Developmental Milestones

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Developmental Milestones
2013-08-06 19:50:52

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  1. Grasp Patterns (cube)
    • 1. 4m-primitive squeeze: hand pulls object back to squeeze precariously against other hand or body, no thumb inv.  
    • 2. 5m-palmar grasp: fingers on top surface of object press into center of palm with thumb add.  
    • 3. 6m-radial-palmar: fingers on far saide of object press it against opposed thumb & radial side of palm (7m-wrist straight)
    • 4. 8m-radial-digital grasp: object held with opposed thumb & fingertips, space visable between (9m-wrist extended)
  2. Stages of holding pencil
    Put in order or development
    1) static tripod
    2) palmar-supinate grasp
    3) dynamic tripod
    4) digital-prontate
    • 1. palmar-supinate 1-1.5
    • 2. digital-pronate 2-3
    • 3. static tripod 3.5-4
    • 4. Dynamic tripod 4.5-6
  3. Stages of release
    • 1. 0-1m no release
    • 2. 1-4m involuntary release
    • 3. 5-6m two-stage transfer (taking hand grasps before releasing hand lets go
    • 4. 6-7m one-stage transfer (taking hand & releasing hand perform simultaneously
    • 5. 7-9m voluntary release
    • 6. 9m release by full arm extension
    • 7. 12-15m precise, controlled release into small container wrist extended
  4. Development of Cutting
    Put in order from youngest to oldestcomplex figures
    1. Complex figures
    2. holds, snips, open & close in controlled manner
    3. circles
    4. geometric shapes
    5. straight forward on line
    6. simple figures
    • 1. 2-3 yrs: holds, snip, open & closes controlled manner
    • 2. 3-4: straight forward on line
    • 3. 3-4: geometric shapes
    • 4. 3.5-4.5: circles
    • 5. 4-6: simple figures
    • 6. 6-7: complex figures
  5. Feeding Skill Development
    Put in order youngest to oldest
    1. scoop food & bring to mouth
    2. take cereal from spoon
    3. finger-feed soft foods
    4. hold & bang spoon
    5. self-feed by sucking on cracker
    6. bring filled spoon to mouth
    • 1. 5-7m: taking cereal from spoon
    • 2. 6-9m: self feed by sucking on cracker
    • 3. 6-9m: holding & banging a spoon 
    • 4. 9-13m: finger-feed soft foods
    • 5. 12-14m: bringing filled spoon to mouth
    • 6. 15-18m: scooping food & bringing to the mouth
  6. Grasp patterns
    • 1. Ulnar palmar
    • 2. primitive squeeze-no thumb involvement
    • 3. palmar grasp-thumb adducted
    • 4. radial-palmar
    • 5. radial-digital
  7. What age?  
    Hand held rattle, wrist bracelet for visual & auditory awareness
  8. What age
    Communication device
    12-18 months
  9. Button switch for cause & effect
    6-9 months
  10. in-hand manipulation
    turning pages in a book
    • shift
    • linear movement of each page on the finger surface.  Thumb opposed
  11. in-hand manipulation
    unscrewing a bottle cap
    • simple rotation
    • turning/rolling of an object held at the finger pads with the fingers acting as a unit & thumb in opposition
  12. in-hand manipuation
    picking up coins or placing coins in slot
    • finger to palm translation
    • palm to finger translation
    • linear movement of an object from the palm to the finger or fingers to the palm
  13. in-hand manipulation
    Turning pencil over to erase
    • complex rotation
    • rotation of object 360 degrees
  14. in-hand manipulation
    picking up pennies with thumb & forefinger while sorting them in the ulnar side of the hand
    • in-hand manipulation with stabilization
    • several objects are held in hand & manipulation of one object occurs while simultaneously stabilizing others.
  15. sit unsupported
    8-9 months
  16. Quadraped position
    7-12 months
  17. For a child recovering from partial thickness burns, what do you encourage during ADL training
    Use full AROM without use of adaptive equipment to maintain ROM
  18. Sensory integration invloves
    individualized tx from trained therapist in neuroscience.  Goal is to improve neurological functioning vs skill development.
