Typical vs Atypical Motor Development Flashcards
What is the key to normal motor development for a child?
Variability of Movement
Gives the planes of control in the sequence that they are acquired.
Plane 1: Sagittal (Flexion/Extension)
Plane 2: Frontal (Head righting reaction)
Plane 3: Transverse (Rotation for rolling)
What are the 3 directions of normal development?
Cephalic->Caudal
Proximal->Distal
Total Body synergies->dissociated motor patterns and individual movements
Give some examples of the total body synergies->dissociated motor patterns and individual movements.
- Kicking reciprocally-> reciprocal walking
- Reaching with UE without LE moving
- Neonate individual movements-> purposeful individual movement
Abnormal development is the absence of what?
Variability and adaptability
Name the plane where atypically developing kids “get stuck”. What are two consequences of that?
Sagittal plane; difficult to grade flex/ext against gravity and failure or delay of righting and equilibrium reactions to emerge
What 5 things are different with atypical developing kids in regards to their direction of development?
- Cephalic-> caudal (stays the same)
- Lack of inhibitory control
- Synergic motor patterns continue
- Exaggerated reflex behavior
- Select movements can’t be executed
When would you determine that a child was atypical?
When they started to assume more upright positions
Why is it easier to pick out an atypically developing child once they start developing?
Because they are starting to move more, their bodies are getting bigger, and their muscles and bones aren’t developing correctly
Normal prone development includes what movements?
Antigravity movements
Extended arms
Dissociation
Weight shifts
What would a hypotonic child look like in prone? A hypertonic child?
Hypertonia: Extensor hypertonicity OR flexor synergies, ATNR persists, Indwelling thumb persists, shoulder elevation, poor shoulder girdle stability, and scores well on standardized exams up to 4 months.
Hypotonia: Inability to lift head, hinging, shoulder elevation, poor shoulder girdle stability, and poor dissociation.
Normal supine development of a child will look like?
Flexion against gravity, midline orientation, knees/feet up, hands to feet, bridging controlled in play
Give the two types of abnormal development for a baby in supine.
Hypertonia: Pelvis anteriorly tilted, UE and shoulder girdle retracted, postural asymmetry persists (ATNR)-lateral curve of spine, persistence of primitive reflexes
Hypotonia: Poor antigravity flexion, LE flexed and wide ABD (frog leg), poor abdominal control (feet and legs not in visual filed), may develop extensor hypertonicity later (>5 yo), and sinking into gravity
What would be considered normal for side lying development?
Lateral righting of cervical spine and trunk
Muscle balance- abs and back
Head in midline
Arms to midline
Give the abnormal development for side lying.
No lateral righting
No muscle balance- therefor usually flop to belly or back
Increased cervical and trunk extension in children with hypertonia
Normal rolling development includes what?
Normal initial attempts are initiated by pushing into extension
Segmental rolling with lateral head righting bilaterally at 6 months
Atypical rolling development will look like?
Hypertonia: supine to prone push through extension then flop (not segmental), prone to supine harder (spastic hemiplegia push with 1 UE to flip to back)
Hypotonia: Rare that they will roll, MAYBE at a 1 y.o.
What would normal sitting development look like?
Pelvis Perpendicular
Prop sitting or high guard (5-6ish months)
Coordinated flex/ext at hips and trunk
Protective Extension and equilibrium reactions at 7-8 months
PTS with active flexion at 5-6 months
How would you find an atypical child sitting?
Hypotonia: lack of ext against gravity, trunk forward with hinging with cervical spine hyperext., wide ABD of hips provide stability, PTS: head lag into 1st year of life
Hypertonia: Spine ext (premature) with high guard, sit on sacrum, PTS: appears to be helped by using tone and co-contraction)–This looks advanced but isn’t because it is not volitional
How would an older child atypically developing try to sit?
Patterns changes as child ages, compensation for lack of mobility and stability, W sitting common, Tight hip and back extensors cause posterior pelvic tilt- sacral sitting, long sitting: hip ADD, posterior pelvic tilt and PF
Normal creeping includes what types of movements?
Lateral wt shifting practice in prone and sitting—- Lateral trunk righting
Stability through wide BoS (ABD, ER)
Trunk Rotation and equilibrium reactions narrow support
Dissociation for LE for reciprocal creeping
Pick one of the two atypical developments for creeping from the given information: Less motivated that other children, poor trunk control-swayback, transition through W sit or full ABD (splits), crawl short distances (easily fatigued), very delayed (over 1 y.o.)
Hypotonia
A hypertonic child would creep how?
Same motivation as typical children, commando crawling (UE pull, legs and stomach drag, hips ADD IR and PF), Spastic diplegia (bunny hopping)
The normal standing development of a child looks like?
Supported standing with wide BoS (ABD, ER) Rotation components emerge Indep. amb. with wide BoS Pelvic rotation emerges 1/2 kneeling to pull to stand Always refining balance and posture
