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234 Cards in this Set

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International Classification of Functioning, Disability, and Health
Not focused on disease or disorder, but the health of the individual
Interactions between components of ICF
Health condition (disorder/disease)
Body functions and structures
Env and personal factors
All interacting w/ activities
Biomedical paradigm
Major focus of health research has been to uncover the causes of ill health and disease and test treatment techniques and drugs that can "fix" the underlying disorder.
Social (ecological) paradigm
Considers the factors "outside of the body". Determinants of health come from a wide range of env factors that interact w/ person variables.
Umbrella term for impairments, activity limitations, or participation restrictions.
An outcome of the relationship between a person and the environment.
Environmental barriers
Any aspect of the env that constrains satisfactory performance/participation:
Continuing to grow; not just living, but also doing
You can just be there
Circle of friends:
People you live with
People who are your friends
People who you see regularly
People who are paid to be in your life.
For someone w/ a disability, may not have what we consider "normal friends." Most are in the category of those who are paid to be in life.
Environmental supports
Any aspect of the environment that enables or encourages satisfactory performance/participation. Physical, social, cultural, institutional.
Nature and extent of a person's involvement in life situations and level of enjoyment.
Measuring participation
Person's preferences and interests, doing, where and w/ whom, how much enjoyment, how much satisfaction, etc.
Human development
A pattern of change that begins at conception.
Lifelong, multidimensional/system
Plastic (individual pathways w/ different trajectories)
Studied by many disciplines
Contextual and biological
Human development is shaped:
by a dynamic and continuous interaction between biology and experience.
Culture influences every aspect.
Kids are participants in their own development
Growth of self regulation-
cornerstone of early childhood development
Theories of motor development:
Neural-maturationist (neurofacilitation)- Gessel 20-40s
Cognitive theories- Piaget, Pavlov, Skinner (50-70s)
Dynamic systems- Thelan, Ulrich, Heriza (80-90s)
Systems theory- woollacott & Shumway-Cook (90s)
Combined early Hierarchical theory and reflex theories.
Movement controlled by highest intact portion of CNS and/or reflex arch.
Emphasis placed on exam of stages of reflex development and motor milestones
Neural-maturationalist intervention based on
Assessment w/ norm referenced tools based on motor milestones and reflexes.
Direct hands on therapy to work on the next motor milestone, inhibit/integrate attitudinal reflexes, and facilitate righting and equilibrium reflexes.
Reeval based on readministration of milestones and reflex eval
Piagetian theory
Piaget, 1952
Combination of maturation of cognitive and neural structures nad the environment.
Stages of development- cognitive development
Behavioral theory
SKinner, 1972
Environment is motivator and shaper of motor and cognitive development.
Response to stimulus w/ reinforcer
Dynamical systems
Dynamic cooperation of the many subsystems in a task-specific context.
Development not seen as series of discrete stages, but a series of states of stability and instability and phase shifts in which new stages become stable aspects of motor behavior.
Multiple systems and processes developing at any given time.
Dynamical systems intervention based on:
Eval of constraints
Meaningful env support for constraints and opportunity for practice in env.
manipulation of control parameters (attractor states- speed, strength, etc)
Systems approach theory for motor control
Combines elements of all theories.
Emphasizes that movement occurs from interaction between individual, task, and env.
Movement principles:
Action plans
Interventions for systems approach based on:
Individual, task and env
cognition, perception, action
Functional grouping
Discrete vs continuous
Stability vs mobility
Regulatory movement determiined by BOS
Non regulatory- performance by env- doesn't depend on env; env may affect movement but isn't shaped by it
Begin in flexion, gradually move into extension
In flexion at first and everything is tight. When start elongating, extensors are long and begin to activate extensors and flexors will lengthen.
Head control comes first
Begin in symmetry, move to asymmetry, then more symmetry.
Move proximal to distal
Keep BOS at first, then move to walking and being mobile
Action plans
learn the best ways to accomplish tasks
Sensitive periods
Optimal periods for certain motor skills to develop quickly
Spiraling patterns of development
Learn to write w/ a crayon, then pencil, then caligraphy; everything spirals around
Human development is important so:
We know what children do.
Leads us to develop interventions that support kid's functional activites and occupations.
Movements are self-directed and meaningful to the individual at their particular place in development.
