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NBCOT: Therapy Ed (7th edition)-Chapter 5 Human Development Across the Lifespan

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Rooting
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Onset age: 28 wks gestation Integration age: 3 months Stimulus: Stroke the corner of the mouth, upper lip, and lower lip. Response: Movement of the tongue, mouth, and/or head toward the stimulus. Relevance: Allows searching for and locating feeding source.
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Suck-swallow
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Onset age: 28 wks gestation Integration age: 2-5 months Stimulus: Place examiner’s index finger inside infant’s mouth with head in midline. Response: Strong, rhythmical sucking. Relevance: Allows ingestion of nourishment.
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Traction
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Onset age: 28 wks gestation Integration age: 2-5 months Stimulus: Grasp infant’s forearms and pull-to-sit. Response: Complete flexion of upper extremities. Relevance: Enhances momentary reflexive grasp.
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Moro
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Onset age: 28 wks gestation Integration age: 4-6 months Stimulus: Rapidly drop infant’s head backward. Response: First phase: arm extension/abduction, hand opening. Second phase: arm flexion and adduction. Relevance: Facilitates ability to depart from dominant flexor posture: protective response.
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Plantar grasp
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Onset age: 28 wks gestation Integration age: 9 months Stimulus: Apply pressure with thumb on the infants ball of the foot. Response: Toe flexion. Relevance: Increases tactile input to sole of foot.
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Galant
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Onset age: 32 weks gestation Integration age: 2 months Stimulus: Hold infant in prone suspension, gently scratch or tap alongside the spine with finger, from shoulder to buttocks. Response: Lateral trunk flexion and wrinkling of the skin on the stimulated side. Relevance: Facilitates lateral trunk movements necessary for trunk stabilization.
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Asymmetric tonic neck
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Onset age: 37 wks gestation Integration age: 4-6 months Stimulus: Fully rotate infant’s head and hold for 5 seconds. Response: Extension of extremities on the face side, flexion of extremities on the skull side. Relevance: Promotes visual hand regard.
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Palmar grasp
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Onset age: 37 wks gestation Integration age: 4-6 months Stimulus: Place examiner’s finger in infant’s palm. Response: Finger flexion; refexive grasp. Relevance: Increases tactile input on the palm of the hand.
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Tonic labyrinthine-supine
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Onset age: >37 wks gestation Integration age: 6 months Stimulus: Place infant in supine. Response: Increased extensor tone. Relevance: Facilitates total-body extensor tone.
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Tonic labyrinthine-prone
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Onset age: >37 wks gestation Integration age: 6 months Stimulus: Place infant in prone. Response: Increased flexor tone. Relevance: Facilitates total-body flexor tone.
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Labyrinthine/optical (head) righting
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Onset age: birth – 2 months Integration age: persists Stimulus: Hold infant suspended vertically and tilt slowly (about 45 degrees) to the side, forward, or backward. Response: Upright positioning of the head. Relevance: Orients head in space; maintains face vertical.
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Landau
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Onset age: 3-4 months Integration age: 12-24 months Stimulus: Hold infant in horizontal prone suspension. Response: Complete extension of head, trunk, and extremities. Relevance: Breaks up flexor dominance; facilitates prone extesion.
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Symmetric tonic neck
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Onset age: 4-6 months Integration age: 8-12 months Stimulus: Place infant in the crawling position and extend the head. Response: Flexion of hips and knees. Relevance: Breaks up total extensor posture; facilitates static quadruped position.
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Neck righting (NOB)
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Onset age: 4-6 months Integration age: 5 years Stimulus: Place infant in supine and fully turn head to one side. Response: Log rolling of the entire body to maintain alignment with the head. Relevance: Maintains head/body alignment; initiates rolling (first ambulation effort).
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Body righting (on body) (BOB)
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Onset age: 4-6 months Integration age: 5 years Stimulus: Place infant in supine, flex one hip and knee toward the chest and hold briefly. Response: Segmental rolling of the upper trunk to maintain alignment. Relevance: Facilitates trunk/spinal rotation.
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Downward parachute (protective extension downward)
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Onset age: 4 months Integration age: persists Stimulus: Rapidly lower infant toward supporting surface while suspended vertically. Response: Extension of the lower extremities. Relevance: Allows accurate placement of lower extremities in.
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Forward parachute (protective extension forward)
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Onset age: 6-9 months Integration age: persists Stimulus: Suddenly tip infant forward toward supporting surface while vertically suspended. Response: Sudden extension of the upper extremities, hand opening, and neck extension. Relevance: Allows accurate placement of upper extremities in anticipation of supporting surface to prevent a fall.
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Sideward parachute (protective extension sideward)
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Onset age: 7 months Integration age: persists Stimulus: Quickly but firmly tip infant off-balance to the side while in the sitting position. Response: Arm extension and abduction to the side. Relevance: Protects body to prevent a fall; supports body for unilateral use of opposite arm.
