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Pediatric PT > Intro + Typical Development (0-12 Months) > Flashcards

Intro + Typical Development (0-12 Months) Flashcards

1
Q

The “Pediatric” pt population refers to which age group?

A

0-18 years of age

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2
Q

Stages of Chronological Development

A

Infancy: Birth - 1 year (Neonatal: Birth - 2 weeks of age +
Infant: 3 weeks - 12 months of age)

Toddlerhood: 13 months - 2 years (2 years, 11 months)

Early Childhood: (Preschool - 3 to 5 years + Elementary School - 5 to 10 years, 11 months)

Adolescence: 11 - 18 years

Young Adulthood: 18 - 22 years

Adulthood: 22 - 40 years

Middle Age: 40 - 65 years

Late Adulthood (Older Adult): 65+

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3
Q

Advanced Maternal Age (AMA)

A

Pregnancy where mother is 35+

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4
Q

What did Erik Erikson believe?

A

A specific psych struggle occurs throughout the 8 stages of a person’s life

These struggles contribute to your personality throughout your development

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5
Q

Erik Erikson’s Stages

A
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6
Q

What is a child’s main occupation?

A

Play!

Normal development skills typically acquired through play

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7
Q

What has the greatest influence on a child’s functioning/development as an adult?

A

Family!

What impacts the child also impacts every other member of the family

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8
Q

ICF-CY

A

ICF Child and Youth Version

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9
Q

The ICF-CY attempts to ___.

A

Capture growth/development of a disability

Identify variety of abilities/levels of functioning seen in children with the same diagnosis

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10
Q

ICF-CY Model (vs. Traditional Classification Systems)

A

Play codes to reflect child’s occupation of play

Continuity of documentation (transition from child to adult services)

Focuses on life, NOT mortality (QOL > inabilities)

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11
Q

ICF Terminology
(Function, Activities/Participation, Impairments)

A

Function: Relates to body organ/system, NOT functional activities

Activities/Participation: Functional activities

Impairments: Of the body, NOT the activity

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12
Q

The ICF-CY recognizes ___ and ___ as parallel processes.

A

development, disability

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13
Q

EBP “Stool” (Management of Children w/ Disabilities)

A

Best research evidence

Clinical expertise

Patient and their family/environment (important!!)

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14
Q

4 Elements of Good EBP (Law, MacDermid)

A

Awareness (PT aware of evidence that is available)

Consultation (child / family consulted as part of decision-making process)

Judgement (professional judgement in analyzing / using the info as it applies to a particular child and environment)

Creativity

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15
Q

Elements of Child Management (Leading to Optimal Outcomes)

A

Examination

Evaluation

Diagnosis

Prognosis

Intervention

Outcomes

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16
Q

Examination

A

Gathering data

3 Components: History / Systems Review / Tests & Measures

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17
Q

The type, frequency, and duration of the interventions are based on which factors? What is this list referred to as?

A

Age

A&P changes related to growth development

Chronicity/severity

Comorbidities

Degree of limitations

Level of cog ability / cooperation

Family (desires / degree of participation)

Caregiver ability / expertise

Resources

Concurrent services

Community support / psychosocial + socioeconomic factors

Above refers to Clinical Picture of Pt

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18
Q

3 Dimensions of Outcomes (Guralnick)

A

Child / family characteristics

Program / intervention features

Goals and objectives

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19
Q

3 Periods of Gestation

A

1st Trimester: Weeks 1 -12 (all major body systems established)

2nd Trimester: Weeks 13-26 (body proportions grow to newborn proportions)

3rd Trimester: Weeks 27-40 (body weight x3 and length x2, body fat accumulates to aid in temp. regulation)

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20
Q

At what point during gestation do Lungs develop?

A

36 weeks

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21
Q

Embryo vs. Fetus

A

Embryo: 1st 8 weeks

Fetus: 8 weeks until birth (full gestation is 40 weeks)

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22
Q

What determines the effect of environmental factors on fetal development?