Prenatal time frame
Total of about 266 days
Germinal period:
period of the zygoid about 2 weeks from conception to implantation. Fertilization in fallopian tube. Rapid division as moves from uterus to fallopian tube. Zygote attaches to uterine wall. Blastocyst (inner layer of cells) becomes the embryo and outer layer form support systems to support and nourish the embryo.
Embryonic period
occurs during 3-8 week of pregnancy.
Allmajor sturctures and systems are established. Endoderm becomes digestive sys, respiratory sys, and vital organs. Mesoderm becomes circ sys, bones and muscles. Ectoderm developes into NS, skin, and hair. By end of month 2 eyes, nose, arms and legs are develop. Can move and respond to touch. Ultrasound often taken here to screen for growth and development.
Exposure to env toxins has a particularly traumatic effect.
- substance or event causing damage during prenatal period. Common include nicotine, alcohol, and methylmercury.
Fetal period
Spans 7 months. Fetus continues to increase in size and weight. Organ systems refine and mature. Brain continues to develop
12 weeks gestation
At 12 weeks fetus can smile, frown, and suck; sex is evident
15-16 weeks gestation
15-16 weeks, movement can be felt by mother and a heartbeat is discernable.
By 24 weeks gestation
By 24 weeks, fetus respons to sound and is sensitive to light
22-28 weeks gestation
22-28 weeks, fetus becomes viable (can survive outside uterus). Below 26 weeks, may not do too well. 26 weeks can survive, but will most likely have severe disability.
38-42 weeks gestation
38-42 weeks fetal period ends at birth. (normal fetal development here)
Genetic influences on development
Error or mutation in the production or translation of genetic code.
46 chromosoms (2 pair of 23)
Addition or deletion of entire chromosome ore gene w/in a chromosome.
Range of disability dependent upon addition/deletion or impairment
Numerical chromosome disorder:
Additional chromosome (trisomy)- 47 chromosomes (DS, trisomy 21).
Deletion (monosomy)- 45 chromosomes- usually incompatible w/ life; Turner syndrome
Sturcutral chromosome disorder
Deletion (portion missing): Cri-du-chat syndrome: cry of a cat; high pitched cry for communication and severe cognitive impairments.

Translocation (transfer of portion of one chromosome to another)- form of DS
Single gene abnormality
Cystic fibrosis- lungs immature from birth. Kiss and baby tastes salty.

Muscular dystrophy- usually die in childhood

Both become worse w/ age.
Alcohol and development
Fetal alchohol syndrome- hyperactive, sensitive, jittery, cognitive impairments
Tobacco and development
Prematurity, LBW, lower global intelligence
Drugs and development
Go through withdrawal at birth.
May have high BP, skeletal abnormalities, etc.
Marijuana- hyperactive, impulsive, inattentive
Cocaine- Premature, LBW, neurobehavioral abnormalities
Other env influences on development
Maternal infection, disease, meds, Rx
Lead, aluminum
maternal nutrient deficiency or chronic stress.
Failure to thrive
Neurodevelopmental probs and lack of energy to explore
Excessive eating
Physical, emotiona, and social concerns and lack of energy to explore
Learned helplessness
Kids who have a disability and everything is done for them.
SES (socioeconomic status)
Health insurance
Quality day care
Adequate housing
TV watching
All impact development
1 month:
Not doing much.
Beginning to move slightly against gravity
2 months:
Start to bring hands to mouth and hold head in midline/neutral. Symmetry pattern.
3 months:
Play in side lying, tuck chin, lift head, push up on elbows.
4 months:
Able to grasp, but can't release yet.
Swimming pattern
Extend elbows more when on tummy
5 months:
Begin to bring feet and hands to mouth.
Can grasp and pick things up.
6 months:
Begin to see some start of rolling supine to prone (first).
Place in sitting and can maintain sitting.
Start mouthing toys.
Can release grip.
Begin pivoting on belly.
7 months:
More independent sitting.
Can reach and do things more in sitting
Belly crawling, beginning of creeping and kneeling.
8 months:
Can begin pulling up to stand.
Begin to rotate wrist to look at things (supinate)
9 months:
Side stepping/cruising.
