OT Development 1

Apply the "A-B-C" Method of Analysis

"A" - ANTECEDENT What happened before the behavior occurred? "B" - BEHAVIOR Identify the inappropriate behavior "C" - CONSEQUENCE Identify the consequence of the behavior

standards

"Developmentally Appropriate and Inappropriate Practices in the Education of Young Children" -Based on knowledge of normal development -Allows for individual differences -Based on "hands-on" learning -Many facets of development are enhanced (cognitive, social, motor, artistic, etc.)

Classification of Newborn Infants: Birthweight

(453.6 g = 1 lb.): -Average weight (above 2,500 grams or 5.5 lbs.) -Low birthweight (1,500-2,500 grams or below 5.5 lbs.) -Very low birthweight (1,000 -> 1,500 grams or below 3.3 lbs.) -Extremely low birthweight (under 1,000 grams or 2 lbs.)

Classification of Newborn Infants: Gestational age

(GA-number of weeks post-conception) -Full-term (37-42 weeks) -Preterm (28 to under 37 weeks) -Extremely preterm (under 28 weeks) -Post-term (above 42 weeks)

fine pincer

(age 12-13 mo)

digital pronate

(age 2 years)

radial palmar

(age 6-7 mo)

radial digital

(age 8 -9 mo)

Mature reflexes

(automatic postural reactions) develop during the 1 - 2nd year and remain persistent There are two major categories of mature reactions: -Righting reactions -Equilibrium reactions

Language

(communication) -Use of a symbolic code to give and receive thoughts, ideas, feelings Involves both: -Receptive skills -Expressive skills -can use devices to communicate -receptive always comes before expressive -ASD = can have speech without communication (just repeating) (eventually can use symbols to communicate thoughts)

Physical readiness

(for total independence in toileting) -child can sit and walk independently -child can handle basic clothes (not fasteners) -child can assist in cleansing self (wash hands)

Speech

(talking) requires the use of: -Respiration -Phonation -Articulation -respiration = breathing rate -phonation = air moving through the vocal tract to produce sounds -articulation = use of tongue, lips, and palate to produce certain sounds

Premature Infant

(under 37 weeks gestation) -11.4% (USA) of all infants are born prematurely (2015) -prematurity accounts for ~ 35% of infant deaths among newborns.

palmar grasp

*6 months* -Flexion of all fingers around object with forearm pronated -Thumb may make contact with object -passively vs. actively

traditional bimanual skills

*6-7 months* Child transitions from approaching object simultaneously with both hands to using a successive bilateral approach (one hand approaches the object before the other) -Size of object influences whether a bilateral or unilateral approach is used. (7 mos.) -The infant uses a bilateral approach with larger objects and a unilateral approach with smaller objects. -Bilateral movements are primarily used for object manipulation and exploration at this time. In-hand manipulation is not present. -Mouthing continues to be an important part of the infant's exploration of objects. -Able to play with 2 objects at a time - (7 mos.) Example: bangs 2 objects together -Arms tend to move in symmetry. -Demonstrates crossing their midline by 9 mos. (uses hand in contralateral space).

Scissors grasp

*8 months* lateral pinch When the infant grasps a very small item, the thumb holds pellet to side of index finger; the hand is stabilized on the grasping surface and the ulnar fingers are flexed to provide stability of the hand.

radial digital grasp

*8-9 months* (tripod, 3 jaw chuck)(8-9 mos.) thumb, index, & middle fingers hold object without contact in palm; infant is able to prehend small objects (like a Cheerio)

INFANT (birth - 24 mos) PLAY

*SENSORIMOTOR STAGE* - Infants explore everything! They begin by exploring their own bodies and then other people and objects. They enjoy the sensorimotor qualities of play (i.e. the way things feel, taste, sound, etc.) and they repeat the activity over and over.

transferring objects hand to hand

*about 7 months* This is the first purposeful release pattern; it is also considered an "assisted release" ; other assisted release patterns include: releasing against a table surface release")

behaviors that may appear to be somewhat unusual or extremely intense are described as

*multiply determined*— that is, a single behavior expresses many motives, some of which the person can recognize and control and others that are guided by unconscious thought.

Language development: 18-24 months

-2 word stage -Toddler uses words to express concepts -Telegraphic speech - use of short and precise words to communicate (non-essential words are left out) -Beginning of syntax (grammar) -50 words or more in vocabulary -Jargon discarded -Identifies most body parts and names -using two word phrases (ex: mama here) -subject and verb of what they want

Second Trimester:

-2 lbs at 6 mos old -Begins to suck and swallow -Hair growth -Mother can feel fetal movement (quickening) -5 mos - extremities flexed -6 mos - UE activity > LE activity -usually less nauseous -UE = upper extremity -increased survival rates at birth at this point nowadays

Suspect results

-2 or more Cautions and/or 1 or more Delays -Rescreen in 1-2 weeks to rule out temporary factors such as fatigue, fear, illness

Fine Motor Skills Sequence

-3 mos - fingers and hand play -6 mos - whole hand palmar grasp -9 mos - primitive pincer grasp -12 mos - primitive tripod grasp -15 mos - palmar grasp -18 mos - refined pincer grasp and tripod grasp -2 yrs - preferred hand -2.5 yrs - improved tripod grasp -4 yrs - mature pincer and tripod grasp

What OT & Parents can do for a toddler

-Allow and encourage pretend play; -Have toys/objects available that encourage pretending; -Have toys available that encourage hand use and putting together. -If your child likes TV, have child watch programs which foster pretending. -Encourage play with only 1 or 2 children at this stage.

How to decrease state stress reactions?

-Allow as much sleep as possible -Wake gently; unswaddle

Role of OT/Caregivers:

-Allow exploratory behaviors -Be open to questions -Treat child with respect -Promote peer interactions -Send consistent messages of acceptance, praise, sense of worth -Don't compare to other children or, criticize personal traits...which is different than reprimanding or re-directing an undesirable behavior

Neuromaturation theory

Motor development is dependent on only one system -Motor development is dependent upon the maturation of the central nervous system (CNS) -McGraw 1920's -Gesell 1920's -CNS = brain and spinal cord -everything with the brain (neurons) determines development

Major Change During This Time...

CHILD GOES TO SCHOOL! -2001: 52% of 3-4 yr olds went to school (an -increase from 20% in 1970) Sources of influence expands beyond family -Radius of significant others is expanding greatly! -School environment (teachers, peers) -Neighborhood -TV -Other formal group activities (T-ball, swimming lessons)

EARLY SCHOOL AGE (4-7 years) PLAY

COMPLEX CONSTRUCTIVE PLAY - Construction skills are more complex, thus, the child can play with more complex toys (eg. legos). This indicates a higher level of skilled hand use and motor planning.

unfold over time with experience and practice

More complex processes such as decision making, learning and memory, emotional expression and recognition, planning, and participation in meaningful social interactions require the interaction and feed-back among several areas, including increasing engagement of the prefrontal cortex

team play

Children often become involved in team sports. -HOWEVER, children can obtain skills typically learned during team sports by involvement in other group activities: 4-H Club, Girl or Boy Scouts, etc. [It's important to keep in mind that not all children will be interested in team sports.]

How to test preference?

Observe child during eating, scribbling, & throwing a ball. When objects are placed in midline, which hand does the child typically use for skilled hand use? -test for preference = tell them to pick up and object placed at midline

Continuity

Occupational development is a lifelong process -Changes in human development lead to changes in occupational development -Occupational changes often mirror developmental changes

TV and Children

Children spend a lot of time watching TV TV has a great impact on children Facts: -children spend more time in front of TV set than they do with their parents -TV is most influential mass medium that affects children's behavior -20,000 hours of TV is watched by the time the average American adolescent graduates from high school; more hours than spent in classroom

Alert State: Active Awake

Eyes open with considerable motor activity - Thrusting movements of the extremities and even a few spontaneous startles; reactive to external stimuli with increase in startles or motor activity; infant is fussing but not crying

inferiority summarized

Feelings of lack of worth and inadequacy, self-doubt

Positive self-esteem

Feels sense of worth; feels loved, valued, & admired -enhanced by feelings of belonging, success, etc., seen more 4-6

Negative self-esteem

Feels worthless, ignored, rejected, & inadequate -high risk for aggression and acting out, 2nd-4th grade more common (more comparisons to peers)

Language Development: Newborn

First communication is crying -Sound = baby crying, nasally cry, means of all communication, different cries mean different things

Skills Reflective of Cognitive Development: 6-9 months

-Beginning of object permanence -Beginning awareness of spatial relationships -Beginning to imitate new behaviors -Can focus attention to 2 objects at once (ex: can attend to 1 block held in each hand)

What are some factors that influence a child's ability to control impulses?

-Intrinsic: temperament, birth order, sensory threshold, fine and gross motor abilities, communication skills -Environmental: -Social: learned behaviors (at home school etc.), caregiver expectations, cultural-social demands

6-9 months, CAREGIVERS SHOULD:

-Introduce strangers slowly based on infant's reaction -Provide opportunities for socializing with other adults and children -Begin introducing limits ("no") -Ignore tantrums by diverting attention -"baby-proof" house

Righting reactions

-Labyrinthine Head Righting -Landau -Neck Righting Acting on Body -Body Righting Acting on the Head

3.5-4.5 fasteners

-Laces shoes -Unbuckles and buckles belt -Inserts belt into loops -Snaps most snaps -Zips front separating zipper -Buttons/unbuttons most buttons

The Psychosocial Crisis: Shame and Doubt

-Lacks confidence -Expects to fail -Avoids new activities -Insecure/Embarrassed -Feels inadequate -Needs "Help" with basic tasks that he/she could physically do easily if attempted

guilt overview

-Lacks self confidence -Needs prodding to engage with tasks, peers, indifferent to stimuli in environment -Rejected, picked on, obviously different

Toilet Training

-Leads to a sense of competence -2-3 years -Girls before boys Independent toileting is extremely important socially

Causes of low birth weight

-Length of gestation -Poor maternal diet -Poor economic status -Smoking

Primitive Reflexes

-Rooting -Sucking-Swallow -Moro -Traction -Flexor Withdrawal -Palmar Grasp -Plantar Grasp -Galant -Positive Supporting -Proprioceptive Placing -Spontaneous Stepping -Tonic Labyrinthine Reflex (TLR) -Asymmetrical tonic neck reflex ATNR -Symmetrical tonic neck reflex STNR

What are some forms of locomotion toddlers engage in?

-Running -Jumping -Hopping -Balancing -Skipping -Climbing -Riding a bike -Swinging (learning how to pump) -Sledding, swimming, playing rough

BRAZELTON - Neonatal Behavioral Evaluation Scale

-Standardized test to evaluate the use of behavioral states of consciousness and response to various stimuli -20 reflexes tested and 26 behavioral responses to environmental stimuli -Presentation of a variety of simple objects/stimuli (face, ball, bell) followed by observation of infant's response, reflex testing (9 pt scale)

18-24 months

-Standing without holding furniture -Crawls up and down stairs -Walking becomes more refined -narrower base of support -squatting a lot -move in different planes (backwards, sideways, etc) -autonomy is huge = independence

Psychosocial crisis

-State of tension that occurs as a result of the developmental needs of the individual and the social expectations of the culture -Trust vs Mistrust in Infancy

RED FLAGS 0-8 mos

-Still keeps one or both hands clenched in fist -Arms are very stiff -Not able to prop self up when prone -Not able to sit for short periods -Not able to roll over to get objects

Elements of discipline

-Stop or interrupt the forbidden action -Provide a "cooling down" period -Point out more acceptable behavior for future -Give a reason why the action is wrong and why another is more appropriate -It should stimulate the child's ability to empathize with the victim of the misdeed

HARSH PUNISHMENT + NO WARMTH ------------>

INCREASED AGGRESSION

PERMISSIVENESS + WARMTH OR INDIFFERENCE -->

INCREASED AGGRESSION OR DECREASED SOCIAL COMPETENCE

CLEAR LIMITS + WARMTH & NURTURING --------->

INCREASED SOCIAL COMPETENCE

*psychosocial crisis*

INDUSTRY VS. INFERIORITY

Psychosocial Crisis:

INITIATIVE VS. GUILT

sensitive periods

If a particular task is not learned during the sensitive period, it may be much more difficult to learn later on.

Reading: N&N week 3

Motor development VVVV

FROM YOUR PERSPECTIVE, WHAT ARE SOME OF THE SKILLS NECESSARY TO MAKE AND KEEP FRIENDS?

-communication -shared interests -initiate and response (reciprocal interaction) -sharing -expression of feelings

Preconceptual period

2-5 years -use of a symbol system to represent thought (language) -increased fantasy play (pretending) -skills: tower of 10 cubes (by 3 yrs.); imitates bridge; imitates vertical & horizontal stroke, circle, and cross. -animism = inanimate objects that are capable of actions and have lifelike qualities

First Trimester: Embryonic stage

2-8 wks -Amniotic sac surrounds embryo -Rapid growth -*Period of Organogenesis -*Very sensitive to Teratogens -Neural tube develops by end of 3rd week -rapid/dramatic development -ectoderm, endoderm, mesoderm, trophoblast (layers) -most important organs are developed -neural tube abnormality = spina bifida -morning sickness -8th week = looks like a human

infants can register vision

20 cm away

fork or spoon use

22 mo -stabbing is hard -holding with a fist -ulnar side to mouth -spoon use = fist grasp, stir and scoop hard still, radial side to mouth, bimanual (other hand helping to get it in)

distinction between people and inanimate objects happens around

3 months

Describe the typical sequence of how infants learn to chew solids - 3 steps

3 steps: munching (6-9 months, side to middle lateralization), biting (9-12 months, phasic bite, middle to side lateralization), internal jaw stability with rotary movement (18-24 months, end of this = really good jaw control)

writing

3-4 years = build tower of 9 blocks 4-5 years old = write name, hand dominance 5-6 years old = Coloring in lines, drawing triangle 6-7 years old = consistent in drawing line 7-8 years old = paragraphs/story writing

Variations from the Norm:

3-4% babies born with breech birth: born rump first, feet first, or arm first (2015) C-section (Caesarean) -occurs with 32.7% deliveries (2013) -surgical removal of the baby from the uterus -conducted when baby is in distress (lack of oxygen); with difficult labors; etc.

Bilateral Coordination, Motor Planning

3-7 years = riding bikes, dancing, sports, play, etc.

Neurosocial Behavioral Development: Coming Out

32-35 wks. of gestational age; more physiologically stable and may be able to oral feed; able to interact socially but often at a physiologic cost; must monitor stress signals.

First Trimester: Fetal Stage

39wks-9 mos Appearance of first bone cells signals change of name from "embryo" to "fetus" (~8 wks) -8 weeks to 3 months -head is 1/3 size of the body -sex organs -fetal position -some reflexes are present

Cognition: Understanding Gender

4 elements: 1.) Learn use of correct label (boy/girl, he/she, aunt/uncle) 2.) Understand gender is stable (i.e. boys grow up to be men; girls grow up to be women.) 3.) Understand constancy 4.) Understand genital basis of gender (the knowledge that women and men have different sexual organs (3-5 yrs.))

Lateral head righting

4 months -leaning the baby side to side and their head stays with the line of the body (move together)

First habits

4 weeks - 4 months Reflexes are used to explore objects or for other purposes -Used without its eliciting stimulus (ex: suck thumb to calm) Primary circular reactions -A behavior is performed to reproduce an interesting or pleasurable event (ex: sucking on fingers) -Infant's own body remains the center of attention

secondary circular reactions

4-8 months -Infant becomes more object-oriented or focused on the world -Able to connect an action with a certain outcome -ex: shake rattle --> hear noise

recognize sound of their own name by

5 months -form language perception too

Should children attend preschool before kindergarten?

50% do go to preschool -Not necessarily if parents have commitment, time & energy to provide a good learning environment -(eg. exposure to other children (play group), experiences with coloring, playgrounds, etc.).

babbling starts changing pitch based off their native language by

6 - 10 months

language preference by

6 months (hearing)

On the move, balance, vision, proprioception, vestibular

6-12 months

What months mark the period of "transitions" on the child? On the parents?

7-8 months parents = baby proof baby = more autonomy

coordination of means and ends

8-12 months -Infant uses actions to achieve new goals -ex: shakes a rattle to get attention or drops a toy to get attention). -ex: pulls string to obtain ring -behaviors are more purposeful -problem-solving = use a stick to reach a toy (cause and effect)

Chronological Age:Adjust for Prematurity Exam Date: 8/20/1990 Child's DOB: 6/1/1990 6 weeks premature

90 8 20 90 6 1 = 2 mo 19 days 1 14 = *1 month 5 days*

Reactive Attachment Disorder

A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following: ● The child rarely or minimally seeks comfort when distressed. ● The child rarely or minimally responds to comfort when distressed. A persistent social or emotional disturbance characterized by at least two of the following: ● Minimal social and emotional responsiveness to others ● Limited positive affect ● Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers

2 Primitive Reflexes that impact Fine Motor Development

ATNR Palmar Grasp

Psychosocial Crisis

AUTONOMY vs. SHAME & DOUBT -development <--> occupation <--> environment <--> -*interactionalist perspective* (need to know for exam)

Cognition

Ability to think and reason logically, and to understand abstract principles Tune into cognition—it impacts on play and self-care

Administration

Allow 3 trials to perform unless otherwise indicated Record the score on the bar, near the 50% hatch mark Complete the Test Behavior Scale May determine if child should be retested -always write outcome letter (pass "P", etc.) on the 50% mark -caregiver should be present (educate them to reduce their concerns)

Alert State: Quiet Alert

Awake with bright look; seems to focus attention on source of stimulation (an object to be sucked or visual or auditory stimulus) and process information; motor activity at minimum.

Sensory Processing Development

Ayres believed that the first 7 years of life are critical for the development of sensory integration -Sensory integration lays the foundation for later learning!

Anxious-avoidant

avoids contact with mother following separation; mothers may demonstrate more rejection of the infant (less holding and cuddling)

4 months vision

can follow the gaze of another person toward an object

baby toys

can help or hinder -ex: jumpers are good, but only for so long

No Opportunity (NO)

can only use on report items ** These do not count against the child*** -doesn't effect score

7-8 Months - PRONE

can pivot in a circle using arms and legs; belly crawls to propel self -helps with experimenting

3 months hearing

can relate a voice to a face

walking

can walk and hold something

language perception

capacity to recognize language sounds, including the combinations of sounds made by letters and words and the rise and fall of pitch as words and sentences are spoken, is called

Anxious-resistant

cautious with strangers; decreased exploratory behaviors following caregiver's departure; may resist parent upon her/his return due to anger; mothers are inconsistent in their responsiveness to infants (loving or neglecting) -may love or neglect parent with return

zygote

cell produced when the sperm has fertilized the egg -travels down the fallopian tube and divides as it travels toward the uterus without growing larger. After about a week, this mass of cells implants in the uterus.

Weight-bearing progression:

cephalo-caudal ---> symmetrical ---> asymmetrical ---> proximal-distal.

State Control: PREMATURE INFANTS

do not develop state control before 36 weeks gestation. -Focused alertness does not develop until after 37 weeks gestation; periods of alertness will also be brief and sporadic -Preterm infants sleep longer than full-term infants; they spend more time in the disorganized state of light sleep

What is an appropriate pencil grasp for a 5 year old?

dynamic tripod

3 through 5 months Vision

easily follows objects 180 degrees and in circles; can focus on small pellet Visual information is used to prepare the hand for ___shape___ of a particular item; the hand begins to open and shape itself prior to the grasp according to the object's size and shape.

10 to 12 month vision

easily pursues moving object; uses vision as a __________ guide to object manipulation.

The uterine contractions serve two central functions:

effacement and dilation. -Effacement and dilation occur without deliberate effort by the mother.

gametes

egg and sperm cells -23 chromosomes each

2 Limitations to a Toddlers Thought that influences Play

egocentrism animism

What is the role of a play companion?

elaborate on capacity on pretend play and help them expand their new domains/ideas of fantasy play

The key to the disappearance of stepping and the increase in kicking is in the role of

gravity as infants' legs gain mass. As the legs gain in fat, the muscle strength needed to lift the legs against the force of gravity is not sufficient to permit the stepping action.

Sensory diet

group of sensory activities we have the child do throughout the day, provide sensory input and change regulation

sensorimotor adaptation

growth of intelligence

Sometime between 4 and 7 months, infants are able to recognize and classify some expressions such as

happiness, fear, and anger

Ego psychology

has become a study of the development and differentiation of the ego as integrative, adaptive, and goal directed

Ego

has two related meanings. One is the idea of ego as a person's self, including one's physical self, selfconcept, self-esteem, and mental representations of the self in relation to others.

What does SPD Look Like?

hate over stimulation, light sensitivity, can't dress themselves, decreased pain receptor, lack of concentration, picky eater, poor gross motor, walk on toes, complain about tags on clothing, no tickling or cuddling, selective hearing or difficulty hearing, etc.

3 months and head lag

head lag is decreasing

physiological flexion

higher muscle tone in flexors at birth (fetal flexion)-flexors shortened and extensors lengthened. -when first born -fetus position -supine

children in bilingual programs typically score

higher on tests of English than do children in all-English immersion programs

Disorganized Attachment

higher prevalence in high-risk families (maternal depression, low-income, multi-problems in the family); infant shows no consistent pattern for managing the stress of separation (may demonstrate fear or anger toward parent); parents tend to be abusive, neglectful, alcohol- or drug-induced rages, psychotic delusions, etc. -disordered

evolutionary theory

highlights three phases of the life span: (1) healthy growth and development leading up to the reproductive period; (2) success in mating and the conception of offspring; and (3) the ability to parent offspring so they can survive, reach reproductive age, and bear offspring of their own (Charlesworth, 1992).

Standing with Support

holding onto everything

14 through 36 months crayon use

holds crayons in fingers (digital-pronated grasp) -static hold

single-word utterances accompanied by gestures, actions, vocal intonation, and emotion are called

holophrases.

With increased life expectancy, we as health care professionals need to consider

how human occupation changes and how we help our clients achieve higher standards of living and new levels of functioning later in life.

Cognitive developmental theory focuses specifically on

how knowing emerges and is transformed into logical, systematic capacities for reasoning and problem solving.

infants show an increased sensitivity and preference for

human sounds/voices by 3 months

Active participation

humans are active participants in their own development by shaping and directing their own life

the three structures of personality

id, ego, superego Freud

The conscience includes

ideas about which behaviors and thoughts are improper, unacceptable, and wrong. It carries out the punishing function.

central process is

identification

Developmental Changes in Self-Theory: Early & middle school age

identify strengths over weaknesses, help with self-essteem, compare self (ex: I am thinner and you are bigger) Children do more "________________" assessments; compare self with social norms and other people; more preoccupied with self-evaluation and social comparison.

Labeling

identifying the names of objects

Response to Intervention programs can

improve fine motor and visual-motor skills in children

hearing rather than vision

is the sense that provides the very earliest link between newborns and their mothers. -Newborns show a preference for the sound of their mother's voice over an unfamiliar voice.

touch stimulation to a newborn

is the strongest sense (swaddling, tickling, etc.)

Occupational Therapist have traditionally relied on

knowledge from major developmental theorists from many fields to help shape our understanding of human occupation:

Cognitive competencies consist of

knowledge, skills, and abilities.

learning words

learn 5-8 words a day from 1-6 years old

sensorimotor intelligence

learned by doing, encompasses the elaboration of patterns of movement and sensory experiences that the infant recognizes in association with specific environmental events. (ex: tying your shoes) (ex: infant adapting reflexes to be more effective)

Learning/plasticity

learning influences the interaction between the person and the environment; behavior is modified as a result of experience

Footnote

left end of bar refers to back of sheet for specific instructions

APGAR: Heart Rate

less than 100 bpm-1; more 2; absent-0

FIVE-SIX Months - SUPINE

lifting the pelvis more -flexible (feet in their mouths) = increased flexor control

symbols

look similar to objects they represent -symbol ex: using a block for a phone

Infants who weigh less than 2,500 grams (about 5 pounds, 8 ounces) are called

low-birth-weight babies.

Language Development 4 years

more consistent in rules of grammar; improved understanding of word meaning

6 Months - Side lying; lateral control

more control

a top-down framework for examination of the occupation of handwriting may be useful in considering

potential interactions between the child, the task, and the environment. -need for occupational therapists to con- sider additional factors that may impact handwriting of students with learning and/or behavior problems.

reading week 4

pp. 144-151

how are skills learned?

practice --> receive internal and external feedback --> skill becomes automatic --> this allows for concentration on higher level processes (Skillful people monitor & adapt their performance constantly.) Children with motor planning problems continue to put effort into basic skills and therefore have less energy for higher level learning.

Sleep State: Deep sleep

predominantly regular breathing, eyes closed, no activity except startles or jerky movements, no eye movements, relaxed facial expression.

Semiotic thinking

pretend play is not possible without semiotic thinking. It underlies the capacity for imagination, for allowing objects and ppl to take on new identities and new meaning -1 thing can stand for another -Differentiate a child's use of symbols and signs -role playing, using symbols and signs in their play

According to psychosocial theory, at each stage of life, consistent efforts to face and cope with the psychosocial crisis of the period result in the formation of basic adaptive capacities, referred to as the

prime adaptive ego qualities.

the biological system includes

processes necessary for the physical functioning of the organism and for mental activity

One hand support

progressive for balance with walking

Infants begin to "categorize" objects based on

properties or function -3 mos: infants categorize stimuli as people or objects (will smile more with people) -12-24 months: toddlers can do some simple sorting of objects

Defense mechanisms

protect the person from anxiety so that effective functioning can be preserved. They distort, substitute, or completely block out the source of the conflict. They are usually initiated unconsciously. -may lead to positive social outcomes

vision/gazing in infants

provides an early and continuing source of information that guides social interactions and learning about the physical environment By 4 months of age, babies can follow the gaze of another person toward an object and by 9 months, they use the gaze and head turning cues of others to direct their attention. By gazing at others and following the gaze of others, babies use vision to form social connections, focus attention, and gain information from others about important objects and activities in their environment

Dynamic Weight Shifting

provides weight bearing with movement: the center of gravity changes and the weight-bearing surface changes

This sense of ego emerges as

psychic energy and is directed toward the self—a process that is sometimes called *primary narcissism.* The idea is that the sense of self is born out of self-love, an enthusiasm and excitement for one's body, one's experiences, and one's emerging sense of agency.

skin

pudgy and wrinkly -sometimes flakey

Prone to quadruped

pushes back to quadruped (hands and knees); rocks back and forth and sideways; uses STNR; prepares for creeping -Kneeling-moves quadruped to kneeling

Developmental Milestones of Toilet Training: 4-5 years

remains dry at night; manages clothes by self

Schoolwork

resources available and education type, style, and availability effect development

Adaptive response:

response after your brain has integrated all the senses, and the response your body exhibits (what is your goal directed action)

assisted reproductive technology (ART)

result in live births -fertilization of one or more ova (Artificial Insemination, Fertility Drugs, In Vitro Fertilization/Fertilization in an Artificial Environment, Intracytoplasmic Sperm Injection, Gamete Intrafallopian Transfer (GIFT), In Vivo Fertilization (Fertilization in a Living Body), or Surrogate Mother) -ARTs have raised many legal and ethical questions.

Mature reactions

righting reactions and equilibrium reactions VVVV

piaget

schemes and operations

ADOLESCENCE (13-19 years) ACTIVITIES

school clubs, crafts, camping, musical instrument, choir, dancing, aerobic exercise, gymnastics

During the third prenatal trimester, especially between 30 and 34 weeks of gestation, certain self-regulatory functions related to

self-calming in the face of unpleasant stimuli and organization of wake-sleep cycles become integrated and synchronized. Babies born before 30 weeks do not have the benefit of positive features of the uterine environment that support these aspects of self-regulation.

Bear Crawl

on hands and feet

*Difference between inferior pincer grasp and fine pincer grasp?*

on midterm. -inferior = using the surface, pads of the fingers, fingers extended (10 mo) -fine = good opposition, no table support, tips of the fingers (12 mo)

Adjusted age

once the baby reaches full term, the baby's age may be adjusted for prematurity; number of weeks premature subtracted from chronological age -premature babies reach milestones much later = adjust milestones

The human voice

one of the earliest stimuli to evoke an infant's smile. Infants appear to be particularly sensitive to language sounds -By 3 months, however, babies showed a clear preference for human over monkey vocalizations, suggesting that human auditory preferences take shape rapidly in the first months of life

exosystem refers to

one or more settings that do not involve the developing person as an active participant, but in which events occur that affect—or are affected by—what happens in the setting containing the developing person.

