Child Development: Difference between revisions
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== Introduction == | == Introduction == | ||
As a child grows they learn and acquire more refined gross and fine motor skills, as well as developing social skills. Reflexes that initially developed to aid survival, become integrated into more refined movements as the child matures. Children tend to acquire these skills in an orderly fashion and within certain age brackets. This | As a child grows they learn and acquire more refined gross and fine motor skills, as well as developing social skills. Reflexes that initially developed to aid survival, become integrated into more refined movements as the child matures. Children tend to acquire these skills in an orderly fashion and within certain age brackets. This pattern of skill acquisition is often referred to as 'Normal or Typical Development', and is used to monitor a child's developmental progress. In some cases late acquisition of these 'milestones' can indicate developmental delay . However, it must be remembered that the time span within which acquistion of these skills is still considered 'normal' is wide (see WHO Study discussed later), and that some children may skip a milestone altogether eg crawling. <ref name="Piper">Piper MC. Motor Assessment of the Developing Infant. WB Saunders Company; 1994.</ref> | ||
The average age at which gross motor, fine motor and social skills are acquired | The average age at which gross motor, fine motor and social skills are acquired is outlined below. | ||
== Principles of Typical Development == | == Principles of Typical Development == | ||
* | *Cranial to Caudal | ||
*Proximal to Distal | *Proximal to Distal | ||
*Flexion to Extension | *Flexion to Extension | ||
Line 36: | Line 36: | ||
Slight intentioned movements of the head in prone and supine <br> | Slight intentioned movements of the head in prone and supine <br> | ||
In supine there are large movements of the | In supine there are large movements of the upper limbs, <br> | ||
In prone activities are limited to the lifting and turning of the head to | In prone activities are limited to the lifting and turning of the head to breathe <br> | ||
Slight increase of extensor muscles control head / neck <br> | Slight increase of extensor muscles control head / neck <br> | ||
Line 64: | Line 64: | ||
'''''Functional Achievement: ''''' | '''''Functional Achievement: ''''' | ||
Slight movements in rotation of the head + lateral flexion of the trunk when trying to move the head, gesture, | Slight movements in rotation of the head + lateral flexion of the trunk when trying to move the head, gesture, stare at the mother. <br> | ||
'''''Posture:''''' | '''''Posture:''''' | ||
Line 70: | Line 70: | ||
''Head Position:'' | ''Head Position:'' | ||
* | *Hyperextended and rotated (Asymmetry) | ||
''Trunk Position:'' | ''Trunk Position:'' | ||
Line 92: | Line 92: | ||
'''''Functional Achievement:''''' | '''''Functional Achievement:''''' | ||
Raises head less than 45°, pushes the floor with the fists trying to lift head against gravity and against the resistance of spinal and hip that remain in flexion.<br> | |||
'''''Weightbearing:''''' | '''''Weightbearing:''''' | ||
Line 110: | Line 110: | ||
''Trunk Position:'' | ''Trunk Position:'' | ||
*Lumbar flexion and asymmetric in the frontal plane (concave or | *Lumbar flexion and asymmetric in the frontal plane (concave or convex) | ||
''Pelvic Girdle:'' | ''Pelvic Girdle:'' | ||
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'''''Functional or Antigravity Achievement:''''' | '''''Functional or Antigravity Achievement:''''' | ||
Stares and visual tracking. | |||
Head control and | Head control and maintains in midline. | ||
Coordination between; hands-mouth, hand-hand and feet-feet these are up of the plane of support. | Coordination between; hands-mouth, hand-hand and feet-feet these are up of the plane of support. | ||
Line 158: | Line 158: | ||
''Head Position: ''<br> | ''Head Position: ''<br> | ||
*Chin tuck, selective movement of rotation, not deviations in trunk or shoulders. Cervical | *Chin tuck, selective movement of rotation, not deviations in trunk or shoulders. Cervical vertebrae elongate and dissociate. | ||
''Upper Limbs:'' | ''Upper Limbs:'' | ||
