Newborn Flashcards
How do we view motor development?
Chronological
Positional
Chronological view of motor development
Looks at multiple positions at different times in a baby/human life
Able to compare baby to typical development - age appropriate skills
Able to provide understanding of development
Positional view of motor development
Looking at how an individual positions mature through time and development
Allows us to look at quality of motion and the progress of that particular skill
How does an individual progress throughout the prone position over age
Able to provide understanding of development
What are theories of motor behavior
Assumptions about development/movement
Guides therapists in performing evaluation and interventions
Individual, task, environment
Reflexive and Hierarchial Theory
Top down control
Observed progression of development
Neuro-maturational theory
utilizing the ideas of reflex and hierarchical theory to explain infant development
Reflexes are typically thought of as a response to a stimulus - reflexes are now thought of as a role in development but not the sole determinant
Reflexive, Hierarchical, neuro-maturational are all based on the idea of
Neuro-facilitation
Theory of motor behavior - Task-oriented approach
Organized around behavioral goals
Less around neuro-facilitation
Movement observed after lesion based on remaining systems abilities =
Compensations
For task oriented approach it it Important to practice ____ rather than ___
Important to practice functional tasks rather than movement patterns for their own sake
Dynamic systems theory of motor behavior
Complex interactions
Incorporates multiple systems - body, environment, task and motivation
Factors impacting development
Genetic
CNS maturation
Environment
Anatomical (body type, mm fiber type, ROM, tone)
Typical vs. Normal development
Should use the word typical
There is a normal bell shaped curve
TYpical motor development begins with
Fetal development
Supported womb full term = 38-40 weeks, premature = 36 weeks or earlier
Unsupported womb
Placenta rupture, womb with alcohol in it..
Observed progression of development based in reflexive and hierarchical model
Cephalo-caudal
Prox - distal
Automatic - reflex - voluntary
Mass - isolated - integrated
Mobility - stability, controlled mobility - static dynamic - skill
Gross - fine
dominaed by gravity - control over gravity
Anti-gravity movement progression - start in
physiological flexion and progress to anti-gravity extension Physiological flexion Active extension Active balance btw flexors/extensors Rotation - dynamic control Transition occurs
Head control n prone
Healthy infant initially able to clear nose via rotation at birth
Begins with rotation that progresses toe xtension, balance btw flexors and extensors, and then dynamic head control
Equilibrium reactions
Bodies ability to maintain upright postiion against gravity
Starts by gaining head control
Trunk follows with elongation to lift body against gravity
Weight shift - named of position by side weight shifted towards
UE development begins with
Weight bearing
Shoulders begin in ext/add/IR/elbow flexion
As weight bear thorugh forearms and hands continues –> shoulders abduct and flex, pushing through forearms, development of movement in hands
Develops Protective Reactions in the UEs
Protective Reactions
like stepping reactions in legs but for the arms
Pelvic hip development and mobility/stability
Weight shifts caudally towards pelvis
Pelvis drops towards the floor - weight bearing through pelvis
Development of hip extension/ankle PF - antigravity
Reflexes =
Response of the body to a certain stimulus
Reflexes are typically either:
Present or Absent
Reflexes - integrated
when a child uses it when needed/required as a survival skill
Reflexes - obligatory cs non obligatory
Obligatory - stuck in reflexive pattern that should be integrated
Why do we have reflexes
Adaptive and used for survival skills
Examples of reflexes - rooting and sucking
Rooting - stroke side of cheek and baby turn head - functional for eating
Sucking reflex - also for eating
Reflexes also persist due to
Usefulness for skill
Alter by adapting environment/sensory cues
Lack of more mature pattern - slow/atypical development
Usefulness for skill - ATNR
ATNR - with cervical rotation, same side elbow extension, opp side flexion
Present at birth
Integrated 4-6 months
Alter by adapting environment/sensory cues
Flexor withdrawal - steps on tack, withdrawal with noxious stimulus
Present at birth
Integrated at around 2 months
Tonic/brainstem reflexes - Tonic Labyrinthine - TLR and ATLR
TLR = when head tilts back in supine the body extends, when head tilts forward in prone the body flexes