Language Development 1 year

one word utterances

young infants = indicate loudness, pitch, duration, and location of sounds

onset at birth, increasing in sensitivity by 6 months

Play companions

Part of the role as an OT will be as a "play companion" to facilitate fantasy play person that plays with the child

abnormal ATNR

Pathological response = neurological impairment -seen when retained later in life

Multiple Patternicity

Patterns of occupational development mirror those of general human development -Multiple variation

Physical and social

People learn from interaction with their physical and social environment

5 years feeding

Spreads with table knife

7-8 months standing

Standing - moves from kneeling to standing by pushing down with arms and extending with legs; stands with legs widely abducted and supports self mostly with arms against furniture; bounces in standing position -supported by objects/people

Evaluation Process is based on sound clinical judgment

Subjective, interpretive component based on the OTR's clinical experience and frame of reference

Teratogens

Substances that are capable of producing fetal abnormalities -Drugs -Smoking -Alcohol -Caffeine -Narcotics -Environmental Toxins -transmitted through the placenta -increased occurrences of SIDs

Adjust for Prematurity

Subtract the number of weeks premature from the child's CA

fertilization

Swimming at the rate of 1 inch every 8 minutes, sperm may reach the egg in as little as 30 minutes, but the journey usually takes about 6 hours; sperm can stay alive in the uterus for up to 5 days.

TODDLER (2-4 years) TOYS

Symbolic: play kitchen, toy cars, dress-up clothes, farm sets with animals, musical instruments, dolls, tricycle, rocking horse, sand box, large empty boxes, etc. or Simple constructive: blocks, simple put-together toys, stringing beads, finger painting, puzzles with several pieces, pegboards,

The Embryonic Period

The 3 weeks following implantation are devoted primarily to elaboration of the supportive elements that will house the embryo. An amniotic sac surrounds the embryo and fills with a clear, watery fluid. -placenta formed -teratogens harmful -

motor development milestones

The Contributions of Nature and Nurture in Motor Development

Sensory Integration

The ability to perceive, organize, assign meaning from the information we take in through our senses... and to effectively utilize the information to respond to the demands of our environment "organization of sensation for use" -Ties sensory processing to the person's occupation -Refers to the process of neural organization of sensory information Frame of Reference -Used by OT's in evaluation and treatment -The senses all integrating to process for your body (all working together)

Self-Control

The ability to: -Comply with a request -Modify or manage behavior -Postpone actions/reactions (delay gratification) -Act in socially appropriate ways -Assess a situation and redirect impulses -Improves between 2-4 yrs of age -delay gratification = end of the day get a treat for being good

Insecurely Attached Infants

The baby avoids the mother or is ambivalent toward her; fears strangers and is upset by minor, everyday separations. -Anxious-avoidant -Anxious-resistant -within normal development -ambivalent = uncaring

independent living skills

able to learn how to cook, wash clothes, clean, manage allowance, care for babies, mow lawn, take out garbage, etc. -These are critical skills in helping prepare for adolescence and adulthood.

signs

abstract representations of objects (letters & words for objects) -signs ex: letters or words for objects

What develops first - active flexion or extension? How would you evaluate the quality of active extension? Active flexion?

active extension -ex: put them in prone (how are they moving/positioning) flex = put them in supine

release 10-11 months

active release

secure attachment

actively explore the laboratory setting and interact with strangers while their mothers are present. After separation, the babies actively greet their mothers or seek interaction. If the babies were distressed during separation, once the mothers return the infants go to the mothers for comfort, and the mothers effectively reduce their distress. Then the babies resume exploring the environment.

assimilation

adding more information to a knowledge base (ex: know a car can drive, has wheels, etc.) -Have a base knowledge

WHAT ARE SOME OF THE BENEFITS AND SKILLS LEARNED AS CHILDREN DEVELOP CLOSE FRIENDS?

affection, closeness with peers, sharing, etc.

Neural plasticity

all changes in interconnections among neurons as a result of learning and experience

newborns can distinguish between

all tastes

Motor development refers to

all the changes in a child's ability to control and direct movement, including movement of the eyes and head, as well as movement of fingers, arms, legs, and torso. -Motor development begins during the prenatal period as the fetus twitches, hiccups, waves its arms, kicks its legs, sticks out its tongue and orients its body within the amniotic fluid. These prenatal movements lay the groundwork for neural pathways that will eventually sustain more coordinated movement after birth.

Motor development

all the changes in a child's ability to control and direct movement, including movement of the eyes and head, as well as movement of fingers, arms, legs, and torso. -begins during the prenatal period as the fetus twitches, hiccups, waves its arms, kicks its legs, sticks out its tongue and orients its body within the amniotic fluid. These prenatal movements lay the groundwork for neural pathways that will eventually sustain more coordinated movement after birth.

How would you enhance a toddler's sense of autonomy?

allow them to perform things that they can be successful in (builds confidence)

Areas of the brain associated with memory:

amygdala, hippocampus, limbic areas, store emotional memory -Newborn research on olfaction shows preferences to mother milk and amniotic fluid -Functionally: See emergence in likes, dislikes, -Temperamental traits begin to declare around 3 months

Occupation

an activity in which one engages "Culturally valued, coherent patterns of actions that emerge through transactions between the child and environment and as activities the child either wants to do or is expected to do."

Object relations theory

an adaptation of psychoanalytic theory that places less emphasis on aggression and sexuality and more emphasis on human relationships as the primary motivational force in life

Categorization

an aid to information processing. By treating certain individual objects as similar because they belong to the same basic grouping, like two individual red blocks or two wiggly goldfish, the potential amount of information to process is reduced.

phasic biting

an up and down movement of the jaw. (not biting, just motion)

The preconscious is

analogous to the part of the iceberg near the waterline. Material in the preconscious can be made conscious if attention is directed to it. Preconscious thoughts are readily accessible to consciousness through focused attention.

Primitive reflexes

appear during gestation or at birth and become integrated by 6 - 12 mos. -present in all normal newborns. -purpose: for protection and survival -Involuntary: changes in body tone/movement controlled through the CNS in response to a specific stimuli

normal levels of guilt

are associated with prosocial behavior and high levels of empathy -normal guilt is fine, but it shouldn't persist

Social Attributes

are formed by our interaction with other people over our lifetime. An Individual Attribute, such as anger, might be displayed as aggression in a social context

Humans

are multi-faceted living systems that grow and develop at several levels -Interdisciplinary studies of human growth and development have taken place for more than a century

Lateral protective extension

arm going out to the side to protect self from falling

Newborn interactions with environment: pyramid

The infant must have stability in the lower subsystems in order to organize behavior in a higher subsystem. *bottom --> physiologic subsystems --> motor --> state --> attentional --> self-regulation --> top* -physiologic = HR, BP, breathing regularity, color, etc. -motor = tone, posture -state = different states of consciousness (alert, quiet, etc.) -attention = ability to become alert/focused -s-r = modification of all subsystems (ex: able to sooth,

6 months and beyond, the infant starts babbling and

attaches meaning to certain sound combinations around them

Four basic information-processing abilities that support the maturation of sensorimotor intelligence:

attention, processing speed, memory, and representational abilities

Sensitivity

attentiveness to the infant's state, accurate interpretation of the infant's signals, and well-timed responses that promote mutually rewarding interactions

avoidant attachment

avoid contact with their mothers during the reunion segment following separation or ignore their efforts to interact. They appear to expect that their mothers will not be there when needed. They show less distress at being alone than other babies. Mothers of babies who were characterized as avoidant seem to reject their babies. It is almost as if they were angry at their babies. They spend less time holding and cuddling their babies than other mothers, and more of their interactions are unpleasant or even hurtful. At home, these babies cry a lot, they are not readily soothed by contact with the caregiver, and yet they are quite distressed by separations. Mothers of infants who show an avoidant attachment are often dismissive or devaluing of their own childhood attachment experiences

9 months vision

use the gaze and heading turning cues of others to direct their attention

first words

Between 12 and 18 months of age words emerge as more salient than gestures as a way to refer to objects

The central process suggests

a way that the person takes in or makes sense of cultural expectations and, as a result, changes the self-concept.

What component functions are critical for movement in and out of sitting?

-trunk extension -active extension -weight baring -head in line -head control -abdominal muscles -etc.

Sensory Experiences Vary

Full term Infant VS 26 week infant

Psychosocial Crisis

Trust vs. Mistrust -The most important resolution of the "crisis" is that the infant develops a sense of confidence that his/her needs will be met -This develops through consistently meeting the child's needs Psychosocial crisis—state of tension that occurs as a result of the developmental needs of the individual and the social expectations of the culture -Crisis means a normal set of stresses and strains rather than an extraordinary set of events/struggle between positive and negative poles -In Infancy, trust vs mistrust focuses on the fundamental nature of an infant's sense of connection to the social world -In adults, trust emerges in the course of a relationship....in infancy, trust is an emotion—a positive experiential state of confidence that their needs will be met and that they are valued.; feelings of comfort with caregivers, parents develop trust by consistently meeting the child's needs

development of moral feelings can serve as

a. proactive function - child will consider other person's feelings and modify behavior; b. reactive function - child will feel remorseful for hurting other person.

Self-Care Development: Dressing

VVVV

Synactive Theory of Development

VVVV

PPT: Developmental Tasks of Infancy

VVVV Birth to age 2

PPT: Normal Oral Motor and Feeding Development

VVVv

Number of Items to be Given

Varies with age of the child Need at least Passed 3 items completely LEFT of age line -Basal level Keep testing until 3 Failures are recorded -Ceiling level

Proximal Sensory Systems

Vestibular Proprioceptive Somatosensory (tactile) -proximal = dominate a child's interaction with the world -vestibular = anything where your head is moving -proprioceptive = joints, body in space -tactile = touch

Bullying

Victims Tend to have low self-esteem, cautious Intervention -Create environment of warmth and caring -Clear, firm limits about unacceptable behavior -Adequate adult monitoring

Distal Sensory Systems

Visual Olfactory (smell) Auditory Gustatory (taste)

Reflexes Lead to

Voluntary Movement -Most early motor responses appear to be reflexive -Very young infants can support their full weight through the strength of their grasping reflex When propped in an infant seat, they will grasp and reach reflexively at an object with 40% accuracy -4 weeks it disappears, but by 5 months replaced by voluntary reaching, accurate grasping, clutching, and releasing.

lower mental processes

Vygotsky could be observed in animal behavior and in the problem-solving behaviors of infants and very young children, and higher mental processes, which arise as children encounter and master the cultural tools of their society.

3rd stage of social attachment

ability to crawl towards caregiver and coordinate reaching and grasping to be picked up -touch to learn

attention

ability to focus on an object or task as well as to shift or redirect focus from one object or task to another (ex: how long an infant looks at an object/tracks it)

Poking with Index Finger

able to isolate movement in index finger to poke and point to small objects; -precursor to fine pincer grasp -helps for communication = pointing

sports skills

able to learn almost any adult sport; not as strong as adolescent but has same coordination, timing, and concentration

faceness

by 6-months they expect faces to be organized in certain patterns and to move and respond in special ways.

start to use gestures

by 8 months (along with their grunting and whining) -ex: raise arms towards caregiver to be picked up

mistrust

can arise from at least three sources: infant wariness, lack of confidence in the caregiver, and doubt in one's own lovableness.

Many Things Affect Feeding Performance...

-All human domains of development -The environment (ex: financial opportunities (what are we eating, when, how much), distractions, holidays, culture, etc.)

*Protective Extension Forward P.E. / Forward parachute*

Onset: 6-9 months Integration: persists through life Stimulus: sitting and pushing them forward Response: hands and arms out front, flexion at shoulders

*Protective Extension Laterally P.E*

Onset: 7 months Integration: persists Stimulus: pushing from one side to the next Response: arms abducts, elbow extends, fingers extend to be able to catch themselves

*Protective Extension P.E. backwards*

Onset: 9 -10 months Integration: persists Stimulus: pushing them backwards Response: shoulder extension to catch themselves

Proprioceptive Placing reflex

Onset: Birth Integration: 2 months Stimulus: Hold the child in front of a table and provide stretch to the dorsum of the hand at the edge of a table Response: Wrist flexion and extension of the fingers and arm

*Palmar Grasp reflex*

Onset: Birth Integration: 4-6 months Stimulus: Insert your finger into the palm of their hand Response: Flexion and adduction to finger (sustained) -for survival

*Tonic labyrinthine reflex (TLR)*

Onset: birth Integration: 6 months Stimulus: supine or prone placement Response: -supine = extends the head (no head control) and extend the spine -prone = can't keep head extended, follows gravity and flexes/ limbs fall

*Asymmetrical tonic neck reflex ATNR*

Onset: birth (strongest at 2 months) Integration: 4-6 months Stimulus: visual stimuli to track the baby's head to one side Response: face side has the straight arm, back of the head has the bent arm (fencing position) *Important for hand eye coordination and grasping *

Recognize Role Changes and Emergence of New Occupations

Parent Infant Siblings Extended family -women are treated differently when they are pregnant -seen as sensitive -adolescent pregnancy = feel shame -family members carry out new roles (ex: now a grandma or father or sister) -less attention is usually given to the older children

Development of Moral Behavior

Parent-child relationship The strong affectional bonds between a parent and a child are the most effective forces in promoting positive ________ behavior.

Causes of mistrust

Parents may not identify and meet child's needs for a variety of reasons.

2 Types of Touch Receptors

Primitive/Diffuse Receptors Complex/Precise Receptors

9-12 months grasp with self feeding

Pronated grasp resulting in inverting the spoon Pronated grasp, bringing it to the mouth and inverting the spoon (start with thicker foods that won't fall off the spoon as easy)

Tummy Time/Head Control Video

Prone - increased extension throughout trunk and legs; head up in midline; Landau beginning to develop (extensor posture in prone, head extension, hip extension slight arching of the back and arms retracted with elbow flexion) -pushing up on the arms -weight on the belly -head and hip extension -tummy time gives the infant opportunities to push up (good for development)

Side sitting/lying

Prone to side-lying- plays in this position

clinical significance of proprioception

Proprioception is the "Glue" that helps all of our other sensory systems function well

Development Through Life: A Psychosocial Approach Organization of Text:

Provides a chronological introduction of human development from conception to very old age outlining an 11 stage "Life Span Age"...as a conceptual framework for understanding human development *Emphasizes that at each life span age there are developmental tasks, a psychosocial crisis, a central process and adaptive vs. non-adaptive ways of resolving each stage. -like Erik Erickson's stages of psychosocial development

Why facilitate fantasy play:

Provides an opportunity to develop social reciprocity... Kids with special needs are isolated at times and may go through this stage longer.... -learn turn taking -delayed child may go through this stage longer

"Traditional" views vs "Current" views

Psychology Physical education Physical and occupational therapy Medicine

Toddler (12 months to 3 years)

Psychosocial issues -Aim is to feel like a separate person from parents Will resist parents to prove his/her separateness -Seeks control but also needs limits -Parents need to seek a balance between over-rigidity and over-permissiveness -what they can/can't have, what they can get away with -overall autonomy (ex: "no I do it" when going to cut a baby's food)

The Psychosocial Approach

Psychosocial theory presents human development as a product of the ongoing interaction between individual biological and psychological needs and abilities on the one hand and societal or social expectations and demands on the other hand. -Biological-Psychological Needs and Abilities *+* -Societal Expectations and Demands -The integration of these systems leads to a complex, dynamic portrait of human thought and behavior

3 through 5 months Grasp

Purposeful grasp: Voluntary ____________develops between 4-6 mos. The infant begins to use both tactile and visual input to adjust hand to the object and grasp it. During the next several months, the infant becomes capable of using a variety of grasping patterns based on the object to be prehended; initially the infant uses only a few patterns indiscriminately. SQUEEZE GRASP or ULNAR PLAMAR GRASP (5-6 mos.) - (1st active grasp) holds object against _their palm_with ulnar fingers; squeezes objects tightly without gradation; no thumb activity in holding object

Difference between the 2?

Purposefully drop an object with full finger and thumb extension is active release, controlled is more steady, like with the ability to stack blocks

7-8 Months - SITTING

Quadruped to sitting - uses trunk rotation to make these transitions full, functional sitting; able to weight shift in all directions to reach for objects using good trunk control

ADOLESCENCE (13-19 years) PLAY

RECREATION/LEISURE ACTIVITIES: Engages in a more mature form of play with sophisticated rules, etc. -Eg. bowling, skating, dancing, etc.

Developmental Changes in Self-Theory: Toddler

confident and loved, more autonomous, not much social comparrisioin until 3-4, categorize (ex: I have brown hair you have blonde)

Encodings refer to

constructs or schemes the person has about the self, the situation, and others in the situation.

Static Weight Bearing

contact area of body with the earth or object provided by the force of gravity

6 Months - SUPINE to ROLLING

controlling obliques, lateral control

When coping is unsuccessful and the challenges of the period are not adequately mastered, individuals are likely to form maladaptive orientations, referred to as

core pathologies.

artistic skills

dance, music, art forms, cooking, crafts, sewing, writing stories/poems, theatre, etc.

Assessment

data gathered from specific procedures or evaluation tools -ex: interview, tool, etc.

Motor skills

develop as a result of physical growth and maturation in combination with perceptual information and opportunities for exploration of the environment. The infant's drive to explore and master the environment as well as encouragement from caregivers contribute to the rate and sequence of motor development

Gesell

developed extensive developmental milestones, developmental norms (0-6y) which are used as a foundation for many development evaluations -flexion/extension, asymmetrical/symmetrical movements were studied -what age motor development occurs

physical characteristics

development based off work and surroundings and resources -ex: more muscular hands because of a life of hard labor

Multiple variation

development is neither smooth or unidirectional; development is complex because of the dynamic interaction of multiple subsystems which results in different patterns of development at different times.

*Sequence of Coordinated Movement Development*

development of coordinated movement occurs in the following sequence: Physiological Flexion --> Active Extension --> Active Flexion --> Balance of Flexion and Extension --> Lateral Control --> Rotation and Diagonal Movements

3 through 5 months Reach

directed 2 or 1 arm approach, hands are in a __pronated__ position at 3 months but active supination gradually increases by 6 mos. so child can mouth it and visually regard it.

Whenever changes in the organism or in the environment require a revision of the basic structures, they are thrown into

disequilibrium

STNR

symmetrical tonic neck reflex -whatever the head is doing the arms are doing, but the lower extremities are doing the opposite -ex: head and arms are extending = legs are flexing

munching

-Munches on solid foods (cracker/cookie; first form of chewing) -Munching involves up/down/in/out movement of the tongue against the palate to mash the food before swallowing (no tongue lateralization occurs yet)

BE AWARE

-Parents are responsible for what their child is offered to eat, where and when it is presented -Child is responsible for how much he/she eats -BE AWARE OF THE DIVISION OF RESPONSIBILITY

causes of guilt

-Parents who severely limit experimentation -Parents who are consistently impatient with questions -Parents who react to fantasy play as if it is silly/stupid -authoritarian environment

Initiative overview

-Period of intellectual curiosity, -Why Questions?? -Not afraid to explore -Spontaneous -Enhanced feelings of belonging

Environment Determinants

-Physical and social -Historical & cultural attributes

1 through 2 months Grasp

grasp reflex present (pronated grasp; holds object in palm when placed; ); develops the week first of life; strongest between 1 - 3 months and becomes altered 4-5 months

Oral Motor & Feeding Development: Newborn (birth-1 month)

-Responds reflexively to touch -Major skills: Takes in liquids using a suckling pattern on bottle or breast -Suck-swallow reflex (suckling) -Rooting reflex -Gag reflex -Phasic biting

prenatal period senses

-Responds to tactile input (5.5 wks gestation) -Response to proprioceptive input (9 wks gest) -Response to vestibular input - (9 wks gest)

4-6 months

-Rolling -Learns to sit -Beginning lateral control -rolling prone to supine -reaching and grasping

Activities that Promote Fine Motor Development: Pincher

-turning a key in your little tike car -video game -coins into a piggy bank -play piano -clothes pins -tearing paper (to make a picture) -holding a deck of cards -buttons in slots

ATNR

2 months asymmetric tonic neck reflex -fencing reflex = gravity pulls the head to the side and the arms move into the fencing position -strongest at 2 months -has to do with hand eye coordination later on in life

PPT: Infancy

2 months --> 1 year

translation =

2 types = finger to palm and palm to finger (develop at different times) (finger to palm = picking up pegs) (palm to finger = holding in the palm and bringing it to the fingers to pinch)

Language Development 2 years

2 word phrases; telegraphic speech (daddy here, mommy work)

cutting

2-2.5 years old -Snips paper with scissors 3 years old -Cuts paper in half 4 years old -Turns paper when cutting

A time of wonder and rapid learning....

2-4 years old

Lateral Control

trunk control of adductors and abductors -starting to roll is a good indication

Coordination refers to

two related characteristics of interaction: matching and synchrony. .

palmar supinate grasp

(12-18 mo)

How do children internalize parents' values, standards, and limits?

Consider the Development of... -MORAL THOUGHT (COGNITIVE) -MORAL FEELINGS -MORAL BEHAVIOR

10 to 12 monts grasp

Consistent radial digital grasp for Cube -Pellet

What factors contribute to high levels of prosocial behavior and social responsibility?

-want parent comfort and support -social role playing (siblings best way to accomplish this) -confidence and self-esteem support -involving children with decision making

APGAR: Reflex Irritability

-weak cry, grimace, cough, sneeze-1; vigorous cry, grimace, cough, sneeze-2; no response-0

radial palmar grasp

(28 wks., 7 mos.) thumb & radial fingers press the object into the palm; when this is combined with forearm supination, the infant is able to bring objects to mouth. The sides of the hands begin to differentiate for function: the radial side used more for prehending (skill side of hand) and the ulnar side to provide stability. -block in palm, using radial fingers

Neural-based theories

"Traditional" -Rely on neural explanation of motor control -Neuromaturation theory

"Delayed" items

"failure" or "refusal" score on an item that falls completely LEFT of the age line "Delayed" items should be colored in on the right end of the bar for easy identification

"Normal" items

"failure" or "refusal" scores that fall to the RIGHT of the age line -all age related functioning in the category was passed

"Advanced" items -

"pass" completely RIGHT of the age line. -child has advanced functioning in that category if they pass any of the tests administered that are past their age line

The zone of proximal development is

"the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined through problem solving under adult guidance or in collaboration with more capable peers" (Vygotsky)

Social referencing involves three coordinated processes:

(1) The infant coordinates attention between the adult and an ambiguous object or situation; (2) the infant understands that the adult's emotional reaction refers to the specific object or situation; (3) the infant uses the information from the adult's emotional reaction to guide behavior toward the object

Four factors come into play in producing the kind of sensitivity that underlies secure attachments:

(1) cultural and subcultural pathways, (2) the caregiver's personal life story, (3) contemporary factors, and (4) characteristics of the infant

Four key concepts in Vygotsky's theory are introduced here:

(1) culture as a mediator of cognitive structuring, (2) movement from the intermental to the intramental, (3) inner speech, and (4) the zone of proximal development.

five components of the psychoanalytic theory

(1) motivation and behavior, (2) domains of consciousness, (3) the structure of personality, (4) stages of development, and (5) defense mechanisms. Two extensions of the theory, object relations theory and ego psychology, are briefly explained.

four patterns of attachment behavior have been identified:

(1) secure attachment, (2) avoidant attachment, (3) resistant attachment, and (4) disorganized attachment.

In order to understand how a person copes with a stressful situation, one must consider

(1) the nature of the stressor, (2) how it is perceived by the person, and (3) the range of resources that are available to address the situation

The logic of the id is called

*primary process thought.* It is characterized by a lack of concern for the constraints of reality. In primary process thought, there are no negatives. Everything is yes. There is no time. Nothing happens in the past or in the future. Everything is now. Symbolism becomes flexible. One object may symbolize many things, and many different objects may mean the same thing. Many male faces can all represent the father. The image of a house may be a symbol for one's mother, a lover, or the female genitalia as well as for a house.

According to Freud, the basic defense mechanism is

*repression*, a process whereby unacceptable impulses are pushed into the unconscious.

In the ego, primary process thought becomes subordinated to a more reality-oriented thinking, called

*secondary process thought*, the kind of logical, sequential thinking that we usually mean when we discuss thinking. It allows people to plan and act in order to engage the world and to achieve gratification in personally and socially acceptable ways. It enables people to delay gratification. It helps people assess plans by examining whether they will really work.

One of the most notable ways that infants and adults have of co-constructing their reality is the mechanism of

*social referencing* in which infants gather information about a situation or an object by assessing their parent's or caregiver's reactions.

The id expresses its demands according to

*the pleasure principle*: People are motivated to seek pleasure and avoid pain. Its rule is to achieve the immediate satisfaction of impulses and to discharge energy without regard to the feelings of others.

The ego operates according to

*the reality principle*. Under this principle, the ego protects the person by waiting to gratify id impulses until a socially acceptable form of expression or gratification can be found.

Pregnancy can bring many + or - feelings depending on the context

+ when anticipated - when unmarried?; poor financial situations, too young, etc.

concrete operations

- 11-12 years -Increased understanding of the physical world and relationships -Mental Operations - thought process used to mentally alter the relationships among objects

playfulness play

- A style of interacting; can help work seem more like play.

Characteristics of "Child-Centered" Kindergarten

- Focused on the whole child (physical, cognitive, emotional, social, play, etc.) - instruction organized around the individual child's needs, interests, and learning styles (should allow for differences) focus on process, not amount of content (play, exploring, experimenting)

monitor milk and juice consumption

- If the child is drinking too much juice or milk between meals or before meals, he/she may not be hungry for food at mealtime. - Solutions: offer water in between meals; allow the child to drink milk or juice after he/she has eaten half of meal. - 16-24 oz. of milk a day is enough for a toddler

Sensory Nourishment

-"Sensory input is necessary for optimal brain function -Wilbarger- 'sensory diet' -Malfunction of the nervous system occurs with sensory deprivation -Too much sensory stimulation may generate stress

Classification of Newborn Infants: Relation between WEIGHT and AGE

-(Appropriate for gestational age; between 10th and 90th percentile) -Chronological age (CA; days/weeks of life) -Adjusted age

INFANT (birth - 24 mos) TOYS

-0 to 6 months: rattles, squeeze toys, toys with faces, mobiles, etc. -6 to 12 months: blocks and containers, cause and effect toys, busy box, nesting toys -12 to 24 months: simple form boards, picture books, pop-beads, blocks, push-pull toys, balls, scribbling with fat crayons, dolls and stuffed animals

Feeding Difficulties

-80% of children diagnosed with developmental delays will also have co-morbid feeding issues -Problems associated with birth trauma, prematurity, and prolonged hospitalization, and chronic illness can interrupt the normal progression of feeding skills -Neurologic, Motor, Sensory Problems

"Caution" items

-A "failure" or "refusal" score on an item where the age line falls on or between the 75th and 90th percentile -The age line is in contact with or passes through the blue box and the child fails or refuses the item. -Write a "C" at the far right side of the bar -a sign for concern, further review

object permanence

-A property of objects (9-10 months) -The realization that objects continue to exist when removed

Reciprocal socialization

-A variable influencing the quality of attachment -the view that socialization is bidirectional (parent influences baby; baby influences parent) -Interactions can be thought of as a dance; the actions of the partners are closely coordinated

Neurobehavioral Organization

-Ability of infant to interact with environment in an organized, -smooth, balanced, and generally stress-free manner -Present in healthy full-term infants -Absent in premature infants d/t limited maturation -how do they cope when stressed -reacting without help

active release

-Able to purposely drop objects using full finger and thumb extension -May stabilize hand on surface to release -dropping everything off the high chair -wrist slightly flexes with release most likely -full finger and thumb extension

NINE to TWELVE Months

-Able to sit in a variety of ways; good balance -TRANSITIONS! Moves in and out of a variety of positions -Half-kneel to stand (pulls up on low surfaces) -May begin to walk at 12 months -Standing and beginning walking; creeps well; good trunk control in sitting allows for freedom of hands for manipulation (sitting is a functional position) -easily moves in and out of a variety of positions (prone, all-fours, sitting, kneeling, standing) -becoming more vertical

18-24 months spoon feeding

-Able to spoon feed neatly holding spoon in a SUPINATED position -Able to scoop and does not turn spoon over at mouth Supinated grasp with ability to self-feed with improving neatness and accuracy is seen in 18-24 month olds.