Begin clapping
Pinser grasp
Good at sitting
10 months:
Standing w/ support
Begin hide and seek play
11 months:
Pointing begins
Supportive forward walking
12 months:
ostural control
Body's orientation in space.
The orientation of body parts in relation to one another.
Interaction of individual, task, and env.
Consequences of postural instability
Can't move
Overshoot in reaching
Lose balance
Don't have locomotion: loss of functional independence falls, make diagnoses more severe.
Adaptive/feedback postural control
Take in sensory info and aapt to environment. If adaptive doesn't work, you may compensate and do it differently than everyone else.
Anticipatory postural control (feedforward)
When you do a voluntary movement, CNS programs itself anticipating that you're going to be off balance. Preparation for voluntary movement.
In postural stance, when perturbed, muscles activate
distal to proximal.
Postural instability
Inability to counterac the destabilizing force using direction specific postural adjustments
Underlying factors of postural instability:
Motor components: postural synergies not programmed
Sensory components: Inability of sensory paths to elicit activity in the synergies
Cognitive problems
Problems in the motor component of postural control
Motor coordination
Musculoskeletal contributions
Loss of anticipatory postural control
Critical: Coordination of multiple muscles into postural muscle synergies.
Sequencing problems:
Reversal in muscle recruitment order
Delayed recruitment pattern
Delayed activation of responses (timing)
Amplitude of muscle response
Ankle strategy-
Conscious or unconscious response to counteract perturbation. It's a strategy b/c it's repeatable under the same conditions.
Normal response to forward perturbation
Gastroc first, then hamstring. On a spastic side, will see hanstrings first, then gastroc.
Toe walkers-
COM forward of BOS. Need to use hamstrings along w/ gastroc strongly.
Consequences of abnormal recruitment sequence:
Muscle force (reduced torque)
Biomechanics (lateral shifts in COM large)
Postural response/standing of a child becomes like that of an adult at...
7 y/o
Reversal in recruitment order:
proximal to distal.
Toe walkers activate tib ant before gastroc when falling forward and are more likely to fall backwards. Use reverse walker.

Seating in spastic diplegia: will activate neck to hip, antagonists before agonists.
Delayed recruitment pattern:
Response patterns: 36 ms vs. 60-80 m sec
Consequences of delayed recruitment sequence:
Muscle force (coactivation- will have no motions at joint.)
Biomechanics (excessive joint motion at hip and knee)
Characterized by simultaneous contraction of muscles on the anterior and posterior part of the body or joints.
Antagonist muscles
Normal in very young healthy children.
Task specific, not only explained by abnormal neural response.
Stability limits
Limits flexibility
Linked to cognitive phase of learning before forces linked to a motor task are integrated.
Coping strategy to postural instability.
Motor incoordination
Problems modifying postural control.
Appropriate size of muscle response
Combination of feedforward and feedback control mechanisms
Inability to adapt amplitude of m response to perturbations of increasing distance and velocity.
Postural adaptation
Postural adjustment of environmental conditions and changing task conditions
Typical adjustment in children w/ CP (sitting):
Top-down recruitment of postural mm.
Excessive antagonistic coactivation.
Incomplete modulation of amplitude to task constraints.
Musculoskeletal contributions:
Joint movement constraints
Changes in m structure (size and distribution of fibers)
Changes in muscle force (recruitment of agonists)
Relation of body segment to one another, body position relative to gravity and BOS
Limited movement at ankle joint
Reduced ankle strategy
Delay in onset latency of gastroc in response to backward perturbation
Reduced distal-proximal m response sequence
Increase in use of hip and trunk m for balance.
Loss of anticipatory postural control:
Dependent on previous experience and learning
EMG onset of postural mm preceding activation fo arm muscles during pushing or pulling
Sensory disorders:
Sensory organization
Loss of one sense
Loss of sensory redundancy
Sensory organization and selection probs
Impaired cognitive function
Dual or multi-tasks- Parkinson's disease and TBI
Motor incoordination in individuals w/ Alzheimer's
Sensory disorganization w/ restricted vision in individuals w/ Alzheimer's
Parent identified stressors in the NICU
Sights and sounds of the unit
Infant appearance
Parental role alteration
Altered relationship w/ their infant
Fullterm pregnancy
38-42 weeks
Preterm birth
Before 38 weeks
Post term birth
After 42 weeks.
