Pediatric Development/Milestone Flashcards
Rooting
- Onset age
- Integration
- Stimulus
- Response
- Relevance
- Onset age - 28 weks gestation
- Integration - 3 months
- Stimulus - Stroke the corner of the mouth, upperlip, and lower lip
- Response - Movement of the tongue, mouth, and/or head toward the stimulus
- Relevance- Allows searching for and locating feeding source.
Suck-Swallow
- onset age
- integration age
- Stimulus
- Response
- Relevance
- onset age - 28 weeks gestation
- integration age - 2-5 months
- Stimulus - Place examiner’s index finger inside infant’s mouth with head in midline
- Response - Stong, rythmical sucking
- Relevance - Allows ingestion of nourishment
Traction
- Onset age
- integration age
- stimulus
- response
- relevance
- onset age - 28 wks
- Integration age - 2-5 months
- Stimulus - Grasp infant’s forearms and pull-to-sit
- Response -Complete flexion of upper extremities
- Relevance - Enhances momentary reflexive grasp
Moro
- Onset age
- Integration age
- stimulus
- response
- Relevance
- Onset age- 28 weeks gestation
- Integration age - 4-6 months
- Stimulus - Rapidly drop infant’s head backward
- Response -
- 1st phase - arm extension/abduction, hand opening
- 2nd phase - arm flexion and adduction
- Relevance - Facilitates ability to depart from dominant flexor posture: protective response
Plantar Grasp reflex
- Onset age
- Integration age
- Stimulus
- Response
- Relevance
- Onset age - 28wk gestation
- Integration age - 9 months
- Stimulus - Apply pressure with thumb on the infant’s ball of the foot
- Response - toe flexion
- Relevance - Increases tactile input to sole of foot
Galant
- Onset age
- Integration age
- stimulus
- response
- relevance
- Onset age - 32 wks gestation
- Integration age - 2 months
- Stimulus - Hold infant in pron suspension, gently scratch or tap alongside the spone with finger, from shoulders to buttocks.
- Response - Lateral trunk flexioni and the wrinkling of the skin on the stimulated side
- Relevance - faciltiates lateral trunk movements necessary for trunk stabiization
ATNR (Asymmetric tonic neck)
- Onset age
- Integration age
- Stimulus
- Response
- Relevance
- Onset age - 37wks gestation
- integration age - 4-6 months
- stimulus - fully rotate Infant’s head and hold for 5 seconds
- response - Extension of extremities on the face side, flexion of extremities on the skull side
- relevance - Promotes visual hand regard
Palmar Grasp
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 37 wks gestation
- integration age - 4-6 months
- stimulus - Place examiner’s finger in infant’s palm
- response - finger flexion; reflexive grasp
- relevance - increases tactile input on the palm of the hand
Tonic Labyrinthine - supine
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - >37 wks gestation
- integration age -6 months
- stimulus -Place infant in supine
- response - Increased extensor tone
- relevance- facilitates total-body extensor tone
Tonic Labyrinthine - Prone
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - >37wks gestation
- integration age - 6 months
- stimulus - Place infant in prone
- response - Increased flexor tone
- relevance - facilitates total-body flexor tone
Labyrinthine/ Optical (head) righting
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - birth-2months
- integration age - persists
- stimulus - Hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward
- response - upright positioning of the head
- relevance - Orients head in space, maintains face vertical
Landau
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 3-4months
- integration age - 12-24 months
- stimulus Hold infant in horizontal prone suspension
- response - Complete extension of head, trunk, and extremities
- relevance - Breaks up flexor dominance; facilitiates prone extension
Symmetric Tonic neck
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 4-6 months
- integration age - 8-12 months
- stimulus - Place infant in the crawling position and extend the head
- response - flexion of hips and knees
- relevance - Preaks up total extensor posture; facilitates static quadruped position
Neck righting (NOB) Neck on body
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age -4-6 months
- integration age - 5 years
- stimulus - Place infant in supine and fully turn head to one side
- response - log rolling of the entire body to maintain alignment with the head
- relevance - Maintains head/body alignment; initiates rolling (first ambulation effort)
Body righting (on body) (BOB)
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 4-6months
- integration age -5 years
- stimulus - Place infant in supine, flex on ehip and knee toward the chest and hold briefly
- response - Segmental rolling of the upper trunk to maintain alignment
- relevance - Facilitates trun/spinal rotation
Downward Parachute (protective extension downward)
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 4 months
- integration age - persists
- stimulus - Rapidly lower infant toward supporting surface while suspended vertically
- response - Extension of the lower extremities
- relevance - Allows accurate placement of lower extremities in anticipation of a surface.
