Child Development Test 2: Self-Care

How does a child's role in the family pay a part in self care skills?

-As the child ages, they will be required to self care independantly - Cultural beliefs (family beliefs) -Socioeconomic Status (SES): Kids w/out money ma be required/pushed to develope faster vs. kids w/money may be "babied" and not develop as quickly

For feeding, what milestones are met in months 12-15?

-Better sustained bite (but limited by # of teeth) -Playful bites on spoon (this is not a reflex) -Food must be cut into pieces so child doesn't choke -Chewing is primarily vertical + some diagonal movements closer to 15 months (diagonal movements are primarily used after 15 months)

Functional Feeding problems Associated with Specific Disabilities

-Cerebral Palsy: Oral motor patterns, oral reflexes, oral muscle tone, trunk/neck/jaw stability, postural control, general mobility, tonic bite -Sensory Processing Dysfunction:Oral motor patterns, oral reflexes, oral muscle tone, trunk/neck/jaw stability, postural control, general mobility, tonic bite -Autism: Sensory defensiveness, interaction skills, tolerance of taste/texture/sight, behaviors -Respiratory or Cardiac Issues: Endurance, coordination suck/swallow/breathe, cough strength -FTT: Negative behaviors, interactions between child and caregivers, sensory processing dysfunction

Demand vs. Scheduled feedings

-Demand feedings: Commin in orinary children, they'll eat to satiation & this can be seen as a child's 1st attempt at communication; the baby cries=food! -Schedules feedings: Common in sick children(NICU); Most premature infants do not wake up to eat, so if left to demand feedings, they'll end up loosing weight, therefore their put on a 2-3 hour schedule usually via nasogastric tube until they've reached the adjusted age of 32-34 wks gestational age when bottle feeding starts (they'll slowly ween off the tube)

Concrete Operation Stage

-Developes at 7-13 yrs; This child beggining to apply basic principles of logic, helps to understand relationships between objects. -Key behaviors achieved at this time: Reversibility, Seriation, Classification, Conservation (ofsubstance, distance), Transformation, Moral Development, Symbolic Thinking

Seriation

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Ability to put a variety of things into some kind of order; To test, give child a variety of objects of various sizes, shoes and patters, weights and volumes & ask the child to put them in order -A 6 yr old will put them in order by size (a more obvious charecteristic)....7 yr old puts them in order of patter...9 yr old puts them in order by weight....10 yr old will put them in order by volume, as in how much does each object hold

Reversibility

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Ability to put things in order (backwards or forwards) -To Test: put 3 colored blocks in a row (Red, Green, Blue), push them into the left end of the tunnel w/red being first -Repsponses: pre-operational: W/e block goes in 1st must come out first Concrete operation:

Conservation

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Ability to realize that one aspect of something can remain the same while other aspect is changing; 2 types 1.Conservation of Substance: Test by having child pour an 8 ounce cup of water into a tall, thin cylinder, then have them pour 8 ounce cup of water into small, fat bowl & ask them which has more water in it....5 yr old says taller object will have more...8 yr old will say they both have the same amount (8ounces=8ounces) 2. Conservation of Distance: Test by drawing 2 lines that start and end at the same point, make one straight and the other curved, ask the child which is longer or which takes longer to follow....5 yr old will say they both take the same time/distance (don't consider relative length)... 8 yr old will say the curved line takes longer

Classification

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Ability to sort stimuli into categories according to certain characteristics Relational classification: Objects put together by common function or association (fruits, tools) Descriptive Classification: Putting objects together by common attribute (plants, animals) Generic Classification: Basic method that uses general classes or categories -To Test: Give the child a variety of objects, ask to sort them....4-5 yr olds will sort based on striking features, usually color or shape, some mistakes may be made... 6-8 yr olds will be more descriptive vs. differenet types of cars

Transformation

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Ability to tell how one state or apperance of a substance can be changed into another, ex-butterflies come from a cocoon; to test, place a glass of ice on a table and let the ice melt, then put the water on the stove and let it boil, ask the child what happened to the ice and then the water....4-5 yr old will say the ice cube has dissappeared, then the water dissapeared...8 yr old will know that ice is frozen an when it is warm it melts, then when its heated the steam is water evaporation

Symbolic Thinking

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Children no longer need visual cues to think of things, they'll just come, they'll start to ask "what if" questions; they can also remember past events and anticipate future events based on past experiences...similiar to cause and effect...To test, ask child where do dreams come from, where is the dream made?....5 yr old does not know/"dreams are in front of you"...8 yrs old will be able to tell you dreams come from your head, they realize things do not need to be present in the environment for dreaming to take place.

Moral Development

-Develops during Piaget's Concrete Operation Stage: 7-13 yrs =Development of sense of ethics and values, this also involved problem solving; To test ask the child which is worse, stealing a loaf of bread for your family or stealing a small ribbon for yourself... 5 yr old will make judgement based on what they've learned is good vs. bad behavior, for ex. stealing=bad, so both are bad.... 8 yr old will make judgement based on person's intent, stealing for yourself is worse so stealing for your family is okay. -Could also test by asking what a lie is versus what a mistake is...5 yr old makes judgement based on what they've learned, and lying=breaking rule so its bad... 8 yr old makes judgement based on persons intent, a lie is okay if the truth would hurt them

What are the major developments during Kolberg's Conventional reasoning stage of moral development?

