Develomental Progressions, Advance Motor Skills milestones (from text book and slides) Flashcards
Prone, supine, rolling, and erect standing.
ATNR continues to influence head position in all postures, including prone, until the influence has completely subsided by approximately …
4 months of age
__________ is the earliest antigravity control to develop
Head control in prone
In the infant, the head makes up approximately ________ of the body in length, causing the head to be proportionately large and heavy
one-quarter
With the help of the abdominal muscles to stabilize the pelvis in a relative posterior tilt, the infant begins actively lifting the head at approximately ______
2 months of age
By 4 months, the baby is able to lift the head to 90 degrees.
By 4 months, the baby is able to lift the head to ____
90 degrees
By 3 months, the baby is able to lift the head to ____
45 degrees
If a child exhibits TV shoulders while prone-on-elbows, the strength of the ___________ muscles as well as the strength of the _________ and __________ muscles should be tested.
- serratus anterior
- Cervical flexors and extensors.
Without the ability to elongate this region, the child will not be able to get the elbows into position underneath the shoulders for the prone-on-elbows posture
scapulo-humeral enlogation
(enlogation of the axillary region)
The prone-on-elbows posture is the first call for the upper extremities to be ____ _____
weight bearing. This ability to weight-bear through the forearms, elbows, and shoulders foreshadows the weight bearing that will follow in the quad-ruped position.
The elbows, in the prone-on-extended-arms posture, illustrate the (developmental) principle of weight bearing on ______________
extended limbs after first weight bearing on flexed limbs
Crawling is a locomotive form that infants may use from _______ to __________ of age. Crawling is defined as moving “slowly by dragging the body along the ground.”
3 months to 8 or 9 months
the child may choose plantigrade creeping over creeping in quadruped if he has bare knees and is on a concrete or other rough surface. This illustrates the _______ nature of development. Many factors, in addition to maturation, influence the development of motor skills.
dynamic
Rolling from prone to supine and supine to prone, another means of locomotion, develops in the infant by ______
5 to 6 months of age
(Non-segmental or log rolling: 3 months)
Goals of Motor Development:
- Control against gravity
- Inter and intra-segmental isolated movements
- COM over BOS
What are the “French Angles”?
Used to assess tone/movement in the nursery
(Developed by a Fnench Neurologist)
Scarf Sign
- Passively move the arm across the chest in supine with head in midline
- Term: resistance before midline
- Pre-term: no resistance
Popliteal angle:
- Term: 60 to 90 deg
- Pre-term: 135-180 deg
Ankle DF:
- Passive DF in supine, angle bet lower leg and foot
- term: less than 30 deg
- pre-term: bet 60 and 90 deg
Slip through:
- vertical suspension holdin under axillae
- term: does not slip through
- pre-term: slips through
Pull to sit (French angle):
- Term: no head lag
- pre-term: complete head lag
Rooting reflex:
- stroke corner of mouth
- term: head turns towards stimulus
- pre-term: absent
Sucking reflex:
- Nipple or finger in child’s mouth
- term: strong and rhythmic sucking
- pre-term: weak or absent
Grasp reflex:
- term: sustained flexion and traction
- pre-term absent
ATNR reflex:
- supine, passively turn head to one side
- term: upper and lower extremities extend on face side
- pre-term: absent
Prone progression:
- Physiological flexion
- hip extension, begin to lift head
- 3 mo: head to 45 deg
- 4 mo: head to 90, with chin tuck, must activate cervical flexors
- weigh shifting
- reaching
- Prone on extended arms (4-6 mo)
- beginning of flexion at the hips into quadruped
Pivot prone:
- Seen at 4-6 mo
- allows enlogation of ant trunk
Prone progression locomotion:
- Scooting (1-2 mo), cannot be left alone.
- Crawling; backwards first
- Pivoting in prone (4-6 mo)
- Rolling, prone to supine, then supine to prone
- Creeping (9-11 mo)
- Plantigrade creeping (10-12)
Supine progression:
- Physiological flexion, will gradually decrease
- Head to side until midline controll develops (ATNR until 4-5mo)
- Pull to sit: head lag?
- Reaching for LE, to knees, to feet (around 5 mo): for exploration of the body; cross body reaching, enlongation of the posterior LE musculature in preparation for standing.
Sitting progression:
- Supported sitting: C-curve, initially see Bobbing of the head, sacral sitting.
- Propped sitting: tripod position, not much mobility.
- Ring sitting: (6 mo) wide BOS limit transitions; hands free to play.
- Long sitting: narrower BOS, enhances transitions.
- Side sitting: requires greatest amount of trunk control; seen 1st with propping; then without UE use; requires dissociation of LE’s.
Sitting Propping reactions:
- Forward (tripod) position: 6 mo
- Side to side: 7-8 mo
- Posterior: 9-10 mo
Once ____________ is achieved in the shoulder girdle, the child can reach into space to grasp a toy
stability
When the neonate is pulled to sitting, the examiner gently pulling the infant’s upper extremities at the wrists, the head is held in plane with the body and exhibits no _________, mimicking active head control
head lag
(Due to physiologic flexion. As the physiologic flexion gradually disappears over the first month, when pulled to sitting, head lag is present.
What is the pull to sit progression:
- No head lag
- Mild head lag
- Head in midline
- Active flexion against gravity
The ATNR is seen in normal infants during the first
4 months of life
Once children exhibit dissociation of the two lower extremi-ties and are stable in halfring sitting, some children actually develop a locomotive form in this posture called ________.
Hitching, is when a child, while sitting on the floor, uses ei-ther foot to dig into the surface in order to scoot forward on his buttocks.
