Typical development: newborns to 4 months Flashcards
Development is an interaction of what three main factors
- genetic predisposition
- person’s individual role in development (how/when are they exposed to things)
- environmental factors such as family, community, sociocultural influences
Culture and its relation to milestones
- culture is one of the many varibales known to affect motor development
- in certain cultures there are milestones that happen earlier or later based on when parents are expected to have them do that milestone
- potty training for example
Development milestones occur…
- generally in sequence
- can appear and disappear but generally move in an upward direction
- posture is the most fundamental of motor actions
infant changes behavior and movement from what to waht
- non goal oriented movements to goal and accurately directed movements
Functional movement and development of cognition and perception
- movement helps develop cognition and perception
- cognition helps develop functional movements
- lack of functional movement results in functional limitations/activity limitations
Motor development (describe)
- relation to other systems
- what may effect/predict motor behaviors
- intertwined with development of other systems within the person and their environment
- may take a unique developmental pathway toward attainment of major motor milestones
- experience is a stronger predictor of motor behaviors than age in the emergence of both crawling and walking
Neonate
- newborns 1-4 weeks old full term
- are in physiological flexion: limited hip, knee extension
- random movements are uncoordinated, jerky, and non purposeful
Supported sitting in neonates
- flexion and abduction (legs)
- generalized trunk flexion
- arms held close to body
- head bobbing, head lag with pull to sit
- they now are dealing with gravity
Supporting standing in neonates
- extensor tone
- automatic stepping
Primitive reflexes
- are present at birth and happen automatically in response to stimuli in the baby
- present in utero as well
- are necessary for proper growth and development
Neonate reflexes for survival
- rooting: when you stroke their lip they will follow your finger - helps them find their food source
- sucking/swallowing: have to do with nursing and getting food
Neonates spinal reflexes
- moro
- when their head falls back/they are lowered onto their back they extend their arms out - palmar and plantar grasp
- pressure on their toes/palms of hands cause them to clench and grasp - traction response
- puling limbs toward themselves to protect themselves when people pick them up by their arms - flexor withdrawal
- when stimulating feet or hands they will width drawal into a flexed position - spinal galant
- prepares the baby for walking and crawling
- in newborns, softly stroking just the side of the spine on the lower back initiates a side flexion in the baby and the child’s hip to raise toward touch
- develops coordination/proprioception
Develop of subsystems: skeletal in neonates
- skeletal system
- all systems are tied together in development
- head and trunk large in proportion to extremities with COM at xiphoid process
- spinal lacks curves = c-shaped
- growing bone is less dense and more porous than adults making it more sensitive to compressive and tensile forces
Sensory system and development: (neonates)
1. tactile
2. vision
3. hearing
4. vestibular
- first sensory system to develop, fully myelinated at birth
- newborn acuity is 20/150, accommodation 19 cm; can see contrast, track very briefly, pupils react to light, know who their parents are
- acoustic nerve is not myelinated yet, will respond to loud noise by blinking, changing breathing pattern, startle response, noises can bother them
- vestibular: fully myelinated and functional birth
MORO reflex
- should be inhibited by 4 months of post-natal life to be replaced by an adult startle reflex
- if it does not go away there could be a neuro involvement
Neonate development of subsystems: nervous system
- peripheral nervous system is fully myleinated but not perfect
- mid brain, brain stem, and spinal cord most mature in CNS
- neonatal period time of CNS organization, regulation of body functions and state of body
- their neurons are growing in the 1st 9 months and the brain is developing rapidly
- capillaries are permeable so the nervous system is vulnerable to damage in newborns
- autonomic nervous system is active
Reflexes that develop active head righting
- asymmetrical tonic neck reflex emerging in utero/1 month decrease by 4-6 months
- tonic labyrinthine reflexes begins (decreases by 2 years old)
- labyrinthine head righting keeps head upright during changes in position, optical heading righting and body righting reactions starting
- these three start to develop active head righting
Asymmetrical tonic neck relfexes
- when they are laid down in supine if they look to one side, that arm will extend and the other will be flexed and held close to the body
- present up until about 4 months
Tonic labyrinthine reflex
- activated by head position in space
- tone of neck and leg flexors increase in prone position
- in supping position tone of back and leg extensors increases
Labyrinthine head righting/optical head righting
- head is kept in line and adjusted
One month: Motor behavior in supine
- Supine: Physiological flexion begins to decrease
- Will gaze at overhead mobile or caregiver’s face during feeding
- Pull- to-sit shows some control at the beginning range
One month: Motor behavior in prone
- Prone and ventral suspension: Some active neck extension, brief
- head lag is when some neck extension is not present in the prone/ventral suspension
One Month: vision
- turn head to diffuse light
- maintain attention briefly if it stimulus is novel or resembles a face
- drives movement
One month: Speech and hearing
- guttural noises (gurgling)
- auditory system is now fully myelinated
Head Control: one month and on
- Crucial skill, the foundation for all later movement
- Able to lift her head at about a month old
- Hold it up when placed in a sitting position at around 4 months
- Should be strong and steady by 6 months
Two months old: in supine, prone, supported sitting
Supine:
- Head rotation is increased,
- Body more in contact with surface, (less flexion)
- Random swiping at objects
Prone:
- Head elevation to nearly 45
- bobbing, pectoral muscles becoming more active as baby pushes into surface
- Supported sit: Decreased head lag with pull to sit, beginning to hold head up when trunk is supported
Three to four months: general
- critical time for development with flexion and extension balances occurring (trunk is extended)
- integration of some early reflexes beginning- decrease in frequency with greater variety of movements pattern
- movement becomes more purposeful (shipping/reaching for things with a better idea of distance)
- abdominals becoming more active
Three to four months: motor behavior in supine
- UE/LE lifting and reaching, overshoots objects
- gathers in midline (holding a bottle)
- rolling to side
- some finger mouth play
- active kicking
- working more against gravity
3-4 months: motor behavior prone
- Developing anti-gravity control: will get more extension to get ready to crawl
- active propping on forearms, swimming
- weight shifting with improved control
- rolls to supine accidentally (body follows and gravity assists)
What is the developmental sequence
0 months: infant in total flexion
1-2 months: infant in prone and gains extension
4 months: infant pushes up while in prone
5 months: Rolls to side
5-6: Push up to sit/stage 1 sitting
6-7: Sitting with hands free
7-8: Quadruped
8-9: Kneel to stand
9-10 Crawling
10-11 cruising
11-12: Standing walking
