Week 9 Flashcards
Norm referenced
-Performance (impairments and/or activity limitations) compared to other children same age (consider reference population)
-Is the child functioning at an age-appropriate level?
-May be required for funding or support
-Measurements over time (catch up to peers versus keeping pace vs falling behind)
Criterion referenced
- How well is the child performing particular skills? how competent are they?
- Change over time in skills
- Impairments and/or activity limitations
Spasticity
-A velocity dependent increased resistance to passive movement
-Important influence on child’s developing musculoskeletal system
Can lead to
-Altered biomechanics
-Increased muscle stiffness: decreased ROM, muscle contractures
-Lead to failure of muscle growth
-Alter bony growth
-Lead to joint instability
-Cause cartilage damage and early degenerative changes
0 = no catch on rapid passive movement, 4 = when attempting RPM, the body part appears fixed but moves on slow passive movement
Alberta infant motor scale (AIMS)
Observed posture and movement across 30 minutes: norm referenced
-Preterm (CA) and term infants 0-18 months
-Predictive of atypical motor development at 18 months
-Decreased reliability in extremely young (<4 months) or ambulant children)
Neurological sensory motor developmental assessment (NSMDA)
Observation and hands on assessment of 6 key areas, 30 mins: criterion referenced
1 month to 6 years
6 key areas:
- gross motor
- fine motor
- neurological
- patterns of movement
- Posture and balance
- Sensory motor responses
Hammersmith infant neuromotor examination (HINE)
Scored neurological examination developmental milestones and behaviour (not scored)
Aged 3-24 months, takes 10-15 minutes
Good sensitivity and highly predictive for risk of CP in high risk populations <5 months.
Assesses developing neurological systems:
- Cranial nerves
- Posture
- Movement
- Tone
- Reflexes and reactions
Prechtl’s general movement assessment (GM)
-Birth to 20 weeks of age: criterion referenced
-Observational video of baby in supine while awake, calm and alert for 3-5 minutes
- Highly predictive of CP
Bayley scales of infant and toddler development
Aged 1 month to 42 months, time = 30-60 minutes
Norm referenced
Core assessments: cognitive, motor, language (observed and interaction) plus parent questionnaires for social-emotional and adaptive behaviour
Gross motor function measure (GMFM)
Assessment tool designed for use with children with cerebral palsy (CP)
-5 months to 16 years IF gross motor skills at or below level of a typical 5 year old
-45-60 minutes duration, up to 2 sessions
5 dimensions:
-Lying and rolling
-Sitting
-Crawling and kneeling
-Standing
-Walking, running and jumping
Good inter-rater reliability and valid
Predictive test: can be used to predict a child’s future motor capabilities.
Peabody developmental motor scales
Norm referenced
Birth to 5 years
45-60 minutes
Core assessments: gross motor, fine motor (stationary, locomotion and object manipulation)
4 and 8 months predictive of abnormal development at 18 months.
ICF and ‘f’ words
Fitness (impairment), function (activity), friends (participation), family (environmental), fun (personal) and future
Early intervention for children with neurological impairments
Referral if:
- Child’s motor development impacts their ability to participate at an age-appropriate level
-If the delayed attainment of motor skills is associated with an an impairment
-If the child is from an at-risk clinical group because of biological or contextual factors
Why early intervention:
-Birth and developmental history identify children at risk of developmental delay
-Early motor impairment reliably predicts ongoing and impairment including minimal and mild disabilities
-Early motor competence is the earliest valid measure of general developmental difficulties in at risk populations
-The goal of early intervention is to prevent or minimise motor, cognitive, emotional impairments in young children disadvantaged by biological or environmental risk factors.
Principles of early intervention
Timing
* Within critical periods for neuroplasticity
* Should commence as early as possible
* Occurs within first 18 months of life (up to 7 years)
Content
* Incorporates principles of motor learning
* Routines based
* Functional (self produced movements)
* Goal directed
* Bilateral activity
* Intensive (repetitive)
* Varied
* Scaffolded challenge/difficulty
* Individualised
* Environment enrichment
Capacity and performance building
* Help children obtain and/or maintain their independence and to build their skills
* Practice a meaningful tasks in a range of environments
Family centred
* Support children and their families
* Acknowledge the central role that family plays in the child’s life
* Family are equal and active partners
* Strengths based approach
* Embedded within the family’s goals, routines, priorities and choices
Theories of motor learning, control and development
- Reflex theory
- Hierarchical (neuromaturationist) theory
- Motor programming theories
- Ecological theory
- Dynamic systems theory
Principles of motor learning
- Challenge point
- Task specificity
- Demonstration
- Task variability
- Repetition
- Instructions (minimal)
- Mental rehearsals
- Intensity
- Context of learning
- Transfer of learning
- Saliant
- Feedback (KP, KR)
-Acquisition
-Retention
-Transfer
