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Peds > Toddlers/Toe Walking > Flashcards

Toddlers/Toe Walking Flashcards

1
Q

What are some hallmark, general behaviors of toddlers?

A
  • like to follow and be followed
  • like exploring
  • need redirection
  • “NO” and “MINE” are big words
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2
Q

What are the advanced gross motor skills toddlers are working on?

A
  • running
  • jumping
  • kicking
  • throwing
  • catching
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3
Q

T/F: Toddlers gain full ROM in their LE’s by the end of age 2.

A

true for AROM, not PROM

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4
Q

When do toddlers gain full ROM of their UEs?

A

by end of year 1

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5
Q

When do toddlers develop heel strike?

A

18 mo

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6
Q

What strength is developing at 13 mo?

A

proximal shoulder strength

- shoulder girdle/RTC to push/pull toys

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7
Q

At what age do we get increased abdominal strength, as well as hip abd/add and glut strength? What is this used for?

A

18 months -> used for transitions and walking up/down stairs

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8
Q

Muscle strength in what area is seen at 24 mo? What is it used for?

A

quad and trunk strength: used for jumping

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9
Q

When do children begin throwing?

A

13 mo: think about their strength gains they get at this time

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10
Q

If a child is having difficulty going up/down stairs, what muscles could you work on?

A

hip/glut strengthening, quad strengthening

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11
Q

If a child isn’t jumping, what muscles need strengthening?

A

trunk and quads

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12
Q

When do toddlers begin to run?

A

13 mo

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13
Q

By what max age should late walkers be walking?

A

18 mo

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14
Q

When a 13 mo child is walking, what things should you look at in your eval?

A
  • are they able to slow down and keep balance?
  • are their feet sensitive to varying textures? sensory intolerance?
  • can they run?
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15
Q

T/F: Eye-foot coordination is developed by 2 yo.

A

false, just beginning

- but hand-eye coordination is well developed by 2 yo

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16
Q

T/F: Primary fine motor skills are developed by the first year.

A

true, allows building of coordination through 2 yo

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17
Q

At 3yo, do children have the skills needed to play soccer?

A

yes, hand-foot coordination is more developed then

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18
Q

What are the 5 general things that toddlers are gaining in development?

A

1) full ROM in UE/LE
2) proximal and core strength
3) coordination
4) tolerating input to feet, body awareness
5) controlling speed of movement

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19
Q

By 15 mo, how far should a toddler be able to walk without support?

A

10 ft

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20
Q

Describe the walking capability of a toddler at 15 mo.

A
  • able to slow down easier and keep balance (starts at 13 mo)
  • fast walking cadence wise
  • backwards and sideways walking beginning
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21
Q

How far should a 13 mo child be walking without support?

A

at least 5 steps

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22
Q

When does a child start to explore going down stairs independently? How much can they do?

A

15 mo: start to creep/crawl down a few stairs

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23
Q

What would be a good way to get a child to do sideways walking?

A

hold their hands and tell them to “do what I do”

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24
Q

How do children begin to throw at 13 mo?

A

flinging with elbow: may do better in sitting

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25
Q

How do children catch a ball at 13 mo?

A

carrall it with both legs and hands in sitting

- cannot do standing yet

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26
Q

When does heel-toe gait begin?

A

18 mo

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27
Q

Describe stair navigation improvements from 13 to 18 mo.

A

13: crawling up stairs
18: marks time up/down with hand held

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28
Q

When can a toddler start to throw overhand more?

A

throws overhand 3’ at 18 mo (vs flinging at 13 mo)

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29
Q

What does running look like at 24 mo?

A

running on toes in 10’ intervals

30
Q

Describe kicking skill development in toddlers.

A
  • 15 mo: raises foot to make contact with ball

- 24 mo:

31
Q

Describe running development in toddlers.

A

13 mo: starts trying to run
18 mo: immature run, hurried walk
24 mo: runs on toes for 10’ intervals

32
Q

When does a child begin to pull toys behind them while walking?

A

18 mo

33
Q

When is a child able to walk up/down stairs with hand-held support? What about railing support?

A

18 mo (crawling at 13 mo) hand held

24 mo railing

34
Q

When is a child able to stand on 1 foot?

A

24 mo: stands 1 foot for 1-2 sec

35
Q

What can a 24mo do when walking on a line?

A

walks with one foot on 4” line for 6’

36
Q

At 24 mo, what is a child’s throwing skill?

A

throws a tennis ball underhand 3-7’

37
Q

How old is a child who catches a large ball against their body?

A

2 yo

38
Q

How old is a child that kicks a ball 3ft by walking into it?

