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See all Premium member Presentation Transcript Development of Postural Control : Development of Postural Control OT 3810 Practice I Infants thru Adolescents Progression of Motor DevelopmentRood’s 4 Stage Progression : Progression of Motor DevelopmentRood’s 4 Stage Progression Mobility (development of antigravity movement) Stability Mobility Superimposed on Stability Skill See pg 280 in text Figure 9-1 for a mapping of this Slide 3: Mobility Stability Mobility Superimposed on Stability in WB Mobility Superimposed on Stability in NWB See pg 280 in text Figure 9-1 for a mapping of this RECIPROCAL INNERVATION The contraction of one muscle or group of muscles with the relaxation of muscles that have the opposite function COINNERVATION The contraction of both agonist and antagonist simultaneously.(think isometric contraction) HEAVY WORK MOVEMENT Sustained Proprioceptive Input—Require whole body movement and resistance SKILL Coordinated movement that enables distal segment of an extremity to manipulate an object while in a stabilized posture Assessment Procedures : Assessment Procedures Early Intervention Developmental Profile (0-3 years) Gross Motor Domain Influence of CNS Reflexes on Posture and Movement : Influence of CNS Reflexes on Posture and Movement 0-36 months Gross Motor Scale (Early Intervention Developmental Profile) This measures… : This measures… Integration of Primitive Reflexes Emergence of Righting, Equilibrium, and Protective Reactions Motor Skills Review Milestones : Review Milestones Resource: EIDP Gross Motor Domain Slide 8: Motor Behaviors Roods Progression First…Need to Observe and Think About Slide 9: And then Apply Within a Dynamic Systems Framework Body Systems Context of Movement Task Demand Video of Michael and Zack : Video of Michael and Zack Follow video with Handout on Normal vs Abnormal Motor Development Intervention Approaches for Posture and Movement : Intervention Approaches for Posture and Movement “Systems Approach” Consider many influences contributing to the movement Task requirements Neuromotor system Environment Motivation Learning a Motor Skill : Learning a Motor Skill Not merely due to maturation Result of learning and practice …leading to permanent change in skill How do we facilitate “learning and practice?” Learning and Practice via.. : Learning and Practice via.. Feedback Intrinsic-sensory information generated from the interaction Extrinsic-response of the environment produced because of the action This is “Knowledge of Results” Developmental Reflexes : Developmental Reflexes Concepts : Concepts Reflexes are reactions to stimuli Stimuli includes Position Movement Tactile stimulus Concepts… : Concepts… There are primitive and mature reflexes Primitive reflexes are infantile (0-4 months) Mature reflexes support functional posture and mobility (4 m—adult) Reflexes Reflect CNS Function : Reflexes Reflect CNS Function Spinal Brainstem Midbrain Cortical Supine/Prone Postures Righting/Equilibrium Reactions Slide 18: Primitive Reflexes and Inhibition Primitive reflexes integrate/are inhibited to allow higher level, mature reflexes to emerge Primitive Reflexes and Pathology : Primitive Reflexes and Pathology Primitive reflexes persist and emerge with CNS damage Examples: CP, Stroke, TBI Reflex Testing vs Observation : Reflex Testing vs Observation Traditional method has been to test individual reflexes. Better method is to observe movement and analyze the presence of primitive reflexes absence of mature reflexes Procedure… : Procedure… Learn to identify individual reflexes Understand the significance of each Observe posture and movement to determine presence/absence of reflexes Primitive Reflexes : Primitive Reflexes Babinski Palmar Grasp Moro Reflex (vs Startle Reflex) Flexor Withdrawal Rooting Reflex Crossed Extension Negative Supporting Reaction Positive Supporting Reaction Tonic Labyrinthine Reflex: Prone Tonic Labyrinthine Reflex: Supine Extensor Thrust Asymmetrical Tonic Neck Symmetrical Tonic Neck To Mature Reflex List To Intro Slide 23: Babinski To Primitive Reflex List Stimulus: Stroke bottom of foot Reaction: Fanning of Toes Significance: Positive response indicative of CNS dysfunction if persists after 3 years Slide 24: To Primitive Reflex List Palmar Grasp Reflex Stimulus: Stimulus in palm of hand Reaction: Automatic