Human Development

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Human Development
2015-07-20 19:18:56
NBCOT board exam review
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  1. Prenatal period
    • responds first to tactile stimuli
    • reflex develeopment
    • innate tactile, proprioceptive and vestibular reactions
  2. neonatal period
    • tactile,proprioceptive, and vestibular inputs are critical from birth onward for the eventual development of body scheme
    • vestibular system is fully developed at birth but becomes more refined and impacts the infants arousal levels (helps the individual feel more organized and content)
    • visual system develops as infant responds to faces and items of high contrast placed 10 inches from face
    • Auditory system is immature at birth and develops as the infant orients to voices and other sounds
  3. first 6 months
    • vestibular, proprioceptive and visual systems become more integrated and lay the foundation for postural control, which facilitates a steady visual field
    • tactile and proprioceptive systems continue to be refined (foundation for somatosensory skills)
    • visual and tactile systems become more integrated as the child reaches out and grasps toys (foundation for visual motor integration)
    • infant movement patterns progress from reflex to voluntary and goal-directed
  4. 6 to 12 months
    • vestibular,visualand somatosensory responses increase in quality and quantity as the infant becomes more mobile
    • tactile and proprioceptive perceptions become more refined allowing for FM and motor planning skills
    • tactile and proprioceptive responses lead to ML skills and crossing of ML
  5. 13-24 months
    • tactile perception becomes more precise (discrimination, FM and localization skills)
    • integration of all the systems to increase motor planning
  6. 2-3 years
    period of refinement to increase balance and postural control, improved FM skills, and motor planning
  7. 3-7 years
    child is driven to challenge sensorimotor competencies through play, sports, games, music, chores, schools tasks; also can develop self-esteem and social skills
  8. Reflex development and integration
    • reflex- predictable motor response elicited by a stimuli
    • primitive reflexes are present after birth and are integrated throughout the first year
    • persistence or re-emergence of these reflexes are indicative of CNS dysfunction that may interfere with motor milestone attainment and function.
    • See chart on page 116
  9. General principles of motor development
    • cephalocaudal/proximal to distal direction
    • gross to fine motor
    • stability to controlled movement
    • spiraling manner
    • affected by the environment
  10. important aspects in UE functional development
    • head and neck control
    • eye/hand interaction, sensory-perceptualinteraction
    • shoulder-scapular stabilty
    • humeral control
    • elbow control
    • forearm control
    • wrist control
    • thumb opposition/stability
    • palmar arches of the hand
    • isolated finger control
  11. important components in the development of hand skills
    • reaching skills
    • visual regard accompanied by swinging/batting with a closed fist and abducted shld (newborn)
    • hands come together at ML for bilateral integration, reaching with shlds abducted and interally rotated and hand is more open (6 months)
    • trunk stability increases,shld flexion with slight external rotation, elbow extension,forearm supination, and slight wrist extension, begin to emerge( 9 months)
    • Grasping skills
    • grasp of a pellet
    • novoluntary grasp or visual attention (natal)
    • Visual attention (3 months)
    • raking and contacting object (6 months)
    • inferior scissors grasp (7 months)
    • scissors grasp (8 months)
    • inferior pincer grasp (9 months)
    • pincer grasp(10months)
    • fine pincer grasp(12months)
    • See figures 5-11 and 5-12
  12. releasing skils
    • no release (0-1 months)
    • involuntary release (1-4 months)
    • two stage transfer (5-6 months)
    • one stage transfer (6-7 months)
    • voluntary release (7-9 months)
    • 9 months- relase by full arm extension
    • refinement continues to age four with attainment of graded release
  13. carrying skills
    combination of movements between shoulder, body, and distal joints of the wrist and hands to hold items, make appropriate adjustments and maintain and hold
  14. bilateral hand use
    • asymmetric movements prevail until 3 months
    • symmetric movements prevail until 10 months
    • 12-18 months using both hands for different functions
    • 18-24 months manipulation skills emerge
    • 2.5 years using two hands for two very different functions emerges
  15. manipulation skills