-Instrumental purpose and exchange: Behavior guided by their own and other's interests-what popular? -Maintaining mutual relations: Treat others how you would like to be treated -Social system conscience: Becoming aware of the consequences of actions, they're concerened about rule and following them

What factors Affect Peer Interactions?

-The child has greater interaction w/familiar pple vs. strangers, seen as early as 9 months; However if a familiar person dissapears for a few days, it will be as if their a stranger again -Those who have been around peers show more complex social behaviors vs. those not around peers -Dyad vs. a group: having a 1-on-1 conversation (child/child or child/adult) elicits more social behaviors at a more advanced level of groups.

Typical Behaviors

-learned on Piaget's Preoperational stage (3-7yrs) -3 typical behaviors in preoperational stage: 1. egocentrism=Child tends to be centered on themselves, ex-if a child gets a treat, they need a treat too and a bigger one!, They have difficulty seeing things from another POV 2. Centration=Child can focus on one idea or aspect of an event, they want something "now" that may require time. 3. Animism=Attributing human qualities to inanimate objects

Identification and Labeling

-learned on Piaget's Preoperational stage (3-7yrs) -ID: pointing, gives or touches a requested object -Labeling: Verbally naming objects, highly dependent on language skills

Symbolic Play

-learned on Piaget's Preoperational stage (3-7yrs) -Involves using symbolds to represent real things; ex. little girls have tea parties vs. little boys will use a hammer toy -There is much "make belief" or "pretend" play at this stage, kids will mimic actions they see other pple or seen on tv...This alos leads the child to encounter reality

Representation Phase

-learned on Piaget's Preoperational stage (3-7yrs) -Language to recall experiences developed here -As speech and language improve, so does ability to recall symbols

Describe infancy phase for development of peer directed behavior

0-12 months; Based upon exposure to other infants, they'll began to smile at eachother as early as 2 months, @ 3-4 months they can reach out and touch peers ...At 6 months the social part truly begins, peers will "coo" at eachother

At what age can the child pull their pants off by thereself-especially if wet or soiled & alone in crib

1 year

Dressing trends

1. A child can take things off before putting them on; ex. Child of 6 months takes a sock off as a byproduct of playing w/its feet(its accidental), overtime this will become purposeful. 2. Distal dressing occurs before proximal 3. Children learn how to do fastners (zippers, buttons, laces, hooks) @ about 3 yrs... They'll learn to undo 1st before doing it up; Larger (1 inch) before smaller (0.5 inches)

What are the 4 principles of play?

1. Actions involved in play follow a sequential, developmental progression 2. Play focuses on successful attainemnt of tasks 3. Play is repitition of experience, exploration, experimentation, and imitation of ones surroundings 4. Play is preperation for life's skills

What are Piaget's 3 terms of cognitive development?

1. Assimilation 2. Accommodation 3. Equilibrium

Developmental Progression of Toileting Skills

1. Bowel control precedes bladder control-@ this time, constipation can be a problem, so offer fluids! 2. Day-time bladder control precedes night-time bladder control- Night time accidents are common through 5 yrs due to: A. Child not waking up to realize they need to go; B. Child may be frightened of "monsters under the bed"; C. Child consumes too many liquids prior to bedtime...How can we prevent this? Setting alarm clocks in the middle of the night to ensure the child goes to the restroom, provide verbal reassurance regarding those monsters, restrict fluids (delicate balance, could cause constipation)

What skills and abilities were most important to Havighurst?

1. Building a wholesome attitude toward oneself: Child deals with sexuality and their own specific self care needs 2. Learning to get along with age mates: ability to compromise or hold a grudge formed in yrs 6-12 3. Masculine and feminine roles: 4. Consious morality and scale of views: The child must learn rules and to value others and their contributions (Similiar to Kohlbers Preconvention/Conventional Stages & Selma's self-reflection stage) 5. Achieving more personal independance: The child can act with others and their environment to be successful; At 9-12 yrs, the child will insist they don't need a babysitter 6. Positive attitudes toward social groups and institutions, this child is probably involved in many teams and must work with others to be successful

What are the 2 kinds of sucking reflexes

1. Feeding- 1-2 sec rate 2. Non-nutritive sucking(on thumb)- 2-5 sec rate

What are the 2 main purposes for reflexes related to feeding?

1. Gaining nutrition, getting food toward mouth 2. Prevent chicking/protection

What are the phases of development of peer directed behavior?

1. Infancy phase (0-12 months) 2. toddler phase (13-24 months) 3. preschoolers (24-42 months) ...3 yrs-aware they are part of a group...6 yrs-friends w/same interests...9 yrs- secrets are told/notes passed...11 yrs-care about others

Studies on the Auditory System

1. Infants can discriminate different frequencies of sound 2. Infants have a higher threshold than adults

What specific tasks did Havighurst believe the adolescent needed to accomplish

1. Mature relationships with both sexes: 2. Masculine and feminine roles 3. Emotional Independance 4. Marriage and family life 5. Civic competance: You apart of a society, which dictates rules and regulations 6. Social responsible behavior/set of values These tasks build upon those established in 9-12yr olds.....So these are teenagers +

How does feeding require growth from other areas of development?

