Paediatrics: Typical Development Flashcards
dynamic system theory
body functions as a complex dynamic sustem (visual, MSK, vestibular)
organise movement based on person, environment and task
non linear development process and change in one sub-system can alter the motor behaviour
motor control definition
Ability to regulate or direct the mechanisms essential to
movement
reflex hiecarchy theory
integration of reflexes responsible for postural and movement control
more functional postural and voluntary responses with time
neonatal reflexes?
neonatal reflexes do not disappear but become integrated and cortical centres taken over by lower brain centres to complete more complex motor functions
examples of primitive reflexes
oral - rooting, sucking, snout
auditory - startled by sounds
tactile - grasp hand
attitudinal reflexes
righting reflexes - body on head, neck on body
balance - postural fixation, tilting
what aspect of the CNS controls the the primitive reflex
brainstem
how does the primitive reflex change
is inhibtted and becomes a cortically controlled response
what is indicated if an adult still has these primitve response
neurologically something may be wrong
how does auditor startle reflex work
primitive reflex
sudden auditory noise - automatic response
head and trunk extensions
arms combined elbow extension with shoulder abduction
what system in the body is responding to the moro/startle audtory reflex
vestibular
when does the moro (startle) reflex disappear
3-4/12
in what population do we see a reduction in the moro/startle auditory reflex
floppy babies - hypotonia
asymmetrical in BPL or hemiplegia
what is the placing reflex
anterior tibia placed in fron of edge of table
baby should lift left and place it ontop of table
walking reflex
placing the sole of the foot of a baby initiates recirpocal flexion and extension of legs - walking
at what age does the walking reflex disappear
5-6/52
symmetrical tonic neck reflex
test in 4 point kneeling
flexion of head => UL flexion + LL extension
extension of head => UL extension and LL flexion
https://www.youtube.com/watch?app=desktop&v=RXyDhQrnhog
when is the symmetrical tonic neck reflex present
present from 4-12 months
if the symmetrical tonic neck reflex is present sfter 12 months what does it indicate
may indicate cerebral palsy
tonic labyrinthine reflex
inc. extensor tone in supine
inc. flexor tone prone
https://bloccupationaltherapy.wordpress.com/tonic-labyrinthine-reflex-tlr/
how long is the tonic labyrinthine reflex pattern present
present up to 6 months
asymmetrical tonic neck reflex
baby in supine
head turned to one side
arm and leg extended in direction of head
arm and leg flexed on contralateral rotation
http://www.youtube.com/watch?v=UWqafotPxTg
righting reactions
ability to maintain the head and body in relation to space and parts of body in relation to each other
Baby responds to an externally imposed change to the
position of one body segment by moving other segments
into line.
name example of optical right reactions
orients the head to visual vertical
name example of labyrinthine right reactions
orients the head in response to vestibular signals
name example of body on head right reactions
orients the head to vertical
name example of landau right reactions
combines all optical, labyrinthine and body on head right reaction
landau response
if suspended in prone hold head parallel to trunk momentarily
2/12 old - maintain position
4-5/12 old extend head and trunk
6-8/12 old extended legs
https://www.google.com/imgres?imgurl=https%3A%2F%2Fi.ytimg.com%2Fvi%2FXSS0GibDyBk%2Fhqdefault.jpg&tbnid=4zDKDvhJhjBWRM&vet=12ahUKEwiE0-2PotyBAxVFXkEAHVo_DQgQMygEegQIARB9..i&imgrefurl=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DXSS0GibDyBk&docid=Rb9LvH2eoGjS9M&w=480&h=360&q=landau%20response&ved=2ahUKEwiE0-2PotyBAxVFXkEAHVo_DQgQMygEegQIARB9
what is the expected labyrinthine reflex at birth
complete head lag
what is expected labyrinthine reflex at birth at 12 wks
slight head lag
what is expected labyrinthine reflex at birth at 16 wks
no head lag
neck righting
Rotate baby’s head to one side.
* Trunk follows head and baby rolls over
when is neck righting most present in babies
at 3/12
how would one complete the parachute reaction
baby is held at trunk and lowered head first
response - arms extended and hands reach for floor
at what age is parachute reaction present in children
6-9/12
what information is obtained from testing certain reflexes
may form basis for motor control
set background t assess and treat children with development problems
what development process is complete i the first quarter of the first year
cephalo-caudad
head control develops,
load bearing surfaces shift caudally
what development process is complete i the second quarter of the first year
arm control and upper trunk
what development process is complete i the third quarter of the first year
control of lower trunk and pelvis in upright positions
what development process is complete i the final quarter of the first year
improved lower limb control control w/ upright stances and posture control
at what age does precision gripping emerge in children
4-50 wks
at what age does the grasp reflex disappear
2-3/12
