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nmr I > Human Motor Development > Flashcards

Human Motor Development Flashcards

1
Q

what three aspects play into the process of development?

A
  • biophysical: genetics –> height, weight, anthropometrics
  • psychological: behaviors, experiences, activities
  • social-cultural: norms and expectations
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2
Q

what are the three theories of human motor development?

A

neural-maturational theories, cognitive theories, dynamical system theories

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3
Q

what are the key points of the neural-maturational theories?

A
  • looks at maturation of CNS
  • behaviors and motor skills occur as CNS matures and is response to environment
  • introduces idea of different age ranges for development and motor skills occurring in a linear fashion
  • explains when developmental reflexes and milestones develop
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4
Q

what are the key points of the cognitive theories?

A
  • stages of development that link motor behavior to cognitive development
  • child develops schemas: process of learning rules to evaluate, correct, and update motor plans
  • mind drives change through internal learning processes and scaffolding: caregivers providing environmental challenges to encourage higher level skill
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5
Q

what are the key points of the dynamical systems theories?

A
  • perception and motivation lead to new skills
    – developing CNS, body’s physical properties/affordances for movement, child’s goal/motivation, environment
  • multiple systems engage dynamically to effect change
    – task, environment, individual (*can regress in one when developing)
  • Neuronal Group Selection Theory (NGST)
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6
Q

what is Neuronal Group Selection Theory (NGST)?

A
  • primary neuronal (in utero) and secondary (post-utero) repertoires
    – environmental experiences activate/strengthen and refine neuronal groups and form connections –> complex brain organization that adapt to environment over time
  • embodied mind concept: mind is built through physical activities of the body; cannot separate mind, body, environment
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7
Q

what are the current constructs of development?

A
  • variability and versatility are hallmark of typical development
  • plasticity and change can happen at any time
  • development shaped by experiences
  • efficiencies are gained and lost
  • elongation proceeds activation
  • progress from asymmetry, symmetry, reciprocation
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8
Q

what are the basic characteristics of a neonate?

A
  • birth thru 10 days
  • full term = 40 weeks, correct for prematurity @ 36 weeks or earlier
  • weight 5.5 to 9 lbs
  • sleep 75% of time in small bursts
  • initial challenges with homeostasis
  • visually regard objects in midline
  • cries to indicate needs and quiets when picked up
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9
Q

what does a neonate look like in physiological flexion?

A
  • head: rotated w/ WB bearing on cheek/nose
  • spine: C curve throughout
  • scapula: elevated and ADD
  • UE: shoulder ext/add/IR, elbow flexion off surface, forearm pronation, wrist/finger flex
  • pelvis: post pelvic tilt
  • LE: hip flex/abd/ER, knee flex, ankle DF/inv
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10
Q

what does a neonate look like in supine?

A
  • observe umbilical cord and physiologic flexion
  • rotates head side to side, cannot sustain midline
  • can move head to hand
  • UE: shoulder driven movement in bursts causing wt shift
  • LE: hip driven asymmetrical phasic movement
    – kicking with either hip/knee flexion, ankle remains DR
  • UE/LE recoil due to “flexor tone”
  • barrel-belly b/c ribs oriented horizontal and clavicle elevated
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11
Q

what are the neonatal developmental reflexes?

A

rooting, sucking, galled, grasp, placing palmar and plantar, stepping

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12
Q

what does a neonate look like in prone?

A
  • phasic bursts of asymmetrical extension to change position of head
    – deep proprioceptive input to cheek, ‘stable’ head due to elevated shoulders, elbows off surface
  • phasic bursts at shoulders and hips –> “tone” brings limbs back to flexed position
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13
Q

what is neonate pull to sit and supported sitting?

A
  • PTS used as a measure of head control
    – neonate < head lag than 1-2 month old due to physiologic flexion
  • WB should be on ischial tuberosities in supported sit –> NOT sacral sit
  • dependent sitters needing prox trunk support
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14
Q

what does a neonate look like in supported standing?

