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547 > Typical Paediatric Motor Development & Reflexes > Flashcards

Typical Paediatric Motor Development & Reflexes Flashcards

1
Q

What is the sculptor of the baby brain?

A

Experiences: more experiences = more myelin is layed down in brain

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2
Q

When does the organization of the sensory and motor cortices occur? What does this imply for premature babies?

A
  1. organize during late fetal period.
  2. Premature Babies: born during the late fetal period => integration of sensory and motor cortices is affected bc no longer in the safe environment and affected by gravity => at risk for developmental delay
    BUT can modify environment to ensure proper integration bc brain = plasticity
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3
Q

Describe the brain’s function postnatally in general

A

Function & identity of brain areas remain malleable to input from environment (experiences)

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4
Q

When is the optimal period for early intervention in peds

A

first 2 years of their life (most dramatic and rapid period of myelination of brain)

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5
Q

What is the baby blueprint composed of?

A

genes & environmental input

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6
Q

What is myelination

A

addition of myelin to neuron’s axons

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7
Q

When and where does myelination begin

A
  • prenatal

- in caudal brain stem and progresses rostrally to forebrain

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8
Q

What weeks are the 3 trimesters?

A

1st trimester = wk 1-13
2nd trimester = wk 13-26
3rd trimester = 26-40

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9
Q

Describe the general (neuronal) development of the brain during each trimester

A

Trimester 1

  • Neuron develop
  • Neuron multiply
  • Neuron migrate
Trimester 2
- Neuron multiply
-Neuron migrate
- Neuron branch & form synapses
(brain remains smooth, no sulci/gyri)
Trimester 3
- neuron branch and form synapses
- pruning (apopstosis) & synapses reorganization
- myelination
(all of these continue postnatally)
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10
Q

Why is folic acid recommended to take during 1st trimester

A

ensures closure of neural tube that will become SC (if not spina bifida)

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11
Q

What occurs if baby is born prior to 26 weeks

A

prior to 3rd trimester
=> pruning, myelination, and synapse reorganization occur outside womb
=> can lead to deficit like CP, deafness, blindness…

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12
Q

Describe the general order of development of body parts

A
  1. NS (3 wks)
  2. heart
  3. limbs
  4. eyes
  5. teeth
  6. ear
  7. genitalia
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13
Q

What are the risk factors/predictors of development delay (6)

A
  1. gestational age (prematurity)
  2. apgar scores
  3. birth weight
  4. head circumferences
  5. genetics
  6. epigenetics
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14
Q

How do you calculate adjusted age for prematurity

A

weeks born early until 2yo

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15
Q

What is the critical period/window of development

A

period of time something develop => sooner the better

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16
Q

Critical Period: Binocular vision

A

0-5yo

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17
Q

Critical Period: auditory/visual cortex (seeing/hearing)

A

0-5yo

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18
Q

Critical Period: Receptive Language & speech production (Broca)

A

Prenatal (-1 mo) to 5yo

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19
Q

Critical Period: Higher cognition (prefrontal cortex)

A

prenatal (-3 mo) to 15 yo

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20
Q

Critical Period: Emotional control

A

0.5-5yo

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21
Q

Critical Period: Habitual ways of responding

A

few months old to 5yo

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22
Q

Critical Period: Peer social skills

A

3-7yo

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23
Q

Critical Period: Language

A

0.5-7yo

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24
Q

Critical Period: Symbols (cognition)

A

1 & few months - 5yo

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25
Q

Critical Period: Relative Quantity (cognition)

A

4-7yo

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26
Q

What is the developmental theory?

A

Dynamic system between neuromaturation (reflexive to volitional) & environment & systems (motor, sensory, cognition, motivation)

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27
Q

What is state regulation?

A

Adults need to encourage babies to self-regulate => support infant in being stable/organized/competent

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28
Q

What are the 4 examples of state regulations that adults should support in infants?

A
  1. sucking reflex (want to bring their hand into their mouth bc it soothes them)
  2. self soothing
  3. quiet alert (want them quiet and watching you vs screaming and crying)
  4. functions: feeding & bonding
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29
Q

In babies, what does sensorimotor control/experience entail/include? (6)

A
  1. proprioception
  2. vestibular
  3. tactile
  4. postural control via antigravity control
  5. balance (protective reactions when seated)
  6. self regulation
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30
Q

when does sensorimotor development occur?

A

in utero

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31
Q

what is antigravity control?

A

antigravity control contributes to postural control => ex: able to keep head upright when baby in prone

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32
Q

What are protective reactions? what life skill do they contribute to?

A

Protective reactions contribute to overal balance wheren forward protective reaction (when baby seated, they automatically reach forward with arms) develop[s first then lateral then posterior

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33
Q

describe the overall development of postural control/stability.