grasp Significance: Positive response after 4 months prevents development of voluntary open and closing of hand Slide 25: Moro Reflex To Primitive Reflex List Stimulus: Infant in semi supine position Release support from the infants head, neck and upper trunk. Allow the head to drop back 20 to 30 degrees Reaction: Abduction and external rotation of shoulders; infant will cry Significance: If persists, prevents head control, righting reactions and protective responses Slide 26: Flexor Withdrawal To Primitive Reflex List Stimulus: Rapid stroke sole of foot Reaction: Flexion of stimulated leg at knee and hip Significance: Protective and avoidance response Slide 27: Rooting Reflex To Primitive Reflex List Stimulus: Stimulus around mouth Reaction: Infant turns toward stimulus to find nourishment Significance: Adaptive response in infancy; strength of response depends on hunger, sleep state. Persistence interferes with oral motility Slide 28: Crossed Extension To Primitive Reflex List Stimulus: Flexion of leg Reaction: Flexion and then extension and adduction of opposite leg Significance: Persistence interferes with reciprocal leg motion and walking Slide 29: Negative Supporting Reaction To Primitive Reflex List Stimulus: Maintain infant in standing or upright position Reaction: Hips and knees show slight flexion Significance: Indicative of extensor to flexor phase Slide 30: Positive Supporting Reaction To Primitive Reflex List Stimulus: Hold the infant in upright posture Reaction: Touch soles of feet to firm surface and bounce on balls of feet Significance: Will partially bear weight but will slightly flex at knees and hips Precursor to stepping reaction; as matures will see increased extension at hips and knees Slide 31: Tonic Labyrinthine: Supine To Primitive Reflex List Stimulus: Infant in supine Reaction: Increased extensor tone Significance: Persistence will prevent infant from moving out of supine posture Slide 32: Tonic Labyrinthine: Prone To Primitive Reflex List Stimulus: Infant in prone Reaction: Increased flexor tone Significance: Persistence will prevent infant from moving out of prone posture Slide 33: Extensor Thrust To Primitive Reflex List Stimulus: Stimulate sole of foot Reaction: Extension of leg Significance: Persistence interferes with flexion/extension patterns Slide 34: Asymmetrical Tonic Neck To Primitive Reflex List Stimulus: Turn infants head Reaction: infant assumes “fencer posture” Significance: Persistence interferes with postural control; especially bilateral movement Slide 35: Symmetrical Tonic Neck To Primitive Reflex List Stimulus: Infant in prone position; dorsiflexion of head; ventroflexion of the head Reaction: With DF, arms extend and legs flex; With VF, arms flex and legs extend Significance: Persistence prevents crawling Mature Reflexes : Mature Reflexes Optical Righting Landau Equilibrium Reaction: Prone Equilibrium Reaction: Supine Body Righting Acting On The Head Body Righting Acting On The Body Protective Extension: Forward Protective Extension: Sideways Protective Extension: Backwards Equilibrium Reaction: Sitting Equilibrium Reaction: Quadruped Equilibrium Reaction: Standing Back to Primitive Reflexes To Intro Slide 37: Optical Righting To Mature Reflex List Stimulus: Place infant in vertical, prone, supine position Reaction: Orients head in opposite postion Significance: Emergence supports postural control and stability Slide 38: Landau To Mature Reflex List Stimulus: Hold infant in prone position Reaction: Infant assumes an extension posture; “flying position” Significance: Allows prone extension, sitting and standing. Slide 39: Equilibrium Reaction: Prone To Mature Reflex List Stimulus: Place infant in prone on a tiltboard and tilt side to side Reaction: Infant will extend his neck and arch his back towards the elevated side and abduct and extend his arms Significance: Precursor to sitting balance Slide 40: Equilibrium Reaction: Supine To Mature Reflex List Stimulus: Place infant in supine on a tiltboard and tilt side to side Reaction: Infant will extend his neck and arch his back towards the elevated side and abduct and extend his arms Significance: Precursor to sitting balance Slide 41: Body Righting Acting on The Head To Mature Reflex List Stimulus: Infant in supine, flex one leg and rotate it across pelvis to opposite side Reaction: Infants pelvis, trunk, shoulders