A
  • neonate bears weight when bounded/leaned forward, can take reciprocal steps
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15
Q

what are some red flags to look for in a neonate?

A
  • feeding problems
  • excessively irritable –> should soothe but its a problem if they don’t
  • stiff UE/LE/trunk or floppy
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16
Q

how does a baby at 1-2 months act to diminish physiologic flexion?

A
  • gravity and increased active movement
  • decrease flexor tone leads to appearance of hypotonicity
  • decreased head control and coordination of movement
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17
Q

what are some characteristics of a baby at 1-2 months? (symmetry, attention, reflexes)

A
  • increased symmetry with wider excursions of movement
  • increasing alertness to people and environment
  • increased visual attention to begin tracking
  • reflexive grasp
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18
Q

what does a baby at 1-2 months look like in supine?

A
  • increased head mobility (shoulders have to come down a bit for rotation), less midline control, can begin to track objects
  • UE: gravity pulls into more extended position; able to bring hands to mouth
  • LE: decreased hip flexion “tone” = increased ABD and ER (reciprocal kicking)
  • ATNR teaches about L vs R
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19
Q

what does a baby at 1-2 months look like in prone?

A
  • gravity compressing into surface causing passive asymmetry by 2 mo
  • less flexion of T spine, wider excursion of head movement leads to WBing on ear
  • lifts head briefly
  • UEs slide away from body and elbow down on surface (prone prop)
  • forearms remain behind shoulders
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20
Q

what does a baby at 1-2 months look like in PTS and supported sitting?

A

PTS
- 1mo: more head lag than neonate
- 2mo: most amount of head lag due to “transient hypotonia”
sitting: require max support, WBing on ITs, head lifts for brief periods when supported

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21
Q

what does a baby at 1-2 months look like in supported standing?

A

1 mo: lift head momentarily, LE WBing, stepping present but diminished
2 mo: less control, absent LE WBing/stepping (astasia abasia)
– absent LE WB b/c gained weight but don’t have strength

22
Q

what are the characteristics of a 3 month old?

A
  • *symmetry of eyes and midline orientation
    – ability to hold head up drives refinement of sensory
  • increased activity, alertness to caregiver and environment, visual interaction and socialization
  • improved anti-gravity flexor control
  • homeostasis is well established
    – systems have stabilized, shouldn’t have any challenges
23
Q

what are the characteristics of a 4 month old?

A
  • controlled, alternating movements
    – able to turn flexors and extensors on/off
  • coordination of R/L sides
    – not smooth but still more coordinated
  • increased visual fixing, socializes with strangers, babbles
    – enough breath support and oral motor control to start making sound
24
Q

what does a 3 month old look like in supine?

A
  • beginning chin tuck in midline and visual convergence; increased horizontal tracking
    – capital flexors activate against gravity –> beginning of keeping head up in sitting
  • bring hands to midline at nipple line
    – will continue to move south w/ inc. flexor control
  • UEs rest at side with elbows mostly extended; holds object in hand when placed
  • LE reciprocal kicking in air or against floor; feet come together, lower abs active
25
Q

what does a 4 month old look like in supine?

A
  • increased visual convergence and beginning to disassociate eyes from head
    – tracking objects w/ eyes instead of moving head
  • hands to lower abdomen and upper leg when hip is flexed; begin to reach for toys
  • can roll to sidelying when head flexes/rotates
    – *see notes for importance
  • LE continue as above w/ inc. activity and knee ext
  • begin ulnar palmar grasp
26
Q

what does a 3 month old look like in prone?

A
  • prone on elbows (elbows in line or in front of shoulders)
  • increased head/neck ext = more post wt shift and spinal ext
  • baby may accidentally roll with head rotation
  • increasing hip ext but still flexed; symmetrical LEs
27
Q

what does a 4 month old look like in prone?

A
  • increased head/trunk symmetry and extension (balance of neck flexors/extensors)
  • pivot prone - come up on extended arms (A/P wt shift at WBing on lower rib cage)
    – elongating of trunk; brings ribs down
  • rolling prone to sidelye
28
Q

what does a 3 month old look like in pull to sit and sitting?

