Motor Development Flashcards
What is development?
the process of change in behavior or
capacity that relates to the age of the individual
How do normal developmental changes occur?
Normal developmental changes typically occur in a positive
direction (abilities are gained with time), but can occur in a
negative direction (speed and accuracy of movement decline
after maturity)
How do older adults perform motor activities?
Older adults perform motor activities more slowly and take
longer to learn new motor skills
What occurs before old age?
Leveling off of abilities during adulthood (around age 65) can
occur before the decline at old age
What is impaired neuromotor development?
infers the opposite
of “normal or typical” development
What is impaired neuromotor development caused by?
Generally caused by central and/or peripheral nervous system
damage or dysfunction
What does the life span perspective of motor development include?
Life span perspective of motor development includes all
motor changes occurring as a part of the continuous
process of life
How is development divided?
Development is generally divided into age-related
segments of childhood, adolescence, and adulthood
• Process in not linear, but circular – continuity occurs
from beginning to end
What are the three domains that movement occurs within?
physical, psychological, and social
What are core concepts that are relevant to neuromotor development? (6)
– Development is life long
– Development is multidimensional
• Fosters and supports intelligence and social interaction
– Development is plastic and flexible
• Change in response to cognitive and social requirements
– Development is influenced by heredity and reflects
individual differences
• Genetic predispositions and timing or rate of maturation
– Development is contextual
• Psychological, social and physical surroundings that encourage
exploration and learning
– Development is embedded in history
• Time person lives, culture, or nature/quality of life’s experiences
What are developmental time periods?
Stages of cognition and societal expectations of certain
roles and function are associated with age
When is prenatal?
Conception to birth
When is infancy?
Birth to 2 years
– Establishes trust and becomes autonomous
– Uses sensory information to cue movement and uses
movement to explore and learn
When is childhood?
2 to 10-12 years
– Fosters initiative to plan and execute movement strategies
and solve problems
– Thinking is preoperational with reason centered around
self
– Self-regulation and self-image is learned/established
When is adolescence?
10-12 to 18-20 years
– Lasts 8 years regardless of when it begins
– Identity and values of individual are forged
– Physical and social-emotional changes occur
– Cognitively abstract problems can be solved by inductive
and deductive reasoning
When is adulthood?
18-20 years to Death – One long period of development • Early adulthood: 18-20 to 40 years • Middle adulthood: 40 to 70 years • Older adulthood: 70 years to death
What do impairments in cognitive ability affect?
Impairments in cognitive ability affects ability to
learn and move
What comes from intellectual curiosity?
Motivation to move comes from intellectual curiosity
What does learning to control environment begin with?
Learning to control environment begins with
controlling the body
What do psychological theories reflect?
Psychological theories reflect the role movement has
in the development of intelligence, personality, and
perception
Who are some theorists?
Piaget, Maslow, and Erikson
How does movement progress?
Movements progress from generalized to specific
What is movement?
Movement is an interplay between stability and
mobility
What is the right way to move?
There is more than one right way to move
What is movement the product of?
Movement is the product of multiple developing
elements
– Sensation, biomechanics, energy, motivation, cognition,
anthropometric measures, perception, central and
peripheral nervous system processing
What is the dynamic systems theory?
Movement emerges from the interaction of multiple body
systems
What is the neuronal group selection theory?
Motor skills result from the interaction of developing body
dynamics and the structure/function of the brain
What is epigenesis?
grows and develops from a simple
organism to a complex one through progressive
differentiation – occurs in an orderly sequence based
on what has come before
– Head control, rolling, sitting, creeping, and walking (gross
motor milestones)
– Sequences may overlap working on several skill levels at
the same time
Does the lower skill need to be perfect?
Lower level skill does not need to be perfect before
moving on to something new
What are the directional concepts of development?
cephalic to caudal, proximal to distal, mass to specific, gross to fine
What is cephalic to caudal?
• Head control develops, followed by trunk control, upper
extremities, and then lower extremities
• Head control does not need to be perfected before trunk and
body movements – when one part moves, other parts are affected
by that movement
What is proximal to distal?
