NICU, Gait, EI, BPI Flashcards
Week 3
What is the purpose of pediatric tests and measures?
To assess developmental progress, identify delays, and guide interventions.
How are pediatric tests categorized in the ICF model?
Body structures/functions, activity limitations, participation restrictions, environmental factors.
What standardized tests assess gross motor development?
AIMS, PDMS-2, GMFM, BOT-2.
Which test is used to evaluate functional school-based performance?
School Function Assessment (SFA).
Which test assesses sensory processing in children?
Sensory Profile.
What is the scoring method for AIMS?
Observational approach scoring postures in prone, supine, sitting, and standing.
What percentile rank is concerning on AIMS at 4 months?
<10th percentile.
What is a key characteristic of AIMS scoring?
Limited handling to observe natural movement.
What is the etiology of OBPI?
Traction injury to the brachial plexus during birth, often due to shoulder dystocia.
What are the classifications of OBPI?
Erb’s Palsy (C5-C6), Klumpke’s Palsy (C8-T1), Global Palsy (C5-T1).
What is the classic presentation of Erb’s Palsy?
Waiter’s tip position: shoulder IR, elbow extended, wrist flexed.
What is the classic presentation of Klumpke’s Palsy?
Claw hand deformity: hyperextension of MCP joints, flexion of IP joints, possible Horner’s syndrome (if T1 involvement).
What is the classic presentation of Global Palsy?
Flaccid arm, absent reflexes, no movement in shoulder, elbow, or hand.
What are key medical interventions for OBPI?
Nerve transfer, muscle transfer, Botox, osteotomy.
What is a key predictor of recovery in OBPI?
Presence of active elbow flexion by 3 months.
What are early therapy goals for OBPI?
Maintain ROM, prevent contractures, facilitate active movement.
What is the prognosis for OBPI?
Better if recovery begins within 3-6 months; severe cases may lead to lifelong impairments.
How does chronic OBPI impact development?
May cause muscle imbalances, joint contractures, and compensatory movement patterns.
What are interprofessional roles in OBPI management?
PT, OT, orthopedic surgeon, neurologist, pediatrician, family support services.
What is the purpose of early intervention under Part C of IDEA?
To enhance child development, minimize delays, and support families.
What are the key components of early intervention?
Team collaboration, evaluation/assessment, IFSP, natural environments, transition planning.
What is an IFSP?
Individualized Family Service Plan, guiding early intervention services.
How does early intervention differ from hospital-based care?
Hospital-based care is medically driven; early intervention is family-centered and routine-based.
What is the transition plan in early intervention?
A process to help children move from Part C to Part B (school-based) services.
What are the categories of neonatal nurseries?
Level I: Well newborn, Level II: Special care, Level III: NICU, Level IV: Regional NICU.
What defines preterm birth?
Birth before 37 weeks gestation.
What are the categories of low birthweight?
LBW: <2500g, VLBW: <1500g, ELBW: <1000g.
What is a major cause of cerebral palsy in preterm infants?
Periventricular leukomalacia (PVL).
What is bronchopulmonary dysplasia (BPD)?
Chronic lung disease caused by arrested alveolar development in preterm infants.
What are signs of neonatal dysregulation?
Arching, flailing, gaze aversion, irregular breathing, mottling.
How does NICU-associated stress impact infants?
May lead to altered brain development and long-term sensory processing issues.
What are common PT interventions in the NICU?
Positioning, kangaroo care, parent education, developmental support.
What is the importance of family-centered care in the NICU?
Supports parent-infant bonding, enhances developmental outcomes.
What pediatric test measures self-care, mobility, and social function?
Pediatric Evaluation of Disability Inventory (PEDI).
What is the difference between norm-referenced and criterion-referenced tests?
Norm-referenced compare to a peer group, criterion-referenced compare to specific skill benchmarks.
What pediatric test assesses motor proficiency in older children (4-21 years)?
Bruininks-Oseretsky Test of Motor Proficiency (BOT-2).
What pediatric test is used for evaluating infants at risk for motor delays UP TO 4 months?
