Theories of Infant Development that Drive Treatment Flashcards
Describe NDT (neuro development treatment)
- Tx developed for adult CVA & children with cerebral palsy & developmental delay
- Uses handling techniques to inhibit abnormal tone & abnormal postural reflexes that interfere with movement; facilitate normal postural (balance) reactions to improve quality of movement
NDT treatment goals
- ID and treat pathological & poor quality patterns EARLY
- Understand normal & abnormal motor development /timing
- Analyze trace back to original problem, understand how & why
compensations in movement have occurred, treat both original
problems and compensations - Elongate/stretch muscles shortened from overuse, tone or
positioning - Facilitate normal motor responses and inhibit abnormal,
compensatory movements - Use dynamic treatment utilizing righting & equilibrium reactions.
- Follow preparatory treatment techniques with FUNCTIONAL
ACTIVITIES
Progression of abnormal development
- Original pattern: poor quality of movement,underlying hypotonia
- Habit: Repetition of poor movement patterns become habitual
- Contractures: Muscle shortening with increase tone or constant
overuse with no opposing muscle to counterbalance - Deformities: Fixed changes in muscle & bone structure from
contracture - Surgery: Required to change muscle and bone for improved
function (ie. Muscle lengthenings, osteotomies)
What are the 4 levels of development
- Mobility
- Stability
- Mobility imposed on stability in WBing (closed chain)
- Mobility imposed on stability in NWB (open chain): SKILL
Define ROOD’s development model
- Framework of treatment for children & adults with neurological deficits to improve sensorimotor function
Rood’s 9 key patterns:
a progression of positions (developmental sequence)
- Supine flexion
- Rolling
- Prone extension pivot prone
- Prone on elbows
- Prone on extended arms
- Quadruped / bear stance
- Stance
- Walking
- Squatting
Define sensory integration
- Organizing sensory information for use, allows many parts of the nervous system to work together for effective, purposeful interaction with the environment (an adaptive response)
Areas of sensory integration dysfunction can be in
- Registration/modulation
- Motor performance
- Discrimination
Sub categories in registration/modulation
- Ability to receive, process, and modify sensory input
- Tactile hypo, hyper
- Vestibular hypo, hyper
- Proprioception
- Visual
- Auditory
Sub categories in discrimination
- To discern a difference in sensory input
- Tactile
- Auditory
- Visual / Spatial
The Neuro-Maturational Reflex Model theory was popular in the 1920’s to 1970’s, which emphasized specific developmental
sequence and milestones in linear progression is being challenged by newer
theories that development, treatment and outcomes are influenced by
- The environment
- Multi-component systems
- Non-linear progression
- Meaningful task specific skills
- Practice and variation
Define motor control
- involves interaction of many body systems to process sensory info, integrate and execute appropriate motor
responses
What is the process of motor learning
- Perceive need to move
- ID stimulus
- Attend to environmental conditions
- Develop idea for movement
- Motor plan (ROM, strength, tone, sensation)
- Execute selected muscles (with feedback for control)
What are the components of motor control
- Perception
- Cognition
- Arousal
- Sensation
- Flexibility
- Strength
- Tone
- Movement patterns (coordination/balance)
What are the Motor learning strategies
- Practice
- Feedback/feedforward
- Transfer
- Motivation
What are the phases of learning
- Early: cognitive
- Intermediate: associative
- Final: autonomous
What is the developmental progression for motor learning
- Cephalo-caudal
- Isometric-isotonic
- Eccentric-concentric
- Symmetrical-asymmetrical
- Discrete-continuous movement
Define the dynamic systems/Chaos theory for motor control/motor learning
- Behavior is a product of self-organizing, multi complex system, evolving over time
A change in any system may alter outcomes
7 Interacting systems work together in integrated fashion with shifting dominance to accomplish functional tasks
- Musculo-skeletal system (NDT) posture, tone, coordination
- Neuromuscular system (NDT) timing, graded control, type of muscle contraction
- Sensorimotor system (SI) visual, tactile, prop, vest, sensory processing &
organization - Environmental system state of environment, & adaptations (stationary, moving, manipulation)
- Regulating system (SI) for optimal learning: alert, attention, motivation (effort)
- Commanding system(Motor Learning) stimulus,cognitive,emotional drive, be
motivated - Comparing system (Motor Learning) knowledge of results/performance, error
detection
Described motor development as characterized by 2 phases of variability
- Primary variability is characterized by variation in motor behavior and the
absence of the ability to adapt the various movement possibilities to the specifics of the situation - Secondary variability involves the process of selection, and is based on active trial-and-error experiences that are unique to the individual.
Consequences of early brain lesions
- Reduced repertoire of motor strategies results in less variable and more
stereotyped motor behavior - Limited ability to select a strategy out of the movement repertoire due to
deficiencies in processing sensory information brought about by self-produced
actions
Both lack of variability and excessive variability in movement patterns are observed in people with neurological lesions
- Lack of variability hinders development of skilled, functional action
- Excessive variability interferes with the production of automatic, dependable, & typical functional action
What are the key learning principles
- Specificity (task specific)
- Intensity (lots of repetition)
- Salience (meaningful/motivation)