1. Motor Skills-Bringinf food to mouth, chewing & maintaining balance while eating 2. Cognitive skills-Identifying different foods, understanding whats edible/inedible 3. Social Skills- Optimal; This starts early w/"attachment", or a parent/child emotional bond, includes safety and nourishment...as the child ages they develop trust vs. mistrust in feeding in that they trust someone will provide nourishment and the correct amount.

How does self-care pull from other areas of development?

1. Motor Skills: Kids will use AROM to dress themselves + reaches, grasping and releasing; Hand-eye-coordination used for fastners; Balance & equilibrium rxns used to dress oneself w/vision occcluded or on 1 foot. (better motor skills=easier dressing) 2. Cognitive skills: Problem solving to decide what to wear based on weather 3. Sensory Awareness: Do you clothes fit? Are they inside out? 4. Body Awareness: 2 arms cannot get into 1 sleeve, a shirt if for the upper body vs. pants are for the lower body 5. Tactile Awareness: Knowing what your clothing feels like, are they too big/small? 6. Sense of accomplishment *So, its frustrating when kids aren't motivated to self-care, because it will help develop other areas as well, therefore encouragement is important!

Describe the developlmental sequence of the "location" charecterisitic of sound.

1. Neonate: Sharp sounds elicit eye blinks or reflexive movements; Soft, pleasant sounds elicit eye widening; no head turning, but the eyes may move in the direction of the sound. The head may or may not turn. 2. 2-3 months: Head will turn laterallyto general direction of the sound. 3. 3-4 months: The infant will turn both the head and the eyes to the side of the sound. 4. 5-6 months: Downward localization begins; So the child can look down +to the right or down + to the left 5. 6-7 months: Upward localization begins 6. 8-9 months: Curved arc downward; So instead of looking to the side, then downward, the infant can combine these movement in a "curve". The infant can also follow a sound as it moves downward. 7. 9-10 months: Curved arc upward; The infant can also follow a sound as it moves upward 8. 11-12 months: Diagonal head turning, this implies the infant can look directly at the object, wherever it is, this is the highest skill level. *Note: Downward auditory localization comes first, its a flexion response vs. extension , righting or equilibrium rxns may be required to maintain balance.*

What are Kohlberg's Stages of Moral Development?

1. Preconventional Reasoning: Lowest level, present up to age 9, child's behavior/responses are guided by ext. system of punishment and obedience-They understand rules and avoid breaking them to avoid punishment, they'll say "please" to get what they want. 2.Conventional Reasoning: Seen from 9yrs through adolesence, this child has internalized certain rules and standards that others have imposed. @ this time, "instrumental purpose and exchange" developes, or the child's behavior is guided based on their own interests- whats "popular?"...Maintaining mutual relationship also develops-"treat others how you expect to be treated"....Social system conscience developes-Awareness of consequences of own actions, concerned about rules and what happens if someone goes against them 3. Postconventional Reasoning: Final level of moral development, seen in adolescence-adulthood; has developed strong int. standard of what is right vs. wrong; This person has worked through many issues and seen how different pple work through situations differently

Anatomical differences:newborn vs. adults

1. Retracted mandible: Tongue looks bigger 2.Sucking pads: "chubby cheeks" 3. Limited Movement of tongue: only forward/backward 4. Obligate nose breathers 5. Epiglottis/soft palate relationship: They touch 6. Eustachian tube: It's horizontal in the 1st yr of life

What are Piaget's 4 stages of cognitive development?

1. Sensorimotor (0-2yrs?) 2. Pre-operational: (3-7 yrs) 3. Concrete Operation 4. Formal Operations

What are the 4 basic types of play?

1. Sensorimotor: seen in children under 2 yrs 2. Imaginary play 3. Constructional play 4.Game play: often evolves into "gang" play

What are some anatomical differences in an infant vs. an adult?

1. Small, retracted mandible: Causes a smaller oral space, this limits the tongue movement(the tongue is normal size) 2. Sucking pads: Children have "chubby cheeks", these provide anatomical stability for facial muscles to help support sucking -Help support negative pressure!(creates vacuum in back part of mouth) This allows swallowing to be easier -These dissappear around 6 months of age 3. Tongue is limited to forward/backward movement: This causes liquid to often be lost from from the mouth; Tongue movement will increase as the mandible moves into a better position(@ about 5-6 months) 4. Obligate Nose Breathers: Infants have trouble breathing through their mouth because their tongue takes up too much space! So when feeding, a bottle may be taken from the child to allow them to breath in between sips; This presents a problem when the babies have a cold, they'll have trouble breathing! 5. Epiglottis/Soft Palate Relationship: They touch! This will protect against aspiration, How? If "swallow" is not initiated, liquid will NOT fall into the trachea; Larynx is also higher(& protected by epiglottis)...All this protection is importance because an eating baby is not always coordinated w/breathing+eating at the same time...Also allows child to be fed while prone or supine. 6. Eustachian Tube: Will be positioned in a relatively parallel position (horizontal); If their is fluid backup in the tube, this could be due to infant not swallowing everything & extra fluid is left in the mouth, leads to fluid entering into the tube & plugging it-Causes middle ear infection, this can impair the infants hearing and therefore they'll have trouble responding appropriatley; If their are multiple infections in 1st yr, could lead to permanent damage.

