«The newborn must adapt quickly to new environmental conditions and to autonomously manage neonatal functions»
He undergoes:
Regulation of the autonomic nervous system
Adaptation to sensory perceptions coming from inside and outside his body
Less contained and confined postural-motor system
Autonomous regulation of behavioral states of sleep-wakefulness
Attachment process
Main factors influencing psychomotor development
New synapses and experiential stimuli
There are "sensitive - vulnerable" periods during development
Main factors influencing psychomotor development
Neuronal plasticity
Ability to reorganize and restructure synapses as a function of changing environmental conditions;
Mechanisms that come into play following brain damage and are the basis of functional recovery;
It represents the basis of learning processes;
It is expressed more in developmental age
Overtime…..
«Motor learning is defined as an adaptive modification of motor behavior that leads to the stable acquisition of skills, implemented through a complex perceptual-motor-cognitive process, in the search for a solution to a task that emerges in the interaction between the individual and the environment»
1995
«Contact with the outside world, living immersed in the surrounding world, from which he receives and to which he is forced to give, is one of the essential conditions for his growth»
G., 1995
«Adapting to the new environment is in fact the first form of learning that the child has to face after birth»
Bottos, 2003
Woollacott M.H.
Sabbadini
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Clinical Objectivity
Instrumental Investigations
Evaluation of Functional Abilities
Evaluation of Adaptive Functions
FUNCTIONAL ABILITY EVALUATION
Systematic observation of the patient
Classification systems
Rating scales
Questionnaires
Video recording
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
VIDEO RECORDING
It is an essential methodological tool for documenting over time the evolution of the child's adaptive functions and his development potential, guiding the definition of enabling/rehabilitative training.
Method widely used both in clinical practice and in scientific research
Potential
Allows a longitudinal evaluation of individual paths
Il offers the possibility of grasping and generalising typifying forms of behavior on the basis of wich one can extraxt guidin criteria for a prognostic judgemnt
Limits
However, it involves a preliminary subjective judgmetn
Few and non-homogeneous protocols used
Method not always available
It allows for greater discussion with the parentabout the patient’s stregths
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
VIDEO RECORDING PROCEDURE
MULTIDISCIPLINARY INTEGRATED EVALUATION
Video recording General Movements 0-3 months
Video recording postural motor skills and Alberta Scale compilation
Video recording and evaluation of visual fuctions (orthoptist)
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
Video recording mother-child interaction-relationship (psychologist)
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording General Movements 0-3 months
Spontaneous motility
Video perspective Camera n° Setting Timing Activity
Full Body View 1 (horizontal plane) Patient positioned on the mat alone, with supervision and safely using nearby cuschions
2 minutes of video recording Spontaneous motility
VIDEO RECORDING PROCEDURE OF POSTURAL MOTOR SKILLS AND FUNCTIONS
18 MONTHS
Day Hospital di Neuroriabilitazione ed Attività Sportiva Adattata OPBG
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording postural motor skills and ALBERTA SCALE compilation
Prone, supine and sitting position
(frontal plane)
2 (sagittal plane)
3 (horizontal plane)
Patient positioned on the mat, with supervision and/or interaction from the therapist
Variable activation times based on the patient’s adaptation and spontaneous activation
Posture aimed at motor approach to the object and/or visual auditory attention to a target
2 (sagittal plane)
3 (horizontal plane)
Patient kept in an upright posizion by the therapist
Variable activation times based on the patient’s adaptation and spontaneous activation
Posture supported by visual /auditory attention to a target
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
ALBERTA SCALE compilation
AIMS (Alberta Infant Motor Scale)
Origin and year of publication: Canada 1990
Age target: 0-18 months
Test elements: Gross motor skills
Objective: identify delays in gross motor development, assess changes in motor skills over time following the child's maturation or an intervention, provide useful information for the drafting of the rehabilitation program
Administration method: conducted by a specialist
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
ALBERTA SCALE compilation
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Below are some of the most well-known scales on specific fuctional skills with respect to motor development:
AIMS (Alberta Infant Motor Scale) HINT (The Harris Infant Neuromotor Assessment) EMQ (The Early Motor Questionnaire)
PDMS-II (The Peabody Developmental Motor Scales) GMFM (Gross Motor Function Measure) GMFCS - Gross Motor Function Classification System
ATTENTION DO NOT SHARE THE VIDEOS AND IMAGES THAT WILL BE CONTAINED IN THE NEXT SILDES!
