Lifespan Development: Reflexes

7 month standing

full wt but uses arms for stability and control may pull to standing from quad bounces but no lat weight-shift plops to the floor not controlled

6 month old in prone

functional position:they like it better, strong antigravity extensor control, decreaded lumbar lordosis equilibrium reactions are present in prone.

6 Month prone pivot

landau position moves between pivot prone ext and WB on ext arm Pivoting: weight shift on ext arms, rotates head weight shift onto face side arm--pulls self sideways makes circles in prone on elbow

Catching

large light ball: hits-no attempt traps against body catches without trapping Smaller: tennis ball uses both hands and traps uses both hands but does not trap uses 1 hand

One month: Posture Movement

physiologic flexion still present but decreasing movement: more alert but similar to neonate

8 months general

protective ext sideways but not backwards equilibrium rxn in sitting

2 Month Fine Motor

swipes at objects no volitional grasp or release briefly retains object when placed in hand reflexively sctatches and clutches blanket

1 month oral motor & communication

belly breather, drooling more- more mvmt of jaw and not a lot of lip control, suckling pattern, and same eating habits

7 month mobility and transitional movement

belly crawling sit to prone prone to quad quadruped to pull to standing at table stand to floor sit= plop

3 months supported vision

convergence for brief periods with head stabilized in midline tracks 180 in prone eyes and head move together still does not have control to look down can visually attend to objects at midline but difficulty crossing midline with vision *Observes hand* shifts glance between two objects

9 months Quadruped

crawling on all 4s reciprocal crawling: dissociation between LEs Bunny hop no dissociation b/w LEs, delayed development

8 month quadruped

creeps well on hands and knees kneeling with UE support but cant get full ext still not full hip ext

11 months walking

cruises and reaches furniture out of reach climbing skills and can turn themselves around now

9 month standing

cruising along furniture semi turns in direction falls to floor walks with two hands held: steppage gate

Palmar Grasp

0-4 months Elicit: pressure on ulnar surface of the hand Response: Flexion of the fingers

Rooting reflex

0-4 months Elicit: supine or sitting, stroke corner of the mouth Response: lower lip drops at the corner and tongue moves toward stimulus as thenhead turns.

Bite Reflex

0-5 months Elicit: place object between gums or teeth Response: mouth will close and hold, bite with no release

Neck Righting

0-6 months Elicit: supine arms and legs extended, passively rotate head to one side Response: body rotates as a whole to the same side, log rolling

Labyrinth on Head

1-2 months throughout life Elicit: blindfold child and do the same thing as optical righting Response: same response

Optical righting

1-2 months to throughout life Elicit: hold child in space and tilt to the side Response: will flex towards the upright position or uphill

Standing Equilibrium

15-18 months throughout life Same shit

Running level 1

UE: high guard: abduct should, flex elbow LE: feet flat, minimal flight, abducted swing leg

Hopping level 2

UE: swinging upward LE: body lean allows ext of knee and ankle, repeated hops, inactive swing leg

2 Month Vision

very attentive develops affordance: perceptual function to determine if object is useful for them ATNR Tracking: midline to side is starting come in, still no dissociate with eye and head

Throwing

voluntary release first fling at floor overarm throwing underarm throwing requires instruction <3: only arm being used Early: Proficient: trunk rotation is segmental, big difference is stepping with opposite leg.

10 months walking

walk with two hands held. cruises on furniture

Kicking

walks or runs into object kicks stationary ball runs and kicks a stationary ball kicks a rolling ball runs and kicks a rolling ball Early:

8 months walking

walks with 2 hands held steppage gate pattern leads with trunk cruise sideways,

Asymmetrical Tonic Neck Reflex (ATNR)

0 to 4-6 months Elicit: supine arms and legs extended, turn head to one side Response: Face side: increased extensor tone in LE & UE Skull side: increased flexor tone in LE & UE

Symmetrical Tonic Neck Reflex STNR

0 to 4-6 months Elicit: prone over examiners knees, flex or ext the neck Response: Flexion UE: increased flexor tone LE: increase ext. tone Extension: UE: increased extensor tone LE: increased flexor tone

