Movement Motor Control Intervention Flashcards
What is the Importance of Motor Control & Movement in Development
Motor Control required to engage in daily occupations!
Addressing postural/motor control can target other areas of need!
Kids need movement so that they can
play!
Common Diagnosis seen in EI/Preschool:
Developmental Coordination Disorder (DCD)
Cerebral Palsy
Down Syndrome
Acquired Brain Injury (ABI)
Autism
Brachial Plexus birth injury
Torticollis
Developmental Delay
Various Syndromes
What causes low or high tone?
Most of the time - High tone is often caused by a brain injury
Low tone is often a result of chromosomal abnormality
What is the difference between muscle tone and strength?
Muscle tone is tension in the muscle at rest
Muscle strength is the ability of the muscle to contract when the brain signals.
Motor Learning:
The process of understanding and retaining motor skills
Motor control
Ability to regulate or direct mechanisms essential to movement
Motor Praxis:
Also referred to as “motor planning” is the ability of the brain to conceive, organize, and carry out a sequence of unfamiliar actions.
Bottom Up Approaches (treating underlying causes of motor impairment) what are some treatment you would use?
- Neurodevelopmental Treatment (NDT)
- Sensory Integration
- Reflex Integration Therapy
Bottom up approach Focus on addressing the underlying deficit to improve performance However there is
-Limited evidence improving occupations of childhood: should be used in conjunction with other approaches
Neurodevelopmental Treatment (NDT) Description:
Description: Specialized handling techs to facilitate normal movement experiences
NDT Principles
Principles: Benefits from “feeling” typical movement patterns
Abnormal tone interferes with movement
Goal to provide input to “normalize” tone & acquire normal movement
NDT strategies
Strategies: 1- Inhibit/Facilitate tone
2-Key points of control
3-Symmetrical alignment, full ROM, base of support and weight bearing, muscle strength, postural control
4- Intervention strategies to integrate reflexes
NDT Treatment - Look for:
Facilitation/Inhibition
Key points
Symmetrical alignment, ROM, weight bearing etc.
Integration of reflexes
Why is sensory integration considered a bottom up approach?
Working on child specific needs, foundational skills that you need to build upon to get to higher level activities.
Sensory Integration Description
Description: Engages children in movement during intervention which takes place in simulated environments to which the child adapts and responds to sensory stimuli
Sensory integration Principles:
When children complete adaptive responses, change occurs at the neuronal level
Sensory integration strategies
Strategies: Child directed vestibular, proprioceptive and tactile activities designed to facilitate the “just right challenge”
Proximal or power senses
Reflex Integration Approach - Description
Description: Based on the premise that reflexes that are not integrated in the sequence and rate of typical development interfere with the acquisition of normal movement.
Reflex integration principles
Principles: Based on hierarchical models for motor development
reflex integration Strategies
Strategies: Provide intervention activities that will integrate reflexes
What are the 7 key concepts in motor learning
Meaning
Transfer of Learning
Feedback
Knowledge of Results and Knowledge of Performance
Distribution and variability of practice
Whole vs Part Practice
Mental Practice
Motor learning - meaning
Meaning- Participation in task influenced by the extent to which the child can identify in own interests and goals and believes they will be more effective in those motor tasks.
Motor learning transfer of learning
(Generalization) applying learning to new situations
Motor Learning Feedback
Feedback
Intrinsic feedback- allows the child to self-correct. Most effective for sustaining motor performance
Extrinsic feedback- used in the early stages of motor skill development. Consists of providing verbal cueing or physical guidance.
Demonstrative feedback- modeling or imitating movements. Best when provided before the child actually practices the movement.
Motor Planning - Knowledge of Performance-
helps children understand how they performed the desired movement that improves quality of movement.
Motor learning - Knowledge of Results
- Related to the desired outcome.
Motor learning Distribution and variability of practice-
Performs motor tasks in a variety of ways.
Motor Learning - Whole vs Part Practice-
Engaging in whole occupation vs shaping ability to perform task.
Motor Learning - Mental Practice-
Effective in early and later stages of learning, combined with physical practice.
What are the 5 principles of motor learning
Knowledge of performance
knowledge of results
distribution and variability of practice
Whole Vs. Part Practice
Mental practice
Stages of Development of Motor Control
Cognitive- skill acquisition
Associative- skill refinement
Autonomous-perform movement functionally
Cognitive stage of motor learning intervention
Use simple statements
Catchy words or pneumonics
Repeat skills
Provide time for problem solving
Allow child to review progress
Associative stage of motor intervention
Relate new tasks to past activities
Use the same words/cue for similar tasks
Help child see links to previous success
Allow child to review process by relating to other activity
Autonomous motor learning Intervention
Set up environment in which child can be successful
Allow child to self-reflect
Provide few, if any cues
Do not correct or address quality-allow child to self-evaluate
Impacts of Impaired Movement
- Limits sensorimotor experiences
- Lost interests in the world that they can not control
- Learned helplessness
- Diminished expectations of caregivers and others
- Lack of curiosity & initiative
- Decreased intellectual performance
- Decreased social interaction
Long term physical restriction during infancy or early childhood can significantly alter and disrupt
the entire subsequent course of emotional 0r psychological development of the involved child
Impacts of Impaired Movement- Hypotonia
Limited in ability to maintain secure posture
Exploration deprivation
May limit cognitive development
Self- stimulation to fill sensory void
Impacts of Impaired Movement - Hypertonia (High Tone)
Positive sign of spasticity (increased tone)
Excessive co-contraction of muscles
Excessive sustained muscle activity
Loss of muscle extensibility
Loss of some sensory perceptual abilities
Children have difficulties initiating, sustaining and terminating ______________
movement
Movement Intervention - How can we help
Locomotive experience predictive of adaptive responding and NOT age
Need practice, practice at EACH stage (multiple squats, multiple falls)
We know that TONE (high or low) can limit movement and engagement in a child’s daily occupations.
Locomotive experience predictive of adaptive responding and NOT ______
Age
Kids with movement needs, need lots of
practice
We know that TONE (high or low) can limit movement and engagement in a child’s daily occupations. How can we help
Movement intervention - low tone
- Child is active participant
- Light touch used
- Allow time to respond to sensory input
- Work on developing controlled movements in midranges
What is more activating? light touch or deep
light touch and tapps
Low tone kids tend to be
underresponsive
What are controlled movement in midrange
mid part of the movements are harder. going slower is harder.
Movement intervention for Hypertonia (High Tone)
Start with the base of support
Head and trunk control and alignment of spine
Relaxation- joint approximation, thoracic extension with rotation
Gaining range of motion and mobility
Use handling and facilitation to help gain functional developmental patterns
