Workbook1

Question 1

REFLEXES AND POSTURAL REACTIONS Neonatal Positive Support Reflex (LE)

Answer 1

AGE RANGE (from onset to integration) starts at 35 weeks of gestation -TEST POSITION OR METHOD- have infant in vertical position and support -STIMULUS- have baby make firm contact with floor -RESPONSE- LE flexor and extensor muscles contraction - this will minimally support weight - hips and knees remain in partial flexion -OTHER-

Question 2

REFLEXES AND POSTURAL REACTIONS Asymmetrical Tonic Neck Reflex

Answer 2

AGE RANGE (from onset to integration) Onset from 0 to 2 months - Integration from 4 -6 months -TEST POSITION OR METHOD- baby in supine -STIMULUS- turn the infants head gently to one side -RESPONSE- tone/flexion of UE on side opposite to the side of the turned head.- increase tone in UE extensor ipsilateral to head turn -OTHER-

Question 3

REFLEXES AND POSTURAL REACTIONS Symmetrical Tonic Neck Reflex

Answer 3

AGE RANGE (from onset to integration) onset: 4-6 months integration: 8-12 months -TEST POSITION OR METHOD- on floor quadraped position -STIMULUS- passively flex head forward followed by head extension -RESPONSE- flexion of head will produce: - UE flexion - LE extension extension of head will produce: - UE extension - LE flexion -OTHER-

Question 4

REFLEXES AND POSTURAL REACTIONS Tonic Labyrinthine Reflex (Prone)

Answer 4

AGE RANGE (from onset to integration) Onset: Birth Integration: 6 months -TEST POSITION OR METHOD- prone -STIMULUS- prone: lift infant - evaluate flexor tone -RESPONSE- prone: flexor tone is dominant -OTHER- Functional significance - persistence of TLR will impede activities which require graded coactivation of flexor and extensor muscles

Question 5

REFLEXES AND POSTURAL REACTIONS Tonic Labyrinthing Reflex (Supine)

Answer 5

AGE RANGE (from onset to integration) Onset: Birth Integration: 6 months -TEST POSITION OR METHOD- supine -STIMULUS- Supine: lift child to sitting - observe extensor tone -RESPONSE- supine: extensor tone is dominant -OTHER-

Question 6

REFLEXES AND POSTURAL REACTIONS Optical head righting reaction

Answer 6

AGE RANGE (from onset to integration) Onset: Birth - 2 months Integration: Lifetime persistance -TEST POSITION OR METHOD- Vertical position -STIMULUS- From vertical - tilt child posterior, anterior, and lateral -RESPONSE- The head should orient to vertical position - maintained vertically in enviroment -OTHER- Functional significance - allows the head and body to be upright to the horizon

Question 7

REFLEXES AND POSTURAL REACTIONS Forward (UE) protective extension

Answer 7

AGE RANGE (from onset to integration) Onset: 6-7 months Integration: lifetime -TEST POSITION OR METHOD- Vertically - but supported -STIMULUS- bring the child downard -> head first -RESPONSE- extend & abduct arms fingers extended and spread (as if to break a fall) -OTHER- necessary for prop sitting

Question 8

REFLEXES AND POSTURAL REACTIONS Sideways (UE) protective extension

Answer 8

AGE RANGE (from onset to integration) Onset: 7 months Integration: Lifetime -TEST POSITION OR METHOD- Long sitting position -STIMULUS- displace center of gravity by applying force on shoulder -RESPONSE- Arms: Abduct and Extend to side of fall weight on an open palm and fingers -OTHER- Needed for indendepent sitting

Question 9

REFLEXES AND POSTURAL REACTIONS Stepping (LE) protective reaction

Answer 9

AGE RANGE (from onset to integration) Onset: 15-18 months Integration: lifetime -TEST POSITION OR METHOD- Standing -STIMULUS- Push child in every direction -RESPONSE- Child will do Corrective movement - this will restore center of gravity -OTHER- protection in upright posture

Question 10

REFLEXES AND POSTURAL REACTIONS Sitting equilibrium reaction

Answer 10

AGE RANGE (from onset to integration) Onset: 7 months Integration: Lifetime -TEST POSITION OR METHOD- Sitting -STIMULUS- Push child in different directions -RESPONSE- Child will do corrective movement (will support themselves with hands and arms) - this will restore center of gravity -OTHER-

Question 11

GROSS MOTOR DEVELOMENT MILESTONES Birth-3 months

Answer 11

PRONE able to clear airway (head held up), weight on forearms, may tip over, head to 60 degrees, can close and open fists SUPINE life legs off surface, head in midline, can bring hands to mouth SITTING back rounded, head close to midline, still has head lag in pull-to-sit STANDING little weight, astasia (can’t stand) POSSIBLE WARNING SIGNS Motor: Has trouble lifting head Legs are stiff with little movement Hands are fisted, arms lack movement when supine, pushes back with head OTHER

