Week 5 and 6 study Flashcards
What Grasp pattern?
Dynamic tripod
What are the 4 mature grasp patterns?
Dynamic tripod, lateral tripod, dynamic quadrupod, lateral quadrupod
Mature VS immature grasp
How are they “produced”?
How can you improve immature?
- Mature grasp pattern produced by intrinsic mm of hand
- Immature grasp pattern produced by extrinsic mm of the arm. This leaves the fingers in a static posture
- Look at intrinsic mm and try to improve mature grasp through targeting muscles in HEP.
4 elements of efficient grasps
proximal stability
stability within the hand
mobility within the hand
muscle tone
stability is on the _____ side of hand.
Mobility is on the _____ side.
mm tone provides ___ ___..
How does hyper/hypo tone effect grasp?
what are interventions for each?
- Stability on ulnar side of hands
- Mobility on radial side (thumb)
- Increased tone spasticity=decreased mobility and flexibility
- Stretching exercises, weight bearing, dynamic splinting
- Decreased tone = decreased joint stability
- Orthotics! Give them stability they need.
functional wrist postition is
how can we help a child acheive this easily?
40-45 degrees wrist extension
15 degrees ulnar deviation
Interventions for child to facilitate wrist extension in a child to help handwriting.
Bouncing ball, playing drums. Use slant board/ write on wall board. Light bright toy.
ALWAYS go GROSS TO FINE MOTOR when doing the
Pinch grasp patterns
How to Document if don’t know?
A. Radial cross palmar grasp
B. Palmar supinate grasp
C. digital Pronate grasp
F. Cross thumb grasp
G= Static tripod Grasp
H. Four Finger Grasp
I. Lateral Tripod grasp
J. Dynamic tripod grasp
When documenting write what you see instead of categorizing it. (how many fingers, extension/flexion, forearm and wrist position. Grasps-Gross, tips, pinch
what do the palmar arches do?
Support functional position
“cups” hand for cocave surface
accomodates objects
oppose thumb to fingers
move object with hand against palm
The _____ arch splits hands right and left
The ______ arch goes from pinky to thumb
the ________ arch is furthest away
How do we get a defined arch?
what condition presents with underdeveloped oblique arch?
- C. Longitudinal arch splits hands right and left
- B. Oblique arch from pink to thumb
- A. Furthest away distal transverse
*Children with down syndrome tend to not have a great oblique arch
*In order to get a defined arch child needs to crawl!!! Weight bearing on hands defines the arches
Dissociation of the two sides of hand AKA _____.
the Ulnar side gives _____ for grip and _____ for hand.
the Radial side provides ____ and is the “____” side.
AKA Hand separation
- Ulnar = power (ring finger and pinky). Provides stability for hand and power for grip.
- Radial= skilled side (thumb, index and middle fingers) provides mobility
describe the 5 types of in hand manipulation AKA ______.
1.
2.
3.
4.
5.
- Finger to palm translation
- Palm to finger translation in the video
- Shift (example of picking up pencil or threading a needle)
- Simple rotation- 90 degrees or less
- Complex rotation- reposition 180-360 degrees within the palm
Scissor skills involve:
FM coordination AKA ______.
using both hands but for different jobs (Turn/hold paper, cut with scissors etc.) AKA _______.
Also involves ______ coordination.
- Fine-motor coordination (AKA interdigital dexterity)
-
Bilateral coordination
- When kids hold paper with non dominant hand and don’t turn paper. Arm stays still= Poor bilateral coordination
- Eye-hand coordination
Prerequisites for scissors
- Use a fork or spoon.
- Open and close his/her hand.
- Use his/her hands together in a leader/helper way
- Isolate the thumb, index, and middle fingers.
- Stabilize his/her shoulder, forearm, and wrist
Cutting skill progression
1.
2.
3.
4.
5.
- cutting scrap paper
- snipping the edges
- cutting straight lines
- cutting angles
- cutting curves
What are some wrong scissor techniques?
Down grades for scissor use?
