Human Development (ch 5)- peds Flashcards
What is normal gestational period?
38-42 weeks
Conceptual age =
age of a fetus or newborn in weeks since conception
Sensorimotor Development in each trimester:
Muscle spindle
1st- muscle starts to differentiate; tissue becomes specialized-
2nd- motor end plate forms; clonus response to stretch
3rd- some muscles are mature and functional, others still maturing
Sensorimotor Development in each trimester:
Touch and tactile system
1st- *first sensory system to develop! Response to tactile stimulus
2nd- receptors differentiate
3rd- touch functional; actual temp discrimination at the end of 3rd trimester; most mature sensory system at birth
Sensorimotor Development in each trimester:
Vestibular system
1st- functioning at the end of first trimester (not completely developed).
(no more!)
Sensorimotor Development in each trimester:
Vision
1st- eyelids fused; optic nerve and cup being formed
2nd- startle to light; visual processing occurs
3rd- fixation occurs; able to focus (fixed focal length)
Sensorimotor Development in each trimester:
Auditory
2nd- Will turn to auditory sounds
3rd- debris in middle ear, loss of hearing
Sensorimotor Development in each trimester:
Olfactory
3rd- nasal plugs disappear, some olfactory perception
Sensorimotor Development in each trimester:
Taste
1st- taste buds develop
3rd- Can respond to different tastes (sweet, sour, bitter, salt)
Sensorimotor Development in each trimester:
Movement
1st- sucking, hiccuping; fetal breathing; quick generalized limb mvmt; positional changes; 7.5 weeks can bend neck and trunk away from perioral stroke
2nd- quickening; sleep states; grasp reflex; reciprocal and symmetrical limb mvmts
3rd- 28 weeks primitive motor reflexes; rooting, suck, swallow; palmar grasp; plantar grasp; MORO; crossed extension
Development of Sensorimotor Integration:
Prenatal period
- responds first to tactile stimuli
- reflex development
- innate tactile, proprioceptive, and vestibular reactions.
Development of Sensorimotor Integration:
Neonatal period
- tactile, proprioceptive, and vestibular inputs are critical from birth onward for the eventual development of body scheme
- vestibular system, although fully developed at birth, continues to be refined and impacts infant’s arousal level (helps infant to feel more organized/content.)
- visual system develops as infant responds to faces and items of high contrast w/in 10 inches of face.
- auditory system is immature at birth and develops as the infant orients to voices and other sounds.
Development of Sensorimotor Integration:
First 6 months
- vestibular, proprioceptive, and visual systems become more integrated and lay foundation for postural control, facilitating a steady visual field
- tactile and proprioceptive systems continue to be refined, laying foundation for somatosensory skills
- visual and tactile systems become more integrated as child reaches and grasps objects, laying foundation for eye-hand coordination
- infant movement patterns progress from reflexive to voluntary and goal-directed
Development of Sensorimotor Integration:
6-12 months
- vestibular, visual, and somatosensory responses increase in quantity/quality as infant becomes more mobile.
- tactile and proprioceptive perceptions more refined, allowing for dev of fine motor and motor planning, and lead to midline skills and crossing midline.
- auditory, tactile, and proprioceptive perceptions are heightened allowing for dev of sounds for the purpose of communicating.
- tactile, proprioceptive, gustatory, and olfactory perceptions are integrated, allowing for primitive self-feeding.
Development of Sensorimotor Integration:
13-24 months
- tacticle perception becomes more precise allowing for discrimination and localization to further refine fine motor skills
- further integration of all systems promotes complexity of motor planning as the toddler’s repertoire of mvmt patterns expands.
- symbolic gesturing and vocalization promotes ideation, indicating the ability to conceptualize.
- Motor planning abilities contribute to self concept as toddler begins to master environment.
Development of Sensorimotor Integration:
2-3 years
- period of refinement as the vestibular, proprioceptive, and visual systems further develop, leading to improved balance and postural control.
- further dev of tactile discrimination and localization leading to improved fine motor skills
- motor planning and praxis ideation also progress during this period.
Development of Sensorimotor Integration:
3-7 years
- child is driven to challenge sensorimotor competencies through roughhouse play, playground activities, games, sports, music, dance, arts/crafts, househodl chores, and school tasks.
- child also learns social development and self esteem through these activities.
