PTE 743: exam 1

infant development, toddlerhood, early childhood, developmental testing, and historical overview

what is the definition of primitive reflexes?

automatic, involuntary movements that are present in newborns and young infants

T or F: development of reflexes parallel typical voluntary movement.

T

poor integration of which primitive reflexes indicate a moderate chance of developmental problems?

moro, galant, ATNR, STNR

what is the definition of postural reactions?

a series of responses that help maintain an upright position; righting reactions incorporate into equilibrium reactions

T or F: postural reactions appear to proceed functional control.

T

list the time frames of the first 4 quarters of life.

1. 0-3 months

2. 4-6 months

3. 7-9 months

4. 10-12 months

what are the main motor “goals” for each quarter of life?

• first= head control

• second= trunk control

• third= horizontal movements

• fourth= vertical movements

at what age does the integration of primitive reflexes occur?

4 months

• rooting, galant, babinski, palmar grasp, crawling, primitive standing, and stepping

T or F: postural reactions usually appear in the first quarter of life.

T

• TLR, landau, labyrinthine and optical righting, body-on-head, and body-on-body

during the first quarter of life, what angle of head control does an infant have in prone?

head unsustained at 45 degrees with forearm support

T or F: during the first quarter of life, an infant’s head remains in midline in supportive sitting and dependent standing.

T

• “head in midline” and head “aligned with body”

play during the first quarter of life is termed “_______ play” because an infant is stimulating movement with his/her actions.

experimental

• hands open consistently

• brings hands to mouth

• playing with fingers, hands, and toes

what is an infant’s acuity during the first quarter of life?

20/100

• improving color, depth, and size perception

T or F: an infant during the first quarter of life lies within Piaget’s sensorimotor substage 1.

F; substage 2 (primary circular reaction)

what is a game that assists with the development of object permanence and causality during the first quarter of life?

peek-a-boo

when do infants begin to recognize universal sounds and imitate vowel sounds?

first quarter: 0-3 months

what emotions appear around the first quarter?

joy, sadness, disgust, and possibly anger

list the reflexes and postural reactions that occur around the second quarter of life (4-6 months).

• landau

• tilt and parachute in prone

• body-on-body righting response with spinal rotation

what is a “big” motor milestone that occurs during the second quarter of life?

rolls from prone to supine

T or F: brief sitting can occur during the second quarter.

T

• with upper extremity support tho

when do infants’ oral motor control improve to more active sucking with liquid loss from lip corners?

second quarter of life (4-6 months)

can infants have solid foods during the second quarter?

yes as long as they have up and down jaw movement

describe the fine motor control that an infant may have during the second quarter?

• grabs toy, holds it, shakes it, and/or brings it to mouth

• picks up toy in one hand and holds it in palm

• reaches or grabs toy with both hands

T or F: an infant in the second quarter can reach and grab for objects as small as a Cheerio

F; they cannot grab the objects until the third quarter (often using the raking motion)

an infant during the second quarter lies within which of Piaget’s sensorimotor sub-stages?

sub-stage 3 (secondary circular reactions)

• selective attention is developing

when does babbling using both consonants and vowels begin?

6 months old

when do the emotions of fear and surprise appear?

second quarter

list the postural reactions that occur during the third quarter of life (7-9 months).

• tilt reaction response in supine, sitting, and maybe quadruped

• protective extension forward and sideways

what is a “big” motor milestone that occurs during the third quarter of life?

sitting independently/without support

when does the radial digital grasp develop?

third quarter

when do teething and sucking on thumb usually begin?

third quarter

T or F: during the third quarter, infants have free use of tongue and can suck liquid from a cup but may still experience liquid loss.

T

describe the fine motor patterns of an infant in the third quarter of life.

• grabs objects with one hand

• holds toy with tips of fingers rather than in palm

• able to place toy on surface without dropping it

when can a parent feed his or her baby spaghetti?

during the third quarter bc baby can now successfully grab at string-like objects

describe the perception-cognition of an infant in the third quarter.

• coordination of vision and sense of touch is developing

• behavior is intentional

• evidence of combining of schema

when can an infant begin to understand words and gestures to communicate needs and wants?