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Backward parachute (protective extension backward)
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Onset age: 9-10 months Integration age: persists Stimulus: Quickly but firmly tip infant off-balance backwards. Response: Backward arm extension or arm extension to one side spinal rotation. Relevance: Protects body to prevent a fall; unilaterally facilitates.
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Prone tilting
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Onset age: 5 months Integration age: persists Stimulus: After positioning infant in prone, slowly raise one side of the supporting surface. Response: Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs. Relevance: Maintain equilibrium without arm support; facilitate postural adjustments in all positions.
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Supine tilting and Sitting tilting
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Onset age: 7-8 months Integration age: persists Stimulus: After positioning infant in supine or sitting, slowly raise one side of the supporting surface. Response: Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs. Relevance: Maintain equilibrium without arm support, facilitate postural adjustments in all positions.
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Quadruped tilting
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Onset age: 9-12 months Integration age: persists Stimulus: After positioning infant on all fours, slowly raise one side of the supporting surface. Response: Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs. Relevance: Maintain equilibrium without arm support; facilitate postural adjustments in all positions.
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Standing tilting
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Onset age: 12-21 months Integration age: persists Stimulus: After positioning infant in standing; slowly raise one side of the supporting surface. Response: Curving of the spine toward the raised side (opposite to the pull of gravity); abduction/extension of arms and legs. Relevance: Maintain equilibrium without arm support; facilitate postural adjustments in all positions.
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Exploratory play (categories of play)
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Age: 0-2 years -Child engages in play experiences through which the child develops a body scheme. -Sensory integrative and motor skills are also developed as the child explores the properties and effects of actions on objects and people. -Child plays mostly with parents/caregiver(s).
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Symbolic play (categories of play)
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Age: 2-4 years -Child engages in play experiences through which the child formulates, tests, classifies, and refines ideas, feelings and combined actions. -This form of play is associated with language development. -Objects that are manageable for he child in terms of symbolization, control, and mastery are preferred by the child. -Child is mostly involved in parallel play with peers and begins to become more cooperative over time.
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Creative play (categories of play)
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Age: 4-7 years -Child engages in sensory, motor, cognitive, and social play experiences in which the child refines relevant skills. -Child explores combination of actions on multiple objects. -Child begins to master skills that promote performance of school and work related activities. -Child participates in cooperative peer groups.
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Games (categories of play)
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Age: 7-12 years -Child participates in play with rules, competition, social interaction and opportunities for development of skills. -Child begins to participate in cooperative peer groups with a growing interest in competition. -Friends become important for validation of play items and performance, while parents assist and validate in the absence of peers.
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Creeping (gross motor skill)
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7 months: -Crawls forward on belly 7-10 months: -Reciprocal creep 10-11 months: -Creeps on hands and feet 11-12 months: -Creeps well
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Walking (gross motor skills)
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8 months: -Cruises sideways 8-18 months: -Walks with two hands held 9-10 months: -Cruises around furniture, turning slightly in intended direction 9-17 months: -Takes independent steps, falls easily 10-14 months: -Walking: stoops and recovers in play 11 months: -Walks with one hand held -Reaches for furniture out of reach when cruising -Cruises in either direction, no hesitation 15 months: -Able to start and stop in walking 18 months: -Seldom falls -Runs stiffly with eyes on ground
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Release (gross motor skills)
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0-1 month: -No release; grasp reflex is strong 1-4 months: Involuntary release 4 months: -Mutual fingering in midline 4-8 months: -Transfers object from hand to hand 5-6 months: -Two-stage transfer; taking hand grasps before releasing hand lets go 6-7 months: -One-stage transfer; taking hand and releasing hand perform actions simultaneously 7-9 months: -Volitional release 7-10 months: -Presses down on surface to release 8 months: -Releases above a surface with wrist flexion 9-10 months: -Releases into a container with wrist straight 10-14 months: -Clumsy release into small container; hand rests on edge of container 12-15 months: -Precise, controlled release into small container with wrist extended
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No attempt to grasp, but visually attends to object (Grasp of pellet: prone or sitting)
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3 months
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Raking and contacting object (Grasp of pellet: prone or sitting)
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6 months
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Inferior scissors grasp (Grasp of pellet: prone or sitting)
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7 months -raking object into palm with adducted totally flexed thumb and all flexed fingers, or two partially extended fingers
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Scissors grasp (Grasp of pellet: prone or sitting)
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8 months -between thumb and side of curled index finger, distal thumb joint slightly flexed, proximal thumb joint extended
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Inferior pincer grasp (Grasp of pellet: prone or sitting)
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9 months -between ventral surfaces of thumb and index finger, distal thumb joint extended, beginning of thumb opposition
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Pincer grasp (Grasp of pellet: prone or sitting)
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10 months -between distal pads of thumb and index finger, distal thumb joint slightly flexed, thumb opposed
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Fine pincer grasp (Grasp of pellet: prone or sitting)
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12 months -between fingertips or fingernails, distal thumb joint flexed
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Primitive squeeze grasp (Grasp of the cube)
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4 months -visually attends to object, approaches if within 1 inch, contact results in hand pulling object back to squeeze precariously against the other hand or body, no thumb involvement
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Palmar grasp (Grasp of the cube)
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5 months -fingers on top surface of object press it into center of palm with thumb adducted
