465 Exam 2

Personal resources

Each resources has its own developmental trajectory, which varies among each person

Newell's Model of constraints

An individual's motor behavior involves multiple factors, including the person's personal attributes, task requirements, and environmental conditions.

7 Components of DST model

Self organization, Context and task, Attractors, Nonlinear phases shift, Intrinsic dynamics, collective variables, modeling the attractor dynamic

Self organization

Patterns of behavior emerge spontaneously from the cooperation of multiple subsystems

Subsystems are any internal or external factor that affects performing a behavior

They are able to self organize

Context and Task

Context refers to the interrelated conditions in which a behavior exists.

Task refers to the behavior to be performed, the overall function or objective of a behavior

Attractors

Preferred patterns of behavior

An attractor pattern can be stable or unstable

In order for one attractor to be replaced by another, some component of the system must disrupt the current stability, induce variability or make other solutions possible so that the system can explore alternatives

Nonlinear phase shift

Shifts in behavior from one pattern to a new pattern to accomplish the same task often nonlinear; the new pattern is distinctly different

A critical component in this construct is called a control parameter, it is the last subsystem to converge that pushes the system into a new pattern of behavior

Intrinsic Dynamics

Collective behavior of a system that occurs in the absence of specific task requirement (extrinsic)

This arises from one's history, biomechanical properties, neurophysiological properties, it's what each performer brings to a movement context.

Collective variables

When multiple subsystems self organize and result in a patterned behavior, that behavior can be characterized

A collective variable is a low dimensional descriptor of a complex system's behavior, often expressed as an equation of motion.

Modeling the attractor dynamic

Placing the motor behavior in the context of a natural physics law

A behavior is developed out of discovery, but within the context of natural physics law

Dynamic Systems Theory (DST)

DST proposes that behavior results from the interaction of multiple subsystems

Dynamic systems: A complex system that changes over time, reflecting interaction of multiple subsystems; changes are often nonlinear, and behavior can be characterized by relatively simple equations of motion

components of DST

Interaction of multiple subsystems: multiple things organized to produce a behavior

Changes are nonlinear: they are variable and often do not occur within a specific trajectory or at a steady rate

Characterized by a simple equations of motions = behaviors produced make biomechanical and energy efficient sense and are the result of specific factors that collectively produce a behavior

What encourages those with DS to participate in physical activity

Perceive social opportunities
( Most reason to be active)

Highly structured environment
Motivating environment

A sibling is present

Down Syndrome

Genetic diseases
Trisomy 21: Trisomy is a genetic abnormality in which there are three copies, instead of two of a chromosome
1/733 live births
Shortened life span
Diagnosed before or at birth

Symptoms of DS:

Flattened facial features • Upward slanting eyes • Small head • Vision issues • Hearing/vestibular issues • Oversized tongue • Often protrudes • Small body stature • shorts arms/legs • Short fingers • Syndactyly • Webbing of digits • Typically surgically corrected in infancy

Cerebral palsy

Disorder of movement, muscle tone or posture caused by lesion in the developing brain

Occurs before, during or shortly after birth

Signs and symptoms appear during infancy or preschool years

Impaired movement association w exaggerated reflexes/rigidity of the limbs and trunk, abnormal posture, involuntary movements, unsteadiness of walking

Spastic CP (50%)

Repetivie contraction of affected muscles

Hypertonic muscles, mostly flexors and internal rotators, nearest limbs tend to pull towards midline, display spastic or scissor gait

Athetoid CP (30%)

Damage to basal ganglia
Muscle tone fluctuates from hypertonic to hypotonic
Involuntary muscle movement
Difficulty in head control
Lordotic posture
Difficulty with eating,drinking speaking, tracking objects, performing quick accurate movements

Altaxic CP (10%)

Damage to the cerebellum

Result in balance & muscle coordination issues
Diagnosed at onset of walking
Display ataxic gait: wide, unsteady
Difficulty in basic locomotor skills
Clumsy, frequent fall
Involuntary eye movement

Symptoms of CP

Intellectual impairment
Epilepsy
Chronic pain
spasticity
Gastrointestinal issues
Vision problems
Hearing problems
Stunted growth
Over or underweight
Scoliosis or lordosis of spine
Contractures

