Wk 7-10 Neurology

What are the princples of Pediatrics?

Functional: Activities and goals must be functional and play‑based for children

Holistic: Considering all ICF domains + the child’s support network.

Strength-based: Focusing assessment and intervention on the child’s strengths.

Culturally responsive: Resident’s individual and communities' cultural beliefs, customs and traditions.

Activity & Participation: Supporting the resident’s activity and participation, considering what is important

Evidence based: Evidence based practice is essential to high quality care

Goal orientated: Autonomy over their goals and priorities and therapy should target these.

Inter-professional team: Intervention should include multiple members of the interdisciplinary team

Active over passive: Children should actively engage in therapy; active, variable tasks are most effective.

Aim for quality & efficiency: Goal should be to work towards function that is high quality and efficient

Age-appropriate Activities: Ensure activities selected are age appropriate for the resident

What is the core idea of Neuromaturational Theory? + key limitations

Development occurs through predetermined brain maturation in a hierarchical sequence

• i.e., sitting happens before crawling, then standing, then walking etc.

Limitations:

• Ignores environment

• Caregiver influence

• Infant competencies

What is DST? And what are the 3 factors influencing development in Dynamic Systems Theory (DST)? + limitations

Used to explain the development of postural control

1. Individual

2. Environmental

3. Task factors

Limitations:

• Does not consider neuroplasticity or innate competencies

What are the two stages of Neuronal Group Selection Theory (NGST)?

• Primary variability (highly variable spontaneous movement)

  • Tool 1: Movements → writhing/ squirming/ whole body, with waving arms and kicking legs

  • Tool 2: Reflexes → Response to stimuli

• Secondary variability (trial‑and‑error learning)

  • Emerging

  • Consolidating

  • Refining

Why is variability important in Neuronal Group Selection Theory (NGST)?

It drives neural connectivity, synapse formation, and adaptive motor learning.

What characterises early spontaneous infant movements?

Smooth, variable, non‑reflexive whole‑body movements.

What are survival reflexes?

Reflexes essential for survival at birth (e.g., breathing, sucking, blinking).

What are primitive reflexes?

Reproducible movement patterns in response to specific stimuli.

What factors increased sitting proficiency?

Context (surfaces, positions), opportunity (time in sitting), caregiver proximity.

Key gross & fine motor milestones (0–3 months)?

Gross:

• Forearm prop

• Emerging head lift

• Symmetrical supine

• Fidgety movements

Fine:

• Hand‑to‑mouth,

• Grasp reflex

• No active release.

Key gross + fine motor milestones (3–6 months)?

Gross:

• Rolling supine→prone

• Swimming in prone

• Sits with support.

Fine:

• Gripping objects

• Unilateral response

Key gross + key motor milestones (6–9 months)?

Gross:

• Crawling

• 4‑point kneeling

• Pull to stand

• Transitions in/out of sitting

Fine:

• Bilateral reach

• Releasing objects

Key gross motor milestones (9–12 months)?

• Cruising

• Standing

• Walking

• Climbing

Gross motor milestones at 12–18mths / 18-24mths / 2-3 years / 3-4 years / 4-5 years?

2-18mths → First steps, walking, climbing, throwing/rolling ball.

18-24mths → Kicking ball, stairs with assistance, early running.

2-3 years → Jumping, running, stairs, standing on one leg

3-4 years → Hopping, tandem walk, tricycle riding

4-5 years → Catching, skipping, bike with training wheels

What are the 3 components of paediatric subjective assessment?

1. Rapport

• Build relationship

2. Informal observation

• State of arousal, parent-child relationship, interaction w/ environment, active movements

3. Shared information

• Medical/birth/birth history, developmental history, main concerns/priorities, goals

What is task analysis in paeds?

Breaking down what the child can/can’t do, how they do it, and what is possible

What systems must be assessed objectively?

• Gross motor

• Neuro‑motor

• Musculoskeletal

• Sensory,

• Fine motor

• Feeding

• Communication

• Learning

What defines atypical development in peds?

Inefficient, uneconomical, unsuccessful, or dependent movement patterns.

What can disrupt NGST and lead to atypical development?

In‑utero events, genetic conditions, neurological injury, limited environment/caregiver support.

What is child abuse? + When must you report?

Single or repeated incidents causing or risking significant harm

• Report when a child is harmed or at risk AND caregiver is unwilling or unable to protect them. Call 000