Line 197: | Line 197: | ||
''Upper Limbs:'' | ''Upper Limbs:'' | ||
*Shoulders abducted, elbows in line with shoulders, forearm support on immature extended arm support the end of 3 months elbows in 90º of FLEX and in front of shoulders. | *Shoulders abducted, elbows in line with shoulders, forearm support on immature extended arm support. At the end of 3 months elbows in 90º of FLEX and in front of shoulders. | ||
''Trunk Position:'' | ''Trunk Position:'' | ||
Line 209: | Line 209: | ||
''Lower Limbs:'' | ''Lower Limbs:'' | ||
*Hips abducted and externally rotated, knees semi- | *Hips abducted and externally rotated, knees semi- flex. <br> | ||
|} | |} | ||
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Beginning of Landau Reaction in Extension | Beginning of Landau Reaction in Extension | ||
Strong synergy between flexor and extensor muscles of the neck, chin in more retraction. | Strong synergy between flexor and extensor muscles of the neck, chin in more retraction. Begins gripping feature, can hold an object but loose it by chance. | ||
Begins gripping feature, can hold an object but loose it by chance. | |||
Lateral rocking | Lateral rocking | ||
Line 275: | Line 273: | ||
Touches knees with hands, choosing to do it both hands at the same time or independence one from the other. | Touches knees with hands, choosing to do it both hands at the same time or independence one from the other. | ||
Grasp and manipulate in the midline staring the toy. Gripping still | Grasp and manipulate in the midline staring the toy. Gripping still from the ulnar side of the hand, with palmar flexion and supination to explore the toy with mouth | ||
| align="left" valign="top" | | | align="left" valign="top" | | ||
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'''''Weightbearing:''''' | '''''Weightbearing:''''' | ||
Weight on hands, lower abdomen and thighs. Triangle base of support between nape elbow and thigh and face knee | Weight on hands, lower abdomen and thighs. Triangle base of support between nape elbow and thigh and face knee. Uses this base of support to liberate the face arm and wrap a toy with more stability. <br> | ||
|} | |} | ||
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''Head Position:'' | ''Head Position:'' | ||
*Lateral head righting when the baby | *Lateral head righting when the baby reaches to the lateral side. | ||
''Upper Limbs:'' | ''Upper Limbs:'' | ||
*Base support arm is in 90° of FLEX, slight EXT ROT, elbow in flexion and pronation, hand open. Oscillate arm shoulder in ABD, elbow in semi-flexion and pronation, hand open. Scapulas dissociated one | *Base support arm is in 90° of FLEX, slight EXT ROT, elbow in flexion and pronation, hand open. Oscillate arm shoulder in ABD, elbow in semi-flexion and pronation, hand open. Scapulas dissociated: one has weight bearing functions and the other a basic movement to grasp a toy. | ||
''Trunk Position:'' | ''Trunk Position:'' | ||
Line 342: | Line 340: | ||
Lower Limbs: | Lower Limbs: | ||
*The rolling | *The rolling starts with triple flexion and finishes with legs in extension. | ||
'''''Weightbearing in Rolling:''''' | '''''Weightbearing in Rolling:''''' | ||
Line 399: | Line 397: | ||
Supporting legs on hands and knees (four legs)<br> | Supporting legs on hands and knees (four legs)<br> | ||
Comando | Comando creeping | ||
Lateral sitting | Lateral sitting | ||
Line 407: | Line 405: | ||
Can take one object in each hand | Can take one object in each hand | ||
Answers to name | |||
Starts eating some solid food | |||
|- | |- | ||
Line 419: | Line 417: | ||
*Puts foot in mouth with hands | *Puts foot in mouth with hands | ||
*Contact Eye - Hand - Feet - Mouth | *Contact Eye - Hand - Feet - Mouth | ||
*Radial Gripping Digit | *Radial Gripping Digit | ||
Line 425: | Line 423: | ||
'''''Antigravity Movements:''''' | '''''Antigravity Movements:''''' | ||
* | *Begins to get in 4 point kneeling | ||
*Begins to creep forward | *Begins to creep forward | ||
*Play in lateral support position | *Play in lateral support position | ||
Line 436: | Line 434: | ||
|- | |- | ||
| colspan="2" | | | colspan="2" | | ||
*In the 8th month is when all structures, bones and muscles, are prepared for the child can sit. | *In the 8th month is when all structures, bones and muscles, are prepared for the child can sit. | ||