Moro

0 to 4-6 months Elicit: supine, raise head and shoulders up and drop head back Response: arms abduct, ext, ER, fan fingers

Gag

0- lifetime Elicit: lights touch to pharyngeal wall or posterior 1/3 of tongue Response: contraction of constrictors muscles of pharynx

Primitive Stepping/Primary Walking

0-1 month Hold under arms and lean forward Response: rhythmical stepping

Flexor Withdrawal

0-2 months supine, legs ext, brush sole of foot Response: hip and knee flexion, ankle DF, toe ext

Extensor Thrust

0-2 months Elicit: one leg extended, other flexed, BRUSH sole of foot of flexed leg Response: uncontrolled ext of flexed leg

Crossed Extension

0-2 months Elicit: one leg extended, other flexed, FLEX the extended leg Response: leg flexed will now extend.

Tonic Labyrinthine

0-4 months Elicit: 1. supine arms and legs ext 2. prone arms and legs flexed Response: 1. supine: increased ext tone 2. Prone: increased flexor tone

Negative Supporting

0-4 months Elicit: hold under arms, bounce on soles of feet then lift into the air Response: Flexion when in air

Positive Supporting

0-4 months Elicit: hold under arms, bounuce on soles of feet Response: increased extensor tone in LES, PF of feet, genu recurvatum may occur

Sucking Reflex

0-4 months Elicit: place fingers on lips Response: immediate sucking of lips, rhythmically

Sitting Equilibrium

10 months -> life Elicit: sit on tilt board Response: lateral flexion, abduction on high side

Kneeling Equilibrium

15-18 months through lifetime, after child walks and stands independently Elicit: kneel either direction Response: adjust

Single limb stance milestones

16-19: balance on 1 ft with assistance 32-35: single limb stance momentarily 4-4.5 years: single limb stance for 6 seconds CDC: age 4: 5 sec age 5: 10 sec

Running milestones

16-19: runs stiffly 32-35: starts to look like running 3-3.5 years: sharp turns 4-4.5: smooth at varying speeds 5-5.5: 35 yards in 10 seconds

hopping milestone ages

4 = level 3 3.5-4 = can hop on preferred foot

6-7yeas walking

4-6 period of disequilibrium Posture: neutral angle (hip), heel position is mature, COM at L3 mature gait pattern temporal space characteristics continue to change

Protective Extension Down- parachute

6 months - lifetime Elicit: prone in space, tilt head towards surface Response: extension of arms to protect head

Prone Equilirbrium

6 months throughout life Elicit: prone on tilt board tilt laterally Response: trunk concave on high side, head rotates toward high side of tilt, extremities slight abduction on high side

Protective Extension Forward

6 months- life Elicit: in sitting push child forward Response: immediate extension of arms forward

Landau-Swimming

6 months-2.5 years Elicit: hold child prone in space support thorax, raise head passive or active Response: extension of head trunk legs

Amphibian reflex

6 months-lifetime Elicit: prone arms extended over head, legs extended, lift pelvis on one side Response: automatic flexion of arm hip and knee on side being liifted

Body righting on body

6 months-lifetime Elicit: supine arms and legs extended, passively rotate head to one side Response: segmental rotation of trunk between shoulders and pelvis

Supine equilibrium

7 months to throughout life Elicit: supine on tilt board Response: trunk concave on high side, head rotates toward high side of tilt, extremities slight abduction on high side

Protective Extension sideways

7/8 months - life Elicit: sitting push sideways Response: abduction of arm on falling side

Quadruped Equilibrium

8 months to throughout life Elicit: all fours on tilt board Response: trunk concave on high side, head rotates toward high side of tilt, extremities slight abduction on high side

Negotiating stairs

9 mo: creeps up all 4s 10: creeps down 16-19: walks up 1 hand held 20-23: walks down 1 hand held 24-27: walks up and down, rail non-reciprocal 32-35: walks up rail reciprocal 3-3.5: walks up, no rail reciprocal 3.5-4: walks down, reciprocal 4-4.5: walks up and down no rail or reciprocal