    • finger to palm translation (i.e. picking up coins) 12-15 months
    • palm to finger translation (i.e. placing coins in a slot)  2-2.5 years
    • shift-
    • simple rotation-turning object <90 degrees (ie unscrewing cap) 2-2.5 years
    • complex rotation-turning object 360 degrees (i.e.turning pencil over to erase) 6-7years
    • in-hand manipulation with stabilization (ie picking up objects with fingers while holding them in palm) 6-7 years
  16. pencil grasp
    • palmar supinate grasp(1-1.5years)
    • digital pronate grasp(2-3 years)
    • static tripod posture (3.5-4 years)
    • dynamic tripod grasp(4.5-6 years)
    • see figure 5.13
  17. prerequisites for scissor skills
    • open and close hands
    • isolate or combine movements of thumb, index and middle finger
    • use hands bilaterally(asymetrically)
    • coordinate arm, hand and eye movements
    • stabilize wrist, elbow and shoulder joints for distal movement
    • interact with environment in constructive developmental play stage
  18. scissor skills development
    • interest in scissors(2-3 yrs)
    • holds and snips with scissors (2-3 years)
    • opens and closes scissors in controlled fashion (2-3years)
    • manipulates scissors in a forward motion (3-4years)
    • cuts a straight line (3-4years)
    • cuts a simple geometric shape (3-4 years)
    • cuts circles (3.5-4.5 years)
    • cuts simple figure shapes (4-6years)
    • cuts complex figure shapes (6-7 years)
  19. adaptation
    responding to environmental challenges as they occur
  20. mental schemes
    organizing experiences into concepts
  21. operations
    the cognitive methods used by the child to organize schemes and experiences to direct subsequent actions
  22. adapted intelligence
    cognitive competence
  23. equilibrium
    the balance between what the child knows and can act on and what the environment provides
  24. assimilation
    the ability to take a new situation and change it to match an existing scheme or generalization
  25. accomodation
    development of a new scheme in response to the reality of a situation or discrimiation
  26. hierarchial development of cognition
    • reflexive stage: schemes begin in response to reflexes (1month)
    • Child progresses from reflexive activity to mental representation to cognitive functions of combining and manipulating obects in play
    • preoperational (2-7 years)
    • classification
    • seriation
    • conservation
    • pre-conceptual (child expands vocabulary and symbolic representations 2-4 years)
    • intuitive thought phase (child imitates copies or repeats what is seen or heard 4-7 years)
    • Concrete operations (7-11 years)
    • reversibility
    • rules
    • empirical-inductive thinking
    • logical thinking
    • Formal operations (11- teen years)
    • hypothetical-deductive thinking
    • logic to hypothesize and can draw from past experiences
  27. Exploratory play
    • 0-2 years
    • engages in play experiences in which the child develops a body scheme
    • sensory integrative and motor skills are developed as the child explores the properties and effects of actions
    • child plays mostly with parents/caregivers
  28. Symbolic play
    • 2-4 years
    • child engages in play experiences through which the child formulates, tests, classifies, and refines ideas, feelings, and combined actions
    • associated with language develeopment
    • objects that are manageable for the child in terms of mastery and control are preferred
    • parallel play and becomes more cooperative over time
  29. creative play
    • 4-7 years
    • sensory, motor, cognitive and social play experiences
    • child explores combinations of actions
    • master skills that promote school and work related activities
    • participates in cooperative peer groups
  30. games
    • 7-12 years
    • participates in play with rules, competition, social interaction and opportunities for development of skills
    • growing interest in comepetion while working cooperatively
    • friends become important for validation of play items and performance
  31. Oral motor development
    see page128
  32. progression of dressing skills, toileting skills, home management skills
    see page 130
  33. Assessment of Preterm Infants' Behavior
    • assesses infant's pattern of developing behavioral organization in response to increasing sensory and environmental stimuli
    • method- behavior checklist and scale
    • scoring- scores reflect the degree of facilitation provided by the examiner; function and integration of the physiological, motor, state, attentional/interactive and regulatory systems are determined
    • population-preterm and full term infants
  34. Neurological Assessment of Preterm and fullterm newborn infant (NAPFI)
    • population-preterm and full term newborn infants
