Pediatrics (L1) - Theories of Motor Development

________________________ is a critical part of motor development

Postural Control

Which functional skills require come level of postural control?

All of them

(sitting, standing, crawling, reaching, manipulating stuffs, speaking, eating, etc.)

all of the "-ing"s

What is the primary driver of the reflex-hierarchal (neural maturalistionist) theory of Development?

Nervous System

What is the primary driver of the Cognitive theory of Development?

Learning processes/external influences of social scaffolding

What is the primary driver of the Motor Learning Theory of Development?

Predetermined motor programs

What is the primary driver of the Dynamic Systems Theory of Development?

There isn't one!

Involves the interaction of multiple sub-systems within the person, task, and environment

What domains of information can be gathered by watching a child's movement?

- Cognition (what they know)

- Adaptive skills (changing environment)

- Communication (exchanging ideas)

- Social/emotional (connecting with others)

What is the term for the pattern of progression (sequence) of development that is observed within the reflex-hierarchical theory of development?

Cephalocaudal (from head to toe)

What is know to be the main source of maturation of reflex-hierarchical development? (What's the control center behind the neural control structures?)

The Central Nervous System

(R-H development is directly related to CNS development)

T/F The appearance of primitive reflexes is the best way to assess increasing maturity of cortical structures?

False, the appearance AND the disappearance (integration) of reflexes gives the best "big picture" of development

What's the definition of a reflex?

Involuntary stereotyped movement in response to a specific stimuli

When do reflexes begin to appear in da womb (prenatally)?

28 weeks gestation

What are attitudinal reflexes? What does this consist of?

A subtype of infant/primitive reflexes

Consists of:

- Asymmetrical Tonic Neck Reflex (ATNR)

- Symmetrical Tonic Neck Reflex (STNR)

What is typically seen with the symmetrical tonic neck reflex?

The arms follow the head

Neck flexion --> elbow flexion

What is the labyrinthine righting reflex?

An infant's ability to correctly orient their head to vertical following a displacement (tilt) anteriorly, posteriorly, and laterally of 45 degrees or more

What is the appropriate progression of the labyrinthine righting reflex?

- Lifted and steady from prone - 4 months

- lifted and steady from sideways - 4-6 months

- lifted and steady from supine - 7 months

Why is the labyrinthine righting reflex important?

- integration of this reflex lasts throughout life

- emergence supports development of postural control and stability

What's the definition of an equilibrium reaction?

The whole body adapting to a slow change/shift in COM within base of support (trying to remain upright after being messed with).

Tends to involve a rotational component.

ERs include tilting reactions like the head-righting reflex

When does a staggering reaction occur?

in response to instability in the lateral direction

What is a protective reaction responsible for?

Protecting the body from harm AFTER the COM has been displaced BEYOND the BOS

(think about learning to "cover up" in neuro II when you felt the WC falling backwards)

What's the protective reactions development progression (in sitting)?

Forwards - 6-7 months

Sideways - 7-8 months

Backwards - 9 months

What's kinda cool about the sub-systems within the body and their function in relation to the dynamic system theory?

They're constantly crunching numbers and self-organizing to determine the most effective movement solution for each specific task

Compared to the progressions of some of the other developmental theories... the dynamic system theory stands out because...

- it's development is non-linear and doesn't adhere to a time-table

- Huge variability in that one sub-system can take charge and alter direction of development

- It lacks a control parameter in that the driving influence can change over time

The development of postural control relies heavily on the complex interaction between... ?

Neural and musculoskeletal systems

AND

the environment

What is "body schema"?

Understanding the body and the relationship of its parts as a whole

How does a child develop a "body schema"?

By moving in a gravity environment and having some serious trial and error

T/F: Steady-state postural control is NOT present at birth.

True

If you see a baby that's fresh out the oven and they're wiggling all over the place, is this a bad thing?

Nope. According to Prechtl, this disorganized movement is indicative of a intact neural system

What is the first main sensory driver to the development of motor control whether that's head control or other gross motor skills?

Vision

What sense is considered to be responsible for calibrating somatosensory inputs for the control of head posture?

Vision!

Remember: Babies rely on Visual input before Somatosensory input

What's the general rule of thumb when guiding an infant to the development of motor control?

Start with maximal support and limitations of their DOF for safety, then gradually decrease their support and increase their DOF as they gain control.

What type of balance control typically emerges first in a rapidly developing newborn?

Reactive balance appears BEFORE anticipatory control

In order for an infant to learn how to control swaying when standing/walking, which two strategies must be combined and utilized?

- Exploratory postural sway (F Around)

- Performatory postural say (Find Out)

At what age do children have postural control similar to that of adults?

7-10 years old

When does a child tend to exhibit signs of multisensory reweighting to be more stable and upright in standing (refined sensory organization for standing)?

4 years old

What are the key features of motor learning?

- Learning through exploration through variability and error

- Repetition, repetition, repetition

- Loads of trial and error

What are the 5 key differences between motor learning in children vs. adults?

- Children grow fast so their idea of motor control is constantly changing

- Children have decreased information-processing ability

- Children require goldilocks feedback schedules

- Children require age-specific practice schedules

- It takes a long time and a ton of practice for a child to develop a new motor skill

What are the specific deficits in cognition that children have that would make learning hard?

- able to process less information in general

- slower information processing rate

- decreased selective attention and object recognition

What practice type has been found to be most effective to use with a child at first?

block practice

How many steps and falls per day does the average toddler experience?

14K steps (46 football fields)

100 falls