Hand pronated
thumb too far in hole (shouldnt be on joint)
using 2 hands (DO NOT ALLOW)
Fingers outside of holes/ in extension (sign of poor hand separation)
hold paper with forearm NOT supinated
wrist extension
poor positioning/ no support
avoiding crossing midline by turning body
Adaptive scissors, keep paper on table for stability, use a line drawn on paper as visual support,
Adaptive scissors
A. Wooded block wedge scissors- no fingers, high tone in hand, SCI with limited distal function. Child pushes on scissors and
B. Loop Scissors- squeeze and spring mechanism. Can open and close hand. Don’t have to have isolated control.
C. spring scissors - Spring scissors for really little kids. Better for playdough. Yello piece flips
D. Dual control training scissors- HOH assist
E. regular child sized scissors = Fiskers
Intervention ideas for scissor skils?
- Scissor scoop tongs in sensory bin
- Squirt gun
- Spray bottle
- Playdoh cutting
4 areas of FM development birth to 5 y/o?
- What are the 4 areas discussed in this video?
- Stability & strength
- hand, shoulder, and body
- Bilateral Coordination (2 types) (when documenting make sure to mention which type)
- hands together doing same job (catch ball), each hand doing different job(cutting)
- Sensory Processing
- Dexterity
- Grasp/release, pinch/thumb, finger coordination, wrist movement
- Why do preschool teachers encourage large pencils or triangular pencils promote functional grasps?
- Why use small pencils for writing?
- Why use crayons?
- Why do preschool teachers encourage large pencils or triangular pencils promote functional grasps?
- Easier to grasp onto for weaker hands, puts fingers in more functional grasp
- Why use small pencils for writing?
- promote an open web space and better positioning
- Why use crayons?
- doesnt rip paper, wax adds resistance for kinesthetic feedback to reader
Developmental sequence of aquisition of prewriting skills
1-2 years old
2-3 years old
3-4 years old
4-6 years old
1-2 years old: scribble/ circular scribble
2-3 years old: vertical/horizontal strokes, then lines
3-4 years old: circles and intersecting strokes and lines
4-6 years old: diagonal lines and the ability to form shapes by putting prewriting strokes together
Types of CP
categorized by body areas affected
categorized by motor type
monoplegia, Hemiplegia. Diplegia, Quadriplegia
- Spastic- Most common
- mm. stiff and tight due to motor cortex damage (High brain)
- Athetoid (dyskinetic)
- Characterized by involuntary movements arises from basal ganglia damage (mid brain)
- Ataxia
- Categorized by shaky movements, affects balance and sense of positioning in space. Arises from cerebellum damage (Low brain)
CP interventions
CP interventions
- Positioning (handling & equipment)
- Handling techniques; slow rocking, bouncing, rotation
- Weight bearing and wt. shifting promotes postural alignment and independent movement
- Switches & AAC
- Adaptive equipment
- Medical management (sx, botox, oral baclofen)
- Complementary Alternative Medicine CAM (hippotherapy, massage, refer p.327)
- CIMT Protocol
Principles of motor learning
- ___&_____ ____ foster brain plasticity.
- ____ ____ ____ stimulate learning.
- ____ activities are motivating for ______.
- _____ _____ fosters development.
- Children learn best through _____ _____ _____.
- Using ____ objects facilitates more _____ and _____ __ _____.
- Practice & meaningful repetition foster brain plasticity which results in learning
- Problem solving movements stimulate learning
- Shaping activities allow children to perform, they are motivating for future repetitions
- Children are motivated to learn; intrinsic motivation fosters development.
- Children learn best through positive enjoyable experiences
- Using authentic objects facilitates more repetition and quality of movement
Learning from Neuroplasticity is a result from
- _____ (after activity), ______ (comes before activity-anticipate or predict what they need to do)
- _____
- _____
- _____
- _____
Learning from Neuroplasticity is a result from
- Feedback (after activity), feedforward (comes before activity-anticipate or predict what they need to do)
- practice
- modeling
- demo
- transfer of learning