Types of Group play

1. Solitary play: occurs up to 2 yrs, they play with themselves 2. Onlooker Behavior: 2yrs-lifetime, the child has not seen this activity before so they'll watch, but won't participate 3. Parallel play: 2-3 yrs, 2+ children will be inn the vicinity of eachother, but won't play together 4. Associative play: 3-4 yrs, kids will begin to interact w/eachother during play, often follow a theme, each child has their own toy 5. Cooperative play: 5-6 years, kids are apart of a group

What are the pre-req's for toileting skills?

1. Sufficient sphincter controle (anal & urethral): Requires meylination of the sacral plexus, pne sign that this has occurred is a child standing & taking 2 steps (Usually 12-18 months) 2.Recognition & attending to the feeling of fullness in the bladder: Usually occurs @ 18-24 months; Asking the child if they need to use the bathroom=verbal reminders 3. Verbal Communication from the child that they need to go: This is NOT required, but good to have; If they cannot provide these, they may provide non-verbal signals like "dancing" with their lower body or "hiding" for a few minutes, then returning....However, if the parent can read non-verbal signs, it's important that the child does not become dependant or they'll regress. *It be useful for parents to bring their child to the bathroom after meals and before/after bedtime/napping in order to get on a schedule, the key is to be consistent!*

How is spoon feeding influenced?

1. cultural expectations: In the USA, infants are expected to eat solid foods @ 6 months 2. discretion of primary feeder: they decide when to start spoon feeding *prior to 4-6 months, infants lack stomach enzymes to digest solid foods, if they do they would have diarrhea or constipation*

2 definitions of legal blindness

1. if visual acuity is 20/200 or less in best corrected eye 2. if there is a 20% visual field loss

What are the 4 charecteristics of sound? Why are they significant?

1. loudness/amplitude/threshold: the intesnity of the sound 2.Frequency/pitch: Measured in hertz, higher=more likely for damage 3. Duration: How long the auditory stimulus lasts; Longer the 4. Location: Related to registering the sound and orienting to it; Occurs in a developmental sequence. These are significant as they can affect your behavioral state and affect your responsiveness.

Our vision takes in what ration of the visible light spectrum?

1/70th

At what age can a child take their shoes and socks off without help?

13-18 months

Describe Toddler phase for development of peer directed behavior

13-24 months; complimentary and reciprocal play will begin; reciprocal play involves 2 behaviors that compliment eachother (throwing a ball & retrieving it); Social behaviors increase, however with family 1st vs. unfamiliar people....@ 12-18 months, infants are tied to their mother & tangible objects, they need to have both!...18-24, infant moves away from mother

When does skilled tongue movement become present?

15 months

At what age does the child have bowel control, will indicate of wet pants?

15-20 months

At what age is Cause and effect learned?

18-24 months

When does mental representation develop?

18-24 months, this involves retrieving an object that is not actually present at a given time (ex. diapers); Parents must talk to their child and this will help mental representation develop! This is the 6th substage of Paget's Sensorimotor stage

When to kids learn to handle deferred info?

18-24 months; This is when @ 1st a chid cannot wait for anything, however when this is learned they can resist & wait for this desired "thing"; this is in Piaget's 6th sub division of Sensorimotor

Describe how an infant begins cup drinking

1st attempt @ 6-12 months, this will be sloppy! & the infant can revert back to suckling due to jaw instability on a new surface (so stuff will be spit up again)...After 2 months of practice, infant progresses to sucking pattern on a cup (8-14 months), however the tongue is not stable & may rest on the cup rather than lowering to lip to solve this.....15-18 months, the jaw still lacks stability, this can be due to spout cup, which can contribute to a lack of stability; The child will bite the cup to allow better lip and tongue movement...2 yrs=fully developed jaw stability, tongue will no longer rest on cup and infant will no longer bite on the cup, lips instead control fluids and there is the ability to take multiple sips if desired

When does consequences of actions become a reality?

2 years

At what age can the child differentiate bowel and bladder functions verbally & will ask by w/e terms necessary?

2.0 years

At what age will the child become dry during the day; muscles of the bladder are coming under control & they'll pull their pants down at the toilet, but seldom able to replace?

2.0-2.5 years

At what age will the child become dry through the night, but only if taken to the toilet 1-2x p/night & generally requests help removing pants, wiping self & dressing?

2.6 years

At what age can a child undress completley, including shirt or jacket if unfastened for him; Pulls on sweater if given to him the right war around?

21 months

At what age could the child resist the toilet(potty chair) @ specific times when s/he doesn't need to go, but will demonstrate little resistance to the toilet in general?