*Immature crawling | *Immature crawling | ||
*Landau postural reaction complete | *Landau postural reaction complete | ||
*Stranger anxiety | *Stranger anxiety | ||
*Follows a falling object with eyes | *Follows a falling object with eyes | ||
*Discover a hidden toy | *Discover a hidden toy | ||
*Play Peek-a-boo | *Play Peek-a-boo | ||
Line 451: | Line 449: | ||
*Start of immature crawling | *Start of immature crawling | ||
* | *From lateral support reaches the sitting position alone | ||
*Can grip 3 toys at the same time | *Can grip 3 toys at the same time | ||
Line 513: | Line 511: | ||
Walks Autonomously | Walks Autonomously | ||
Squat Position <br> | Squat Position <br>Moves from standing to squat and back to standing without any support<br>Tower of two bricks, put a chickpea into a plastic bottle, and eat with spoon<br>First Words. (Mama, Baba, Dada…)<br>Help in Dressing | ||
Moves from standing to squat and back to standing without any support<br> | |||
Tower of two bricks, put a chickpea into a plastic bottle, and eat with spoon<br> | |||
First Words. (Mama, Baba, Dada…)<br> | |||
Help in Dressing | |||
|- | |- | ||
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Jumping on the same spot | Jumping on the same spot | ||
Walks up and down stairs with handrail | |||
Tower of 6 bricks, turn pages of a book | Tower of 6 bricks, turn pages of a book | ||
Line 787: | Line 777: | ||
Windows of Milestone Achievement in Months <ref name="WHO">WHO Multicentre Growth Reference Study Group. ‘WHO Motor Development Study: Windows of achievement for six gross motor milestones’. Acta Paediatrica. 2006: Suppl 450; 86-95.</ref><br> | Windows of Milestone Achievement in Months <ref name="WHO">WHO Multicentre Growth Reference Study Group. ‘WHO Motor Development Study: Windows of achievement for six gross motor milestones’. Acta Paediatrica. 2006: Suppl 450; 86-95.</ref><br> | ||
While motor milestones are | While motor milestones are undoubtably a useful way of monitoring a childs' development, it must be remembered that each child is different and will achieve the various milestones at different rates. There is a wide window for achievement of these milestones, during which achievement of the milestone is still considered to be in line with normal development. A study published by the World Health Organisation in 2006 demonstrates just this. This study recorded the variations in milestone achievement in 816 children and generated windows during which achievements of these milestones is considered to be normal development, these are outlined in the table above. It should also be noted that this study found that 4.3% of participants never exhibited the hands and knees crawling milestone<ref name="WHO" />. | ||
== Primitive Reflexes == | == Primitive Reflexes == | ||
Line 823: | Line 813: | ||
<u>'''Moro:'''</u> | <u>'''Moro:'''</u> | ||
The Moro reflex is typically elicited by rapid extension of the child's neck. However it can also occur in response to loud noises. The reflex is intact if the child | The Moro reflex is typically elicited by rapid extension of the child's neck. However it can also occur in response to loud noises. The reflex is intact if the child symetrically and simultaneously abducts and extends the upper limbs, and extends the trunk. The upper limbs then immediately adduct<ref name="Zitelli et al" />. This reflex is demonstrated in the clip below. | ||
<u>''Age of Integration:''</u> 3-6 months<ref name="Votroubek 2009" /> | <u>''Age of Integration:''</u> 3-6 months<ref name="Votroubek 2009" /> | ||
Line 839: | Line 829: | ||
{{#ev:youtube|uXsb7bxTc5g}}<ref name="ATNR">Dr. Prodigious. Primitive Reflexes, Asymettric Tonic Neck-3 months-Infant clinical exam (MRCP. Available from: http://www.youtube.com/watch?v=uXsb7bxTc5g)[last accessed: 17/06/13]</ref> | {{#ev:youtube|uXsb7bxTc5g}}<ref name="ATNR">Dr. Prodigious. Primitive Reflexes, Asymettric Tonic Neck-3 months-Infant clinical exam (MRCP. Available from: http://www.youtube.com/watch?v=uXsb7bxTc5g)[last accessed: 17/06/13]</ref> | ||
== References == | == References == | ||
<references /></div> | <references /></div> | ||
[[Category:Paediatrics]] | [[Category:Paediatrics]] |
Revision as of 22:02, 26 February 2019
Original Editor - The Open Physio project.
