Journal Article•
The Development of the Infant and Young Child, Normal and Abnormal
01 Aug 1970-Journal of the Royal Society of Medicine (Royal Society of Medicine Press)-Vol. 63, Iss: 8, pp 852-853
TL;DR: Professor Illingworth concludes that developmental tests in infancy are of great value in that they can detect mental retardation and neurological conditions with a considerable degree of accuracy and there is little evidence that mental superiority can be detected at this early age.
Abstract: IN this new book Professor Illingworth is principally concerned with applying the fundamental and pioneering observations of Dr. Arnold Gesell and others to everyday paediatric practice. After quoting a number of cogent reasons why paediatricians, general practitioners and others should be fully conversant with the normal pattern of child development and its variations, the author proceeds to examine the predictive value of developmental assessment. He concludes that developmental tests in infancy are of great value in that they can detect mental retardation and neurological conditions with a considerable degree of accuracy. On the other hand, there is little evidence that mental superiority can be detected at this early age. To achieve a reliable assessment, Professor Illingworth emphasises the importance of taking into account all factors likely to influence a child's development and in this respect he lays particular stress on a careful evaluation of pre-natal, peri-natal and environmental factors and on a basic knowledge of conditions commonly associated with mental defect (over 75 are listed). These observations are succeeded by a chapter in which the pattern of normal development is discussed with the aid of 50 excellent illustrative photographs. There follows two extremely important chapters in which the author considers and emphasises the wide variations which occur not only in individual fields of normal development, notably speech, motor development and sphincter control, but in normal development as a whole. Subsequent chapters deal with history taking, examination, relative importance of different fields of development, mental retardation, cerebral palsy and mental superiority, with a final chapter on mistakes and difficulties in developmental diagnosis. There is also an extensive bibliography which will be of great help to all interested in furthering their reading of this important subject. Professor Illingworth's refreshingly critical and practical manner of presentation adds greatly to the value of this book which is, without question, an extremely valuable and instructive publication-one which should be read and retained for reference by all paediatricians.
Citations
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TL;DR: The development of mature gait is studied in rats using a probabilistic approach and shows clear signs of decline in the older age group, particularly in the legs and ankles.
Abstract: The development of mature gait. D Sutherland;R Olshen;L Cooper;S Woo; The Journal of Bone & Joint Surgery
907 citations
TL;DR: It was concluded that the development of the precision grip was based upon the formation of a lift synergy coupling grip and load force generating circuits and that it seems to involve a transition from feedback control to feedforward control.
Abstract: The coordination of manipulative forces was examined while children and adults repeatedly lifted a small object between the thumb and index finger. Grip force, load force (vertical lifting force), grip force rate and the vertical position of the test object were continuously measured. In adults, the force generation was highly automatized and was nearly invariant between trials. After a preload phase in which the grip was established, the grip and load forces increased in parallel under isometric conditions until the load force overcame the force of gravity and the object started to move. During this loading phase, the force rate profiles were essentially bell shaped and single peaked, suggesting that the force increases were programmed as one coordinated event. Children below the age of two exhibited a prolonged preload phase and a loading phase during which the grip and load forces did not increase in parallel. A major increase in grip force preceded the increase in load force, and at the start of the loading phase, the grip force was usually several Newtons (N). The force rate profiles were multi peaked with stepwise force increases most likely allowing peripheral feedback to play an important role in the control of the forces. After the age of two, the grip force increased less during the preload phase. The loading phase was more regularly characterized by a parallel increase of the grip force and load force and the duration of the various phases decreased. The older children programmed the forces in one force rate pulse indicating the emergence of an anticipatory strategy. Yet, the mature coordination of forces was not fully developed until several years later.(ABSTRACT TRUNCATED AT 250 WORDS)
353 citations
Cites background from "The Development of the Infant and Y..."
...Some researchers have suggested that the grasp reflex fades away before voluntary grasping begins (Illingworth 1975), while others propose that the reflexes remain and interact with voluntarily controlled motor activity (Twitchell 1970)....
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TL;DR: ABILHAND-Kids is a functional scale specifically developed to measure manual ability in children with CP providing guidelines for goal setting in treatment planning and its range and measurement precision are appropriate for clinical practice.