Gestational age
Number of weeks fetus was in uteral
SGA, AGA, LGA describe
Infant's birth weight for their gestational age
Small for gestational age; below 10th percentile; often associate w/ smoking, poor prenatal care, prematurity
Appropriate for gestational age
large for gestational age; above 90th percentile; Often associated w/ a mother who is diabetic
1 pound = ___ grams
Normal birth weight
2500-3999 g (5.5-8.8 lbs)
Low birth weight
1500-2500 g (3.3-5.5 lbs)
Very low birth weight
below 1500 g (3.3 lbs)
Extremely low birth weight
Below 1000 g (2.2 lbs)
Apgar scores
Objective measure of infant well-being at birth
Scored at 1, 5, and 10 minutes
Infant scored on: color, pulse, reflex irritability, muscle tone, breathing efforts
Numeric score of 1-3, possible range of 0-10
Respiratory Distress syndrome (RDS)
Respiratory distress or failure caused by immaturity of lungs, insufficient surfactant, collapse of alveoli, fluid in lungs.
Surfactant production begins:
about 24, fully developed by 34-36 weeks; coats alveoli to prevent sticking and collapse
Treatment of RDS
Surfactant replacement, CPAP, ventilation
Chronic lung disease (Bronchopulmonary dysplasia-BPD)
Chronic lung disease affecting primarily premature or sick infants who've been mechanically ventilated and continue to need supplemental oxygen at 36 weeks.
Scarring of lung tissue, lung tissue is stiff, abnormal chest x-ray, increased work of breathing w/ retractions, weheezing, poor feeding and poor weight gain, risk for developmental delay
Nasal cannula
Short, thin tubes placed into the nostrils through which oxygen is administered. Used in cases of mild or hronic lung disease which aren't severe enough to require CPAP or ventilator
Nasal CPAP
Aplication of continuously pressurized air and oxygen to the airwaysa nd lungs via small tubes placed in the nostrils or a soft mask placed over the nose.
Tubes fit tighter to the nostrils than a nasal cannula.
Keeps lungs partially inflated between breaths, which makes breathing easier.
machine used to assist breathing via an endotracheal tube inserted into the trachea. Required by infants who can't breath on their own due to lungs that are too immature or sick.
Conventional vent
Delivers breaths to an infant that mimic the type of breaths the infant would take on their own
High frequency vent
Very small rapid breaths to breath for an infant in a very efficient manner. Reduces barotrauma to lungs.
Bleeding within or around the ventricles of the brain which may extend into the brain tissue and surrounding structures.
Prematurity is the leading risk factor.
Originates in germinal matrix, source of cortical cells; area is poorly supported and very vascular.
Highest risk before 33 weeks
IVH Grades
1- Hemorrhage limited to germinal matrix; prognosis good
2- Bleeding into normal sized ventricles; prognosis good
3- Bleeding into ventricles that causes ventricle enlargement; Mortality below 10% Complications 30-40%
4- Extension of bleeding into brain tissue; Mortality almost 80%, complications 90%
Complications of IVH
Periventricular leukomalacia (PVL)- hemorrhagic infarction and necrosis of white matter around ventricles; high incidence of spastic diplegia

Porencephalic cyst- fluid filled cyst at site of IVH
necrotizing entercolitis (NEC)
Inflammation of the bowel wall caused by bacterial invasion. Results in swelling, necrosis, and potential perforation of the bowel.
Treated w/ antibiotics, surgery, NPO
Complications: bowel rupture, necrosis of bowel, scarring and narrowing, short gut syndrome
Retinopathy of prematurity
Disease of the developing eye.
Blood vessels of retina not mature until close to term age.
Changes in oxygen levels in blood may affect te growth of retinal blood vessels.
Scar tissue and irregular blood vessel growth can lead to retinal detachment and blindness
Laser treatment destroys peripheral retina to stop vessels from growing over scar tissue
Extracorporeal membrane oxygenation
Treatment of last resort when other forms of ventialtion haven't been successful
Can't be used on infants below 34 weeks
Removes infant's venous blood, filters CO2 and adds oxygen, then returns blood to circulation bypassing lungs allowing them to rest.