8 months

T or F: at 0-6 months, infants become familiar with individuals and will respond to them, but at the third quarter of life, infants may demonstrate stranger anxiety.

T

list the motor controls that occur during the fourth quarter of life (10-12 months).

• abdominal-thoracic breathing pattern is developing

• protective extension backwards

what is a “big” motor milestone that occurs during the fourth quarter of life?

baby can pull to stand and cruise along furniture

when does baby’s first steps usually occur?

anytime between 12-17 months of age

when does chewing with a mixture of up, down, and diagonal patterns occur?

fourth quarter

describe the fine motor patterns of a baby in the fourth quarter of life.

• develops bimanual dexterity

• demonstrates early hand preference

• throws a ball with forward arm motion

• assists with turning pages

during the fourth quarter, the _____ grasp develops which is described as grabbing a small object with isolated control of thumb and index finger.

pincer

what is an infant’s acuity during the fourth quarter of life?

20/20

• according to some sources, but others say acuity reaches 20/20 at 2 years of age (Dr. Williamson’s slides say both)

T or F: infants slow to habituate to stimulus have better memories than infants who habituate to stimulus more quickly

F; they have poorer memories

when can you expect a baby to say his or her first word?

fourth quarter

what word is important to include into a baby’s receptive language?

“no” —> set limits and expectations of baby

what quarter of life is this infant demonstrating?

first quarter (0-3 months)

what quarter of life is this infant demonstrating?

second quarter (4-6 months)

what quarter of life is this infant demonstrating?

third quarter (7-9 months)

what quarter of life is this infant demonstrating?

fourth quarter (10-12 months)

what age is considered toddlerhood?

13-36 months

at what age is the landau postural reaction integrated?

13-24 months

at what age is equilibrium in standing (with some staggering) present?

15-18 months

when does a toddler’s adult binocular vision develop?

around 2 years old

T or F: self-produced movement in the right environment facilitates depth perception.

T

describe the spatial perception a young toddler experiences when walking/cruising.

• at 13 months: ability to detour around a barrier

• at 14 months: can take shortest route

play during toddlerhood is termed “_______ play” bc babies are understanding functional relationships and basic conceptual categories.

pretend/symbolic

if a toddler presents with a long attention span, what might that be indicative of?

autism

• toddlers usually have short attention spans

T or F: expressive language makes up > 50 words of vocabulary by 18 months and 200-300 words by 24 months.

T

• with two-word phrases by 24 months

what’s the difference between holophrastic speech and telegraphic speech?

• holophrastic speech: a stage of language development when children use single words or short phrases to express ideas

• telegraphic speech: a stage of language development where children speak in short, simple phrases that convey the main idea

at what age does separation protest peak?

at 15 months

appearance of which “self-conscious” emotions begin to develop during toddlerhood?

empathy, jealousy, and embarrassment

T or F: social referencing, gender typing, and beginning of self-regulation develop during toddlerhood.

T

describe the gross motor patterns of a toddler aged 25-36 months.

• jumping from 12 inches with both feet

• running

• ascending stairs with railings

• underhand throwing of a ball

• open doors

what is an example of a toy that toddlers would enjoy and further their gross motor development?

tricycle

• or any feet-propelled wheeled riding toys

describe the fine motor patterns of a toddler aged 25-36 months.

• hold handled cup in one hand

• unbutton large buttons and unzip large zippers

• pouring and filling containers

• stack 4-6 blocks

toddlers can assist with basic hygiene. what are some examples of basic hygiene skills?

washing hands, washing face, and brushing hair

T or F: with a toddler’s improved hand-eye coordination, they can place objects together and complete simple classification tasks.

T

when can a baby recognize and express pain and its location?

toddlerhood (specifically aged 25-36 months)

what are the three mental states of metacognition that babies begin to understand in toddlerhood?

1. perceptions

2. desire

3. emotions

at what age do children begin to transition to adult communications?

by 36 months when children demonstrate functional grammar and can use plurals

when do temper tantrums peak?

toddlerhood (specifically around 25-36 months)

describe the social development a child experiences at the end of toddlerhood.