  19. TEACCH curriculum
    • individualized or small groups
    • structured environment
    • increase communication, social skills, fine & gross motor, and self-help skills
  20. What should you avoid when working with child with juvenille arthritis
    What do you want to ensure in therapy
    • resistive materials such as clay, leather, copper sheets
    • this causes pressure to joints which exacerbates the condition
    • joint protection & energy conservation
  21. T/F A child with mental retardation who is learning to dress I would benefit from 
    A. Adaptive clothing
    B. Adaptive equipment
    C. proper positioning
    D. adapted teaching techniques
    D-All aspects of dressing depend on the child's ability to learn procedures; thus one must consider task analysis & teaching approach first such as chaining or behavioral modifications.
  22. WB ___________ flexor tone
    Traction _________spasticity in flexor muscles
    • inhibits
    • increases
  23. T/F
    First step in general problem analysis of a child's OT eval is to identify the critical elements of development & role performance for the age of the child
    • T
    • Next: define & describe the child's problems
    • Last: consider the effects of the the problem on developmental tasks & performance
  24. Child with low tone & difficulty performing act. against gravity.  OT wants child to play.  What is the best position to encourage play.
  25. What type of play
    helps children develop body scheme, sensory integrative & motor skills, and concepts of sensory characteristics & actions on objects.
    Unstructured obstacle course
    exploratory play
  26. What type of play
    associated with development of language and concepts
    dress-up materials
    Symbolic Play
  27. What type of play
    refinement of skills in activities that allow construction, social relationships, and dramatic play
    finger painting
    Creative Play
  28. What type of play
    leisure experiences that allow exploration if interests and roles
    arts, crafts, sports
    Recreational Play
  29. Long-thin nipple
    • recessed tongue
    • assists with bringing the tongue forward while feeding.
  30. wide nipple
    cleft palate
  31. single hole nipple
    children who perform better with a steady flow of liquid versus a burst of fluid typically provided via nipples with several holes
  32. broad-based nipple
    • cleft palate 
    • tends to create suction
  33. T/F Adult's hand when feeding from the side
    jaw opening & closing are controlled with your index finger & middle finger; place thumb on the cheek.
  34. T/F Adult's hand when feeding from the front
    jaw opening & closing are controlled with your index finger & middle finger; place thumb on the cheek.
    F-thumb placed on chin with middle finger under the chin to control opening & closing & index finger rests on the side of the child's face
  35. T/F Picking up raisins with pair of tweezers targets isolation finger use
  36. T/F Drawing on sandpaper targets isolated finger use
    F-used to increase kinesthetic awareness & finger strength
  37. T/F Copying shapes is primarily a perceptual motor task
  38. T/F Rolling out play dough is primarily a perceptual motor task
    F-promotes bilateral hand use & development of palmar arches.
  39. T/F Interventions for the transition from school to adult life should focus on real-life fun. activities in actual work settings.
    • T-working in natural setting affords students opp. to develop skills necessary for success in community jobs.   
    • Working in sheltered workshop or their own school doesn't provide real-life settings for job training.
  40. T/F 5 yr. old child is considered age-appropriate if he can dress unsupervised, tie & untie knots, but generally doesn't know how to tie a bow independently.
  41. Put in order
    in/off, on, behind/first/last
    • in/off 30 months
    • on 36 months
    • behind, first, last 5.5 yrs.
  42. Backward chaining
    • OT completes all steps of tasks except last one.  As child becomes competent, the OT completes all but last 2, and so on until the child is able to perform the entire activity.  
    • Method provides immediate gratification & useful for children with low frustration tolerance & poor self-esteem.
  43. Physical guidance
    provides least amount of cognitive ability & provides children with opp. to learn through sensory motor experience.
  44. Forward chaining
    • Begins with child completing the first step and OT completing the rest.  When competent, child progressively takes on more steps.  
    • Beneficial for ind. who have diff. with sequencing & generalization.  
  45. T/F Co-contraction is the ability of the opposing muscle groups to contract at the same time, providing stability around a joint
    • T- To assess for co-contraction for sitting balance, sit child in unsupported chair & ask child to grap OTs thumb & gently rock to see how lone they maintain seated position.  
    • Push and pull in in an arch like motion, up & toward the child & down and away from the child.  Child should be able to stay relatively still.
  46. T/F Righting reactions help child right head against gravity and realign bodies around movement of head.
    T- child who is in prone and then moves to pron on elbows is showing righting reactions
  47. T/F Reactions proceed from equilibrium to righting to primitive reflexes
    F- primitive reflexes to righting to equilibrium
  48. T/F children with innate temperament problems need cognitive strategies to help overcome anxiety in order to approach and participate in activities.
  49. Presbycusis
    age-related sensorinural loss that results in decreased hearing.