21 months

At what age may a child try to put on some clothing independently, but they won't necessarily be successul (often puts both feet in 1 pant leg)

24 months

At what age will the child begin to "work" to please others in order to gain acceptance/congragulations?

24 months

When does rotary chewing occur?

24 months; this involves the ability to bite off pieces of hard foods on either side of the mouth & grinding foods into small pieces; Food should still be cut into small pieces (they eat/swallow too fast); Lip closure is present; There is a sweeping motion of the tongue to clear both lips

Describe preschool phase for development of peer directed behavior

24-42 months; there's a lot of pretend play! Communication will have meaning to describe what they want/when they want it

At what age does the child care for themselves at the toilet with the ability to pull down clothing and replace?

3.0-3.6 years

At what age can a child button their coat or dress?

3.4-4.0 years

At what age can a child dress without supervision?

3.6-4.0 years

At what age will a child throw tantrums during dressing or sags & refuses to cooperate with dressing

30 months

At what age can a child dress with supervision, with some errors with shoes and socks?

30-36 months

At what age can a child undo accessible large buttons, snaps, shoelaces and zippers?

36 months

When do we typically start spoon feeding?

4-6 months; However we need to introduce foods slowley, every 2-3 days (in case of allergies we'll be able to identify what food is causing it); At this time, since the spoon is new, there is a Wide Jaw Excursion, regardless of spoon size or quantity + Jaw stability is lost again! & suckling pattern returns

At what age can a child distinguish front & back; Dresses himself completley, except for shoelace tying & other difficult fastners; Manages regular shirt or blouse buttons and zippers?

4.0-5.0 years

At what age will the child become dry through out the night?

4.0-5.0 years

By what age are kids usually independent with self care?

5 yrs, this includes basic hygiene, toileting, dressing,and feeding

At what age can the child remove socks?

6 months

Describe Piaget's Sensorimotor Stage of cognitive Developement

6 subdivision A. 0-2 months=Reflexive stage, this child is controlled by reflexes, there is no voluntary movements B. 1-4 months: Primary circular Rxn's, this child repeats body-centered movements over and over again. ex- fingers in mouth, flailing extremities C. 5-8 months: Intentional behaviors, child actively rolls/reaches for objects, at this time object concepts developes D. 8-12 months: Goal-oriented, at this time object permanence, cause & effect, Time & space, Imitation all develop E. 12-18 months: Active motor experimentation; Here the child is very active and tests what they're capable of; there will be bruises F. 18-24 months: Language skills increase, child becomes aware of own effects on the environment; At this time mental representation and handling deferred info., combining objects together and spatial relationships develope

When does munching occur?

6-8 months or 2 months after spoon feeding; This involves up/down movement of the jaw and tongue (together); HALLMARK: Noise! (mouth is kept open)

At what age can a child tie their shoelaces?

6.0 years

At what age can the child help w/dressing by holding out arms for sleeves, boot for shoe?

7-12 months

When does tongue lateralization begin

8-10 months

When does vertical jaw movement occur?

8-10 months; Gums/teeth move up/down to "eat" ground or soft junior foods; @ this time, the jaw doesn't exert enough power to bite off a piece of food and chew it & food size could choke infant if large/dense enough -@ 8 months: Infants upper lip moves downward/forward to rest on spoon -@10 months: upper lip moves forward, down & into remove food from spoon(mature pattern) & lower lip is active-moves as spoon is removed -@ this time, during chewing the lips do not hold food into mouth, but rather move with the jaw -Tongue laterlization begins

When to children become goal-oriented?

8-12 months, this is the 4th sub-stage of Piaget's Sensorimotor stage & where key cognitive development are made

What ration of our vision comes from the periphery?

80% vs. 20% from our central vision

Optimal position for feeding

90-90-90

What is object permanence and when does it develop?

=If an object dissapears, the child will not be distracted & wants that exact object back; this occurs @ 18-24 months during Piaget's 4th sub-stage of the Sensorimotor stage

Vision Perception

=Making use of ALL visual information to respond appropriatley and accurately to the environment; There are 3 aspects 1. Visual Attention: ability to concentrate on some part of the environment, includes the time element; Alerting, selective attention(figuring out what to focus on) and vigilance (how long to stay with task) are all important for visual attention. 2. Visual Memory: Ability to remember and call back to mind some info. that had been received via the eyes; Sequential memory is the ability to recall what was seen exactly as it was seen, includes long and short term memory. 3. Visual Discrimination: Developes at 3.5-7 yrs, ability to detect specific features of a stimulus to recognize it from others; This is the basis of how well a child will be able to use his/her eyes for learning, understanding what they see

What is Failure to Thrive(FTT)? What are the different types?

=When a child's weight has fallen below the 5th percentile for an infants height; their are 2 types: 1. Organic FTT: Due to physiological problems, often a specific metabolic problem that disrupts the digestive process. 2. Non-Organic FTT: This is serious! it's caused by the caregiver because the infant is not getting enough food! This child isn't getting the nourishment needed to support/improve CNS development; Leads to delayed gross motor development (ex. sitting, standing)

Where is the vestibular system located?