• Body is linked – axis (midline) must provide a stable base for head,
eye, and extremity movements to occur with control
• Controls midline of neck, then trunk, followed by shoulders and
pelvis, and finally arms, legs, hands, and feet
What is mass to specific?
(simple to complex)
• Mass is the whole body and specific is smaller parts of the body
• Movement is characterized by mass movements of the trunk and
limbs (moves body as one unit before separating movements)
• Ability to separate movement in one body part from another body
part is “dissociation”
– Mature movements are characterized by dissociation
What is gross to fine?
• Large muscle movement to more discrete movement
• Arm and leg thrusts occur in play before infant reaches with a
single limb
• Not all gross motor skills come before fine motor skills
What is reciprocal interweaving?
• Reappearance of certain patterns of movement at
different times during the development
• Periods of equilibrium balanced by periods of
disequilibrium
What happens at each stage of development?
At each stage of development abilities emerge,
regress, or are replaced
What happens during disequilibrium?
During disequilibrium, movement patterns regress to
what they were at an earlier time, but later new
patterns emerge with new control
When do movement patterns appear?
Movement patterns appear at different periods
depending on needs
How does motor development occur?
Motor development occurs in two phases of variability and the mechanism for switching from Phase I to Phase II is unknown (usually around 18 months of age)
What is phase I?
• Motor patterns are extremely variable as mover explores all
kinds of possible movement combinations
• Sensory information generated by these movements
continues to shape the nervous system
What is phase II?
• Begins when nervous system is able to make sense of
sensory information produced by movement and selects the
most appropriate motor response for the situation
• Basic motor functions include: posture, locomotion,
reaching , and grasping
What factors affect movement?
Factors affecting movement include the biomechanics of the
situation, muscle strength, and the level of neuromuscular
maturation and control
What is physiologic flexion?
Full term babies are born with a predominant flexor muscle
tone
What is antigravity extension?
As development progresses, active movement towards
extension occurs
When are extensors ready to begin functioning?
Extensors are ready to begin functioning before the
shortened flexors
When can lateral trunk flexion and rotation occur?
Once antigravity control of the head and trunk is
accomplished, lateral trunk flexion and rotation can occur
What is progression of change in movement patterns for the head and trunk?
from physiologic flexion to antigravity extension, to
antigravity flexion, to lateral flexion, and finally rotation
How do extremity movements occur?
Extremity movements occur from flexion and adduction to
extension and abduction
What is motor development the result of?
growth, maturation, and adaptation
What is growth?
any increase in dimension or proportion
• Some changes in motor performance can be linked to changes in
body size
What is maturation?
result of physical changes due to
preprogrammed internal body processes (genetically
guided)
What is adaptation?
process by which environmental influences
guide growth and development
• Occurs when physical changes are the result of external
stimulation
What is a milestone?
a significant point in development or a
significant functional ability achieved during the
development process
What is the emphasis on milestones?
The emphasis on milestones is translated into
addressing a child’s ability to function within their
environment
What do functional activities allow the child to do?
Functional activities allow the child to access their
environment and independently meet their own
needs
Birth-3 month milestones
initial flexor tone, begins head control
4 month milestones
head to 90° in prone, hand to midline
5 month milestones
head movement into flexion in supine, dissociation
of head and limbs
6 month milestones
righting reactions, transitional movements
7 month milestones
unsupported sitting, lateral protective reactions
8 month milestones
creeping, increased upper extremity strength
9 month milestones
quadruped position, cruising
12 month milestones
ambulation, hips and knees in flexion
16-18 month milestones
arm swing/heelstrike, balance reactions
2 year milestones
kick a large ball, “true” running
4 year milestones
galloping, catch a small ball
6 year milestones
stand on one foot for 10 seconds, developing sports
skills
What are gross motors?
Gross motor refers to large
muscle movements
What are fine motors?
Fine motor refers to small
muscle movements
What are the most important milestones?
Head control and sitting are most important milestones – if unable to control head and trunk then extremity movements will be difficult or impossible
What is prehension?
the act of grasping
What must occur to grasp an object?
reaching must occur
What do reaching patterns do?
Reaching patterns influence the ability of the hand to
grasp objects
What is ATNR?