Newborn individualized devlopmental care and assessment program (NIDCAP)
Educational framework taht offers training for professionals in family centered individualized developmental care for infants and their families.
The only theory driven, evidence based approach to devlopmental care that incorporates the evironemtn, infant caregiverinteraction, cargiving strategies, andt eh family
Challenges faced by the preterm infant that may impact brain development:
NICU environment
Set of changes in the body and brain that are set into motion when tehre are threats to physical or psychological wel being.
Survival requries apacity to mount a stress response, but frequent or prolonged stress may negatively affect development
Toxic stress
strong, frequent or prolonged activation of the body's stress management system
tolerable stress
briefer periods, allows for recovery; related to presence of supportive relationships
Positive stress
Short lived stress responses; related to learning; helps develop sense of master, control and management
During stressful events, the brain...
Puts future-oriented processes in the body on hold (related to feeding, fighting infectiosn, and learning)
Regulates stress response of the adrenal glands
Adrenal glands during stress produce:
Adrenaline- SNS; acute stress, fight or flight

Cortisol: steroid hormone; breaks down protein for energy, suppresses immun system, suppresses physical growth, inhibits reproductive hromones, affects areas of brain functioning that control attention, memory, planning and behavior control
Experience of pain in newborn period leads to long term alterations in neural circuits and behavior. may occur peripherallly, at the SC, and somatosensory cortex
Painful periods early in gestation seem to...
Dampen responses to subsequent pain.
Painful experience later in newborn phase...
accentuates response to pain
Snesory experience of fetus
Warm fluid env
Rhythmic sounds
Gentle movement throughout day
Reduced effects of gravity
Predictable 24 hour cycle
Sensory experience of preterm infant
Cool dry env
Visual, auditory, and tactile stim profoundly increased
Experience full effect of gravity
Irregular movement
Lack of durnal rhythmicity
adverse developmental ffects experienced by preterm infants in NICU
Prologned diffuse sleep states and unattended crying
Supine positioning
Routine and excessive hadnling
Ambient sound
Lack of opportunity for sucking
Poorly timed social and caregiving interactions
Brain development in the full term infant occurs in...
env mediated by maternal protection from perturbations, ongoing supply of nutrients, continuous temp control, regulating chronobiological rhythms
Preterm infant's brain being shaped in a setting characterizedd by...
stark sensory mismatch to developing NS's biologically shaped expctiation for env inputs
Neurodevelopmental care
Recognizes infants as participants in own development and views parents and infant's most important nurturers
Synactive theroy of development
Infant behavior is meaning ful and communicates to us
Behavioral subsystems
Infant states
Deep sleep
Light sleep
Drowsy (transition to waking)
Quiet alert
Fussy (active alert)
Synactive theory of development
infantbehavioral subsystems interact constabntly w/ one another and imultaneously w/ env.
Observable behaviors w/in each subsystem can act as communication cues.
When demands are w/in the infant's current developmental expectations, organized, self-regulatory behaviors are observed.
when demands exceed infants expectations and threshold, disorganized, avoidance behaviors are observed
Autonomic subsystem
Respiratory pattern- smooth
Color- good, stable
Visceral signs-stable digestion
Autonomic avoidance/disorganization behaviors
respiratory pauses
color change to mottled, webbed, cyanotic, gray, flushed
Gaggin, gasping
Spittin gup
Straining or actually producing a bowel movement
Tremors, startling, twitching
Motor subsystem
Muscle tone
Quality of movements
Self-regulatory mvoements
Hand clasp, foot clasp
Finger fold
Hand to mouth or face
Suck searching and sucking
Hand holding
Leg bracing
Avoidance motor behaviros
Motor flaccidity or tuning out of trunk, extremities, or face (gape face)
Motor hypertonicity w/: extension of trunk (arching), legs (sitting on air; leg bracing)
Arms (airplane; salute)
Hands/feet (splays)
Face (grimicing, tongue extension)

Hypertonicity w/ protective maneuvers (hand on face, high guard arms)
Hyperflexion (fisting, trunk and extremity tuck)

Frantic, diffse activity
State and attention/interaction subsystems
Range of states
Clarity of states
State transitions
Self-regulatory behaviors for state and attention
Clear, robust sleep states
Rhytmical, robust crying
Good self quieting and/or consolability
Shiny-eyed alertness w/ intent and animated facial expressions such as frowning, cheek softening, mouth pursing, cooing, attentional smiling
Disorganized state/attention behaviors
Diffuse sleep or awake states w/ whimpering, facial twitches, and discharge smiling
Strained fussing or crying
Panicked or worried alertness
Glassy-eyed strained alertness
Irritability and diffuse arousal
Rapid state oscillations
Eyefloating, staring, gaze averting
Self-regulatory subsystem
Efforts and successes
Supports in physical env
Family comfort
Infants clothing
Supports to maintain position and aid self-regulation
Goals of positioning
Relative symmetry
Midline orientation
Promote flexor, self-regulatory behavior
appropriate alignment
Suppors for interactions
Cluster caregiving
Transition facilitation
Increase support as infant awakens
Balance snensory input from caregiver and env
Pacing timing and intensity of interactions
Standards of measurement
Test only valid when used for purposes for which it was developed.
