Chapter 5: Human Development Across the Lifespan

human develop, sensorimotor development, cognitive development, development of play, self-care development

human development

• sequential changes in the function of the individual

• qualitative or quantitative

• influenced by biologic determinants and biopsychosocial environmental experiences

fetal sensorimotor development

• three trimesters

• development of:

1. muscle spindle

2. touch and tactile system

3. vestibular system

4. vision

5. auditory

6. olfactory

7. taste

8. movement

fetal sensorimotor development: first trimester (3 months)

• muscle spindle

  • muscle starts to differentiate

  • tissue becomes specialized

• touch and tactile system

  • first sensory system to develop

  • response to tactile stimulus

• vestibular system

  • functioning at the end of the first trimester (not completely developed)

• vision

  • eyelids fused

  • optic nerve and cup being formed

• taste

  • taste buds develop

• movement

  • sucking, hiccuping

  • fetal breathing

  • quick generalized limb movement

  • positional changes

  • 7.5 weeks: bend neck and trunk away from premolar stroke

fetal sensorimotor development: second trimester (6 months)

• muscle spindle

  • motor end plate forms

  • clonus response to stretch

• touch and tactile system

  • receptors differentiate

• vision

  • startle to light

  • visual processing occurs

• auditory

  • will turn to auditory sounds

• movement

  • quickening

  • sleep states

  • grasp reflex

  • reciprocal & symmetrical limb movements

fetal sensorimotor development: third trimester (9 months)

• muscle spindle

  • some muscles are mature and functional, others still maturing

• touch and tactile system

  • touch is functional

  • actual temperature discrimination at the end of the third trimester

• vision

  • fixation occurs

  • able to focus (fixed focal length)

• auditory

  • debris in middle ear, loss of hearing

• olfactory

  • nasal plugs disappear, some olfactory perception

• taste

  • can respond to different tastes (sweet, sour, bitter, salt)

• movement

  • 28 weeks, primitive motor reflexes

  • rooting, suck, swallow

  • palmar grasp

  • plantar grasp

  • MORO

  • crossed extension

gestational age

• age of the fetus or newborn, in weeks, from first day of mothers last normal menstrual period

• normal gestational period is 38 to 42 weeks

• divided into three trimesters

conceptual age

• age of fetus or newborn in weeks since conception

development of sensorimotor integration

1. prenatal period

2. neonatal period

3. first six months

4. six to twelve months

5. thirteen to twenty-four months

6. three to seven years

development of sensorimotor integration: prenatal period

• responds first to tactile stimuli

• reflex development

• innate tactile, proprioceptive, and vestibular reactions

development of sensorimotor integration: neonatal period

• tactile, proprioceptive and vestibular inputs are critical from birth onward for the eventual development of body scheme

• vestibular system, although fully developed at birth, continues to be refined and impacts on the infants arousal level (helps the infant feel more organized and content)

• visual system develops as infant responds to human faces and items of high contrast placed 10 inches from face

• auditory system is immature at birth and develops as the infant orients to voices and other sounds

development of sensorimotor integration: first 6 months

• vestibular, proprioceptive, and visual systems become more integrated and lay the foundation for postural control, which facilitates a steady visual field

• tactile, and proprioceptive systems continue to be refined, laying the foundation for development of somatosensory skills

• visual and tactile systems become more integrated as the child reaches out and grasps objects, laying the foundation for eye-hand coordination

***infant movement patterns progress from reflexive to voluntary and goal directed

voluntary and goal directed

in the development of sensorimotor integration: first six months, infant movement patterns progress from reflexive to…

development of sensorimotor integration: 6 to 12 months

• vestibular, visual, and somatosensory responses increase in quantity and quality as the infant becomes more mobile

• tactile and proprioceptive perceptions become more refined, allowing for development of fine motor and motor planning skills ---> this eventually leads to crossing midline

• auditory, tactile, and proprioceptive perceptions are heightened allowing for development of sounds for the purpose of communication

• tactile, proprioceptive, gustatory, and olfactory perceptions are integrated, allowing for PRIMITIVE SELF FEEDING

development of sensorimotor integration: 13 to 24 months

• tactile perception becomes more precise allowing for discrimination and localization to further refine fine motor skills

• further integration of all systems promotes complexity of motor planning as the toddlers repertoire of movement patterns expands

• symbolic gesturing and vocalization promotes ideation, indicating the ability to conceptualize

• motor planning abilities contribute to self concept as the toddler begins to master the environment

development of sensorimotor integration: 2 to 3 years

• vestibular, proprioceptive, and visual systems further develop leading to improved balance and postural control