  50. How would you use a tongue depressor to help with a hyperactive gag reflex
    • walk it from the front of tongue to the back
    • can desensitize gag reflex
  51. When working with a child with mild CP in a preschool setting, what type of intervention approach should be used to develop typical grasp patterns
    Grade the sizes & shapes of objects to be grasped.
  52. An adolescent with C4 injury.  During initial session, what should OT do
    • set up chin operated bed-side ECU to access the environment
    • call staff, operate TV/radio, answer phone, turn on/off lights
    • Gives adolescent self-control
  53. What ages
    A. wiping tabletop
    B. Taking out trash
    C. sorting laundry
    D. making bed
    E. Picking up and putting away toys when reminded & copying parents
    • A. 3yrs
    • B. 5 yrs
    • C. 4 years
    • D. 5 years
    • E. 2 yrs
  54. A school-aged child with Rett's syndrome has lost skills.  What is the best for the OT to recommend to the parents.
    • Perform PROM to prevent contractures
    • Rett is progressive disorder.  If child is school-aged highly likely that she has significant functional decline.  Can't regain lost skills.
  55. Cataracts cause loss of _______vision.
    T/F Ind. with cataracts have diff. with glare.
    • central
    • T-no direct lighting
  56. Prism glasses
    • bend light by 90 degrees
    • This angle allows ind. who are lying on their backs to read anything that is resting on his lap or watch TV
    • Good for those with limited mobility and help with neck strain.
  57. This type of adaptation helps child with dysphagia drink from cup while protecting airway
    nosey cup-allows child to keep chin tucked when drinking
  58. These adaptations helps with what
    drinking spout with small opening, pinching straw, or suing a vacuum feeding cup with a control button
    methods caregivers use to control or slow the rate of liquid intake for ind. who demonstrate poor judgement or impulsivity.
  59. What types of cups and utensils are best for child with bite reflex
    plastic cups and plastic-coated untensisl, these prevent damage to oral structures
  60. What child would benefit from a body-length prone scooter
    • spastic diplegia
    • abnormal tone affects all extremities with primary involvement on LE.  Child can use UE to propel self while having LE positioned on scooter.
  61. What child benefits from airplane mobility
    child with good LE function who need support in UE.
  62. A power W/C is designed for individuals with limited _______ and _________ extremity function.
    UE and LE
  63. Erikson: Basic trust vs mistrust
    • 0-18m
    • infant realizes that survival & comfort needs will be met
    • hope is integrated into personality.
  64. Erikson: Autonomy vs doubt & shame
    • 2-4yrs
    • child realizes that he can control bodily functions
    • self-controlled will integrated into personality
  65. Erikson: Initiative vs guilt
    • Preschool age
    • social skills & a gender role identity
    • sense of purpose integrated into personality
  66. Erikson: Industry vs inferiority
    • Elementary school age
    • gains sense of security through peers & gains mastery over activities 
    • feeling of compentency is integrated into personality
  67. Erikson: Self-identity vs role diffusion
    • teenage years
    • make choices about adult roles & with resolution of identity crisis a sense of fidelity or membership with society in integrated into personality.
  68. Erikson: Intimacy vs solidarity
    • Young adult
    • establishes intimate relationship with partner & family
    • capacity of love is achieved.
  69. Generativity vs self-absorption
    • Middle adulthood
    • finds security in his chosen personal/professional roles
    • capacity to care.  
  70. Integrity vs despair
    • Maturity
    • mature adult reflects on own value & shares with younger generation
    • wisdom acquired.
  71. visual loss in middle & older ages characterized by inability to focus properly and blurred images, due to loss of accommodation, elasticity of the lens.
  72. Opacity, clouding of the lens due to lens protein.  
    Gradual loss of vision
    Central vision loss first then peripheral
    Problems with glare, general darkening of vision, loss of acuity, & distortion
  73. increased intraocular pressure with degeneration of optic disc
    early loss of peripheral vision (tunnel vision)
    • Glaucoma
    • if untreated progresses to total blindness
    • surgery and medications are effective treatments
  74. loss of central vision due to decreased blood flow or abnormal growth of blood vessles
    may retain some peripheral vision
    increased sensitivity to glare, diff. adjusting to light change, may progress to total blindness
    Macular degeneration
  75. damage to retinal capillaries or hemorrhage
    leads to retinal scarring & detachment
    central vision impaired, vision blurred
    complete blindness is rare
    Diabetic retinopathy