Emotional Development: 6 months

-Active in creating social contact -Caregivers should: -Promote a focused attachment to a small number of people -E.g. 1-2 people at day care

Dominant Characteristics of the Toddler

-Activity -"No" stage -Need for self-regulation -increased awareness of dependence and independence (Increased curiosity, play, self feeding) -Wanting to do things independently (autonomy) -Saying no -Temper tantrums -Not wanting to listen -Constantly moving, keeping busy -Curiosity

9 traits you look at to determine if the child is easy or difficult

-Activity Level -Distractibility -Intensity -Regularity -Sensory Threshold -Approach/Withdrawal -Adaptability -Persistence -Mood

Common features of a premature infant:

-Acute respiratory distress -Low muscle tone (decreased physiologic flexion) -Poor state regulation (drowsy/lethargic; irritability; poor range of states) -Apnea's (cessation of breathing) and bradycardias (decreased heart rate) -Poor oral feeding abilities -Decreased tolerance for environmental stimulation (due to immature CNS) -Uncoordinated, tremulous movements

Based on the Psychosocial Approach of viewing human development in "Life Stages" we will examine the following and establish the relationship between human development and occupational development :

-Age -Developmental tasks -Psychosocial crisis -Central process -Resolution (Prime Adaptive Ego vs. Core Pathology)

to gain initiative, parents should ...

-Allow exploratory play and be open to questioning -Questions should be answered as honestly as possible -Give only information that child is asking for allow exploratory play and be open to questioning; questions should be answered as honestly as possible; give only information that child is asking for. -kids questioning things/curious at this age -know differences in body parts (boys vs girls) -see differences in children with disabilities

18-24 months, Caregivers should:

-Allow for swings in behavior -Show acceptance of toddler for who she/he is -Show unconditional positive regard and affection

10-18months, Caregivers should:

-Allow infant to try and do things her/himself -Provide a safe and stimulating environment

industry summarized

-An eagerness to learn new skills, positive attitude toward work, school -Ex, babysitting, cleaning house, volunteer, community involvement, -Intrinsic motivation is high -Independence is emerging -Confident about skills

Body righting (trunkal adjustment)

-Anterior weight shift - observe spinal extension -Posterior weight shift - observe trunk flexion (abdominals) -Lateral weight shifts - observe for lateral flexion on non weight-bearing side and elongation on weight-bearing side -Diagonal weight shifts - observe rotation of the trunk -tilt baby forward (anterior) = should observe spinal extension to maintain balance (opposite with posterior)

How do OT's use developmental theories?

-Apply developmental theories from other disciplines to help us understand a person's development (motor, cognitive, psychosocial) -We analyze how a person's development affects occupational performance -to have a baseline comparison

Ways in which OTs use PLAY

-As a medium in intervention to improve the child's skills in various areas (motor, sensory, cognitive, & language) -To enhance play as occupation or to enhance play development -To diminish stress; to work through fears -To facilitate playfulness during work or a difficult activity -play can act as a medium to adapt other skills, like fine motor or gross motor or education, etc. (can grade activities) -ex: medium in intervention = child finding the letters in the pile of pillows

Other problems seen when a child has fine motor skill difficulties

-Avoid/refuse to participate in fine motor tasks -Frustration with precise eye-hand coordination tasks -Poor self-esteem when compared to same aged peers -Poor academic performance -Poor computer skills -takes them longer to accomplish/finish things = teachers move on and other students ahead = poor self-esteem

Learning Theory

-Avoidance conditioning -Observation of models -Learned expectations of situational factors -learn through the process of rewards and punishment. -avoidance conditioning = fear of being punished so avoid bad behavior -observation of models = desire to imitate children who behave appropriately (who is getting rewarded) and avoid behaviors of those getting punished -learned expectations of situational factors:= learn that certain behaviors wont go unnoticed in certain settings (e.g., they can't punish me in a restaurant for running around)

Feeding & Gastrointestinal Control

-Baby is born with reflexes of suck and swallow but may not demonstrate initially -Premature infants: Often fed by nasogastric tube prior to 34 weeks gestation -baby has stored up extra sugar, fat, tissue & fluid from mother prior to birth. It may take a couple days for the infant to become efficient with sucking.

6 Functions of the vestibular system

-Balance: Vestibular is key player (vision and proprioception are also important) -Ocular Motor Function: Connections between visual and vestibular system allow us to maintain eye contact while moving -Muscle Tone: Influences speed and strength of contraction of muscles (Vestibular system communicates with muscles through the descending tracks. (low tone = may be problems) ) -Limbic: Responsible for the emotional reactions to movement (pleasure, displeasure); serves to protect body. -Visual Perception: vestibular system assists in the development of spatial relationships (up/down, close/far) and contributes to visual perception. -Autonomic Nervous System: vestibular system communicates with the ANS to serve as a protective mechanism. Will see ANS responses to too much or too little movement.

Developmental Frame of Reference

-Based on knowledge of developmental theories -Used to guide evaluation and intervention process when working with children, adolescents, and adults Developmental theory --> Developmental FOR --> Developmental Evaluation and Developmental Intervention -guides us in what tools to use, processes, etc.

What OT & Parents can do for adolescence

-Be honest in your appraisal of your child's performance; don't say he/she did a good job when its not so; -Encourage your child to take small jobs outside the home; -Talk to your child about what he/she wants to do; what his/her strengths are, etc. -Encourage your child to develop recreation/leisure interests; give opportunities to experience various activities and allow child to choose what he/she likes.

Pretense

-Beginning of pretend play and can start to understand the difference between real and fantasy (although not completely consistent in thought) -Provides insight into his or her "theory of mind" -Children as young as 2 can tell when someone is pretending and can follow the transformations in a pretend sequence -complex social play aka -3-4 years -as young as 2 they can tell the difference between real and fantasy -cognitive skills, reciprocal processes and role playing, planning, negotiating, social interaction, etc. required

6-9 months Cup

-Beginning to experiment -Approaches like a bottle -Initially see choking, sputtering, and much liquid loss -See a lot of up/down movement of jaw -spouted or lidded cup until able to suck out of cup

Vestibular System

-Begins to develop at 10-11th week in utero -Responsible for awareness of head/body position and movement in environment and for producing balance (equilibrium) responses

6-9 months self feeding

-Begins to feed self finger food -Holds own bottle -Improved Active Participation -palmar grasp -baby starts to want independence -improved = grab spoon or grab your hand that is on the spoon -a little less messy, still some trouble with technique

Expulsion of fetus

-Begins with full dilation -95% of time - head first delivery

Age Scale

-Birth - 6 years -Monthly intervals until 2 years of age -2 years and on - three-month intervals

9-12 months liquids

-Bottle- consistently see mature sucking pattern -Cup- places cup far in mouth and bites on edge to compensate for poor jaw control/stabilization (assisted release) -Jaw moves up/down during drinking -May be some liquid loss -encourage cup during the day with meals

Development of Sensory, Perceptual, and Motor Functions

-Brain Development -Sensory/Perceptual Development -Motor Development

Motor changes are a result of:

-CNS maturation -Increased body weight and muscle mass -Use of feedback to improve skill

Third Trimester:

-CNS matures -Develops nutritive sucking -Strong active movements -Sensitive to changes in musical notes -Sensitive to familiar voice (increased HR) -Mother starting to get uncomfortable -acid reflux, discomfort (lack of sleep)

Administration

-Calculate the child's age (adjust for prematurity) -Draw the age line *important to be accurate* -Write test date above age line -Complete test form identifier information

Language development: 36 months

-Can speak using up to 8-9 word sentences -Knows some rhymes -Gives full name -learning some repetition -whoever is around them the most can understand them the most -more complex sentences -harder words

"Traditional" Rules of Development Based on Neural Theories

-Cephalo-Caudal Directional Development -Development proceeds from Proximal --> Distal -Movements proceed from Gross --> Fine motor -Reflexive movements precede voluntary control -head control development before trunk control -1 thing/factor can effect milestone -leg movements are not patterns = not developing proximal to distal = all develop together -fine motor and gross motor develop at the same time -*all these points above have been proven false*

traditional development said we develop

-Cephalocaudal(head to foot) -Proximal --> Distal -Gross --> Fine motor control -Reflexive --> Voluntary

Psychological and/or cognitive readiness

-Child can understand process of toileting -Recognizes internal cues -Uses words or signs to communicate they need to go or that they went -Emotional readiness- to sit on potty chair

self-evaluation

-Children are pre-occupied with self-evaluation and in analyzing their strengths and weaknesses -They need to gain a realistic view of these because this will assist in a positive occupational choice Children tend to base self-evaluation on EXTERNAL EVALUATION (teacher's comments, peers, grades, parent approval, etc.) -Teacher's expectations -Self-fulfilling prophecy -Parent expectations of gender-related skills -How can we help?

Strategies adults use to enhance a child's language acquisition

-Children need early exposure to language to acquire competent language skills -Imitation and reinforcement facilitate language -baby sign language helpful for communication of needs -labeling objects = telling them what everything is (reinforces language for hope of imitation)

Dr. A. Jean Ayres

-Conceptual founder of "Sensory Integration" Theory -OT and Educational Psychologist -40 Year Life Span Work -Work focused on the proximal senses -Developed the theory of sensory integration -One of the first occupational therapists to use "evidence based practice" -Conducted systematic research to build constructs and demonstrate efficacy -Invented tests, equipment, and intervention methods that have become one of the most common OT frameworks -assessments, what equipment, what strategies, etc. for sensory integration

What factors influence the quality of attachment: Primary Caregiver Role

-Consistent caregiving -Emotionally available/committed caregiver -Financial stability -Parental Resources and social support

Sensory-Motor Development

-Continues to enjoy variety of gross motor activities which provide vestibular, tactile, and proprioceptive input -Children continue to enjoy and are skilled at playing on playgrounds

Principles that guide Occupational Development

-Continuity -Multiple Determinicity

Self Control develops in two general ways:

-Control of Impulses -Self-regulated goal attainment

Resolution: Central Process: Education

-Critical process responsible for development of a personal sense of industry -Education does not always take place in school -Goal of education - develop basic tools of learning -School: The goal of education is to develop the basic tools of learning (foundation skills).

How to decrease physiologic stress?

-Decrease sensory input (Dim lights) -Minimize handling (Graded and gentle) -Position prone or side lying in flexed position -Swaddle

Test Information

-Denver II is a *standardized screening tool* -Organized method for collecting a clinical impression of how the child performs compared to other children -Takes 10-20 minutes to administer -standardized = order to presenting information and how to distribute it -for those already showing signs of developmental issues/delay/etc. OR those at risk for developmental problems

Parent's Role in TV Viewing

-Develop good viewing habits early in child's life -Encourage planned vs. random viewing of shows -Look for programs that feature same age children -Make sure TV is not used as a substitute for participating in other activities -Discuss sensitive issues brought out in programs -Balance reading and television activities -Help children develop a balanced viewing schedule in terms of types of shows (comedy, education, fantasy, sports, etc.)

Synactive Theory of Development

-Developed by: Heidi Als & Associates -Purpose: to explain the way in which newborns respond to the environment so that caregivers can adapt their interaction to meet the needs of the infant -meeting the infant's needs

skill learning

-Development of skill depends on a combination of component function (motor, sensory, cognitive, social) -Need to be taught and need practice (motor learning)

When to Refer to OT?

-Difficulty with bilateral integration -Child has difficulty crossing midline -Poor hand and finger strength -Difficulty with hand-eye coordination -No hand dominance at 4-5 years old -Difficulty with object manipulation -Awkward or immature pencil grasp for their age -Messy, slow, strenuous drawing, coloring, writing skills -Fatigues quickly when writing or typing or engaging in any fine motor tasks -Difficulty with precise manipulation tasks (buttoning, zipping, tying shoelaces) -Difficulty/uncoordination when using scissors -Difficulty performing age appropriate self-care tasks independently

palmar concavity results from the formation of three arches that run in different directions

-Distal transverse: concave curvature formed at the meta- carpal heads of the index, middle, ring and little fingers. -Longitudinal: a carpometacarpo-phalangeal arch that extends from the crease of the wrist to the tip of either the middle or the index finger -Oblique: concavity formed by the opposable thumb with the index, middle, ring and little fingers. -Kinematic transverse arch: the articulation between the thenar and hypothenar planes about the middle plane formed by the carpus-index MCP-middle MCP.

3 years feeding

-Drinks from cup with one hand -Able to eat with a small fork -Feeds self well with little spillage -Hand preference with feeding is emerging and may be established -Should be able to eat with a small fork.

Three Types of Infant Temperaments

-Easy = Positive mood, regular body functions, low or moderate intensity of reaction, adaptability, positive approach rather than withdrawal from new situations -Slow to Warm = Low activity level, tendency to withdraw on first exposure to new stimuli, slow to adapt, somewhat negative in mood, low intensity of reaction to situations -Difficult = Irregular body functions, unusually intense reactions, tendency to withdraw from new situations, slow to adapt to change, generally negative mood

12-18 months solids

-Eats regular table foods cut-up -Appetite may decrease during this time

10 to 12 months

-Efficient and functional use of hands -Manipulates with hands more than mouth -Uses objects based on their specific function -Well-coordinated reaching -Infant is able to approach an object with hand shaped according to its characteristics. This is based on perception and understanding shape and size. -Uses objects based on their specific function. (eg. pound hammer, bring spoon to mouth)

Cultural Variations

-Emotional /Educational Support Systems -Prenatal/Postnatal Care & Resources -Role of the Father -Control of birth process -ex: cuvad syndrome = father takes to the bed because he is experiencing the same symptoms as the mother -some cultures have extreme restrictions in the care with pregnant mothers (ex: in Korea)

Emotional Development

-Emotional regulation -Temperament

THE FOUR SOURCES OF INFORMATION WHICH INFLUENCE JUDGEMENT OF SELF-EFFICACY

-Enactive attainments -Vicarious experience -Verbal persuasion -Physiological signals

How to decrease motor stress?

-Encourage flexed positions -Avoid hyperextension and brisk movement

Role of OT in Facilitation of Autonomy

-Encourage imitation -Be patient/tolerant -Follow natural interests -Give Choices -Model appropriate behaviors/skills -Build control into therapy sessions -Provide opportunities to engage child and encourage mastery and repetition until personal confidence is achieved

Emotional Development: 6-9 months

-Engages in turn-taking behaviors (peek-a-boo, patty-cake) -Imitates adults -Demonstrates stranger anxiety -Increased socialization with people.

Play Functions

-Enhances socialization with peers -Enhances cognitive development -Child learns new skills in a relaxed & pleasurable way -Allows children to practice various roles -Can help a child deal with anxieties and work through feelings -Improve motor, language, & sensory development -role playing -help with environmental changes -language/communication skills -fine and gross motor

Administration Procedures

-Establish rapport -Introduce test to caregiver *goal to identify the child's developmental status* -Order of Testing

Roles of OTs

-Evaluation of Oral, Pharyngeal Abilities -Evaluation of Contextual factors: Timing, quantity demands, age appropriate food presentation and skill progression, -Assessment of Underlying Motor, Sensory, and Cognitive abilities that would effect feeding abilities. -Treatment: Engage families and Child in treatment activities that will promote maximal skill acquisition once primary limiting factors are identified. -Environmental Modifications -Caregiver Education on effective strategies

Neurologic, Motor, Sensory Problems can present as:

-Feeding Aversions -Dysphagia -Aspiration -Difficulty transitioning between textured foods and or stages of eating -more swallowing related = speech, more sensory or picky eaters = OT -dysphagia = difficulty swallowing -aspiration = inhaling -aversions = a strong dislike or disinclination

Language development 9-18 months

-First words ~12 months -Words are for tangible, concrete objects -Semantics - meaning of words known -Holophrase hypothesis - single word is used to imply a complete sentence in infant's mind -girls talk sooner than boys, impacted if other siblings in the house, -Between 17 and 97 words by 18 months (toys, foods, greetings, animals, colors, features, family, etc.) -can use sounds to describe the word/object (ex: I want a moo) -semantics = know the meaning of the words they are using, use them appropriately -no articulation

9-12 months biting

-Gaining control and strength in jaw closure -Bites everything (spoon, cup, objects, etc) -Through experimentation, learns how hard to bite on food to break it off -Can bite through cookie or cracker by 12 months -1 year can usually bite through a cookie or cracker -good sensory activity (love playing with food) -9 months = prefer table foods over baby food

Order of Testing

-General order of presentation (Personal-Social --> Fine Motor-Adaptive --> Language --> Gross Motor) -In each sector, begin with items that fall completely left of the age line and continue to the right -Begin with easier items first and praise child for efforts -Only one test item should be on the table at a given time to prevent distraction

Major Characteristics

-Going to school! -Wide-ranging curiosity -Self-concept is transformed -Expansion of thought vs. action (rebelliousness) -pre-school kindergarten (new experiences, new information, new opportunities, new influences, beliefs challenged) -has a lot of questions (self-concept transformed) -expansion of thought vs action = very autonomous before, now more rebellious in thought (verbally)

vestibular receptors

-Gravity receptors: Utricle and Saccule (head position); activated by force of gravity alone -Motion receptors (semi-circular canals): Sensitive to rotation, acceleration, and deceleration

Brain Development

-Growth leads to changes in: formation of neurons, continuous growth of axons and dendrites, connections between the axons, speed of firing increases, -During 1st 3 years, brain triples in weight and creates about 1,000 trillion connections among neurons -learning immensely

3 through 5 months

-Hands to midline and to mouth -Raking objects, bangs/shakes objects -Intense visual inspection of objects -Better proximal control -Squeeze grasp or ulnar palmar grasp (1st active grasp) -Release: involuntary dropping of items -Weight-bearing activities on hands -Bimanual skills -able to reach toward an object, place hands on top of it, and rake it toward self -bangs and shakes objects -engages in a great deal of mouthing, hand-to-hand fingering, and intense visual inspection of objects

What OT & Parents can do for middle school age child

-Have age-appropriate games available in environment and encourage use of them; -Encourage involvement in team sports or other age-appropriate group activities; -Encourage involvement in simple jobs around the house and neighborhood; -Encourage involvement in groups such as girl scouts, campfire girls, boy scouts, etc.

Suggestions for feeding toddlers:

-Have regular meals and snacks (2-3 hours between) -Make mealtimes pleasant -Avoid pressuring the toddler to eat -Choose your battles carefully -Hang loose about food acceptance -Be realistic about amounts (portion size is 1/4th the size of an adults) -Monitor juice and milk consumption

Dilation of cervix (longest stage)

-Head moves down -Release of amniotic fluids -Go to hospital when 3-5 min apart -could last for days

Respiratory control for breathing

-Healthy newborns initiate spontaneous respiration shortly after birth Premature infants are at risk of having: -Limited amounts of pulmonary surfactant -Irregular breathing with frequent respiratory pauses and higher respiratory rates -A's & B's: Apnea and Bradycardia -pulmonary surfactant is released toward the end of the fetal period to initiate ventilation and oxygenation -premature infants are at risk of having limited amounts of pulmonary surfanctant this causes respiratory dysfunction; tx: administration of surfactant shortly after birth. -irregular breathing with frequent respiratory pauses and higher respiratory rates -a's and b's—apnea usually accompanied by bradycardia—tx: may recover spontaneously or need oxygen administration -Causes of Apnea & Bradychardia: intraventricular hemorrhage, hypoxia, congestive heart failure, lung disease

Strategies parents use to help children manage impulses

-Help talk about feelings and needs -Develop strategies to reinforce desired behaviors -Diminish impulsive, negative behaviors -Respect toddlers communication strategies/abilities -Use of fantasy play -Model appropriate behaviors

Person Determinants

-Heredity -Learning/plasticity -Active participation

gender preference depends on

-How closely strengths match sex-role standards -A strong preference for the same sex parent -Environmental cues regarding the value of one sex or another

Central process

-How to resolve the crisis? -Consistency of caregiver

Self-organizing principles of movement

-Humans are complex, multidimensional, cooperative systems -Development in these subsystems may NOT occur in a synchronized fashion which may explain the variations we see in normal development -1 subsystem may be rate limiting at a given time -Self-organizing principles of movement—many systems work together to make movement possible Interaction between subsystems is self-organizing and not driven by any one system -Rate limiting—examples: balance may limit independent walking if he has adequate posture control and strength; child may be cautious and not want to walk -heteroarchial = all working together

Benefits of Kangaroo Care to Parents

-Improved bonding, feelings of closeness with their babies -Increased breast milk supply -Increased confidence in ability to care for their babies -Increased confidence that their babies are well cared for -Increased sense of control -increased utilization of kangaroo care in hospitals because of the proven benefits

Neonatal Assesment: APGAR

-In the 1st minute after birth and then again at 5 minutes the newborns life signs are evaluated using the apgar scoring method. -PURPOSE: to identify "at risk" infants early and to predict infant mortality -5 life signs are rated on a score from 0-2: heart rate, respiratory effort, muscle tone, reflex irritability, and body color **Table 5.1, page 139 in N&N -Score 7-10: infant is in good condition -Score 4-6: infant is is fair condition and may require the administration of supplemental oxygen -Scores 0-3: extremely poor condition and the need for resuscitation -Appearance, pulse, grimace, activity, respiration -score of 2 is ideal for each category -

tactile achievements in the first 6 months

-Increased awareness and use of hands -Mouths hands -Actively grasps objects -Midline play connects 2 sides of body -Coordination use of eyes and hands leads to eye-hand coordination

What are the benefits of fantasy play?

-Increased creativity -Connect more with surroundings -Incite into roles -More independence -Socialization skills (peers and objects) -Start of interests/skills -Psychosocial/emotional needs = use it as talking about different events going on in their life (ex: moving to a new neighborhood = in therapy, role play to learn how to make friends) -Cognitive, social, emotional *#1 occupation in this age range is play*

gross motor feeding 6-9 months

-Increased gross motor (proximal control) provides stable head control and intrinsic muscle control over mouth musculature and pharyngeal muscles -Infant generally sitting independently and upright throughout day -Increased tongue mobility and volitional control -More obvious communication behaviors: Leans toward feeder, opens mouth, spits out food, purses lips if not interested turns head, vocalizes -lean towards the feeder now -turn away/vocalize with distaste in food -can spit out food -can throw food (release) -waning = introducing softer, chunked food with soft food (ex: whole peas with mashed)

Emotional Development: 3 months

-Increased interaction around people -More smiling, body movements, squealing, cooing, kicking -Caregivers should provide: -Initiate frequent social interaction -Provide frequent physical contact -Respond promptly to needs

Skills Reflective of Cognitive Development: 3-6 months

-Increased interest in objects -Imitates behavior already in repertoire -ex: smiles, sounds

Skills Reflective of Cognitive Development: 9-12 months

-Increased mobility allows for increased interaction with people -Likes toys with a function (ex: cause and effect toys, like pop-up toys, pull toys; etc) -Continues to imitate new behaviors -Improved manipulative skills which prepares for preschool (ex: . cubes: matches cubes horizontally and bangs together; then begins to match vertically and stack; puts objects in and out of containers.) -Anticipates events (doesn't open mouth for food that is disliked which indicates the use of memory)

6 through 9 months

-Increased proximal control in trunk -Engages in long sequences of handling behaviors involving a combination of visual and tactile exploration using mouth and hands -Prone play strengthens arms and hands -weight shifting on extended arms helps to expand the hand and develop the palmar arches.

Language development: 0-3 months

-Increased sound production -Variation in cry is more clear -1st sounds are made in combination with movement -"Cooing" sounds -throaty coos 15-20 seconds long -can move their mouth to make it look like they are talking, just like the people they have witnessed talking around them (might include grunting or whining)

7-8 months

-Independent sitting -TRANSITIONS in and out of sitting, kneeling, etc. -CREEPING -Protective extension sideways (7 mos.) -Trunk rotation (8 mos.) -Baby learns to creep, able to sit independently with full balance; equilibrium reactions present in supine, sitting and beginning in quadruped (on all 4s). -Protective reactions sideways are present. Trunk rotation develops

Transitions

-Infant engages in many transitions -Much more movement in environment -"Baby-proof" house! -prone to all 4s, etc. -rocking

Emotional Development: 10-18 months

-Infant is able to follow simple commands -Throws toys on floor -Gives toy to adult -Desires to be independent

Pellet

-Inferior pincer grasp (10 mos) -Fine pincer grasp (12-13 mos)

General Principles

-Initially the arm, hand, and finger move together as a unit -Grasp with pronation precedes grasp with supination -Reflexive grasp precedes voluntary grasp -Ulnar grasp precedes radial grasp -Voluntary grasp precedes voluntary release -Ulnar = grasping with our pinky and ring finger -Radial = power grip, with remaining 3 fingers

Cognition Leads to the development of:

-Insight -Problem-solving -Abstract thought all are necessary for learning and independent living

major gains in

-Intellectual growth- read, write, math -Skill development- hobbies, sports, music, arts -Growing investment in work- learn jobs around house (cook, clean, laundry), babysit, mow lawn -Significant social development- closer peer friendship enhance communication skills for later relationships (playdates)

Receptive skills

-Interpretation of sound and words -Child must hear and discriminate sounds (or see and interpret symbols)

Oral Motor & Feeding Development: 1-3 Months

-Major Skills: Continues to take in a liquid diet (bottle/breast) -Suckling-rhythmical and efficient (bottle or breast, between baby and feeder) -Uses mouth to explore environment (Begins to mouth/suck hands and objects; uses mouth more than hands to explore environment.) -Pureed foods may be introduced

Oral Motor & Feeding Development: 3-6 Months

-Major Skills: Pureed foods are generally introduced in a graded manner (Stage 1-2 foods) -Liquids - Continues to use suckling to obtain liquids. (sucking does get stronger at 6 months) -Pureed: Able to swallow pureed foods from a spoon; generally has poor lip closure. (food gets everywhere because they can't close their lips ye) (scrape food onto roof of mouth) -Continues to mouth objects as a form of exploration (toys, hand, pacifier, bottle/breast nipple) (mouthing = exploration) American Academy of Pediatrics: Puree foods should generally be introduced at 6 months (some will allow at 4 mo)

What OT and Parents can do for Early School Age Children

-Make complex constructive toys available in environment; -Make sure the child has enough opportunities to play with other children; -Teach the child simple games such as the ones mentioned above; -Be patient with the child's questions during this stage. Teach them that active questioning and investigation of the world is informative and pleasurable. -Encourage play at outdoor playgrounds.

Examples of various perspectives on Human Development

-Maturationist -Environmentalist -Interactionalist -Contextual

24-36 months

-Mature, reciprocal, heel-toe gait -Uses nonreciprocal gait to ascend/descend stairs with one hand support -Running -Beginning balance on one leg to allow kicking with other -Increased pelvic stability -tricycle riding = can get leg over

12-18 months feeding

-May be weaned from bottle/breast and take all liquids by cup -Will eat a solid diet of table foods vs. baby/puree foods

6-9 months Liquids

-May begin to demonstrate a mature sucking pattern indicating better tongue & lip control -Sucking-up/down movement of tongue on nipple, this is observed during the first couple weeks and later between 6-12 months, indicating better tongue and lip control. -suckling disappears around 6 months, appears around 2 months -suckling and sucking are different -sucking strong at 6 months

Pureed foods may be introduced

-May begin to take some pureed foods by about 3-4 months -Depends on family tradition and Dr recommendations (controversy) -Most infants begin taking cereals between 3-5 months -Approaches spoon like nipple using a sucking action -Choking may be seen initially with spoon feeding -takes a lot of practice for child to take food from a spoon (no lip closure yet, approach the spoon like a nipple/sucking action because used to nipple or bottle)

12-18 months liquids

-May take all liquids by cup (generally with a lid or spout) -Sippy cups, straw, juice boxes -weaned off of bottle (formula or breast milk) by now -introduce straws

Skills Reflective of Cognitive Development: 12-18 months

-More curious, knows more strategies in using objects (more creative in playing with same object) -Play is dominated by trial and error Skills: -Stacks 3-4 cubes -Scribbles spontaneously w/ palmar grasp -Dumps pellets from bottle (problem-solving) -Beginning to match 3 simple shapes

Oral Motor & Feeding Development: 6-9 Months

-More refined movements of lips, tongue, and cheeks (dissociation, instead of working on their own) -May be a critical period for chewing (6 months, now have what they need to be able to chew) Major skills: -Continues to drink liquids from breast/bottle -Eats pureed foods 2-3 times/day (intro more textured foods (Stage 3 foods-soft solids)) -Mashed table foods and "teething type" foods may be introduced by 8-9 months -Beginning to develop chewing skills -teething food ex: puffs, cheerios, teething biscuit

Expulsion of Placenta

-Mother and infant have contact -Placenta expelled -Alteration of hormone system to stimulate lactation and shrink the uterus

Strategies adults use to enhance a child's language acquisition

-Motherease -Recasting -Expanding -Labeling

General Information Collected on Each Child Tested

-Name -Birth date -Correctly calculated chronological age (CA) -Date of examination

Temperament

-Natural, Inborn style of behavior -Different in every child -Influences how he/she reacts -Important to establish rapport with infant/child to understand temperament and to help child adapt to their environment in the most functional way (identifying and reflecting on child's temperament helps us understand the child's behavior and adapt the way in which we interact with the child) -9 traits identified by Thomas, Chess, & Birch in their research from 1956-present -Defined traits on a continuum from EASY to DIFFICULT

18-24 months cup drinking

-Neatly drinks from a cup without spilling -Lack of observable up/down movement of jaw during cup-drinking with the presence of jaw control. -By two years of age many children are transitioned to whole milk/soy milk and may be weaned from breast feeding. -Internal Jaw control is well established by 3 allowing children to drink neatly and safely from most cups. -jaw control = developed 18-24 months, but stronger at 3

Feeding is an Important Occupational Activity

-Necessary for survival, growth, and health -Form of *Social Interaction and Communication* -Pleasurable Occupation -one of the first ADLs newborn is learning -even if child is tube fed initially, still promotes survival, may impact social interaction (lack of bonding) -getting mom and dads attention -trust vs distrust = needs met: feeding = trust -may effect trust/enjoyment of feeding: painful procedures while feeding, separate from parent, lack of responsiveness (attachment)

Why is normal development information important to know?