Who benefits from cochlear implants

Conductive hearing loss does

Hearing loss vs hard of hearing

Hearing loss is the #1 disability in the US
Hard of hearing- refers to a hearing loss that makes understanding speech through the ear alone difficult but not impossible (MOST PEOPLE ARE THIS NOT DEAF)

Conductive hearing loss

Sound is not transmitted well to inner ear
No distortion but words are faint
Hearing aids often help
Most have intelligible speech

Sensorineural hearing loss

Occurs when there is is damage to the inner ears coachella or to nerve pathways from inner ear to brain

Vision Loss

total blindness, legally blindness is several steps above
Visual impairment refers to least severe
Loss of vision is more disruptive to motor control development than loss of any other sensory system -onset of motor skills significantly delayed

Spina Bifida

Developmental congenital disorder caused by the incomplete closing of the embryonic neural tube
Congenital disorder: abnormality that develops at or before birth, most likely in the embryonic phase of development (3-8 week gestation)
Neural tube: Embryo's precursor to CNS, which comprises the brain and spinal cord.

Muscular Dystrophy

Neuromuscular disease
Dystrophy: Degeneration of muscles
Group of inherited diseases characterized by progressive diffuse, weakness or various muscle groups
Secondary complications to muscle degeneration are fatal ( such as respiratory failure)

Becker (MD)

Insufficient production of dystrophin
Onset: adolescence or adulthood
Life expectancy: mid to late adulthood

What is ASD

Autism spectrum disorder and autism are both general terms for a group of complex disorders of brain development


includes autistic disorder, Asperger's disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) • DOES NOT include Rett syndrome, as previously thought. Why?

What are some signs of autism

Difficulties in social interaction, verbal and nonverbal communication, an repetitive behaviors

Can be associated with ID, difficulties in motor coordination and attention, physical health issues such as sleep and gastrointestinal disturbances.

Some excel in visual skills, music, math and art

What is FMS

Fundamental motor skills

Ex:running, jumping, throwing, catching

Differentiate between the main types of muscular dystrophy

Myotonic (Steinert’s disease)

Congenital myotonic dystrophy

Facioscapulohumeral (Landouzy-Dejerine dystrophy)

Duchenne

Becker

Limb-girdle

Oculopharyngeal

Distal

Emery-Dreifuss

Congenital

Differentiate between the 3 types of spina bifida

Myelomeningocele- (spina bifida cystica)

Meningocele- (spina bifida cystica )

Meninges: membranes that cover brain and spinal cord

SB cystica: a cyst protrudes through the defect in the vertebral arch
The defect is externally visible

Describe ASD related motor delay

Head lag reported as one of the earliest signs of ASD

Retrospective video suggest that motor delays are present prior to walking, qualitative differences in movements involving major milestones, such as lying sitting, crawling, walking evident 6-12 months

Young children with ASD 12 to 36 months found significant gross motor delay


Conclusion: Findings suggest that motor delays are evident by preschool and have potential to become a diagnostic indicator, but what about relationship to communication and social skills

DS medical complications

Heart defects (50%) are born with a defect
Leukemia
Upper respiratory infections
Alzheimer's
Sleep apnea
Obesity
Thyroid issues
Atlantoaxial Subluxation ( loss of ligamentous stability between atlas and axis causing instability of joint )

ASD risk factors and cause

No one cause of autism just as there is no one type of autism

Rare gene changes, mutations, associated with autism

Most cases caused by combination of autism risk genes and environmental factors influencing early brain development

Aging parents, especially father increase risk

If you have one child with ASD, 2-18% chance of having a second

Stepping response in DST

Task: Newborn stepping,

Context: Disappears in some connects (ankle weights), but not in other postures (leaned forward) and contexts (chest high water)

Duchenne muscular dystrophy

What: An absence of dystrophin (protein that helps keeps cells intact)
Most severe
Most common

Cause: X-linked recessive gene inherited from mother

Onset: age 2-3

Symptoms
Muscles wasting og hip, pelvic, thighs shoulders (first )
Muscle wasting of all voluntary muscles, heart and respiratory muscles (progression of systems)
Enlarged Calves

Loss of walking in late childhood
Life expectancy: mid 20s or early 30s- die of respiratory complications

Motor behavior of a person with Duchenne muscular dystrophy

Frequent falls
Waddling gait
Slow movement, slow reaction time
Difficulty getting up from sitting/lying (Gower Maneuver)
Lack of coordination