    • focus-rating scale consisting of a brief neurological examination incorporated into routine assessment
    • method- items administrated in a sequence, first in a quiet or sleep state, then during the awake state
    • scoring and interpretation-infants state is recorded based on six gradings for each item; interpretation of the scores allows the therapist to document a pattern of responses to reflect neurological functions and identify deviations for diagnosis;comparison between preterm and fullterm infants is provided
  35. Denver Developmental Screening Test
    • population-1 month to 6 years
    • focus- standardized task performance and observation screening tool for early identification if children at risk for developmental delaysin four areas (social, fine motor, langauge, gross motor)
    • method- 125 test items, each item scored indiciates the chronological age at which it is expected to be performed at; child's score is compared to determine whether the child's performance is appropriate or delayed; test discontinues with three failed items
  36. Bayley Scales of Infant Development-third edition (BSID-III)
    • population-1-42 months
    • focus- standardized rating scales thatassess multiple areas of development to attain a baseline for intervention and to monitor progress (cognition, language, mote,social-emotional, adaptive response)
    • method-age appropriate items are selected from items; involves parent completing questionnaires
    • scoring-composite scores yield qualitative descriptors and performance levels for each domain
  37. First STEP screening test for evaluating preschoolers
    • population-2yrs 9mos- 6 yrs 2mos
    • focus-checklist and rating scale which identifies preschool students at risk and in need of more comprehensive eval
    • method- five areas and optional areas to administer
    • scoring- domain scores are converted to composite scores to determine whether the childs performance is within an acceptable level or if they are at risk
  38. Hawaii Early Learners Profile (HELP)
    • population-children 0-3 years, HELP for preschoolers is available for 3-6 yrs
    • focus-non-standardized scale of developmental levels in six areas (cognition, language, gross motor, fine motor, social-emotional, and self-help)
    • methods- administered in natural environment and in context of daily routines; protocol using a warm-up period, structured play and snack time is recommended
    • scoring- developmental age range levels of skills in each of the areas can be approximated; description of the behavior and possible causes of difficulty can be obtained; developmental structuring of skills is provided
  39. Miller Assessment for Preschoolers (MAP)
    • population- 2yrs9mos-5yrs 8mos
    • focus- standardized task performance screening tool assessing sensory and motor abilities
    • method- items are administered that relate to the age of the subject
    • scoring-measures are obtained in sensory and motor abilities, cognition,and combined abilities; performance is compared with norms; percentile equivalents can be obtained for each index and overall performance
  40. Pediatric Evaluation of Disability Index(PEDI)
    • population-6 months to7.5 years
    • focus- standardized behavior checklist and rating scale that assesses capabilities and detects functional deficits, determines developmental level, monitor child's progress; modifications and caregiver assistance scales determine levels of assistance and adaptations
    • method- observation,interview, and scoring of 3 domains (self-help, mobility, and social skills)
    • scoring-three sections are scored separately, identifies children with patterns of delay, progress and outcomes can be monitored
  41. Bruininks-Oseretsky Test of Motor Proficiency (2nd edition)(BOT-2)
    • population-4-21 yrs
    • focus- standardized test asseses and provides an overall index of motor proficiency(FM and GM while taking into account speed, accuracy and hand/foot dominance)
    • method- long and short form with 8 subtests
    • scoring- total motor composite score consists of four motor areas: fine manual control, manual coordination, body coordination, strength and agility; age equivalencies reported along with strengths and weaknesses
  42. Erdhardt Developmental Prehension Assessment
    • population-children of all ages and cognitive levels with nuerodevelopmental disorders
    • focus-observation checklist based on performance which assesses three areas (involuntary arm hand patterns; voluntary movements of approach, and prewriting skils)
    • method- test administered in sections according to age level; section 1 looks at R and L hand scores. section 2-scores are placed at a developmental level. section 3- function is determined. section 4- gaps in hand skills and developmental levels can be determined.