Reflexes (onset age, integration age, stimulus, response, relevance):
Rooting
onset 28 weeks gestation
integration 3 months
stimulus- stroke the corner of the mouth, upper lip, and lower lip
response- mvmt of tongue, mouth, and/or head toward stimulus
relevance- allows searching for and locating feeding source
Reflexes (onset age, integration age, stimulus, response, relevance):
Suck-swallow
onset 28 weeks gestation
integration 2-5 months
stimulus- place you index finger inside infant’s mouth with head in midline
response- strong rhythmical sucking
relevance- allows ingestion of nourishment
Reflexes (onset age, integration age, stimulus, response, relevance):
Traction
onset 28 weeks gestation
integration 2-5 months
stimulus- grasp infant’s forearms and pull-to-sit
response- complete flexion of upper extremities
relevance- enhances momentary reflexive grasp
Reflexes (onset age, integration age, stimulus, response, relevance):
Moro
onset 28 weeks gestation
integration 4-6 months
stimulus- rapidly drop infant’s head backward
response- 1st: arm extension/abduction, hand opening. 2nd: arm flexion and adduction
relevance- facilitates ability to depart from dominant flexor posture: protective response
Reflexes (onset age, integration age, stimulus, response, relevance):
Plantar grasp
onset 28 weeks gestation
integration 9 months
stimulus- apply pressure with thumb on the infant’s ball of the foot
response- toe flexion
relevance- increases tactile input to the sole of foot
Reflexes (onset age, integration age, stimulus, response, relevance):
Galant
onset 32 weeks gestation
integration 2 months
stimulus- hold infant in prone suspension, gently scratch or tap alongside the supine with finger, from shoulders to butt
response- lateral trunk flexion and wrinkling of the skin on the stimulated side
relevance- facilitates lateral trunk mvmts necessary for trunk stabilization
Reflexes (onset age, integration age, stimulus, response, relevance):
Asymmetric tonic neck
onset 37 weeks gestation
integration 4-6 months
stimulus- fully rotate infant’s head and hold for 5 seconds
response- extension of extremities on the face side, flexion of extremities on the skull side
relevance- promotes visual hand regard
Reflexes (onset age, integration age, stimulus, response, relevance):
Palmar grasp
onset 37 weeks gestation
integration 4-6 months
stimulus- place your finger in infant’s palm
response- finger flexion; reflexive grasp
relevance- increases tactile input on the palm of the hand
Reflexes (onset age, integration age, stimulus, response, relevance):
Tonic labyrinthine- Supine
onset >37 weeks gestation integration 6 months stimulus- place infant in supine response- increased extensor tone relevance- facilitates total-body extensor tone
Reflexes (onset age, integration age, stimulus, response, relevance):
Tonic labyrinthine- Prone
onset >37 weeks gestation integration 6 months stimulus- place infant in prone response- increased flexor tone relevance- facilitates total-body flexor tone
Reflexes (onset age, integration age, stimulus, response, relevance):
Labyrinthine/optical (head) righting
onset birth-2 months
integration… it persists!
stimulus- hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward
response- upright positioning of the head
relevance- orients head in space; maintains face vertical
Reflexes (onset age, integration age, stimulus, response, relevance):
Landau
onset 3-4 months
integration 12-24 months
stimulus- hold infant in horizontal prone suspension
response- complete extension of head, trunk, and extremities
relevance- breaks up flexor dominance; facilitates prone extension
Reflexes (onset age, integration age, stimulus, response, relevance):
Symmetric tonic neck
onset 4-6 months
integration 8-12 months
stimulus- place infant in the crawling position and extend the head
response- flexion of hips and knees
relevance- breaks up total extensor posture; facilitates static quadruped position
Reflexes (onset age, integration age, stimulus, response, relevance): Neck righting (NOB)
onset 4-6 months
integration 5 years
stimulus- place infant in supine and fully turn head to one side
response- log rolling of the entire body to maintain alignment with the head
relevance- maintains head/body alignment; initiates rolling (first ambulation effort)
Reflexes (onset age, integration age, stimulus, response, relevance): Body righting (on body) (BOB)
onset 4-6 months
integration 5 years
stimulus- place infant in supine, flex one hip and knee toward the chest and hold briefly
response- segmental rolling of the upper trunk to maintain alignment
relevance- facilitates trunk/spinal rotation
Reflexes (onset age, integration age, stimulus, response, relevance): Downward parachute (protective extension downward)
onset 4 months
integration… it persists!
