EDS milestones in infants

Question 1

What type of tongue / jaw movements are seen in infants between 12 and 18 months

Answer 1

Rotatory

Question 2

When is cup drinking introduced

Answer 2

6 months

Question 3

What type of tongue movements does early sucking consist of

Answer 3

Up and down

Question 4

When should pureed solids be introduced

Answer 4

6 months

Question 5

Up to 2 years of age, saliva and food may be lost due to …

Answer 5

incomplete lip closure

Question 6

Describe the rooting reflex

Answer 6

• When the corner of a baby’s mouth is stroked, they will turn their head towards the stimulus and open the mouth with tongue thrusting to look for food source

Question 7

How long does the rooting reflex last

Answer 7

From birth to 4-6 months

Question 8

How does the rooting reflex present in infants with cerebral palsy?

Answer 8

• It persists after 4-6 months when it should disappear in typically developing infants

Question 9

Describe the moro reflex

Answer 9

• a normal reflex for an infant they are startled or feel like they are falling
• the infant will have a startled look and the arms will fling out sideways with the palms up and the thumbs flexed, and may begin to cry

Question 10

How long does the moro reflex last for

Answer 10

From birth, then gradually disappears at 3-5 months

Question 11

How does the moro reflex present in babies with cerebral palsy?

Answer 11

it persists after six months

Question 12

From 9-12 months, the tongue transfers food from where to where while chewing?

Answer 12

from the centre of the mouth to the sides

Question 13

How early is sucking and swallowing observed

Answer 13

• In the womb
• can be as early as 15 weeks gestation

Question 14

How does the anatomy of swallowing differ in typically developing infants to adults (3)

Answer 14

• infants have no teeth until roughly 6 months
• hard palate is flatter
• larynx and hyoid are higher

Question 15

What are the different types of cerebral palsy?

Answer 15

• Spastic
• Dyskinetic
• Ataxic
• Hypotonic
• Mixed

Question 16

Describe spastic CP

Answer 16

• most common (80%)
• increased muscle tone
• can be mild (only affect one side or one limb)
• can be severe (quadraplegic spasticity most severe with associated learning difficulties)
• caused by damage to brain’s motor cortex

Question 17

Describe dyskinetic CP

Answer 17

• fluctuating tone
• movements can be slow and writhing OR rapid and jerky
• face and tongue can be affected making it hard to suck, swallow and talk

Question 18

Describe hypotonic CP

Answer 18

• low muscle tone
• lack of head control, poor balance
• instability and floppy muscles can cause child to miss developmental milestones
• involuntary movements

Question 19

Describe ataxic CP

Answer 19

• problems with balance and coordination
• may walk with their legs far apart (wide gait)
• struggle with tasks requiring coordination such as writing, reaching for things or walking

Question 20

Describe mixed CP

Answer 20

• Mixed cerebral palsy occurs when damage is not limited to one area of the brain
• most common type of mixed CP is spastic dyskinetic

Question 21

What are the early signs of CP

(list 5)

Answer 21

• irritability
• poor feeding
• abnormal reflexes
• abnormal muscle tone
• asymmetrical movements

Question 22

True or false: CP is a progressive disorder

Answer 22

FALSE

it is static and will not get worse with age

Question 23

List 6 possible complications of CP

Answer 23

1. Pain
2. Intellectual disability
3. Hearing impairment
4. Visual impairment
5. Bladder/bowel problems
6. Epilepsy/seizures

Question 24

What would you recommend/refer if parent wanted to find out more about cause of their child’s CP?

Answer 24

Refer to MRI scan

Question 25

What are the following MDT’s roles in cerebral palsy management:

1. Physio
2. OT
3. SLT
4. orthopaedic specialist

Answer 25

1. physio reduces impairment and optimises function
2. OT increases self care and independence
3. SLT assesses dysphagia and improves communication
4. orthopaedic specialist helps with scoliosis and braces for movement

Question 26

What does the motor cortex control

Answer 26

Voluntary movement

Question 27

True or false.. motor neurons on the left hand side of the motor cortex send signals to the right hand side of the body

Answer 27

TRUE! and vice versa

Question 28

Pyramidal

Answer 28

Voluntary

Question 29

Extra pyramidal

Answer 29

involuntary

Question 30

Name three possible causes for CP

Answer 30

• prematurity
• genetics
• brain damage in prenancy or shortly after birth