• talk about their own and others’ emotions

• cause and consequences of feelings

• beginning to control behavior

• difficulty with delay-gratification

what age range is considered early childhood?

3-5 years old

describe the gross motor patterns of a child.

• walking backwards

• ascending and descending stairs foot over foot

• developing advanced motor skills

list the six advanced motor skills of a child.

1. running

2. jumping

3. throwing

4. hopping

5. catching

6. galloping

children should be able to self-dress (shoes, socks, pants, front zippers, snaps, and belt buckles) by age 3 but what two dressing skills are not developed until 5 years of age or older?

1. back fasteners

2. tie shoes

at what age should a child be potty trained?

by 3 years old

at what age should a child brush and floss teeth thoroughly?

by 5 years old

when does primitive reasoning begin to develop?

around 4-7 years old

a child should develop syntax and pragmatic language during early childhood. what do syntax and pragmatic language mean?

• syntax: the arrangement of words and phrases to create well-formed sentences in a language

• pragmatic language: the ability to use language in a way that is appropriate for social situations

at what age should a child improve self-control and be able to distinguish themselves from others in concrete, physical descriptions?

by 5 years old

T or F: a child aged 3-5 is egocentric and unable to understand cause and effect but is beginning to consider other’s viewpoints.

T

describe the main social development points of early childhood.

• 3 years old: play with others

• 4 years old: strong emotion relationships

• 5 years old: cooperative play

IFC model

IFC model case example: an older woman presents with L LE weakness after suffering a MCA stroke. she lives with her husband and currently gets around via wheelchair. her goal for therapy is to stand for longer periods of time to do house work.

• health condition: MCA stroke

• body structure/function: L LE weakness

• activities: cannot stand for long periods of time

• participation: uses wheelchair

• environmental factors: lives with husband

• personal factors: older

what are the three models of motor control?

1. reflex

2. hierarchical

3. systems

reflex theory model of motor control

• reflexes are the basis of all movement

• coordinated movement is the accumulation or compounding of reflexes

• motor control comes from peripheral parts of the nervous system- “peripheralist view”

hierarchical model of motor control

• higher center selects and delegates motor programs to subordinate centers for execution

• basis of traditional neurologic physical therapy

• normal movements driven by motor programs (muscle activation patterns) issued from within the nervous system- “centralist view”

systems model of motor control

• movements are not driven but emerge as result of interaction among many systems, each contributing to different aspects of control

• control of movement includes the neurological system, environment, the musculoskeletal system, etc.

• control is over abstract aspects of motor behavior

what are the three neurologic rehab (therapeutic) approaches?

1. muscle re-education approach

2. facilitation approach

3. task-orientated approach

muscle re-education approach

• patient is an active participant in rehab

• approach is based upon knowledge of gross muscle anatomy and on human willpower

• goal of approach is to strengthen motor units in weak muscles by activating individual muscles and individual motor units

facilitation approach

• assumes nervous system can be modified to control movements more effectively if it experiences “normal” movement patterns guided by “skilled” therapists

• primary neurophysiological aim: inhibit abnormal tone and primitive reflexes and facilitate normal movement patterns

task-oriented approach

• assumes control of movement is organized around goal-directed, functional behaviors

• therapists do not limit training to one “normal” movement pattern but allows patients to learn alternative movement strategies to coordinate motor behaviors as efficiently as possible

list a few ideas on how someone could learn to move to perform functional tasks with somatosensory loss.

• compensate with vision

• proprioceptive training

• practice/develop motor learning and coordination

• assistive devices

• postural control and balance training

feedforward and feedback systems work throughout our body. which theory of motor control has limitations due to these systems?

reflex model

what is the overall order of what a therapist should test during the neurological exam?

1. impairments

2. strategies

3. functional tasks

what is Phase 1 of differential diagnosis?

overview of initial assessment

• comprehensive history taking

• physical exam

• initial diagnosis

• basic diagnostic tests

(from chatgpt)

what is Phase 2 of differential diagnosis?

further investigation and refinement of diagnosis

• targeted diagnostic tests

• referral to specialists

• monitoring disease progression

(from chatgpt)