PAEDIATRIC PHYSIOTHERAPY
REVIEWS WITH ANSWERS.
Gestational age (GA) - Answers-How many weeks gestation the baby was when they
were born
EDB/EDA - Answers-Estimated date of birth/arrival
When is a fetus considered viable? - Answers->23 weeks gestation
At how many weeks is a baby called premature? - Answers-< 37 weeks
At how many weeks is a baby called a 'term baby' - Answers-37-40 weeks
Plurality - Answers-Multiple births
Term for 0-4 week y/o - Answers-Neonate/newborn
Term for 4 week - 1 y/o - Answers-Infant/baby
Term for 1-2 y/o - Answers-Toddler
Term for 3-5 y/o - Answers-Pre-scholar
Term for 6-12 y/o - Answers-School aged child
Term for 13-18 y/o - Answers-Adolescent
LBW - Answers-Low birth weight
SGA - Answers-Small for gestational age
IUGR - Answers-Intrauterine growth retardation
HIE - Answers-Hypoxic ischemic encephalopathy - type of brain damage that occurs
when an infant's brain doesn't receive enough O2 and blood
NICU - Answers-Neonatal intensive care unit
SCN - Answers-Special care nursery
HDU - Answers-High dependency unit
PICU - Answers-Paediatric intensive care
,TPN - Answers-Total paternal nutrition - the feeding of a person intravenously,
bypassing the usual process of eating and digestion, Person receive nutritional
formulae.
TPT - Answers-Transpyloric tube - tube placed via the nose into the upper small bowel
BD - Answers-Twice per day
TDS - Answers-3 time a day
PRN - Answers-Whenever needed
What are the expected abilities of children described in terms of? - Answers-Gross
motor skills
Fine motor skills
Self-help skills
Speech and language
Cognitive skills
Typical motor development - Answers-Motor development and bone and soft tissue
growth that goes with it are driven in healthy babies by their own active attempts to
master the movement of their limbs
Motor learning: acquisition of skill, involves practice and exercise. Cannot be directly
observed but inferred by observation of consistent improvement in performance -
acquisition and/or modification of movement
Motor control: the way the body and its nervous system work together to produce
purposeful movements that is coordinate over a variety of environments - nature and
control of movement ALREADY acquired
When is functional head control achieved? - Answers-2 months - begin to hold head in
midline (head needs to be fully support for 6 WEEKS - head lag)
3 months - hold in midline, turn head, lift head when on stomach
4 months - head control in sitting
5 months - head lag testing stopped
When is independent sitting achieved? - Answers-6 weeks - can sit with help (rounded
spine)
3 months - can sit with help (rounded spine), but can turn head
,4 months - straighter back, still needs assistance, can lift head
5 months - not enough support to fully sit by self (reaching can throw off balance)
6/7 months - sitting independently, wide BOS, can lean a little bit and reach (within
BOS)
When is reaching achieved? - Answers-Attempt reaching as soon as born
7 weeks: look at objects, batting at objects
4 months: reach with both hands and grasp
Developmental milestone: grasp/manipulation - Answers-Palmar grasp - reflex, after 4-5
months: stops being a reflex, starts being a purposeful movement
6 months: raking, pulling things towards them
8 months: combined reaching and manipulation e.g. Feeding
9 months: pincer grasp - 'pick up blueberries', poking and pointing
Developmental milestone: locomotion - Answers-Variability in achievement in terms of
rate, quality, sequencing
Primary standing - standing reflex
Stepping - stepping reflex, scraping foot on surface will initiate a step
Astasia/abasia = collapsing of knees, unable to take weight = NORMAL
3/4 months - bears weight
6 months - bounces, creeping/commando crawling
3-6 months: roll prone to supine
4-7 months: rolls supine to prone
9 months: crawling, bear walking (lifting knees when crawling) pull to standing, dragging