-Need to be able to identify delays -Educate parents on realistic expectations

TV's Many Roles:

-Negative Aspects of TV: social development, temperament -Positive Aspects of TV: learning

Theories of Motor Development and Control:

-Neural-Based Theories -Dynamic Action Theory

Normal results

-No Delays and a maximum of 1 Caution -Conduct routine rescreening at next well visit

Potty training Program: Pot-by-Clock approach

-No diaper -Timer set for pre-determined intervals -Taken to potty when timer goes off -Successful = reward -Length between timers is gradually increases

Imaginary Companions

-Normal part of fantasy play and development -A Mental representation of a peer or friend...usually a positive association or friend (not a bully or antagonist) -doesn't have to be a person -some kids will engage in self talk, others will verbalize to others about friend and incorporate them into activities -4-5 years old normal age for this

RED FLAGS 8-12 mos

-Not able to grasp toys and release -Does not bring toys to mouth or bang together -Not able to bring hands together at midline (clapping) -Not able to finger feed self, using thumb and index finger -Cannot move around on the floor to get desired toys

Middle school age

-Not much personality growth occurs -Children learn many fundamental skills valued by their culture

Understanding Objects and Object Permanence

-Objects exist even when they are out of sight -Important cognitive function -Usually occurs around 9 months: correlation with separation anxiety -Cognitive function—forms attachment, categorization of objects -One reason why babies experience separation anxiety is that they are uncertain whether a person to whom they are attached will continue to exist when the person is out of sight. **Once the child has a clear understanding of object permanence the fear that a loved caregiver will disappear when he or she leaves the house is reduced -child thinks what they cannot see/what disappears is gone forever/doesn't exist

Each reflex reviewed will cover

-Onset (all primitive reflexes are present at birth except the STNR) -Integration -Stimulus -Response -onset = what age -integration = when it becomes voluntary/disappears -stimulus = action

*Rooting reflex*

-Onset = 20 weeks gestation -Integration = about 3 months voluntary -Stimulus = touch the corner of the mouth of the baby with anything (usually bottle or finger -Response = turns head towards stimulus -for survival

Palmar Grasp

-Onset: birth -Integrated: 4-6 mos -Helps develop reach and grasp

ATNR

-Onset: birth -Integrated: 4-6 mos; strongest at 2 mos -Helps develop hand-eye coordination & grasping

Effects of TV on Children's Aggression and Prosocial Behavior

-Outcomes of longitudinal, correlational studies -TV violence can induce aggressive or antisocial behavior -Children need to be taught critical viewing skills to counter the adverse effects of TV violence

6 through 9 months Grasping cubes

-Palmar grasp (6 mos) -Raking, scratching movements -Radial palmar grasp (7 mos) -Radial digital grasp (8-9 mos) -Poking with index finger

Development Across the Lifespan according to the psychosocial approach suggests that these 5 assumptions are true

-Physical, emotional, psycho-social growth evolves through every period of life. -Individual lives show continuity and change as they progress through time -We need to appreciate the "whole" people -Behavior must be analyzed in the context of relevant settings and personal relationships -People directly affect their development

exam question possibilities

-Precursor to crawling = STNR -ATNR precursor to hand eye coordination (strongest at 2 months) -moro reflex = startle = abducted arms, cry, retracted arms

Obligatory Responses (pathological)

-Primitive reflexes that persist beyond time they should have been integrated..OR -Primitive reflexes that are present with abnormal muscle tone -The individual tends to be dominated by the reflex activity.

Equilibrium Reactions

-Prone equilibrium -Protective Extension Downward P.E. / Downward Parachute -Protective Extension Forward P.E. / Forward parachute -Protective Extension Laterally P.E -Protective Extension P.E. backwards

Standardized tests

-Provide an objective and uniform procedure for administering and scoring a sample of behavior -Have a fixed number of items, fixed administration procedures, and fixed scoring procedures -Provides validity and reliability -tells you exactly what to say/do/how to administer

How to decrease attention/interaction stress reactions?

-Provide one sensory stimulus at a time -Respect stress signals by pausing -Offer pacifier

18-30 months dressing

-Puts on hat, may be backwards -Puts on shoes -Helps put on pants; may do independently -Put head through hole of shirt

3.5-4.5 dressing

-Puts on shoes, may be wrong foot -Puts on boots, if loose fitting -Orients pants & shirts correctly and puts on -Can turn clothing right side out

2.5-3.5 dressing

-Puts on socks with correct heel orientation -Puts on shoes, may be on wrong feet -Puts on open-front shirt -Puts on overhead garment (shirt, dress) -Puts on pants, may need some verbal orientation

What are some ways to enhance language development?

-Reading -Singing (you singing to them or them singing to you) -Games: telephone, story telling, telling jokes, word games, I-spy -talking during meal time ("what did you do today?" "how was your day?")

Integration of reflexes

-Reflex is no longer present: inhibited by a higher center in the brain -Reflex works with other reactions to improve movement performance -Primitive reflexes are often components of more complex movements *Primitive reflexes also may reappear as a result of CNS damage -absent reflexes when they are supposed to be present = potential neurological disorder A reflex is inhibited by higher centers in the brain which modify that reflex so that the pattern of response may no longer be recognizable. The reflex does not disappear completely however it may work with other reactions to improve the performance of movement. Primitive reflexes are often components of more complex movements. They may become reactivated under stress or during activities requiring great effort.

Untestable results

-Refusal scores on 1 or more items completely to the LEFT of the age line or on more than 1 item intersected by the age line in the 75%-90% area -Rescreen in 1-2 weeks

make meal time pleasant

-Respect the toddler's tempo -Realistic expectations for child ability to sit still at table -Don't sit in silence

Focus of Intervention with Premature Infants:

-STRESS PREVENTION!! -Assist infants in managing stress & organizing behavior -premature infants experiencing stress prevention = increase in beneficial development

Strategies to enhance communication

-Scaffolding: Desire to match verbal expressions used by adults, in pronunciation and in selection of words -Expansion: Elaboration of child's words -Reading aloud -Talking to the child -Labeling -Singing/Music -Sign language -Scaffolding = repeat words/actions that parents use (ex: parent believes in spanking = child will spank their doll)

Materials

-Screening Manual -Test Form Kit containing: -Red yarn pom-pom -Raisins -Rattle -10 1" square colored blocks -Small clear glass bottle -Small bell -Tennis ball -Red pencil -Small doll with feeding bottle -Plastic cup with handle

Major Principles of Dynamic Action Theory

-Self-organizing principles of movement -Functional synergies -Motor Behaviors

Sensorimotor Intelligence: Processing, Organizing, & Using Information

-Sensorimotor Adaptation -Processing speed -Memory -Causal Schemes -Object permanence -Categorization of objects -Intelligence is based on sensorimotor experiences -Exploration of self and of environment -using sensory and motor together -memory ex: remembers falling while walking

Functions of an imaginary friend?

-Serves as play companion for pretend play -Practice role playing -Serves as a confidant for children's private expression -Helps differentiate between right/wrong -Practice social schemes and learned behaviors -confidant = child will tell them their true feelings/thoughts

friendship

-Similar interests draw children together during this time -Children spend about 40% of their day with peers, or more

Elaboration of Locomotion 4-5 years

-Skips -Hops on 1 foot -Jumps from stairs -Improved initiation & inhibition of actions -4-5 = more self control, more autonomy

body changes

-Slow, consistent growth -Grows 2-3" per year up to 11 years -Gains 5-7 lbs per year -11 yr olds: females ~4'10 & males ~4'9.5 -Legs longer -Trunk thinner -Weight is mainly from muscles and bones (less fat)

Emotional Development: 2 months

-Smiles responsively -Smiles more around familiar people -Follows moving person

2.5-3.5 undressing

-Some assistance may still be needed for more difficult pieces of clothing -Should be able to undress simple and loose clothing

Imitation

-Some research shows that infants can imitate actions very early on -Infants can imitate caregiver's tongue protrusion Information processing psychologists believe infants are more competent than Piaget believed -Attentional -Imitative -Conceptual capabilities

Strengths and advantages to this test

-Speedy administration and scoring -Can be administered and scored by support staff with training and supervision -The DDST was validated against Bayley and Stanford-Binet tests -Test-retest reliability and interrater reliability ratings are high. IT IS A STANDARDIZED TEST.

Optimizing an Infant's Development

-Spend time with the child; be available when the child needs you. -Provide warmth and affection; express positive feelings toward the baby in many ways—verbally, through touching and hugging, and through playful interactions. -Play with the baby; sing songs; make up little games. -Communicate often, directly with the child; engage the child in verbal interaction. -Read to the baby; tell the baby stories. -Provide stimulation. -Encourage the child's active engagement in and exploration of the indoor and outdoor environments. -Help the child understand that he or she causes things to happen. -Help the child engage in directed problem solving. Encourage the child to persist in efforts to reach a goal. -Keep things predictable, especially when the infant is very young. -Guide language development by using words to name, sort, and categorize objects and events. -Accept the child's efforts to achieve closeness. -Be sensitive to the child's state; learn to interpret the child's signals accurately; time your responses appropriately. -Find effective ways to soothe and comfort the child in times of distress. -Help the child interpret sources of distress and find ways to regulate distress. Minimize the child's exposure to intensely negative, hostile, and frightening events. -Be aware of the visual and auditory cues you send when you interact with the child. -Pay attention to how the child is changing over time. -Monitor the child's emotional expressions to evaluate the success of specific actions and interventions.

Artificial insemination

-Sperm injected into vagina -Intra-uterine insemination - sperm injected into uterus In vitro fertilization

Characteristics of Play

-Spontaneous -Fun -Self-initiated -Flexible -Totally absorbing -Vitalizing -Occurs in a relaxed setting -can reach flow with play

9-12 months mashed foods

-Spoon feeding -Continues to display good lip closure around spoon -Mashed, soft solids, soft meats, vegetables

Benefits of Kangaroo Care to Baby

-Stabilization of the baby's heart rate -Improved (more regular) breathing pattern -Improved oxygen saturation levels (an indicator of how well oxygen is being delivered to all the infants organs and tissues) -Gain in sleep time -More rapid weight gain -Decreased stress/crying -More successful breastfeeding episodes -Earlier hospital discharge -c section = father skin to skin because the mother is sterile

parents can inhibit aggressive behavior by

-Stop the aggression & remove child from situation (time out = as long as they are years old) -Talk about the inappropriate behavior when child is calm at a later time; arouse feelings incompatible with anger (empathy for victim); talk about reason for anger and discuss alternatives to hitting -Minimize exposure to stimuli that promotes aggression (TV) -Explain the consequences of aggression -talk about the appropriate behavior after they have calmed down (what they can do better next time, why they did it initially)

Attachment

-Stranger Anxiety -Separation Anxiety -Patterns of Attachment

Indications of sensory processing difficulties

-Stress - certain occupations that should be automatic aren't (eg. getting dressed, eating, walking, running). -Child avoids activities for fear of failure, therefore, he/she misses opportunities to develop further skills. -Tactile _______________ -Gravitational insecurity -Poor motor planning (dyspraxia)

Indications of Sensory Processing Difficulty (SPD)

-Stressful ADL's, (dressing, eating, walking, schoolwork, play, social relationships) -Child avoids activities, is clumsy, uncoordinated -Tactile defensiveness, does not tolerate socks, shirts with tags, walking barefoot, or walks on ball of feet, does not like touched or the other extreme, self-stimulates, bites, hits, pulls hair -Gravitational Insecurity...fear of climbing or swinging...age appropriate activities -Poor motor planning -Food refusals -Handwriting, reading, concentrating problems

3 months

-Strong symmetry -Active neck flexion -Midline orientation -symmetry = head, eye, neck coordination -flexion = bilateral neck muscle control

Examples of Critical Periods:

-Sucking < 3-4 months -Social Attachment: 6-12 months -Intelligence: < 3years

Routine Procedures at Birth

-Suction nose and oropharynx with bulb syringe ASAP to clear mucous and blood -Baby takes in first breath (given oxygen as needed to prevent anoxia) -Umbilical cord is clamped and cut -Kept warm and swaddled -Apgar Test: 1 & 5 minutes -given to the mom asap -maconeum aspiration = inhaling first poop (black and tarry)

Potty training program: Gentle approach

-Take child (calmly and confidently) to toilet every 1.5-2 hrs -New toy kept only in bathroom and can play after goes on potty -Have something relaxing in bathroom (singing, story)

Birth Adjustment

-Takes approximately 48 hrs -Birth is sudden and critical experience -Autonomic (physiologic) system is one of the first to reach full maturity by 38-40 wks gestation

What factors influence the quality of attachment: Infants

-Temperament -Intrinsic patterns (sleep, wake cycles) -Physiologic -Cognitive -temperament can impact caregiver care/attention

A healthy full-term infant should be able to carry out the following physiologic functions independently:

-Temperature regulation -Respiratory control for breathing -Cardiovascular control -Feeding and Gastrointestinal control -Excretory functions

The Psychosocial Crisis: Autonomy

-The ability to behave independently -A strong sense of self -A strong desire to be independent from caregiver and "do it myself"

physical changes

-The child is growing more slowly so won't be as hungry -Toddler will eat less overall -Appetite may be sporadic and erratic** -might want more frequent snacks than just meal time

4.5-5.5 fasteners

-Ties overhand knot -Laces shoes -Manages shoes with velcro

parent's readiness

-Time to devote to training -Interest to training -Dedication to training

Separation Anxiety

At about 9 months, infants give another indication of the intensity of their attachment to their parents. They express rage and despair when their parents leave them.

hang loose about food acceptance

-Toddlers are meal-phobic: they dislike new food. (give new foods often and in different ways) Suggestions: - introduce children to new foods often, but don't force them to eat it; allow them to approach it on their own. - toddler are more inclined to try a food if they are familiar with it - encourage the toddler to try different foods; give her/him permission to take it out of their mouths if they don't like it. - don't over-react to trying new foods. (over praising or being negatory)

Complex/Precise Receptors

-Transmit tactile and proprioceptive input (deep touch). Much of this is provided through contact with caregiver. -Responsible for the development of discriminitive touch and the development of tool usage and fine motor skills (gives specific qualities of the environment). -Responsible for stereognosis: the ability to recognize objects without the use of vision. -more constant, deeper touch -need a balance of these receptors to have appropriate tactile stimulation

18-30 months fasteners

-Tries to assist with fasteners -Unsnaps -Zips & unzips

2.5-3.5 fasteners

-Unbuttons most front buttons -Buttons medium and large front buttons -Opens front separating zipper

18-30 months undressing

-Unties and removes shoes -Helps push down pants/able to remove underpants -May be able to remove most simple clothes with assistance by 2.5

Expressive skills

-Use of symbols to convey thoughts -Speaking, signing, pointing to pictures

12-18 months self-feeding

-Uses spoon, fills poorly, spills, turns it at mouth -Begins to hold cup for cup drinking Self Feeding 12-18 month old is all about positive engagement and opportunity to be independent and explore textures.

summary

-Variability in developmental sequence -Motor development is not viewed as simplistically as it used to be -Less rigid views of motor development -All subsystems influence each other

What is Communicative Competence:

-Verbal and Non-Verbal ways of conveying needs -Becoming adept at using all aspects of language that promote participation in culture. -Receptive and expressive skills are used to meet functional needs -They are learning to relate to their world based on needs and wants (Ex: repetitively asking for something, point, throw grab, yell, cry, physically go get it) -delayed: expressive skills and no receptive skills can delay their competency

Elaboration of Locomotion 2-3 years

-Waddle smooth gait -Removal of diapers -Heel-toe strike & reciprocal arm movements -Rides tricycle (around 3) -Hops on both feet -Balances on 1 foot -losing diaper, pumping on a swing motion

12-18 months

-Walking with better control; arms come down to side -Begins to explore climbing steps, jumping, climbing play equipment -Refinement of walking: better trunk control allows for arms coming down to sides; reciprocal movements of arms and legs; beginning to develop a heel-toe gait -*begins to anticipate bumps and changes in the surface (sidewalk, carpet) -12-13 mo = independent walking

information-processing abilities

Attention Processing Speed Memory Representational Skill

initial independent standing

-Wide base of support -Standing with high guard (helps trunk position) -walking with very high knees, awkward

choose your battles carefully

-You can stop a toddler for doing something you don't want him/her to do; you can't make her/him eat. -Is it really worth the fight to force a child to eat? (don't make them hate meal time)

5.5-6.5 fasteners

-Zips, unzips, hooks, unhooks separating zipper -Ties bow on shoes (6 - 6½ yrs.)

Developmental Milestones of Toilet Training: 3-4 years

-able to go to the bathroom by self (needs assistance with fasteners and cleansing) -able to wash and dry hands -toilet trained; may need reminders to go to the bathroom

Suggestions for Beginning Dressing

-assist mom in dressing -identifying body parts -asking them questions/quizing them -toys that have different fasteners

What does "autonomy" refer to?

-autonomy = child wants independence, developing strong sense of play

Appearance of full-term infant:

-average weight - 7.5 lbs -height - 20 inches -proportions (head is 1/4 size of body) -face (may be bruised and puffy) -downy hair growth on body -neck is short -skin may be blotchy

3 Months - PRONE

-balance of flexion and extension in the neck -weight shift in stomach -up supine with extension

Activities which enhance the development of hand skills: Fine Motor Play

-board games -puzzles -planting seeds -playdough (pinching) -coloring/drawing -sorting small objects into specific categories -counting coins -dressing dolls -measuring for cooking

Motor skills

-boys outperform girls because of increased strength -better overall coordination therefore skills expand greatly (biking, skating, various sports) -can sit for longer periods of time, but prefers activity (needs exercise!)

HOW ARE MALE AND FEMALE FRIENDSHIPS DIFFERENT?

-boys: networks larger and looser, more outside of school relationships -girls: tighter dyads, more in school friends

examples of occupations

-brushing your teeth -feeding -dressing ADLs -occupations occur and concur at different ages

types of writing grasps

-dynamic tripod -dynamic quadrupod -lateral tripod -lateral quadrupod -lateral = thumb is wrapped

group games

-ex: More physical, like; hide and seek, duck duck goose, Simon says -benefits: including others, physical, etc

video: 5 months - Rolling Supine to Prone

-fetal position --> extended more, arms still tucked

VIdeos: Pregnancy & Childbirth: The Real Story Conception to Birth - Visualized

-first trimester = organs, heart beat, etc. (14 weeks most important) -fertilization --> zygote divides --> uterus = blastocyst --> CNS develops --> embryo -week 7 = placenta -weeks 10 to 12 = features -mother blood tests are important throughout pregnancy -12 week ultrasound = test for downs -2nd trimester = baby moves and decreased nausea -placenta = nutrients, o2, teratogens, blood, etc. to the baby (want the placenta in the upper part of the uterus) -measurements of the belly (fungus growth) = determines healthy growth of the fetus -19 to 28 weeks = sense sound, eyes, vocal cords -3rd trimester = 28 weeks to birth -balanced diet is important -head into pelvis = ready -uterus contracts = cervix gets wider (because the fibers are shortening) -stages = contractions --> baby birth --> birth of placenta

Preterm infants who receive Kangaroo Care as well as other forms of gentle touching and massage:

-gain weight faster -improved temperature regulation -improved alertness as compared to babies who do not receive the systematic comfort of human touch

Give examples of how you can promote a positive self-esteem in early school age children during your therapy sessions

-give them just right challenges -praise them with success -make them understand it is okay to struggle a little -break down tasks into smaller parts when needed -find their strengths -acknowledge differences -unconditioned positive regard for the child

Activities that Promote Fine Motor Development: whole hand

-hammer/wack a mole -playing kitchen -play phones holding -little tike car (steering) -stacking cups -squeezing a stress ball/sponge -sandbox play -turkey baster

Developmental Milestones of Toilet Training: 16-23 months

-has regular bowel movements -may be toilet regulated by an adult (adult knows child's pattern and puts child on potty during "prime times") -may anticipate need to eliminate; uses same word for both functions (#1 and 2)

at two months

-hypotonia -decreasing flexion and increasing extension -active neck extension and weight on the forearms when prone -poor head control = need support on their trunk while sitting up -No lateral head control -No active flexion of neck (head lag = support neck)

WHAT ARE SOME OF THE BENEFITS OF PEER FRIENDSHIPS?

-increased perspective taking -cognitive flexibility increase (ex: doing what your friend wants to do) -understand limits -decreased self-centeredness -leads to flexible thinking with this friendship

Activities which enhance the development of hand skills: Gross Motor Play

-larger blocks to build -catch -racket ball -rolling a ball/bowling -watering plants -shoveling -playdough (making bigger objects) -hanging from monkey bars/climbing -bear crawl -dress up

Othe potty training programs

-learning curve on knowing when to go to the potty -Other considerations: sit on the potty while playing with a toy, give them a lot of liquid and take them every 30 min,

5-6 Months - Ring or Prop Sitting

-legs make a ring shape in front = base of support to sit up -using arms to push up/hold up

video: Rolling at 6 months

-less fuss and faster

4 months - SITTING

-less trunk support, but still needed -less rounded back

WHAT ARE GENDER SCHEMES AND HOW DO CHILDREN USE THEM?

-males are repremanded for liking feminine things (sissy, wimpy, etc.) -girls don't play with trucks

How is this information relevant to your interactions with children as you provide OT services?

-may need to teach some of these gender roles/messages -have a big influence on them -watch your verbiage -be aware of how you reinforce sex-role standards

Activities that Promote Fine Motor Development: whole arm

-monkey bars -throwing a ball -climbing -racket play -dunking a basketball -reaching over head to color on a board on a sealing -stirring

w sit

-not good! -physical problems attributed -hips in extreme extension

Securely Attached Infants

-these babies use the caregiver as a secure base from which to explore the environment. -characteristics: child moves freely away from parent; will tolerate being held by others; fusses less when left; stops crying more easily when mother leaves parents: tend to be sensitive to infant's signals; are more affectionate and maintain longer physical contact with less interference -within normal development -need one consistent caregiver

Difference between radial palmar and radial digital grasp?

-palmar = radial fingers into palm (age 7 mo) -digital = radial fingers into digets (index, middle, thumb, with open web space) (8-9 mo)

Progression of Writing Grasps

-palmar supinate (12-18 mo) -distal pronate (24-36 mo) -static tripod (3.6-4 years) -dynamic tripod (4.6-6 years) -dynamic = just moving the fingers

Activities that Promote Fine Motor Development: Pincer

-peg boards -sorting small objects into categories -light bright -eye droppers (to make a picture) -tweezers to sort -hair bands/clips use -small stickers

Grasping Cheerio - 7 mos old video

-poking/pointing -raking with one finger -scissor grasp

WHAT ARE SOME OF THE WAYS IN WHICH FAMILIES INFLUENCE A CHILD'S SOCIAL COMPETENCE?

-positive relationships with parents (leads to increased social interaction) -gives them the skills to make friends and keep friends (inclusion, talking, listening, etc.)

Developmental Milestones of Toilet Training: 2-3.5 years

-potty training begins; uses toilet with assistance (daytime control) -remains dry in between regular toileting -uses gestures or words to indicate need to use toilet -has infrequent bowel accidents -most preschools require potty training before attending -every child is different, do what works for them

Birth - 3 months: NEWBORN

-primitive reflexes -physiological flexion dominates (resistance against extending) -head moves with gravity -lay the baby on its back to sleep prone: -pelvis is high -wight on the shoulders and face (suffocation issues) -surfaces influence movement

6-9 months dressing

-pull off hat and socks -passively cooperate, actively participate by 9 months

Critical Periods in Prenatal Development

-purple on chart = teratogens most effective/sensitive periods

Grasping puff - 7 mos old video

-raking -scissors grasp

at one month

-reduced flexion -active extension increasing, weight off the head and shoulders more when prone

Developmental Milestones of Toilet Training: 12 - 15 months

-remains dry for 1-2 hour periods -indicates discomfort over soiled diapers verbally or by gesture (or crying)

Benefits of play

-sense of mastery over body and environment -physical development (gross & fine motor) -can provide a variety of sensory input (vestibular, proprioceptive, tactile) -fosters interpersonal relationships with caregivers & peers -can improve cognitive skills (colors, shapes, counting, problem-solving, etc.) -can improve receptive & expressive skills -can foster imagination, curiosity, & creativity -can allow child to practice adult roles

Piaget hypothesized that cognitive development occurs in four stages, each characterized by a unique capacity for organizing and interpreting information.

-sensorimotor intelligence -preoperational thought -concrete operational thought -formal operational thought

Difference between squeeze grasp/ulnar palmar grasp and palmar grasp?

-squeeze = grab object with ulnar fingers/into palm on ulnar side (age 5-6 mo) -palmer = thumb may contact or not, into the palm (age 9 mo)

3 months sitting

-still requires trunk support -head more in line with the body -neck more rounded

What are appropriate strategies for waking an infant?

-stroke the bottom of the foot, hand, or cheek -unswaddle/undress -turn the lights on slowly -talk slowly *only use one sensory input/technique at a time*

4 Months - PRONE

-symmetrical -lateral flexion control increasing -extension increasing -landau reflex -weight baring

video: Primitive reflexes in 1 month old

-test both sides to observe any asymmetries -reflex persists = can disrupt in development and functioning

Societies differ in their

-worldviews, including the emphasis placed on collectivism or individualism, ideas about the major sources of stress and ways to alleviate stress, and beliefs about which groups are viewed as more powerful or more important than others. -age-graded expectations, such as when a person is considered to be a child, an adult, or an elder, and how people in these age roles should be treated. -definitions of morality, beauty, bravery, wealth, and other ideals that may define individual and group aspirations.

simple reflexes

0-4 weeks -Basic means of coordinating sensation and action is through reflexive behaviors -ex: rooting leads to food which leads to satiation) -involuntary response to some type of stimulation

Rule of thumb:

1 Tbsp/serving/age of the basic 3-4 foods

Laterality

1 side of brain becomes specialized for skilled hand use -"preference" occurs between 2-5 yrs

Exam Date: 9/8/2014 Child's DOB: 7/25/2013 7 wks premature

1 year 1 month 14 days - 1 month 21 days = *11 months and 22 days*

Behaviors reflecting the development of industry -

1) An interest in learning new skills & a positive view of work. Children can learn many new skills at this age; eg. babysitting (12 yrs.), walking dog, paper boy, cleaning house, cooking, etc.). The child not only learns the actual skill, but will also learn the importance of responsibility and follow-through. Children find many aspects of work intrinsically motivating: increased independence, increased self-worth, money, etc. 2) A heightened sense of competence about the possibilities for mastery/success in future work and other tasks. *Parents need to encourage small jobs and group involvement during this age.

Principles

1) Continuity 2) Multiple Determinicity 3) Multiple Patternicity

4 Developmental Tasks

1) Gender Identification 2) Early Moral Development 3) Self-Theory 4) Peer Play

going to school

1) Provides a source of anxiety for the child - goes further from home; is a new environment with new people; provides new opportunities for success & failure and peer group formation. 2) Has a symbolic meaning for the parents - child is growing up; being evaluated externally -some may welcome it and some may be scared of it -challenged in different ways -child needs to adapt to positive and negative feedback

Factors Influencing Gender Identity

1) cognition 2) biological factors 3) social 4) gender preference

2 potential causes of shame and doubt

1) constant criticism and discouragement from parents 2) failure at most attempted tasks from real or perceived limitations -REAL: Learning Disability, Cerebral Palsy, etc. -PERCEIVED: unrealistic expectations of self -avoid new activities because they think they are going to fail -real = someone who actually has a diagnosis/disability -perceived = think they will mess up

Parental Discipline

1) discipline should help child interrupt or inhibit the forbidden action 2) it should point out a more acceptable form of behavior for future 3) It should give a reason why the action is wrong and why another is more appropriate 4) It should stimulate the child's ability to empathize with the victim of the misdeed parents' discipline helps mold child's moral code and her/his behavior. Purpose of discipline: to teach the child that certain behaviors are wrong and should be changed and that some are positive and should be repeated; to teach certain moral principles (tell truth, be generous, respect other's feelings, etc.).