A

Timing of exposure

Degree to which fetus is exposed

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23
Q

STORCH (Common Detrimental Environmental Influences)

A

Syphilis (bacterial infection spread through sexual contact)

Toxoplasmosis (parasitic infection, explanation as to why pregnant people should avoid changing cat litter)

Other Infections (HIV, Coxsackie Virus (lives in human digestive tract), Varicella-Zoster Virus (type of Herpes virus - chickenpox, shingles))

Rubella (viral infection, distinctive red rash, aka Measles)

CMV (Cytomegalovirus, related to Chickenpox + Herpes Simplex)

Herpes Simplex Virus (viral infection, painful blisters / ulcers)

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24
Q

“Typical Development” is dependent on ___.

A

NS maturation

Genetics

Environment

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25
Development occurs in a ___ direction.
cephalo-caudal proximal to distal gross motor to fine motor
26
Newborns NEED to be able to ___.
breathe suck and swallow
27
Apgar Score
Test performed at 1 minute / 5 minutes / 10 minutes (if needed) after birth 5 sections (scored 0 to 2) / total score of 1 to 10 Higher score = the better the baby is doing after birth
28
Around how long has fetal development been occurring once a baby is born?
38 - 42 weeks (40 weeks full term)
29
Premature vs. Extreme Premature
Premature: 37 weeks or less Extreme Premature: 28 weeks or less
30
Newborn Appearance
Head proportionally larger with short LEs Kyphotic, horizontal ribs Dominated by physiological flexion and lack of anti-gravity muscle control
31
Newborn ROM Differences
Excessive DF 30 degree flexion contracture at hips and knees
32
Newborn Prone
UE flexion / held to body / hands fisted LE flexion / highly positioned pelvis Head turned to one side
33
Newborn Supine
UE flexion LE flexion, abd, ER Head turned to one side (no anti-gravity neck flexion so unable to hold in midline)
34
Newborn Pull to Sit
Head lag Flexion throughout spine (c-curve) Flexed at hips
35
Newborn Sitting
Head forward: no control / head bobbing C-curve with flexion throughout spine (no anti-gravity extension) Secondary spinal curves not yet developed
36
Newborn Vision
Easiest to fixate on a moving object laterally and vertically Prefer strong contrasts Best at 8 - 9 inches away
37
Primitive Reflex Definition
Involuntary motions that aid in the development of certain skills in babies / help babies survive and thrive Replaced with voluntary motion as the baby's brain matures
38
What can happen if the involuntary movements associated with primitive reflexes do NOT become voluntary as the child matures?
Child will struggle with both motor (running / cycling / posture) and cognitive (eye-hand coordination / eye tracking / difficulty focusing) skills
39
Flexor Withdrawal Reflex
Appears ~28 weeks gestation Integrates 1 - 2 months Stimulus - noxious stimulus to sole of foot Response - flexion withdrawal of leg
40
Crossed Extension Reflex
Referring leg opposite to side engaged in Flexor Withdrawal reflex Appears ~28 weeks gestation Integrates 1 -2 months (inconsistent) Stimulus - noxious stimulus to sole of foot Response - flexion of stimulated leg and extension of opposite leg with adduction
41
Positive Support / Primary Standing Reflex
Hold baby under their arms / support their head / touch their feet to a flat surface Will extend legs for 20 - 30 seconds before flexing legs and collapsing into sitting position (bearing weight for 20 - 30 seconds before collapsing) Appears ~ 35 weeks gestation Integrates 1 - 2 months
42
Support & Stepping / Automatic Walking
Steps reciprocally when inclined forward and pressure is applied to plantar aspect of foot Appears ~ 37 weeks gestation Integrates 3 - 4 months Re-appears at 10-15 months in preparation for walking
43
Rooting Reflex
Appears 28 weeks gestation Integrates by 3 months Stimulus - baby in supine, stroke cheek Response - turns head and lips towards stimulus
44
Sucking Reflex
Appears ~28 weeks gestation Integrated by 3 months Supine , bottle / knuckler, baby sucks symmetrically and strong
45
Suck-Swallow Reflex
Rhythmic excursion of jaw Appears 28 - 34 weeks gestation Integrates at 5 months