@ the inner ear, next to the cochlea; Its because of the proximity of these 2 systems that when you hearing is affected, it can also effect your balance (vestibular)...There is a link between visual and auditory systems.

Development of self care abilities are AKA

Adaptive skills or adaptive behaviors

@ what point are diagonal movements of the mouth primarily used for feeding?

After 15 months

By what age are kids extremely concerned of their social welfare of their friends?

Age 11

At what age will kids pursue friends?

Age 6

At what age do kids tell secrets/pass notes?

Age 9

Changes of the 1st year of life

Anatomical protection will be lost-Oral space will become bigger (mandible moves down & foward), sucking pads decrease in size (if infant stays on bottle & does NOT progress to cup, the pads may stay longer than normal), eustachian tubes moves into a more vertical position

Erickson's 6th stage= Intimacy vs. Isolation

Associated with young adulthood; Establishing long term relationships are explored, if accomplished their is a sense of completion/commitment; Isolation=opposite, intimate relationship are not established due to fear or lack of opportunity, this can lead to depression

What does receptive language rely on?

Auditory system for verbal messages; Auditory system= 3 divisions: 1.External ear structures: consists of pinna (visible structure that is our ear) and ear canal; the pinna is used to funnel sound sound through the ear canal via sound waves. The ext. ear ends @ tympanic membrane/eardrum 2. Middle ear: Developes at 7 wks gestation, reaches adult lvls @ 6-8 months gestation; purpose=further transmits sound waves to inner ear via malleus, incus and stapes 3. Inner ear:Contains hearing and vestibular organs; Organ of Corti= hearing receptor and located within the cochlea; The cochlea have tiny hair cells that connect w/the auditory nerve; Sound waves are converted to electrical signals here & transmitted by the auditory nerve & interrpreted by the CNS.

How would we go about teaching dressing?

Backward Chaning-Perform individual steps of each task (t-shirt, pants), but start w/the last step (shirt) 1st....Help the child a little less each time for that step

Describe how we are able to visually scan

By using saccadic eye movements in order to direct our gaze so that the image looked at falls on the fovea centralis, or point of clearest vision...This movement as a whole is known as Accomodation (we are not aware our eyes are changing shape or of our saccadic eye)

How does Geographic location play a role in self care?

Colder regions: kids will become accustomed to jackets, zippers, mitten, boots vs. Kids from the south may have never seen these pieces of clothing....Same idea for rainy regions

Define communication and receptive language

Communication: The ability to receive and respond to verbal or non-verbal messages Receptive language: Receiving a message; Depending on HOW we receive the message dictates how we will respond (related to our ability to identify non-verbal messages); For ex. if a teacher calls your name-"here", if a parent calls your name w/exasperated tone-your in trouble!

What is Convergence? Divergence?

Convergence: The coordinated movement of two eyeballs toward a common near point of fixation Divergence: Coordinated movement of two eyeballs away from a near point of vision

How long does it take before a child is usually independent with dressing? What does it require?

Dressing takes about 4 years for a child to become independent w/it; To be independent, it requires knowledge of their body (where is it in space & how parts relate to one another) and balance/equilibrium rxn's (COG will shift as the child moves to put the clothing on)

Erickson's 8th stage=Integrity vs. despair

Final stage, seen >65yrs, at retirement, staying active helps maintain integrity, this person wants to pass wisdom down to younger generations, their is a reflection on successes/failures

Importance of social interactions

How a child interacts with other kids and adults determine their social competancy; Peers-Children that share similiar abilities; peers are important becaus they serve as a source of reinforcement and models for each other, peers also help with egocentrism (frustrations felt by similiar age group)

Visual Scanning

Infants do not scan the environment, but rather focus on a single feature outside of a stimulus(light reflected on a face), as well as moving objects(talking mouth)-by 2 months they'll look at a whole object

What is internal locus of control in terms of children?

Infants will have internal locus of control, or "who's in charge"when it comes to feeding, this is exhibited because the child will make it known when their hungry, full or doesn't like the food(by crying?)....This establishes autonomy, or the child will do what it chooses....Contributes to social-emotional development.

How does the gag reflex first appear?

It appears in the front of the mouth 1st , however children place objects into their mouth which allows the stimulus to move backwards...Onset=16.5 wks gestation, integrated through life.

Cultural Environment

It is important to understant the normal progression of self-care, but the source of the information must be considered(info. may be coming in from everywhere!), so we can teach accordingly

What are the models of Socio-emotional development?

Kohlberg, Selman, Erickson and Havighurst

What is the Organ of Corti?

Located at the inner ear, it is the hearing receptor located within the cochlea....The cochlea have tiny hair cells that connect w/auditory nerves, the auditory nerve then converts sound waves into electrical signals & are transmitted by the auditory nerve to be interpretted by the CNS and allow the child to hear and interpret their environment

Describe Havighurst's Social Developmental Tasks

Looked at the contribution that learning social skills had on children and adolescents; Critical behaviors and abilities that are critical for a child to learn at different ages, for ex.-middle childhood tasks (6-12yrs) that are necessary for school include: a. learning skills needed for games b. ability to read, write and calculate c. developing concept needed for everyday life... Skills and behaviors that lead to social competancy are most important to Havighurst, but specific tasks also needed to be accomplished.

