most important stimuli for infants
skin contact ans warmth
Co- activation
create stability, for example bicep and triceps both muscles are activating one of the muscles has to stay back when the other is activated, so movement occurs
spastic CP
Hypertonic and spastic, know that increase movement can lead to more spasticity, distribution is in all four extremities or half side hemi or quad
dyskenstic CP 3 types
athetosis-fluctuation of tone, poor co activation not able to stabilize difficult for pt to grasp, will look different in every child
Choreoathetosis- jerky movements from high to low
Dystonia- twisted abnormal movement
ABNORMAL TONE IN DYSKENSTIC
ALL FOUR EXTREMITIES quad
Ataxia
clumsy, public intoxication, someone walking thats drunk
mixed
combination of high and low tone
flexor synergies occurs in
upper extremitites
extensor synergies occur in
lower extremitites
IND
intellectual disability IQ
DYsarthia
motor issue unable to speak
Dysphagia
difficulty swollowing
Growing into disability happens with CP
Impairments such as contractures poor body alignment can change over time with growth
Positioning-
wedged, special chairs, positioning support *is static, using varity offer multiple experience Neuroplasticity is huge in children, keep them going it can only benefit them in there function
Handling
is Dynamic* key points of control, balbath
sensory Integration FOR
jean Ayres providing controlled sensory input
organizing the childs sensory input equalizing the highs and lows
inhibition
weight bearing, slow rocking, vibration, sustained pressure on tendon not directly on muscle belly
Facilitation
quick stretch, tapping, fast input, brushing, joint compressions
public law99457
part C birth to 3
part b 3-21
stress
normative life event
when working with families most important role
consultive
Cota cannot work in
NICU
MD with Duchenes
its progressive wheelchair bound by 10-11, muscle mass replaced by fat and scare tissue
types of juvenile arthritis
still disease, pauciarticular, polyarticular
Arthrogryposis
joint in LE and UE affected but not the spine
Osteogenesis imperfecta
bones donnot develop correctly
Amputation
congenital or acquired, thumb and below elbow most common
Achondroplasia Dwarfism
stunted growth, disorder of growth cartilage, different physical features
Down syndrome
trisomy 2, low muscle tone, facial features
cri du chat
rare, weak, meowing cry, widely based downward eyes, failure to thrive, intellectual disabilities, developmental delay
Fragile X
genetic cause by limited brain development, intellectual diabilities
prader willi syndrome
over eating, self mutilation, intellectual disablities, outburst, better of in a group home, structured environment
Spina bifita
one or more vertebra not formed properly
occulta
meningocele
myelomeningocele
Erb Palsey
caused by stretching or tearing nerves in the brachial plexus
Retts syndrome
only females unable to walk, breathing problems,intellectual disabilities
Hematologic disorder
anemia, sickle cell anemia
pulmonary Disorder
Asthma, cystic fibrosis
burns
thermal, electrical, chemical, radioactive
test-rule of 9
percent of body surface
neoplasm disorders
abnormal growth of tissue
leukemia
tumor in CNS
bone cancer and solid tumor
Augmentative and alternative communication device
low-tech: picture exchange communication system PECS
High-tech: voice output communication aid VOCA
low vs high tech
low: easy to obtain, easy to use, low cost
high: more difficult to obtain, required greater skills, costly
switch modes
direct mode: maintain contact with switch
switch-latch mode: turn on and off
timed mode: activate turn on for programmed amount of time
to reduce aspiration and facilitate swallowing in an infant
slightly flexed
foundation of all eating patterns
24 months
peigi sensory motor stages
0-2
HEP
client centered, related to goal, realistic, simple directions
most advanced grasp
Dynamic tripod
ulnar palmar
4-6m
radial pamar
6-7m
raking
7-8m
lateral pincer
8-9m
fine/neat
10-12m
3 jaw chuck
10-12m
palmar supinate
1-2years
digital pronate
2-3years
scissors
5years
static tripod
4-6 years
dynamic tripod
6-7years
NDT concept
neuroplasticity
frontal lobe
organizer of all function
inhabitation
ability to stop ones actions at an appropriate time
shift
ability to think freely
emotional control
regulate emotions
POC, FOR and models
frame our practice
Direct selection
straight forward method of making a choice either yes or no
indirect selection
requires intermediate steps to selection scanning and coding
direct selection
is more difficult requires more refinement and controlled movement, faster and less cognitively complex
play
an intrinsic activity engaged for its own sake rather than a means to an end
environmental control units
require input and output
CP
not progressive, affect development of CNS brain and spinal cord
tay-sachs
degenerative disorder
infections
meningitis, encephalitis
Anoxia ischemic encephalopathy
lack of oxygen blood flow to the brain
hypotonia
decrease tone, flobby
hypertonia
increased tone, stiff
Common problems of motor development we will see in Cerebral palsy
hypermobility, abnormal muscle tone, poor sensory processing, muscle weakness, decreased exploration of the environment
reflex hierarchical model believes in
concept of hard wiring repetitive necessary for motor learning
Hand writing is a complex skill
visual perceptual, fine, cog, sensory, gross
pre writing strokes
2-3 should be doing vertical and horizontal lines pg 423
3-4 circles and intersecting line
4-6 diagonal lines and ability to form shapes
learning style
visual, Auditory, kinesthetic
VIsual perception skills
Visual discrimination: the ability to detect a difference or distinction between one item or picture and another, for example: the ability to identify which picture is not like the others.
Visual memory: the ability to remember a shape or word and recall
facilitation
are used to increase muscle tone to a normal level
ex:Light moving touch, tapping, fast vestibular input, heavy joint compression, weight bearing and weight shifting, quick and variable movements, stimulating environment
inhibitory
are used to reduce hypertonicity (increased muscle tone)
Sustained pressure on tendon, slow rocking, rolling, or stroking, rotation, weight bearing and weight shifting, heavy joint compression, wrapping or swaddling, hand vibration, calming environment
�The Peabody Developmental Motor
The Peabody Developmental Motor Scale-2 evaluates copying and
writing readiness skills and provides an
age-equivalent score on grasp development
The Test of Visual Motor Integration
The Test of Visual Motor Integration-Revised combines both the developmental sequencing of geometric shapes and visual motor integration.