• improved fine motor skills

• motor planning and praxis ideation also progress during this period

development of sensorimotor integration: 3 to 7 years

• child is driven to challenge sensorimotor competencies through roughhouse play, playground activities, games, sports, music, dancing, arts and crafts, household chores, and school tasks

• promote social development and self esteem

reflex

predictable motor response elicited by tactile, proprioceptive, or vestibular stimulation

reflex development and integration

• primitive reflexes are present at or just after birth and typically integrate throughout the first year

• disturbance demonstrates CNS dysfunction; affects development

rooting reflex (onset and integration)

onset: 28 weeks gestation

integration: 3 months

rooting reflex (stimulus)

stroke the corner of the mouth, upper lip, and lower lip

rooting reflex (response)

movement of the tongue, mouth, and/or head towards the stimulus

rooting reflex (relevance)

search and locate feeding source to begin feeding

suck-swallow reflex (onset and integration)

onset: 28 weeks gestation

integration: 2-5 months

suck-swallow reflex (stimulus)

place finger inside mouth, with head in midline

suck-swallow reflex (response)

strong, rhythmic sucking

suck-swallow reflex (relevance)

facilitates nutritive sucking for ingestion of liquid

traction reflex (onset and integration)

onset: 28 weeks gestation

integration: 2-5 months

traction reflex (stimulus)

grasp infants forearms and pull to sit

traction reflex (response)

complete flexion of upper extremities

traction reflex (relevance)

enhances momentary reflexive grasp to enable the child to hold onto mother when being pulled

moro reflex (onset and integration)

onset: 28 weeks gestation

integration: 4-6 months

moro reflex (stimulus)

rapidly drop infants head backwards

moro reflex (response)

• 1st phase: arm extension/ABduction, hand opening

• 2nd phase: arm flexion and ADDuction

moro reflex (relevance)

protective response to stress; helps to develop extensor tone during period when flexor tone is dominant

plantar grasp reflex (onset and integration)

onset: 28 weeks gestation

integration: 9 months

plantar grasp reflex (stimulus)

apply pressure with thumb on the infants ball of the foot

plantar grasp reflex (response)

toe flexion

plantar grasp reflex (relevance)

increases tactile input to sole of foot; integration is associated with readiness for independent gait

galant reflex (onset and integration)

onset: 32 weeks gestation

integration: 2 months

galant reflex (stimulus)

hold infant in prone suspension, gently scratch or tap alongside the spine with finger, from shoulders to buttocks

galant reflex (response)

lateral trunk flexion and wrinkling of the skin on the stimulated side

galant reflex (relevance)

facilitates lateral trunk movements necessary for trunk stabilization

asymmetric tonic neck reflex (onset and integration)

onset: 37 weeks gestation

integration: 4-6 months

asymmetric tonic neck reflex (stimulus)

fully rotate infants head and wait for 5 seconds

asymmetric tonic neck reflex (response)

• flexion of the elbow on opposite side which head is turned

• extension of arm on the side the head is turned

righting reactions

• aka labyrinthine reflex

• develops shortly after birth in response to gravity

• aligns the head and trunk

• functions to align upper body and lower body

  • directs head into vertical alignment

• integrated movement for postural alignment

  • integrates movement between head, trunk, body, and gravity

  • may resulting in decreased movement of the head when rolling over, getting out of bed, getting up from kneeling if not fully integrated

protective reactions

• develops at approximately 10 months of age

• test position: seated or kneeling

• positive response: arms extend to front, back or sides to protect head and face

  • LE ex: stepping or hoppi

  • functional implication: may not catch self when falling/injury/LOB

• assessed by observation of balance during functional activities

asymmetric tonic neck reflex (relevance)

• promotes visual attention to UE/hand regard

  • helps to establish eye-hand coordination/bilateral UE coordination

  • may have difficulty reaching midline/eye-hand coordination if not fully integrated