  43. Peabody Developmental Motor Scales (PDMS-2)
    • population- birth to 6 yrs
    • focus- standardized rating scales of gross and fine motor development
    • method- substests; test items are administered one below the child's expected motor age to obtain a basal; administration ends with three consecutive zeros
    • scoring-standard scores, percentiles,and age equivalents are determined
  44. Toddler and infant motor evaluation (TIME)
    • population-birth to 3 yrs6mos
    • focus-assess quality of movement
    • method-five subtests
    • scoring- cutoff scores are indicative of moderate or significant delays
  45. Beery-Buktenica Development Test of Visual Motor Integration (VMI)
    • population- 2-100yrs
    • focus- assesses visual motor integration
    • method-copies 24 geometric shapes sequenced according to difficulty level; test ends when the child fails to meet criteria
    • scoring- raw score translated into percentile ranks, standard score,and age equivalents
  46. Developmental Test of Visual Perception (DTVP-2)
    • population- 4 to 10yrs; adolescent/adult version 11-74 yrs
    • focus- assess visual perceptual skills and visual motor integration
    • method- eight subtests for child version, 4 for adult version
    • scoring- raw scores, age equivalents, percentiles, subtest standard scores,and composite scores; three indexes (general visual perceptual,motor-reduced visual perception, visual motor integration)
  47. Motor Free Visual Perceptual Test (3) MVPT
    • population- 4-95yrs
    • focus- standardized quick eval to asses visual perception
    • method-number of items administered depends on the age of the child
    • scoring- raw scores are translated into perceptual ages
  48. Sensory Profile (infant and toddler) (11 to 65 yrs)
    • population-birth to 36 months; 11-65 yrs
    • focus-measures reactions to daily sensory experiences
    • method- caregivers' judegement and observations of a child's sensory processing,modulation and behavioral/emotional response in each sensory category
    • scoring-cutoff scores indicate typical performance,problable, definite and significant difference
  49. Childhood Autism Rating Scale (CARS)
    • population-children over two years who are diagnosed with autism
    • focus-determines severity of autism (mild,moderate,or severe)
    • method-observational tool to rate behavior
    • scoring-scores below 30=no autism,31-36.5=mild to moderate autism, 37-60= severe autism
    • M-CHAT is a screening for autism
  50. School Function Assesment (SFA)
    • population-school age children
    • focus-asseses and monitors functional performance in order to promote participation in a school environment
    • method-criterion referenced questionnaire assesses the students level of participation, type of support required, and performance on school related tasks
    • scoring-two scoring mechanisms 1)basic level of criterion cutoff scores (below a certain score indicates performance does not meet expectations) or 2) scoring from 0-100 indicating appropriate grade level functioning
  51. child abuse
    • any behavior directed toward a child by a parent, guardian,caregiver,other family member,or other adult that endangers or impairs a child's physical or emotional health and development.
    • types:physical,emotional/mental, sexual, neglect
    • OTs are mandated reporters
    • interventions could include treating physcial, emotional, or developmental delays; developing trusting relationships between child and non-abusers; providing support to non-abusing caregiver; refer to appropriate disciplines and agencies
  52. organ changes in aging
    • decrease in functional capacity
    • decrease in homeostatic efficiency
  53. gerontology
    scientific study of the factors impacting the normal aging process and the effects of aging
  54. geriatrics
    the branch of medicine concerned with the illnesses of old age and their care
  55. ageism
    discrimination and prejudice leveled against individuals based on their age
  56. categories of elderly
    • young elderly 65-74
    • old elderly 75-84
    • oldest elderly 85+
  57. review of aging and break down
    see end of chapter 5