46
Moro Reflex
Sudden change in head position (extension) in relation to trunk results in crying + two movements back to back: flexion, abduction of shoulders and elbow extension / extension, adduction of shoulders and flexion of elbow Appears ~28 weeks gestation Integrated by 3-5 months
47
Asymmetric Tonic Neck Reflex (ATNR)
(In supine) head rotation elicits arm and leg extension (chin side) / arm and leg flexion (skull side) Appears ~20 weeks gestation Integrates at 4-5 months
48
Palmar Grasp
Appears ~28 weeks gestation (can be elicited at 25 weeks postconceptional age) Integrates 4-7 months (In supine) PT strokes infant's palm with index finger Two Phases: Finger flexion to enclose examiner's finger (Finger Closure) / pressure to palm produces traction on finger's tendons (Clinging)
49
What could a weak Palmar Grasp reflex possibly indicate?
Peripheral nerve involvement - injury to root / plexus / SC
50
Persistence of the Palmar Grasp Reflex beyond ___ months is usually present in children with ___.
7 , spastic cerebral palsy
51
A reappearance of the Palmar Grasp Reflex in adulthood indicates what?
Cortical lesion affecting medial or lateral frontal cortex (e.g., ischemic or hemorrhagic stroke)
52
Tonic Labyrinthine Reflex (TLR)
Present at birth / integrated by 6 months (best seen at 3 months) Prone - infant with greater flexion tone / supine - infant with greater extension tone Neck extended - increased extensor tone / extension of all limbs Neck flexed - increased flexor tone / flexion of all limbs
53
Symmetrical Tonic Neck Reflex (STNR)
Appears 4-6 months / integrates 8-12 months W/ head flexion - arms flex and hips extend W/ head extension - arms extend and hips flex Helps with learning how to fall / crawling TLR less involved at this point
54
Plantar Grasp Reflex
Pressure to sole of foot (just distal to met head) / supported standing Responds by flexing toes Appears ~28 weeks gestation Integrates by 9 months
55
If a TLR is not integrated after 6 months, what symptoms could be observed?
Poor posture Weak muscle tone (skinny arms / legs) Poor sense of balance / dislike of sports Inability to alternate between looking closely and looking in the distance easily (e.g., copying notes off the board) Poor spatial awareness (usage of space) Poor sequencing skills (math / reading / writing) Poor sense of time (management, difference between yesterday and tomorrow)
56
Galant Reflex
(In supported prone aka ventral suspension) stroke one side of infants lateral trunk / paraspinals Trunk should laterally flex toward stimulus Appears 28 weeks gestation Integrates 3-6 months
57
At what point does a delay in the integration of the Galant Reflex become a concern?
Beyond 9 months Could result in fidgeting / inability to sit still
58
In a 1 month old, we begin to see reduced effects of ___ ___.
physiological flexion As extension develops
59
1 Month Prone
Less UE / hip flexion More anterior pelvic tilt Able to lift head momentarily (more active neck extension)
60
1 Month Supine
Less UE flexion / some reaching / hands fisted Less LE flexion / reciprocal and symmetric kicking Head turned to one side (no anti-gravity flexion yet)
61
1 Month Pull to Sit / Sitting
Pull to Sit: More pronounced head lag due to loss of physiologic flexion / spine in flexion (c-curve) / flexed at hips Supported Sitting: Head forward (in line with trunk for short periods and head bobbing) / curved spine (no anti-gravity trunk extension)
62
2 Months Prone
Less UE flexion / more shoulder abduction Less LE flexion / pelvis closer to surface Able to lift head 45 degrees (WB on elbows, elbows behind shoulders)
63
2 Months Supine
Increased shoulder ER Decreased hip flexion / decreased hip abduction / decreased hip ER Increased neck rotation
64
2 Months Pull to Sit / Sitting
Pull to Sit: Continued head lag and flexion throughout spine Supported Sitting: Head bob (intermittent head and neck extension) / flexion throughout spine (no anti-gravity trunk extension)
65
2 Months Standing
Does not accept weight on LEs (appearance of motor incoordination / poor orientation of feet)
66
3 Months Prone