Abstract: OBJECTIVE: To develop a clinical tool for measuring manual ability (ABILHAND-Kids) in children with cerebral palsy (CP) using the Rasch measurement model. METHODS: The authors developed a 74-item questionnaire based on existing scales and experts' advice. The questionnaire was submitted to 113 children with CP (59% boys; mean age, 10 years) without major intellectual deficits (IQ > 60) and to their parents, and resubmitted to both groups after 1 month. The children's and parents' responses were analyzed separately with the WINSTEPS Rasch software to select items presenting an ordered rating scale, sharing the same discrimination, and fitting a unidimensional scale. RESULTS: The final ABILHAND-Kids scale consisted of 21 mostly bimanual items rated by the parents. The parents reported a finer perception of their children's ability than the children themselves, leading to a wider range of measurement, a higher reliability (R = 0.94), and a good reproducibility over time (R = 0.91). The item difficulty hierarchy was consistent between the parents and the experts. The ABILHAND-kids measures are significantly related to school education, type of CP, and gross motor function. CONCLUSIONS: ABILHAND-Kids is a functional scale specifically developed to measure manual ability in children with CP providing guidelines for goal setting in treatment planning. Its range and measurement precision are appropriate for clinical practice.
319 citations
TL;DR: The successful application of this technique in children suggests that electromagnetic stimulation of the motor cortex has the potential to allow detection of abnormality in motor pathways in newborn babies and young children.
Abstract: The motor cortex can be excited in adults using electromagnetic stimulation, and the latency to the evoked muscle action potential allows an assessment of the integrity of corticospinal tracts. We applied this technique in children to describe the maturation of corticospinal tracts. The latency from cortical stimulation to the onset of the evoked muscle action potentials and the subject's height were recorded. The subject's height was divided by the latency to the onset of the evoked muscle action potential to provide an index of the conduction velocity within descending motor pathways (VI). It is possible to evoke muscle action potentials after electromagnetic stimulation of the motor cortex in children including preterm babies and there is a stepwise increase in the sensitivity to stimulation between 8 and 11 years of age. In addition there is a progressive increase in VI with age; adult values are attained at about 11 years. The successful application of this technique in children suggests that electromagnetic stimulation of the motor cortex has the potential to allow detection of abnormality in motor pathways in newborn babies and young children.
171 citations
TL;DR: The view that very early treatment will give the best results is stressed and the reasons for this view given.
Abstract: UMMARY
The view that very early treatment will give the best results is stressed and the reasons for this view given. The need for an early recognition of cerebral palsy is emphasised, as treatment started later, i.e. after the age of 1 or 2 years, when athetosis or spasticity are stronger and abnormal patterns of posture and movement established, can achieve only limited results. The principles and aims of treatment are given. Normal motor development, in terms of the evolution and elaboration of the basic motor patterns responsible for the child's expanding and complex spontaneous activities, is outlined. The importance of a thorough knowledge of these basic motor patterns for assessment and for the planning of treatment is stressed. Some examples of treatment methods are given.
RESUME
Le traitement tres precose de la palsie cerebrate
L'auteur insiste sur l'idee qu'un traitement tres precose donnera les meilleurs resultats et expose ses raisons. II souligne l'importance de reconnaitre la palsie cerebrale tot, parce que le traitement commence plus tard, c'est-a-dire apres l'âge de 1 ou 2 ans, lorsque athetosis et spasticite sont plus forts et les types anormaux de maintien et de mouvement sont etablis, ne peut atteindre que des resultats limites. On donne les principes et les buts du traitement. On expose les grandes lignes du developpement moteur normal, en considerant ľevolution et l'elaboration des types moteurs basiques responsables des activites spontanees complexes et en expansion de l'enfant. On insiste sur l'importance d'une connaissance approfondie de ces types moteur de base pour l'evaluation et pour l'etablissement d'un plan de traitement. Quelques exemples de methodes de traitement sont donnes.