Teachers & parents need to help children:

1) identify when they know something & when they don't; and 2) learn study techniques to enhance recall and application of the information.

inferiority can result from

1) organ inferiority - a physical, mental, or social limitation that prevents the learning of certain skills (eg. cerebral palsy, mental retardation, learning disabilities, etc.). It is critical for adults to help these children identify their realistic strengths and compensate for weaknesses. 2) Social environment gives a lot of "failure messages" (from parents, teachers, peers). The child may receive a lot of criticism for weaknesses (eg. teasing) and may avoid certain tasks for fear of failure. 3) Parents limiting opportunities for work. Eg. Over-protective parents. 4) When weaknesses happen to be in culturally valued skills (eg. reading, academics)

The Categorization of Objects. Physical objects have basic properties:

1. Objects have a location and a path and speed of motion. 2. Objects have mechanical properties that include how they move and their relation to other objects. 3. Objects have features, such as their size, shape, and color. 4. Objects have functions; this is what objects do or how they are used

Developmental Tasks of Toddlerhood

1). Expanded Locomotion 2). Fantasy Play 3). Language Development 4). Self-Control -All contribute to child's emerging independent -ready to express independent thoughts, exercise some control in making choices, and do some things independent

First Trimester: Germinal stage

1-2 wks -Zygote divides -Implants to uterus within 10 days -Referred as embryo -fertilization --> 2 weeks -

Changes in Fantasy Play during Toddlerhood

1. Action components become more complex 2. Focus shifts from self to fantasies that involve others and multiple roles (social pretend play) 3. Play involves use of substitute objects; may invent things 4. Play becomes more organized and planned and play leaders emerge

What OT & Parent can do for an infant

1. Allow opportunities for baby to explore self and environment; 2. Make sure age appropriate toys are available in the environment; 3. Establish some everyday routines to help child establish a sense of security and predictability. 4. Encourage parallel play instead of group play.

Components of Equilibrium Reactions

1. Head righting 2. Body righting (trunkal adjustment) 3. Extremity reactions (abduction of arms/legs) 4. Protective extension of arms to catch self -BR = what is the body doing in response to the head -all of this helps with protective extension = putting arm(s) out to protect from falling and getting hurt

Social Learning Theory & Sex Role Standards

1. PARENTS - a. Fathers tend to guide children into more traditional sex-role play (girls - look pretty, be nurturing, enjoys baby dolls, etc.; boys - encouraged to be involved in more aggressive forms of play) b. Mothers tend to direct both males and females to more female sex-typed activities. 2. PEERS - Children teach each other sex-appropriate play. Children navigate toward same sex friends around 4 years and eventually are socialized into "female" or "male" culture. 3. SCHOOL & TEACHER INFLUENCES - Research shows that boys are involved in more interactions with teachers than girls; boys are given more remediation, praise, and criticism; curricula tend to be based on male developmental pattern. Sex equity education research - focuses on female vs. male outcome curricula; eg. more of a focus on human relation, writing, etc. 4. MEDIA INFLUENCES - TV: men tend to be in more leader roles than women; women associated more with household products; etc. 5. LANGUAGE - Use of sexist language; eg. use of "he" for referring to everyone.

Several factors have been identified as important for predicting which people will form the infant's hierarchy or radius of significant attachment figures

1. The amount of time the infant spends in the care of the person. 2. The quality and responsiveness of the care provided by the person. 3. The person's emotional investment in the infant. 4. The presence of the person in the infant's life across time.

Parten's Classic Study of Play

1. Unoccupied Play 2. Solitary Play 3. Onlooker Play 4. Parallel Play 5. Associative Play 6. Cooperative Play

Stages of Social Attachment

1.) 0-3 months 2.) 3-6 months 3.) 7-9 months 4.) 9-12 months 5.) 12 months +

Five Stages in the Development of Attachment

1.) Birth to 3 months: Infant uses sucking, rooting, grasping, smiling, gazing, cuddling, crying, and visual tracking to maintain closeness with caregivers. 2.) 3 to 6 months: Infant is more responsive to familiar figures than to strangers. 3.) 6 to 9 months Infant seeks physical proximity and contact with objects of attachment. 4.) 9 to 12 months: Infant forms internal mental representation of object of attachment, including expectations about the caregiver's typical responses to signals of distress. 5.) 12 months and older: Child uses a variety of behaviors to influence the behavior of the objects of attachment in ways that will satisfy needs for safety and closeness.

Stages of Labor

1.) Dilation of cervix (longest stage) 2.) Expulsion of fetus 3.) Expulsion of Placenta

Symbolic Play

1.) Involves Imitation: Simple to complex 2.) Involves Use of Objects: Real to representational 3.) Involves Taking on Various Roles 4.) Evolves from a Loose Structure to More Organized & Planned 5.) Shifts from Solitary Pretense to Social Pretend Play -2.) use moms phone to pretend they are calling someone, but also use block as a phone -4.) lose = no rules (parallel play = 2 kids playing side by side, not interacting playing together with more rules = organized) -5.) more socializing with peers (2-3 years)

3 Lessons of Friendship:

1.) Learn to appreciate many points of view (perspective taking and cognitive flexibility) (peers can see things differently) 2.) Experience peer group pressure; may experience acceptance or rejection -Factors that contribute to loneliness & rejection (want peers approval, want to be accepted, peers more important than teachers; aggressive, withdrawn, looking for differences) 3.) Develop close dyad friendships (best friends) -Benefits and skills learned as children to develop close friends -Male/female friendship differences

Additional Comments on Denver II

1.) Make child comfortable -Keep test items out of reach except the ones being tested -Position child in front of examiner -Use clear, short sentences when talking to the child -Avoid asking the child to perform an item but instead request the child perform the task 2.) Denver II score sheet -Calculate CA accurately -Draw age line through child's exact age 3.) Adjust for prematurity -If infant was 2 or more weeks early -Document child's CA and Adjusted Age

5 Kinds of Play

1.) Physical (gross motor) 2.) Manipulative (fine motor) 3.) Symbolic 4.) Games 5.) Playfulness

What OCCUPATIONS do...

1.) Prenatal fetus typically develop? 2.) Newborns typically develop? 3.) Infants typically develop? 1.) growing, sleeping, kicking/motor movement, sucking/swallowing/feeding, excretory 2.) crying, sucking/swallowing/feeding, growing, sleeping, gross motor movements, fine motor movements, excretory, social interaction 3.) crying, sucking/swallowing/feeding, growing, sleeping, gross motor movements, fine motor movements, excretory, social interaction, crawling, playing, speaking/babbling, self feeding, track/follow (visual)

Piaget and Inhelder (1966/1969) described six phases in the development of causal schemes

1.) Reflexes 2.) first gambits (Use of reflexive responses to explore new stimuli) 3.) circular reactions (Use of familiar actions to achieve new goals) 4.) coordination of means and ends (Deliberate use of actions to achieve new goals) 5.) experimentation with new means (Modifications of actions to reach goals) 6.) insight (Mental recombination of means and ends)

Summary/Examples of Thelen's Research

1.) Rhythmical movements in infancy 2.) Studies related to development of locomotion 3.) Studies questioning our understanding of "reflex integration" -relationship between movement and motor milestones -2 ex: vertical stepping vs supine kicking = pattern -3 ex: newborns stepping, becomes integrated, then cortically controlled later on -3 ex: no stepping with weights on ankles = body weight affects reflex (infant gaining fat = effects stepping)

6 Phases in the development of causal schemes

1.) Simple Reflexes 2.) First habits 3.) Secondary circular reactions 4.) Coordination of means and ends 5.) Experimentation with new means 6.) Internalization of schemes

Two keys to successful evaluation

1.) Skill in observation and use of the assessment tool (science) 2.) Skill in gaining trust and cooperation of the client (art)

Sensorimotor Intelligence and Primitive Causality

1st stage -Intelligence is based on sensorimotor experiences -Infants first demonstrate *simple* patterns of exploration and then more *complex* patterns -Causality (cause & effect): the realization that certain actions will have specific effects -eventually becomes a routine/habit -ex: bang cubes together --> put it into a container --> stack them -helpful for sensorimotor intelligence

Observe and analyze: -Type of sensory input received during activity -Sensorimotor skills needed to succeed in activity 1.) Swinging on the horse swings 2.) Going down the slide 3.) Climbing curved ladder 4.) Boy swinging from one ring to another

1.) Vestibular (linear or rotary, this was linear) and proprioception. Needed balance, motor planning, coordination, 2.) Motor planning, proprioception, vestibular, visual, slight tactile to get up ladder, balance to get up ladder, weight baring/strength 3.) Proprioception, inner drive, balance, vestibular, strength/weight baring, tactile, a lot of motor planning, visual, body map (knowing where your body is) 4.) Proprioception and vestibular. Motor planning, weight baring/grip strength,

concrete operations: Skills Learned

1.) conservation: change in form of an object does not change quantity, weight, number, length or volume. Child must understand: -identity: same quantity -reversibility: transition either way -reciprocity - same amount different levels 2.) Classification: objects can be grouped according to some dimension they share in common 3.) Combinatorial skills: able to manipulate numbers (addition, subtraction, multiplication, division) 4.) Metacognition: processes and strategies used to assess and monitor our knowledge -become aware of when they know something and when they don't *Children generalize these principles to their thinking about friendships, team play, and their own self-evaluation.

Fetal Development

1.) ovulation 2.) fertilization (day 1) 3.) cell division takes place (2-4 days) 4.) blastocyst reaches uterus (days 4-5) 5.) blastocyst implants (5-9 days) -ovary --> fallopian tube --> uterus -zygote = fertilized egg

6 phases of development of sensorimotor capacity

1.) reflexes (birth) 2.) first habits (2nd week -->) 3.) circular reactions = use of familiar actions to achieve new goals (4 mo -->) 4.) coordination of means and ends = deliberate use of actions to achieve new goals (8 mo -->) 5.) experimentation with new means (11 mo -->) 6.) insight = problem solve in head and anticipate outcomes (18 mo -->)

Inferior pincer grasp

10 months prehension between pad of thumb and index finger with wrist/hand stabilized on table; fingers are more extended than flexed.

When does active release occur?

10-11 months

life stages

11 stages of psychosocial development, each with the following approximate age range: (1) prenatal, from conception to birth; (2) infancy, from birth to 2 years; (3) toddlerhood, 2 to 4 years; (4) early school age, 4 to 6 years; (5) middle childhood, 6 to 12 years; (6) early adolescence, 12 to 18 years; (7) later adolescence, 18 to 24 years; (8) early adulthood, 24 to 34 years; (9) middle adulthood, 34 to 60 years; (10) later adulthood, 60 to 75 years; and (11) elderhood, 75 until death. -everyone is different, these stages are not set in stone

Fine pincer grasp

12-13 months -Use of tip of thumb and index finger to prehend small objects -No support of hand/wrist on table -Good thumb opposition -The infant is more coordinated in grasping small objects.

Experimentation with new means

12-18 months -Infant becomes interested in the variety of properties of objects and by the multiplicity of things they can make happen to objects -"physical problem-solving"; -ex: explores new ways to play with objects - pushes, fings, bangs block -creativity -all trial and error

words emerge around

12-18 months -receptive language = ability to understand words -language production -grammer

Bilateral Coordination, discriminatory touch

12-24 months = painting

5th stage of social attachment

12months+ will use a variety of behaviors to influence behavior of their parents—asked to be read to, cuddled at bedtime, taken along on errands

When does controlled release occur?

13-18 months

find chronological age: Exam Date: 12/8/2014 Child's DOB: 1/12/2005

14 12 8 05 1 12 = 9 years 11 months 26 days

find chronological age: Exam Date: 8/15/2014 Child's DOB: 10/23/2012

14 8 15 12 10 23 = 1 year 9 months 23 days

Internalization of schemes

18-24 months -Infant's mental functioning shifts from a purely sensorimotor plane to a symbolic plane -demonstrates pretend play without needing actual object present -ex: use a block for a phone -2 years = pretend play big

Original Denver developed in

1967

MEAL PLANNING:

A meal should provide one serving of each of the following ... -Protein: meat, fish, poultry, egg, cooked dry beans, seed or nuts. -Bread or cereal: bread, bun, noodles, spaghetti, etc. -Fruit or vegetable or both -Milk (whole milk the healthiest from 1-4)

Disinhibited Social Engagement Disorder

A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following: ● Reduced or absent reticence in approaching and interacting with unfamiliar adults ● Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries) ● Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings ● Willingness to go off with an unfamiliar adult with little or no hesitation

PPT: Toddler Development

A personal quest for autonomy...

Mistrust

A sense of wariness -Withdrawal, depression, irritability, flat affect, lack of emotion, eating difficulties. The child is uncertain whether his/her needs will be met. Risk factors: Multiple caregivers -Kids with special needs -Kids in foster homes -Prematurity or severe illness and prolonged hospitalization as infant -Statistically will have emotional/behavioral issues -"Startle response" & Moro reflex in response to sudden loss of support -6 months = stranger anxiety -foster homes = inconsistency of caregivers

Resistant Eaters

Texture Aversions or Complete Refusal -like starchy, soft, usually -no crunchy, chewy, soft, smell, mentioning Show more autonomy

Prehensile Reactions

All complex movements that occur when individual reaches for, grasps, and releases an object

An OT practitioner places a 6-month old infant in the supine position and arranges attractive toys overhead to provide an opportunity to work against gravity. This position will MOST likely encourage: A.) Shoulder flexion and protraction B.) Shoulder extension and retraction C.) Head control D.) Trunk control

Answer: A

An OTR is assessing the reflexes of a 4-month old infant. The OTR places the infant in sitting and encourages the infant to actively flex the neck forward to look at an object held near the infant's chest. Which of the following responses indicates the presence of the symmetrical tonic neck reflex? A.) Flexion of upper extremities and extension of lower extremities B.) Flexion in both upper and lower extremities C.) Flexion of lower extremities and extension of upper extremities D.) Extension of both upper and lower extremities

Answer: A

To avoid overstimulation when handling a stable, 12-week premature infant in the Neonatal Intensive Care Unit setting, the OT practitioner must FIRST: A.) Provide gentle human touch to enable the infant to slowly respond to intervention B.) Establish a calm state by utilizing an infant musical mobile C.) Rock and then swaddle the infant in a blanket to provide containment and warmth to assist with self-regulation D.) Establish a bond through visual orientation to the therapist's face

Answer: A Tactile stimulation, tactile senses develop first!

When assessing the motor skills of an 11-month old child, the OT observes the child assume a quadruped position and then begin to rock back and forth. This behavior MOST likely indicates: A.) Perseverative tendencies B.) Normal development C.) Low muscle tone D.) Limitation in movement repertoire

Answer: B Should be crawling by this age, so it is normal

A 6-month-old child, when pulled into sitting with several trials, demonstrates a head lag. This movement MOST likely indicates that head control is: A.) Developing in a typical manner B.) Slightly delayed by 1 month C.) Significantly delayed by several months D.) Advanced

Answer: C Head control should be developed by 2-3 months

The BEST position in which the OT can place a 15-month-old child to provide opportunity to further develop trunk rotation is in the: A.) Supine position B.) Prone position C.) Side-lying position D.) Sitting position

Answer: D

Which of the following BEST represents a normally developing 1-1.5-year-old child's functional mobility? A.) The child uses a narrow base of support, low arm guard position, and takes big steps B.) The child uses a wide base of support and can navigate uneven ground C.) The child uses a narrow base of support and low arm guard position D.) The child uses a wide base of support and can walk well for very short distances

Answer: D

A newborn baby exhibits a reflex that includes: hand opening, abducted and extended extremities following jarring motion. Which of the following correctly identifies the reflex? A. ATNR reflex B. startle reflex C. grasping reflex D. Moro reflex

Answer: D -startle = arms -moro = combination of actions/reactions

The OT is planning treatment to promote developmental acquisition for an infant in the neonatal intensive care unit. Which of the following actions will have the most PERMANENT impact? A.) Modify the environment to protect the infant from additional stressful stimuli B.) Recommend early intervention referral to assess the infant upon discharge home C.) Complete the neurobehavioral assessment and identify interventions emphasizing developmental skill acquisition D.) Create a comfortable foundation for fostering parent skills through parent-therapist collaboration

Answer: D Baby goes home = collaboration with therapist

A Level II fieldwork student begins an affiliation at a rehabilitation hospital. His first assigned case is an individual with right hemiplegia. The supervising therapist reminds the student that primitive reflexes can emerge when someone incurs a CVA. The therapist demonstrates this point by rotating the individual's head to the right, and stating that the person's response demonstrates a subtle ATNR. The therapist asks the student to describe the observed behavior that resulted in the therapist's interpretation. The most accurate response for the student to make is that he observed: A.) Increased flexor tone of the right upper extremity B.) Increased extensor tone of the left upper extremity C.) Increased extensor tone in both upper extremities D.) Increased extensor tone of the right upper extremity

Answer: D Because turning the head to the right

A child with a diagnosis of traumatic brain injury (TBI) is seen in OT for the initial evaluation. The child presents with extension of both upper extremities and flexion of both lower extremities following a stimulus of neck extension. The OT interprets and describes this observation as: A.) + ATNR, which is "abnormal" & has reappeared after the TBI B.) + STNR, which is "normal" C.) + ATNR, which is "normal" D.) +STNR, which is "abnormal", and has reappeared after the TBI

Answer: D Only abnormal because of the brain injury (reappeared, should be integrated)

In screening a child who has been referred to OT, the PRIMARY goal of the OT practitioner is to: A.) Obtain necessary information for an OT consultation with teachers or parents B.) Test a wide variety of developmental behaviors C.) Establish an information base for the OT treatment plan D.) Determine the need for further evaluation

Answer: D Screen = does this child need to move forward with

Why review all this?

Appreciate the complexity of human development Recognize the significant ramifications when the process is disrupted or when things go wrong With birth comes occupational changes for everyone involved

school function and OT

Areas relevant to OT" -Education, play/leisure, ADLs, social participation, beginning work Classroom Playground/recess Mealtimes Bathroom/hygiene Transitions Transportation

standing control

Arms down at sides -Squat to stand

Other methods of conception

Artificial insemination In vitro fertilization Use of fertility drugs (Clomid, Pergonal)

Administration: Personal-Social

Assesses child's ability to get along with people and take care of personal needs -assess = interviewer asks caregiver about the child's typical/current functional abilities -figure out age and test the child within that range (lower and higher, based on abilities assessed)

Administration: Language

Assesses child's ability to hear and to understand and use language

Administration: Fine Motor-Adaptive

Assesses eye-hand coordination, manipulation of small objects, and problem-solving

Administration: Gross Motor

Assesses sitting, walking, jumping, and large muscle movements

Assist infants in managing stress & organizing behavior

Assist infants in managing stress & organizing behavior HOW? Individualized development care GOALS: -Facilitate development of approach behaviors; and -Discourage stress reactions

function of the proprioceptive system

Assists in the development of a body map and world map which is necessary for praxis (motor planning).

control of impulses

Between 2 & 4 yrs, increasingly can control impulses and tolerate delay in gratification because of: -More sensitivity to the distress of others: Can recognize distress in others and more sensitive -A better sense of time: More aware of time ("later" vs. "now") -see another child = learn what appropriate behavior/non-appropriate behavior is -become more empathetic -more trusting in parents and request for delay Psychosocial for babies -Trust vs mistrust, with trust achieved by gratification and needs met in a timely manner

tongue lateralization 6-9 months

BIG Milestone! -Side to middle lateralization occurs first -Present when small bits of food are placed to side of the mouth beginning chewing is present when small bits of foods are placed to the side of the mouth [tongue lat. from side to middle]. -second stage of 6-9 months = tongue lateralization (side to middle first = present food to the side of the mouth and they move it to the middle)

Communication

Babbling Gestures Baby signs First words

Developmental Sensory Experiences

Babies receive sensory input naturally within the context of their everyday interactions with the world and with their caregivers

infant sense of smell

Babies recognize the odor of their mother's milk. This familiarity strengthens feelings of comfort and increases the willingness to suck, both of which contribute to the infant's survival

Why are early school age children vulnerable to fluctuations in feelings of depression and worthlessness?

Because of hormones, comparison to peers, more people communicating to them, could be compared to siblings, acceptance important, self-perception of certain topics (ex: think school is important but not doing as well as peers = impact on self-esteem), body dissatisfaction begins around age 5

7-8 months cruising

Begins to cruise sideways against furniture (use abduction and adduction of legs) -using supports and moving, shuffled

6-9 months chewing skills

Begins to develop chewing skills -munching -tongue lateralization

Emotional Development: 5 months

Begins to discriminate strangers

6-9 months solids

Begins to gum or mouth solid foods/teething foods -First tooth generally erupts during this time -first tooth usually impacts 4-12 months (biscuit, pizza crust, pineapple core, teething ring, etc.)

animism

Believe that inanimate objects have "lifelike" qualities and capable of action ex: mickey mouse is real, get mad at a toy for hurting them, etc.

6-9 months control

Belly still on floor but pushing up with palmar arches, arms extended

The Cultural Context of Pregnancy and Childbirth

Birth Culture: The beliefs, values and guidelines for behavior regarding pregnancy and childbirth; the way a culture perceives and reacts to pregnancy -in Japan, motherhood is above all (positive position) -some cultures though see pregnancy as negative

vestibular receptor location

Bony labyrinth of inner ear

Breastfeeding vs. Formula Fed

Breastfeeding: -Provides natural antibodies hat help your baby's immune system -More easily digested than formula -Babies are less constipated and gassy -Lowers the risk of SIDs -Raises child's intelligence -Reduces the risk of being overweight, developing asthma, type 1 and type 2 diabetes, high cholesterol Formula: -Convenient -Flexible -Partner can help with nighttime feedings and share bonding experience with the baby -Scheduling feedings may be easier (Formula isn't digested as quickly as breast milk) -Can have a glass of wine or cocktail once in a while

Infant grammer

By 7 to 8 months of age, infants show the ability to recognize the specific regularities in spoken speech and to detect rules about the combination of language sounds.

Usability in OT

Can be used by O.T.'s as well as other health care personnel in infant and preschool programs, well-baby clinics and other pediatric settings for screening purposes only.

Weaknesses ad limitations to this test

Cannot obtain clear-cut developmental levels without abusing the test. -some language is different for children (ex: saying puppy instead of dog) -there are limitations of what you can accept -some more advanced directions or ways of communication in which the test directs you to communicate in may not be understood by the child

Occupational Development

Change over the life span; development may be a systematic progression of growth and maturation for participation in a repertoire of occupations related to age; or development may be shaped by life circumstances that require an unexpected developmental path. "The gradual change in occupational behaviors over time, resulting from the growth and maturation of the individual in interaction with the environment."

Interdependence of family

Changes in one family member are accompanied by changes in the others.

inferiority

Characteristics reflective of "inferiority" - feelings of lack of worth and inadequacy; self-doubt; withdrawal

5-6 months

Characterized by emerging lateral weight shifting and lateral righting reactions; by 6 months equilibrium reactions are developing in prone; protective extension forward develops Sitting - sits with straighter back; ring sits with wide base; uses arms for support (will sit independently by propping on arms for short intervals) Pull-to-sit- assists with flexor control; no head lag -protective extension forward = protects self from falling

PEER PLAY

Child begins to engage in group games -More structure & more reality than toddler -Use fantasy play w/ more elaborate themes

EARLY MORAL DEVELOPMENT

Child develops an internal sense of right and wrong -Demonstrate more internal control of behavior -Parents' standards, limits, and values become part of the child's self-concept

identification

Child identifies with primary caregivers to: -Enhance own self-concept -Feel closer to parent -Allow for more independence -Help strengthen personality; develops an "ideal self" -want to take on characteristics of adults -don't always need parent to help (independence) -ideal self = image they desire to be based on current values, beliefs, etc. -develop work skills based on interests

Sensory Modulation Problems

Child reacts to stimulation by over reacting or under reacting (ex: autism, ADHD) -Sensory registration problem

Moro pathological

Child with cerebral palsy = high tone = moro reflex comes back

Toilet training is Influenced by 2 factors:

Child's readiness Parent's readiness

Piaget

Cognitive development occurs through adaptation which occurs through: -assimilation -accommodation

Examples of various theories that have shaped our understanding:

Cognitive, Cultural, Social Role, Psychosexual, Theory of Evolution, Theories of Learning, Systems, Psychology -Each theory emphasizes key factors that lead the way in shaping human behavior

bimanual skills 11 months

Coordinated bimanual skills Arms can move in complementary directions (coordinated asymmetric action) which marks beginning of mature bimanual skills -Increased hand dexterity (12 mo) -Cooperative use of 2 hands together (12 mo) -Coordinated asymmetric actions (12 mo)

In summary

Course will emphasize aspects of human development that are particularly relevant to OT Will also emphasize development of occupational performance areas

reciprocal creeping

Creeping -eventually becomes reciprocal (uses STNR initially)—STNR precursor to crawling—when head is extended extension in UE and flexion in LE, head flexed flexion in UE and extension in LE

Critical Periods for Attachment

Critical Periods are referred to "sensitive" periods of time that the infant is in a state that is "maximal sensitivity" or readiness to learn a skill or develop a pattern of behavior or motor/emotional sequence -6 to 12 months

3-7 years sensory

Critical Stage!! Strong desire to seek out and meet own sensorimotor challenges through various occupations/play experiences -Visual Motor Games -Playground play -Sports, dance, gymnastics, karate -Bike riding, swimming -Use of household tools -Success at school -Social acceptance

Relevance to Occupational Therapy and Proprioception

Critical for motor coordination and learning new skills Hyper-responsive: avoid hugs Hypo-responsive: lack of awareness of body -Dyspraxia -Handwriting - push too hard -Crash into furniture -issue with one proximal system = most likely problem with proprioception -dyspraxia = difficulty writing, motor coordination May see --> hyper- or hyporesponsivity to proprioceptive input

6 years feeding

Cuts with a knife

13 through 18 months release

Demonstrates better graded control of releasing an object; able to release cubes in a cup, beginning to stack one cube on top of another; precise release of pellet into container with wrist flexion -Able to stack (2-4) cubes -Scribbles with crayon

Attachment

During 2nd half of first year, 2 signs of child's growing attachment to a specific person are observed: stranger anxiety and separation anxiety

Evaluation Process is based on facts

Data collected from objective measures of a child's performance -ex: strength measurements, measurements of angles in degrees of freedom of a joint, etc.

Sensory Input Provided in Static Weight Bearing

Deep pressure (tactile) Proprioceptive input (muscles and joints) that: -provides the brain with information about body position in relation to a surface; and -assists in integrating tactile based reflexes (grasp, rooting, etc.) and normalizing the response to touch to more sensitive body areas (mouth, hands, and feet). -Vestibular (static receptors) provides brain with information on body position (upright, supine, prone)

Skills Reflective of Cognitive Development: 18-24 months

Deferred imitation Skills: -Tower of 7 cubes -Aligns cubes for train -Imitates vertical and circular scribble

19 through 24 months

Demonstrates better strength and control of hand's arches and increased dissociation of fingers leading to greater functional skills -increased control of release pattern (stacks 6-7 one inch cubes by 2 yr.; manages feeding utensils, places puzzle pieces, etc.) -palmar grasp of crayon -object manipulation: accurate knowledge of how to use simple objects (key, spoon, cup, shoes, etc.) & manipulate appropriately. -Bimanual skills: greater control of bimanual skills; eg. stabilize bowl and scoop with other hand; hold paper while scribbling with other hand; stringing beads, etc. -The infant's hand skills increasingly reflect development of cognitive and perceptual abilities.