Protective Extension Backward

9 months to throughout life Elicit: sitting push backwards Response: immediate extension backward

Jumping milestones

<20: jump down 1 ft 20-23: jumps in place 24-27: jumps down from bottom step, 2 feet 3-3.5: jumps forward 2 ft 3.5-4: jumps down 12 in 4.5-5: backward jump over 4in obstacle

1 month prone Position Movement

Arms: more ER and abduct, elbows behind shoulders Legs: decreased hip and knee flexion, DF remains Pelvis: is lower due to improved upper body control, less rounded spine, less weight on upper body and face Movement: lifts head with cervical hyper extension can only hold for a short time, turns head side to side, random extremity movement

2 Month other

Astasia Abasia: coordination goes away Smiling: starts as accident then is reinforced

2 Months General

Astasia Abasia: motor coordination for walking and standing has gone away Asymmetry: ATNR, optical righting and labyrinth on head appear

Automatic Sitting Reflex

Birth to 6-8 weeks Elicit: supine, apply pressure on thighs of extended legs with one hand, flex head toward chest with other hand Response: automatic righting to a sitting position

6 month prone mobility

Commando crawling may begin short distances UE weightshfit and pull, LE weightshift and push, requires R/L and UE/LE dissociation belly, combat, army crawl

9-15 month misc

EMG study: lots of cocontraction for stability hams and quads locomotion limited by: ext strength dynamic balance postural control

4 Month Supine

Head/Trunk: increased flexor control to balance strong extension Arms: bring hands together in space, brings hands to knees (shoulder and elbow extension) Legs: increase extension, active hip and knee flexion anterior/posterior pelvis motilitym random pushing with legs, rolls to side and plays

3 months Prone

Head: increased extension of neck: head up to 90 at midline, rotates head freely when elevated in prone, bilat contraction of cervical extensors is extending caudally into thoracic spine Easier to life head: labyrinth on head and optical righting increasing, increased spine extension ROM, change in shoulder/UE position, increase in synergetic spine stabilization Arms: support body on forearms: requires equal horizontal abduction/adduction, elbows in line with shoulders, UE ER, increased chest elevation, proprioception into shoulders Legs: pelvis continues to lower hip flexion contracture decreases Movement: cannot direct gaze downward: if the baby looks down they will lose control of flexors and extensors Cannot use hands in POE: head rotation causes weight shift to face side, may cause them to fall or roll supine

3 months Sitting

Head: up with increased back extension pelvis still perpendicular cane move head and still maintain supported sitting Arms: Scapular adduction Humeral Extension Legs: Lean forward due to low tone in low back and hips legs don't support much

One Month Supine

Head: cervical rotation ROM increasing, baby holds head turned to the side UE: increased ER and abduct, elongation of chest muscles, active shoulder abduction LE: extension of hips and knees increases Movement: turns head side to side, Random extremity movement, kicking continues, neck righting on body

2 month Supine

Head: increased rotation to the side, rarely in midline Arms: increased abduction and elbow extension, ATNR, arms move away from body Legs: decrease Flexion increased ER, soles od feet on the support surface Movement: lots of it, smiles with the whole body, head movements toward visuals

2 Months Prone

Head: lifts and turns it, lift to 45 degrees but cannot control it Arms: increased shoulder ER and abduction, bears weight on forearms and hands cannot do this independently, must be placed in this, elbows behind shoulders Legs: more extension, thighs now rest on supported surface, lower pelvis, pelvis lifts when baby lifts head or flexes legs and hips

Neonate Prone: Head Position Legs Arms

Head: turned to the side bearing weight on the cheek can lift and rotate head: takes a lot of energy can only hold head up for 1-2 seconds Arms: adduction and flexion Legs: flexed under baby with pelvis high, may kick legs, can scoot on butt hips: flexion abduction, ER Knees: flexed Ankles: DF