and then head follows the leg segmentally Significance: Facilitates rolling Slide 42: Body Righting Acting on The Body To Mature Reflex List Stimulus: Turn head sidewards Reaction: Segmental follow in direction of rotated head Significance: Enables rolling and integrated when infant is able to transition from supine without rolling and moving to quadruped position Slide 43: Protective Extension: Forward To Mature Reflex List Stimulus: Hold infant around chest and plunge head first, face down Reaction: Extension of arms with some abduction and fingers extend as to protect self Significance: Preparation for support in sitting; critical for development of crawling Slide 44: Protective Extension: Sideways To Mature Reflex List Stimulus: Place infant in sitting and direct force to cause fall to side Reaction: Infant abducts on arm on side infant pushed toward with extension of elbow, wrist, fingers Significance: Preparation for support for and balance in sitting; critical for crawling Slide 45: Protective Extension: Backwards To Mature Reflex List Stimulus: Sitting with legs out in front and direct enough force to cause infant to fall backwards Reaction: Extension of arms backward on displacement of position Significance: Preparation for support and balance in sitting; critical for development of crawling Slide 46: Equilibrium Reactions: Sitting To Mature Reflex List Stimulus: Tilt forward or backwards or pull body laterally to one side by gently tugging on arm Reaction: Infant will right to opposite of tilt motion Significance: Precursor to sitting balance Slide 47: Equilibrium Reaction: Quadruped To Mature Reflex List Stimulus: Move tiltboard side to side Reaction: Infants arms and leg on the elevated side will abduct and extend; the other arm will also abduct Significance: Precursor to reciprocal crawling Slide 48: Equilibrium Reaction: Standing To Mature Reflex List Stimulus: Tilt in backwards position or hold his arm in abduction/extension and tug gentlly Reaction: Infant will maintain or right his head in normal vertical position or in backward direction will move in an anterior position and feet will dorsiflex Significance: Necessary for standing and walking To Intro 0-2 Months : 0-2 Months Prone: Turn heads to both sides In prone, move baby slowly, assisting her to turn her head. Gradually reduce the amount of assistance as the child gains skill. 0-2 months : 0-2 months Turn from side to back (neck righting) Position on side. Turn head and face up toward shoulder so that is off the floor. Continue to move the head. Body will follow automatically so rolls to back http://vimeo.com/140800 0-2 months : 0-2 months Upright: Head bobs but stays erect Hold upright in your arms to her head is above your shoulder. Provide support at scapula and neck, provide gentler compression to facilitate 0-2 months : 0-2 months Prone, optical righting Begin in prone position with gravity minimized..gradually increase the demand to vestibular receptors; trunk extensors 0-2 months : 0-2 months Facilitate with prone wedge and mirror 0-2 months : 0-2 months Baby in suspended, horizontal position with good support under trunk. Have someone call name, sing, encouraging to look up. 0-2 months : 0-2 months Prone: raises head to 45 degrees for at least 30 seconds Place bolster or towel under chest to raise head and chest slightly. Assist in lifting head What is THAT? 0-2 months : 0-2 months Moves legs in alternating patterns when kicking Slowly bend knees, one at a time, to chest in bicycle action. Diaper changing time is good time to play this bicycle game. Place elastic (not tight) ankle bracelets on baby’s ankles to facilitate awareness of feet moving Use Crib Gym 3-5 months : 3-5 months Prone: pushes up bearing weight on her forerarms raises so that chest and head raised to to 90 degrees (puppy position) Hi Baby!! Hi Baby!! 3-5 months : 3-5 months Straighten legs and take some weight on his feet when upright Hold firmly on the chest and bounce him on feet until you can feel him taking weight on his own Do not do stimulate the bottoms of his feet if spasticity in lower extremities. Child must have sufficient head control to maintain head in upright position 3-5 months : 3-5 months Come to sitting without head lag Support baby’s scapula; feel for contractions..gradually work distally as baby is able to work on her own from supine to upright DO NOT allow baby’s head to fall backward. Never pull to sitting with baby’s hands until you are certain she has adequate scapular and neck stability. 