OPBG uses parental consent to video and photos, promotes respect for the privacy of the patient and his family
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording postural motor skills and ALBERTA SCALE compilation
INFANT 6 MONTHS
Right unilateral chianal atresia
Neuropsychiatric consulation in ENT
Total P. ALBERTA ; 5° percentile
SUPINE
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording postural motor skills and ALBERTA SCALE compilation
INFANT 6 MONTHS
Right unilateral chianal atresia
Neuropsychiatric consulation in ENT
Total P. ALBERTA ; 5° percentile
PRONE
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording postural motor skills and ALBERTA SCALE compilation
Infant 11 months
Delayed acquisition of motor stages
Sent by the pediatrician
Total p. ALBERTA: inferiori to 5° percentile
SITTING POSITION
Infatn 9 months Dealyed acquisition of motor stages
Neuropsychiatric consultation
Total p. ALBERTA: inferior to 5° percentile
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording postural motor skills and ALBERTA SCALE compilation
STANDING
Infant 2 and 15 days
Delay in postural –motor acquisitions
Sent by the pediatrician
Total p. ALBERTA: 5° percentile
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
VIDEO RECORDING PROCEDURE
MULTIDISCIPLINARY INTEGRATED EVALUATION
Video recording and evaluation of visual fuctions (orthoptist)
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording and evaluation of visual fuctions (orthoptist)
Observe and recognize the signs of risk of visual disorders in newborns and infants
Neurobehavioral signs
DIRECT
- Localization of light source
- visuoal attachment with a cotè gaze
-head movements towards a visual target
- stimulus tracking
-movement of the limbs towards the visual target
INDIRECT
-the «avoiding» or avoidance reaction;
-postural reactions;
- Facial expressions
-blinking of the eyelids
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording and evaluation of visual fuctions (orthoptist)
Infant 2 and 15 days
Delay in postural –motor acquisitions
Sent by the pediatrician
Total p. ALBERTA: 5° percentile
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording and evaluation of visual fuctions (orthoptist)
Infant 2 and 15 days
Delay in postural –motor acquisitions
Sent by the pediatrician
P. totale ALBERTA: 5° percentile
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording and evaluation of visual fuctions (orthoptist)
Vision- Test Lea Gratings
Infant 11 months
Delayed acquisition of motor stages
Sent by the pediatrician
Contrast Sensitivity- Test Hiding Heidi
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
VIDEO RECORDING PROCEDURE
MULTIDISCIPLINARY INTEGRATED EVALUATION
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
Adaptive functions
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
projection setting required skills
3/4 in front
zoom on the eyes
A: cot or carpet
B: suspended ball with transparent string and stick (length 30 cm, diameter 2 cm)
C: supine
D: stationary object placed on the median line and to the side; then three-dimensional cross movement with slow and fast movements, the bath must be placed first in a vertical position (perpendicular to the pinnacle) then horizontal to the child.
Reaching of the object on the space sectors
Mode of adaptation of the upper limb to the characteristics of the object
Hand eye coordination
Infant 4 months
Dealayed acquisition of motor stages
Sent by pediatrician
Total p. ALBERTA: 5° percentile
3/4 in front
A: On the carpet (near the mother)
B:Interesting gift for the child
C: supine
D:Initially without the object, then move or operate the object placed to the side or above, attracting the child's interest to evoke or facilitate a pivoting, rolling, crawling and possible transition to a sitting posture.
