Gross Motor

Question 1

Percentage of children walking by 11 months

Answer 1

25%

Question 2

Median age of children beginning to walk

Answer 2

12 months

Question 3

Limit age (2 SD) of children beginning to walk

Answer 3

18 months

Question 4

Impact of bottom-shuffling compared to crawling on walking time

Answer 4

50% bottom shufflers walking by 18 months; 97.5% walking by 27 months, compared with crawling normal values

Question 5

Median age at which head is raised to 45°

Answer 5

6-8 weeks

Question 6

Median age at which child can sit without support

Answer 6

6 months with round back; 8 months with straight back

Question 7

Median age for crawling

Answer 7

8-9 months

Question 8

Median age for “cruising” on furniture

Answer 8

10 months

Question 9

Median age for steady walking

Answer 9

15 months

Question 10

When does global developmental delay become apparent?

Answer 10

Within the first 2 years

Question 11

What are the main causes of motor delay?

Answer 11

Cerebral palsy (central motor deficit), congenital myopathy, Spina Bifida (spinal cord lesions), global developmental delay

Question 12

Is hand dominance and asymmetry of motor skills ever normal?

Answer 12

Only from 1 year

Question 13

What is cerebral palsy?

Answer 13

Abnormality of movement and posture attributed to non-progressive disturbance to the foetal or infant (

Question 14

What is the most common cause of motor impairment in children?

Answer 14

Cerebral Palsy; 2 in 1000 live births

Question 15

What is the cause of cerebral palsy?

Answer 15

80% occurs antenatally due to vascular occlusion or cortical maldevelopment. 10% occur due to hypoxia at birth. 10% occur due to meningitis/encephalitis, trauma, hypoglycaemia or hyperbilirubinaemia or prematurity

Question 16

Why does prematurity have an increased risk of cerebral palsy?

Answer 16

More likely to have periventricular leukomalacia (PvL) where there is damage to the white matter surrounding the ventricles. Mechanism unknown

Question 17

What is spastic cerebral palsy?

Answer 17

UMN (pyramidal or corticospinal) damage. Limb tone increased with associated brisk reflexes and extensor plantar response. Tone is velocity dependent, giving the “clasp knife” response.

Question 18

What are the types of spastic cerebral palsy?

Answer 18

Hemiplegic (face sparing) may have normal PMH and present 4-12mo; Quadriplegic associated with poor cortical development or perinatal hypoxic encephalopathy; Diplegic (legs more affected) associated with prem

Question 19

What is dyskinetic cerebral palsy?

Answer 19

Damage to the basal ganglia or other extrapyramidal system. Causes chorea/athetosis/dystonia towards the end of the first year of life. Caused by kernicterus or hypoxia at birth

Question 20

What is ataxic cerebral palsy?

Answer 20

Hypotonia and ataxic gait due to genetic conditions or cerebellar lesions