Criteria for selection of standardized tests
Primary complaints and family goals
Current functional status
Therapist knowledge and experience
Psychometric properties
Purposes of the TIMP
Use by PT/OT to ID infants w/ motor delay before 4 months corrected age
Plan intervention progams
Document changes
Test of functional motor behavior in infants
Used for children up to 16 weeks
Conceptual framework
Help ID items that are critical in development and how you confine yoruself to what the tool can do.
Conceptual basis of TIMP
Human infant is a self-organizing being
Multiple systems interact to create actions of the motor ensemble.
Self-organization occurs in a task context shaping the movements used to accomplish a purposeful task
Self-organization links action w/ perception through movment
TIMP tasks pose probs for the infant to solve
Age range for TIMP
32 weeks gestational age to 16 weeks post term
TIMP constructs
Postural control
Selective control- when you see that w/ infant w/ suspected neuro disorder, you know they will be fine b/c they're able selectively move one part of the body. Break out of symmetry.
TIMP is composed of 2 parts:
Observed and elicited items
Observed items
Used to rate spontaneous movement: selective control, midline alignment, quality of movement.
head in midline less than 3 months is a big accomplsighment
Individual finger movement (selective control)
If can move fingers on both hands, won't develop CP.
Elicited items
Deal w/ perception-action
Assess infant's motor responses to placement in various positions and to visual/auditory stim.
Drop one leg and leave the other- for the anti-gravity hip flexion. LMN lesion will have hypotonicity/flaciddity. Could also be weakness or sensorimotor processing.
Rolling fromm leg- deals w/ alignment of body segments
Construct validity of TIMP
Sensitive to developmental change w/ incrasing age.
Infants w/ high risk have lower scores
Score should increase w/ age
Discriminative validity
Term and low risk preterm vs CNS lesion, chronic lung disease (BPD), low birth weight/ low gestational age.
Kids w/ CNS lesion had lowst TIMP scores
Ecological relevance of TIMP
98% of items were observed during caregiving
Concurrent validity
Correlation between TIMP and AIMS
Predictive validity
Correlated w/ scores on PDMS at preschool age
Deviations at 3 weeks of age W/ CP
Unable to hold head in midline fore even a couple of seconds, lack of anti-gravity arm movmeents during face covering
Deviations w/ CP at 9 weeks
Failure to inhibit neck righting, poor AP head control
Deviations w/ CP at 12 weeks
Poor prone head control, anti-gravity activity supine and sidelying, reaching and fingering objects, and failure to adopt synergies using extesnion in supine and prone
TIMP tailored test
For use in screening or fori nfants to fragile to tolerate full test.
Administer screening set of 11 items
Decide wheter to use easy or hard set next.
Takes 10-15 min
What is screening?
use of a brief, objective, and validated instrument
Goal to help differentiate children that are probably ok vs those needing additional investigation.
Performed at a set point in time
Objective vs subjectiv impressions
Pick up those who do have the problem that's being measured. Overidentifies. Want screening tools to be very sensitive
Screeningvs serveillance
Screening was designed to be quick and is a normed, validated tool
Serveillance is what a pediatrician will do. Monitor motor milestones. More informal
Process of screening
Select a population
Select a tool
map the process
Purpose of screening
ID kids who may have developmental delays or disabilities.
