Exam 1 study guide


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Exam 1 study guide

  1. 1. Lifespan Test Study Guide In study guide orderNOTE There are a few sections that are not completed, which are in bold.Perceptual, cognitive, psychosocial development lecture summary does notinclude every word from powerpoint. It is a summary with what I think/hopeare the important parts. - Directional concepts: o Cephalo-caudal – head  tail o Proximal-distal – closer to the head/midline  farther from head/midline - Developmental positions: (NAMED FOR WEIGHT BEARING SIDE) o Prone – on stomach o Prone on forearms – on stomach and forearms o Prone on extended elbows/arms – on stomach w/ straight arms o Swimming (prone extension) – feet off ground, arms off ground laterally o Supine – on back o Hands to knees – chin tuck/knees up to chest o Foot to mouth – duh? o Pull to sit – chin tuck, traction??? o Side-lying - trunk on ground o Side-sitting – trunk propped up/off ground o Long leg sitting – legs straight out in front o Splay sitting – legs out in “V” o Bench sitting–sitting at edge of chair o Tailor sitting – “Indian style” o Ring sitting – “butterfly” o “w” sitting – abducted, internally rotated, flexed at knees… BAD o sitting on heels – on knees, sitting on heels o quadruped – hands and knees o crawling – slithering on floor.. commando style o creeping – “crawling” o kneeling – up tall on knees o half kneeling – one knee and one foot o plantigrade – walking on all 4’s o pull to stand - duh o modified plantigrade – hands and feet on different levels o cruising – walking while in modified plantigrade o standing - duh o squat - duh o tandem standing – “drunk walk”
  2. 2. o single limb stand– duh- Key skills gained in trimesters after birth (Lecture/video #1) o 1st Trimester – Infantile Phase – 0-3 months  head control in all planes and extension of the trunk and hips against gravity. o 2nd Trimester – Preparation phase – 4-6 months  All of the following is due to “anti-gravity muscle control”  Sustained head control in all planes  Increased neck and back extension in all planes  Weight bearing and weight shifting through upper and lower extremities to allow unweighting  Rolling  Beginning reach and grasp o 3 rd trimester - Modification phase – 7-9 months  sitting, sidelying, quadruped, kneeling, squatting, standing w/ support o Refinement phase – 10-12 months  Increased freedom of movement/speed/coordination/etc…  Majority are walking by 12 months.- Prone Progression: o lying in full flexion o lying in less flexion o on forearms o on forearms w/ head up vs gravity o head continues to rise; able to weight shift o full forearm support w/ elbows in front of shoulders o extended arm support o log rolling prone to supine o swimming o reaching from forearm support o pivoting from prone o rolling prone to supine w/ segmental rotation o four point kneeling o propped sidelying o reciprocal crawling o 4-point kneeling to sitting o reciprocal creeping w/ abducted legs and lumbar lordosis o reaching from creep position o 4 point kneeling w/ legs neutral o modified 4 point kneeling o reciprocal creeping w/ flat spine and neutral legs- Supine Progression: o Lying in flexion
  3. 3. o Lying in less flexion o Lying with arms and legs extended at elbows/knees o Lying with hands to midline o Hands to knees o Pushes legs into more extension o Hands to feet o Log rolling supineprone o Segmental rolling supineprone o Supported sitting o Propped arm sitting (brief support) o Pull to sit o Unsustained sitting o Sitting with full arm support o Weight shift in unsustained sitting o Sustained sitting o Reaching in sit o Sitting to prone o Sitting to 4 point kneel o Moving all around while sitting- Stages of motor control: o Mobility  Presence of functional range of motion through which to move and/or ability to initiate and sustain active movement through the range.  Deficits b/c – tight tissue, no active initiation, inc/dec muscle tone  0-3 months… random movements, based upon reflexes, difficult to sustain vs gravity.  EX – head extension and shoulder flexion in prone on elbows position. o Stability  Ability to maintain position/posture requiring tonic hold of all muscle around joint  “co-contraction” or “co-activation”  Prerequisite  Mobility  Deficits would be noted w/ inability to hold position, increased postural sway, or poor alignment in position  3-6 months… head/neck stability and shoulder girdle/upper trunk stability seen  EX – Shoulder girdle, neck, elbow muscles used in prone on elbows o Controlled Mobility  Weight shifting proximal segments over fixed distal segments… AKA CLOSED CHAIN movement  Mature weight shift = elongation of weight shifted side
