Quiz 3 Flashcards
Biomechanical FOR
-Applied when a person cannot maintain posture through automatic muscle activity
* General goals of biomechanical frame of reference for positioning children for functioning:
o reducing demands of gravity and align the body
o Address performance skills by providing external support for proximal stability
o This reduces need for or demands on postural reactions and compensatory techniques
Biomechanical Approaches for pre-
writing and handwriting
- Paper should be slanted so that it is parallel to forearm of the writing hand (roughly 25-45 degrees to the left)
o Left handed kidsà 25-45 degrees to the right - Writing surface should be at 20-30 degree slant can improve pencil grasp
o Provide a slant board: slant automatically positions hand
in wrist extension and angles hand in slight supination.
o A wrist extended position facilitates finger flexion and grasp. Can also facilitate eye-tracking
Supine position benefits
- Flexor activity develops head control:
o midline control and chin tuck - incorporate shoulder protraction and flexion against gravity
- Hands to midline
- Reduced demands on trunk; more effort can be given to head, oral,
ocular, and shoulder control - A pillow may be placed beneath the head and A roll under the thighs may place hips in a flexed position (allow the soles of the feet to be in contact with the floor)
- Oral motor control is taxed in this position, as it is more difficult to bring the tongue forward and lips together and to stabilize the jaw
Prone Position benefits
- Head righting in a horizontal plane
- Interaction of dorsal extensors and ventral flexors for propping on forearms
- Shoulder stability during weight bearing (propping) and mobility on stability during weight shift
- Increased range of shoulder flexion is necessary when reaching from
horizontal position - Decreased effects of gravity on lateral asymmetries that occur with upright positioning
- Hands more likely to be in visual field by nature of shoulder position when propping
- Wedge provides basic support to enhance prone positioning for a child who cannot prop independently
- Wedge should be wide enough so that it does not tip if the child starts to roll over
- length of the wedge determined by point of support at the chest and hips
- demand on the shoulder for weight bearing is influenced by
o amount of contact of the wedge on the chest.
o lower the contact of the wedge on the chest the greater the demands on the shoulder girdle for weight bearing
Side lying position
- Differentiation of two sides of the body (bottom side weight bearing,
top side mobile) - Hands easily placed in visual field
- Hypertonicity reduced; tonic labyrinthine reflexes inhibited
- Effects of gravity on shoulder flexion/extension reduced
- For a child who cannot maintain side lying position
- Supports on back, between legs, and anterior
Sitting position
- The therapist must first correct or support any inadequacies in the base, especially at the pelvis
- This may decrease tone, compensatory movements, or associated reactions elicited by stress
- Slight anterior pelvis tilt or neutral is preferred
- Make sure femur is properly supported/aligned in its entire length from the back to around 1-inch behind knee (popliteal area)
o Use a short seat depth for children who can self-propel using legs
and feet. Add some anterior tilt if this is the case - Note: if compensatory postures are used for function, provide a home exercise program to elongate the
“tightened” musculature to minimize a child’s risk of increased deformity and secondary complications
Seating: cushions
o Planar: required for minimal body contact with support surface
o Contoured: more contact with body surface . good for child who has
fixed contractures and asymmetries of pelvis and spine
o Custom
* back support : not too high (this causes postural dependency)
* leave the scapula area clear for upward and downward rotation
of the scapula with humeral movement
Seating: when Belts used
- generally : 60- to 90-degree angle to the hips
- If good trunk and pelvic control–> pelvic belt should be positioned below the anterior superior iliac spine (ASIS) and comes from the seat at a 90-degree angle, perpendicular to the floor
- If child can achieve a neutral alignment position but cannot keep it there due to weakness –> pelvic belt that positioned below the ASIS at a 60-degree angle to the seat
- Pelvis obliquity/asymmetry –> padded 4-point belt
motor learning theory
- Movement arises from interaction of multiple processes, including those related to sensory/perception, cognitive, and motor systems