A
  • head in midline; *demonstrates chin tuck part way through PTS
  • sits with support (less flexed than previous months); can hold head up a few seconds
29
Q

what does a 4 month old look like in pull to sit and sitting?

A
  • increased flexor control with PTS
  • placed baby can sit for short periods of time with B UE propping
    – not functional –> if they move their head a little they lose the prop
    – arms are yoked (part of balance and postural control system)
30
Q

what does a 3 month old look like in supported standing and stepping?

A
  • gained some extension through LEs –> takes weight on feet when supported (astasia abasia disappears)
  • able to lift head upright, arms in high guard for postural control
31
Q

what does a 4 month old look like in supported standing and stepping?

A
  • increased WBing on LEs and narrowed BOS with support at UEs
  • more hip ext
32
Q

what are the general characteristics of a 5-6 month old?

A
  • asymmetrical, dissociated, reciprocal movement
    – asymmetry b/c now controlled and dissociated
  • improved antigravity ext in trunk/hips and antigravity flex head/trunk
    – balanced action of flexors and extensors in sagittal plane now allows for movement into frontal plane
  • socialized but begins separation anxiety
  • more developed vision to differentiate between familiar and unfamiliar
  • becomes increasingly vocal with more complex babbling
    – head and neck upright = easier to talk
33
Q

what does a 5 month old look like in supine?

A
  • hands to knees/feet when LEs are flexed, ABD, ER
    – elongate hip extensors for creeping, PTS, walking
  • early “bridging” with minimal lift
    – WB on heel –> heel stike
  • roles to sidelye - UE/LE in midline, can lift head off surface when pushing w/ UE
    – asymmetrical sensory info, shapes hip, GH strength, different visual and vestibular info
  • high sidelye - tuck largely inactive
34
Q

what does a 6 month old look like in supine?

A
  • hands to feet with knees extended –> hamstrings elongated
  • feet to mouth
  • uses radial-palmar grasp
    – WB on ulnar side, allows for functional radial grasp
  • inc pelvis mobility
  • UEs disassociated from LEs
    – also R and L dissociation
  • rolls to sidelye - vaulted position
  • rolls supine to prone
    – don’t roll prone to supine as much b/c not as functional
35
Q

what does a 5 month old look like in prone?

A
  • maintains prone on extended hands (higher up in space, more trunk off surface)
    – lower trunk not active
    – more of an extended arm position –> differs from 4 mo old
    – inc elongation of intercostals and drops ribs
  • rotation of head drives ext down spine
    – variable BOS and wt shift
36
Q

what does a 6 month old look like in prone?

A
  • extension across pelvis by 6 mo
  • controlled wt shift for reaching in prone
    – homolateral pattern
  • pivoting in prone and belly crawl/combat crawl
    – control of flexors and extensors means rotation can begin to develop
  • beginning transition to quadruped from prone
    – * see notes for importance
  • protective ext intact anteriorly; mature landau
  • rolls prone to supine
37
Q

what does a 5 month old look like in pull to sit and sitting?

A
  • still a little head lag
  • develop more control through range from 4 to 6 mo
  • still leaned forward in ring sit
  • yoked
  • not much function in sitting
38
Q

what does a 6 month old look like in pull to sit and sitting?

A
  • assists with active chin tuck (NO HEAD LAG) and pulls w UEs
  • sits independently w/ variety of postures
    – sits without external support
    – UEs may be in high guard at times
    – arms free, can use for play
    – may prop with one arm to reach with other arm
    – head rotation in sitting may lead to them falling over
    – controlled weight shift A-P not M-L
  • *note: sits independently = baby stays upright when placed in sitting
39
Q

what does a 6 month old look like in supported standing and stepping?