stimulus- rapidly lower infant toward supporting surface while suspended vertically
response- extension of the lower extremities
relevance- allows accurate placement of lower extremities
Reflexes (onset age, integration age, stimulus, response, relevance): Forward parachute (protective extension forward)
onset 6-9 months
integration… it persists
stimulus- suddenly tip infant forward toward supporting surface while vertically suspended
response- sudden extension of the UE, hand opening, and neck extension
relevance- allows accurate placement of UE in anticipation of supporting surface to prevent a fall
Reflexes (onset age, integration age, stimulus, response, relevance): Sideward parachute (protective extension sideward)
onset 7 months
integration… it persists
stimulus- quickly but firmly tip infant off-balance to the side while in sitting position
response- arm extension and abduction to the side
relevance- protects body to prevent a fall; supports body for unilateral use of opposite arm
Reflexes (onset age, integration age, stimulus, response, relevance): Backward parachute (protective extension backward)
onset 9-10 months
integration… it persists
stimulus- quickly but firmly tip infant off-balance backward
response- backward arm extension or arm extension to one side; spinal rotation
relevance- protects body to prevent a fall; unilaterally facilities
Reflexes (onset age, integration age, stimulus, response, relevance):
Prone tilting
onset 5 months
integration… it persists
stimulus- after positioning infant in prone, slowly raise one side of the supporting surface
response- curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms & legs
relevance- maintain equilibrium without arm support; facilitate postural adjustments in all positions
Reflexes (onset age, integration age, stimulus, response, relevance):
Supine tilting and Sitting tilting
onset 7-8 months
integration… it persists
stimulus- after positioning infant in supine or sitting, slowly raise one side of the supporting surface
response- curving of the spine toward the raised side (opposite the pull of gravity); abduction/extension of arms & legs
relevance- maintain equilibrium without arm support; facilitate postural adjustments in all positions
Reflexes (onset age, integration age, stimulus, response, relevance):
Quadruped tilting
onset 9-12 months
integration… it persists
stimulus- after positioning infant on all fours, slowly raise one side of the supporting surface
response- curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms & legs
relevance- maintain equilibrium without arm support; facilitate postural adjustments in all positions
Reflexes (onset age, integration age, stimulus, response, relevance):
Standing tilting
onset 12-21 months
integration… it persists
stimulus- after positioning infant in standing, slowly raise one side of the supporting surface
response- curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs
relevance- maintain equilibrium without arm support; facilitate postural adjustments in all positions
Motor development occurs in which direction?
cephalocaudal/proximal to distal
Motor development progresses from ___ to ___ movement.
gross to fine movement
Motor development progresses from stability to ______ ________.
controlled mobility
Motor development occurs in a spiraling manner, with periods of _______ and ________.
equilibrium and disequilibrium
Sensitive periods of motor development occur when the infant/child is affected by _______ input.
environmental
Handedness is considered to be stable by age…
5 (although strong preferences can be seen much earlier)
Bilateral integration and crossing midline begin around age….
9-12 months
Hand skills…
Reaching skills
1. Visual regard accompanied by swiping/batting, with closed hand and abducted shoulder- age?
2. Hands come together at midline for bilateral reaching with shoulder abducted with partial internal rotation, forearm pronation, and full finger extension- age?
3. Increased dissociation of body sides, allows for unilateral reaching with less abduction and internal rotation of the shoulder, and hand is more open- age?
4. As trunk stability improves, shoulder flexion with slight external rotation, elbow extension, forearm supination, and slight wrist extension begin to emerge- age?
- newborn
- 4 months
- 6 months
- 9 months
Hand skills…
Grasping skills
See other deck with pictures!
Hand skills…
Bilateral hand use
Asymmetric movements until 3 months, then symmetric mvmts emerge until 10 months.
By 12-18 months, baby uses both hands for different functions.
At 18-24 months, manipulation skills emerge
At 2.5 years, ability to use two different hands for two very different functions.
Manipulating skills (Exner's Classification system)- define and age: Finger-to-palm translation
linear mvmt of an object from fingers to palm of hand (ex picking up coins). 12-15 months
Manipulating skills (Exner's Classification system)- define and age: Palm-to-finger translation
with stabilization, a linear movement of an object from palm of hand to fingers (ex planing coins in a slot). 2-2.5 years.