Top Contributors - Naomi O'Reilly, Siobhán Cullen, Admin, Chelsea Mclene, Kim Jackson, Oyemi Sillo, Lucinda hampton, Tony Lowe, WikiSysop, Simisola Ajeyalemi, 127.0.0.1, Lauren Kwant, Claire Knott, Rucha Gadgil, Amrita Patro, Rachael Lowe, Jess Bell, Paule Morbois, Olajumoke Ogunleye, Matt Huey, Scott Buxton and Saeed Dokhnan
Introduction[edit | edit source]
As a child grows they learn and acquire more refined gross and fine motor skills, as well as developing social skills. Reflexes that initially developed to aid survival, become integrated into more refined movements as the child matures. Children tend to acquire these skills in an orderly fashion and within certain age brackets. This pattern of skill acquisition is often referred to as 'Normal or Typical Development', and is used to monitor a child's developmental progress. In some cases late acquisition of these 'milestones' can indicate developmental delay . However, it must be remembered that the time span within which acquistion of these skills is still considered 'normal' is wide (see WHO Study discussed later), and that some children may skip a milestone altogether eg crawling. [1]
The average age at which gross motor, fine motor and social skills are acquired is outlined below.
Principles of Typical Development[edit | edit source]
- Cranial to Caudal
- Proximal to Distal
- Flexion to Extension
- Asymmetry - Symmetry - Asymmetry
- Gross to Fine; Simple to Complex
- Global Patterns in 3 Planes (Frontal, Sagital, Transverse) [2]
Typical Development Global Patterns & Positions[edit | edit source]
0 - 2 Months[edit | edit source]
You can download the Centres for Disease Control and Prevention 2 Month Milestone Checklist here
Asymmetry and Flexion Period Physiological Flexion Mass Movements Slight intentioned movements of the head in prone and supine In supine there are large movements of the upper limbs, In prone activities are limited to the lifting and turning of the head to breathe Slight increase of extensor muscles control head / neck The baby is more alert, begins to respond to the environment MORO Primitive Reflex Active TACR Present |
[3]
2 Month Milestone: Makes Smoother Movements with Arms and Legs |
SUPINE | PRONE |
Functional Achievement: Slight movements in rotation of the head + lateral flexion of the trunk when trying to move the head, gesture, stare at the mother. Posture: Head Position:
Trunk Position:
Upper Limbs:
Pelvic Girdle:
Lower Limbs:
|
Functional Achievement: Raises head less than 45°, pushes the floor with the fists trying to lift head against gravity and against the resistance of spinal and hip that remain in flexion. Weightbearing: On cheek, hands, forearms and upper chest. Posture: Head Position:
Upper Limbs:
Trunk Position:
Pelvic Girdle:
Lower Limbs:
|
3 Months[edit | edit source]
Symmetry Begins (Control of Bilateral Neck Muscles) Begins orientation to the midline of head The Tonic Grasp Reflex is gone so can play with hands; hand-hand coordination and hand-eye coordination begins Increase of Extension TACR and MORO decreased or disappear. Increased visual control independent from the head also can do visual tracking of 180 degrees of rotation of head to follow an object | |
SUPINE | PRONE |
Functional or Antigravity Achievement: Stares and visual tracking. Head control and maintains in midline. Coordination between; hands-mouth, hand-hand and feet-feet these are up of the plane of support. Immature kicking. Posture: Head Position:
Upper Limbs:
Trunk Position:
Pelvic Girdle:
Lower Limbs:
|
Antigravity Movement: Pushes against surface to raise head at least 45° Chest elevated. Weightbearing: Symmetrically distributed on forearms (epitroclea and hands) and abdomen. Posture: Head Position:
Upper Limbs:
Trunk Position:
Pelvic Girdle:
Lower Limbs:
|
4 Months[edit | edit source]
You can download the Centres for Disease Control and Prevention 4 Month Milestone Checklist here
Development of Sagital Plane Strong symmetry, flexion and extension increased; Beginning of Landau Reaction in Extension Strong synergy between flexor and extensor muscles of the neck, chin in more retraction. Begins gripping feature, can hold an object but loose it by chance. Lateral rocking Able to remove a blanket from the face with both hands |