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Radial-palmar grasp (Grasp of the cube)
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6-7 months -fingers on far side of object press it against opposed thumb and radial side of palm (6 months), with wrist straight (7 months)
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Radial-digital grasp (Grasp of the cube)
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8-9 months -object held with the opposed thumb and fingertips, space visible between (8 months) with wrist extended (9 months)
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Finger-to-palm translation (Manipulation skills)
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12-15 months -a liner movement of an object from the fingers to the palm of the hand; e.g., picking up coins
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Palm-to-finger translation (Manipulation skills)
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2-2 1/2 years -with stabilization, a linear movement of an object from the palm of the hand to the fingers; e.g., placing coins in a slot
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Shift (Manipulating skills)
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-a linear movement of an object on the finger surfaces to allow for repositioning of the object relative to the finer pads; e.g., separating 2 pieces of paper (3-5 years) -rolling a piece of clay into a ball (3-6+ years) -shifting on marker or pencil (5-6+ years)
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Simple rotation (Manipulation skills)
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2-2 1/2 years -the turning or rolling of an object held at the finger pads approximately 90 degrees or less; e.g., unscrewing a small bottle cap
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Complex rotation (Manipulation skills)
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6-7 years -the rotation of an object 360 degrees; e.g., turning a pencil over to erase
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In-hand manipulation with stabilization (Manipulation skills)
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6-7 years -several objects are held in the hand and manipulation of one object occurs, while simultaneously stabilizing the others; e.g., picking up pennies with thumb and forefinger while storing them in the ulnar side of the same hand
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Palmar-supinate grasp (Pre-writing skills)
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1-1 1/2 years -writing tool held with fisted hand, wrist slightly flexed and slightly supinated away from mid-position; arm moves as a unit.
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Digital-pronate grasp (Pre-writing skills)
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2-3 years -writing tool held with fingers, wrist neutral with slight ulnar deviation, and forearm pronated; arm moves as a unit
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Static tripod posture (Pre-writing skills)
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3 1/2-4 years -writing tool held with crude approximation of thumb, index, and middle fingers, ring and little fingers only slightly flexed, grasped proximally with continual adjustments by other hand, no fine localized movement of digit components; hand moves as a unit
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Dynamic tripod posture (Pre-writing skills)
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4 1/2-6 years -writing tool held with precise opposition of distal phalanges of thumb, index, and middle fingers, ring and little fingers flexed to form a stable arch, wrist slightly extended, grasped distally, MCP joints stabilized during fine, localized movements of PIP joints
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Shows interest in scissors (Stages of development of scissor skills)
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2-3 years
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Holds and snips with scissors (Stages of development of scissor skills)
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2-3 years
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Opens and closes scissors in a controlled fashion (Stages of development of scissor skills)
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2-3 years
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Manipulates scissors in a forward motion (Stages of development of scissor skills)
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3-4 years
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Coordinates the lateral direction of the scissors (Stages of development of scissor skills)
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3-4 years
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Cuts a straight forward line (Stages of development of scissor skills)
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3-4 years
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Cuts simple geometric shapes (Stages of development of scissor skills)
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3-4 years
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Cuts circles (Stages of development of scissor skills)
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3 1/2-4 1/2 years
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Cuts simple figure shapes (Stages of development of scissor skills)
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4-6 years
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Cuts complex figure shapes (Stages of development of scissor skills)
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6-7 years
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35 weeks of gestation or after (Oral-motor development)
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-jaw and tongue movements are strong enough to allow for feeding
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40 weeks of gestation (Oral-motor development)
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-rooting reflexes, gag and cough reflex are present for up to four months, protecting the airway and decreasing the chances of aspiration
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4-5 months (Oral-motor development)
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-munching occurs consisting of a phasic bite and release of a soft cookie
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6 months (Oral-motor development)
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-strong up and own movement of the tongue
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7-8 months (Oral-motor development)
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-beginning of the mastication of soft and mashed foods with diagonal jaw movement
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9 months (Oral-motor development)
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-lateral tongue movements make mastication of soft and mashed foot effective, able to drink from a cup; however, jaw is not firm
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12 months (Oral-motor development)
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-jaw is firm; there is rotary chewing allowing for a good bite on a hard cookie
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24 months (Oral-motor development)
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-able to chew most meats and raw vegetables `
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Evaluation of feeding
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-Parent interview including parent’s concerns, feeding history, behavior during feeding, weight gain or loss. -Medical and developmental history. -Observation of feeding including postural control, oral sensitivity; motor control of the jaw, lip, tongue, and cheek; and coordination and endurance of all. -Recommendation for videofluoroscopy swallow study especially if the child has a high rise of aspiration.