-Motor control: how the body directs movements & how musculoskeletal system interacts to achieve these movements
-Motor Learning:
-strategies and techniques used to teach others how to move
-considers type of practice , experience, motivation, reinforcement, type of
feedback, motor skill, and developmental progress, that can lead to relatively permanent change in person’s capability for skilled action
Motor learning theory: Dynamic
systems theory
- Shifts away from traditional reflex hierarchical view of motor behavior
- Motor control is dependent on non-linear & transaction between env & person
- Relationship between the person, environment and task
- Each individual develops preferred movement patterns for common
functional tasks through active experimentation, experience, and practice - Therapists should consider child’s preferred and most efficient patterns of moving and all of person–task–environment subsystems (control
parameters) affecting child’s task performance when planning intervention
Principles of learning theory
-Practice
* “just right challenge”
* should occur during typical, functional, routines throughout the day; massed practice, discrete trial practice, various strategies
-Experimentation
-Variation
* In skill
* In environment
-Developmentally appropriate support
* zone of proximal development
-Feedback
sporadic feedback is best for longterm learning
Concepts of motor learning theory
- Child
-Person factors - Task
-complexity, degree of structure, and purpose
-influenced by the social and physical demands of the environment - Skill
-consistency in achieving a motor goal with economy of effort - Environment
-A major factor in task performance - Regulatory conditions
-Closed tasks (environment predictable, stable)
-Open tasks (environment unpredictable, always changing)
Play postulates
-Play is intrinsically motivated.
-Play is characterized by self-imposed
goals that can change at the whim
of the player.
-Play is person-centered behavior and is believed to stimulate and
maintain the person’s arousal level.
-Play involves an internal locus of control.
-Play has a pretend quality.
-Characterized by flexibility and freedom from externally imposed rules.
-The child actively engages in play
Arousal-Modulation Theories
of Play
Developed by Dr. Berlyne
-Developed a theory of intrinsic motivation in which play was
associated with exploration.
-Presumed that the CNS has an optimal level of arousal.
Piaget- cognitive approach of play
Sensorimotor play (practice games):
* Characterized by exploration of sensations and movement, e.g., jumping into a puddle.
* Involves the doing of actions purely for the pleasure of practicing them.
* Dominates the first 2 years of
childhood, but occurs throughout childhood whenever new skills are acquired and practiced.
Symbolic play (symbolic games):
*Characterized by imagination during make-believe or pretend play, e.g., feeding a doll with invisible food.
*Begins at 2 years of age and
becomes increasingly complex in the
preschool years with longer
sequences of pretend behaviors
when playing with peers (called
“sociodramatic play”).
Games with rules:
-Explicit rules that are socially constructed and followed during
cooperative play between two or more individuals.
-Predominates the play of children 7 to 11 years of age and continues to be a dominant mode of play throughout life..
Importance of play
✘ Maintains optimal arousal level.
✘ Enhances gross-motor, fine-motor, and oral-motor development.
✘ Promotes self-help skills.
✘ Facilitates social-emotional development.
✘ Facilitates cognitive development.
✗ Promotes creativity.
✗ Promotes problem-solving.
✘ Enhances development of language
Play Development
✘ Sensorimotor play peaks in the second year of life
✘ Exploratory play begins in infancy
✘ At the end of the first year children begin to learn concept of cause and effect
✘ In the second year play focuses on combining objects and developing purpose to play
✘During preschool years children engage in constructive play with identifiable outcomes such as sandbox, puzzle, and block table
✘ During middle childhood and adolescents it develops into more abstract play or creative play like arts and crafts
✘ Symbolic play and pretend play develop at the end of the first year and through the second year peaking at 5 years of age
✘ During middle childhood symbolic play and fantasy play are seen in mental games, secret clubs, and daydreaming, or in secret codes
and riddles
✘ By the age of 3 children are able to learn about social systems and cultural norms