[4]
Brings Hands to Mouth |
SUPINE | PRONE |
Antigravity Movement:
|
Weightbearing:
Antigravity Movement:
|
5 Months[edit | edit source]
Good lateral weight transfer, symmetry enables coordination between both sides. Increased Landau Reaction Swimming Position Important manipulative strategies in supine. | |
SUPINE | PRONE |
Antigravity Movement: Touches knees with hands, choosing to do it both hands at the same time or independence one from the other. Grasp and manipulate in the midline staring the toy. Gripping still from the ulnar side of the hand, with palmar flexion and supination to explore the toy with mouth |
Antigravity Movement: Chin tucked and chest elevated. Flexion and extension of knees, may play with feet together, lateral weight shift to wrap with the opposite hand. The infant may also push backward in this position. Weightbearing: Weight on hands, lower abdomen and thighs. Triangle base of support between nape elbow and thigh and face knee. Uses this base of support to liberate the face arm and wrap a toy with more stability. |
6 Months[edit | edit source]
You can download the Centers for Disease Control and Prevention 6 Month Milestone Checklist here
[5]
Rolls Over in Both Directions Front to Back, Back to Front |
[6]
When Standing, Supports Weight on Legs and Might Bounce |
[7]
Rocks Back and Forth, Sometimes Crawling Backward before Moving Forward |
SUPINE | PRONE | PIVOTING |
Antigravity Movement: Eyes-feet-hands coordination, rolls from supine to prone. Movement initiated by shoulder, pelvis or head. Posture during Rolling: Head Position:
Upper Limbs:
Trunk Position:
Pelvic Girdle:
Lower Limbs:
Weightbearing in Rolling:
|
Antigravity Movement Swimming posture. Active weight shift to one side and grasp with the other hand. Weightbearing: Weight on one forearm or open hands, and distal thigh. Posture: Head Position:
Upper Limbs:
Pelvic Girdle:
Lower Limbs:
|
Weightbearing: Weight on trunk, arms and hands Posture: Head Position:
Antigravity Movement Pivots:
|
7 Months[edit | edit source]
Supporting legs on hands and knees (four legs) Comando creeping Lateral sitting Can pass one object from one hand to the other Can take one object in each hand Answers to name Starts eating some solid food | |
SUPINE | PRONE |
Antigravity Movements:
|
Antigravity Movements:
|
8 Months[edit | edit source]
| |
PRONE | |
Antigravity Movements:
|
9 Months[edit | edit source]
You can download the Centers for Disease Control and Prevention 9 Month Milestone Checklist here.
Pulling with the arms can stand starting from a kneeling position. Will remain standing only a few seconds. Mature Crawling. Bisyllables “Papa”, Tata” Waves “Bye, Bye” with hand | |
[8]
Can get into Sitting Position |
[9]
Crawls |
10 - 12 Months[edit | edit source]
You can download the Centers for Disease Control and Prevention 12 Month Milestone Checklist here
Makes side/lateral walking supported by hand on a table. Stands alone | |
[10]
Pulls Up to Stand, Walks Holding on to Furniture |
[11]
May Take a Few Steps without Holding On |
12 - 18 Months[edit | edit source]
You can download the Centers for Disease Control and Prevention 18 Month Milestone Checklist here
Walks Autonomously Squat Position | |
[12]
Walks Alone |
[13]
May Walk Up Steps and Run |
[14]
Pulls Toys While Walking |
[15]
Can Help Undress Herself |
18 - 24 Months[edit | edit source]
You can download the Centers for Disease Control and Prevention 24 Month Milestone Checklist here
Runs, walking on toes and heels Jumping on the same spot Walks up and down stairs with handrail Tower of 6 bricks, turn pages of a book Bladder Control | |
[16]
Begins to Run |
[17]
Makes or Copies Straight Lines and Circles |
3 Years[edit | edit source]
You can download the Centers for Disease Control and Prevention 3 Year Milestone Checklist here
Pedal Tricycle One Leg Standing Uses Scissors Uses Spoon and Fork | ||
[18]
Runs Easily |
[19]
Takes Turns in Games |
5 Years[edit | edit source]
You can download the Centers for Disease Control and Prevention 5 Year Milestone Checklist here
Walk in a High Narrow Line
[20]
Stands on One Foot for 10 Seconds or Longer |
[21]
Hops; May be able to Skip |
Gross Motor Activities[edit | edit source]
Activity |
Age |
Lifts head to 45° | 2/12 |