Muscular dystrophy cause

Cause: X-linked recessive gene inherited from mother
Incidences: 1 in every 3,600 males

Spina bifida medical complications

Depression/low self-worth
Precocious puberty (early onset)
Cystica may cause
Hydrocephalus: excess CFS increase pressure on brain, treated with a shunt
Neurological deficits
Seizures
ID
Paralysis
Bowel/bladder incontinence
Chiari ii malformation
Herniation of brain from foramen magnum
Tethering spinal cord
Latex allergy
Pressure sores
Bone density issues

Muscle tissue in muscular dystrophy

Dystrophy: degeneration of muscles

Symptoms of muscular dystrophy

Progression of symptoms
Fatigue
Weakness & wasting in voluntary muscles
hypotonia
Progressive joint deterioration (contractures, stiffness, deformities)
Foot drop
Spine curvature
Loss of mobility or increased difficulty
Increased risk of respiratory infections.

What is TBI

Acquired injury to the brain
Caused by external force
Does not apply to brain injury resulting from congenital, degenerative, or birth trauma

Spina bifida diagnosis

Occulta diagnosed at birth
Imaging studies- detect
Often undiagnosed

Myelomeningocele and meningocele (cystica) diagnosed in utero

Blood tests: alpha-fetoprotein (AFP)
If pos, ultrasound is ordered

Ultrasound- image of defect on spine or in brain
If pos AFP, but negative ultrasound, amniocentesis is ordered

Amniocentesis- elevated levels of AFP
If defect is open, CFS will leak into amniotic fluid, high AFP

Walking therapy in DS

When do babies with DS walk
24 months avg
Treadmill training allows them to walk 4 months early

Teaching someone with ID

Minimize distractions , careful w senses
First person term

Person first terminology

First person terms
Incorrect: The autistic boy
Correct: The boy with autism
See the person first not the disability
(This is challenged by those who identify with their disability)

Norm Referenced

Assessment instruments that are QUANTITATIVE elevations designed to compare a person's skills and abilities with those of others from similar age, sex, and socioeconomic categories

Criterion Referenced

Assessment instruments evaluate the quality of a person's performance
Comparing to criteria, NOT others performance

Rehabilitation Act of 1973

Prohibits discrimination on the basis of disability in federally supported programs employment and agencies
4 key sections
Section 504: is one of the most interest to APA
Focuses on educational rights

PL 94-142

1975
Education for all handicapped children act
Requires public schools to accept federal funds to provide equal access to education for children with physical and intellectual disabilities and ID
IEP
Protects the right of parent and youth with disabilities

ADA (1990)

Americans with disabilities act
Prohibits discrimination and guarantees individuals with disabilities the same opportunities as everyone else
Employment, public entities, accommodations, telecommunications, misc. Provisions
Modeled after the civil rights act of 1964
Discrimination based on race, religion, sex, national origin, and other characteristics are illegal.

IDEA

Individuals with disabilities act (1990)
Reauthorization of education for all handicapped children
Governs how to provide early intervention, special education, and related services to children with disabilities
FAPE
Free and appropriate public education
Meets the educational standard of the state
Includes what is recommended on an IEP

Spina Bifida Risk factors

Maternal diabetes • Maternal anti-seizure meds • Maternal increased temperature • Hot tubs/saunas • Agent Orange herbicide exposure • Agent Orange Benefits Act (1997) • Offers benefit package for Vietnam vet's children who were born with spina bifida

Most common form of DS

Trisomy 21: Trisomy is a genetic abnormality in which there are three copies, instead of two of a chromosome

Developmental period

Conception- 18

Most common cause of ID

Down syndrome

Atlantoaxial what should be avoided

Anything that places the neck in vulnerable
situations that could result in stress or pressure on the cervical vertebrae
Football, wrestling, some gymnastics, heading in soccer, diving, etc.

What is play

Enjoyable, spontaneous, voluntary and intrinsically motivating
• Play is an important aspect of a child's physical, cognitive, social, linguistic and emotional development

Why is play behavior important

Development of gross motor skills afford opportunities for children to participate in play, however interactions may hinge on how well a child is able to perform FMS • Strong interaction between physical and social domain during critical periods in development