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Overall Development Assessments (Pediatrics)
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1. Denver Developmental Screening Test II 2. Bayley Scales of Infant Development. 3rd edition (BSID-III) 3. First STEP Screening Test for Evaluating Preschoolers 4. Hawaii Early Learning Profile, Revised (HELP) 5. Miller Assessment for Preschoolers (MAP) 6. Pediatric Evaluation of Disability Inventory (PEDI)
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Motor Assessments (Pediatrics)
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1. Bruininks-Oseretsky Test of Motor Proficiency (2nd ed.) (BOT-2) 2. Erhardt Developmental Prehension Assessment (EDPA) Revised and Short Screening Form (EDPA-S) 3. Peabody Developmental Motor Scales (2nd ed.) (PDMS-2) 4. Toddler and Infant Motor Evaluation (TIME)
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Visual Motor and Visual Perception Assessments (Pediatrics)
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1. Beery-Buktenica Developmental Test of Visual Motor Integration – VMI, 6th edition 2. Developmental Test of Visual Perception (2nd ed.) (DTVP-2) and Developmental Test of Visual Perception – Adolescent and Adult (DTVP-A) 3. Erhardt Developmental Vision Assessment (EDVA) and Short Screening Form (EDVA-S) 4. Preschool Visual Motor Integration Assessment (PVMIA) 5. Motor-Free Visual Perception Test (MVPT-3) 6. Motor-Free Visual Perception Test-Vertical (MVPT-V) 7. Test of Visual-Motor Skills (TVMS) and Test of Visual-Motor Skills: Upper Level (TVMS-UL) 8. Test of Visual-Perceptual Skills (3rd ed.) (TVPS3)
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Sensory Processing Assessment (Pediatrics)
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1. Sensory Profile (SP): Infant/Toddler Sensory Profile 2. Sensory Profile (SP): Adolescent/Adult Sensory Profile
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Psychological and Cognitive Assessments (Pediatrics)
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1. Childhood Autism Rating Scale (CARS) 2. Coping Inventory and Early Coping Inventory
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Play Assessments (Pediatrics)
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1. Play History 2. Revised Knox Preschool Play Scale (RKPPS) 3. Test of Playfulness (ToP) Revised Version 3.5 4. Transdisciplinary Play-Based Assessment (TPBA)
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Social Participation Assessments (Pediatrics)
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1. Participation Scale (P Scale) (Version 6.0) 2. School Function Assessment (SFA)
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Parallel Group
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18 months – 2 years -minimal awareness of or interaction with others
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Project Group
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2-4 years -limited in duration, cooperation, and sharing
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Egocentric Group
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9-12 years -cooperation, competition, longer in duration, builds self-esteem
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Cooperative Group
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9-12 years -compatible group, members concerned with meeting the needs of fellow members
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Mature Group
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15-18 years -differing roles, concerned with completion of task as well as meeting the needs of fellow members
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Cataracts
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-Opacity, clouding of lens due to changes in lens proteins; results in gradual loss of vision: central first, then peripheral; increased problems with glare; general darkening of vision; loss of acuity; distortion. -Surgery is an effective treatment
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Glaucoma
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-Increased intraocular pressure, with degeneration of optic disc, atrophy of optic nerve; results in early loss of peripheral vision (tunnel vision). -If untreated, it can progress to total blindness. -If diagnosis is made early, surgery and/or medications are effective treatments.
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Macular degeneration
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-Loss of central vision associated with age-related degeneration of the macula compromised by decreased blood supply or abnormal growth of blood vessels under the retina; typically individuals retain some peripheral vision; increased sensitivity to glare, and difficulty adjusting to light change; may progress to total blindness.
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Diabetic retinopathy
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-Damage to retinal capillaries, growth of abnormal blood vessels and hemorrage leads to retinal scarring and finally retinal detachment; central vision is impaired, vision is blurred; complete blindness is rare.
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CVA, homonymous hemianopsia
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-Loss of 1/2 visual field in each eye (nasal half of one eye and temporal half of other eye); produces and inability to receive information from right or left side; corresponds to side of sensorimotor deficit.
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Medications that may cause impaired or fuzzy vision
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antihistamines, anti-psychotics, anti-depressants, and steroids