Question 12

GROSS MOTOR DEVELOMENT MILESTONES 4-6 months

Answer 12

PRONE extended arms, heads 90 degrees, rolling to side and supine, reaches for toys, can roll to supine SUPINE reaches hands to feet, feet to mouth, rolling to side and prone, can roll to prone, toy can be transferred from one hand to another SITTING propping to sitting more erect with poor control STANDING taking most weight may be bouncing POSSIBLE WARNING SIGNS Motor: - back rounded while sitting - cannot lift head - head control is poor - difficulty reaching out or bringing arms forward - when pulling to sit: arches back and legs stiffen - in supported stand: holds arms back, legs are stiff OTHER

Question 13

GROSS MOTOR DEVELOMENT MILESTONES 7-9 months

Answer 13

PRONE prone to sit, crawl on all fours SUPINE Supine to sit. SITTING sitting with more stability, can hold things and play, uses both hands turns head and tracks objects visually STANDING pull to stand, can do some lateral cruising (moving side to side), tried to lean towards, reach for, and pick up toys. POSSIBLE WARNING SIGNS Motor: - single hand use predominately - in sitting: rounded back, cannot straighten back, poor use of arms - crawling is difficult - Uses just one side of body to move - cannot bear weight on legs - does not take toy from one hand and transfer it to the other. OTHER

Question 14

GROSS MOTOR DEVELOMENT MILESTONES 10-12 months

Answer 14

PRONE SUPINE SITTING Sits unsupported, can turn head to look at objects while keeping balance. Can throw objects while maintaining balanace STANDING Pulls to stand, cruises on furniture. Stands alone, takes several steps independently Can move into and out of various positions, will explore environment and get toys. POSSIBLE WARNING SIGNS Motor: - Getting to stand is difficult - due to pointed toes and stiff legs - When pulling up to standing, only uses arms - in sitting: weight on one side - arms strongle flexed or stiffly extended - Needs hand use to keep sitting position - in upright position: poor head control OTHER Clasps hands, releases objects into a container with large opening, can pick up tiny objects with thumb and pointer finger.

Question 15

GROSS MOTOR DEVELOMENT MILESTONES 13-18 months

Answer 15

PRONE SUPINE SITTING STANDING Independent walking: squats and picks up toys POSSIBLE WARNING SIGNS Motor: - cannot take independent steps - frequent falls, poor balance while standing - toe walking - does not pull to stand - cannot crawl to climb stairs - pincer grasp (thumb to forefinger) not used when holding small objects. OTHER Stacks objects, helps with getting dressed and undressed

Question 16

GROSS MOTOR DEVELOMENT MILESTONES 19-24 months

Answer 16

PRONE SUPINE SITTING STANDING POSSIBLE WARNING SIGNS OTHER Coordination - Frequently moves into and out of various positions such as crawling, cruising, walking, and climbing. Will explore and get objects coordinated movements to play and explore Walking: heel-toe pattern (not primarily on toes) - enough endurance and strength compared to peers - Keeps balance when catching ball or with gentle bumps - Can keep balance when throwing and catching a ball - Uses hands to change positions - equal use of both hands >50 words, comprehends new words quickly, imitates words, names pictures and objects, can uderstand simple pronouns such as me, you and my; will identify 3-5 body parts.

Question 17

GROSS MOTOR DEVELOMENT MILESTONES 2-3 years

Answer 17

PRONE SUPINE SITTING STANDING POSSIBLE WARNING SIGNS OTHER Motor: tiptoe standing, kicking ball, running, climbing onto furniture sans help, walking up and down stairs (while holding on), overhead throws, can make or draw straight lines. 30 Months Uses - 2 to 3 word phrases - in and on -caregivers understands %50 percent speech - follows 2 steps directions (unrelated) understands nouns and pronouns (basic ones) - mine and yours. 36 Months - asks what and where - uses plural - caregiver understands most speech -

Question 18

GROSS MOTOR DEVELOMENT MILESTONES 4-6 years

Answer 18

PRONE SUPINE SITTING STANDING POSSIBLE WARNING SIGNS OTHER Motor (5 years): - single leg standing >10secs - hops; possibly skips - somersault - fork and spoon use (sometimes knife) - independently use toilent - swings and climbs

Question 19

GROSS MOTOR DEVELOMENT MILESTONES 6-10 years

Answer 19

PRONE SUPINE SITTING STANDING POSSIBLE WARNING SIGNS OTHER Coordination: - endurance and strength adequate to play with peers - heel toe-pattern - Maintains balance when catching ball, getting gently bumped. - Keeps balance on uneven surfaces - Does not bump into objects or people when walking through a new room - Only sits slumped, leans on furniture or walls when tired - Can coordinate movements for quicker activities. - Use of appropriate force while playing with pets and peers. - Use of appropriate force while holding objects - Can keep good sitting posture - necessary for school tasks - Can quickly go around moving peers - Can do challenging tasks that are balance demanding: (riding a bike) - Uses fingertips to pick up objects