week 3 Typical Motor Development Birth to 2 years old

Childhood occupations

play, feeding, dressing, grooming, communication, functional mobility

primitive reflexes

involuntary (automatic, CNS) motor responses originating in the brain stem present after birth in early childhood development that facilitates survival. eventually integrated/inhibited by 4-6 m, and replaced with voluntary motor movements

Retention

occurs when reflexes dont integrate, difficulty with volitional smooth movement 

• delayed milestones, poor motor coordination, poor balance and posture, learning difficulties, behavioral concerns, sensory processing 

Delayed milestones

crawling, transitions, walking

poor motor coordination

fine and gross motor, writing, cutting, dressing

poor balance and posture

maintaining balance despite changes in posture

learning difficulties

difficulties with reading and writing

behavioral concerns 

impacts habit and routines 

sensory processing

over or under sensitivity to stimuli

Newborn primitive reflexes

rooting, sucking, moro, spinal galant, symmetrical and asymmetrical tonic neck reflex, grasp, stepping, tonic labyrinthine response 

Rooting reflex

supports infant feeding 

Stimulus: stroke side of cheek 

Response: head rotates to the side of the stimuli, mother opens wide with tongue thrust 

Integration: around 4 m 

Retention: feeding difficulties, speech and articulation, movement and head control 

Sucking Reflex

Stimulus: light touch to inside the mouth 

Response: closes mouth, sucks and swallows, more control 

Integration: around 3-5 m 

Retention: poor suck, swallow, breath coordination. Under development of dissociation of tongue and jaw movements 

Moro (startle) reflex

Stimulus: hold child and drop head more than 30 degrees 

Response: arms extend and hands open (fear) followed by arm flex and hands closed (protect) 

Integration: around 6 - 10 m 

Retention: impacts development of head control, equilibrium and protective reactions 

Galant reflex

Stimulus: in quadruped or supported prone, stoke along side of spine up/down

Response: lateral flexion and hip external rotation towards stimulated side 

Integration: around 3-9 m 

Retention: poor reciprocal movements such as crawling and walking 

Asymmetrical Tonic Neck Reflex (ATNR, Bow and Arrow) 

Stimulus: in supine, turn head to one side

Response: arms and legs extend on nasal (turned side). arms and legs flex on occipital side) 

Integration: around 5-6 m 

Retention: impacts hand eye coordination, reaching, grasping, bilateral coordination, rolling 

Symmetrical Tonic Neck Reflex (STNR)

baby is prone

Stimulus: flex head, extend head 

Response: arms flex and legs extend, arms extend and legs flex 

Integration: around 5-6 m 

Retention: crawling and walking 

grasp reflex (hand and plantar)

Stimulus, Response, Integration, Retention

Stimulus: pressure on ulnar surface/palm or ball of foot

Response: fingers flex/close or toes flex/curl

Integration: around 5-6m

Retention: impacts voluntary release of objects and standing/ambulation

Spontaneous stepping reflex . Stimulus, Response, Integration, Retention

Feet responding to surface underneath, no voluntary control on gait 

Stimulus: supported while bounced on feet 

Response: legs extend, may hyper extend knees 

Integration: around 1-2 m 

Retention: impacts gait, standing, walking 

Tonic Labyrinthine Response 

Stimulus: arms and legs moved into flexion (supine). arms and legs moved into extension (prone) 

Response: extensor tone of neck, arms, and legs increase. flexor tone of neck, arms, and legs increase 

Integration: around 6-10 m 

Retention: impacts turning/rolling, transitions from lying to sitting and crawling 

Righting reactions

motor behavior that appear at 4-6 m and are important in developments of posture. automatic postural responses that allow the body to maintain or return to an upright orientation in space using visual, vestibular and somatosensory input to align the head and body related to gravity 

Equilibrium reactions

motor behaviors that begin to emerge at 7-8 m and include protective reactions of the limbs and curvature of the spine to accommodate trunk displacement. starts to begin when a baby starts to move as they are losing balance. 

Types of righting reactions

landau righting reaction, labyrinthine head on body righting, optical righting, body on body righting

Landau “airplane”

a righting reaction 

Stimulus: head in prone suspension 

Response: hips and legs extend, arms extend and abduct 

Integration: onset: 3-6 m. integrate around 12 m 

Retention: impacts development of prone extension, sitting, standing 

Labyrinthine (head on body) righting reaction

Stimulus, Response, Onset, Integration, Retention

a righting reaction, replies on vestibular (understanding where head is in relation to body) 

Stimulus: head vertically and tilted to the side with eyes covered 

Response: maintains head in upright position. onset: 4-6m, integrate: remains in tact/present throughout lifespan

Integration: never, goes into adulthood, but can be overrided as an adult 

Retention: ability to lift head and perform transfers, maintain head in position despite movement 

Optical Righting

Righting reaction 

Stimulus: head vertically and tilted to the side with eyes  uncovered 

Response: maintains head in upright position using visual information 

Integration: onset: 4-6 m. integrate; remains intact throughout lifespan

Retention: maintain head in position despite movement 

Body on Body righting

righting reaction, correcting to midline orientation 

Stimulus: displace/move the body or the head 

Response:body reorients itself to the surface despite change in head position

Integration: onset: 5-6m. Integrate: remains in tact/present through lifespan 

Retention: impacts ability to move in rotary positions, impact learning to transitions into sitting or quadruped, rolling 

