FINAL: FINE MOTOR Flashcards
Motor skills defined:
“movements that are goal-directed, organized and adaptive”
- intention = cognitive process
- organized, adaptive = precise; for specific tasks
- goal-directed = action specific
Components of hand skills:
- sensorimotor system
- muscles and skeletal system
- but also: self-efficacy, focus on and comprehension of task, motivation, perception
- experience, repetition, practice (motor learning/ control) KEY to helping kids transfer/generalize
How to determine what is needed:
- Know development.
- Know what capacities underlie skills.
- Know what is required (expectations/support)
- Know what matters to parents/child
- Use your clinical reasoning.
How to assess fine motor skills:
- work samples
- file review
- interview (likes and dislikes will give you a clue!)
- observations
- assessments: (Denver, PDMS-2, Battelle, HELP)
What do we look for?
- positioning (and their environment)
- everyday tasks
- specific tasks that challenge them
Flexor or extensor synergy pattern:
This is when movement is constrained by either flexion or extension. You can break up the pattern by applying its opposite, or try to use what is there functionally. *Consider how movement patterns work together/impact each other.
Activity demands to consider:
- objects and properties
- space demands
- social demands
- timing/sequence needed
- required actions
- required body functions and structures
Perceptual/cognitive demands to consider:
- Visual system: vis. attention (alertness, selective attn), vis. memory, vis. discrimination
- attention and cognition
- Also: Imitation, analysis, imagery, flexibility
Tx planning for hand skills:
Address:
- positioning for task engagement
- tone/postural stability (because stability typically precedes the use of mobility)
- relationship betw. sensory and motor control
Also:
- Select materials for ease of handling.
- Provide sufficient time for task completion.
- Use appropriate cueing for hand skills.
Models of practice to guide intervention: Soundbyte for
- neurodevelopmental
- developmental/acquitional
- biomechanical
- sensorimotor
Neurodevelopmental: helps brain and body make new connections that support movement
Developmental/Acquisitional: supports development and acquisition of skilled movements
Biomechanical: helps restore ability for motion w/ remedation and compensation
Sensorimotor: incorporates sensory strategies to facililate motor skills
NDT: postural preparation for fine motor skill development:
For low tone: Bounce, jump, use gross motor play to activate trunk musculature for stability.
For anyone: Sit on therapy ball or T stool for different pelvic tilt, movement, alertness.
NDT: Proximal stability and control:
- Weight bearing on arms is good prep. for fine motor activities. (It usually develops through crawling but can be activated via side sit with leaning or reaching other arm across.)
- Vertical surface for writing (for support)
- tummy time
NDT: Forearm rotation
- stabilize humerus against trunk (elbows at 90) in proneto for pronation
- elongation of ulnar side of wrist (to stretch supinators)
- gentle oscillation ulna/radius (to stretch fascia)
NDT: for wrist extension / hand expansion
- wt bearing activities on flat hands: wheelbarrow, donkey kicks
- slantboard, easel, chalkboard, (vertical surfaces)
- rolling pins
- heavy work - moving chairs, holding heavy bag - to develop stability (correct flexion if you see it)
- wt bearing on open hand (lateral movement, anterior/posterior weight shift)
- *to open flexed hand: pressure on thenar eminence, then open hand out to radial side to encourage extension and E.R.
NDT: arch development for grasp
- pressure on mid-palm to facilitate arches
- tapping (for low tone)
- wt bear on hands with something held in palm
- for spasticity: just firm pressure / opening