Manipulating skills (Exner's Classification system)- define and age: Shift
a linear mvmt of an object on the finger surfaces to allow for repositioning of the object relative to the finger pads. ex separating 2 pieces of paper (3-5 years), shifting on marker or pencil (5-6+ years).
Manipulating skills (Exner's Classification system)- define and age: Simple rotation
the turning or rolling of an object held at the finger pads approx 90 degrees or less. ex. unscrewing a small bottle cap (2-2.5 years)
Manipulating skills (Exner's Classification system)- define and age: Complex rotation
the rotation of an object 360 degrees. ex. turning a pencil over to erase (6-7 years)
Manipulating skills (Exner's Classification system)- define and age: In-hand manipulation with stabilization
several objects are held in the hand and manipulation of one object occurs, while simultaneously stabilizing the others. ex. picking up pennies with thumb and forefinger while storing them in the ulnar side of the same hand (6-7 years)
Stages of development of scissor skills
2-3 years…
Interest in scissors
Holds and snips with scissors
Opens and closes scissors in controlled fashion
3-4 years…
Manipulates scissors in a forward motion
Coordinates the lateral direction of the scissors
Cuts a straight forward line
Cuts simple geometric shapes
3.5-4.5 years… Cuts circles
4-6 years… cuts simple figure shapes
6-7 years… cuts complex figure shapes
Theorists:
Erikson
Ego adaptation is the adaptive response of the ego in the development of the personality.
8 stages of man include a crisis that when resolved give the individual a sense of mastery and results in acquisition of a personality quality.
1. Basic trust vs mistrust- child realizes need will be met; is hopeful (birth- 18 months)
2. Autonomy vs doubt and shame- child realizes he can control bodily functions (2-4 years)
3. initiative vs guilt- child gains social skills and gender identity; sense of purpose (preschool age)
4. Industry vs inferiority- child gains sense of security through peers and gains mastery over activities of his age group (elementary school age)
5. Self-identity vs role diffusion- teenage beings to make choices about adult roles and with resolution has sense of membership in society (teenage years)
6. Intimacy and solidarity vs isolation- young adult establishes intimate relationship with partner/family; capacity to love (young adulthood)
7. Generativity vs self-absorption- adult finds security in contribution of his chosen personal/professional roles; capacity to care (middle adulthood)
8. Integrity vs despair- mature adult reflection on his value, shares with younger generation; wisdom acquired (maturity)
Theorists:
Kohlberg
Stages of Moral Development
Level 1= preconventional (until age 8)…
stage 1 punishment and obedience (child is obedient to avoid punishment);
stage 2 instrumental relativism (child is moral to benefit self)
Level 2= conventional morality (occurs around 9-10 y/o)…
stage 1 social conformity (child desire to gain approval of others)
stage 2 law and order (rules and social norms internalized)
Level 3= postconventional morality (age varies and not all achieve this level)... Social contracts (young adult has social awareness and awareness of legal implication of decisions/actions)
Theorists:
Maslow
Hierarchy of basic human needs… if lower levels aren’t met, person can’t work on higher levels
a. physiological (food, water, warmth)
b. safety (physical and psychological security)
c. love and belonging (need for affection, emotional support, group affiliation)
d. self-esteem (need to believe in one’s self as competent and valuable member of society)
e. self-actualization (creativity, morality, spontaneity, lack of prejudice, problem-solving skills
Theorists:
Piaget
Cognitive development from birth to adolescence
- sensorimotor period (birth-2 years)…
- preoperational period (2-7 years)
- concrete operations (7-11 years)
- formal operations (11-teens)
Sensorimotor development of gross motor skills (age and what kid does):
Prone position
0-2 months: turns head side to side; lifts head momentarily; bends hips with butt in air; lifts head and sustains in midline; rotates head freely when up; able to bear weight on forearms; able to tuck chin and gaze at hands in forearm prop; attempts to shift weight on forearms, resulting in shoulder collapse
5-6 months: shifts weight on forearms and reaches forward; bears weight and shifts weight on extended arms; legs are closer together and thighs roll inward toward natural alignment; hips are flat on surface; equilibrium reactions are present
5-8 months: airplane posturing on prone position; chest and thighs lift off surface.
7-8 months: pivots in prone position; moves to prone position to sit.