When an object passes a childs midline, there eyes may look away, then return and focus on the object, what is this called?

Midline Jerk

What is the importance of muscle control when is comes to feeding?

Muscle control is important in feeding! Most feeding muscles are also very important in speech production; The head and trunk control is also necessary as to hold themselves up in order to swallow effectively

Describe Paget's Preoperational Stage

Occurs @ 3-7 years; At this time there is a huge Concept Development, kids learn what they feel/look like & can name objects...So concrete and abstract concepts are learned....matching and sorting is also learned...ID and labeling is learned

Gag Reflex

Onset: 16.5 wks gestation Integrates: Lifetime Position: Infant supine, head slightly flexed Procedure: Use finger, toothbrush or small spoon to stimulate posterior half of tongue or pharyngeal area Response: Infant lowers jaw and there will be a foward, downward movement of the tongue Significance: Protects from foreign material entering trachea; If absent, this child shoul be tube fed(their not a safe oral feeder); If hypoactive=precaution to oral feeding; If hyperactive=Any touch to oral area results in gag reflex, this child can be orally fed, but limited to certain textures

Swallowing Reflex

Onset: 1st observed @ 10 wks gestation; Infantile pattern of suck-swallow @ birth; Mature pattern of suck-swallow @ 6-12 months Integrates: Infantile pattern (sucking)-6 wks; Mature pattern-12 wks, then persists Position: Infant supine, head slightly flexed Procedure: Saliva, food or liquid in contact w/back of tongue, soft palate, pharynx and epiglottis Response: Swallowing is observed by visible elevation of hyoid bone; Infants form-jaws seperate, tongue thrust, less jaw movement, sucking during swallowing and predominant use of facial muscles; Mature form-No tongue thrust, more jaw movement present and jaws brought together Significance: Clears oral area of food, drink and saliva; If absent-increases likely hood of aspiration and this child should NOT be orally fed; often absent/weak in premature infants, associated w/asphyxia

Rooting Reflex

Onset: 28 wks gestation Integrates: 2-3 months Position: Infant supine w/hands on chest Procedure: Use finger/nipple & stroke periorial skin @ corner of mouth, moving laterally Response: Head will turn from side-to-side & stop at the stimulus; @ 2-3 wks, after stimulus at corner of mouth, there will be a direct head turn toward stimulated side, grasping it w/lips and sucking. -Stimulation of upper lip: Leads to opening of mouth and retroflexion of head -Stimulation of lower lip: Leads to opening of mouth and jaw drop Significance: Helps find food and contracts neck muscles; May be absent/weak in premature infantsassociated w/asphyxia; Rooting tends to be strong in breast fed infants

Sucking Reflex

Onset: 28 wks gestation Integrates: 2-5 months Position: Infant supine, hands on chest Procedure: Place finger/nipple into infants mouth-If finger, pad should upward to protect hard palate from fingernail Response: Rhythmical sucking movements with alternating bursts of sucking and rest periods-If Nipple is removed, the infant will flex their head foward to attempt to keep it in their mouth Significance: Functions to obtain nourishment, may be absent in weak/premature infants (associated with asphyxia)

Reflexive Chewing

Phasic Bite Reflex: Present at birth & integrates @ 3-5 months; Involves NO controlled, sustained bite, its a reflex! So it does NOT indicate a child is ready for purposeful chewing (@ this time the tonic bite reflex may also be present-inability to open mouth due to tone)

Physical impairments

Remember, anatomical changes decrease the protection, however the child may still need to be bottle/cup fed...This increases aspiration risk, repeated aspirations can lead to pneumonia, malnutrition & non-organic FTT

What is Otitis media?

Results when the eardrum is blocked due to fluid build-up. This fluid is normally drained via Eustachian tube, but if their is an infection, this cannot happen=otitis media....This infection disallows sound waves to enter the middle ear and disrupts hearing, therefore the child will have difficulty responding appropriately...So this occurs @ the middle ear.

What would happen if a parent cannot identify their child's rhythems & cues?

Rythems and cues is how a parent must "time" the feedings or a child will spit food back out/it'll fall out; If this is not solved, failure to thrive is a consequence

Erickson's 2nd stage= autonomy vs. shame & doubt

Seen @ 1-3 yrs; Hallmark= The child, with a parent's encouragement, is beginning to make independent choices.

Erickson's 3rd stage=Initiative vs. guilt

Seen @ 3-6 yrs; The child will begin to initiate more, they'll invite others to play and become curious about they're age, if a rule is broken they'll feel guilty.

Erickson's 4th stage= Industry vs. Inferiority

Seen @ 6 yrs-puberty; The child can be given a task and they will complete it with a sense of accomplishment/pride; Encouragement leads to becoming industrious, lack of encouragement leads to inferiority

Erickson's 1st stage=Trust vs. mistrust

Seen @ newborn-1 yr, trust develops early-they belive someone will feed, provide security for them and they'll cry in order to get this. If the infant cries for a long time and nobody helps them, mistrust may develope and therefore fear.