A

18 mo

lifts foot to make contact at 15

39
Q

Describe kicking skill development in toddlers.

A

15 mo: raises foot to make contact with ball

18 mo: kicks ball 3’ by walking into it

24 mo: kicks ball 3’ more in midline

40
Q

What jumping skill is seen in 2 yo?

A
  • jumps up 2in with feet together

- jumps of stair with one foot leading

41
Q

Describe catching skill development for toddlers.

A

13 mo: corralling ball when in sitting

24 mo: catches large ball against body

42
Q

How old is a child that throws a tennis ball underhand for 3-7’?

A

24 mo

43
Q

Describe throwing skill development for toddlers.

A

13mo: flinging
18mo: starts throwing ball overhand 3’
24 mo: throws tennis ball underhand 3-7’

44
Q

A child doing a hurried walk for a run is how old?

A

18 mo

45
Q

How old are children when they can push/pull objects?

A

13 mo: developing proximal shoulder strength to do so

46
Q

When is walking backwards mastered?

A

2 yo (starts at 13-15 mo)

47
Q

When does a child pull toys behind them while walking?

A

18 mo

48
Q

When do toddlers get better at stopping/starting gait?

A

18 mo (begin trying at 13 mo, but can’t stop w/o losing balance)

49
Q

What muscles assist a toddler in standing balance, but are weak during gait at 13-18mo?

A

abdominals

50
Q

When does concentric dorsiflexion begin for gait?

A

13-18 mo

- think about heel strike: starts at 18 mo

51
Q

T/F: Toddlers now have a narrower BOS that is less than the width of their shoulders.

A

true

52
Q

A child who maturely weight-shifts in transitions to stand and and creeping up stairs is how old?

A

18 mo

53
Q

T/F: Toddlers have more mature weight shifts in static standing now.

A

true

54
Q

T/F: Toddlers have immature weight shifts in running at 24 mo.

A

true, think about the fact that they just have developed this skill really

55
Q

A child who is beginning to arm swing is how old?

A

18 mo

56
Q

A child with increased arm swing as well as counter-rotation of the trunk is how old?

A

24 mo

57
Q

Discuss rotational ability in a 13 mo.

A
  • able to rotate well over one leg on floor
  • good transitional movements on floor
  • no arm swing or rotation of trunk yet, walking is still new with maturing weight shifts
58
Q

Discuss the gait of a 24 mo. (5)

A
  • arm swing and trunk counter-rotation occuring
  • running on toes for 10’ intervals with immature weight shifts
  • able to walk backwards and sideways well
  • increased stride/pelvic mobility
  • good hip/knee control
59
Q

What are 13mo’s able to do during gait that requires UE strength?

A

push/pull objects

60
Q

What are the main skills we’re working on with toddlers?

A 
walking
running
jumping
catching
throwing
kicking
climbing stairs
61
Q

What are the 3 reasons kids walk on their toes?

A

1) sensory issues
2) underlying diagnosis (MD)
3) idiopathic

62
Q

What are the expected treatment outcomes for ITW?

A

1) At least 10 deg DF with KE
2) Heel strike 75% of time
3) Age appropriate gross motor/balance skills

63
Q

Why do we attack ITW with more aggression these days?

A
  • avoid lacking ankle ROM in adulthood
  • allow for development of mature gait
  • reduce need for invasive treatments later on
  • prevent pathological outcomes in adulthood
64
Q

How would you screen for ITW?

A

1) check DF with KE
2) check AROM of ankle with knee flex/extend
3) ask about sensory sensitivity
4) check for CNS issues (tone, clonus, DTRs)
5) presence of equinus or ortho condition
6) communication in ages/stages

65
Q

T/F: ITW is not painful.

A

true, shouldn’t be

66
Q

At what age does a child have active DF?

A

18 mo

67
Q

What percent out of 100 that a child toe walks qualifies a child as idiopathic toe walking?

A

> 25%

68
Q

What test is recommended for use to assess ITW?

A

observational gait scale

69
Q

What is a perfect score on the observational gait scale?

A

22 (11 on each leg)

70
Q

What should be included in your assessment of ITW?

A

1) observational gait scale
2) physical assessment of gross motor skills
3) CNS screen

71
Q

What kind of gait should you measure when using the observational gait index?

A

their typical gait: if they’re toe walking more than 50% of the time, encourage them to do this (even if parents remind them to get heels down)

72
Q

What are some common PT interventions for ITW?

A

1) HEP: PF stretch, trunk and LE strengthening (ant tib)
2) Manual therapy
3) Serial casting/night splints
4) Auditory feedback to get heel down

Peds (2 decks)

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