Infant first recognizes the hands at 2 months when
they enter the field of vision (ATNR)
When does the ability to release a grasped object occur?
The ability to release a grasped object occurs as
voluntary control of the wrist, fingers and thumb
extensors develop
What are even months associated with?
Important stages in the first year are associated with even months - 4, 6, 8, 10 and 12
What are odd months good for?
Odd months are crucial because they prepare the infant for achievement of control necessary to attain these milestones
What are righting reactions?
Lateral bending in response to a
weight shift
What are transitional movements?
Movements that allow
change of position – prone to sitting, all fours to
kneeling, or sitting to standing
– Only a few movement transitions take place without
segmental trunk rotation
What is sitting?
Most functional position of an 8 month old
What should be avoided?
“W sitting” should be avoided since this causes
developmental movement problems and can lead to
difficulty in learning to use the trunk muscles for balance
What is creeping?
Simultaneous movements of opposite arm
and leg while maintaining weight on remaining two
extremities
– Primary means of locomotion for several months
– Requires counter-rotation of trunk segments
What is cruising?
Walking sideways while being supported by
hands or abdomen on a supporting surface
What is walking?
At 1 year infant becomes toddler and
attempts at forward locomotion occur
What about baby walkers?
Use of baby walkers too early poses safety concerns and
does not allow sufficient development of upper body and
trunk strength
What are some fundamental movement patterns 3-6 years?
running,
jumping, hopping, skipping, throwing, catching,
kicking, galloping, and striking
What is considered immature?
Performance used to meet the minimum standard of
movement is considered immature and can be
improved to acquire a mature performance
– Mature form of running is a sprint
What is done at 3 years?
At 3 years tandem standing and standing on one leg
for up to three seconds is possible
What reaches maturity by age 10?
Nervous system reaches maturity by age 10,
however changes in movement patterns do occur in
adolescence and adulthood
How do developmental movement patterns trend?
Developmental order of movement patterns across
childhood and adolescence trends toward symmetry
and as a person ages more towards asymmetry
What is asymmetry due to?
Asymmetry may be due to less trunk rotation,
stiffening joints, or decreased muscle strength
What is posture?
– Ability to maintain an erect posture declines with
advanced age
– Increased thoracic kyphosis and increased or decreased
lumbar lordosis
– Forward head accentuated compensating for increased
thoracic kyphosis and degenerative changes in neck
What are postural changes related to?
Postural changes may be related to aging process and lack
of movement
• Decreased activity can accentuate age-related postural
changes
What is sensory information needed for?
to respond quickly to
changes in internal and external environments to maintain
postural balance
How does the change in internal and external environments affect balance?
• Structural changes to the sensory receptors occurs
decreasing the quality of information relayed
• Decline in the number of sensory receptors
• Awareness of vibration is lessened resulting in increased
postural sway during quiet stance
• Declines in visual acuity, depth perception, peripheral vision,
and ability to adapt to changes in light or dark environments
• Loss of ROM in the ankle limiting sway
• Decreased ability to produce a concentric contraction
(eccentric contraction remains normal)
• Decline in muscle strength begins around age 50 but does
not become functionally important until around 60 (by 80
strength declines accelerate)
How does the change in internal and external environments affect gait?
– Cadence, velocity, and stride length are decreased and
stride width increased to provide a wider base of support
for better balance
– Gait changes may be due to age-related musculoskeletal
changes and deterioration of the sensorimotor system
– Creates difficulties in functional movements (stepping
over objects or ascending and descending stairs)
– Decreased step length increases probability of stepping on
object thereby increasing risk for fall
What would be some implications for treatment?
Age-related losses of ROM, strength and balance
may be accentuated by the lack of physical activity
and the presence of neurologic deficits (CVA, SCI,
TBI)
What can be partially reversed with appropriate exercise?
Decline in strength and endurance can be partially
reversed with appropriate exercise
What should precautions be considered for?
Precautions must always be considered regarding
preexisting disorders and modifications made to
treatment interventions
What should the PT instruct the PTA in?
