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SEQUENCES OF DEVELOPMENT:

The First Trimester of Development

M Tshabalala

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DEVELOPMENT OF LOCOMOTION:

VENTRAL SUSPENSION

A Newborn held in prone position with the hand under the abdomen,

almost complete lack of head control is observed.

At 6 weeks begins to momentarily hold the head in plane of the body

At 8 weeks maintain position & at 12 weeks head held beyond the

plane of the rest of body

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Development of Head controlFirst 4 weeks: complete head-lag, PTS

Newborn baby: PTS shows head lag

2 months: head lag not complete, PTS 3 - 4 mo: slight to NO Head lad

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One Month (First 4 weeks):

At 4 wks, gravity and development of ext. reduce

physiological flexion, baby more extended

Head lifting in prone is improved, and wt is shifted

caudally, thus improving head controlNeck flexion in supine appear minimal during PTS,

indicates that muscles are elongated by gravity and dev. Of

active extension

NB: Antigravity action of muscles not yet developed!

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One Month (4 weeks)

Gross Motor: Ventral suspension (VS) Elbows flexed, hips partly

extended, knees flexed.

Prone:pelvis high, kns under abdomen. Momentarily lifts chin off the

couch. Head predominantly turned to one side.PTS: almost complete head lag,

Supine: ATNR seen at rest

Held in standing: flops at kns and hips. Walking reflex when sole of foot

stimulated.

Hands: mostly fisted, Grasp reflex evident.

General Understanding: watches mothers face when spoken to.

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TWO MONTHS (8 WEEKS):

Stage ofasymmetry characterized by hypotonia, thus the child has

decreased flexion and increased extension

Physiological flexion significantly reduced by gravity and extensor activity

Extensor activity not yet balanced by active antigravity flexion

Prone: hips more ext, pelvis closer to the surface at rest.

This decreases fwd wt shift, making head turning & lifting easier, but the head

cannot be maintained in midline during ext. The hands wt-bear a little due to

increased active shoulder abd.

6 8 wks: Hips ext, pelvis flat 8 wks: chin off the couch

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TWO MONTHS (8 WEEKS)

Supine: the head rotates predominatly to one side due to effects of

gravity and unilateral activity of neck extensors without counter flexor

activity.

This simulates ATNR, which is seen in babies with more ext. tone.

Hands: frequntly open, grasp reflex disappearing. Hand eye regard and

uncontrolled swiping at the toys.

Vision: follows moving person, in supine can focus on objects beyond

midline.

Communication: makes cooing sounds using his mouth , these arevowels, smiles and vocalizes when spoken to.

Social dev: more arlet, 1st smile at familiar faces. Bright colours excites

child and encourage progress.

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THREE MONTHS (12 WEEKS)

3rd Month: Characterized by beginning of symmetry & bilateral control ofneck muscles

Antigravity flexor activity of the head and upper trunk region evident

Midline orientation of head, eyes and hand developing

ATNR less frequently stimulatedGross motor: VS- head conrol much improved, held in same plane of the

body

Prone: neck ext followed by trunk ext when lifting and turning the head.Achieve puppy prone since trunk extensors & chest flexors are activatedat humerus. Thus develop stability. Pelvis flat on couch, marked hip ext.

rot.during spinal ext background for Lx spine hyperextension &ant.pelvic ext

There is also foot on foot contact play future standing & body awareness

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THREE MONTHS (12 WEEKS)

Supine: beginning of symmetry evident. Head frequently in midline, thus

less ATNR. Babys UL rest on the chest and hands come together. Body

awareness improved, also feet come feet come together as in prone.

PTS: slight or no head lag.

Held in sitting: head held up, may still bob. Baby still dev trunk

control, thus back becomes rounded.

Vision: has hand regard, follows dangling toys through 1800, looks at

objects in midline.

NB:Neck flexor action, facilitate action oftrunk flexors, thus antigravity flexion dev

in a cephalo-caudal direction!

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Three Months: continued

Communication: squeals with anger or delight. Progress from vowelsounds to consonant sounds at this stage he gurgles.

e.g. Ahroo

GrooKroo

Ahgroo

Social dev: open to outside world, prolonged vocalization, mimicry.Cries rarely and not during daytime. Uses body language to beunderstood. Has established sleeping habits. Could start to beweaned.

Takes an interest in his hands, puts them in his mouth & sucks them forlong periods. Oral contact allows him sensory stimulation.

Stage of mouthing to explore objects!