• decreases incidence of rolling

• expected to integrate during early childhood

palmar grasp (onset and integration)

onset: 37 weeks gestation

integration: 4-6 months

palmar grasp (stimulus)

place finger inside infants palm

palmar grasp (response)

finger flexion; reflexive grasp

palmar grasp (relevance)

increases tactile input on the palm of the hand; prepares muscles for voluntary grasp

tonic-labyrinthine SUPINE reflex (onset and integration)

onset: >37 weeks gestation

integration: 6 months

tonic-labyrinthine SUPINE reflex (stimulus)

place infant in supine

tonic-labyrinthine SUPINE reflex (response)

increased extensor tone

tonic-labyrinthine SUPINE reflex (relevance)

facilitates total body extensor tone; allows posture to adapt to that of head

tonic-labyrinthine PRONE reflex (onset and integration)

onset: >37 weeks gestation

integration: 6 months

tonic-labyrinthine PRONE reflex (stimulus)

place infant in prone

tonic-labyrinthine PRONE reflex (response)

increased flexor tone

tonic-labyrinthine PRONE reflex (relevance)

facilitates total body flexor tone; allows posture to adapt to that of head

labyrinthine/optical (head) righting reflex (onset and integration)

onset: birth-2 months

integration: persists

labyrinthine/optical (head) righting reflex (stimulus)

hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward

labyrinthine/optical (head) righting reflex (response)

upright positioning of the head

labyrinthine/optical (head) righting reflex (relevance)

basis for head management and postural stability; orients head in space; orients head in space vertically

landau reflex (onset and integration)

onset: 3-4 months

integration: 12-24 months

landau reflex (stimulus)

hold infant in horizontal prone suspension

landau reflex (response)

complete extension of head, trunk, and extremities

landau reflex (relevance)

regulates tone; promotes prone extension to manage flexor tone

symmetric tonic neck reflex (onset and integration)

onset: 4-6 months

integration: 8-12 months

symmetric tonic neck reflex (stimulus)

place the infant in the crawling position and extend the head

symmetric tonic neck reflex (response)

flexion of hips and knees

symmetric tonic neck reflex (relevance)

facilitates quadruped position in preparation for crawling; breaks up total body extension

neck righting (NOB) reflex (onset and integration)

onset: 4-6 months

integration: 5 years

neck righting (NOB) reflex (stimulus)

place infant in supine and fully turn head to one side

neck righting (NOB) reflex (response)

log rolling of the entire body to maintain alignment with the head

neck righting (NOB) reflex (relevance)

facilitates rolling; maintains body orientation in response to cervical position changes

body righting (on body) BOB reflex (onset and integration)

onset: 4-6 months

integration: 5 years

body righting (on body) BOB reflex (stimulus)

place infant in supine, flex one hip and knee toward the chest and hold briefly

body righting (on body) BOB reflex (response)

segmental rolling of the upper trunk to maintain alignment

body righting (on body) BOB reflex (relevance)

promotes trunk/spinal rotation to facilitate sitting and quadruped positions

downward parachute (protective extension downward) reflex (onset and integration)

onset: 4 months

integration: persists

downward parachute (protective extension downward) reflex (stimulus)

rapidly lower infant toward supporting surface while suspended vertically

downward parachute (protective extension downward) reflex (response)

extension of the lower extremities

downward parachute (protective extension downward) reflex (relevance)

prepares LEs for surface contact (standing); breaks a fall

forward parachute (protective extension forward) reflex (onset and integration)

onset: 6-9 months

integration: persists

forward parachute (protective extension forward) reflex (stimulus)

suddenly tip infant forward toward supporting surface while vertically suspended

forward parachute (protective extension forward) reflex (response)

sudden extension of the upper extremities, hand opening, and neck extension

forward parachute (protective extension forward) reflex (relevance)

places UEs in anticipation of surface contact to break a fall; supports prop sitting

sideward parachute (protective extension sideward) reflex (onset and integration)

onset: 7 months

integration: persists

sideward parachute (protective extension sideward) reflex (stimulus)

quickly but firmly tip infant off-balance to the side while in the sitting position

sideward parachute (protective extension sideward) reflex (response)

arm extension and ABduction to the side

sideward parachute (protective extension sideward) reflex (relevance)

unilaterally support body for use of opposite arm; prevents fall

backward parachute (protective extension backward) reflex (onset and integration)

onset: 9-10 months

integration: persists

backward parachute (protective extension backward) reflex (stimulus)

quickly bur firmly tip infant off-balance backward

backward parachute (protective extension backward) reflex (response)

backward arm extension or arm extension to one side spinal rotation

backward parachute (protective extension backward) reflex (relevance)

protects from backwards falls

prone tilting reflex (onset and integration)

onset: 5 months

integration: persists

prone tilting reflex (stimulus)

after positioning infant in prone, slowly raise on side of the supporting surface

prone tilting reflex (response)

curving the spine toward the raised side (opposite to the pull of gravity); ABduction/extension of arms and legs

prone tilting reflex (relevance)

facilitates postural adjustments to maintain COG; maintain equilibrium without arm support