Evaluating Fine Motor in Pediatrics Flashcards
6 Patterns of hand function
Reach, carry, in hand manipulation, bilateral hand use, release, grasp
All 6 patterns of hand use play a part in what
refined fine motor skills
How do hand functions develop in terms of social factors
role expectations may change and socioeconomic status will change what tools are available. what type of toys do they have access too
How do hand functions develop in terms of cultural factors
expectation of independence, availability of tools or different tools used.
How does hand functions develop in regards to somatosensory functions
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.
What do kids with varying tones have trouble with in terms of developing hand function?
somatosensory function
How does hand function develop in regardst o visual perception cognition
I need my visual skills to do puzzles and shapes
musculoskeltal integrity effect on hand function development
if the kids has low tone or high tone it will effect the pattern of hand function.
How do we evaluate fine motor skills in young children?
observations, informal assessment, formal assessments
Observations-
grasp type, object manipulation, bilateral integration, tool use
Example of Informal Assessments
◦ Martha’s “Get a Grip”
Examples of Formal Assessment
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.
How do we evaluate
Types of grasp observed
Bilateral Integration
Tool Use
observe the child playing while speaking to parent.
Take not if there is any hand preference
observe any asymmetries
Developmentally, When would we expect a hand preference?
up to 6, which is the latest.
Grasp and associated release begin with
reflex activity and are integrated via weight bearing.
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?
primitive reflexes that normally would have been integrated.
grasp and release develops largely due to
interest in objects
grasp and release is stimulated by
Stimulated by touch and produces strong flexion
Release is facilitated by the
environment or own body
Primitive reach
asymmetry, swiping: ATNR brings hands in field of vision. reaching activated but not guided by vision
Transitional reach
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)
Mature reach
Plays with 2 toys (bangs together) (9 months)
Coordinated and complementary bimanual movement (11 months)
Coordinated asymmetrical move (one stabilizes & one manipulates) (12 months)
Primitive release
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.
transitional release
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
Mature release
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
PRIMITIVE GRASP
Reflex activates flexion of hand
transitional grasp
scratching / raking
ulnar palmer grasp
reach and pat
palmar grasp
poking
instinctive grasp (radial palmar grasp)
radial digital grip
Mature grasp
visual orientation
lateral pinch
inferior pinch
superior pinch
manipulative prehension
Active forearm supination is required in order to have
fine motor skills
wrist extension with stability is required for
fine motor skills
controlled and dynamic thumb opposition is required for
fine motor skills to develop
dissociation of the radial and ulnar sides of the hand is required for
fine motor skills to develop
What formal assessments would you use?
Peabody Developmental Motor Scales (PDMS2/PDMS3)
Miller Function & Participation Scales (M-FUN)
Peabody 2
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)
Peabody 3
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
Miller functional & Participation scales (M-Fun)
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
What are the three steps for writing outcomes in early intervention?
- Gather information
- observe families and children
- document quality IFSP outcome statements.