3-5 months : 3-5 months Pulls self to sitting without head lag Progress to baby being able to use fixation scapula, shoulder, elbow and wrist to pull. With baby in sitting, slowly descend baby to prone position while initially providing complete proximal support and gradually reducing… 3-5 months : 3-5 months Prone: Rolls to Supine In a side lying position, turn head toward the shoulder that that is off the floor and gently start to roll baby on her back Use novel items to facilitate child to roll from supine to back 3-5 months : 3-5 months Integration of STNR Place baby face down on floor. Offer a toy or bottle at a height that will encourage him to lift his head and trunk to look or listent. Support baby just under the hips and lower chest so he arches most of his back as he raises up. 3-5 months : 3-5 months Prone: Integration of tonic labyrinthine reflex (TLR) Place baby in prone over your lap. Assist to lift her legs until she is able to do this alone 3-5 months : 3-5 months Supine: Integration of tonic labyrinthine reflex (TLR) Tie bells or colorful bows on child’s feet. Help him reach for his feet by lifting his legs and wiggling his feet until he notices them. 3-5 months : 3-5 months Supine: Integration of asymetrical tonic neck reflex (ATNR) Encourage hands at midline when in sidelying position. When holding baby, keep hands in front of her when cradled in one of your arms for feeding. 6-8 months : 6-8 months Sitting: trunk erect in chair 6-8 months : 6-8 months Sitting: eret You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Postural Control benjatchison Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 3552 Category: Education License: All Rights Reserved Like it (21) Dislike it (0) Added: September 29, 2009 This Presentation is Public Favorites: 2 Presentation Description No description available. Comments Posting comment... By: benjatchison (7 month(s) ago) Of course! I;m pleased you found it useful Saving..... Post Reply Close Saving..... Edit Comment Close By: aleali (7 month(s) ago) hello; this is a request for permission of dowloading the postural control presentation. with regards aleali Saving..... Post Reply Close Saving..... Edit Comment Close By: benjatchison (15 month(s) ago) Dear Soohyuning Thanks for the comment..I'm glad it was helpful to you Saving..... Post Reply Close Saving..... Edit Comment Close By: soohyuning (15 month(s) ago) Wonderful presentation. this is really helpful Saving..... Post Reply Close Saving..... Edit Comment Close By: drharmeet (19 month(s) ago) thanx fr such a gr8 help.. Saving..... Post Reply Close Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript Development of Postural Control : Development of Postural Control OT 3810 Practice I Infants thru Adolescents Progression of Motor DevelopmentRood’s 4 Stage Progression : Progression of Motor DevelopmentRood’s 4 Stage Progression Mobility (development of antigravity movement) Stability Mobility Superimposed on Stability Skill See pg 280 in text Figure 9-1 for a mapping of this Slide 3: Mobility Stability Mobility Superimposed on Stability in WB Mobility Superimposed on Stability in NWB See pg 280 in text Figure 9-1 for a mapping of this RECIPROCAL INNERVATION The contraction of one muscle or group of muscles with the relaxation of muscles that have the opposite function COINNERVATION The contraction of both agonist and antagonist simultaneously.(think isometric contraction) HEAVY WORK MOVEMENT Sustained Proprioceptive Input—Require whole body movement and resistance SKILL Coordinated movement that enables distal segment of an extremity to manipulate an object while in a stabilized posture Assessment Procedures : Assessment Procedures Early Intervention Developmental Profile (0-3 years) Gross Motor Domain Influence of CNS Reflexes on Posture and Movement : Influence of CNS Reflexes on Posture and Movement 0-36 months Gross Motor Scale (Early Intervention Developmental Profile) This measures… : This measures… Integration of Primitive Reflexes Emergence of Righting, Equilibrium, and Protective Reactions Motor Skills Review Milestones : Review Milestones Resource: EIDP Gross Motor Domain Slide 8: Motor Behaviors Roods Progression First…Need to