Test of Infant Motor Performance (TIMP).
What is the typical age range for AIMS assessment?
Birth to 18 months or independent walking.
What is the purpose of percentile rankings in AIMS?
To compare an infant’s motor development to age-matched peers.
What is the difference between Erb’s Palsy and Klumpke’s Palsy?
Erb’s: C5-C6; Klumpke’s: C8-T1 with hand weakness and possible Horner’s syndrome.
What is a secondary complication of chronic OBPI?
Glenohumeral dysplasia due to muscle imbalances.
What are red flags for referral in OBPI?
Lack of elbow flexion at 3 months, severe muscle imbalance, limited PROM.
What surgical interventions are used for OBPI?
Nerve graft, muscle/tendon transfer, osteotomy.
What is the timeline for completing an IFSP after referral?
Must be completed within 45 days of referral.
What is the difference between an IFSP and an IEP?
IFSP is family-centered (Part C, birth-3 years); IEP is school-based (Part B, 3-21 years).
What is a ‘natural environment’ in early intervention?
A setting where a child typically spends time (home, daycare, playground).
What is the Apgar score used for?
Quickly assesses an infant’s health at 1 and 5 minutes after birth.
What is the significance of corrected age in premature infants?
Used to assess developmental progress by adjusting for early birth.
What are the five components of the Synactive Theory of Development?
Motor, Attention/Interaction, Autonomic, State Regulatory, State Organizational.
What are key interventions for infants with bronchopulmonary dysplasia (BPD)?
Positioning, oxygen support, breathing exercises, parent education.
What are common feeding difficulties in NICU infants?
Poor suck-swallow coordination, difficulty with oral motor control, fatigue during feeding.
How does preterm birth impact sensory development?
Increased risk for sensory integration difficulties and delayed vestibular processing.
What are PT strategies to support motor development in the NICU?
Facilitate flexion, midline positioning, and gentle handling.
What is kangaroo care and why is it important?
Skin-to-skin contact that improves infant regulation, bonding, and neurodevelopment.
At what age do 50% of infants achieve independent standing?
10.5 months.
At what age do 50% of infants take their first steps?
11 months.
When is mature sagittal plane gait typically developed?
By 3.5 years.
What are the five early determinants of mature walking?
Duration of single-limb stance, walking velocity, cadence, step length, ratio of pelvic span to ankle spread.
What are key characteristics of early walking?
Wide base of support, increased hip/knee flexion, full foot initial contact, short stride, increased cadence, relative foot-drop in swing.
What is the most important factor in infant gait development?
Frontal plane stability (lateral weight shifts).
At what age does heel strike at initial contact emerge?
Mean time frame of 22.5 weeks after onset of independent walking.
When should consistent heel-toe gait be observed?
By 2.5 years.
What are characteristics of gait at 9-15 months?
Wide BOS, hips in abduction/flexion/lateral rotation, COM at lower thoracic level.
What are characteristics of gait at 18-24 months?
Lower COM (lumbar), decreased head/trunk oscillations, improved stability in single-limb stance.
When does running typically emerge?
50% by 16 months, 90% by 21 months.
When does a narrow BOS in walking typically develop?
By 2 years.
What system provides the first stable reference frame for postural control in new walkers?
The pelvis.
When does head stabilization in space emerge for walking on level surfaces?
Between ages 3-6 years.
What is a key characteristic of preschoolers’ postural control in gait?
They resort to ‘en bloc’ head-trunk movement during challenging tasks.
At what age does head stabilization in space during complex tasks emerge?
By 7-8 years.
Which sensory system reaches adult-level function first for postural control?
Somatosensory system (by ages 3-4).
Which sensory system reaches adult-level function last?
Vestibular system (not fully mature by 15 years).
What happens to gait when plantar cutaneous sensation is desensitized?
Subjects shift weight to retain sensation and alter muscle recruitment strategies.
Is intermittent toe walking normal in early development?
Yes, it may be observed in early standing, cruising, and first 3-4 months after walking begins.
At what age is persistent toe walking considered atypical?
After 2 years of age.