3-3.5 years Posture and ROM

Hip: anterversion but decreasing Knee: max valgus Foot: eversion is decreasing. consistent heel strike mature EMG activation

Jumping:

Jump: 2 legs with 2 ft take off and landing Hop: 1 leg if they Leaping: 1 foot to the opposite foot refined into adolescence

1 month supported standing

LE: bears some weight, feet DF and pronated UE: some elbow extension Reflexes: automatic walking may or may not be present

18-24 months LE

Narrower base of support Hip: excessive anteversion, more ext, abduct not as much Knee: knee is straight varum is resolved Foot: everted inconsistent heel strike stance phase is prolonged high cadence

Neonate Supported Sitting

Sitting with max support head will flop forward and back is rounded legs in flex abd ER

Righting Reactions (6)

Orient head in vertical space: 1. optical righting 2. labyrinth on head Align head with trunk: 1. Neck righting 2. Body righting on body Other: 1. Landau 2. Amphibian

Running 4

UE: arm swing and spine rotation are independent LE: decreased stance time increased flight and step length

Running Level 2

UE: arm swing begins, spine rotation, arms flail LE: foot flat, increased knee flexion, more flight

9-15 months: posture and joint ROM

Posture: wide base of support, COM as T12, head is large, response to perturbations Hip: flex, ER, Abd Knee: varum, IR tibia Foot: everted Adult walking on ice, increased hip flexion, full foot contact, with footdrop.

Neonate Reflexes

Rooting Sucking primitive stepping moro grasp tonic labyrinthine flexor withdrawal extensor thrust crossed extension positive supporting negative supporting bite gag ATNR STNR neck righting finger sequencing automatic sitting primary righting galant placing plantar grasp

One month reflexes

Rooting Sucking primitive stepping moro grasp tonic labyrinthine flexor withdrawal extensor thrust crossed extension positive supporting negative supporting bite gag ATNR STNR neck righting finger sequencing automatic sitting primary righting galant placing plantar grasp

2 Month Oral motor

Suckling great variation in crying still only breast and botle

3 month General Information

Symmetry is increasing effect of ATNR is lessening increased midline orientation Flexor Control: developing against gravity in cervical muscles Organization: start of organized movements

Running 3:

UE: arm swing increases, spine rotation increases LE: HEEL Strike, support leg reaches full ext at tow off

Hopping leve 1:

UE: high guard LE: hips and knees quickly flex, little flight, 1-2 hops, swing leg is inactive,

9 month sitting

Trunk: good ctrunk control, can reach overhead protective ext to the rear most functional position ring, long or combo of the two in sitting frequently side sitting: IR on one side ER on the othe A-P tilt fine motor skills in sitting

hopping level 3

age 4 UE: active together, arms assist with lifting body LE: coordination, swing leg pumps to support

7 month old general

antigravity in all 3 planes protective extension

hopping level 4

arm oppistion of swing leg other arm is in front of body ball of foot used to land, support leg has good ext, increased swing leg range

hopping level 5

arms are coordinated LE: same as 4

8 month pull to stand

at coffee table stands with one hand held, causing weight shift leading to start of cruising

6 month prone on extended elbows

bear weight on hands and extended elbows, but reverts to weight on elbow increased spine extension range and strength pushes up: ext stronger than flexion, pushes back when trying to go forward, beginning to pivot

10-12 month feeding

begins weening from breast/bottle increasing liquid intake by cup coontroled sustained bite on cookies drooling rarly occurs may posture mouth to gain stability with more challenging movements

Neonate other

belly breather nasal cry needs help soothing/calming sleeps 16-18 hours a day

Neonate: Time frame Posture Movement

birth to 1- days Spine flexed: physiologic flexion Pelvis posterior tilt No active flexion against gravity Large random mvmt when awake, visible in supine.