UE increased abduction Hip ext / abd / ER Pelvis flat on surface Knees flexed / feet together Able to lift head 90 degrees (upper trunk extension, WB on forearms, elbows in line with shoulders)
67
3 Months Supine
Hands together resting in midline on chest / some reaching Hip and knee flexion / abduction / still some ER / heels together Head in midline (chin tuck - neck flexor activity / less neck rotation - decreased ATNR)
68
Head Righting
When suspended in a vertical position and tilted slowly side to side, the child will move their head to a vertical position Trunk flexion Present at birth / strongest at 3 months
69
3 Months Pull to Sit / Sitting
Pull to Sit: Asymmetric head lifting / neck flexors work inconsistently with extensors / slight head lag (but improved) Sitting: Head in midline (shoulder elevation, upper cervical extension) / flexion throughout spine (still not enough trunk extension)
70
3 Months Standing
Accepts some weight on feet again Hips abd Knees in stiff extension Toes curled (Plantar Reflex) Automatic walking integrated
70
4 Months Prone
Scapular adduction with trunk extension Hip extension and adduction / increased APT with lumbar extension Head and chest lifted - upper trunk extension / WB on forearms, elbows close to body / may accidentally roll to side-lying
71
4 Months Supine
Reaching above body in midline / hands to knees (log roll to side-lying) Increased pelvic control (PPT w/ hands to knees) Head in midline
72
4 Months Pull to Sit / Sitting
Pull to Sit: No head lag / assists with upper chest and UE flexion - overflow to abs and LEs Sitting: Head in midline / holds head steady in supported sitting / flexion at hips / curved spine below point of upper trunk extension
73
4 Months Standing
Takes more weight on LEs Can be held by hands instead of chest Pelvis behind shoulders Legs may flex or extend
74
5 months marks the beginnings of ___ and ___.
Lateral WS / Lateral righting reactions of head and trunk To prepare for postural responses to emerge at 6 months
75
5 Months Prone
Extended arm WB (WB through hands, pelvis) / WS on forearms with reaching Hip ext / add / neutral rotation Head and upper trunk lifted (Swimming: Total spinal extension, movement of UEs and LEs)
76
5 Months Prone Reaching
WS on forearms LEs: *WB Side: Hip ext / add / IR * Reaching Side: Hip hike / flexion / abd / ER *Development of LE dissociation May roll prone to supine
77
5 Months Supine
Reaching with full shoulder flexion and adduction / elbow, wrist, finger extension; hands to feet Increased pelvic control / PPT with feet to hands and mouth Asymmetrical rolling to side-lying (UE and LE dissociation)
78
5 Months Side-Lying
Lateral flexion of head away from floor Elongation of WB side (bottom leg: extended and adducted / top leg: flexed and abducted)
79
5 Months Pull to Sit / Sitting
Pull to Sit: No head lag / increased abdominal control, LE flexion / holds head in line with body / assists with UEs / often will pull to stand Sitting: Flexion at hips / propping on arms or "high guard" position to stabilize
80
5 Months Standing
May pull to stand with knee extension and PF Hips in abd / ER Hips almost in line with shoulders Lumbar lordosis
81
Landau Response / Reflex
Emerges from 3-5 months / lasts up until 12 months Infants held horizontally in the air in prone (head above horizontal with trunk and extremity extension) / examiner flexes head and hips flex (feet go down)
82
6 Months Prone
Reach forward with WS on extended arm (shoulder girdle stability / elbow, wrist, finger extension) Better pelvic control, less anterior tilt Head and upper trunk lifted - Mature Swimming
83
6 Months Supine
Reaching bilaterally / transfer objects from one hand to the other Increased pelvic control / play with legs in the air Asymmetrical rolling to prone (UE and LE dissociation) Head: Chin Tuck
84
6 Months Pull to Sit / Sitting
Pull to Sit: Independent / chin tuck and LE flexion / at half-way point knees extend to prepare to sit Sitting: Back straight, decreased trunk flexion / PPT / hips flexed, abducted, ER / UEs used for reaching and manipulating / Anterior Protective Extension
85
Righting vs. Equilibrium
