Evaluating Fine Motor in Pediatrics

Question 1

6 Patterns of hand function

Answer 1

Reach, carry, in hand manipulation, bilateral hand use, release, grasp

Question 2

All 6 patterns of hand use play a part in what

Answer 2

refined fine motor skills

Question 3

How do hand functions develop in terms of social factors

Answer 3

role expectations may change and socioeconomic status will change what tools are available. what type of toys do they have access too

Question 4

How do hand functions develop in terms of cultural factors

Answer 4

expectation of independence, availability of tools or different tools used.

Question 5

How does hand functions develop in regards to somatosensory functions

Answer 5

our ability to process touch, pain. we need these to know how much pressure to use and how to adjust grasp depending on what toy/tool we’re using.

Question 6

What do kids with varying tones have trouble with in terms of developing hand function?

Answer 6

somatosensory function

Question 7

How does hand function develop in regardst o visual perception cognition

Answer 7

I need my visual skills to do puzzles and shapes

Question 8

musculoskeltal integrity effect on hand function development

Answer 8

if the kids has low tone or high tone it will effect the pattern of hand function.

Question 9

How do we evaluate fine motor skills in young children?

Answer 9

observations, informal assessment, formal assessments

Question 10

Observations-

Answer 10

grasp type, object manipulation, bilateral integration, tool use

Question 11

Example of Informal Assessments

Answer 11

◦ Martha’s “Get a Grip”

Question 12

Examples of Formal Assessment

Answer 12

Peabody Developmental Motor Scales (PDMS2)
Miller Function & Participation Scales (M-FUN)

These don’t have the 5 domains. They focus on fine motor and gross motor.

Question 13

How do we evaluate
Types of grasp observed
Bilateral Integration
Tool Use

Answer 13

observe the child playing while speaking to parent.

Take not if there is any hand preference

observe any asymmetries

Question 14

Developmentally, When would we expect a hand preference?

Answer 14

up to 6, which is the latest.

Question 15

Grasp and associated release begin with

Answer 15

reflex activity and are integrated via weight bearing.

Question 16

If kids was in NICU a lot first years and you get the kid in early intervention. what would you expect to see in regards to movements?

Answer 16

primitive reflexes that normally would have been integrated.

Question 17

grasp and release develops largely due to

Answer 17

interest in objects

Question 18

grasp and release is stimulated by

Answer 18

Stimulated by touch and produces strong flexion

Question 19

Release is facilitated by the

Answer 19

environment or own body

Question 20

Primitive reach

Answer 20

asymmetry, swiping: ATNR brings hands in field of vision. reaching activated but not guided by vision

Question 21

Transitional reach

Answer 21

Object held with both hands (4 months)
two handed reach
object transfer hadn to hand (5 months)
bilateral approach with bilateral object manipulation (7 months)

Question 22

Mature reach

Answer 22

Plays with 2 toys (bangs together) (9 months)

Coordinated and complementary bimanual movement (11 months)

Coordinated asymmetrical move (one stabilizes & one manipulates) (12 months)

Question 23

Primitive release

Answer 23

Before 4 Months - Release involuntary as a result of total UE movement or touch on the hand.
PRIMARY RELEASE: Avoidance reflex produces extension of the fingers
Mouthing of objects assists with release because the child can stabilize the object with his mouth and pull his hand off the object.

Question 24

transitional release

Answer 24

By 6 or 7 Months - Transfer of objects from hand to hand serves a similar purpose to mouthing.
By 7 Months - Extension of UE and fingers develops with support and protective reactions.
Baby “drops” objects with full extension pattern.* This is the true beginning of voluntary release

Question 25

Mature release

Answer 25

By 10-11 Months - Child uses fingers to pick up objects and with support on ulnar border, releases objects with control

By 14-16 Months – Child can set objects down with control Including objects held with fingertips

Question 26

PRIMITIVE GRASP

Answer 26

Reflex activates flexion of hand

Question 27

transitional grasp

Answer 27

scratching / raking

ulnar palmer grasp

reach and pat

palmar grasp

poking

instinctive grasp (radial palmar grasp)

radial digital grip

Question 28

Mature grasp

Answer 28

visual orientation

lateral pinch

inferior pinch

superior pinch

manipulative prehension

Question 29

Active forearm supination is required in order to have

Answer 29

fine motor skills

Question 30

wrist extension with stability is required for

Answer 30

fine motor skills

Question 31

controlled and dynamic thumb opposition is required for

Answer 31

fine motor skills to develop

Question 32

dissociation of the radial and ulnar sides of the hand is required for

Answer 32

fine motor skills to develop

Question 33

What formal assessments would you use?

Answer 33

Peabody Developmental Motor Scales (PDMS2/PDMS3)

Miller Function & Participation Scales (M-FUN)

Question 34

Peabody 2

Answer 34

Age Range:birth up to 6 years

Administration:20-30 minutes for each motor-related subtest or 45-60 minutes for entire assessment

Subtests:
- Reflexes
- Stationary
- Locomotion
- Object Manipulation
–(Gross Motor Quotient)

Grasping
Visual Motor
- (Fine Motor Quotient)

Question 35

Peabody 3

Answer 35

Age Range:birth up to 5 years 11 months

Administration:20-30 minutes for each motor-related subtest or 45-60 minutes for entire assessment

Subtests:
Body Control
Body Transport
Object Control
Gross Motor Index
Hand Manipulation
Eye-Hand Coordination
Fine Motor Index

Question 36

Miller functional & Participation scales (M-Fun)

Answer 36

Age Range:2:0 - 7:11 years

Administration:20-30 minutes for each subtest or 45-60 minutes for entire assessment
(takes longer then they say) there is a script and an order.

Subtests:
Visual Motor
Fine Motor
Gross Motor

Question 37

What are the three steps for writing outcomes in early intervention?

Answer 37

• Gather information
• observe families and children
• document quality IFSP outcome statements.