A

overall: reflexive to volitional
1. antigravity control develops to allow for stability in midline alignment
=> antigravity movement in prone THEN supine
2. Then combination of mobility and stability => first weight-bearing then weight-shifting

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34
Q

DM Postural control: newborn

A

fetal position (arms and knees flexed, in prone, chin tucked in)

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35
Q

DM Postural control: 1 mo

A

in prone: chin raised (arms and legs remain flexed, chest still prone)

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36
Q

DM Postural control: 2mo

A

in prone: chin and chest up (arms and legs remain somewhat flexed)

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37
Q

DM Postural control: 4 mo

A

sits when supported

38
Q

DM Postural control: 7 mo

A

sits unsupported/alone

39
Q

DM Postural control: 9 mo

A

stands holding onto furniture

40
Q

DM Postural control: 10 mo

41
Q

DM Postural control: 11 mo

A

walks if led & stands alone

42
Q

DM Postural control: 12 mo

A

walks alone (with falls) and creeps well

43
Q

Name in order the developmental positions.

A
  1. supine
  2. prone
  3. rolling: prone to supine THEN supine to prone
  4. sitting
  5. crawling THEN kneeling
  6. standing
  7. walking
44
Q

DM Postural control/locomotion: 15 MO

A

walks alone & creeps upstairs

45
Q

DM Postural control/locomotion: 18 mo

46
Q

DM Postural control/locomotion: 2 yo

A

walks up and downstairs

jumps

47
Q

DM Postural control/locomotion: 3 yo

A

alternate feet going upstairs

48
Q

DM Postural control/locomotion: 4 yo

A

alternate feets when going down stairs

hops on 1 foot

49
Q

Describe the principles of sensorimoto development

A

goes from gross/generalized movement to fine/dissociated/dissociated movements
=> we develop cephalo caudal (head to feet) so shoulders have to develop first to provide stability so that grasp can be performed more distally

50
Q

Why is tummy time important? How often should the baby be performing tummy time?

A

allows to work on antigravity control in prone position
- can encourage baby by going to their level and providing smile and toy
- 1h/day (progressively) @ 3mo
- 80 min/day @ 4mo
(make sure to not have baby sleeping on tummy bc increased risk of choking & asphyxiation)

51
Q

What antigravity activity should be encouraged in supine?

A

bringing and encouraging baby to bring hands to feet in supine

52
Q

What are the 2 equilibrium reactions?

A
  1. center of gravity & base of support

2. rotational component (ex: being able to turn head whilst seated)

53
Q

DM Fine motor - grasp: 1-1.5 yo

A

cylindrical grasp (like a fist) => more ulnar movement

54
Q

DM Fine motor - grasp: 2-3 yo

A

digital grasp: whold with fingers with pen on palmar side but not holding it with palm

55
Q

DM Fine motor - grasp: 3.5-4 yo

A

modified tripod grasp

56
Q

DM Fine motor - grasp: 4.5-7

A

tripod grasp (normal grasp)

57
Q

What would you explain to parents to encourage them to do tummy time with their baby?

A

works on antigravity control (upright head in midline looking at parent or at toy), on proximal stability (needed for fine mortor), weight shiftiing, socialization, sensory development

58
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Rooting (searching) reflex

A

primitive reflex

start: 28 wk gest
integrated: 3 mo
- Stroke cheek and cheek will turn torwards that side
- role: breast feeding

59
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Suck (swallow) reflex

A

primitive reflex

start: 28 wk gest
integrated: 2-5 mo
- put finger in their mouth and they will suck
- role: to eat

60
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Traction reflex

A

primitive reflex

start: 28 wk gest
integrated: 5 mo

  • when position bby in seated position, they reflex flex their UE and perform grasp
  • role: prepares for voluntary grasp
61
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Moro reflex

A

primitive reflex

start: 28 wk gest
integrated: 6 mo

  • create falling sensation (dropping bbys head) or loud noise => bby will first extend and abduct arm then rapidly flex and adduct arm (throws and head flings limb)
  • role: create instinct to cling to mother
62
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Plantar grasp

A

primitive reflex

start: 28 wk
integrated: 9 mo

apply pressure to sole of foot => babys toe will curl over finger
- role: prepare for standing position & prevents hypersensitivity and gravitational insecurity

63
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Galant reflex

A

primitive reflex

start: 32 wk
integrated: 2 mo
- create stimulus on one side of spine => will flex that side
- role: prepares for crawling/walking by facilitating trunk stabilization

64
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Palmar grasp

A

primitive reflex

start: 37 wk gest
integrated: 4-6 mo
- touch palm of hand & hand will grasp
- role: increases tactile input at palm (needs to be integrated to allow for grasp, fine motor)

65
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

asymmetric tonic neck reflex (ATNR)

A

primitive reflex

start: 37 wk gest
integrated: 6 mo

  • in supine, rotate head by 90 => arm facing face will extend and arm facing skull will flex
  • role: head eye coordination (if not: poor reading comprehension bc cant cross midline, handwriting, hand eye coordination, bringing arms to midline to bring things to mouth, reaching for object at front), rolling
66
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

tonic labyrinthine relfex (TNR)

A

primitive relfex

start: 37 wk gest
integrated: 6mo

  • in prone: flexor tone; in supine: extensor tone
  • role: if not integrated, will have difficulty extending/lifting head in prone bc flexor tone, and diff sitting up from supine bc extensor tone, poor m coordination
67
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Symmetric tonic neck reflex (STNR)