PT should instruct PTA in how the response to treatment
should be monitored during treatment and if not
provided, then PTA needs to request this information
before treatment is initiated
What pulmonary and cardiac conditions need to have vital signs monitored during exercise?
– Decline in cardiopulmonary reserve capacity can be
compounded by loss of fitness and conditioning
– Walking can require 40% of the oxygen taken in requiring an
older person to slow down the speed of walking depending on
availability of oxygen
– Measurements of heart rate, blood pressure, respiratory rate,
oxygen saturation, rate of perceived exertion, level of dyspnea,
or angina provide information on the patient’s response to
treatment
How would history be obtained for a child with impaired neuromotor development?
For a child with impaired neuromotor development,
history is obtained by reviewing medical and
educational records and interviewing the child,
parents, caregivers, and/or teachers
What can standardized tests be used for?
Standardized tests can be used to examine a child’s
activity and participation developmental status
What is the Pediatric Evaluation of Disability Index (PEDI)?
focuses on what tasks the child can achieve and not on
how the child accomplishes the tasks
What is the School Function Assessment (SFA)?
used in the
school environment for children in kindergarten through
sixth grade and consist of three parts: participation, task
support and activity performance
What is the Alberta Infant Motor Scale (AIMS)?
used to
examine the motor development of children from birth
to 18 months of age
What is the Peabody Developmental Motor Scales-2 (PDMS-2)?
assesses qualitative and quantitative aspects of gross
and fine motor development
What is the Gross Motor Function Measure (GMFM)?
used to
assess gross motor function in children with CP
What is postural control good for?
• Postural control is fundamental to movement and is
essential for the emergence and refinement of motor
milestones
• Directionally appropriate motor responses to sitting
platform perturbations develop slowly
What develops slowly?
• Postural control develops gradually over time and by the
age of 7-10 years, reactive postural responses are
similar to those of an adult
When do infants begin to stand independently?
Infants begin to stand independently at about 9-11
months
When does postural control develop?
7-10 years
What is standing development timeframe?
A) Newborn requires total support to stand bearing some body weight
intermittently on the flexed lower extremities
B) 8 month olds requiring support to stand, bear full weight, and have an
upright trunk and head
C) 12 month old stands independently but cannot take a step forward
without losing balance
What is the Bruininks-Oseretsky Test of Motor Proficiency (BOT)?
• Standing on preferred lower extremity on floor
• Standing on preferred lower extremity on balance beam
• Standing on preferred lower extremity on balance beam,
eyes closed
• Walking forward on walking line
• Walking forward on balance beam
• Walking forward heel-to-toe on walking line
• Walking forward heel-to-toe on balance beam
• Stepping over response speed stick on balance beam
What are some anthropometric characteristics?
• Joint range of motion (ROM) changes significantly from
birth through the growing years
• Increase in length, width, and girth because of postnatal
skeletal modeling of the cartilage models
• Shape and joint angles of the knees also change
throughout childhood
• Atypical neuromuscular activity can cause joint
dysfunction and disability
• Strength increases throughout childhood
• Gains in strength generally parallel the typical growth
curves for height and weight
• Muscle size accounts for much of the age and gender
differences in strength during childhood and
adolescence
• Measurement of muscle strength in children with
neuromotor disorders helps to identify deficits that may
contribute to activity restrictions
What is reflex integrity?
Developmental reflexes consist of attitudinal reflexes,
righting reactions, and balance and protective reactions
What is developmental reflex?
stereotyped response to a
specific stimulus and is categorized as primitive or
reactive
What are muscle tone abnormalities associated with?
Muscle tone abnormalities are associated with Down
syndrome, Prader-Willi syndrome, and mental
retardation
How would you guide rehabilitation evaluation and interventions?
• It is important to examine how a child moves to guide
rehabilitation evaluation and interventions
• There is no well-accepted procedure for examining
movement quality
What should a basic examination include?
Basic examination should include measurements of heart
rate, respiratory rate, and blood pressure
Who would have reduced aerobic capacity?
Studies indicate that children with CP and muscular
dystrophy have reduced aerobic capacity
What are some cardiovascular/pulmonary factors?
Factors include abnormalities in structures (heart, lung,
muscle tissue) or physiological function
