Pediatric Development and Reflexes Flashcards
Babinski’s reflex
after sole of foot has been stroked big toe extends, other toes fan out
ATNR
asymmetrical tonic neck reflex
head turns to one side and arm on ipsilateral side extends
arm on contralateral side flexes
STNR
symmetric tonic neck reflex
Head flexes, arms flex, legs extend
arms extend, legs flex
breaking up extensor pattern
precursor for creeping/crawling
TLR
Tonic labyrinthine reflex
where the head goes, the extremities go (meatball)
Gross Motor Skills development (progression)
Lift head (1 month)
sit w/support
Sit IND (6 months)
creep
crawl
pull to stand
IND stand
walking (12 months)
Grasp Development (progression)
primitive squeeze
ulnar grasp
palmar grasp
radial-palmar grasp
radial-digital grasp
inferior pincer grasp
fine pincer grasp
What age does fine pincer grasp typically develop?
12 months
Is TLR integrated before or after STNR?
before
Feeding development: 0-4 months
latches onto nipple
suck-swallow-breathe
Feeding development: 4-7 months
spoon feeding introduced
opens mouth in anticipation
Feeding development: 7-9 months
begin to drink from cup
up and down chewing
Feeding development: 10-12 months
rotary chewing
IND finger feeding
Feeding development: 13-15 months
controlled bites based on texture
lip closure
spoon to mouth
Feeding development: 16-18 months
holds and drinks from cup
Feeding development: 18-24 months
chews wide variety of textures completely
uses spoon independently
Feeding development: 2-3 years
drink from straw
36 months uses a fork
Feeding development: 3-5 years
pour and scoop without spills
spread butter
Feeding development: 5-6 years
supervision with a knife
Feeding development: 6.5 years
use utensils independently
What is the progression of utensil usage?
least to most pointy
Development: dressing 1 y
cooperating
doffs shoes/socks
Development: dressing 2-3 y
doffs coat w/out fasteners
doffs pants with elastic waistband
unbutton large buttons
Development: dressing 3-4 y
unzip zipper
zip zipper w/assistance
button buttons
dress w/SUP
Development: dressing 4-5 y
weave belt through belt loops
dress w/out SUP
Development: dressing 6 y
tie bow
manage fasteners
Development: toileting 1-2 y
shows discomfort when soiled
sit on toilet w/SUP
Development: toileting 2-3 y
shows interest in toileting
toileting schedule
wakes up dry
wash hands IND
Development: toileting 3-4 y
goes to bathroom IND
needs assistance w/wiping
needs assistance w/clothing
Development: toileting 4-5 y
IND
Motor milestones: 0-3 months
involuntary release skills
prone: push into prone
supine: turn head side to side
sitting: stabilizing head
hands coming to midline (3 months)
Motor milestones: 4-6 months
prone: shifting weight to forearms, bearing weight on forearms, equilibrium actions
supine: hands together in space
sitting: good head control, support selves momentarily, then prop w/arms
6 months-sit unsupported
standing: increased ability to bear weight on legs
Motor milestones: 7-10 months
prone/supine: pivot to prone and prone to sit
rolling/creeping/crawling: creep before crawl
sitting:
standing: pull to stand
walking: furniture cruising
Motor milestones: 11-18 months
rolling/creeping/stair climbing: creep well and up stairs
sitting/standing:
walking: w/hand held
15 months- walk w/out hand
18 months- run
ADLs:
Moro reflex
Startle reflex
