a cap) 2-2.5 yrs 5. complex rotation: 360* 6-7 yrs 6. In hand manipulation with stabilization: 6-7 yrs (picking up pennies and storing them in ulnar side of hand) |
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Pre-writing skills
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1. Palmar supinate grasp: 1-1.5 yrs. arm moves as a unit
2. Digital pronate grasp: wrist in neutral, forearm pronated, arm moves as unit. 2-3 yrs 3. Static tripod: crude approximation of thumb and other digits. No fine movements, adjustments w/other hand, hand moves as unit. 3.5-4 yrs 4. Dynamic tripod: precise opposition, stable arch, wrist extension, fine movements of PIPs. 4.5 - 6 yrs. |
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Scissor skills
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Holds and snips: 2-3 yrs
Opens and closes with control: 2- 3 yrs Manipulates with forward motion: 3-4 yrs Cuts straight line: 3-4 yrs Cuts simple shapes: 3-4 yrs cuts circles: 3.5-4.5 yrs cuts simple figures: 4-6 cuts complex figures: 6-7 |
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Prerequisites for scissor skills
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1. open/close hand
2. isolate/combine thumb index and middle finger movements 3. bilateral hand use 4. coordinate arm, hand, and eye movements 5. stabilize wrist, elbow, shoulder 6. interact in constructive play stage |
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Primary circular reactions
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reflexive patterns result in learning about cause and effect.
Repeated for enjoyment 2-4 mos |
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secondary circular reactions
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Fist true awareness of cause and effect.
Voluntary movement patterns in result of coordination of vision and hand function. 5-8 mos |
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coordination of secondary schemata
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voluntary movement in response to stim that cannot be seen 9-12 mos
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Tertiary circular reactions
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child seeks new schemes (concepts). tool use begins. 12-18 mos
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sensorimotor period
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0-2 yrs.
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preoperational period
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2-7 yrs
child classifies and conservates objects despite changes preconceptual phase (2-4 yrs, expands vocabulary) intuitive thought phase: imitation, copying, repeating 4-7 yrs. Inductive reasoning denotes transition to next stage Symbolic/verbal play |
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concrete operations phase
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7 - 11 yrs
increased spatial awareness increased application of rules (help adjust to social demands) logical thinking |
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Formal operations stage
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11-teen years
can hypothesize and use past experiences to plan |
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Early object use
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1. action-based (shake, bang). 3-6 mos
2. Explores characteristics (pull, turn, poke) 6-9 mos 3. relational play combines objects (put in container) 8-9 months 4. Notice relationships between complex actions and consequences (close doors, lid on container, roll ball) 9-12 months 5. Links simple schemes (put baby in stroller and push) 12-15 mos 6. Links multischeme combinations into meaningful sequence (food in bowl, scoop with spoon, feed to doll). 24-36 mos |
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Problem solving skills 6-9 mos
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-finds hidden object
-uses movement to get toy -anticipates object movements -attends to consequences of actions and repeats in result |
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Problem solving skills 9-12 mos
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-uses tool following demo
-goal directed behavior -performs action to produce response |
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Problem solving skills at 12-15 mos
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-seeks adult help
-inspects objects -uses trial and error -attempts to activate simple mechanism |
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Problem solving skills at 18-21 months
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-attends to shape of objects and uses appropriately
-begins to think before acting -begins to replace trial and error with thought process -operates mechanical toy -begins to presume causes |
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problem solving skills at 21-24 months
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matches shapes in shape sorter
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problem solving skills at 24-27 months
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discriminates sizes
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problem solving skills at 27-30 months
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builds with blocks horizontally and vertically
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problem solving skills at 27-30 months
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begins to relate experiences to one another based on prior knowledge
creates mental plan of action without acting it out |
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problem solving skills at 36-48 months
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can build tower of 9 cubes (balance and coordination)
organizes objects by size |
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Symbolic play (progression)
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1. 12-16 mos. make believe using self (sleeping, eating)
2. 12-18 mos, projects make-believe play on others, 3. 18-24 mos. increased use of substitution objects for pretending |
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Development of play
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1. Exploratory play (0-2yrs)
2. Symbolic play (2-4 yrs) 3. Creative play (4-7 yrs) 4. Games (7-12 yrs) |
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Exxploratory play
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0-2 yrs
play experiences facilitate development of body scheme exploring properties of objects and people assists with sensory integrative and motor skills most play with caregivers |
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Symbolic play
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2-4 yrs
formulates, tests, classifies and refines ideas, feelings, and actions language development mostly parallel play, becomes cooperative over time |
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Creative play
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4-7 years
refines skills in sensory, motor, cognitive, and social explores combination of actions on multiple objects cooperative peer groups |
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Games play
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7-12 years
rules, competition, interaction and development of skills cooperation of peers groups friends important for validation of items and performance |
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When are infants able to be fed orally?
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prior to 33 wks gestation, not fed oraly
at 35 wks gestation, jaw and tongue movements strong enough 40 wks gestation: gag and cough reflexes present to protect airway for up to 4 mos |
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Oral motor development
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4-5 mos: munching on soft cookie
6 mos: stong up and down tongue movement 7-8 mos: soft and mashed foods beginning mastication w/ diagonal jaw movement 9 months: tongue lateralization, drinks from cup 12 mos: jaw firm; rotary chewing allows biting on hard cookie 24 mos: chews meats and hard veggies |
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observations for feeding evaluation
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postural control
oral sensitivity motor control (jaw, lip, tongue, cheek) coordination and endurance |
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Intervention for oral motor control
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Positioning: trunk stability, avoid neck extension
Hand positioning of caregiver (index finger under lip, middle finger under chin, thumb on mandible). Facilitate lip closure w/ upward pressure from index finger Jaw closure: pressure from middle finger under jaw |
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Inhbiting tongue thrust
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hand positioning of index/middle fingers (under lip and chin)
push bowl of spoon downward and hold on tongue |
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Facilitating swallow
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lip closure
downward pressure of spoon on middle aspect of tongue |
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Facilitating chewing
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place foods such as long, soft cooked veggies between tongue and teeth
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Eliminating tonic bite reflex
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firm downward pressure from spoon to middle aspect of tongue
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Eliminate tongue thrust
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can result in loss of food/liquid, drooling, FTT
facilitate lip closure |
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Consequences of tongue retraction
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possibility of choking
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How/when to decrease tactile sensitivty for feeding
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prior to feeding and at other times
provide firm pressure encourage sucking/chewing on a cloth rub gums, palate, and tongue promote oral exploration of toys use a NUK brush vary food textures introduced mashed mixed with other textures (soft veggies, meats) |
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What consistency is easiest to swallow and manage?
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thick foods
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When does a child take baby food from a spoon?
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5-7 mos
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When does child finger feed self?
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9-13 mos
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When does child begin (likely unsuccessful) spoon use?
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12-14 mos
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When does child scoop with spoon and eat food?
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12-18 mos
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When does child use fork successfully?
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24-30 mos
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Apgar score
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assesses infant HR, respiration, reflex irritability, muscle tone, and color at 0, 5, and 10 mins.
Each item scored 0, 1, or 2 Max score is 10 |
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Neurobehavioral organization: signs of stress/irritability
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1. autonomic systems (physiological)
2. motor systems: fluctuating or consistent tone 3. Emotional state: disorganized, clam, alert 4. attention-interaction: distress upon attending, difficulty shifting attention 5. self-regulation: ability to organize and balance |