Props on forearms in prone | 3/12 |
Rolls over | 5/12 |
Prone on extended arms | 6/12 |
Balance reactions | 6/12 |
No Head lag | 5/12 |
Sitting without support | 6-8/12 |
Pulls to stand | 8-9/12 |
Cruises | 8-9/12 |
Crawls reciprocally | 9/12 |
Stands alone | 11/12 |
Walks alone | 12/12 |
Runs | 18-24/12 |
Walks up and down stairs with handrail | 2 yrs |
Pedals tricycle | 3 yrs |
Walks narrow line | 5 yrs |
Fine Motor Skills[edit | edit source]
Activity |
Age |
Follows objects with eyes | 1-2/12 |
Grasps objects | 4/12 |
Hand to hand transfers | 5/12 |
Finger feeds | 6/12 |
Objects into container | 12/12 |
Builds 2 block tower | 14/12 |
Helps with dressing | 15/12 |
Builds 6-7 cube tower | 2 yrs |
Uses fork and spoon skilfully | 2.5 yrs |
Holds pencil with adult grasp | 4 yrs |
Colours inside lines | 5 yrs |
Social Skills[edit | edit source]
Activity/Interaction | Age |
Smiles when stimulated | 1/12 |
Vocalises to self | 6/12 |
Plays peek-a-boo | 8/12 |
Stranger anxiety | 8/12 |
Drinks from cup | 12/12 |
Uses spoon | 13/12 |
2-6 words | 15/12 |
Feeds self fully | 2 yrs |
Bladder and bowel control | 2 yrs |
Has 50+ words, understands 1000+ | 2 yrs |
Undresses | 2.5 yrs |
Gramatically correct speech | 4 yrs |
Fluent | 5 yrs |
Age Ranges of Skill Aquisition[edit | edit source]
Windows of Milestone Achievement in Months [24]
While motor milestones are undoubtably a useful way of monitoring a childs' development, it must be remembered that each child is different and will achieve the various milestones at different rates. There is a wide window for achievement of these milestones, during which achievement of the milestone is still considered to be in line with normal development. A study published by the World Health Organisation in 2006 demonstrates just this. This study recorded the variations in milestone achievement in 816 children and generated windows during which achievements of these milestones is considered to be normal development, these are outlined in the table above. It should also be noted that this study found that 4.3% of participants never exhibited the hands and knees crawling milestone[24].
Primitive Reflexes[edit | edit source]
The primitive reflexes are movement patterns that can be involuntarily elicited in a newborn. They exist to enhance chances of survival. These reflexes should be integrated as the child's motor development matures. The persistence of these reflexes beyond the usual ages of integration is suggestive of ischemic brain injury. Below several of the primitive reflexes, their appearance and integration dates are discussed.
Rooting Reflex:
The rooting reflex can be elicited by gently stroking the child's cheek. The reflex is intact if the child's response is to attempt to bring the object to their mouth[25]. This is demonstrated in the video below.
Age of Integration: 3-4 months
Palmar Grasp:
This reflex can be elicited by stimulating the palmar surface of the child's hand. The reflex is intact if the child reflexively grasps the object stimulating the palm[25]. Both this and the plantar grasp reflex are seen in the next video clip.
Age of Integration: 4 months[27]
Plantar Grasp:
This reflex is elicited by stimulating the plantar aspect of the child's foot, just below the toes. The reflex is intact if this cuases toe flexion.
Age of Integration: 9 months[27]
[28]Moro:
The Moro reflex is typically elicited by rapid extension of the child's neck. However it can also occur in response to loud noises. The reflex is intact if the child symetrically and simultaneously abducts and extends the upper limbs, and extends the trunk. The upper limbs then immediately adduct[25]. This reflex is demonstrated in the clip below.
Age of Integration: 3-6 months[27]
[29]
Asymmetrical Tonic Neck Reflex (ATNR):
This reflex is elicited by turning the child's head to one side. A normal response is seen if the baby's extensor tone increases on the side the head is facing, and flexor tone increases on the opposite side[25]. This is demonstrated in the clip below.
Age of Integration: 6 months[27]
[30]References[edit | edit source]
- ↑ 1.0 1.1 1.2 Piper MC. Motor Assessment of the Developing Infant. WB Saunders Company; 1994.
- ↑ 2.0 2.1 Stamer MH. Posture and movement of the child with cerebral palsy. 2015.
