Grasp Development

• spontaneous grasp and release

• Palmar grasp reflex

Other Reflexes

• Rooting reflex (head turns to direction face/cheek is being touched)

• Asymmetric Tonic Neck Reflex (ATNR -- head turns to same side arm is in extension; contralateral arm in flexion)

• Galant reflex (lateral trunk flexion to same side as touched along spine -- integration by 2 months)

• Positive support reflex (legs and trunk into extension when weight on balls of feet -- integration by 2 months)

• Stepping reflex (reciprocal stepping in supported upright position -- integration by 2 months)

• Startle reflex (loud noise causes UE abduction and elbow flexion)

• Moro reflex (sudden head drop causes UE abduction)

Advanced Motor Movements

• Extension starts to develop from the neck down

• Can lift head 45 degrees from supporting surface

• Starting to support self on forearms

• Random leg and arm motions in supine

• Hands start to open during first month

Other

• Eyes and hands start to "link" -- allows for some reaching and grasping

• Body may rotate with head as one unit (primitive neck righting reflex)

• Mostly continues to use Palmar grasp reflex

Primitive Reflex Integration

• Rooting reflex should be integrated

Advanced Motor Movements

• Head control:

  • Can lift head in midline past 90 degrees in prone

  • Head in midline in supine

  • Hands together at midline (lots of "aha" moments & can bring objects to mouth)

  • When pulled to sit and tilted in any direction, head is in midline with body

• Some pelvic mobility begins

  
  

• Raking motion

Primitive Reflex Integration

• Moro and startle reflexes should be integrated

Advanced Motor Movement

• Lifts head against gravity from supine

• Works to keep head from moving backward when being lowered to supporting surface

• During pull to sit -- head leads movement with chin tuck (may reinforce with trunk flexion)

• Can bring feet in front of face (helps lengthen hamstrings and strengthen abdominals)

• Reciprocal kicking

• More extension in prone ("swimming")

• Leg and arm extension and can hold up off supporting surface

• Sit with support (may stabilize with one arm while reaching with other)

  
  

• Voluntary palmar grasp

Primitive Reflex Integration

• ATNR and Tonic Labrinthe Reflex should be integrated

Advanced Motor Movements

• Mobility in prone

• Shift weight to one extended arm while reaching forward with other

• Landau reflex -- in prone: max extension of head and trunk along with abduction of limbs away from body

• Segmental rolling (prone<>supine; supine<>prone)

• Sit unsupported (may implement "W sitting" b/c of increased stability)

• Can use arms and hands to play with toys while seated (extend arms forward for protection if looses balance)

• Pull to sit -- infant may pull all the way to standing

Like to WB on feet (may bounce or rock back and forth)

Other

• Bang and shake objects/toys

• Radial palmar grasp -- thumbs begin to adduct -- radial side of hand & thumb used to pick up objects

Advanced Motor Movements

• Greater trunk strength, stability and control

• Can narrow base of support (adduct LE) while sitting

• Reaches laterally if looses balance

• Transfers objects from one hand to another

• Increased trunk rotation

• Increased segmental motion (less as a whole body)

• More complex movements (arms move across midline, supinated reaching)

Move movement in general:

• From side-lying can move in and out of sitting

• "Bear walking" -- WB on hands and feet and "tries" to walk after pushing backwards on hands

• "Hitching" -- scoots on bottom with or without hand support

• Use "pushing" for locomotion -- in prone they may "push" themselves backward while performing random LE movements

• Plantar Grasp

Grasp Development

• Radial-digital grasp

Advanced Motor Movements

• Changing positions constantly

• Moving in and out of sitting

  • Side sitting

• Moving into four-point position and reciprocal movements

• Creeping

• Pulling up into standing position using crib railing or furniture/leans against support surface

• Equilibrium reactions of feet (toes alternately claw floor/ flare upward) when standing to assist w/ balance

• Practices dissociating arm w/ leg movements when in standing

• Cruising: sideways "walking" w/ arm support on furniture

Primitive Reflex Integration

• Symmetric tonic neck (8-12 months)

Grasp Development

• Inferior Pincer (10-12 mo)

• Superior Pincer

• Three-jaw chuck

Advanced Motor Movement

• Attempts forward locomotion

  • Caregiver hand hold/infant walker

  • First attempts at walking are lateral weight shifts w/ arms in high guard (arms held high w/ scapula adducted/shoulders ER & abducted/elbows flexed/wrist & fingers extended) which results in strong extension of upper back

  • As an upright trunk is more easily maintained, arms are lowered to midguard (hands at waist level/shoulders ER), to low guard (shoulders more neutral/elbows extended), & finally to no guard

    • Hips/knees are slightly flexed to bring COM closer to ground

    • Minimal ankle movements w/ whole foot contacting ground

    • Walk slowly w/ small steps & short amount of time spent in single-limb stance

• Toddler is at ease w/ walking & can carry/pull a toy at the same time

• Demonstrate a "running-like" walk

• Goes up/down stairs 1 step at a time with help

• Independently creeps up the stairs & may creep/scoot down on buttocks

• Walk sideways and backward

• Stands from supine position by rolling to prone, pushing up on hands and knees or hands and feet, assumes a squat position, and rises to standing

• Falls decline due to improved balance reactions in standing and ability to monitor trunk/LE movements kinesthetically and visually

• First signs of jumping: stepping off "jump" from a bottom stair

• Exhibit reciprocal arm swing & heel strike by 18 months

• Momentary balance on 1 foot

• Gait becomes faster, arms swing reciprocally, steps are bigger, and single-limb stance time increases

• Ascend/descend stairs 1 step at a time

• Jump off step w/ two-foot take-off

• Kick a large ball

• Throw a small ball

• Stepping over low objects

• True running: both feet off the ground at same time

  • Cannot stop/start quickly

  • Directional changes require large areas

• Jumping off the ground: 1 foot leaves the ground, followed by the other

3 Years

• Fundamental motor patterns (hopping, galloping, skipping) begin to develop

• Reciprocal actions are mastered: pedaling tricycle/climbing ladder or jungle gym

• Locomotion can be started/stopped based on demands from environment: playing dodge ball on crowded playground

• Makes sharp turns while running

• Balances on toes & heels in standing

• Tandem balance

• Single-leg balance for 3 sec

• Reciprocal gait pattern used to ascend stairs/descending stairs 1 step at a time

• Increased jumping abilities

  • Running broad jump

  • Standing broad jump

• Hopping 1-2 times on preferred foot by 3 1/2

4 Years

• Rhythmic relaxed galloping

• Improved static & dynamic balance (single-leg balance 4-6 sec)

• Descend stairs w/ alternating feet

• Catch a small ball w/ outstretched arms

• Throw ball overhand from some distance

• Improved striking abilities: overhand/sidearm/underhand or kicking

• Balance on either foot 8-10 sec

• Walk forward on balance beam

• Hop 8-10 times on 1 foot

• Standing broad jump 2-3 feet

• Skip on alternating feet

• Can change directions/stop quickly while running

• Ride bike

• Roller-skate

• Hit a target w/ ball from 5 feet away

6 Years

• Well coordinated

• Single-leg balance for more than 10 sec EO/EC

• Can throw/catch small ball from 10 feet away

• Walk on balance beam forward, sideways, backward

• Patterns of movement learned in game-playing form basis for later sports skills