ZUSAMMENFASSUNG
Die sehr fruhe Behandlung von Gehirnlahmung
Die Ansicht dass sehr fruhe Behandlung die besten Resultate erzielt, wird unterstrichen und ebenso werden die GruUnde fur diese Ansicht dargelegt. Die Notwendigkeit einer fruhen Erkennung der Gehirnlahmung wird betont, da eine spater begonnene Behandlung d. h. nach dem Alter von 1 oder 2 Jahren, wenn Athetose oder Spastizitat starker sind und abnorme Haltungs-und Bewegungsarten sich festgesetzt haben, nur begrenzte Resultate erzielen kann. Die Grundlagen und Ziele der Behandlung werden dargelegt. Normale motorische Entwicklung in Form der Evolution und Erweiterung der grundlegenden Bewegungsmuster, die fur die komplexen und sich ausdehnenden, spontanen Tatigkeiten des Kindes verantwortlich sind, werden dargelegt. Die Wichtigkeit einer eingehenden Kenntnis dieser grundlegenden Bewegungs-Muster zur Einschatzung und zur Behandlungs-Planung wird betont. Es werden einige Beispiele von Behandlungsmethoden beschrieben.
RESUMEN
El tratamiento muy precoz de la pardlisis cerebral
Se insiste en el punto de vista que un tratamiento precoz dara los mejores resultados, y se dan las razones para este parecer. Se consta la necesidad de un diagnostico precoz en casos de paralisis cerebral, puesto que un tratamiento que empieza mas tarde, es decir, despues de la edad de 1 o 2 anos, cuando la atetosis o la espasticidad son mas graves y ‘patterns’ anormales de postura y de movimiento han sido establecidos, no puede ganar mas que resultados limitados. Se explican los motivos y los objetivos del tratamiento. Se da un resumen de la evolution motriz normal, es decir del desarrollo y elaborateon de los ‘patterns’ motrices basicos que determinan las actividades espontaneas complejas y cada vez mas extensas del nino. Se da importancia a un conocimiento completo de estos ‘patterns’ motrices basicos para hacer un diagnostico y para escoger un tratamiento. Se dan ejemplos de algunos metodos de tratamiento.
163 citations
References
More filters
TL;DR: The development of mature gait is studied in rats using a probabilistic approach and shows clear signs of decline in the older age group, particularly in the legs and ankles.
Abstract: The development of mature gait. D Sutherland;R Olshen;L Cooper;S Woo; The Journal of Bone & Joint Surgery
907 citations
TL;DR: ABILHAND-Kids is a functional scale specifically developed to measure manual ability in children with CP providing guidelines for goal setting in treatment planning and its range and measurement precision are appropriate for clinical practice.
Abstract: OBJECTIVE: To develop a clinical tool for measuring manual ability (ABILHAND-Kids) in children with cerebral palsy (CP) using the Rasch measurement model. METHODS: The authors developed a 74-item questionnaire based on existing scales and experts' advice. The questionnaire was submitted to 113 children with CP (59% boys; mean age, 10 years) without major intellectual deficits (IQ > 60) and to their parents, and resubmitted to both groups after 1 month. The children's and parents' responses were analyzed separately with the WINSTEPS Rasch software to select items presenting an ordered rating scale, sharing the same discrimination, and fitting a unidimensional scale. RESULTS: The final ABILHAND-Kids scale consisted of 21 mostly bimanual items rated by the parents. The parents reported a finer perception of their children's ability than the children themselves, leading to a wider range of measurement, a higher reliability (R = 0.94), and a good reproducibility over time (R = 0.91). The item difficulty hierarchy was consistent between the parents and the experts. The ABILHAND-kids measures are significantly related to school education, type of CP, and gross motor function. CONCLUSIONS: ABILHAND-Kids is a functional scale specifically developed to measure manual ability in children with CP providing guidelines for goal setting in treatment planning. Its range and measurement precision are appropriate for clinical practice.
319 citations
TL;DR: The successful application of this technique in children suggests that electromagnetic stimulation of the motor cortex has the potential to allow detection of abnormality in motor pathways in newborn babies and young children.
Abstract: The motor cortex can be excited in adults using electromagnetic stimulation, and the latency to the evoked muscle action potential allows an assessment of the integrity of corticospinal tracts. We applied this technique in children to describe the maturation of corticospinal tracts. The latency from cortical stimulation to the onset of the evoked muscle action potentials and the subject's height were recorded. The subject's height was divided by the latency to the onset of the evoked muscle action potential to provide an index of the conduction velocity within descending motor pathways (VI). It is possible to evoke muscle action potentials after electromagnetic stimulation of the motor cortex in children including preterm babies and there is a stepwise increase in the sensitivity to stimulation between 8 and 11 years of age. In addition there is a progressive increase in VI with age; adult values are attained at about 11 years. The successful application of this technique in children suggests that electromagnetic stimulation of the motor cortex has the potential to allow detection of abnormality in motor pathways in newborn babies and young children.
