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
what does a 4 month old look like in supine?
- 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
what does a 3 month old look like in prone?
- *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
what does a 4 month old look like in prone?
- 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
what does a 3 month old look like in pull to sit and sitting?
- 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
what does a 4 month old look like in pull to sit and sitting?
- 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
what does a 3 month old look like in supported standing and stepping?
- 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
what does a 4 month old look like in supported standing and stepping?
- increased WBing on LEs and narrowed BOS with support at UEs - more hip ext
32
what are the general characteristics of a 5-6 month old?
- 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
what does a 5 month old look like in supine?
- 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
what does a 6 month old look like in supine?
- 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
what does a 5 month old look like in prone?
- 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
what does a 6 month old look like in prone?
- 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
what does a 5 month old look like in pull to sit and sitting?
- 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
what does a 6 month old look like in pull to sit and sitting?
- 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
what does a 6 month old look like in supported standing and stepping?
- 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
what does a 7-12 month old look like in prone and quadruped?
- 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
what does a 7-12 month old look like in quadruped for creeping?
- 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
what does a 7-12 month old look like in sitting?
- 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
what does a 7-12 month old look like in sitting?
- 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
what does a 7-12 month old look like in pull to stand?
- variety of strategies to go floor to modified plantigrade (tall and 1/2 kneel) - initially upper body driven
45
what does a 7-12 month old look like in supported standing?
- child will become more vertical, narrow their BOS, and require less support as they gain skill in plantigrade - rotation at 10-12 mo
46
what does a 7-12 month old look like in cruising?
- 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
what are the precursors to walking at each age range?
- 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
what does an infant look like when walking?
- 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
how does an infant transition floor to stand?
- 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
what does an infant look like transitioning stand to floor?
- 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