Forward parachute (protective extension forward)
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 6-9 months
- integration age - Persists
- stimulus - Suddenly tip infant forward toward supporting surface while vertically suspended
- response - Suddend extension of the upper extremities, hand opening, and neck extension
- relevance - Allows accurate placement of upper extremities in anticipation of supporting surface to prevent a fall.
Sideward Parachute (Protective extension sideward)
- Onset age
- integration age
- stimulus
- response
- relevance
- Onset age - 7months
- integration age - persists
- stimulus - quickly but firmly tip infant off-balance to the side while in the sitting position
- response - arm extension and abduction to the side
- relevance - protects body to prevent a fall; supports body for unilateral useof opposite arm
4 month grasp
Primitive squeeze grasp
5 month grasp
- Palmar grasp
6 month grasp
radial-palmar grasp
7 month grasp
Radial palmar grasp with straight wrist
8 month grasp
Radial -digital grasp
9 month grasp
Radial digital grasp with wrist extended
Fine motor manipulation skills
12-15 months
Finger-to-palm translation - a linear movement of an object from the fingers to the palm of the hand, picking up coins
Fine motor manipulation skills
2-2 1/2 years old
- Palm-to finger translation: with stabilization, a linear movment of an object from the palm of the hand to the fingers, ie placing coins in a slot
- Simple rotation: the turning or rolling of an object held at the finger pads approximately 90 degrees or less. ie unscrewing a small bottle cap
Fine motor manipulation skills
3-3 1/2 years old
- Shift - a linear movement of an object on the finger surfaces to allow for repositioning fo the object relative to the finger pads, ie Shifting up and down a pencil separating 2 pieces of paper
Fine motor Manipulation skills
6-7 years old
- complex rotation - the rotation fo an object 360 degrees, ie turning a pencil over to erase
- In hand manipulation with stabilization- several objects are held in the hand and manipulation of one object occurs, while siultaneously stabilizing the others, ie picing up pennies with thumb and forefinger while storing them in the ulnar side of the same hand.
Pencil grasp
1-1 1/2 years
Palmar-Supinate grasp - Children often hold their writing tool like a dagger, scribbling using their whole arm.
Pencil grasp 2-3 years
Digital-pronate grasp - All fingers are holding the writing tool but the wrist is turned so that the palm is facing down towards the page. Children begin to stabilise their shoulders, so that movement now comes mostly from the elbow. At this age, children should start being able to copy a
Pencil grasp 3 1/2-4 years
Quadropod grasp - 4 fingers are held on the writing tool, beginning to form the arc between the thumb and index finger (web space). Movement will occur mostly from the wrist and the hand and fingers move as one whole unit. At this age, children should be able to complete simple dot-to-dots, imitate zig-zag and crossed lines, trace dotted lines and draw simple humans (eg. Head, stick body and one other body part such as arm or leg).
Pencil grasp 4-6 years old
- Static tripod posture - This is a 3 finger grasp, where the thumb, index finger and middle finger work as one unit. At this age, children should be able to copy a diagonal line, a square, a diagonal cross, a circle and a triangle. Pictures of humans become more detailed, including both arms and legs and even facial features.
- Dynamic Tripod posture - Children will consistently be using only 3 fingers to hold the writing tool. This is the ideal grip to help move the pencil efficiently, accurately and at a good speed. Your child is now ready to starting practising and perfecting their letter formations! Most children will master the tripod grip by the age of 6 or 7, so there’s no need to raise alarm bells if your child isn’t holding their pencil properly as they start school.
