Professional Documents
Culture Documents
I MH 201 Lecture 8 Handouts
I MH 201 Lecture 8 Handouts
Lectures on Neurodevelopmantal Therapy and Sensory Integration presented by Rosemary White, 1980 to present. Motor Control Translating Research into Clinical Practice p p p.187 - 209 Chapter 8; Development of Postural Control; p The Components of Normal Movement During the First Year of Life and Abnormal Movement, Lois Bly 1983 Monograph, Neuro-Developmental Treatment Association; p. 1 - 40
10/30/2008
Elicited by stimulation to
Proprioceptors in the neck, vestibular To a lesser degree visual and auditory
10/30/2008
Phasic Reflexes/Reactions
Moro Reflex When the child is displaced backwards in space there is an increase in extensor tone in the extremities followed by a return to flexions (vestibular.)
Startle Reflex When there is a sudden sound the infant will have an increase in extensor tone in the extremities and then a return to flexion (auditory.)
Galant Reflex When there is tactile stimulation down the side of the spinal cord the infant will have contractions of the muscles on that side of the trunk leading to lateral flexion and then return to neutral (tactile.)
Stepping Reflex When an infant is held upright with his or her feet placed on a surface, he or she will lift their legs as if they are marching or stepping (touch pressure to the foot).
Righting Reactions
Orientation of head within space, and orientation of the head to the body and ground.
Neck Righting - Rotation of the head and neck and the body follows with no segmentation. Labyrinthine - Orientation of the head within space to bring the nose o e ca positon, ou o o a e a e o gravity. Sensory into a vertical pos o , mouth horizontal relative to g a y Se so y system that influences this is the vestibular. Body on Head - Body responds and re-aligns to movement of the head. Sensory system that influence this are somatosensory in neck, but also visual and auditory can influence. Head on Body - Head and neck respond and re-align to movement initiated by the body. Sensory system that influences this is primarily the somatosensory (proprioception and tactile.) Body on Body - Body parts respond to one another and with regard to orientation to the ground. Sensory system that influences this is the primarily the somatosensory. Optical Righting - Orientation of the neck and body within space using visual input.
SEGMENTATIONSENSORY STIMULUS
None Proprioceptive Tactile Vestibular Vestibular Utricle Saccule Proprioceptive Tactile Vestibular S.C.C Utricle and Saccule. Cerebellum
Neck
Trunk
Proprioceptive and Tactile Vestibular S.C.C. Utricle and Saccule Cerebellum Visual Optical System ? Vestibular
10/30/2008
EQUILIBRIUM REACTIONS
Reactions that serve to maintain or regain balance once the center of gravity has been displaced. Develop in a plane, or during a movement pattern, after all the righting reactions have developed as an equilibrium reaction developed, is made up of all of the righting reactions working together in the presence of normal muscle tone. There are two types of equilibrium reactions:
i. ii. When you move on a stable surface- walking, climbing stairs or really any movement pattern in which you maintain control. When you are stable, but the surface upon which you are supported moves- in a bus, or car, or boat.
EQUILIBRIUM REACTIONS
Equilibrium Reaction
STATIC Support Surface moves (carry, car, Rx Ball) Align center gravity over base of support Proximal/Distal kinesiological aspect of control Begin 6 months prone continues to develop in all positions to 6-7 years DYNAMIC Support surface stable but body moves (roll, crawl, walk, climb, in Rx facilitate thru transitions)
Bring base of support under center of gravity Distal/proximal kinesiological aspects of control
Segmentation
All levels as all righting reactions working together
Sensory System
Proprioceptive Tactile Vestibular Visual Initiating sensory stimulus is from external source
Proprioceptive Tactile Vestibular Visual Initiating sensory stimulus is from internal source
10/30/2008
Postural Adaptation
Muscle Development
Visual Tactile Proprioceptive Vestibular
10/30/2008
*Role of Reflexes
Controversial Some researchers believe that reflexes are the substrates for motor control.
Th ATNR i th b i f eye h d co-ordination The is the basis for hand di ti while others disagree. Righting reactions are the basis for rolling in infants. Are these postural patterns a reflection of neurological maturation - hence as movement emerges they reflect the integration of sensory, affective, emotion maturation?
*Systems Theory
Interaction of the child with the environment
Changes in the musculoskeletal system. Balance of neuromuscular structures. Development of sensory systems. Integration of sensory systems. Internal representations -> mapping of perceptions to action. Considered essential for comparisons, interpret self motion and calibrate motor actions. Adaptive and anticipatory mechanisms -> child modifies the way they sense and move.
Thus the path from sensation to motor actions proceeds via an internal representation structure or body schema (Gurfinkel & Levik, 1978, Hirschfield, 1992)
10/30/2008
10/30/2008
10/30/2008
10/30/2008
Systems theory suggests that the time course for emerging stability is different in each of the sensory systems.
Visual inputs relating the bodys position in space map to muscular action controlling the bodys position during stance emerges earlier than the somatosensory, and the vestibular is not yet known.
10
10/30/2008
11
10/30/2008
12
10/30/2008
Refinement in the sensory aspects of postural control include A shift from predominance of visual control of balance to a somatosensory control of balance by age 3. The ability to adapt senses for postural control appropriately is reduced, in children under 7, when one or more of these senses (visual, somatosensory, vestibular) is inaccurately reporting body orientation information. The ability to perform both postural and cognitive tasks in dual task situation is reduced in children under 7.
Was there something missing in this research when we compare the results of the research to babies responses in the natural environment ? What are the contributors to infants amazing capacities?
13
10/30/2008
14