Develomental Progressions, Advance Motor Skills milestones (from text book and slides)

Question 1

ATNR continues to influence head position in all postures, including prone, until the influence has completely subsided by approximately …

Answer 1

4 months of age

Question 2

__________ is the earliest antigravity control to develop

Answer 2

Head control in prone

Question 3

In the infant, the head makes up approximately ________ of the body in length, causing the head to be proportionately large and heavy

Answer 3

one-quarter

Question 4

With the help of the abdominal muscles to stabilize the pelvis in a relative posterior tilt, the infant begins actively lifting the head at approximately ______

Answer 4

2 months of age

By 4 months, the baby is able to lift the head to 90 degrees.

Question 5

By 4 months, the baby is able to lift the head to ____

Answer 5

90 degrees

Question 6

By 3 months, the baby is able to lift the head to ____

Answer 6

45 degrees

Question 7

If a child exhibits TV shoulders while prone-on-elbows, the strength of the ___________ muscles as well as the strength of the _________ and __________ muscles should be tested.

Answer 7

1. serratus anterior
2. Cervical flexors and extensors.

Question 8

Without the ability to elongate this region, the child will not be able to get the elbows into position underneath the shoulders for the prone-on-elbows posture

Answer 8

scapulo-humeral enlogation

(enlogation of the axillary region)

Question 9

The prone-on-elbows posture is the first call for the upper extremities to be ____ _____

Answer 9

weight bearing. This ability to weight-bear through the forearms, elbows, and shoulders foreshadows the weight bearing that will follow in the quad-ruped position.

Question 10

The elbows, in the prone-on-extended-arms posture, illustrate the (developmental) principle of weight bearing on ______________

Answer 10

extended limbs after first weight bearing on flexed limbs

Question 11

Crawling is a locomotive form that infants may use from _______ to __________ of age. Crawling is defined as moving “slowly by dragging the body along the ground.”

Answer 11

3 months to 8 or 9 months

Question 12

the child may choose plantigrade creeping over creeping in quadruped if he has bare knees and is on a concrete or other rough surface. This illustrates the _______ nature of development. Many factors, in addition to maturation, influence the development of motor skills.

Answer 12

dynamic

Question 13

Rolling from prone to supine and supine to prone, another means of locomotion, develops in the infant by ______

Answer 13

5 to 6 months of age

(Non-segmental or log rolling: 3 months)

Question 14

Goals of Motor Development:

Answer 14

• Control against gravity
• Inter and intra-segmental isolated movements
• COM over BOS

Question 15

What are the “French Angles”?

Answer 15

Used to assess tone/movement in the nursery

(Developed by a Fnench Neurologist)

Question 16

Scarf Sign

Answer 16

• Passively move the arm across the chest in supine with head in midline
• Term: resistance before midline
• Pre-term: no resistance

Question 17

Popliteal angle:

Answer 17

• Term: 60 to 90 deg
• Pre-term: 135-180 deg

Question 18

Ankle DF:

Answer 18

• Passive DF in supine, angle bet lower leg and foot
• term: less than 30 deg
• pre-term: bet 60 and 90 deg

Question 19

Slip through:

Answer 19

• vertical suspension holdin under axillae
• term: does not slip through
• pre-term: slips through

Question 20

Pull to sit (French angle):

Answer 20

• Term: no head lag
• pre-term: complete head lag

Question 21

Rooting reflex:

Answer 21

• stroke corner of mouth
• term: head turns towards stimulus
• pre-term: absent

Question 22

Sucking reflex:

Answer 22

• Nipple or finger in child’s mouth
• term: strong and rhythmic sucking
• pre-term: weak or absent

Question 23

Grasp reflex:

Answer 23

• term: sustained flexion and traction
• pre-term absent

Question 24

ATNR reflex:

Answer 24

• supine, passively turn head to one side
• term: upper and lower extremities extend on face side
• pre-term: absent

Question 25

Prone progression:

Answer 25

1. Physiological flexion 2. hip extension, begin to lift head 3. 3 mo: head to 45 deg 4. 4 mo: head to 90, with chin tuck, must activate cervical flexors 5. weigh shifting 6. reaching 7. Prone on extended arms (4-6 mo) 8. beginning of flexion at the hips into quadruped

Question 26

Pivot prone:

Answer 26

* Seen at 4-6 mo * allows enlogation of ant trunk

Question 27

Prone progression locomotion:

Answer 27

1. Scooting (1-2 mo), cannot be left alone. 2. Crawling; backwards first 3. Pivoting in prone (4-6 mo) 4. Rolling, prone to supine, then supine to prone 5. Creeping (9-11 mo) 6. Plantigrade creeping (10-12)

Question 28

Supine progression:

Answer 28

1. Physiological flexion, will gradually decrease 2. Head to side until midline controll develops (ATNR until 4-5mo) 3. Pull to sit: head lag? 4. Reaching for LE, to knees, to feet (around 5 mo): for exploration of the body; cross body reaching, enlongation of the posterior LE musculature in preparation for standing.

Question 29

Sitting progression:

Answer 29

1. **Supported sitting:** C-curve, initially see Bobbing of the head, sacral sitting. 2. **Propped sitting:** tripod position, not much mobility. 3. **Ring sitting:** (6 mo) wide BOS limit transitions; hands free to play. 4. **Long sitting:** narrower BOS, enhances transitions. 5. **Side sitting:** requires greatest amount of trunk control; seen 1st with propping; then without UE use; requires dissociation of LE's.

Question 30

Sitting Propping reactions:

Answer 30

1. Forward (tripod) position: 6 mo 2. Side to side: 7-8 mo 3. Posterior: 9-10 mo ​

Question 31

Once ____________ is achieved in the shoulder girdle, the child can reach into space to grasp a toy

Answer 31

**stability**

Question 32

When the neonate is **pulled to sitting**, the examiner gently pulling the infant's upper extremities at the wrists, the head is held in plane with the body and exhibits no \_\_\_\_\_\_\_\_\_, mimicking active head control

Answer 32

**head lag** (Due to physiologic flexion. As the physiologic flexion gradually disappears over the first month, when pulled to sitting, head lag is present.

Question 33

What is the **pull to sit progression:**

Answer 33

1. No head lag 2. Mild head lag 3. Head in midline 4. Active flexion against gravity

Question 34

The ATNR is seen in normal infants during the first

Answer 34

4 months of life

Question 35

Once children exhibit dissociation of the two lower extremi-ties and are stable in halfring sitting, some children actually develop a locomotive form in this posture called \_\_\_\_\_\_\_\_.

Answer 35

**Hitching,** is when a child, while sitting on the floor, uses ei-ther foot to dig into the surface in order to scoot forward on his buttocks.

Question 36

Hitching is often see in children with...

Answer 36

* abnormal development and prevents transition to creeping * Children with hemiplegia * Children with LOW tone with wide base of support in ring sitting

Question 37

Standing progression:

Answer 37

1. Automatic standing and stepping. (1 mo) 2. Abasia: baby still takes weight with support (2mo) 3. Astasia: leg give away (2-3) 4. Volitional standing (5mo): hip abd ER flx, knee flx, pronation of the feet 5. Pulls to stand: 7-9 mo 6. Cruising: 10 mo, allows development of weight sifting 7. Independent standing: 11 mo, up to 15 mo is OK. 18 or greater = delay 8. squating: 12 mo; important for play, stretches PF

Question 38

The lack of weight bearing through the lower extremities, which occurs typically during the third and fourth months, is the stage of \_\_\_\_\_\_, literally meaning without standing.

Answer 38

astasia

Question 39

The child begins pulling himself to standing in his crib at about this time:

Answer 39

7 to 8 months

Question 40

\_\_\_\_\_\_\_\_\_\_ of age, the child pulls himself to standing at furniture such as a sofa or low table. Now he gets to standing by going through the knee-standing (tall-kneeling) and **half-kneeling** postures and is adept at getting down with control.