Galant

birth to 2 months Elicit: prone support infant by thorax, stroke on side of trunk between 12th rib and iliac crest Response: lateral flexion toward stimuli

Placing Reaction

birth to 6 months Elicit: hold infant vertical brush dorsum of foot on edge of table Response: flexion and placement on the table

Primary righting

birth to 6-8 weeks Elicit: hold in standing on a firm surface. place baby in squatting with feet flat against the surface Response: extension of legs trunk and maybe head

Toe Grasp or Plantar Grasp

birth to 9 months Elicit: start on medial side and apply pressure to the ball of the foot Response: flexion of toes

Finger Sequencing

birth- 1 month Elicit: lightly stroke ulnar side of the palm Response: extension of little finger, then ring, middle, index in that order. HAND OPENS

Neonate: Oral motor & Feeding

breast milk & formula 2-6 oz every 2-4 hours Suckling: early lick like rhythmic forward and backward tongue movements, jaw moves up and down and forward and back, minimal cheek and lip Sucking: cheek creates neg pressure, small up and down jaw mvmt, lip approximation, more mature pattern

3 months oral motor communication

breast milk or formula suckling increased control of tongue and jaw decreased lip control, loses liquid out of the sides of mouth, choking, coughing belly breather different types of cries

1 month supported sitting

briefly attempts to lift head, back is rounded, pelvis is perpendicular

10 months general

busy child, lots of moving mimic gestures in and out baby sign language is good

4 months Supported Standing

can be held by upper arms rather than just trunk head in midline shoulders must be elevated pelvis behind shoulders legs are not stiff: may flex and extend toes curl

10 month quadraped

can creep over obstacles can crawl backward down stairs kneel without UE support transitions easily to in and out of 1/2 kneeling

7-9 months fine motor

can grasp toys then sit and play with toys UE strength waves, holds object in each hand, drops things into containers finger feeding is not pretty

10 month standing

can stand with one hand on chair legs are active during pull to stand able to rotate lowers self from standing: eccentric quads

11 month quadruped

carries toys while creeping, creeps into out of containers

Protective Extension (4)

change of base of support because of rapid or large displacement of center of mass outside base of support down forward backward sideways

12 month walking

climbing better average of walking is 12-14 months normal is 9-17 months new walker gait: wide base of support, high guard, lots of falls, distance is limited

9 months General

combines gross and fine motor crawling is main locomotion on all 4s climbing furniture and cruising

Galloping

comes in 20 months after walking asymmetric stride: walk on the front, run on the rear early: arms stiff, don't assist with lifting, short stride flat food landing little trunk rotation Later: rhythmic, arms swing, increased trunk rotation

12 month standing

comes to standing without using arms can lower self without UE support can stand without UE support can weightshift and life one leg briefly with UE support

6 months fine motor

depends on position: supine: most support most fine motor sitting: least control wants to bring food to mouth both hands on bottle but not holding reaching = grasping

Neonate Supine Head Arms Legs

dominated by physiological flexion Head: 45 degrees to side, cannot maintain head in midline because not enough active cervical flexion Arms: Shoulders: ER, adducted, flex Hands: loose fist, synergy with arm, if flexed hand closed, if ext hand opens Legs: cannot ext hip and knees = contractures flex, abduct, ER Knees: flexed Ankles: DF

7 months supine

dont like it move out of it when you put then in supine. diaper change issues

6 month oral

everything goes in mouth teething can introduce cup= messy, feeding in high chair, sucking pattern! sounds generated with movement, babbling may begin belly breathing

11 month general

explore, constant movement

10-12 month communication

first real words lots of jargon

6 month General

good head control: can do all mvmt against gravity, head movement effects the body less, can dissociate head from trunk and eyes from head, can chin tuck

8 months sitting

good trunk extension good reaching not using legs as much rotation equilirbrium reactions present, can move sitting to quad easily

Neonate Fine Motor

hands loosely flexed hand and arm mvmt is coupled strong palmar grasp hands to midline and hands to mouth or face in side lying can be soothing

4 months prone

head and trunk: baby can maintain POE, chin tuck and neck elongation together, forearm weight bearing with head in midline, head held at 90 for a long time, head rotation, cant yet reach hand Legs & Pelvis: increased lumbar extension, ant pelvic tilt, pelvic weight shift, hip ext continues, decreased abduct and ER, legs are now in line with trunk Movement: random kicking continues, landau may begin(swimming), rolls on side and may accidentally roll supine

1 month pull to sitting

head lag: no flexor control baby is more alert and aware, focus on person pulling them

9 months kneeling

hip ext is still not complete practices half kneeling climbing over objects and up steps

2 Month Supported sitting

holds head up but it bobs back rounded shoulders elevated with occiput close to shoulders

18-24 month misc

improved strength and dynamic balance efficiency improves: lowerinf COM legs longer decreasing co contraction of antags.