on arm, cruising
Walking - support - Answers-6 week: WB through standing reflex
3 months: collapsing (astasia/abasia)
4 months: WB with support
5 months: reduced support, stronger torso
7-9 months: pulling self to standing by dragging
9 months: pulled to standing from half kneeling (still using support)
12-15 months: stand up and walking without problem
Independent walking - Answers-15 months: more stable gait, can turn, still wide BOS
17 months: can bend, walk sideways, can pull things, turn around, squat
, 18 months: walk/run (fast walk), starting to climb, can walk up hills and on unstable
ground
24 months: runs
What are infantile (PRIMITIVE) reflexes? - Answers-First 3 months of life = integral part
of movement
They all should be integrated in the first year of life (should no longer be a reflex, should
be a controlled movement)
Automatic reflex actions in response to stimuli and are mediate from the BRAINSTEM-
present at BIRTH, most suppressed within first 6 months - naturally inhibit 4-6 months -
voluntary movements start to dominate and postural reflexes emerge to control balance
and coordination
What is suspected if primitive reflexes last beyond 6 months? - Answers-Abnormal
neurologically
Further investigation for cerebral palsy and other neurologically based conditions
Persistence will interfere with typical development and the normal acquisition of motor
skills
EXAMPLE
> Stepping reflex may be retained longer than expected when parents facilitate this
reflex to promote walking at too early an age i.e. 5-7 months
> The ATNR and the TLR have been shown to have maximum strength at 2-4 months
age and then fade - clinically these two primitive reflexes have been considered the
most sensitive indicators of early motor abnormality
Simple screening test for early identification of infants at risk for cerebral palsy -
Answers-Screening test to detect any retained primitive reflexes and abnormal postural
reactions
Galant reflex - Answers-Tested at birth to rule of SpC damage/brain damage
Integrated: 4 weeks
Prone over palm of hand, thumb beside spine from shoulder to buttocks, reflex indicated
by lateral flexion towards stimulus
moro (startle) reflex - Answers-Primitive fight/flight reflex
Integrated 2-4 months
Sudden extension and abduction of UL's with opening hands followed by flexion of UL's
to the midline following brief drop of head (lessened support to infants head in semi
sitting position)
Rooting reflex - Answers-Assists with feeding - stroking babies cheek, automatically turn
head and open mouth
Integrated 2-3 months
Stepping reflex - Answers-Integrated: 2-4 months
REVIEWS WITH ANSWERS.
Gestational age (GA) - Answers-How many weeks gestation the baby was when they
were born
EDB/EDA - Answers-Estimated date of birth/arrival
When is a fetus considered viable? - Answers->23 weeks gestation
At how many weeks is a baby called premature? - Answers-< 37 weeks
At how many weeks is a baby called a 'term baby' - Answers-37-40 weeks
Plurality - Answers-Multiple births
Term for 0-4 week y/o - Answers-Neonate/newborn
Term for 4 week - 1 y/o - Answers-Infant/baby
Term for 1-2 y/o - Answers-Toddler
Term for 3-5 y/o - Answers-Pre-scholar
Term for 6-12 y/o - Answers-School aged child
Term for 13-18 y/o - Answers-Adolescent
LBW - Answers-Low birth weight
SGA - Answers-Small for gestational age
IUGR - Answers-Intrauterine growth retardation
HIE - Answers-Hypoxic ischemic encephalopathy - type of brain damage that occurs
when an infant's brain doesn't receive enough O2 and blood
NICU - Answers-Neonatal intensive care unit
SCN - Answers-Special care nursery
HDU - Answers-High dependency unit
PICU - Answers-Paediatric intensive care
,TPN - Answers-Total paternal nutrition - the feeding of a person intravenously,
bypassing the usual process of eating and digestion, Person receive nutritional
formulae.
