Lecture 6: Motor Development in Infancy Flashcards
KNOW: General progression of development:
* Cephalo to caudal
* Proximal to distal
* radial to ulnar
* Gross to fine
Progression to move is influced by
* Motivation
* Experience
* Practice
* Environment
* Genetics (bigger headed babies are going to have a harder time sitting up etc…)
KNOW: development is not linear - however, once they have a skill they typically don’t lose that skill (once they have sitting they don’t lose sitting)
KNOW: Babies choose the best pattern for them. They try it 1000 different ways and pick the best one
* kids that don’t try the best patterns are the ones were worried about
KNOW: Not all babies go through stages in the “correct” order, not worried about this
Motor milestones are a snapshot - what the babies can do on one day are just tiny peice of information - this might not the their actual norms - shes looking much more than their motor milestones
Motor performance much more dynamic and complex
From 0-10 days posture is dominated by
flexion
* NOTE: extremities usually held close
Do babies move 0-10 days?
Moving while awake
random, wide-range, exaggerated and vigorous movements
Should babies be able to turn head side to side at birth?
Yes
Birth-10 days while in prone:
* Where does head rest?
* What can they do with their head
* Is their trunk / extremtities in flexion or extension
* Where is weight?
Head rests rotated to side
Able to lift and turn head - should knwo this - they’re able to do this from birth
Flexion of trunk and extremtities (this is how they were in the womb)
weight on head
What does babies spine look like at birth?
C curve - gravity puts the curves in spine
Is sitting a functional position at birth
No
0-10 days: sitting
* Is sitting a functional position
* When supported can they lift their head?
* What is their spine like at this point
Not a functional position
When supported may attempt to lift head
Back rounded C curve
Head falls forward-chin to chest
LE’s flexed, abducted, and externally rotated, Do not touch suport surface (FABER) - note once they can get all this touching the surface then they can normally sit because it vastly increases their BOS
UE’s hang loosely when trunk supported
Birth-10 days: Pull to sit
* What happens to heads
* Do abdominals, UE, and LE help?
Facial expression may indicate awareness
May be visible contraction of the neck flexor/shoulder elevators, however not sufficient for movement
Full head lag
No UE. abdominal, or LE activity
Birth-10 days STANDING:
* Do they have a stepping response?
Positive supportive reaction
Able to bear weight through LE’s
Hips remain flexed with pelvis posterior to shoulders (still all flexed up)
Feet close together or crossed
Ankles dorsiflexed (remember this is more than adults)
Genu varum
Well organized reciprocal walking movements when leaned forward in supported stand
* they have stepping response, you lean them forward and they walk
Can a 1 month old respond to environment?
yes, called brightening
Is proximal tone and tightness increasing or decreasing at month 1
Starting to decrease (I think they don’t need as much tone because they arent all curled up anymore)
KNOW: 1 month olds enhoy eating, tracking high contrast objects, being held, cuddled, sung to and rocked
when do UE’s no longer rest close to the body all the time
1 month
When a 1 month old is put on their back what happens to legs?
Stay in flexion due to that physiologic flexion
* NOTE: UE’s no longer rest close to body - gravity assisting in pulling arms into ER - elongation anterior chest and arm muscles
When does reciprocal kicking and bilateraly symmetrical kicking occur) - in supine
1 month
kicking w/ 1 leg or 2 legs
* should do both
NOTE: in prone weight is on their forward at birth, however, at 1 month that weight moves to their cheek
Month 1 Sitting
* Has the spine straightened out head?
* What happens to the head?
Still in c curve
Head falls forward fleeting attempt to lift
Month 1 pull to sit
* can they keep their head up yet?
* Are they able to use their core / Le to help
Total head lag
Abdominals and LE’s do not atively participate
KNOW: As baby gets older that physiologic tone decreases (unless they were born early and never got that tone)
when does reaching start?
2 months~~~
Hands are a fist when they’re extending
At what month can babies briefly lift head in prone? (cervical and thoracic spine extension)
month 2
NOTE: At this month the baby is beginning to use UE’s to push up-not sufficient to maintain weight bearing on forearms
At what month does the baby get extension from cervical through upper t spine when sitting
month 2 sitting
In pull to sit baby can support own head (after being in sitting) for 10-15 seconds at what month? (starting to be able to hold head up)
month 2
however, muscles still arent helping at this point
What is ASTASIA?
Inability to bear weight through legs
What is Abasia
Loss of stepping response/Poor motor control (inability to walk on own)
* looks like they’re uncoorianted if they’re bearing weight
Do you have head control at month 2 standing?
No
KNOW: At month 3 they are alert and aware of environment
* Interacts visually w/ caregiver
* Midline orientation beginning
* Spine remains flexed (c curve)
* Beginning to contorl cervical and thoracic muscle activity
* Enoys toys they can touch, rattles, dangling toys, and caregivers voice
At what month can the baby hold their head in midline in supine?
Month 3
At what month does active knee extenion begin in supine?
Month 3
* more isolated than kicking
When does prone on elbows begin?
3 months
NOTE: head lifting more efficient-Able to lfit 45-90 degrees and maintain it there
Can a 3 month baby sit w/o support?
Nope, this starts around 6 months
In pull to sit when does the baby begin to lift head and chin tuck close to upright?
3 months
When does visual righting with eyes fixed on examiner? (pull to sit)
3 months
At what month do abdominals and LE’s begin to active with pull to sit?
month 3
They don’t really help, but they’re at least activating now
At what month with standing does Astasia-Abasia dissapear?
Month 3
however, still requires support at trunk to stand
* they can’t stand at 3 months on their own
Astasia Abasia = inability to stand and walk