Observe and Think About Slide 9: And then Apply Within a Dynamic Systems Framework Body Systems Context of Movement Task Demand Video of Michael and Zack : Video of Michael and Zack Follow video with Handout on Normal vs Abnormal Motor Development Intervention Approaches for Posture and Movement : Intervention Approaches for Posture and Movement “Systems Approach” Consider many influences contributing to the movement Task requirements Neuromotor system Environment Motivation Learning a Motor Skill : Learning a Motor Skill Not merely due to maturation Result of learning and practice …leading to permanent change in skill How do we facilitate “learning and practice?” Learning and Practice via.. : Learning and Practice via.. Feedback Intrinsic-sensory information generated from the interaction Extrinsic-response of the environment produced because of the action This is “Knowledge of Results” Developmental Reflexes : Developmental Reflexes Concepts : Concepts Reflexes are reactions to stimuli Stimuli includes Position Movement Tactile stimulus Concepts… : Concepts… There are primitive and mature reflexes Primitive reflexes are infantile (0-4 months) Mature reflexes support functional posture and mobility (4 m—adult) Reflexes Reflect CNS Function : Reflexes Reflect CNS Function Spinal Brainstem Midbrain Cortical Supine/Prone Postures Righting/Equilibrium Reactions Slide 18: Primitive Reflexes and Inhibition Primitive reflexes integrate/are inhibited to allow higher level, mature reflexes to emerge Primitive Reflexes and Pathology : Primitive Reflexes and Pathology Primitive reflexes persist and emerge with CNS damage Examples: CP, Stroke, TBI Reflex Testing vs Observation : Reflex Testing vs Observation Traditional method has been to test individual reflexes. Better method is to observe movement and analyze the presence of primitive reflexes absence of mature reflexes Procedure… : Procedure… Learn to identify individual reflexes Understand the significance of each Observe posture and movement to determine presence/absence of reflexes Primitive Reflexes : Primitive Reflexes Babinski Palmar Grasp Moro Reflex (vs Startle Reflex) Flexor Withdrawal Rooting Reflex Crossed Extension Negative Supporting Reaction Positive Supporting Reaction Tonic Labyrinthine Reflex: Prone Tonic Labyrinthine Reflex: Supine Extensor Thrust Asymmetrical Tonic Neck Symmetrical Tonic Neck To Mature Reflex List To Intro Slide 23: Babinski To Primitive Reflex List Stimulus: Stroke bottom of foot Reaction: Fanning of Toes Significance: Positive response indicative of CNS dysfunction if persists after 3 years Slide 24: To Primitive Reflex List Palmar Grasp Reflex Stimulus: Stimulus in palm of hand Reaction: Automatic grasp Significance: Positive response after 4 months prevents development of voluntary open and closing of hand Slide 25: Moro Reflex To Primitive Reflex List Stimulus: Infant in semi supine position Release support from the infants head, neck and upper trunk. Allow the head to drop back 20 to 30 degrees Reaction: Abduction and external rotation of shoulders; infant will cry Significance: If persists, prevents head control, righting reactions and protective responses Slide 26: Flexor Withdrawal To Primitive Reflex List Stimulus: Rapid stroke sole of foot Reaction: Flexion of stimulated leg at knee and hip Significance: Protective and avoidance response Slide 27: Rooting Reflex To Primitive Reflex List Stimulus: Stimulus around mouth Reaction: Infant turns toward stimulus to find nourishment Significance: Adaptive response in infancy; strength of response depends on hunger, sleep state. Persistence interferes with oral motility Slide 28: Crossed Extension To Primitive Reflex List Stimulus: Flexion of leg Reaction: Flexion and then extension and adduction of opposite leg Significance: Persistence interferes with reciprocal leg motion and walking Slide 29: Negative Supporting Reaction To Primitive Reflex List Stimulus: Maintain infant in standing or upright position Reaction: Hips and knees show slight flexion Significance: Indicative of extensor to flexor phase Slide 30: Positive Supporting Reaction To Primitive Reflex List Stimulus: Hold the infant in upright posture Reaction: Touch soles of feet to firm surface and bounce on balls of feet Significance: Will partially bear weight but will slightly flex at knees and hips Precursor to stepping