Postural adaptation
Characteristics of motor activity (variability or stereotype, prevalence distribution pattern)
Initiation, finalization and persistence in voluntary activity
Compensatory strategies with possible exploitation of pathologies
Monitoring mode
visual range
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
projection setting
3/4 in front
3/4 from above (height 1.5 m) distance approximately 1 m zoom on the eyes
A: carpet or floor
B: interesting object
C: sitting
D: place the object to the side, at a distance incompatible with the possibility of catching it while standing still, invite the child to take it to induce movements in the environment ("shuffling", switching to prone and/or all-over positions)
A: chair with non-slip surface; with or without armrests, of a height such that the feet are on the ground; with or without a table spreader at elbow height, possibly with a recess
B: interesting objects related to the child's skills: rattle, doll, telephone, cup with spoon, container with cubes, bottle with screw cap, beads to string, interlocking barrels or matryoshkas, interlocking board, marker with cap and blank sheets of paper, cardboard book, etc.
C: sitting posture that allows the greatest possible freedom in the use of the upper limbs, with a stable trunk and flexion of the hips
D: propose to the child the choice of the sequence of play and spontaneous use of objects; if necessary facilitate the activity with verbal suggestion or imitation of a model of a still object placed on the median line and to the side; subsequently three-dimensional cross movement with first slow then fast movement; the object must be placed first in a vertical position (parallel to the sagittal plane) and then horizontally with respect to the child
required skills
Characteristics of motor activity (variability or stereotypy, prevalence and pattern distribution)
Initiative, finalization and persistence in voluntary activity
Compensatory strategies with possible exploitation of the pathology
Approach method, grasping and releasing
Adaptation (proximal and distal) of the upper limb to the characteristics of the object
Manual preference
Hand-eye coordination
Bimanual coordination Initiative, finalization and persistence of the manager
Practical organization
Problem solving strategies (ability to search for alternatives, to exploit the pathology, etc.)
Verbal and gestural comprehension and communication, contextual
Visual tracking
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording adaptive fuctions (some facilitated tests GPCI protocol)
Infant 9 months
Delayed acquisition of motor stages
Sent by pediatrician
Total p. ALBERTA: 5° percentile
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Adaptive fuctions
ASQ (The Ages and Stages Questionnaire) III
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
VIDEO RECORDING PROCEDURE
MULTIDISCIPLINARY INTEGRATED EVALUATION
Video recording mother-child interaction-relationship (psychologist)
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Video recording mother-child interaction-relationship
Infant 9 months
Delayed acquisition of motor stages
Sent by pediatrician
Total p. ALBERTA: 5° percentile
Administration Scale Griffiths III
Adaptive behavior is a distict but related construct to developmental quotient (DQ)
EVALUATION OF NEUROPSYCHOMOTOR DEVELOPMENT
Assessment of integration skills between functional systems
Le Griffiths’ scales of child development third edition (Griffiths III)
Scale A - Learning Basics: aims to explore the basics of learning by analyzing the level of understanding achieved by the child in exploring objects. It also evaluates working memory and executive functions.
Scale B - Language and communication: evaluates language development.
Scale C - Hand-eye coordination: evaluates visual-motor, fine-motor, speedmovement, strength and grip skills.
Scale D - (Personal-social-emotional): development of the self, interaction, autonomy.
Scale E - Gross motor: evaluates postural, gross motor, resistance, balance and rhythm skills.
Take Home Messagge
EMOTIONAL DEVELOPMENT
MOTOR DEVELOPMENT
Follow up di Screening and evolutionary monitoring
Parent Support and Enriched Environment
SENSORY DEVELOPMENT
NEUROPSYCHOMOT OR DEVELOPMENT
COGNITIVE DEVELOPMENT
Interventi di chirurgia ambulatoriale pediatrica
SOCIALRELATIONAL DEVELOPMENT
FAMILY CENTERED APPROACH TO INTERVENTATION
Developmental Disability: Families and Functioning in Child and Adolescence.
•Rosenbaum P.
Frontiers in rehabilitation sciences volume 2, 2021
FAMILY CENTERED APPROACH TO INTERVENTATION
We believe it is really important to provide educational information material and an exchange of videos/photos provided by the families themselves on moments of daily life.
Thank You!!!!
Vite che aiutano la Vita
Il presente documento è stato elaborato in n.xx slide da Ospedale Pediatrico Bambino Gesù il xxxxxx.
I contenuti sono strettamente riservati; è vietata la riproduzione e la divulgazione, anche solo parziale, senza il benestare scritto di Ospedale Pediatrico Bambino Gesù.
