4 Motor Development and Milestones

What are the motor developmental period?

• Infancy: Birth to 2 years old

• Childhood: 2 years old to adolescence

• Adolescence: Puberty to adulthood

• Adulthood: Approx. age 20 to 70 years

• Older adulthood: 70+

Piaget’s Theory of Intelligence

• Based on behavioral response of his own children

• Four stages of cognitive development

  • Sensorimotor

  • Preoperational

  • Concrete operational

  • Formal operational

• Does not represent life-span of intellectual development

Maslow (theory of lifespan)

Developed a hierarchy where each higher level depends on mastering the one before

Erikson (theory of the entire lifespan)

• Believed each state of a person’s life would be confronted with a personal challenge

• Each person will choose one or the other life stage options

• By making this choice, a person establishes their personality

What are two theories of motor development?

• Dynamic systems theory - movement emerges from the interaction of multiple body systems

• Neuronal group selection theory - no motor programs and neural plasticity

Dissociation

Reciprocal interweaving

Variation and variability

What are the three development processes

• Growth (increase in size)

• Maturation (physical changes that automatically happen)

• Adaptation (environmental influences can affect growth)

Motor milestones

• Every child should do certain tasks by a certain age

• May be a medical problem if a milestone is not met by the upper range of normal - called a developmental delay

Motor milestone progression

1.) Head control

2.) Segmental rolling

3.) Sitting

4.) Creeping/crushing

5.) Walking

6.) Reaching, grasping, releasing

Motor skills

• Gross motor - overall movement of large mm

• Fine motor - small muscles of the hands and the ability to manipulate small object (hand-eye coordination)

What are the typical motor milestones?

• Birth to 3 months:

  • Initial flexor tone

  • Beginning head control ; head to 45 dgs in prone

• 4 months

  • Head to 90 dgs in prone

  • Hand to midline

  • Reaching

• 5 months

  • Head movmt into flex in supine

  • dissociation of head and limbs

What are typic motor milestones for a 6 month old?

• Righting reactions

• Segmental rolling

• Transitional movements

• Grasping

What are typical motor milestones for a 7 month old?

• Unsupported sitting

• Lateral protective reactions

• Voluntary release of objects

What are typical motor milestones for an 8 month old?

• Creeping

• Increased UE strength

What are typical motor milestones for a 9 month old?

• Quadruped position

• Cruising

What are typical motor milestones for a 12 month old?

• Ambulation

• Hips and knees in flexion

What are typical motor milestones for a 16-18 month old?

• Arm swing/heel strike

• Balance reactions

What are typical motor milestones for a 2 year old?

• Kick a large ball

• Arm swing and heel strike with gait

• True running

What are typical motor milestones for a 4 year old?

• Galloping

• Catch a small ball

What are typical motor milestones for a 6 year old?

• Stand on one foot for 10 sec

• Developing sports skills

How does the body change in general during aging?

Asymmetrical → symmetrical → asymmetrical

What happens to posture as you age?

• Cervical curve dec

• Thoracic curve is kyphotic

• Lumbar curve flatten

What happens to balance as you age?

• Sensory systems change

• Larger sway in quiet standing due to dec vibration awareness

What happens to gait in an older adult?

• Cadence, velocity, and stride length dec

• Step width inc to inc BOS

• Difficulty with stepping over object and climbing stairs

Peabody Developmental Motor Scale

• Birth to 5 years old

• Takes 45 -60 min

• Composed of 6 subtests that measure interrelated motor abilities that develop in early life:

  • Reflexes

  • Stationary

  • Locomotion

  • Object manipulation

  • Grasping

  • Visual-moto integration

Bruininks-Oseretsky Test of Motor Proficiency (BOT 2)

• Measures fine and gross motor skills

• 4-21 years old

• Takes 15-60 min

• Consists of 8 subtests:

  • 4 in gross motor (bilateral coordination, balance, running speed, and agility and strength

  • Four in fine motor (fine motor precision and integration, manual dexterity, and upper extremity coordination)

Head control

• 3-4 months

• Holding head up in vertical position

• 45 dgs in prone at birth - 3 months

• 90 dgs in prone at 4 months

• Lift head up in supine at 5 months

Reaching

• 3.5 -4.5 months

• Visually directed reaching

Propping on elbows

• 3-4 months

• Able to get in position automatically

Prone on extended arms

• 4-6 months

• Able to get in position automatically

Rolling (log rolling)

• Rolls both ways

• Prone to supine develops first because it can be done accidentally (it’s easier)

Scooting

• 5 months

• Could start earlier on stomach then sitting

Grasping

• 6-12 months

• Tries different grasping tech (palmar, scissor, radial-palmar, etc.)

Segmental rolling

• 6-8 months

• Baby rolls on a sequential wave-like motion (head, shoulders, hips, legs)

Sitting unsupported independently if placed there

• 7 months

• Will sit if placed in sitting but cannot get there on their own yet

• Back is straight and no hands to support

Grasp and release

• 7-10 months

• Immediately growing an object and then letting go

Creeping

• 8.5 months

• Reciprocal (each side of t he body does something different)

Cruising

• 10-12 months

• Holding on to something and walking sideways

Walking

• 12-18 months

• Wide BOS, legs abd, ER, lumbar lordosis, arms in high guard, scapular add

Climbing stairs alternating legs

• 2.5-3 years

• With rail and without rail