reaction; as matures will see increased extension at hips and knees Slide 31: Tonic Labyrinthine: Supine To Primitive Reflex List Stimulus: Infant in supine Reaction: Increased extensor tone Significance: Persistence will prevent infant from moving out of supine posture Slide 32: Tonic Labyrinthine: Prone To Primitive Reflex List Stimulus: Infant in prone Reaction: Increased flexor tone Significance: Persistence will prevent infant from moving out of prone posture Slide 33: Extensor Thrust To Primitive Reflex List Stimulus: Stimulate sole of foot Reaction: Extension of leg Significance: Persistence interferes with flexion/extension patterns Slide 34: Asymmetrical Tonic Neck To Primitive Reflex List Stimulus: Turn infants head Reaction: infant assumes “fencer posture” Significance: Persistence interferes with postural control; especially bilateral movement Slide 35: Symmetrical Tonic Neck To Primitive Reflex List Stimulus: Infant in prone position; dorsiflexion of head; ventroflexion of the head Reaction: With DF, arms extend and legs flex; With VF, arms flex and legs extend Significance: Persistence prevents crawling Mature Reflexes : Mature Reflexes Optical Righting Landau Equilibrium Reaction: Prone Equilibrium Reaction: Supine Body Righting Acting On The Head Body Righting Acting On The Body Protective Extension: Forward Protective Extension: Sideways Protective Extension: Backwards Equilibrium Reaction: Sitting Equilibrium Reaction: Quadruped Equilibrium Reaction: Standing Back to Primitive Reflexes To Intro Slide 37: Optical Righting To Mature Reflex List Stimulus: Place infant in vertical, prone, supine position Reaction: Orients head in opposite postion Significance: Emergence supports postural control and stability Slide 38: Landau To Mature Reflex List Stimulus: Hold infant in prone position Reaction: Infant assumes an extension posture; “flying position” Significance: Allows prone extension, sitting and standing. Slide 39: Equilibrium Reaction: Prone To Mature Reflex List Stimulus: Place infant in prone on a tiltboard and tilt side to side Reaction: Infant will extend his neck and arch his back towards the elevated side and abduct and extend his arms Significance: Precursor to sitting balance Slide 40: Equilibrium Reaction: Supine To Mature Reflex List Stimulus: Place infant in supine on a tiltboard and tilt side to side Reaction: Infant will extend his neck and arch his back towards the elevated side and abduct and extend his arms Significance: Precursor to sitting balance Slide 41: Body Righting Acting on The Head To Mature Reflex List Stimulus: Infant in supine, flex one leg and rotate it across pelvis to opposite side Reaction: Infants pelvis, trunk, shoulders and then head follows the leg segmentally Significance: Facilitates rolling Slide 42: Body Righting Acting on The Body To Mature Reflex List Stimulus: Turn head sidewards Reaction: Segmental follow in direction of rotated head Significance: Enables rolling and integrated when infant is able to transition from supine without rolling and moving to quadruped position Slide 43: Protective Extension: Forward To Mature Reflex List Stimulus: Hold infant around chest and plunge head first, face down Reaction: Extension of arms with some abduction and fingers extend as to protect self Significance: Preparation for support in sitting; critical for development of crawling Slide 44: Protective Extension: Sideways To Mature Reflex List Stimulus: Place infant in sitting and direct force to cause fall to side Reaction: Infant abducts on arm on side infant pushed toward with extension of elbow, wrist, fingers Significance: Preparation for support for and balance in sitting; critical for crawling Slide 45: Protective Extension: Backwards To Mature Reflex List Stimulus: Sitting with legs out in front and direct enough force to cause infant to fall backwards Reaction: Extension of arms backward on displacement of position Significance: Preparation for support and balance in sitting; critical for development of crawling Slide 46: Equilibrium Reactions: Sitting To Mature Reflex List Stimulus: Tilt forward or backwards or pull body laterally to one side by gently tugging on arm Reaction: Infant will right to opposite of tilt motion Significance: Precursor to sitting balance Slide 47: Equilibrium Reaction: Quadruped To Mature Reflex List Stimulus: Move tiltboard