Righting: The act of realigning the head / trunk with each other or with an outside stimulus Equilibrium: Act of re-establishing balance
86
The Righting Reactions are organized in the ___ portion of the brain.
midbrain
87
Anterior Protective Extension
In sitting, gently push forward - arms extend in front to prevent from falling Usually 1st of protective extensions to emerge Emerges 6-9 months
88
Lateral Protective Extension
In sitting, gently push hips laterally - arm extends to prevent from falling Emerges after Anterior Protective Extension Emerges 6-9 months
89
6 Months Standing
Able to stand holding fingers Full WB on feet / knees locked out initially Hips abducted Can bounce up and down with feet on floor Increased abdominal control and hip extensor activity
90
7 Months Prone
Quadruped - tummy off the floor / rocks in quadruped Prone pivots Belly Crawl
91
7 Months Supine
Does not like supine - rolls out of it!
92
7 Months Sitting
Assumes sitting from quadruped Trunk rotation in sitting Hands free Lordosis Can transition to prone
93
7 Months Side-Lying
Plays frequently in side-lying Good Lateral Righting
94
7 Months Standing
Bears full weight with minimal support Pulls self to stand Bounces
95
UE Parachute
Emerges at 6-7 Months In prone horizontal (suspension at chest), move child toward surface head first (symmetrical arm extension and abduction)
96
8 Months Prone
Creeps on hands and knees - primary mode of locomotion Transitions Quadruped to sitting using lateral righting
97
8 Months Sitting
Good trunk extension Decreased LE positional stability Rotation counter-balanced by sideward protective extension or equilibrium reactions Sitting to quadruped
98
8 Months Standing
Pulls to stand through kneeling / half kneeling Rotates trunk over LEs Cruises sideways Stands with one hand held Walks with two hands held - steppage gait
99
9 Months Sitting
Increased trunk control Most functional, versatile position Utilizes various LE positions Frequently side-sits using increasing hip mobility / may "W" sit
100
Posterior Protective Extension
Onset at 9-11 months In sitting, gently push backwards - arm(s) extend behind to prevent from falling Last protective reaction to emerge
101
Anterior Righting
Emerges around 9 months In sitting, gently pull backward at shoulders - extend head and arms forward to recover balance
102
9 Months Kneeling
Kneeling: Hip extension incomplete May move into half-kneeling to play
103
9 Months Standing / Cruising
Pulls to stand - uses UE (LE more active - goes through half kneeling) Standing - cruises around furniture Semi-turns in direction to which they are going
104
9 Months Supported Walking
Walks with two hands held Decreased LE abduction / ER UE fixing for support
105
10 Months Sitting
Able to long sit Tailor sitting for stability and easy transition to other positions (hip flexion / abduction / ER)
106
10 Months Standing
Rises through kneeling and half kneeling Lowers self from standing - maintains UE support Reaching for toy with one hand
107
10 Months Supported Walking
Walks with two hands held Starting to use some pelvis rotation and more LE stride Marked trunk extension
108
11 Months Sitting
Controlled trunk rotation Varies LE positioning (long sitting / side sitting) Demonstrates increased hip control; able to use kneeling and half kneeling more
109
11 Months Standing
Transitions to standing through kneeling / half kneeling / squatting with symmetrical LE extension and trunk elevation Stands alone - UE use is limited Demonstrates wide BOS; LE abd Cruises and reaches for furniture out of reach
110
11 Months Walking
May attempt unsupported walking UE fixing Steppage gait with ER
111
12 Months Sitting
Engages in a variety of play in sitting Easily moves in/out of sitting from all positions
112
12 Months Standing
Rises from floor with legs No longer needs UEs Able to weight shift and lift one leg
113
12 Months Squatting
May use squatting for play Able to take steps / stop / squat to pick up a toy / re-erect and continue walking
114
12 Months Unsupported Walking
May attempt unsupported walking Trunk extension / scapular adduction / wide BOS (LE abduction)

Pediatric PT (10 decks)

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