Cost of Denver II

Denver II Screening Manual = $15 Denver II Test Forms = $14/pad of 100 Denver II Test Kit = $31 Complete package of above items = $53 Denver II Training Videotape = $200

Developmental theories

Development in various areas of function -cognitive, motor, play Examples of various developmental theorists: Erik Erikson ( psychosocial development = focused on social environment and influences on childhood development), Vygotsky (social interaction influence on cognitive development), and Piaget (developmental = achieve one thing before moving onto the next, four stages of development)

According to the text: 5 major developmental tasks

Development of Sensory, Perceptual, and Motor Functions Sensorimotor Intelligence: Processing, Organizing, & Using Information Communication Attachment Emotional Development 1) Sensory and motor development overlap (effect each other) 2) Intelligence is based on sensorimotor experiences (feeling and reacting/learning) 3) Many communication milestones 4) Specific positive emotional relationships/attachment between infants and caregivers 5) Emotions become more complex as the infant matures

Gender Preference

Development of a personal preference for the kinds of activities and attitudes associated with male or female roles

Prespeech and Language Development

Developmental period before 1st word (0-12 months) Includes: -Oral-motor development and feeding -Respiration

tactile receptor location

Different receptors in skin -skin has different types of receptors for touch, pain, temperature, and discrimination

Attachment: Stranger Anxiety

Discomfort around strangers or unfamiliar adults 9-12 months

Attachment: Separation Anxiety

Discomfort when parent is absent or leaves ~9 months

Self-Concept

Early school age children begin to understand gender as a part of their self-concept and use this as a guide socially. -They begin to group people into 2 sexes and begin to form expectations for both groups. - Children begin to identify what sex they are. Clarity of sex-role identity is a ___________ characteristic and is associated with competence and directiveness. It is thought that a strong, positive identification with appropriate sex is essential for development of self-esteem and elaboration of peer group relationships.

Basic self-care

Eating Dressing Bathing Use of the toilet

Contractions cause:

Effacement - shortening of cervical canal Dilation - enlarging of the cervix which occurs automatically

In vitro fertilization

Eggs retrieved and fertilized in petri dish with sperm and then fertilized egg is placed in uterus

Emotional Development

Emotional Memory and functions become more complex with maturation -New emotions emerge over the period of infancy and become differentiated along dimensions of intensity (from anger to rage, wariness to anxiety) -Child interprets events differently as cognitive function matures -Children develop strategies for regulating their emotions so that they are not overwhelmed by emotional intensity -Emotions serve as a channel for adult-infant communication

Trust

Emotional State: A sense of confidence that needs will be met.

Development of Moral Feelings

Empathy and Perspective-Taking improves moral development -Empathy -How does it develop and evolve? -Perspective-Taking -global empathy = experience distress from others being distressed (baby cries because infant is crying) -egocentric empathy = thinking about themselves and thinking how it would effect them when someone else is distressed -empathy for feelings = -empathy for another's life condition = understand empathy when you understand others life condition (end of age range, more complex) -perspective taking = (increased sharing, cooperation, helping, etc) (more at the end of this age range)

Reflex-Based Theories of Motor Development

Emphasize the hierarchical nature of the CNS Progression of development -Primitive reflexes diminish or are integrated into more mature motor patterns -Cortex increasingly assumes control of motor function and inhibits the reflexes -Reflexes are early movement patterns that form the basis for more functional movement -motor behavior of an infant = reflexes (stimulus and response effect on the lower level of the brain) -doesn't explain variation in development (everyone is different) -reflexes are integrated = some shouldn't be present later on = dysfunction or neurological disorder

12-24 months sensory

Enhanced Tactile Discrimination and localization of touch...enhance fine motor skills Emerging Body Schema, Praxis and Ideation -Understanding, right/left, body parts, motor planning and ability to think about a plan of action before doing a task Tactile: Develops tactile discrimination & localization of touch which enhance fine motor skills. Vestibular-proprioceptive-visual processing allows for further refinement of postural control in upright positions and balance. Development of body scheme & motor planning (praxis = ability to plan and coordinate movements for unfamiliar tasks). An awareness of body leads to an increased ability to plan new actions. Ideation emerges - i.e. an ability to think about a plan of action before doing a task.

Effects of Early Childhood Education

Enhances peer interaction skills More socially competent and mature -Increased confidence -More extraverted -Increased independence & assertiveness -Better adjusted for school Less cooperative with adults; less polite; more aggressive & bossy, less compliant -picking up on peer negative behavior, increasing autonomy

9-12 months self feeding

Enjoys finger feeding and making a mess Exposure to utensils vs. expected use -Will hold spoon and try to feed self but messy -Unable to scoop -Turns spoon over in mouth (spilling foods)

How have we used these theories clinically?

Evaluation -Given us well-developed set of developmental norms (Gesell) that are used in developmental assessment for the identification of developmental delay General principles of normal development -Guided our view of normal development and our approaches to intervention

Developmental Assessments

Evaluation Process is based on facts or sound clinical judgment

Social Attachment

Evidence it has developed: -Infant wants to be with person -Infant becomes upset when caregiver is taken away -Infant is more relaxed and happy when that person is present Infants initially dependent on caregivers cultural beliefs and childrearing practices to shape the infants experiences -Gaze, smiling, research on touch, kangaroo care, research on olfaction and attachment, bonding to mother's scent, via breast milk -Process thru which ppl develop specific, positive emotional bonds with others. -Achieved through reciprocal interaction

Calculating the Chronological Age

Exam Date: 8/11/2000 Child's DOB: 9/14/1999 00 8 11 99 9 14 = 10 months 27 days *The child's age is used as a reference point against which all item performances are compared.*

Test form: Header

Examiner, Date, Patient's Name, DOB, chronological age

coordinated asymmetric actions

Example: one hand stabilizing an object and the other hand active (one hand stabilizing a container while the other removes a block) (12 mos.); testing item: one hand hold the bottle and the other unscrew the lid.

Describe your sex-role standards for males and females (areas to address: appearance, skills, careers, favorite activities, etc.)

Examples -toys brought to bed, babies vs dinosaurs -girls play more pretend play -boys more trucks, cars, tools -Want to promote acceptance/remove gender roles

Excretory Functions

Excretory organs begin to function a few minutes to hours after birth -maconeum = first poop, should occur within 24hrs after birth

Benefits of Fantasy Play

Expansion of thought, used to make sense of the "their" world -can differentiate play from reality as young as 2 yrs of age -lots of different pretend play -by 2: child can differentiate between reality play and pretend play -helps understand every aspect of their world, learn a lot of cognitive skills

Implications for Occupational Choice for the toddler

Experience variety of roles & try through pretending -This stage gives the child the opportunity to experience a variety of roles and try them out through pretending (eg. being a doctor, bus driver, mommy, etc.). This helps him/her become aware of various occupational roles and what expectations go along with that role. Constructive play helps the child learn to use various tools/objects and become more skilled in using his/her hands. This is also a time when the child wants to experience a sense of control; he/she will insist on doing things by himself and in his own way. Allowing the child to do some things independently will help build self-confidence. This will certainly impact later job skills.

Environmentalist

Experiences impact development

Transitional State: Drowsy or semi-dozing

Eyes open or closed, eyelid fluttering; activity level variable with or without mild startles, reactive to sensory stimuli, etc

Emotional development during infancy can be understood along four dimensions.

First, new emotions emerge. Infants express these emotions at different levels of intensity—for example, from a whimper or fussy noise to a full-blown angry rage, or from a happy cooing gurgle to outright laughter. Second, with cognitive maturation, a child interprets events differently. New emotions may become attached to familiar situations. An experience that may once have caused wariness, such as a new toy or a loud noise, may become a source of excitement or joy as the child gains a new understanding of the situation. Third, children develop strategies for regulating their emotions so that they are not overwhelmed by emotional intensity. Fourth, emotions serve as a channel for adult-infant communication.

What is neural plasticity? It can be thought of in two different but related ways.

First, there are all the changes in the interconnections among neurons that occur as a result of learning and experience: ● The formation of neurons. ● The continuing growth of axons and dendrites. ● The formation of synapses, the connections between the axons of one cell and the dendrites of another. ● The sculpting or pruning of synapses. ● The production of neurotransmitters, the chemicals that stimulate or inhibit the firing of specific neurons. ● Myelination, the white fatty substance that insulates the neurons and increases the speed of firing from one neuron to the next. ● The production of glial cells that provide stability for the neural network. Second, neural plasticity can refer to the variety of ways that the brain compensates for injury by making use of alternative resources.

Emotional Development: 1 month

Focuses on faces; differentiates caregivers from strangers

self-theory

Focuses on making the interaction between the person and the world turn out as positively for the person as possible. Self-theory or self-concept is based on one's view about oneself and is influenced by one's roles & experiences -"me" - self as object -"I" - self as one who is aware of one's own actions -Me = self as object; the self one can describe-physical characteristics, personality traits, social roles and relationships, thoughts, feelings -I = more subjective-it is the self as one who is aware of one's own actions (sense of uniqueness, awareness of one's own awareness, sense of initiation of behaviors) (more complex description of self)

What will you do if the family you are working with has sex-role standards that are very different from your own?

Follow their standard, accept them, be open to them

the psychosocial crisis table

For each person, the relative frequency and significance of positive and negative experiences will contribute to a resolution of the crisis.

Commando Crawling

Forearms and elbows still in contact with ground, as well as belly and legs

Freud

Freud labeled this stage "latency" -recent theorists feel otherwise, that a lot happens during these years

5 developmental tasks summarized

Friendship -Perspective, flexibility, peer pressure, conflict... Concrete Operations -Mental operations, classification, conservation... Skill Learning -Academic subjects, sports, arts, IADL's (chores) Self-Evaluation -Beginning to self critique , feedback, self-fulfilling prophecy Team Play...organized sports

5 developmental tasks

Friendship Concrete Operations Skill Learning Self-Evaluation Team Play

MIDDLE SCHOOL AGE (7-12 years) PLAY

GAME STAGE AND TEAM SPORTS - Children learn to obey more complex rules (they have the cognitive skills to understand any adult sport). Teams help them learn about: the division of labor and the importance of interdependence. Both of these are important values for job performance. SUGGESTIONS: board games, card games, collections, jump rope, ping-pong, school plays, etc. -school teams/sports starting

Implications for Occupational Choice for middle school age

Games and work activities allow the child to experience a sense of confidence about the possibilities for mastery. Small jobs (presented in a positive manner) can facilitate a positive orientation toward work and greater feelings of independence.

fine motor skills

Girls outperform boys -6 yr old - can paste, cut with scissors, tie shoes -7 yr old - printing becomes smaller, may learn cursive writing (3rd grade) -10-12 yrs - manipulative skills become close to adult skills

STRESS PREVENTION!!

HOW? Effective recognition and response to infant cues.

Bradycardia

HR under 100bpm

Initial Pull-to-Stand

Half-kneeling to standing—legs more active in moving to standing; by 12 mos uses legs more than arms in coming to stand; cruises sideways and eventually hold on with one hand and rotates body around to reach back; toes initially flex to gain stability -Stands against furniture a lot -More practice standing with support

abnormal STNR

Head extended, arms flexed, legs flexed

Parental Discipline Styles

Helps form inner moral code Control undesirable behaviors Teach right from wrong -teaches right from wrong -permissive = lack limits -last one most effective (one you want to push for)

What is Human Development?

How multiple facets of a person develops: Cognition Social-emotional Motor Language Feeding Etc!

Interaction Determinants

How the interaction between the person, environment influences development -Interaction operates in complex ways -"The good enough environment" (Goal: want to see the "just right environment" to match the person's genotype)

Perspective of human development

Human development is a lifelong process of change

Sensory registration problem

Hypo-responsivity Hyper-responsivity

Sensorimotor Play --> Symbolic Play

Imitating what parents do -ex: playing mom and dad, cooking, cleaning, etc. Start to copy a vivid mental image symbols look similar to the objects they represent Washing dishes Sweeping the floor

A formal theory should meet certain requirements

It should be logical and internally consistent, with no contradictory statements. The hypothetical constructs should be translatable into testable hypotheses that can be explored through systematic research.

Language development: 3-6 months

Improved auditory skills -Turns head toward sounds, recognizes voices, may respond to name Expressively imitates adult sounds Babbling helps facilitate development of articulation skills -babbling (repetition of consonant/vowel combinations which helps facilitate the development of articulation skills) (ex: ba ba ba ba, or da da da da da = not saying real words, just repeating easy sounds)

Parents as Advocates

In addition to providing care themselves, more and more parents are responsible for arranging supplemental care for their infants. As a result, parents become advocates for their child. Parents must review the child care services available to them and select a setting that will meet their infant's needs and accommodate their work requirements and economic resources. Family day care, in-home babysitting, and center-based care are three common alternatives.

Reaching and Grasping,

In the first weeks of life, we see a strong, involuntary grasp reflex. In the first few months of life, babies cannot achieve much in the way of voluntary reaching because they cannot yet keep their head up or their torso from collapsing. By 12 months, babies have mastered the pincer grasp,

Grasping reflex

In the first weeks of life, we see a strong, involuntary grasp reflex. If you put something, like a finger or a rattle handle in a baby's hand, the hand closes tightly. -Over time, this involuntary reflex is transformed into purposeful, goal-directed reaching and grasping (about 5-7mo). Advances in reaching and grasping result from an ongoing interaction among sensory and perceptual abilities, motor skills, cognitive capacities, social interactions, and cultural contexts -12 mo = pincer grasp

The Fetal Period

In the third month, the fetus grows to 3 inches, and its weight increases to 14 grams. The head is about one third of the total body length. During this month, the fetus assumes the fetal position, arms curled up toward the face and knees bent in to the stomach. The eyelids are fused. -gender determination -The 3-month-old fetus moves spontaneously and has both a grasp reflex and a Babinski reflex, in which the toes extend and fan out in response to a mild stroke on the sole of the foot.

Self-care

Independence in ADLs enhances the child's self-esteem and feelings of efficacy -development <--> occupations (ADLs) <--> environment <-->

3.5-4.5 undressing

Independent undressing

18-24 months

Independently drinks from cup and uses spoon and fork with table foods Internal Jaw Control: Big Milestone! Demonstrates jaw control and stabilization which represents a balance of flexion and extension.

Sensorimotor Intelligence and Primitive Causality

Infant learns about the world through exploration and interaction Babies are born with the capacity to receive their world and its surroundings Intelligence (learning, cognitive thought) develops through this interaction

birth to 3 months

Infant learns to control head and orient self in space. -gradual straightening of the body

during the second 6 months

Infants begin to produce babbling sounds and attach meaning to certain sound combinations they hear around them, indicating a reorganization of sensory capabilities as the child learns to listen to people speaking a particular language (plasticity)

Understanding the nature of objects and creating categories

Infants learn early about the properties of objects through exploration -Size -Weight -Color -Texture -Ability to occupy space -exploration = gazing, manipulating, mouthing -visual, fine motor, and tactile/oral motor,

Major developmental changes occur over the first two years of life in regards to feeding performance

Infants progress from liquid to solid diet in about the first 15 months of life

Neurosocial Behavioral Development: Turning In

Infants under 32 wks. gestation; physiologically unstable and tend to become overloaded with even small amounts of sensory input; unable to engage in social interaction because all energy is focused on gaining physiologic stability.

Self-Esteem is influenced by

Influenced by success and failure experiences -Positive self-esteem -Negative self-esteem

MOVEMENT: Being handled by caregivers and self-exploration of body provides tactile, proprioceptive, and vestibular input.

Initially provided by caregiver during activities of daily living (bathing, dressing, rocking, etc) and play; Gradually is self-initiated and occurs during the attempts to explore body move about in the environment. Emerging skills: The skills the child learns (eg. feeding self) allow the infant to provide own self-autonomy

Birth Process (Labor & Delivery)

Initiated by involuntary contractions of uterine muscles & ends with expulsion of fetus/placenta -contractions -time varies: ~14 hrs. for 1st child; ~8 hrs. for 2nd child

when first dressing: advice

Instruct to start sitting in a chair because balance is not the best -helps independence because more successful

6-12 months sensory

Integration of tactile, proprioceptive, vestibular, and visual input allows for the development of numerous locomotor skills (creeping, transitions in & out of sitting, standing & walking). Through movement, the child learns about environmental space and the relationship of her/his body in space. Tactile processing becomes more refined and helps infant to be able to use hands for exploration. Unsupported sitting allows hands free to manipulate objects and enhance tactile input Proprioceptive processing: All of the transitions and movement throughout space enhances the infant's body perception and world map Self-feeding: An important sensory experience. (taste, smell, touch, proprioceptive, visual) Self-feeding experiences enhance eye-hand coordination and "tool" usage -Taste, smell, touch, proprioceptive jaw, tongue control, and eye-hand coordination.

3 significant characteristics of team play that help develop appropriate work behaviors:

Interdependence Division of labor Nature of competition

Physiological factors

Is the child physiologically able to have voluntary control of bowel and bladder? - What are some signs of physiological readiness? -can they say dry longer, pattern or schedule observed, awareness of internal cues (know when they need to go)

Jumping at 6 months

Jumpers are good for strengthening leg muscles -learning to balance, weight baring, muscles, proprioception, etc.

Skin-to-skin contact between mothers or fathers and their infants, sometimes referred to as

Kangaroo Care, has been shown to have benefits for the newborn as well as for parents. It provides a variety of sensory stimulation to the infant and increases the caregivers' confidence and comfort in caring for their baby.

World map

Knowing where body is in space in relation to objects

LGA

Large for gestational age; above 90th percentile

Tactile

Largest sensory system and the first to develop at 5.5 weeks gestation; see reflexive avoidance responses. It primarily requires physical contact for stimulation of the receptors (only one that requires physical contact)

4 months prone

Lateral weight shifting in prone

Development of Moral Thought

Learning Theory Cognitive Development Theory Psychoanalytic Theory

Life Stages (from text)

Life Stage 1: Pregnancy & Prenatal Development Life Stage 2: Infancy (Birth-24 months) Life Stage 3: Toddlerhood (2-4) Life Stage 4: Early School Age (4-6) Life Stage 5: Middle Childhood (6-12) Life Stage 6: Early Adolescence (12-18) Life Stage 7: Later Adolescence (18-24) Life Stage 8: Early Adulthood (24-34) Life Stage 9: Middle Adulthood (34-60) Life Stage 10: Later Adulthood (60-75) Life Stage 11: Very Old Age (75-Death)

Sensory Integration

Locomotion skills assist in development of sensory integration -Provide tactile, proprioceptive, and vestibular input enhances body & world map = improves praxis -All of this motor activity requires motor planning & enhances skill development.

Factors Causing Adjustment Problems:

Loss of weight -Monitored every 1-2 wks Low birth weight -Less than 5 lb. 8 oz or SGA (small for gestational age) -child looses weight then gains weight

Birth to 24 Months: Infancy

Major Changes occur quickly: Moves from Dependency with lack of control over their environment to developing meaningful occupations within a short period of time -Motor -Cognitive -Social -Emotional -Functional -birth = everything is reflexive --> 24 months = develop refined changes -cog = solving problems -emotional = needs at birth --> crying for wants -functional = occupations (dress, play, feed, etc.)

Emotional Development: 18-24 months

May see extremes in behavior -Loving, demanding, stubborn See expansion of social relationships

Vestibular relevance to OT

May see the occurrence of sensory modulation problems. Sensory Registration Problems: Either over or under reacting to the vestibular input Hypo-Responsivity: Failure to register the input -"sensation-seeking" behaviors...swing high, fast, running all the time, jumping, twirling Hyper-Responsivity: Over-orientation to input -"gravitational insecurity", avoids being moved, disproportionate response to movement or when off the ground or stable surface

proprioception receptors

Mechanoreceptors for pressure, tension, and stretch

PPT: Middle School Ages

Middle School ages 6-12 "Where do I fit in?"

APGAR: Muscle Tone

Muscle tone-weak some flexion of extremities 1; active motion strong flexion of extremities; flaccid or limp-0

Functional synergies

Muscles work together in patterns of functional synergies to accomplish common goals The functional act determines what muscles and systems will work together to produce movement -Instead of the view that CNS has all these programmed

Family Context

Must consider factors influencing the developing fetus as well as the expectant parent Most American couples begin their families during their 20s and 30s -Keep in mind diverse ways in which families are brought together & evolve -Blended families, single parent households, families through adoption, etc **WE must consider the CONTEXT

Central Process for Resolving the Crisis

Mutuality with the Caregiver: aka Reciprocal Socialization To resolve the crisis of trust vs mistrust, an infant must establish a feeling of mutuality with a caregiver. Mutuality is built on the consistency with which the caregiver responds appropriately to the infant's needs and the infant learns to expect that his or her personal needs will be met.

Reading

N&N VVVV

Motor Behaviors

New motor behaviors emerge during development as phase shifts not as a rigid linear progression -reorganizes self, combines things, etc., working together -1 behavior not related/dependent of another (ex: crawling early doesn't mean you will walk early)

Synactive Model of Infant Behavioral Organization

Newborn interacts with environment through 5 behavioral subsystems in a hierarchical pattern from lower to higher levels of pyramid -Physiologic (autonomic) subsystem -Motor subsystem -State subsystem -Attentional subsystem -Self-regulation subsystem

Cardiovascular control

Newborn shifts from fetal to adult circulation Premature infants are at risk of the following problems: -Persistent pulmonary hypertension (PPHN) -Higher and more irregular heart rates

neonatal period senses

Newborn uses touch, smell, and movement to maintain contact with caregiver during nursing and while cuddled. Tactile: Touch experiences help establish a mother-infant bond and foster feelings of security. Proprioception: Baby "molds" to the caregiver's body. Weight bearing and movement provide proprioceptive input which enhances body scheme. Vestibular: This is the first system to mature. Vestibular input influences the infant's arousal (caregivers use rocking, swaying, etc. to calm the infant). -When held in upright, the infant detects the pull of gravity and begins to develop head righting. Visual & auditory systems are initially immature; newborn can orient to some visual and auditory stimuli. Visually - attracted to human faces, high-contrast stimuli.

1 through 2 months Release

No active or voluntary release Avoidance reaction (3-8 wks.): fingers abduct and extend with light touch to dorsum of hand; a reflexive reaction

independence in self-care

One of the major developmental tasks of young children Expected to be toilet trained and self-sufficient in eating, dressing, and hygiene upon entering school Universal expectation Increases the child's control over both home and school (Become less dependent upon adult caregivers and achieve greater personal autonomy) Independence in basis self-care is one of the major developmental tasks of young children; the child entering school is expected to be toilet trained and self-sufficient in eating, dressing, hygiene, and simple domestic tasks (consider non-academic tasks). Independence in self-care is a _universal_ expectation. Independence in ADLs increases the child's control over both home & school. They become less dependent upon adult caregivers and achieve greater personal autonomy. These skills are dependent on skill development in - gross motor, fine motor, cognition, sensory, and social-emotional areas.

Labyrinthine Head Righting

Onset: 1-2 months Integration: persists Stimulus: input to the vestibular system provided by head position (developed first in prone, then supine/upright position) Response: head stays in line with the body -Strength of response might depend on the amount of time spent prone (tummy time important) -Infant develops control of neck extension, then lateral control

Flexor Withdrawal reflex

Onset: 28 weeks Integration: 1-2 months Stimulus: Pin prick to soul of foot Response: Extension of toes, knee bend, dorsiflexion of the foot -for protection

Sucking-swallow reflex

Onset: 28 weeks gestation Integration: 2-5 months Stimulation: place nipple or finger into infant's mouth Response: starts sucking -for survival

Traction reflex

Onset: 28 weeks gestation Integration: 2-5 months Stimulus: Grab forearms and try to pull them up to sit Response: Flex forearms -for survival

*Moro Reflex*

Onset: 28 weeks gestation Integration: 5-6 months Stimulation: sudden change in position of the head Response: first extension of the extremities and abduction, then usually bring their arms (flexion) across their chest, usually cry -for protection

*Plantar Grasp reflex*

Onset: 28 weeks gestation Integration: 9 months Stimulus: Pressing on the ball of the foot Response: Toes curl -for survival

*Landau Reflex*

Onset: 3-4 months Integration: 1-2 years Stimulus: held in a horizontal position in the air prone Response: swimming reflex, extension of head and hip and arms then the arms retract with elbow flexion Strength of extensions important for walking

*Galant Reflex*

Onset: 32 weeks gestation Integration: 2 months Stimulus: Rubbing the side of the vertebrae Response: Curving of the trunk to the side being touched

Positive Supporting reflex

Onset: 35 weeks gestation Integration: 1-2 months Stimulus: support the child in a vertical position (under armpits or trunk with feet in contact with surface) Response: Weight bare on legs and knees flexing

Spontaneous Stepping Reflex

Onset: 37 weeks gestation Integration: 6-8 months Stimulus: hold them up standing Responses: automative stepping

*Protective Extension Downward P.E. / Downward Parachute*

Onset: 4 months Integration: persists over life Stimulus: put baby head first (airplane), rapid plunge towards a table Response: hands come out when head approaching a surface

Body Righting Acting on the Head reflex

Onset: 4-6 months Integration: 5 years Stimulus: lay on back and rotate one leg Response: body follows the leg (pelvis, thorax, head in order to roll)

Neck Righting Acting on Body reflex

Onset: 4-6 months Integration: 5 years Stimulus: supine, turn their head to one side Response: segmental roll, body will follow the head turn

*Symmetrical tonic neck reflex STNR*

Onset: 4-6 months (only one not present at birth Integration: 8-12 months Stimulus: extending or flexing upper or lower extremities Response: ex: head and arms flex = LE extend Precursor to crawling

Prone equilibrium

Onset: 5 months Integration: Stimulus: weight shift Response: active spinal extension on weight baring side, flexion on opposite side

gender schemes

Personal theories about cultural expectations and stereotypes related to gender children look for clues about gender, seeking info from their social environment about what activities they should or should not engage in (boys don't dance; girls don't play with trucks)

Four areas assessed

Personal-Social Fine Motor-Adaptive Language Gross Motor Five "Test Behaviors" are also rated to assess child's overall behavior

Oral Motor & Feeding Development: 9-12 Months

Phasic biting stage Major Skills: -Eats junior foods, mashed table foods, & solids -Able to drink from a spouted cup -May transition from baby/junior foods to all table foods -able to finger feed

Impact of Fetus on the Mother:

Physical Emotional Financial Social Status/Role Change -physical = alters the woman's body/body image, nausea, discomfort, etc. -emotional = energy bursts depression, mood swings, anxiety, hormonal overall -financial = babes are expensive, mom might work less or not at all during pregnancy (and after) -social = worker or full-time mom, etc.; treated differently everywhere; usually don't get out as much

Child's Readiness:

Physiological factors Physical readiness Psychological and/or cognitive readiness

Play

Play is a major occupation of childhood -Evolves during development and takes on different forms (Therefore, we must focus a large part of our intervention on addressing this role.) Definition: Action on human and non-human objects that is engaged in for its own sake -Intrinsically motivating and rewarding -A pleasurable activity that is engaged in for its own sake -driven by curiosity, its self-motivated and intrinsically rewarding -play is also a style of interaction (adults can be playful; joke around)

Sensorimotor play

Playing using your sensory systems -trial and error -using in conjunction with our motor skills -ex: with food = bringing food to your mouth and experiencing different textures

Spoon Feeding

Poor lip closure on spoon, feeder wipes food on upper gum and palate to stimulate munching pattern to propel and manipulate bolus of food toward back of oral cavity. -learning mouth closure, up down motion

Impact of the Mother on the Fetus:

Poverty Environmental Genetics Maternal Age Maternal Health -Drug use -Diet -Prenatal Care -poverty = poor prenatal care, usually early age pregnancy, low birth weight, increase in likelihood of smoking/drinking, no vaccinations, etc. -age 16-35 = best uterine environment (amniocentesis > 35) -too much caffeine = problem -teratogens

Premature Infants & Synactive Theory

Premature infants may not be able to coordinate 5 subsystems to interact effectively with environment -Signals of stress -Signs of instability in lower subsystem (subsystem preceding) -States of physiologic instability may threaten infant's well-being -Stressed infants need "time-out periods"

congenital problems

Prematurity, Heart Defects, Anatomical Anomalies, etc... -Down's Syndrome -Cleft Palate

sensory processing problems

Prevalent in certain diagnosis: -Developmental Coordination Disorder (DCD) -Prematurity -Autism Spectrum -Down's Syndrome -Attention Deficit Hyperactivity Disorder (ADHD) -identify processing/organizing occupations senses

causes of inferiority

Real or perceived limitations or disabilities History of failures Criticism from peers, (teasing, last to be chosen) Unsupportive Caregivers...may be well intentioned but too high of expectations placed on child or are too over-protective or hyper-vigilant

What do they need from parents?

Reassurance frequently that they are loved and need to be aware of unique strengths (more positive self-esteem at this age range, but begins to diminish)

language development: 6-9 months

Receptive: begins to understand simple words Expressive: imitates sounds -Babbling reflects sounds infant hears -Jargon - use of sound groups and not really full words -Echolalic - repetition and imitation of sounds -sibling names, animals, toys -jargon = sounds like speech, but it is still their own language (like babbling) -echolalic ex: "uh oh"

What Factors Influence the Quality of Attachment?