side to side Reaction: Infants arms and leg on the elevated side will abduct and extend; the other arm will also abduct Significance: Precursor to reciprocal crawling Slide 48: Equilibrium Reaction: Standing To Mature Reflex List Stimulus: Tilt in backwards position or hold his arm in abduction/extension and tug gentlly Reaction: Infant will maintain or right his head in normal vertical position or in backward direction will move in an anterior position and feet will dorsiflex Significance: Necessary for standing and walking To Intro 0-2 Months : 0-2 Months Prone: Turn heads to both sides In prone, move baby slowly, assisting her to turn her head. Gradually reduce the amount of assistance as the child gains skill. 0-2 months : 0-2 months Turn from side to back (neck righting) Position on side. Turn head and face up toward shoulder so that is off the floor. Continue to move the head. Body will follow automatically so rolls to back http://vimeo.com/140800 0-2 months : 0-2 months Upright: Head bobs but stays erect Hold upright in your arms to her head is above your shoulder. Provide support at scapula and neck, provide gentler compression to facilitate 0-2 months : 0-2 months Prone, optical righting Begin in prone position with gravity minimized..gradually increase the demand to vestibular receptors; trunk extensors 0-2 months : 0-2 months Facilitate with prone wedge and mirror 0-2 months : 0-2 months Baby in suspended, horizontal position with good support under trunk. Have someone call name, sing, encouraging to look up. 0-2 months : 0-2 months Prone: raises head to 45 degrees for at least 30 seconds Place bolster or towel under chest to raise head and chest slightly. Assist in lifting head What is THAT? 0-2 months : 0-2 months Moves legs in alternating patterns when kicking Slowly bend knees, one at a time, to chest in bicycle action. Diaper changing time is good time to play this bicycle game. Place elastic (not tight) ankle bracelets on baby’s ankles to facilitate awareness of feet moving Use Crib Gym 3-5 months : 3-5 months Prone: pushes up bearing weight on her forerarms raises so that chest and head raised to to 90 degrees (puppy position) Hi Baby!! Hi Baby!! 3-5 months : 3-5 months Straighten legs and take some weight on his feet when upright Hold firmly on the chest and bounce him on feet until you can feel him taking weight on his own Do not do stimulate the bottoms of his feet if spasticity in lower extremities. Child must have sufficient head control to maintain head in upright position 3-5 months : 3-5 months Come to sitting without head lag Support baby’s scapula; feel for contractions..gradually work distally as baby is able to work on her own from supine to upright DO NOT allow baby’s head to fall backward. Never pull to sitting with baby’s hands until you are certain she has adequate scapular and neck stability. 3-5 months : 3-5 months Pulls self to sitting without head lag Progress to baby being able to use fixation scapula, shoulder, elbow and wrist to pull. With baby in sitting, slowly descend baby to prone position while initially providing complete proximal support and gradually reducing… 3-5 months : 3-5 months Prone: Rolls to Supine In a side lying position, turn head toward the shoulder that that is off the floor and gently start to roll baby on her back Use novel items to facilitate child to roll from supine to back 3-5 months : 3-5 months Integration of STNR Place baby face down on floor. Offer a toy or bottle at a height that will encourage him to lift his head and trunk to look or listent. Support baby just under the hips and lower chest so he arches most of his back as he raises up. 3-5 months : 3-5 months Prone: Integration of tonic labyrinthine reflex (TLR) Place baby in prone over your lap. Assist to lift her legs until she is able to do this alone 3-5 months : 3-5 months Supine: Integration of tonic labyrinthine reflex (TLR) Tie bells or colorful bows on child’s feet. Help him reach for his feet by lifting his legs and wiggling his feet until he notices them. 3-5 months : 3-5 months Supine: Integration of asymetrical tonic neck reflex (ATNR) Encourage hands at midline when in sidelying position. When holding baby, keep hands in front of her when cradled in one of your arms for feeding. 6-8 months : 6-8 months Sitting: trunk erect in chair 6-8 months : 6-8 months Sitting: eret