11 months kneeling and half kneeing

increase hip control now getting hip ext can kneel without UE support

10 month sitting

increase in use of UE skills UE mirroring during fine motor skills does not spend much time in sitting trunk rotation in long sitting side sitting, ring, tailor, w sit, long sit

3 months Supine

increase symmetry and midline orientation Head: can hold head briefly in midline due to improved flexor control, begins to tuck chin to life head off surface Arms: brings arms together at chest, pull at clothing, anti gravity IR & flexion Legs: frog leg (hip flexion, ER, abduct, knees flexed) with feet together symmetrical kicking

4 Months pull to sitting

increased flexor control and symmetry, tucks chin fixes with eyes arms assist with pull to sit some ab activity some LE flexion

6 month supine

increased flexor control: brings hands to feet, lifts head independently, reaches for mom reaches for toy with 1 or 2 hands and transfers had to hand first time for a purposeful grasp rolls supine to prone

3 months pull to sitting

increased head control & decreased head lag asymmetrical reaction is common uses eyes to try to fix on examiner and/or elevate shoulders to reinforce head stability arms assist but not LE or abs

11 month sitting

increased trunk control provides stable base for UE play controlled trunk rotation through greater range does not interfere with sitting stability

4 months General

increasing symmetry increasing antigravity movement vision is dominant

6 month pull to sitting

independent if presented with hands to pull on OBLIQUES! important for the transition to less belly breathing lifts head independently without using grasp to initiate: cervical and capital extensors anti gravity pull with UE

Jump progression

jump down: 1 ft landing and takeoff jump up and land on both feet jump down with 2 ft jump forward jump over something flat on floor jump over elevated object hopping on 1 ft 2-3 times

SIDS Triple Risk Model

leading cause of death from 1 month to 1 year most from 0-4 months 1. brain defects not enough alone 2. only one risk factor, risk is not as high 3. 3 risk factors present = high risk for SIDS Vulnerable infant: brain defecr Environment or outside stressor: tummy sleep, tobacco, soft bedding, ned sharing, upper respiratory infections Critical Period for development

7 months prone

lots of asymmetry, lateral weight shifts combat crawling for mobility prefers prone, pivots in prone may assume quadruped! not crawling, rocking back and forth = vestibular system lumbar lordosis sitting to quadruped

9 month climbing

loves to climb up stairs not down

2 Month supported standing

may or may not take weight on legs depends on baby weight poor foot orientation with surface hips behind shoulders automatic stepping no longer present holds head up using capital extensors increased elbow extension

4 months sitting

may prop in sitting on UEs head in midline, can hold it there for a long time back straight to thoracolumbar junction but lumbar flexion pelvis is perpendicular little scapular adduction and supported sitting

7 month sitting

modified ring sitting: 1 knee ext one flexed uses legs for stability but can sit alone intitiate reach with shoulder girdle good head control: head rotation still trunk rotation, lots of lordosis weight shift: head and trunk cause weight shift to face side, baby uses legs to control weight shift sitting equilibrium is not great, goes from sitting to prone independently rolls to stomach, pushes into quad, lat pelvic weight shift, righting and equiulibrium, tucks wB leg under and sits back

1 Month vision

monoccular, increased alertness visual awarness head movements are more purposeful, still cannot track across midline, cant dissociate head from eye mvmt

Neonate vision

monocular: eyes used separately random unorganized eye mvmt Fixation: 10-12 in away, prefer faces to toys, strong contrasts Tracking: can track slowly moving objects in lateral fields, cannot track across midline