Reciprocal socialization

Approach/Withdrawal

Refers to the child's characteristic response to a new situation or strangers. Does the child eagerly approach new situations or people? Or does the child seem hesitant and resistant when faced with new situations, people or things? Slow-to-warm up children tend to think before they act. They are less likely to act impulsively during adolescence. -Approach = easy -Withdrawal = difficult

Elaboration of Locomotion

Refinement of motor skills learned first 2 yrs and development of new skills -enjoy physical play

Postural Reflexes/Reactions

Reflexes are those voluntary changes in body tone and or movement that are mediated through the nervous system and occur in response to specific stimuli. Reflexes can generally be divided into two categories: 1. Primitive reflexes 2. Mature Reflexes

Adaptability

Related to how easily the child adapts to transitions and changes, like switching to a new activity. Does the child have difficulty with changes in routines, or with transitions from one activity to another? Does the child take a long time to become comfortable to new situations? A slow-to-adapt child is less likely to rush into dangerous situations, and may be less influenced by peer pressure. -good = easy -poor = difficult

Sensory Threshold

Related to how sensitive this child is to physical stimuli. It is the amount of stimulation (sounds, tastes, touch, temperature changes) needed to produce a response in the child. Does the child react positively or negatively to particular sounds? Does the child startle easily to sounds? Is the child a picky eater or will he eat almost anything? Does the child respond positively or negatively to the feel of clothing? Highly sensitive individuals are more likely to be artistic and creative. -high = easy -low = difficult

Self-Esteem

Related to one's evaluation of own worthiness and is based on 3 sources: -Messages of love and approval -One's own attributes and competencies -One's view of attributes in relation to ideal self -how do I want to be perceived, what do I want to work on

3 through 5 months Release

Release: Involuntary dropping of objects. Instinctive avoiding response: (3-5 mos; fully developed 6-8 mos.) a transitional pattern between ______________ and_______________ release; this response is characterized by pronation with adduction in response to ulnar hand stimulation and supination with abduction to stimulation on the radial side of the hand; seen more when infant is irritable or when tactually defensive; serves to reinforce hand opening Weight-bearing activities on hands enhance an extended wrist and finger position and elongates long finger flexor muscles. These prone activities help strengthen the ________ and _________ muscles; also provides tactile and proprioceptive information. Bimanual Skills: (3 mos.) See hand-to-hand play on the chest; hands may clasp at chest and bring a toy to __mouth___ for exploration; (5 mos.) infants tend to approach an object with both hands to mouth it or visually inspect it

Test Item Bars

Represents where % of population at that age is performing -Left end of bar = 25% -Hatch mark = 50% -Shaded area at the right of the bar = 75% -End of box/right end of bar = 90% -left of the bar, left of the mark = 25%, right of same mark = 50 %

Fine Motor and Gross Motor work together

Research has shown that the development of postural control is related to the development of fine motor skills -postural control and fine motor working together

Skills Reflective of Cognitive Development: 0-3 months

Responds to familiar people, visually tracks objects, attends to sound

Infant Individuality:

Responses to Sensory Input Infants interpret and then respond to a stimulus in one of the following three ways: -NONSTRESSFUL -STRESSFUL, but infant copes in a positive manner to restore stability -EXTREMELY STRESSFUL, but infant is unable to cope and overcome the stress and becomes unstable

Occupational Performance

Results from the relationship between the person, environment, and occupation over the person's lifespan. "Act of doing and accomplishing a selected action (performance skill), activity, or occupation and results from the dynamic transaction among the client, context, and the activity. Improving or enabling skills and patterns in occupational performance leads to engagement in occupations or activities."

6-9 months pureed

See excessive mouth opening with beginning of controlled jaw extension during spoon feeding Lip closure = Able to close lips around spoon to remove food -He/she may also eat mashed or finely chopped table foods. -pureed food usually very thin

Responses to Sensory Input: EXTREMELY STRESSFUL, but infant is unable to cope and overcome the stress and becomes unstable

STRESS (or AVOIDANCE) Reactions: -"Infant has lost control" -Infant is unable to cope with input -Stress reactions vary depending on the subsystem being stressed

TODDLER (2-4 years) PLAY

SYMBOLIC PLAY - Child begins to use imagination, fantasy, and pretend play; child will imitate things observed in his/her environment; these activities help the child experience and understand a little bit more about the real world. (Eg. imitate cooking, driving, "imaginary friend", etc.) to SIMPLE CONSTRUCTIVE PLAY - Engages in simple constructive play (i.e. putting things together and taking apart); toys give "message" to child regarding what to do with it (eg. pop-it beads, blocks, etc.).

friendship groups

Same sex friends, develop distinct peer environment, boys like to play in groups, girls like to play in dyads (groups of 2), girls more fantasy play and boys are more combative

6-9 months: Grasping Pellet

Scissors grasp

Responses to Sensory Input: NONSTRESSFUL

Self-regulation approach signals: -"Everything is OK" -Infant is well-organized -Smiling, cooing, minimal motor activity, alertness, relaxed facial expression -if the baby interprets the interactions as non-stressful

Responses to Sensory Input: STRESSFUL, but infant copes in a positive manner to restore stability

Self-regulation coping signals: -"Warning signs" -Infant is at risk of becoming over-stressed, but can still self-organize at this point -Infant recruits support from some lower systems in order to self-regulate -Sucking, hand-on-face, shifting to lower behavioral state (drowsy), fisting, etc.

Role of OT/Caregiver

Send messages of encouragement Tap into motivation to select appropriate activities Encourage perseverance and dedication in chosen activities Provide the "just right challenge" where demands of task are matched equally to the abilities of the child

Infant: Implications for Occupational Choice

Sense a feeling of MASTERY -A child who is successful in exploring self and environment will begin to sense a feeling of mastery (or "gee, I can do it!); infant will begin to develop a sense of trust in self (i.e. that he/she can do it and have some control). -want autonomy -not playing with other children yet

Types of Fantasy Play

Sensorimotor play Symbolic play Pretense

Role of OT with SPD

Sensory Diet...Determine the optimal combinations of sensory input/experiences that encourage adaptive responses on the child's part (emotional and functional behaviors) "Just right Challenge" Sensory Assessments: Objective/Subjective Parent Surveys/Questionnaires

Early Experiences that Provide: Tactile, Proprioceptive, and Vestibular Input

Sensory Nourishment Static Weight Bearing Dynamic Weight Shifting Random movement and automatic reflexes Volitional movement Emerging skills

Foundation skills for learning:

Sensory integration Motor planning Perceptual/cognitive Social processes

dressing

Sequence of normal development - This information assists both in evaluation and intervention. -Children learn to undress before they learn to dress (pulling clothes off is easier than putting them on). -follows a sequence of development: taking off is easier than putting on

Social Learning Theory & Sex Role Standards

Sex-role standards -Cultural and subcultural expectations about appropriate behavior for males and females -"Traditional" -Expectations are accompanied by conditional rewards, incentives, and sanctions -Gender schemes

Neurologic development: Critical in the period of infancy

Significant period of cortical growth: Birth to 6 months -Synaptic connections -Myelination -Central Pattern Generators -Neural plasticity -"Neurons that fire together... wire together" Global mapping of experiences in brain, forge pathways, lay down the foundation for later development and function....everything matters! -Formation of synapses, myelination—insulates neurons and increases speed of firing from one neuron to the next -During first 3 years the brain triples in weight and creates about 1,000 trillion connections among the neurons -*Different areas of brain experience an overproduction of synapses at different times, with the visual cortex taking the lead, followed by areas related to hearing and language, and the prefrontal cortex where higher level thought and problem solving takes place

sitting control

Sits in a variety of ways; able to side-sit, W sit, and straight leg sit because of improved trunk control

Kangaroo Care

Skin-to-skin contact between mothers and fathers and their infants -baby belly down on chest usually most beneficial -comforting to newborn and parents (increase in relaxation hormones)

SGA

Small for gestational age; below 10th percentile

Emotional Development: 4 months

Smiles at self in mirror

Neurosocial Behavioral Development

Social interaction improves as the nervous system develops. This occurs in the following 3 stages VVV -influences readiness for human reaction (depends on when they were born/stage they are in)

Implications for Occupational Choice for adolescence

TENTATIVE STAGE (10 -15 years) - During this time the teenager is beginning to take jobs outside the home. This adds a new dimension; performance is being evaluated by someone other than parents. These experiences help the teen practice and learn appropriate work behaviors (dressing appropriately, arriving on time, getting job done, etc.) and identify likes/dislikes and strengths and weaknesses. The teen needs to realistically identify strengths, weaknesses, and interests in order to eventually make a realistic career choice.

EARLY SCHOOL AGE (4-7 years) TOYS

TOYS: Sewing cards, dot-to-dot, tracing with templates, building sets, simple arts and crafts, paperdolls PRE-GAME PERIOD - Child can engage in simple games such as Simon Says, duck-duck-goose, etc. These games have simple rules and the child can follow them. They have enough self control to wait their turn. Child is more able to cooperate with the other children indicating more self control. -better motor planning, better self control (can wait their turn, listen to directions, wait for someone to win)

24 through 36 months

Tasks that require precision are performed with fingertip prehension; those that require power use a palmar grasp. -able to manipulate small objects (small pegboard, put pennies in a bank) -beginning to use utensils with skill (spoon, crayons) -increased strength of hand musculature -attempts to use scissors -strings small beads -preference (not dominance)

Implications for Occupational Choice for Early School Age

The child begins to learn to follow simple rules (rules are a part of any job!), to get along with people, and to use his/her hands in a more skilled way.

Developmental changes

The child between 12 - 24 months is learning how to use feeding utensils and will transition to complete self-feeding. -tolerate messes -sensorimotor intelligence with feeding = squishing food, playing with it, throwing it, etc.

MIDDLE SCHOOL AGE (7-12 years) WORK

The child is developing a growing investment in work and is able to engage in simple jobs. AGE-APPROPRIATE JOBS - cleaning bedroom, vacuuming, taking out garbage, cutting the lawn, -chores at home (simple jobs, expectation to help out) = make bed, put away dishes, clean up toys, throw out garbage

The prefrontal cortex

The cognitive skills that we have described in the preceding sections—causal schemes, object permanence, and the categorization of objects—are all evidence of a capacity to generalize principles and devise abstract rules from experience. One hallmark of human intelligence is the ability to derive abstract concepts, rules, and generalizations from sensory and motor experiences and to apply them in new situations.

Before the introduction of hospital deliveries, most cultures had a role for a close female companion who accompanied a woman during childbirth.

The contemporary doula is trained to offer information as well as physical and emotional support during labor, delivery, and the early weeks following childbirth. Her role is to remain at the side of the laboring mother to help her have a safe, reassuring childbirth experience.

Distractibility

The degree of concentration and paying attention displayed when a child is not particularly interested in an activity. This trait refers to the ease with which external stimuli interfere with ongoing behavior. Is the infant easily distracted by sounds or sights while drinking a bottle? Is the infant easily soothed when upset by being offered alternate activity? Does the child become sidetracked easily when attempting to follow routine or working on some activity? High distractibility is seen as positive when it is easy to divert a child from an undesirable behavior but seen as negative when it prevents the child from finishing school work. -low = easy -high = difficult

What is Occupational Development?

The development of occupations across the lifespan What are occupations?

Intensity

The energy level of a response whether positive or negative. Does the infant react strongly and loudly to everything, even relatively minor events? Does the child show pleasure or upset strongly and dramatically? Or does the child just get quiet when upset? Intense children are more likely to have their needs met and may have depth and delight of emotion rarely experienced by others. These children may be gifted in dramatic arts. Intense children tend to be exhausting to live with. -how loud is the child -low = easy -high = difficult

The medical profession describes three stages of labor.

The first stage begins with the onset of uterine contractions and ends with the full dilation of the cervix; this is the longest stage. The second stage involves the expulsion of the fetus. It begins at full dilation and ends with the delivery of the baby. The third stage begins with delivery and ends with the expulsion of the placenta. This stage usually lasts 5 to 10 minutes.

proprioceptive system

The sensing of body position and movement and specifically the sensing of force and extent of movement, muscular tensions, physical pressures, and body position in space.

first 6 months of life

The sensory systems allow for a greater awareness of self and the world. Vestibular-proprioceptive-visual connections combine to provide postural control (begins to develop control in prone, supine and sitting; full head control by 4-6 mos.) Increase in proximal control; decrease in primitive reflexes. Infant's actions become more goal-directed.

Infant touch sense

The skin is the largest sensory organ and the earliest to develop. Touch has a communication function, providing an early form of caregiver-infant interaction. -Touch is an active as well as a passive sense; babies use it to explore objects, people, and their own bodies. Sucking and mouthing are early forms of exploratory touch.

Psychoanalytic Theory

The superego (child's consciousness) is an internalized set of parents' ____________ and __________ (dev. between 4-7 yrs.). Moral development is based on how parents teach child how to inhibit impulses. Freud felt that a stronger superego developed with parents who were more punitive. -Psychoanalytic theory - more severely a parent forces a child to inhibit her or his impulses, the stronger the child's superego will be -Freud assumed that boys would develop more highly differentiated and punitive superegos than girls because he believed that boys' impulses are more intense; because of the greater impulsive energy demonstrated by boys, boys are treated more harshly by their parents than girls. -suggested that boys identify w/ their fathers for 2 reasons: fear of losing the father's love and fear of the father as an aggressor. -a girl identifies with her mother for a single reason : fear of losing her love; since this motivation is considered less intense that that of a boy, he believed that girl's superego would be weaker *Research on development of conscience has failed to support Freud's hypothesis. Studies have shown that young girls are better able to resist temptation than boys and they show a pattern of decreasing moral transgressions over toddlerhood and early school years. *Research has shown that the children of paretns who use harsh physical punishment do not have higher levels of internalization. These children are likely to inhibit impulsive behaviors around their parents but when observed with peers away from home, they tend to be physically aggressive and do not control their behavior well. -superego = voice in their head (stronger superego when parent tries to depress it)

Regularity

The trait refers to the predictability of biological functions like appetite and sleep. Does the child get hungry or tired at predictable times? Or, is the child unpredictable in terms of hunger and tiredness? As grown-ups irregular individuals may do better than others with traveling as well as be likely to adapt to careers with unusual working hours. -regular = easy -irregular = difficult

Current: Dynamic Action Theory

Thelen, 1978-present -Many subsystems influence the development of movement, not just CNS -Movement is an emergent property based on interaction of multiple subsystems -lots of subsystems impacting development, not just the brain -ex: vestibular, visual, diet, proprioception, height, weight, gravity/position, cardio, respiratory, cognition/maturation, biomechanics (muscles, ROM), culture, temperament, etc.

Activity Level

This is the child's "idle speed or how active the child is generally. Does the infant always wiggle, more squirm? Is the infant difficult to diaper because of this? Is the infant content to sit and quietly watch? Does the child have difficulty sitting still? Is the child always on the go? Or, does the child prefer sedentary quiet activities? Highly active children may channel such extra energy into success in sports; may perform well in high-energy careers and may be able to keep up with many different responsibilities. -how active the child is generally -low = easy -high = difficult

Persistence

This is the length of time a child continues in activities in the face of obstacles. Does the child continue to work on a puzzle when he has difficulty with it or does he just move on to another activity? Is the child able to wait to have his needs met? Does the child react strongly when interrupted in an activity? When a child persists in an activity he is asked to stop, he is labeled as stubborn. When a child stays with a tough puzzle he is seen a being patient. The highly persistent child is more likely to succeed in reaching goals. A child with low persistence may develop strong social skills because he realizes other people can help. -low = easy -high = difficult

Mood

This is the tendency to react to the world primarily in a positive or negative way. Does the child see the glass as half full? Does he focus on the positive aspects of life? Is the child generally in a happy mood? Or, does the child see the gall as half empty and tend to focus on the negative aspects of life? Is the child generally serious? Serious children tend to be analytical and evaluate situations carefully. -positive = easy -negative = difficult

ADOLESCENCE (13-19 years) REALISTIC CHOICE STAGE (16-20 yrs):

This is the time that the teenager thinks more carefully and realistically about career choices. *** Remember, this stage occurs as a result of development in the previous stages.

Central Process: Imitation

This is the vehicle for how toddlers learn new skills and mastery of these skills with positive praise is what brings about a sense of autonomy How toddlers learn new skills and master them: ex: see you constantly putting people down = they will, but if you show independence, they will -OT: modeling, role playing

Normal Fetal Development

Three Trimesters -First - 1-3 mos -Second - 4-6 mos -Third - 7-9 mos Typical 40 week Gestation -40 weeks after first missed menstruation

purpose of preschool

To enhance child's development in many areas -Should not be formal academic training -Should not be stressful -To enhance the child's development in many areas (cognitive, social, physical, emotional, etc.). -Preschool should not be formal achedemic training; it should not be stressful nor should it be a downward extension of elementary education

functions of tactile sense

To interpret a variety of tactile input (pain, temperature, pressure, light touch, deep pressure) for protective and discriminatory purposes and a general awareness of the environment.

Purpose of this course:

To understand how development across the lifespan relates to human occupational development Part 1: Human growth and occupational development from birth through middle childhood Part 2: Early adolescence to very old age

egocentrism

Toddler sees world from own perspective -Why sharing toys is difficult at 2 yo; more appropriate at 4 yo world revolves around that toddler (everything is mine, 4 able to want things and give them back)

Self Control: Self-regulated goal attainment

Toddlers want to control the events around them to achieve a goal -Making decisions/need for clear choices Toddlers use speech to control and direct their own behavior & problem-solve ("egocentric" speech or self-talk) -Talk through what they want to do -Often use speech that parents use to guide them -"good job" -"be careful" -"that's dangerous" -give them a choice when they are mad

9-12 months Solids

Tongue lateralization from middle to side -Able to lateralize foods placed in center of mouth Munching decreases and see more chewing movements (dissociation patterns) (eg. crackers, cheerios) The infant displays tongue lateralization from middle to side of mouth when foods are placed in the middle of the mouth (i.e. the infant moves the food from the middle to the side for chewing/gumming). Munching decreases and we begin to see more chewing movements (i.e. the tongue and teeth work together to break up the food for swallowing). -ex: cheese, noodles, etc. chopped up finer (no raw vegetables yet) -learn about different textures -introduce a spoon -now able to take it from the middle and move it to the side

Temperature regulation

Transitioning from 100° to ~68-70° Swaddled to keep warm Premature infants -Lack capacity to respond to cold by shivering -Incubators provide temperature support -Temperature regulation = transitioning from 100 degrees to 68-70 degree environment. Newborns are swaddled to be kept warm -premature infants have problems with temperature regulation they lack the capacity to respond to cold by shivering. Incubators provide temp support needed to survive; swaddled and kept in warm environment

In-Hand Manipulation Skills

Translation -Finger to palm (2-4 years old) -Palm to finger (4-6 years old) Rotation (4-6 years old) Shift (4-6 years old) Use these skills more purposefully and functionally by ages 6-7 -use small objects to manipulate objects in hand

Primitive/Diffuse Receptors

Transmit pain, temperature, and diffuse input. These receptors are responsible for alerting (danger), for vague awareness of input, and for telling us about general qualities of the environment. -usually seen in early life -triggered by light/unexpected touch

12-18 months dressing and undressing

Undressing -Removes socks or hat on request & other simple clothing (mittens) -Removes unfastened shoes -Removed unbuttoned coat Dressing -Tries to put on shoes

States of Consciousness

Used by infant to maintain control over internal and external environments 6 states most commonly used by therapists -2 sleep states -1 transitional state -3 alert states -6 states = depends on physiological variables (state of consciousness)

Developmental tests

Used to determine the child's functional status in comparison to typically developing peers Purpose is to identify delayed development -Test items bring out characteristic reactions at specific ages and lead to opportunistic evaluation of the child

Developmental Screening tests

Used to identify young children who are asymptomatic but who may have a disorder that interferes with normal development -Help to promote early identification and intervention of disabilities -NOT diagnostic; identify possible problems Example: Denver II ! -screen before full assessment, detects possible abnormalities

PPT: Denver II

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PPT: Developmental Frame of Reference

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PPT: Play Development

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PPT: Reflexes

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Play Development

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Reading: N&N Ch. 5

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Sample NBCOT Exam Questions!

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Toddler Development of Occupations

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Typical Feeding Behaviors in Young Children

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chapter 4 reading

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reading: N&N 136-139

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readings: week 5

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The Period of Pregnancy and Prenatal Development

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Components of Motor Development

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Newborn

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PPT: Cognitive & Language Development

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PPT: Early School Age Development (4-6 years old)

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PPT: Fine Motor Development

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PPT: Sensory processing Development

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PPT: Theories of Motor Development

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expect a theory of human development to provide explanations for six questions:

What is the direction of change over the life span? What are the mechanisms that account for growth from conception through old age? Do these mechanisms vary across the life span? How relevant are early experiences for later development? How do physical, cognitive, emotional, and social functions interact? How do the environmental and social contexts affect individual development? What factors are likely to place the person at risk at specific periods of the life span?

Embryo

When implantation is successful, by the 6th day after fertilization, the egg makes contact with the lining of the uterus and begins to attach itself there.

In order to understand a theory, we must answer three questions:

Which phenomena is the theory trying to explain? What assumptions does the theory make? What does the theory predict?

Shame and Doubt

With an overwhelming presence of shame and doubt, the toddler generally lacks confidence and expects to fail; the toddler may avoid any new activities

Occupational Development

With physical maturation comes societal expectations and age graded expectations -occupational deprivation = causes delayed development (ex: child not given proper attention when in need)

A sensitive period

a time of utmost readiness for the development of certain skills or behavior patterns. The particular skill or behavior pattern is not likely to emerge before the onset of the period, and it is extremely difficult if not impossible to establish once the sensitive time period has passed.

Emotional regulation refers to

a variety of processes that allow infants to control the intensity of their emotional state and reduce feelings of distress. These abilities, which mature over the first 2 years, have important implications for a child's successful social participation in preschool and later childhood

behavioral inhibition,

a combination of fearfulness, a low threshold for arousal in the presence of novel or unusual stimuli, and general cautiousness.

memory

a complex capacity that includes recognizing something as similar to something one has seen or experienced in the past, holding information in mind for a brief period before using it and recalling information as needed (ex: tested by seeing how the infant reacts to a stimulus that was given previously)

intersubjectivity

a condition in which two conscious minds have the same thought or feeling.

intersubjectivity

a condition in which two conscious minds have the same thought or feeling. -ex: baby points to object and parent knows what they want

Researchers now regard the regularities in motor behavior as a result of

a dynamic process in which infants coordinate their physical actions with the demands and opportunities of the situation and the expectations of the culture.

withdrawal refers to

a general orientation of wariness toward people and objects.

A theory

a logical system of concepts that helps explain observations and contributes to the development of a body of knowledge.

cognitive map

a mental representation of the learning environment.

Vagal tone

a process through which changes in heart rate vary during changes in environmental conditions. Typically, when you breathe in, heart rate increases; when you breathe out, heart rate decreases. Under conditions when a task requires attention and concentration, heart rate increases, which allows for the adaptive mobilization of resources. When the situation becomes more intense or threatening, heart rate slows, leading to conservation of resources and the ability to achieve a more calm state. The vagal system contributes to regulation of arousal and reactivity and is considered to be a basic neural component of self regulation, information processing, and emotion

suck- swallow reflex

a rhythmical, total movement of the mouth to take in food; good coordination with breathing; good strength of suck.

By 6 or 7 months of age, infants treat faceness as

a special visual category, showing surprise when facial features are disorganized or upside down

reflexes

a specific stimulus evokes a particular motor response without any voluntary control or direction. -infant = sucking, grasping, rooting (turning the head in the direction of the cheek that is stroked), coughing, and stepping. (table on page 141)

A psychosocial crisis refers to

a state of tension that results from the discrepancies between the person's competences at the beginning of a stage and the society's expectations for behavior at that period of life -At each developmental stage, the sense of crisis arises because one must make psychological efforts to adjust to the demands of the social environment. The word crisis in this context refers to a normal set of stresses and strains rather than to an extraordinary set of events.

the unconscious

a storehouse of powerful, primitive motives of which the person is unaware. Unconscious as well as conscious motives may motivate behavior simultaneously.

Temperament

a theoretical construct that refers to relatively stable characteristics of response to the environment and patterns of self-regulation

the disorganized attachment,

babies' responses are particularly notable in the reunion sequence. These babies have no consistent strategy for managing their distress. They behave in contradictory, unpredictable ways that seem to convey feelings of extreme fear or utter confusion. Observations of mothers and infants who are described as having a disorganized attachment highlight two different patterns. Some mothers are negative, intrusive, and frighten their babies in bursts of intense hostility. Other mothers are passive and helpless, rarely showing positive or comforting behaviors. These mothers appear to be afraid of their babies, perhaps not trusting their own impulses to respond appropriately. The mothers often have experiences of loss or abuse in their childhood that have disrupted their own attachment experiences. Only a small percentage of infants show the disorganized pattern. Research has suggested links between the disorganized attachment and serious mental health problems in later childhood and beyond, including depression, borderline personality, and dissociative reactions

Equilibrium reactions

balance, movement with safety (weight sheets, gravity, etc.) Help the individual move about with relative safety. These reactions occur as the body accommodates to a shift in the weight and gravity to maintain balance.

hands and feet blue

because the circulatory system is underdeveloped

Developmental Changes in Self-Theory: Infant

becoming aware of independent existence, needs Developmental changes occur as a result of cognitive changes and expectations of others

McGraw

believed that maturation of the CNS was unitary driving force in motor development & dev of voluntary control is a cortical function in the CNS -infants can lift their head = attributed to cortical development in the spine -motor coordination development

Interactionalist

bi-directional person-environment effect development

Reciprocal Socialization

bidirectional; children socialize parents just as parents socialize children" -conversation with child, communication, attention

Preterm births

births before 38 weeks of gestational age—now

What are 1-2 significant changes observed in an infant's feeding between 9 and 12 months?

biting, better mouth closure, transition away from breast milk, lateralization from middle to side, finger feeding, transition to table foods

The superego includes

both a punishing and a rewarding function. -superego tends to be harsh and unrealistic in its demands. It is often just as illogical and unrelenting in its search for proper behavior as the id is in its search for pleasure.

Neural plasticity

changes in structure and function of the brain through right environemtn and just right challenge

Young infants can distinguish

changes in the loudness, pitch, duration, and location of sounds. They can use auditory information to differentiate objects from one another and to track the location of object. Many of these capacities are present among newborns but become increasingly sensitive by 6 months.

accommodation

changing of current knowledge to understand something (ex: view of disability changing) (ex: know a car moves, but learn what cars move faster)

Alert State: Crying

characterized by intense crying that is vigorous and strong. It is difficult to break through with stimulation.

prehension

characterized by the quality of opposition allowing the hand to conform to the shape of an object (preshaping) according to its intended use

EARLY SCHOOL AGE (4-7 years) ACTIVITIES

checkers, dominoes, simple classification board games, organized outdoor games. -3-4 kids starting to get involved in outdoor activities/sports that goes into play

Pass (P)

child completes the item per the requirements

positive resolution

child learns that active questioning and investigation is good

Solitary Play

child plays alone and independently of others; child engrossed in activity; common in 2 - 3 y.o.

Onlooker Play

child watches other children play and may verbally interact but not engage in play.

Refusal (R)

child will not attempt the item

Fail (F)

child's performance does not meet the criteria

sensorimotor intelligence.

children become aware of their potential, of their individual role and also of their potential role within a group.

representational skills

cognitive abilities that allow a child to let one thing stand for something else (ex: playing pretend)

Expectancies refer to

cognitive assessments about one's ability to perform, ideas about the consequences of one's behavior, and the meaning of events in one's environment.

Physical (gross motor) play

emphasis is on action (eg. playgrounds, play wrestling, riding a bike, etc.)

manipulative (fine motor) play

emphasis on manipulation of small objects or using "tools" (eg. stringing beads to make a necklace; coloring with crayons or chalk; constructing with legos; etc.)

Symbolic play

emphasis on pretend play which is not governed by rules; this play is made up of various elements: objects (dress-up clothes), theme (wedding), roles (bride & groom).

developmental systems theory (Molenaar, Lerner, & Newell 2014)

emphasizes the ongoing interaction and integration across many levels of the human organism from the genetic to the behavioral level. -The challenge to developmental systems theory is to understand the bidirectional regulation of the person and the environment over time.