TPT - Answers-Transpyloric tube - tube placed via the nose into the upper small bowel
BD - Answers-Twice per day
TDS - Answers-3 time a day
PRN - Answers-Whenever needed
What are the expected abilities of children described in terms of? - Answers-Gross
motor skills
Fine motor skills
Self-help skills
Speech and language
Cognitive skills
Typical motor development - Answers-Motor development and bone and soft tissue
growth that goes with it are driven in healthy babies by their own active attempts to
master the movement of their limbs
Motor learning: acquisition of skill, involves practice and exercise. Cannot be directly
observed but inferred by observation of consistent improvement in performance -
acquisition and/or modification of movement
Motor control: the way the body and its nervous system work together to produce
purposeful movements that is coordinate over a variety of environments - nature and
control of movement ALREADY acquired
When is functional head control achieved? - Answers-2 months - begin to hold head in
midline (head needs to be fully support for 6 WEEKS - head lag)
3 months - hold in midline, turn head, lift head when on stomach
4 months - head control in sitting
5 months - head lag testing stopped
When is independent sitting achieved? - Answers-6 weeks - can sit with help (rounded
spine)
3 months - can sit with help (rounded spine), but can turn head
,4 months - straighter back, still needs assistance, can lift head
5 months - not enough support to fully sit by self (reaching can throw off balance)
6/7 months - sitting independently, wide BOS, can lean a little bit and reach (within
BOS)
When is reaching achieved? - Answers-Attempt reaching as soon as born
7 weeks: look at objects, batting at objects
4 months: reach with both hands and grasp
Developmental milestone: grasp/manipulation - Answers-Palmar grasp - reflex, after 4-5
months: stops being a reflex, starts being a purposeful movement
6 months: raking, pulling things towards them
8 months: combined reaching and manipulation e.g. Feeding
9 months: pincer grasp - 'pick up blueberries', poking and pointing
Developmental milestone: locomotion - Answers-Variability in achievement in terms of
rate, quality, sequencing
Primary standing - standing reflex
Stepping - stepping reflex, scraping foot on surface will initiate a step
Astasia/abasia = collapsing of knees, unable to take weight = NORMAL
3/4 months - bears weight
6 months - bounces, creeping/commando crawling
3-6 months: roll prone to supine
4-7 months: rolls supine to prone
9 months: crawling, bear walking (lifting knees when crawling) pull to standing, dragging
on arm, cruising
Walking - support - Answers-6 week: WB through standing reflex
3 months: collapsing (astasia/abasia)
4 months: WB with support
5 months: reduced support, stronger torso
7-9 months: pulling self to standing by dragging
9 months: pulled to standing from half kneeling (still using support)
12-15 months: stand up and walking without problem
Independent walking - Answers-15 months: more stable gait, can turn, still wide BOS
17 months: can bend, walk sideways, can pull things, turn around, squat
, 18 months: walk/run (fast walk), starting to climb, can walk up hills and on unstable
ground
24 months: runs
What are infantile (PRIMITIVE) reflexes? - Answers-First 3 months of life = integral part
of movement
They all should be integrated in the first year of life (should no longer be a reflex, should
be a controlled movement)
Automatic reflex actions in response to stimuli and are mediate from the BRAINSTEM-
present at BIRTH, most suppressed within first 6 months - naturally inhibit 4-6 months -
voluntary movements start to dominate and postural reflexes emerge to control balance
and coordination
What is suspected if primitive reflexes last beyond 6 months? - Answers-Abnormal
neurologically
Further investigation for cerebral palsy and other neurologically based conditions
Persistence will interfere with typical development and the normal acquisition of motor
skills
EXAMPLE
> Stepping reflex may be retained longer than expected when parents facilitate this
reflex to promote walking at too early an age i.e. 5-7 months
> The ATNR and the TLR have been shown to have maximum strength at 2-4 months
age and then fade - clinically these two primitive reflexes have been considered the
most sensitive indicators of early motor abnormality
Simple screening test for early identification of infants at risk for cerebral palsy -
Answers-Screening test to detect any retained primitive reflexes and abnormal postural
reactions
Galant reflex - Answers-Tested at birth to rule of SpC damage/brain damage
Integrated: 4 weeks
Prone over palm of hand, thumb beside spine from shoulder to buttocks, reflex indicated
by lateral flexion towards stimulus
moro (startle) reflex - Answers-Primitive fight/flight reflex
Integrated 2-4 months
Sudden extension and abduction of UL's with opening hands followed by flexion of UL's
to the midline following brief drop of head (lessened support to infants head in semi
sitting position)
Rooting reflex - Answers-Assists with feeding - stroking babies cheek, automatically turn
head and open mouth
Integrated 2-3 months
Stepping reflex - Answers-Integrated: 2-4 months