A

primitive reflex

start: 4-6 mo
integrated: 8-12 mo
- crawling and flex head: arms flex and legs extend (butt in air)
- crawling and extend head: arms extend and legs flex
- role: if not integrated: difficulty siting from supine (bc need to flex head first to sit up but that would cause leg to extent), poor m tone, poor posture (bc if arm bend then legs extend and vis vs => causing slouching forward)

68
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Landau (superman)

A

primitive

start: 3-4 mo
integrated: 12-24 mo
- hold bby horizontally in air prone => extension of nexk, limb, trunk
- role: break flexor tone, posture

69
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Neck righting

A

start: 4-6 mo
int: 5 yo
- supine and turn head fully to one side: baby will roll in that direction (log roll ie less mature rolling) to maintain head trunk alignment
- role: head trunk alignment & positioning of head

70
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Body righting

A

start: 4-6 mo
int: 5 yo
- supine & flex hip/knee torwards chest => baby does segmented roll (mature so body parts roll in fragments)
- role: trunk rotation

71
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

optical head righting

A

start: birth - 2 mo
int: lifetime
- suspend vertically and slowly tilt them off center (side to side, backwards) => bby maintain upright px by turning head using vision
- role: orient head in space when body taken out of position

72
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Labyrinthine righting

A

start: birth-2mo
int: lifetime
Suspend baby vertically and slowly tilt them off center (side to side, backwards) w blindfolds => will maintain upright px of head via vestibular system
- to orient head in space

73
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Downward parachute (protective reaction)

A

start: birth - 2mo
lifetime

Lower baby toward surface whilst suspended vertically => will extend LE
- protection against fall w accurate placement of feet

74
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Forward parachute (protective reaction)

A

start: 6-9 mo
lifetime

Tip baby forward whilst vertically suspended => extension of neck, UE with hands open
- protection against falls

75
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Sideward parachute (protective reaction)

A

start: 7 mo
lifetime

Tip baby to side whilst sitting => arm extend/abduct to side
- protection against falls, for sitting

76
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Backward parachute protective reaction)

A

start: 9-10 mo
lifetime

Tip baby backward => arm extend to side spinal rotation
- for walking

77
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Prone tilting (equilibrium rxn)

A

start: 5 mo
lifetime

Prone, tilt baby and raise 1 side of surface => baby spine curve and limbs extend/abduct
- for balance & postural adjustment & to maintain equilibrium w/o arm support

78
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Supine tilting (equilibrium rxn)

A

start: 7-8 mo
lifetime

Supine/sitting, tilt board, raise 1 side of surface => baby spine curve and limbs extend/abduct
- for balance & postural adjustment & to maintain equilibrium w/o arm support

79
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Quadrucep tilting (equilibrium rx)

A

start 9- 12 mo
lifetime

On all 4s, til board, raise 1 side => baby spine curve and limbs extend/abduct
- for balance & postural adjustment & to maintain equilibrium w/o arm support

80
Q

Reflexes: starts at, integrated at, description (how to perform reflex & its role)

Standing tilting (equilibrium rxn)

A

start 12-21 mo
lifetime

Position baby standing on board and tilt and raise one side => baby spine curve and limbs extend/abduct
- for balance & postural adjustment & to maintain equilibrium w/o arm support

81
Q

what does integration mean

A

the reflex now becomes voluntary

82
Q

what activity should parents do with their children to practice antigravity movement (apart from tummy time)

A

gently bring their feet to their eyesight so that they reach for it or putting toy in middle or putting their hand or feet in their mouth

83
Q

What activity should parents do to practice rolling

A

gently touch and rock baby on bottom or thigh and roll them halfway, supporting their trunk
OR
place them on tummy and weight of head causes baby to roll on back to see more

84
Q

Name all reflexes that begin at 28 wk gest and when they are integrated (5)

A
  1. rooting (3 mo)
  2. suck (2-5 mo)
  3. traction (5 mo)
  4. moro (6 mo)
  5. plantar (9mo)
85
Q

name all reflexes that start at 32 wk and when they are integrated

A

galant (2 mo)

86
Q

name all reflexes that begin at 37 wk gest and when they are integrated (3)

A
  1. palmar (4-6 mo)
  2. ATNR (6 mo)
  3. TLR (6 mo)
87
Q

Name the 4 righting reactions in order

A
  1. neck righting: 4-6 mo to 5 yo
  2. body righting: 4-6 mo to 5 yo
  3. optical head righting: birth-2mo to lifetime
  4. labyrinthine righting: birth-2mo to lifetime
88
Q

name the protective reactions in order

A

all lifetime

  1. downward: birth-2mo
  2. forward 6-9 mo
  3. sideward 7 mo
  4. backward 9-10 mo
89
Q

name the equilibrium rxn in order

A 
all lifetime
1. prone tilting: 5 mo
2. supine tilting: 7-8 mo
3/ quadrcupet: 9-12 mo
4. stnading: 12-21 mo
90
Q

name the tonic reactions in order

A
  1. atnr: 37 wk gest to 6 mo
  2. TLr 37 wk to 6 mo
  3. STNR: 4-6 mo to 8-12 mo

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