Guide decisions about referrrals for further eval
When appropriate connect families to resources that may help mitigate or mnimize severity of delay or disability
Screening assists in sorting kid into 3 categories:
Needs additional eval- didn't pass screen
Needs close monitoring- passed, but has risk factors
need ongoing monitoring in context of well-child care- passed and no known risk factors
High sensitivity trade off
false positives
High specificity trade off
false negatives
True positive/(true pos+false pos)
true neg/ (false neg+true neg)
true pos/(true pos+false neg)
true neg/(true neg + false pos)
Developmental screening
Procedure designed to ID kids who should receive more intensive assessment or diagnosis for potential delays
Early detection improve health and well-being
4 purposes for assessments/measures:
Predictive (ex:TIMP)
Program planning (ex:SFA)
Peabody developmental motor scale (PDMS) purposes:
Discriminative, evaluative, program planning
Areas of ICF assessed by PDMS
Body function and structure
Ages for PDMS
Birth-six years
Purpose of PDMS and how it would assist in clinical decision making:
Check for gross and fine motor developmental delay and performance of different tasks.
See if at appropriate age level.
Help choose interventions.
Battelle Deveopmental inventory (BDI II) purposes:
Discriminative, evaluative, program planning
5 domains of BDI II
motor, adaptive, communication, cognitive, personal/social
ICF domains addressed by BDI II
Body function and structure, participation, and activities
Ages for BDI II
Purpose and how to use BDI II in clinical decision making
Assess typical child or child w/ disability/delay, plan and provide instruction and intervention, evaluate programs
Bruininks-Oseretsky Test of Motor Proficiency (BOT2) purposes
Discriminative, evaluative
Purpose of BOT 2:
Goal directed activities to measure a wide array of motor skills. Measure fine and gross motor skills.
Ages for BOT2
Pediatric Evaluation of Diability inventory (PEDI) purposes
Evaluative and program planning
Domains of PEDI
Functional skills, caregiver assistance, and modification
Ages for PEDI
6 mo-7.5 yr. If older and functioning below normal age range, can use this.
School Function Assessment (SFA) purposes
Evaluative and program planning
3 parts of SFA
Participation, task supports, and activity performance of physical tasks.
Purpose of SFA
Help guide program planning for sudents w/ disabilities attending elementary school.
Child preference indicator
Program planner uses what family knows about child's preferences. Guide to assess info held byf amily.
GMFM purpose
measure change in gross motor function over time in kids w/ CP and DS.
Ages for GMFM
5 months on w/ CP/DS
5 dimensions of GMFM
Lying and rolling, sitting, crawling and kneeling, standing and waling, running, jumping
What's the difference between GMFM 66 and 88?
88- for CP and DS
66 only for CP
Children's assessment of participation and enjoyment (CAPE) purpose
Document child's participation outside of mandatory school activities
Ages for CAPE
6-21 y/o
Areas of ICF assessed by CAPE
Participation and personal factors
PEGS purpose
program planning. Child self reporting to establish goals in everyday activities.
Ages for PEGS
5-10 y/o
FirstSTEP purpose
ID children who may have mild to severe school related problems.
Screen for developmental delays in 5 tomain areas of IDEA: cognition, communication, motor, social-emotional, and adaptive functioning
FirstSTEP ages
2 y, 9 mo- 6 y, 2 mo
Ages and stages (ASQ-3)
Designed to ID infants and young children who show potential developmental problem.
Completed by parents/caregivers.
Screening tool.
Ages for ASQ-3
birth- 5 y/o
5 domains of ASQ-3
Communication, gross motor, fine motor, problem solving, personal-social
Denver II
Used w/ apparently well children between birth-6years by assessing child's performance on various age-appropriate activities.
Denver II sections (4)
personal-social, fine motor, language, gross motor, behavior
Pre-screening Developmental Questionnaire (PDQ-II)
Parent anwered regarding child's current level of development.
Each question corresponds to Denver II item.
Calculating age:
Year Mo Day (of test) -- Year Mo Day (of birth)

Borrow 30 days for one moth, 12 months for one year

16 days or more, bump them up a month.
Adjust for prematurity=
Only if 24 months or younger

Y, Mo, Day (test) -- Y, Mo, Day (DOB)= Age of child -- Prematurity (divide weks in to mo and days)