Erickson's 7th stage= Generativity vs. Stagnation

Seen in middle adulthood (25-64 yrs); generativity=working toward goals, family established and secure in career; The danger here is becoming over -involved and the person neglects themself ....opposite is stagnation, they feel their is no purpose in life and do not contribute to society, leads to "middle age crisis"

Describe the progression from a bottle to a cup

The 1st pattern is "suckling", a combo of the suck & licking motion (remember, the tongue has limited motion, but the jaw has mobility)....Suckling is rhytmical @ a rate of 1 suck p/sec and requires coordination with sucking/swallowing/breathing....from birth-2 month: 1-2 sucks p/breath, but @ 3 months: 10-30 sucks p/breath, this ration will increase with age, but if the child is not coordinated w/sucking/swallowing/breathing, this could lead to aspiration....@ 6 months, there is better jaw control, lip closure & allows the tongue to move independently from the jaw; Improved jaw and tongue control/movement leads to the development of true sucking or pump suck-the tongue no longer moves in/out, it'll sit in a groove....Sucking is present for life; Airway ill enter infants stomach, which leads to burping

Visual Tracking/Pursuit

The ability to follow a moving object smoothly and continuously.; require saccadic eye movements to keep object focused on fovea centralis....This provides a more accurate, real time picture of the entire environment (vs. visual fixation)

What is the hallmark of Selman's Self-Reflection stage?

The child begins to "guess" about how others feel. This stage is seen at 8-12yrs and the child can see others have a different POV, but can't understand how both can be right.

What did Erickson's Personality Development model focus on?

The individuals ability to act, be independant and interdependant in their environment....in other words how do children socialize and act in their environment....In Erickson's Model, he believed we develop through stages and if w do=we're compentant, if we don't our personality may be affected.

In what position will infants be fed when they are still dependant?

The infant is fed in different positions, depending on the feeders preference and infants degree of motor control, but the infant should be kept @ or above 30 degree's upright, this helps facilitate swallowing & keeps food down. Goal: Infant can sit uprigh & eat a variety of foods

Chronological age vs. Developmental age

These ages affect a childs performance, for ex. a child's gross and fine motor skills may indicate 1 yrs of age (Developmental age) for a child who is actually 4 yrs of age (Chronological age)... 4 yrs vs. 1 yrs is a big difference in what we would expect, so we need to understand that a specific child's developmental age and match that with the correct progression of gross/fine motor & cognitive skill in order to teach the appropriate self-care skills next.

What kind of reflex is the Babkin or Palmar Mental Reflex?

This is a nutritional reflex-It can be used to trigger the child to feed

Nystagmus

This is a response to vestibular stimulation (spinning)....So if you spin a healthy person around for, say 30 seconds, and then hold them stationary and look into their eyes, their eyes will be rapidly moving back and forth=nystagmus, this can last from 10-60 seconds; It's also possible that nystagmus won't be present, this person just has a hypo-responsive vestibular system

Describe Selman's Social Role Taking model of develoment

This model examines a child's ability to see another person's POV, where are they coming from? 1.Own perspective: Can a child see everything from their own perspective, these children are not selfish (they don't grasp impact of own actions/cause and effect) just they know what they feel, they cannot understand that another person can feel different. 2. Social Informational stage: Seen at 6-9 yrs, the child realizes that others may interpret actions/words the same or in another way as themselve, however they cannot understand these other views yet. The child is more aware other are intepretting their own verba;/non-verbal skills 3. Self-Reflection: Seen at 8-12 yrs; These kids see that others have a different POV from their own actions, however its discarded because they dont get that both can be correct; Hallmark: "guessing" at how others feel 4. Mutual roles: Seen in 10-15 yr olds, child realizes everyone has their own POV, they can now "step out" and see from anothers perspective 5. Social Conventional System: Seen from adolesence-adulthood, the child understands that different POV's do not necessarily lead to understanding, thereofre compromise may be needed-ability to compromise indicates higher level of cognition thought.

Erickson's 5th stage=Identity vs. Role Confusion

Transition from being a child into an adult; They're should be encouragement to become independant, identity crisis is common

How is Swallowing observed? What is the infantile vs. mature form?

Visible elevation of the hyoid bone -Infantile form: Jaws will serperage, significant tongue thrust, reduced jaw movement & sucking during swallowing; predominant use of facial muscles -Mature form: there is no tongue thrust, jaws are brought together & there is more jaw movement

What is visual reception? Visual acuity?

Visual reception: The ability to see things as they really are, this person has good visual clarity Visual Acuity: How clearly one see's -The optic nerve is not completely myelinated at birth, this will occur in the first 6 months of life.

What does it mean to have impaired visual acuity?

impaired visual acuity= less than 20/70 in best corrected eye (they've already got glasses)

How do we test visual tracking?

object held 1.5-2 ft away, have them track the objects with their eyes only....Start in the periphery, since newborns have better vision here vs. central vision

Visual fixation

refers to how long an individual looks at a specific visual stimuli, if the object is moving, saccadic eye movements help keep the object in the fovea centralis.....This produces a series of still pictures