  4. 4.  Immature (primitive) = lateral flexion of weight shifted side  Prerequisites  mobility and stability  6-8 months… weight shift/rocking and positions held vs gravity are seen  EX – Infant is able to weight shift forward, backwards, laterally AND diagonally in prone on elbows position o Static-Dynamic  Fluid progression from controlled mobility where the weight shift continues to the point where the opposite side limb/body segment lifts off the ground and is no longer part of the BOS. This results in a narrowing of the BOS, requiring greater dynamic control from remaining support limbs.  Prerequisites  everything above..not retyping them all…..  8 months & up  EX – weight shift left and raising right arm in prone on elbows position o Skill  Pretty much the things you can do in a said position once all the above are accomplished.  Manipulation = open chain  Exploration = closed chain  Intralimb = coordination and dissociation with one limb  Interlimb = coordination, timing, symmetry, dissociation between limbs  Ex – reaching, belly crawling, rolling, etc.. from prone on elbows o OVERVIEW OF STAGES OF MOTOR CONTROL:  Mobility  stability  controlled mobility  static-dynamic  skill.  These must be accomplished in a certain developmental position to have the ability to continue onto the next developmental position- Developmental Reflexes and Reactions - (KNOW – Test position, Stimulus, Response) o Spinal Level:  Flexor Withdrawl Position – Supine w/ head in midline, legs relaxed/semiflexed Stimulus – Noxious (pin prick) to sole of foot Response – Withdrawl of stimulated leg  Crossed Extension Position – Supine, head in midline, lower extremities extended Stimulus – Noxious. Firm pressure/stroke sole of foot while holding same extremity extended
  5. 5. Response – Flexion, adduction, extension of opposite lower extremity as if to push examiner away.  Extensor Thrust Position – Supine w/ head in midline, one leg extended, opposite flexed Stimulus – stimulus to sole of foot, flexed leg Response – Uncontrolled extension of said lego Brainstem:  ATNR – Asymmetrical tonic neck reflex Position – Supine w/ head in midline, Stimulus –turn head to one side Response – jaw arm/leg extend, sull arm/leg flex  STNR – Symmetric tonic neck reflex Position – Ventral position supported by trunk over examiner’s leg (or in all 4’s position) Stimulus – flex/extend head Response – w/ flexed head, uppers flex and lowers extend. w/ extended head, uppers extend and lowers flex (THINK CAT)  TLR-p – Prone tonic labyrinthine reflex Position – prone Stimulus – pick child up under chest – horizontal suspension Response – arms flex by chest (if negative, arms extend to bear weight)  TLR-s – Supine Tonic labyrinthine reflex Position – Supine Stimulus – child on back Response – extensor tone dominates if reflex present (arched back, extended limbs, etc..)  Positive supporting Position – Infant supported in vertical position Stimulus – allow feet to make firm contact w/ floor Response – simultaneous contraction of flexors/extensors. Partial flexion of hips/knees (semi- crouch). Child cannot bear full weight.  Astasia Position – Support infant in vertical position Stimulus – allow feet to make firm contact w/ floor Response – alternate flex/extend of hips/knees. Infant jumps/beats floor w/ 1 foot then the other. Feet will drag if infant propelled forward.o Midbrain:
  6. 6.  Righting reactions (vertical/rotational) See packet  Landau Position – horizontal prone in air Stimulus – this position Response – head extended, back arched, legs partially extended @ hips  Moro Position – Supine symmetrical, arms in front/beside chest Stimulus – support child up 20-30 degrees and let go Response – abduction and extension of uppers followed by adduction and flexion (and crying)  Protective reactions in all positions See packet o Cortical  Equilibrium Reactions Same as protective reactions based upon the packet o Other reflexes:  Palmar grasp  finger across palm from ulnar side. Child will flex all fingers and grab your finger. Failure of reflex indicates depressed CNS and/or sensory motor depression  Plantar grasp  pressure on ball of foot resulting in plantar flexing of toes. Failure of reflex indicates same as Palmar. Could make standing erect difficult b/c toes will always curl w/ pressure on sole of foot.  Rooting  stroke corner of mouth laterally and up. Head turns in direction of stimulus and mouth opens and attempts to suck. Lack of reflex leads to hungry/satiated babies. Depressed babies do not have this reflex.  Placing  drag dorsum of hand/foot up over edge of table. Will flex elbow/knee and extend/dorsiflex hand/foot and place on table. Lack of this reflex indicates general depression of CNS/sensory system.  Galant  Prone position. Draw line from shoulder to buttox 3cm from midline. Results in lateral concave curvature. Will be absent below S.C. lesion level and long lasting response can = scoliosis. If reflex persists, will make walking and other developmental processes that need head independence difficult.INCOMLETE SECTION:- Righting reactions/protective extension/equilibrium reactions:
  7. 7. o Know correct test positions, stimulus and response in terms of:  Direction of force  Speed of force  Direction of response  Relation of COG over BOS.  Extremity responses- Perceptual, Cognitive, psychosocial development Lecture: o Physical and social environments:  Proximal  home, family, yard  Distal  community, Church, playground, society, culture, etc…  Sameroff and Chandler: Development is function of interaction between children/family/environment (transactional theory)  Bronfenbrenner: Expands transactional model to include neighborhoods and policy (“ecologic”)  Flow chart: Individual  interpersonal  organizational  community  society o Developing social self:  Social and physical development affect each other o Perception  Involves experience and learning. The act of processing and interpreting sensory stimulus. Results in meaning attached to sensory info and a development of a sensory awareness. o Perceptual Development  Process of learning to interact w/ environment  Sensory judgments evolve through repeated experiences  How does it develop? Exteroceptors (nose, ear, skin) and interoceptors (proprioception, etc..)  Bridge between sensation and motor response o Perceptual Skill  “internal event”  advancement in skill observed through observable (overt) behavior since perception itself is “private” o Terminology:  Detection  body senses stimulus  Awareness  infant is conscious of stimulus  Localization  infant directs attention to stimulus