9 months: begins to dislike prone position.
Sensorimotor development of gross motor skills (age and what kid does):
Supine position
0-3 months: head held to one side; able to turn head side to side
3-4 months: holds head in midline; chin is tucked and neck lengthens in back; legs come together
4-5 months: head lag is gone when pulled to a sitting position; hands are together in space.
5-6 months: lifts head indep; brings feet to mouth; brings hands to feet; able to reach for toy with one or both hands; hands are predominantly open
7-8 months: equilibrium reactions are present
Sensorimotor development of gross motor skills (age and what kid does):
Rolling
3-4 months: rolls from prone position to side accidentally b/c of poor control of weight shift; rolls from supine position to side.
5-6 months: rolls from prone to supine; rolls from supine to side with right and left leg performing indep mvmts.
6-14 months: rolls segmentally w/ roll initiated by the head, shoulder, or hips.
Sensorimotor development of gross motor skills (age and what kid does):
Creeping
7 months: crawls forward on belly
7-10 months: reciprocal creep
10-11 months: creeps on hands and feet
11-12 months: creeps well
Sensorimotor development of gross motor skills (age and what kid does):
Sitting
0-3 months (held in sitting): head bobs; back is rounded; hips are apart, turned out, and bent; head steady; chin tucks; sits w/ less support; hips are bent and shoulders are in front of hips.
5-6 months (supports self in sitting): sits alone momentarily; increased extension in back; sits by propping forward on arms; wide base, legs are bent; protective responses present when falling to front.
5-10 months (sits alone): sits alone steadily, initially with wide base of support; able to play with toys while sitting.
6-11 months: gets to sitting position from prone.
7-8 months: equilibrium reactions are present; able to rotate UB while LB remains stationary; protective responses are present when falling to side.
8-10 months: sits well w/o support; legs are closer, knees straight; incr variety of sitting positions incl “w” and side sit; difficult fine motor tasks may prompt return to wide base of support.
9-18 months: rises from supine by first rolling over to stomach then pushing up into 4-point position.
10-12 months: protective ext backwards, first with bent elbows then straight elbows; able to move in and out of sitting position into other positions.
11-12 months: trunk control and equilibrium responses are fully developed in sitting position; further incr in variety of positions possible
11-24+ months: rises from supine by first rolling to side then pushing up to sitting position.
Sensorimotor development of gross motor skills (age and what kid does):
Standing
0-3 months: when held in standing, takes some weight on legs.
2-3 months: when held in standing, legs may give way.
3-4 months: bears some weight on legs, but must be held proximally; head is up in midline, no chin tuck; pelvis and hips are behind shoulders; legs are apart and turned outward.
5-10 months: stands while holding furniture.
5-6 months: incr capability to bear weight; decr support needed, may be held by arms or hands; legs still spread apart and turned outward; bounces in standing position.
6-12 months: pulls to standing position at furniture.
8-9 months: rotates trunk over the LE; LE are more active in pulling to standing position; pulls to standing by kneeling, then half-kneeling.
9-13 months: pulls to standing w/ legs only, no longer needs arms; stands alone momentarily.
12 months: equilibrium reactions are present in standing
Sensorimotor development of gross motor skills (age and what kid does):
Walking
8 months: cruises sideways
8-18 months: walks with two hands held
9-10 months: cruises around furniture, turning slightly in intended direction.
9-17 months: takes indep steps; falls easily
10-14 months: walking; stoops and recovers in play
11 months: walks with one hand held; reaches for furniture out of reach when cruising; cruises in either direction, no hesitation.
15 months: able to start and stop in walking
18 months: seldom falls; runs stiffly with eyes on ground.
Sensorimotor development of gross motor skills (age and what kid does):
Release
0-1 month: no release; grasp reflex is strong
1-4 months: involuntary release
4 months: mutual fingering in midline
4-8 months: transfers object from hand to hand
5-6 months: two-stage transfer; taking hand grasps before releasing hand lets go
6-7 months: one-stage transfer; taking hand and releasing hand perform actions simultaneously
7-9 months: volitional release
7-10 months: presses down on surface to release
8 months: releases above a surface with wrist flexion
9-10 months: releases into a container with wrist straight
10-14 months: clumsy release into small container; hand rests on edge of container
12-15 months: precise, controlled release into small container with wrist extended.