17. Case History and Primitive Reflexes Flashcards
When does gross motor development occur?
First 12 months of life - at the same time as visual development
Gross motor development is directly related to what?
Visual skills development
What are the 5 things you need to find out for developmental history?
Age they sat up
Age they crawled
Age they walked
Age of first words
What are some reasons that kids will miss developmental milestones?
Too much modern baby equipment
Less tummy time
Different sensory experiences for premature babies
Orphanages
What are the predictors of motor, visual and/or developmental delays during pregnancy?
Viral infection Alcohol/drug abuse Accident or infection HTN Smoking Severe stress
What are the predictors of motor, visual and/or developmental delays at birth?
Prolonged labor Forceps extraction Cesarean Fetal distress Prematurity
What are the predictors of motor, visual and/or developmental delays as a newborn?
Low weight
Incubation
Problems feeding
What are the predictors of motor, visual, and/or developmental delays in infancy?
Absence of crawling
Late learning to walk
Late learning to talk
What are the predictors of motor, visual, and/or developmental delays in childhood?
Motion sickness Difficulty riding a bike Difficulty reading/writing Difficulty telling time Poor eye-hand coordination
At what score do you expect a binocular dysfunction with the COVD quality of life checklist?
Greater than 20
For kids, a score greater than ___ on the CISS is likely for CI.
16
For adults, a score greater than __ on the CISS is likely for CI.
21
What are the 5 stages of gross motor development?
Whole body flexion/extension Separation of head from body Separation of top from bottom Separation of right from left sides Crossing the midline
When does the Moro reflex emerge?
9-12 weeks in utero
When should the Moro reflex be inhibited?
2-4 months of age
What triggers the Moro reflex?
Any unexpected occurrence
What is the response of the Moro reflex?
Startle/freeze - fight or flight
What are some problems that may arise if the Moro reflex is retained?
Vestibular problems
Poor oculomotor and perception
Poor pupil reaction to light
Hypersensitivity to sounds
How is the Moro Reflex assessed?
Duck and pigeon walk
What exercises are done for the Moro reflex?
Starfish Seal and Otter 1/2 body roll Full body roll Duck and pigeon with stick Bear walk
When does the Tonic Labryinthine Reflex (TLR) emerge?
When head enters birth canal
When is the TLR inhibited?
Gradually from 6 weeks to 3 years
What problems arise is the TLR is retained?
Head movement alters muscle tone - poor balance
Difficulty judging space, distance, depth, and velocity
Impedes development of head righting reflexes
Vestibulo-ocular reflex arc impaired
Lack of “creeping” on hands and knees
How do you test for TLR?
Patient raises both legs, both arms, and head simultaneously - if they leave body parts on the floor, can’t hold the pose, or can’t answer basic questions indicates poorly integrated TLR
What activities are suggested to integrate TLR?
Same as Moro (seal/otter, body rolls, etc)
When does the Spinal Galant Reflex emerge?
20 weeks in utero
When should the Spinal galant reflex be inhibited?
3-9 months of life
What does a retained Spinal Galant Reflex cause?
Fidgety child - hip flexion toward side of the stimulus
What behaviors may indicate a retained Spinal Galant Reflex?
Elastic waistband causing fidgeting Bedwetting past 5 years old Poor concentration Poor short term memory Hip rotation to one side when walking
How do you test for Spinal Galant Reflex?
With pt on hands and knees, stroke down lower back with pencil - watch for movement
What exercises are done for Spinal Galant Integration?
Hip twists
Angels in the snow
Lizard Crawl
When does the Asymmetric Tonic Neck reflex emerge?
18 weeks in utero
When should the Asymmetric Tonic Neck reflex be inhibited?
6 months of age
What does the Asymmetric Tonic Neck Reflex look like?
Movement of baby’s head to one side causes the same side arm to extend and the opposite knee to flex
What is the score from the COVD quality of life survey that will likely indicate a reason for referral for VEE?
Greater than 25
After what age are Primitive Reflexes considered aberrant?
After 12 months