A
  • takes full weight on LEs, hips still slightly flexed behind shoulders
  • UEs lower than previous months but still needed for postural control
  • more co-contration at knee, more graded control (not just full flex or ext)
40
Q

what does a 7-12 month old look like in prone and quadruped?

A
  • overall:
    – variability in postures in prone ready the infant for more upright function
    – requires stability in cord and proximal hip and shoulder
    – more frontal plane motions
  • 7-8 mo:
    – high sidelying: emerging neck righting, elongation on WBing side
    – abdomen off surface in prone prop, narrow BOS
  • 8-9 mo:
    – flexed to extended position on feet
    • see notes for input from high sidelying
41
Q

what does a 7-12 month old look like in quadruped for creeping?

A
  • creeping:
    – 4 pt pattern 7-8 mo
    – 2 pt pattern 8-10 mo
  • limb patterns: can be 2 or 4 pt
    – homolateral 7 mo
    – bunny hopping 7-8 mo
  • reciprocal 10 mo
  • *starts w/ A-P wt shift at about 6 mo; more UE driven initially
42
Q

what does a 7-12 month old look like in sitting?

A
  • UEs no longer needed for postural control and can be used for skill (no longer yoked)
  • protective responses develop in sitting:
    – forward @ 6 mo
    – lateral @ 7 mo
    – posterior @ 8 mo
  • 7-8 mo: rotation develops, indicates dynamic BOS
  • 8-9 mo: independent sitter
    – can get in and out of sitting w/o assist
    – radial digital and inferior pincer grasp
43
Q

what does a 7-12 month old look like in sitting?

A
  • general:
    – variety of dynamic sitting postures (circle, long, short, side, splay, side sit)
  • 9 mo: hands come above level of shoulder, indicating trunk control
  • 10-12 mo: superior pincer grip
  • 12 mo: independently get on/off small bench or chair using variety of strategies
44
Q

what does a 7-12 month old look like in pull to stand?

A
  • variety of strategies to go floor to modified plantigrade (tall and 1/2 kneel)
  • initially upper body driven
45
Q

what does a 7-12 month old look like in supported standing?

A
  • child will become more vertical, narrow their BOS, and require less support as they gain skill in plantigrade
  • rotation at 10-12 mo
46
Q

what does a 7-12 month old look like in cruising?

A
  • 9-11 mo
  • early: vision leads w/ UEs to widen BOS, one LE steps followed by quick step of other LE (usually 4 pt)
  • middle: homolateral pattern
  • later: one hand on surface
47
Q

what are the precursors to walking at each age range?

A
  • 8-10mo:
    – walking w/ 2 hands held
    – occurs when infant has more control of trunk
  • 11-12 mo:
    – walking with 1 hand held
    – emerges slightly after cruising w/ 1 UE suppory
  • standing arms free w/o support w/ UEs in high guard and wide BOS
48
Q

what does an infant look like when walking?

A
  • child getting ready to independently walk when:
    – squat and recover w/ minimal support (need UE support 8-9 mo)
    – takes both UEs off surface momentarily –> UEs in high guard
    – cruises w/ 1 UE support
    – stands w/ minimal support and actively rotates head/trunk
  • first steps:
    – large range from 7-15 mo, but 12 mo is average
    – characterized by high guard, wide BOS, anterior COM, fast speed, short strides, lack arm swing
    — swing - excessive hip flexion, LE remains ER
    — stance - no heel stinks, initially stiff legged
49
Q

how does an infant transition floor to stand?

A
  • using kneeling, half kneeling, squatting
    – kneeling and half kneeling are transitional
    – half kneel transitions begin at 9-10 mo and require external support until ~ 3-4 years as front leg doing work w/ anterior diagonal wt shift
  • squat to stand with external support
  • squat to stand w/o support 11-12 mo
50
Q

what does an infant look like transitioning stand to floor?

A
  • early squatting requires support - tibia are vertically aligned (bottom between feet)
  • 1-2 UE support: 10-11 mo asymmetrical lowering
  • arms free: 12 mo; initially diminished eccentric control for lowering

nmr I (3 decks)

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