Types of equilibrium reactions

Protective extension, equality reactions

protective extension

understanding if limb protects from weight shifting/falling

Stimulus: holding at the pelvis, provide sudden movement of the head towards floor (threat). in sitting: push forward, to the side or backwards 

Response: arms extend to catch and protect the head 

Integration: onset: 6m (forward, sideways, backwards) 

Retention: impacts protection when center of gravity is displaced 

the order in which Protective extensions show

forward parachute reflex →  slideward parachute reflex → backward parachute reflex

Equilibrium reactions

body shifts to opposite side that surface shifts 

Stimulus: center of gravity is displaced 

Response: head righting (non weight bearing side trunk flexes, arm and leg abducts and internally rotates, elbow wrist and fingers flex). head righting on weight bearing side (truck extend/elongates, arm and leg externally rotate, elbow wrist and fingers abduct and extend)

Integration: onset 6 m. integrates: remains in tact/present through lifespan

Retention: difficulty with transitional movements and maintaining balance 

Postural Alignment

how the head, shoulder, spine, hips, knees, ankles line up with one another. can be good or bad. 

proper: put decreased pressure through spine and assists with good posture and efficient movement patterns 

non proper: out of alignment, puts undo pressure on another join above or below 

Base of support

used to assess postural alignment. Changes based on position: sitting (long sit→ short sit→ ring sit→ W sit), standing, prone (flat → prone prop)

Center of Gravity 

single pt where a persons entire wight can be considered consolidated/centralized. average location of the persons weight  

Weight Shift

chnage in the base of support away from the center of gravity

transitional movements 

help a person move from one position to another. children perform these movements as they learn to move. (rolling, sitting, kneeling, standing) 

Supine

gives largest surface area. lying on the back, stabilizes head, truck scapula. requires anti gravity movement to engage in hand on body, hand to midline, hand to mouth

Prone

on the belly. develops strength and coordination of the trunk and head, lengths muscles of anterior neck, trunk and hip muscles, pushing up on hands develops palmas arches and proximal shoulder control/stability. explains why tummy time is very important 

side laying

narrower base of support. balance is dependent on control of flexor and extensor. offers gravity lessened position of unweighted. allows for exploration of reaching, kicking, hand on hand body exploration. explore midline in various positions 

sitting

becoming more independent in movement. changes in visual orientation allows for improvement in visual perceptual skills. gross motor progression between supine/prone to stand, walking, crawling. requires delicate balance of flexors and extensors 

standing

more narrow than typical sitting. improve LE joint alignment, balance, LE strength + control for walking. Challenges core strength and stability 

What are developmental characteristics seen in newborns?

physiological flexion. asymmetrical. gravity dependent. random extremity movements. turn head to clean airways. eat and eliminate. establish bonds with caregivers. attempt to self sooth. 

One to Two months development

begins to lift head in prone (big prone age). holds head up when in supported position. hand to mouth for self soothing. shows more facial expressions. begins to start improving suck-swallow-breath coordination 

3 to 4 m development

begins to show symmetry. explores different position (supine, prone, supported sitting), rolls stomach to back. begins to grasp toys. hands to midline-holds bottle. improving self soothing. experimenting with voice for expression. not strong enough for sitting (antigravity) without support causes a stacked spine.

5 to 6 m

achieves symmertry. prone prope on extended elbows. plays and weight shift in prone. rolss both directions. sits independently. maintains side lying. improving control of extremities. pull to sit. begins drinking from cup. babbling/imitating sounds.

7 to 8 m

controlled asymmetry. on the move. prone pivot. commando crawling/cruising. pull to stand. various grasp patterns. finger feeding, improving lip seal. increasing speech sounds. 

9 to 10 m 

creeping. variation in sitting position. pull to standing through half kneel. standing with decrease BOS. Walks with two hand held. protective reactions ( b/c BOS is becoming unsupported). greater grasp patterns to accommodate various objects. 

11 to 12 m

emerging independent stand and ambulation. cruises, walks with one hand assist. refining reach and grasp with voluntary supination. eating solid foods with improved oral musculature. increasing speech with some words. 

18 m

walking forward/backwards. stop and turn. pull toys. walks upstairs with hand held. squats during play. small object manipulation. construction toys. 

2 yr

swings arms when moving. run. stairs with railing (2 step), jumps, emerging hand preference. thread beads on lacing string. challenging independence. tool use- crayons, markers. Dont have a hand dominance and it wont show until 5 (still work on developing skills on both sides) 

When does a child start to develop grasping reflex and visual scanning skills?

birth to 3 m

4 m fine motor grasp

• directed reaching, ulnar palmer grasp

5m  fine motor grasp

palmer grasp. 

Whats the typical age for a child to transfer between hands?

5-6m

At what age will a child have a radial palmer grasp and begin to reach with increase accuracy?

6 m

7m fine motor/grasp

radial digital grasp. raking grasp. voluntary release.

When does a child have an inferior pincer grasp and starts picking up small objects?

9 m

8 m fine motor/grasp

radial digital grasp.

9 m fine motor/grasp

inferior pincer grasp. picking up small objects.

What age will a child develop a fine pincer grasp and release into container?

10 m

12 m fine motor/grasp

pincer grasp. release objects in container and surfaces.