10-12 month fine motor

more refined grasp patterns may begin to see hand preference maniupulations with pushing, pulling, squeezing takes socks off unuties shoes finger feeding attempting spoon feeding imitates adults use of tools hair brush

3 months Other

no movement is random PRACTICE! balance, strength, coordination, endurance all movement is result of vestibular and kinesthetic stimulation that comes from practice and repetitions

One Month Fine Motor

no volitional hand control, Will use grasp reflex to hold object then will drop it or must pry it out of hand Unaware something is in the hand

8 month supine

not functional baby does not like it diaper changes are hard

7-9 months cognitive

object permanence and attachments to people emotional attachment to objects: favorite toys

7 months pull to sit

offer fingers and baby can do it, hip flexion with knee ext

12 month general

righting rxn are well intergrated equilibrium reactions are present in all positions reaching in kneeling and half kneeling lots of squatting

6 month mobility summary

rolls prone to supine 5 months rolls supine to prone 6 months belly crawl

Neonate Supported Standing

shoulders flexed elbows flexed hip flex ER, behind shoulders knees flexed feet close together

4 months vision

sidelying they are using optical righting sustained midline convergence fixates on close objects, start to fixate on objects that are farther away visually directed reach and grasp: delay between vision and grasp increased head control due to refining occular control dissociation of head and eye movements: dont turn their head to track

6 months sitting

sits with trunk and full head control sits w/o UE support for brief periods: play for a miinute, protective ext if fall forward, ER in hips iis a wide base of support

Safe sleep for 1st year

sleep on back in same room as parents firm flat surface nothing with baby in the bed benefits: less fever runny nose ear infections

7-9 month communication

sounds are independent of movement babbling da-da is most common facial expressions to communnicate

4 months Sidelying

stimulates lateral head righting asymmetric proprioceptive and tactile input

7-9 month respiration

stronger ab and trunk muslcles pulling rib cage down less belly breathing

Neonate Pull to Sit

supine, examiner holds hands/forearms and pulls baby to sitting No flexor control but may be some in cervical flexors

3 month fine motor

swipes at toys that give feedback, tactile awarness explores mouth, clothing, bodies with hand strengthens horizontal abduction that started with ATNR strengthening arms and shoulders by pushing against surface in prone vision drives desire to visually scan the environment frustration in prone: cant keep head up and it may be hard to breath sustained voluntary grasp when object is placed in hand release is involuntary

6 month supported Standing

takes full weight hands can be held

3 months supported standing

takes some weight on feet, astasia abasia isi decreasing Head: holds it up, Scapula adduction and high guard arm position used to reinforce spine extension Legs: hips abduct & ER knees flexed feet pronated

7-9 months

teething, mouth hurts everything in mouth by 9 months they do not need postural support in high chair more active biting begin to see chewing

8 month prone

they dont stay here long

0-9 month Gait

too much fat leads to functional weakness Hip: flexion contractures, ER, anteversion Knee: varum, slight IR tibial torsion Foot: everted calc-medial border of foot. 2 hands held if walking.

Equilibrium Responses

total body response to a slow shift of COG, takes practice incorporates righting reactions concavity on high side of the tilt

6 month vision

tracking: full range proximal stability = cog development = explore visually directed reach = explore

2 month pull to sitting

tries to assist due to labyrinth on head and optical righting, less head lag, does not pull with arms yet

6 month prone weight shift weightbearing side: 2 ways

weight shift using head rotation weight shift using shoulder girdle WB side: trunk elongate, hip ext, IR, adduct, shoulder ER horizontal adduction, elbow extended, palmar arches being stretched, weight shift toward ulnar side frees thumb and index finger NWB side: shortening, hip flex abduct ER, arms reaches against gravity Reaching requires: feedforward control visually guided reach dissociation b/w L & R on less stable WB arm

11 months standing

wide base of support UE very little increased leg control pushing through legs

7 month sidelying

works on lat head righting