  8. 8.  Discrimination  infant knows exactly what is going on with stimuluso Toddlers must be able to differentiate world based upon grandients to determine safe/threatening? (color, taste, sound, etc..)o Visual Cliff Study:  6 month olds could be urged over edge of “cliff” by mother  10 month olds could not.o Body awareness  where body is in space, learned through active movement.o Space perception  having body awareness to project body into space. “cat in maze”.. must learn through self-induced locomotion.o FMP – Fundamental movement patterns  learned movements based upon perceptual skillso Cognitive Development:  Cognition – mental processes (attention, memory, etc..)  Intelligence – ability for abstract thought, understanding, communication, etc.. (DID NOT GET THIS DEFINITION FROM PROFESSOR)  Arousal – level of alertness  Attending – concentrating on stimulus  Learning – permanent change in behavior based on experience  Reasoning – use thinking to draw inferences  Problem-solving – consider possible solutions through reasoning  Decision-making – action or non-action to resolve conflict  3 levels of memory: immediate short term long term  2 types of memory: reflexive  tying shoes declarative  my birthday is march 12tho PIAGETS THEORY – MATURATIONAL STAGES Sensorimotor (0-24 months) o Blending sensory and motor activities to gain experience about world o Sensory info cues movement, movement leads to exploration, exploration increases sensory skills Preoperational (2-6 years) o Elaborate on sensory experiences o Egocentric o “all tall people are adults” o mental images and memory can = problem solving b/c of increased language skills Concrete Operational (7-11 years)
  9. 9. o Concrete thought (logical rules, etc..) o Literal o Increased synaptic connections = greater LTM Formal operational (12+) o Can deal with hypothetical and real life o Abstract thought, deductive reasoning Piaget terms: (Piaget’s Adaptation through assimilation and accomidation) o Assimilation – taking info and compare it to what is already “known” o Accommodation – alter perceptions as the new info is added to knowledge baseo Learning Theory (Behaviorism)  Skinner Environment was #1 behavior outcome factor Adult directed/driven reinforcemento Milestones of cognitive development:  Infants/toddlers: Categories – sensory learning, toddlers are little scientists, consequences not understood Memory – reflexive memory (touch, mouth, movement), object permanence (pee-a-boo, flush toilet)  Toddlers: Declarative memory Mental images can be maintained (look for something where it last was seen) Self aware  Preschool: Learn numbers, classify objects More STM and some LTM Time concepts – routines Fantasy play/imagination REAL FEAR.. do not down play  School-aged More LTM for both reflexive and declarative Increased focus/attentionspan Understand consequences/cause/effect  PT IMPLICATIONS: Infant brain develops rapidly. Movement is key, and treatment should start early if problems suspected b/c of this rapid development period.o Psychosocial development:  Milestones/stages  Components: Emotional expression
  10. 10. Self-awareness Temperment  Key processes: Attachment: begins prenatally. Secure attachment = confidence with parent, distress when gone, happy with return. Insecure = either overdependence or lack of interest. Separation – individualization: o MAHLER o Process of achieving self identity apart from caretaker. o 6 stages:  narcissism 0-1 mo.  Social/bio interdependence 1-5 mo.  Lap baby 5-9 mo  Practicing 9-14mo  Reproachment 14-24 mo  Consolidation 24-36mo Emotional development o Important in development of “temperament” o Developing unique reactions to subjective experience. Personality development o Genetic code guides at first o Social context/experience influence personality o Unique organization of traits/behaviors that gives one their personality.o THEORIES OF PSYCHOSOCIAL DEVELOPMENT:  Psychoanalytic – Freud and Erikson Intrinsic drives/motives influence every aspect of thinking and behavior, molding human development. Early experiences can have great effect on long term personality. FREUD: o 4 stages o person’s character comes from mother-child interaction quality ERIKSON: o Stage theory (see slides) o Each stage builds on next (weakness?) o Cultural differences/influences are important in development to meet/react to individual ‘crisis’  Learning Theory Strong S-R relationships
  11. 11. Nurture emphasized Different reinforces for different ages Social referencing  infants look at caregivers for cues on how to act SOCIAL LEARNING THEORY  BANDURA: o Learn by watching caregivers o Motivation is needed to attend to behavior, store and retrieve info. o Key aspects of psychosocial development:  Developing individual self is important  3-6 years  learn about self and self control. Relationship with family is important  6-11  going outside family for life rules. Friends/peers become important influences.  NEVER A BAD CHILD  Be a role model (modeling.. aka Bandura’s learning theory)  Understand nature and nuture both are important, as a PT - -------------------------NOT DONE WITH THIS SECTION (last section in study guide) - Fundamental movement patterns and sensori-motor components for play - -------------------------