- ↑ Centers for Disease Control and Prevention - 2 Month Milestone: Makes smoother movements with arms and legs. Available from: https://www.youtube.com/watch?v=2O5OHu8jrtw [last accessed 13/08/16]
- ↑ Centre for Disease Control & Prevention - 4 Month Milestones:Brings Hands to Mouth. Available from: https://www.youtube.com/watch?v=MoD-xOT9ExI [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 6 Month Milestone: Rolls Over in Both Directions. Available from: https://www.youtube.com/watch?v=KybaUJNhmpo [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 6 Month Milestone: When Standing, Supports Weight on Legs and Might Bounce. https://www.youtube.com/watch?v=Y3EySKt7BmU [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 6 Month Milestone: Rocks Back and Forth. https://www.youtube.com/watch?v=gnwtliGFY5s [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 9 Month Milestone: Can get into sitting position. Available from: https://www.youtube.com/watch?v=6QFwdkuYxdU [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 9 Month Milestone: Crawls. https://www.youtube.com/watch?v=YlVDkF9WXLs [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 1 Year Milestone: Pulls Up to Stand, Walks Holding on to Furniture. Available from: https://youtu.be/fDgMPUtm1os [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 1 Year Milestone: May Take a Few Steps without Holding On. https://www.youtube.com/watch?v=hrTXjv3TjX4 [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 18 Month Milestone: Walks Alone. https://www.youtube.com/watch?v=JaOUmM5ItYU [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 18 Month Milestone: May Walk Up Steps and Run. https://www.youtube.com/watch?v=pJ6lJT0OakY [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 18 Month Milestone: Pulls Toys While Walking https://www.youtube.com/watch?v=E5zpJPaxm18 [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 18 Month Milestone: Can Help Undress Herself. https://www.youtube.com/watch?v=6D4MyzTdyTE [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 24 Month Milestone: Begins to Run. https://youtu.be/6vnTQD0qqGU [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 24 Month Milestone: Makes or Copies Straight Lines and Circles. https://youtu.be/6XV8xXdy0lg [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 3 Year Milestone: Runs Easily. https://youtu.be/wkOOxsIrwgM [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 3 Year Milestone: Takes Turns in Games. https://youtu.be/c9KtszF2_oc [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 5 Year Milestone: Stands on One Foot for 10 Seconds or Longer. https://youtu.be/Ijp0BvoHTzA [last accessed 13/08/16]
- ↑ Centers for Disease Control and Prevention - 5 Year Milestone: Hops; MAy be able to Skip. https://youtu.be/-Pp08tBs0wU [last accessed 13/08/16]
- ↑ 22.0 22.1 Bly L. Motor skills acquisition in the first year: An illustrated guide to normal development. ed. 1. Great Britain: Elsevier Science & Technology books, 1998.
- ↑ 23.0 23.1 23.2 Sheridan M. D. Sharma A. and Cockerill H. From birth to five years. ed. 3. London: Routledge, 2008.
- ↑ 24.0 24.1 WHO Multicentre Growth Reference Study Group. ‘WHO Motor Development Study: Windows of achievement for six gross motor milestones’. Acta Paediatrica. 2006: Suppl 450; 86-95.
- ↑ 25.0 25.1 25.2 25.3 Zitelli BJ, McIntire SC and Nowalk AJ. 2012. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. Ed. 6. Philadelphia: Elsevier
- ↑ onlinemedicalvideo. Physical exam-Newborn Normal: Primitive reflexes-suck, root. Available from: http://www.youtube.com/watch?v=_Vs7_aHfOy8 [last accessed: 17/06/13]
- ↑ 27.0 27.1 27.2 27.3 Votroubek W. 2009. Pediatric Home Care for Nurses: A Family-Centred Approach. Ed. 3. Sudbury: Jones and Bartlett Pblishers Inc.
- ↑ onlinemedicalvideo. Physical exam-Newborn normal: Primitive reflexes-grasp. Available from: http://www.youtube.com/watch?v=BF1j1PXRq-I [last accessed: 17/06/13]
- ↑ Onlnemedicalvideo. Physical exam-Newborn normal:primitive reflexes-moro. Available from: http://www.youtube.com/watch?v=7oD6set72lo [last accessed: 17/06/13]
- ↑ Dr. Prodigious. Primitive Reflexes, Asymettric Tonic Neck-3 months-Infant clinical exam (MRCP. Available from: http://www.youtube.com/watch?v=uXsb7bxTc5g)[last accessed: 17/06/13]