171 citations
TL;DR: The view that very early treatment will give the best results is stressed and the reasons for this view given.
Abstract: UMMARY
The view that very early treatment will give the best results is stressed and the reasons for this view given. The need for an early recognition of cerebral palsy is emphasised, as treatment started later, i.e. after the age of 1 or 2 years, when athetosis or spasticity are stronger and abnormal patterns of posture and movement established, can achieve only limited results. The principles and aims of treatment are given. Normal motor development, in terms of the evolution and elaboration of the basic motor patterns responsible for the child's expanding and complex spontaneous activities, is outlined. The importance of a thorough knowledge of these basic motor patterns for assessment and for the planning of treatment is stressed. Some examples of treatment methods are given.
RESUME
Le traitement tres precose de la palsie cerebrate
L'auteur insiste sur l'idee qu'un traitement tres precose donnera les meilleurs resultats et expose ses raisons. II souligne l'importance de reconnaitre la palsie cerebrale tot, parce que le traitement commence plus tard, c'est-a-dire apres l'âge de 1 ou 2 ans, lorsque athetosis et spasticite sont plus forts et les types anormaux de maintien et de mouvement sont etablis, ne peut atteindre que des resultats limites. On donne les principes et les buts du traitement. On expose les grandes lignes du developpement moteur normal, en considerant ľevolution et l'elaboration des types moteurs basiques responsables des activites spontanees complexes et en expansion de l'enfant. On insiste sur l'importance d'une connaissance approfondie de ces types moteur de base pour l'evaluation et pour l'etablissement d'un plan de traitement. Quelques exemples de methodes de traitement sont donnes.
ZUSAMMENFASSUNG
Die sehr fruhe Behandlung von Gehirnlahmung
Die Ansicht dass sehr fruhe Behandlung die besten Resultate erzielt, wird unterstrichen und ebenso werden die GruUnde fur diese Ansicht dargelegt. Die Notwendigkeit einer fruhen Erkennung der Gehirnlahmung wird betont, da eine spater begonnene Behandlung d. h. nach dem Alter von 1 oder 2 Jahren, wenn Athetose oder Spastizitat starker sind und abnorme Haltungs-und Bewegungsarten sich festgesetzt haben, nur begrenzte Resultate erzielen kann. Die Grundlagen und Ziele der Behandlung werden dargelegt. Normale motorische Entwicklung in Form der Evolution und Erweiterung der grundlegenden Bewegungsmuster, die fur die komplexen und sich ausdehnenden, spontanen Tatigkeiten des Kindes verantwortlich sind, werden dargelegt. Die Wichtigkeit einer eingehenden Kenntnis dieser grundlegenden Bewegungs-Muster zur Einschatzung und zur Behandlungs-Planung wird betont. Es werden einige Beispiele von Behandlungsmethoden beschrieben.
RESUMEN
El tratamiento muy precoz de la pardlisis cerebral
Se insiste en el punto de vista que un tratamiento precoz dara los mejores resultados, y se dan las razones para este parecer. Se consta la necesidad de un diagnostico precoz en casos de paralisis cerebral, puesto que un tratamiento que empieza mas tarde, es decir, despues de la edad de 1 o 2 anos, cuando la atetosis o la espasticidad son mas graves y ‘patterns’ anormales de postura y de movimiento han sido establecidos, no puede ganar mas que resultados limitados. Se explican los motivos y los objetivos del tratamiento. Se da un resumen de la evolution motriz normal, es decir del desarrollo y elaborateon de los ‘patterns’ motrices basicos que determinan las actividades espontaneas complejas y cada vez mas extensas del nino. Se da importancia a un conocimiento completo de estos ‘patterns’ motrices basicos para hacer un diagnostico y para escoger un tratamiento. Se dan ejemplos de algunos metodos de tratamiento.
163 citations
111 citations