Answer 40

**By 10 months**

Question 41

Soon he begins **stepping sideways** while holding onto the furniture. This supported walking at ___ months of age is called **cruising.**

Answer 41

**10**

Question 42

During the cruising phase of development, in addition to practicing his walking, the child's cruising movements contribute to the development and strengthening of __________________ as he sidesteps

Answer 42

hip abduction/adduction and ever-sion/inversion of the ankles

Question 43

During the development of standing, cruising, and walk-ing, the child develops the ability to ________ to **play** as well as to pick up an object from the floor.

Answer 43

squat

Question 44

Locomotion ccurs at about...

Answer 44

**1 year of age,** up to 15 months OK, 18 months or greater = delay

Question 45

Of the child is walking independently by 18 mo is considered

Answer 45

delay

Question 46

Hat age does the child achieves an adult gait pattern?

Answer 46

7 y/o

Question 47

Over the years, a child's cadence during gait will increase or decrease?

Answer 47

**decrease**

Question 48

First independent forward walking generally occurs between ________ months of age, with the typical child walking at _______ of age, plus or minus a month

Answer 48

1. 10 and 15 2. 12 months

Question 49

Stair climbing progression:

Answer 49

1. First with step to pattern 2. two hand on rail facing side 3. 1 hand onrail reciprocally

Question 50

The ability to ascend and descend stairs is affected by a number of factors, most particularly:

Answer 50

opportunity

Question 51

Climbing stairs usually occurs with UE support at:

Answer 51

15-16 months

Question 52

Stands on low balance beam

Answer 52

2 yr

Question 53

Balance on one foot 3-5 sec

Answer 53

5 yr

Question 54

Jumps from bottom step

Answer 54

2 yr

Question 55

Jumps of the floor with 2 feet

Answer 55

28 mo (2.3 yr)

Question 56

Hops 3 times

Answer 56

3 yr

Question 57

Hops 50 feet

Answer 57

5 yr

Question 58

Gallops

Answer 58

4 yr

Question 59

Skips

Answer 59

6 yr

Question 60

Catches a ball using hands only

Answer 60

5 yr important for social play

Question 61

Attempts to kick a ball

Answer 61

18 mo

Question 62

True run

Answer 62

2-3 yr

Question 63

Catches ball using hands and body

Answer 63

3 yr

Question 64

Reaches out to grasp objects

Answer 64

4-5 mo

Question 65

Bangs object together

Answer 65

5 mo

Question 66

Transfers objects from one hand to another

Answer 66

6 mo

Question 67

Holds crayon

Answer 67

11 mo

Question 68

Build tower with 8 cubes

Answer 68

30 mo (2.5 yr)

Question 69

Stands on low balance beam:

Answer 69

2 yr

Question 70

Walks straight line

Answer 70

3 yr

Question 71

Walks circular line

Answer 71

4 yr

Question 72

Balances on one foot for 3–5 sec

Answer 72

5 yr

Question 73

Walks backward

Answer 73

18 mo

Question 74

Jumps from bottom step

Answer 74

2 yr

Question 75

Jumps off floor with both feet

Answer 75

28 mo

Question 76

Hops 3 times

Answer 76

3 yr

Question 77

Hops 8–10 times on same foot

Answer 77

5 yr

Question 78

Hops distance of 50 feet

Answer 78

5 yr

Question 79

Gallops

Answer 79

4 yr

Question 80

Skips

Answer 80

6 yr

Question 81

Catches ball using body and hands

Answer 81

3 yr

Question 82

Catches ball using hands only

Answer 82

5 yr

Question 83

Attempts to kick ball

Answer 83

18 mo

Question 84

Hurls ball 3 feet

Answer 84

18 mo

Question 85

Kicks ball

Answer 85

2–3 yr

Question 86

Throws ball

Answer 86

2–3 yr

Question 87

Fast walk

Answer 87

18 mo

Question 88

True run with nonsupport phase

Answer 88

2–3 yr

Question 89

Stair climbing progression:

Answer 89

1. Step to pattern, 2. Two hand on rail facing side, 3. 1 hand onrail reciprocally