Fully integrated at 6 months
ATLR - in side lie - top leg flexes, bottom leg extends - assists with rolling
Tonic/brainstem reflexes - Tonic neck - ATNR and STNR
STNR - with cervical ext, arms extend while legs bend symmetrically
With cervical flex, arms flex and legs ext symmetrically
Present btw 6-8 months - becomes integrated when crawling is mastered
Tonic/brainstem reflexes - - protective support
Child is placed on their feet and is able to maintain LE extension - primitive maintains up through 6 months - some variability
What occurs when a TLR becomes obligatory
The individual is unable to perform antigravity motion
Spinal reflexes
Palmar grasp
Plantar grasp
Startle
Spinal reflexes - palmar grasp
Pressure on palm of hand
Onset = birth
Integrated at 3-6 months
Spinal reflexes - plantar grasp
Pressure on palm of foot
Onset is 28 weeks gestation
Integrated at 9 months
Spinal reflexes - Startle
Onset = birth and persists thereafter
Righting reactions
Optical Labyrinthine Neck on Body Body on Body Landau
Optical Righting Reaction
Child attempts to visually place visual view o the horizon
Labyrinthine Righting Reaction
Utilizes semi-circular canals for position
Neck on body righting reaction
Cervical rotation will eventually lead to body rotation
Body on body righting reaction
Flex legs up and across, body will follow
Landau righting reaction
airplane postiion - full extension in prone - see it start at 4 to 5 months
Anti gravity movement as needed
Equilibrium reactions
Upright against gravity
Tilting reactions
the bodies attempt to stay upright on a dynamic surface
Protective responses/Support reactions
Extremity attempt to assist in maintaining upright posture - reach towards ground
Protective responses/Support reactions - UE
Develops progressively
1st = ant, comes at 4-6 months
2nd - lateral
3rd - post
Protective responses/Support reactions - LE
Stepping reactions
Functional skills of an infant - Newbron/Infant Organization
Self regulation for daily routines and attention
Sleeping
State = sleepy/drowsy; awake/alert, fussing crying - this needs to be in check for optimal learning
Functional skills of an infant - Newbron/Infant Organization - sleeping state to help it if off
Flexion/midline positioning is a base posture for task and calming in the neonate
Rocking them, pacifier, swaddle them
Functional skills of an infant - Feeding/Communication Relationships
Impact of head and neck on feeding and speech
Head stability for eye tracking and speech
Functional skills of an infant - Exploration for learning - Eye hand for play and manipulation of toys
Shoulder girdle stability for play and reaching
Weight bearing through arms and hands assists in hand arch formation which progresses to fine motor control
Functional skills of an infant - Exploration for learning - Exploration
Upright pelvis to allow movement in sitting
Balance of flexion/extension for stability
Rotation - transitional movement/mobility
Characteristics of a newborn - appearance
Lanugo (hairy covering)
Bowlegged
Twitching
CHaracteristics of a newborn - physiologic flexion
Significant changes in the first 4 months
Other characterisitcs of a newborn
Random movements, some controlled by reflex
COmmunication - different cries, eye contact, may smile
Newborn - body position
Physiological flexion
Newborn prone - COM is shifted
Towards the head
Head turns toward side
Newborn prone UEs
Shoulders Ext IR and Add
Newborn prone LEs
Flexed hips, knees, and ankle DF
Newborn supine
Limited head control
May see slight rotation
Newborn supine UE
flexed
Jerky/tremors
Newborn supine LE
Flexed with ankle DF
Newbron supine skills
Head and hands to midline Some initial attempts at hand to mouth Some kicking Pull to sit - significant head lag Gravity begins to slowly take their body out of physiological flexion - passive extension
Newborn - sensory - visual
Optic tracts not full myelinated Sees best in dim light 8-12 in Prefers black and white Prefers patterns vs colors Horizontal tracking with head movement Will make eye contact
Newborn - sensory - visual - 3 day old can detect
Velocity and direction of a field of dots moving and alter head position
Newborn - sensory - taste
Myelination complete
Prefers sweet
Newborn - sensory - temperature
Will shiver and curl
Newborn - myelination - Tactile
complete
Newborn - myelination - Vestibular
Complete
Newborn - myelination - Smell
complete
Recognize mothers scent at 1 week
Will startle to strong odor at 55 hours
Newborn - myelination - auditory
not complete Responds to vibration Localizes sound at 10 min after birth Calms to high pitch voice Prefers music
Newborn - communication/social
Smile is initially reflexive early on
Social smile - 6 weeks