How can a play companion enhance fantasy play?

encourage pretend play

tactile:

enjoys a variety of age-appropriate tactile activities (clothes on body, sand, finger paint, simple paper projects with glue, etc.); able to use hands in more complex ways (scissors use, coloring, printing)

FIVE-SIX Months - PRONE

extension develops down through pelvis; Landau strong; "swimming movements" seen in prone with weight on abdomen; wt-bearing on extended arms with better shoulder girdle control; can reach forward with one arm and grasp with the other -elbows more extended, not on all 4s yet

Sleep State: Light sleep

eyes closed, rapid eye movements under closed lids; low activity level with random movements and startles or startle equivalents; respirations are irregular, sucking movements occur off and on.

Infants show preference for

face-like stimuli. In the early weeks following birth, infants have optimal focus on objects that are about 20 cm away (approximately the distance between the mother's face and her baby cradled in her arms.)

1-2 months cognition and vision

facial expressions show

Hypo-responsivity to tactile input

failure to orient to input -hypo = can't get enough, might hug you for long periods of time

Occupational therapists assess

fine motor, visual motor, visual percep- tion, and visual skill development

Occupational Analysis Based on the Interactional Perspective

focuses on the concrete details of what goes on among individuals in everyday life. Interactionists study how we use and interpret symbols not only to communicate with each other, but also to create and maintain impressions of ourselves, to create a sense of self, and to create and sustain what we experience as the reality of a particular social situation. -Occupational Development (ADLs) -Environment (Physical, Social, Historical, and Cultural) -Human Development

4th stage of social attachment

form first internal representation of caregiver.

Synaptogenisis

formation of synapses between neurons in the nervous system. Although it occurs throughout a healthy person's lifespan, an explosion of synapse formation occurs during early brain development,

dizygotic (DZ) twins

fraternal twins, from 2 different eggs

Social, cultural & historical influences ...

generations forward will follow by example (habits and routines passed along) -ex: learning gender roles

Heredity

genetic makeup influences development but does not control it; development is governed by the interaction of genes and the environment 'Intrinsic capacities' - these have a bidirectional influence on each other; either + or -

Maturationist

genetic predisposition determines/effects development

13 through 18 months grasp

good ability to prehend objects of various sizes; adjusts grasp to weight and shape of object; able to adjust pressure based on previous experiences with object and tactile & proprioceptive feedback

proprioception:

good gross and fine motor coordination to complete age-appropriate play (legos, playgrounds), ADL tasks (eg. independent in dressing between 4 & 6 years), and schoolwork (begins printing ~5-6 yrs.); good motor planning with new tasks; good awareness of body thus child does not need to rely on vision excessively during tasks.

The ego ideal

includes ideas about what behaviors and thoughts are admirable, acceptable, and worthy of praise, carries out the rewarding function.

id

including instincts and impulses, is the primary source of psychic energy, and exists from birth. Freud believed that newborn infants' mental processes were comprised completely of id impulses and that the ego and superego emerged later, drawing their energy from the id.

cultural tools

including symbol systems, permits individuals to alter their environments and guide, regulate, and redefine themselves.

Late in pregnancy, the fetal brain begins to produce hormones that

increase the production of estrogen in the placenta.This, in turn, leads to a shift from mild to strong uterine contractions, which result in dilation of the cervix, rupture of the amniotic sac, and delivery

4.5 - 5.5 undressing and dressing

independent

Developmental Milestones of Toilet Training: 5-6 years

independent including wiping and handling clothes

resilience

individuals who exhibit positive outcomes in the face of serious threats to development.

raking, scratching movements

infant begins to "scratch surfaces" when contacting surfaces which allows for the practice of the full range of flexion and extension of the fingers.

advances in motor development are important for

infant exploration and growth

Phasic biting stage

infant gains control of flexion or jaw closure

gag reflex

infant will gag when the middle of the tongue is touched; gag reflex is more sensitive at birth.

judgment of self-efficacy

influence's the child's behavior. -Def. - The person's sense of confidence that he/she can perform the behavior in a specific situation.

How do developmental changes influence the development of autonomy?

influence: impact occupation (play, ADLs, gross motor fine motor)

Babbling,

initially characterized by sounds used in many languages, begins to reflect the sounds and intonation infants are most likely to hear. By about 6 months of age, sounds they do not hear dropout of their babbling and, at about this same time, they become less able to tell the differences among sounds not found in their native language

biopsychosocial approach

integration of the biological, psychological, and societal systems -changes in one brings about changes in the others, generally

Body Map

internal awareness of where body parts are

Birth is initiated by

involuntary contractions of the uterine muscles, commonly referred to as labor.

Life expectancy

is increasing and has increased in the United States by 50% during the 20th century -Avg life expectancy of people born in beginning of 20th century was about 49 yrs -2003-life expectancy—28.3 yrs longer than they had in 1900 -2010---white males 76.1, white females 81.8; black males 70.9, black females 77.8 -2015—white males 78 white femailes 83.8; black males 71.9, black females 78.9

Freud assumed that all behavior (except that resulting from fatigue)

is motivated. -behavior has meaning, not random

Expanding

is restating what the child has said in a linguistically sophisticated form.

creeping

main means of locomotion; stomach off of floor; -legs and knees are dragging -eventually leads to crawling

Righting reactions

maintaining head in line with the body (begin to develop before equilibrium responses) -These responses help a person move into and maintain an ideal position for locomotion. They also help keep the body aligned with the head and head aligned with the body.

NICU

management of breathing, temperature regulation, monitoring of heart rate, creation of appropriate stimulation for care of preterm infants -Of the NICUs where an OT was on the team, nurses, physicians and OT were identified as most frequently providers of parent education -OTs play a very important role in providing parent education in the NICU setting -Interventions: 7 sensory systems = feeding, positioning, developmental care, environmental modifications, range of motion, light sensory stimulation, play therapy -developing a womb-like environment for the infant

Multiple Determinicity

many factors influence occupational development at every stage of the life span -Person determinants -Environment determinants -Interaction determinants

reflexes

meaning that a specific stimulus evokes a particular motor response without any voluntary control or direction. -help infants survive and provide a platform upon which they develop more complicated sequences of voluntary behaviors.

"R"

means report from the caregiver is allowable. -report = ask caregiver about child's abilities/performance in specific tasks

Regression

means that a person (child or adult) reverts to an earlier form of drive satisfaction, immature forms of relationships with others, lower moral standards, or more simplistic ways of thinking and solving problems. -can serve ego development if it is not met with extreme disapproval

Habituation

means that the infant's response decreases after each presentation of an identical stimulus. -When a new stimulus is presented, such as a new level of loudness, or the same tone presented to a different ear, the infant shows an increase in alert responsiveness. -one way to determine whether an infant can discriminate between two different stimuli.

reaction time

measured with processing speed usually, it is the amount of time it takes to respond to a stimulus

DESCRIBE "traditional" SEX ROLE STANDARDS:

men are large and muscular, women are curvy and caring

3 Months - SUPINE

midline posture and chin tuck, decreased ATNR, a lot of hands to mouth

Inner drive

motivation, wanting to do something,

Motor Development

motor --> reflexes; ability to control and direct movements of eyes and head, fingers, arms, legs and torso/reaching/grasping -prefer slow, voluntary movements

What develops first, biting or mouth opening?

mouth opening

Good proprioceptive functioning allows us to

move smoothly without having to think about what we are doing or directly watching what the body is doing. It also leads to the development of kinethesia or the conscious awareness of joint position and movement. Lastly, it facilitates the integration of the tactile, vestibular, and visual systems.

Infants respond to a variety of visual dimensions, including

movement, color, brightness, complexity, light-dark contrast, contours, depth, and distance. *Visual acuity* improves rapidly during the first 4 months.

shift

moves and object in a linear movement

rotation

moving an object in a circular motion

dynamic weight shifting provides

moving proprioceptive and deep pressure input; vestibular input to the movement receptors. This allows one to recognize different spaces (front, back, side). And an opportunity to move the non-wt. bearing part of the body (infant learns when (s)he is supporting weight and when (s)he is not. -head righting, equilibrium

social learning evolved from the awareness that

much learning takes place as a result of observation and imitation of other people's behavior

proprioception stimuli

muscle contractions and stretching, joint movement, compression or traction, deep pressure, or weight-bearing. -Receptors tell the brain when and how the muscles are contracting or stretching and when and how the joints are bending or extending. -This information helps us know where our body parts are in space and when they are moving.

proprioception location

muscles, tendons, fascia, & joint capsules

Fine motor skills are difficult for preschoolers to master, because the skills depend on

muscular control, patience, judgment, and brain coordination

To resolve the crisis of trust versus mistrust, an infant must establish

mutuality with a caregiver.

Darwin's theory of evolution by means of

natural selection provided the foundational theoretical framework for much of American psychology through its influences on William James, G. Stanley Hall, John Dewey, and their students.

Sensory input may cause

positive changes in the structure and function of the nervous system (due to neural plasticity) -Increased dendritic branching -Increased synaptic connections -Greater synaptic efficiency -Increased size of brain tissue

Biological Factors

neurological & hormonal factors influence behavior and sex-role preferences.

container syndrome

no opportunity to explore movement because the child is always being contained

Unoccupied Play

not actively engaged in play, but observing the environment (not common in nursery school)

"Just right challenge"

not to overwhelming but not too easy, be successful but still challenging

Rotation and Diagonal Movements

obliques working -starting to reach

vestibular:

observe good balance and coordination (rides bike without training wheels ~5 yrs.); enjoys climbing, swinging, slides, skating, etc.

Bell and Ainsworth (1972)

observed mothers' responses to infant crying during the first year of life. Over the course of the year, the infants crying decreased and the mothers tend to respond more quickly to their cries. Finding suggests a process of mutual adaptation by mothers and infants. The longer mothers delayed in responding to their infants' cries, the more crying the infants did in later months. Babies whose mothers responded promptly in the first 6 mos of life cried less often in the second 6 mos.

6 through 9 months Vision

observes small objects; visual exploration of objects increases while mouthing decreases.

deferred imitation

observes something and can repeat it later (ex: hears daddy have road rage and repeats it at school) (ex: this person cried and got what they want = I am going to cry)

guilt

occurs when child feels curiosity is bad -Characteristics: lack of self-confidence with self-initiated activity, poor self-esteem

Parallel Play

occurs when the child plays separately from others, but with toys like those the others are using or in a manner that mimics their play; common in the toddler.

Effacement,

or thinning, is the shortening of the cervical canal.

Sensory Integration

organizing the sensory systems in order to have a reaction to desired behavior

Neurosocial Behavioral Development: Reciprocity

over 36 wks. gestation; physiologically and motorically stable; good quality alertness and self-regulation abilities; have good tolerance for social interaction. -motorically = muscle/muscle tone

Hyper-responsivity

over-orientation to input -"tactile defensiveness" (want to avoid this because brain is firing and telling the body that they don't like it, can be perceived as pain to them) -picky eaters

Who are other people who can serve as a "play companion"?

parents, peers, siblings, sitters, other family members, educators,

Higher mental processes

particularly language and meaning, emerge from the child's ongoing interactions within social, historical, and cultural contexts, as well as from the child's biological maturation.

What are parental requirements for enhancing autonomy?

patience, tolerating them to make mistakes, giving them choices (think they have control, you still have some), allowing time, being consistence in discipline, being prepared for changes in behavior

Developmental change refers to

patterns of growth and reorganization. Change may be attributed to biological maturation, systematic socialization, self-directed striving, and the interaction of these forces.

Initiative

period of intellectual curiosity -active, conceptual investigation of world -Positive resolution

Motor skills develop as a result of

physical growth and maturation in combination with perceptual information and opportunities for exploration of the environment. The infant's drive to explore and master the environment as well as encouragement from caregivers contribute to the rate and sequence of motor development

ages of sequence

physiological flexion (1 month) --> active extension (2 months) --> activate flexion (3 months) --> balance of flexion and extension (4 months) --> lateral control (6-7 months) --> rotational and diagonal movements (8 months)

APGAR: Skin Color

pink extremities blue-1; completely pink-2; blue/pale-0

Interpretation is determined by

placement of age line

Associative Play

play involves social interaction with little or no organization; children more interested in each other than the particular task; borrowing and lending toys, etc.; common in preschool years.

be realistic about amounts

portion size is 1/4 the size of an adults - toddlers sometimes eat very small amounts (if they're interested in something else or just aren't hungry) - Average calories for 1-3 year olds: 900 - 1800 cal./day; expect day to day variation.

What is the most appropriate state for intervention/interaction?

quiet alert, because the infant is focused (mostly occurs after a feeding)

1 through 2 months Reach

random movements of arms

Language Development 30 months

rapid increase in vocab; 3-5 word sentences

visual acuity improves

rapidly within the first 4 months -visual expectation by 2 months = watch an event and can predict the next step -4 months = see everything an adult would, but still don't have visual cognition

intellectual skills

reading, science, history, math, computer skills -reading: is a significant skill because it allows for learning in many other areas

This ability to understand words, called

receptive language, precedes language production, the ability to produce spoken words and phrases.

4-7 months cognition and vision

recognize others facial expressions

Causal schemes

refer to the capacity to anticipate that certain actions will have specific consequences. Infants develop an understanding of causality based largely on sensory and motor experiences. -by 9 months of age

Recasting

refers to paraphrasing a sentence in a different way. -Eg. "the dog was barking" ---- Mother would say "When was the dog barking?". -reinforces the child's use of speech -This provides a way of elaborating on an interest. -ex: child said "milk no no", you say "no more milk?" = rephrase what they say for better communication

Continuity

refers to stability in characteristics from one period of life to another. It also refers to a sense of sameness over time built on a history of memories, identity, and reflected self.

Stranger anxiety

refers to the baby's discomfort or tension in the presence of unfamiliar adults

Motherease

refers to the way mothers (and other adults) often talk to babies in a higher-than-normal frequency, greater than normal pitch, and simple words and sentences

6 through 9 months Reach

refined, unilateral approach with arm; reaches ipsilaterally with arm closest to object; increased active supination noted

Industry

reflects an eagerness to learn new skills and a positive attitude toward work; it is important for later success in the work world

Sensory/Perceptual Development

sensory modalities function together. Infants hear, see, smell, and touch c/g. voices associated with faces, tastes linked to smells and textures Hearing—provides the very earliest link between newborns and their mothers—research shows fetus is sensitive to auditory stimulation in utero **Sensory systems are functioning at a higher level than motor systems during 1st few mos; overall sensory and motor development overlap -sensory input enhances motor development motor activity brings about new sensations responsive to: -Visual stimulation = sensitive to light, focuses on faces and light/dark contrasts; tracks objects -Sounds = recognizes mother's voice early; smiles in response to voices, can distinguish changes in loudness -Smell = distinguishes mother's smell -Tastes = differentiates sweet and sour -Touch = 1st sensory system to develop; prefers deep touch vs light touch; many responses to touch are reflexive (rooting) -Movement = prefers slow, rhythmical movement

Gender Identification

sex-role identification - more of a focus on the biological dimensions of sex-role (XX vs XY) Gender identity = an internal sense of being male or female -group differences vs individual differences Sexual orientation = attraction to intimate partner

Drives can be thought of as

sexual and aggressive forces that have a biological or somatic origin—they are a result of some metabolic functions but are also intimately linked to psychological processes.

State Control: HEALTHY, FULL-TERM INFANTS

should be able to assume all states and transition smoothly from one state to another without becoming disorganized.

gestures by 9-11 months

showing objects, giving objects, then pointing

Children will develop on a continuum in regards to meeting Oral feeding "milestones"

similar to other domains of development

...a "good enough environment"?

simple living

holophrases

single-word utterances accompanied by gestures, actions, vocal intonation, and emotion -convey the meaning of an entire sentence.

for children with hearing loss: interventions that can promote

skill development along naturally occurring trajectories are the most beneficial

pyramid of learning

slide 33 BOTTOM -CNS -Sensory systems -Sensory Motor Development -Perceptual Motor Development -Cognition and Intellect TOP -need to achieve bottom skills before reaching the top

vernix caseosa

slimy/cheesy coating

APGAR: Respiratory Effort

slow or irregular breathing-1; good crying strong breathing-2; absent-0

2nd stage of social attachment

smile more at familiar person than at stranger, show more excitement when that person arrives and is upset when they leave

Cooperative Play

social interaction in a group with a sense of group identity and organized activity; formal games, etc.; seen in middle school age.

Newborns can tell the difference among

sweet, salty, bitter, and sour tastes. -The food choices a pregnant woman makes influence the flavor of the amniotic fluid. -Taste preferences continue to be influenced by the flavors that are transferred from the lactating mother's diet to her breast milk.

The societal system includes

social roles; social support; culture, including rituals, myths, and social expectations; media; leadership styles; communication patterns; family organization; ethnic and subcultural influences; political ideologies and forms of government; religions; patterns of economic prosperity or poverty; conditions of war or peace; and exposure to racism, sexism, and other forms of discrimination, intolerance, or intergroup hostility. The societal system encompasses those processes that foster or disrupt a person's sense of social integration and social identity

Contextual

society, culture much more influential than intrinsic attributes

Give one example of how "current" theories will influence your evaluation of motor development

someone not walking because of their fear of falling

By 8 months, infants use

sounds like grunting and whining in combination with gestures to achieve a goal. Sounds combined with gestures and looks in a certain direction become part of purposeful communication trying to get the caregiver to reach a cookie or get a certain toy off the shelf.

Individual children grow in

spurts, interspersed with times of slow growth and some periods of regression -all children will develop differently

stages of food

stage 1 thin --> stage 3 chunkier (chicken noodle soup, less pureed veg, etc.)

How do toddlers demonstrate a desire for autonomy?

start doing things themselves, insist on doing things themselves (toileting, dressing, bathing, brushing teeth, ride bike), a lot of persistence with this

A parent you're working with wants to wean her daughter from the bottle before she becomes overly attached to it. What would you recommend?

start experimenting with different cups during the day (depending on the age of the child), only give bottle in the morning and at night

Language Development 3 years

start to use rules of grammar in sentences; ; can express tense, plurals, possession, prepositions (on/off), but may still have difficulty with articulation of words

Active Extension

starting to extend in head and neck first

newborn placed prone

still in flexion -head down because of no neck strength

Apnea

stop breathing for over 15 sec

Games play

structured play involving rules; generally requires turn-taking, communication between two or more people, learning about winning/losing, etc. (eg. checkers, card games, Shutes & Ladders, Memory, etc.)

By the end of the first year, the extent of an infant's negative emotions,

such as irritability and fear, are influenced by the caregiver's depression and anxiety.

Reflexes that facilitate adaptation and survival

sucking pupillary swimming rooting startle

1st stages social attachment

sucking, rooting, grasping, smiling, gazing, cuddling, crying, visual tracking; calms with contact

Evaluation

sum of all results -results to composite picture of the individual's function -observations

Taken together, these information-processing skills

support an infant's ability to form increasingly complex schemes about objects, people, actions, and the relationships among them. -all effect each other, if one is dysfunctioning then they all are in some way

what sensory system is fully developed at brith?

tactile

baby forms taste preferences through

taste of amniotic fluid and mother's breast milk

The psychological system is

the *meaning-making* system that seeks out information, integrates information from many sources, and evaluates experiences as positive or negative, encouraging or threatening. -Emotion, memory, perception, motivation, thinking and reasoning, language, symbolic abilities, and one's orientation to the future are

prefrontal cortex

the ability to derive abstract concepts, rules, and generalizations from sensory and motor experiences and to apply them in new situations.

sensorimotor adaptation

the ability to gradually modify our motor commands in order to compensate for changes in our body and in the environmen

gestational age

the age of the fetus from the time of conception until birth

processing speed

the amount of time it takes to identify a stimulus and figure out its meaning

In the last trimester

the average fetus grows from 10 to 20 inches and increases in weight from 2 to 7 or 71⁄2 pounds. These increases in body size and weight are paralleled by a maturation of the central nervous system. From 20 to 28 weeks of gestational age, fetal heart rate declines and variability and accelerations in heart rate increase. -30 weeks = cognitive memories -

During the second trimester

the average fetus grows to 10 inches and increases in weight to almost 2 pounds. The fetus continues to grow at the rate of about an inch every 10 days from the fifth month until the end of the pregnancy. -uterus stretches -early fetal movements, called quickening. -sensory receptors of the fetus are well established by the end of the sixth month. -25 weeks, the fetus functions well within its uterine environment. It swallows, digests, excretes, moves about, sucks its thumb, rests, and grows.

We can think of longevity as a product of the interaction of

the biological, the psychological, and the societal systems. factors that influence -education -social integration -diet -exercise

Causal schemes

the capacity to anticipate that certain actions will have specific consequences.

Ethology

the comparative study of behavior in its social contexts in order to understand the immediate causes of these behaviors and their adaptive significance.

holophrase hypothesis

the concept that a single word is used to imply a complete sentence in the infant's mind. -ex: "ball" means "I want ball"

object permanence

the concept that objects in the environment are permanent and do not cease to exist when they are out of reach or out of view. A permanent object retains its physical properties even when it cannot be seen.

By 9 months of age, infants show evidence that they anticipate

the direction of an action, like pouring a liquid into a glass or using a spoon to bring soup to the mouth, and are surprised when the action is not completed or takes an unexpected twist. This understanding leads to goal-directed behavior; infants become increasingly intentional and purposeful in their behaviors Eventually, they are able to work backward: They can select a desirable outcome and then perform the behavior that will produce it.

hearing is

the earliest link of infants to mothers -mother's heartbeat and voice

In an effort to elaborate and clarify the set of interlocking systems in which human behaviors take place, Urie Bronfenbrenner (1979, 1995, 1999) developed

the ecological systems theory. -four levels of systems = microsystem, mesosystem, ecosystem, and macrosystem

Perhaps because development is so rapid and dramatic during the first trimester, it is divided further into

the germinal period, the embroynic period, and the fetal period.

Dilation is

the gradual enlargement of the cervix from an opening only millimeters wide to one of about 10 centimeters—large enough for the baby to pass through.

psychoanalytic theory focuses on

the impact of sexual and aggressive drives on the individual's psychological functioning. It distinguishes between the impact of drives on mental activity and their effect on reproductive functions. The theory assumes that very young children have strong sexual and aggressive drives that find unique modes of expression through successive stages of psychosexual development. Throughout childhood, adolescence, and adult life, sexual and aggressive drives operate to direct aspects of one's fantasies, self-concept, problem-solving strategies, and social interactions.

Synchrony means that

the infant and caregiver move fluidly from one state to the next. When infants are paying attention to their caregivers, the caregivers attempt to stimulate them. As babies withdraw attention, the caregivers learn to reduce stimulation and wait until the infants are ready to engage again

Matching means that

the infant and the caregiver are involved in similar behaviors or states at the same time. They may be playing together with an object, cooing and smiling at each other, or fussing and angry at eachother.

A mesosystem comprises

the interrelations among two or more settings in which the developing person actively participates

metacognition

the many strategies used to guide the way we organize and prepare ourselves to think more clearly and effectively.

operations

the mental manipulation of schemes and concepts

The poverty threshold

the minimum cash income needed to support a person or a family in meeting basic needs of daily living. -varies by family size, number of children, and the age of the householder

Infant is initially dependent on caregiver to provide all sensory input...with developmental growth comes

the opportunity to initiate desired sensory inputs -Bathing, dressing, rocking, carrying, and social play, feeding...all provided by caregiver in infancy -Increased mobility and gains in cognition, gross motor, fine motor, self-feeding... all contribute to enhanced sensory input -Self-Initiated input is received through the infant exploring his/her own body and environment

Stages of Development

the oral, anal, phallic, latent, and genital stages. -reflect the emphasis on sexuality as a driving force

Physical Environment

the part of the human environment that includes purely physical factors (as soil, climate, water supply)

Attachment

the process through which people develop specific, positive emotional bonds with others.

schemes

the structure or organization of action in thought

Evolutionary psychology

the study of the evolutionary origins of mental structures, emotions, and social behavior. Whereas ethology focuses on analyzing adaptive behavior patterns across species, evolutionary psychology draws on principles of evolution to understand the human mind. -Cosmides and Tooby

assimilation

the tendency to interpret new experiences in terms of an existing scheme.

is accommodation

the tendency to modify familiar schemes in order to account for new dimensions of the object or event that are revealed through experience.

Transient exuberance

the term given to this rapid increase in the number of neurons, dendrites, and synapses that form during the first 2 years of life.

Conscious processes

the tip that protrudes out of the water; they make up only a small part of the mind. Our conscious thoughts are fleeting. We can have only a few of them at any one time. As soon as energy is diverted from a thought or image, it disappears from consciousness.

avoid pressuring the toddler to eat

the toddler will react to any pressure to eat as a threat to her autonomy; it is common for a toddler to refuse to eat when pressured

object permanence

the understanding that objects continue to exist even when they cannot be perceived (seen, heard, touched, smelled or sensed in any way).

Cognitive Development Theory

there is a developmental sequence in learning moral thought. There is a shift from heteronomous to autonomous morality: -Heteronomous = rules are fixed, laws cant be changed, children need external control (4-7 years) -Autonomous = internalized set of moral principles (begins at 6-7). Improves over the next 10 years, applying basics of right and wrong due to

by 3 months cognition with vision

they can tell the difference between their parent's faces and strangers

self-insight

to be more aware of their thoughts and feelings, and to be less defensive. -Meditation and mindfulness

suckling:

tongue strips the nipple in a forward/backward movement. -tongue both forward and backwards -reflexive, but becomes voluntary

rooting reflex

touch around the mouth will result in the infant turning head/mouth to stimulus.

1 through 2 months Vision

tracks objects; "reaching with eyes" precedes reaching with the hands.

Summarize the difference between "traditional" and "current" theories of motor development

traditional = CNS focused, everything is sequenced current = dynamic development

What is the first purposeful release and when does this occur?

transfering from one hand to the other (7 mo)

The period of pregnancy—typically 40 weeks after the last menstrual period, or 38 weeks from ovulation—is often conceptualized in three 3-month periods called

trimesters

resistant attachment

very cautious in the presence of the stranger. Their exploratory behavior is noticeably disrupted by the caregiver's departure. When the caregiver returns, the infants appear to want to be close to the caregiver, but they are also angry so they are very hard to soothe or comfort. Infants who are characterized as resistant have mothers who are inconsistent in their responsiveness. Sometimes, these mothers ignore clear signals of distress. At other times, they interfere with their infants in order to make contact. These infants do not know if their needs will be attended to. Although these mothers enjoy close physical contact with their babies, they do not necessarily do so in ways appropriate to the baby's needs. The result is the formation of an internal working model of attachment that is highly unpredictable. These babies try to maintain proximity and avoid unfamiliar situations that increase uncertainty about accessibility to their caregiver. Caregivers of infants who have formed a resistant attachment are overly preoccupied with conflicts around their own childhood attachment issues.

What 4 components are needed in fine motor development?

vision, grasp, reach, release

Fine Motor Development Requires

vision, reach, grasp & release ALL 4 work together

Balance of FLEXION & EXTENSION

voluntary and involuntary muscle groups working, you'll know when they are sitting

10 to 12 months reach

well-coordinated reaching with supinated approach; trunk rotation allows for reaching on contralateral side.

An infant's brain is especially vulnerable to exposure to stress.

when the stressors are intense and prolonged, without the support of a caring, responsive social environment, the stress response may be prolonged.

static hold

whole arm is moving as a unit to draw

Four stages of fine motor development set the stage for early writing success

whole arm, whole hand, pincher, and pincer coordination

Collectivism refers to a

worldview in which social behavior is guided largely by goals that are shared by a collective, such as a family, tribe, work group, or political or religious association. Interdependence and group solidarity are valued.

video on Denver II

• between birth and age 6 • For those with not so obvious/apparent signs of delays • Activities that are fun for children to do • "R" in corner means it can be reported by parent • comfort and accessibility of items is important • don't expect child t do everything given to them • comparison test • under 2 years of age = add premature age into chronological age (more than 2 weeks premature only) • chart: write day of testing and notes of prematurity at the top of the age line • let child get comfortable with surroundings and items while getting report (observe child at this time, informal actions) • start with fine motor, language items, gross motor last • 3 items completely left of line (not on it at all) • 3 tries before fail • NO only with reported items • Parent can administer item, but only with very specific administration • "is this behavior typical?" • add items to left until passing 3 • right of age line to test strengths • identifying ceiling and lowest point • demonstrate most gross motor examples • head lag while pulling arms = fail • dropping yarn and baby follows it (after getting baby attention with yarn) = pass • raking the fingers to grab raisin/cereal • shortest of 2 times balancing = the one you accept (at least 4 seconds) • drawing people and getting a certain number of body parts on the page results • delays marked by shading in the right side of the bar • delay = failing/refusing before age line

Five major developmental tasks are especially critical during infancy:

● Establishment and coordination of the sensory, perceptual, and motor systems ● Elaboration of information-processing capacities and sensorimotor intelligence ● Emergence of early communication skills ● Formation of attachments ● Differentiation of the emotional system