Childhood Development Principles

• These notes cover general principles of development, stages of psychosocial development, data gathering methods, frames of reference, common play assessments, fine motor development, and interventions for childhood mental health disorders.

General Principles of Development

• Development involves play, interaction, and proceeds from proximal to distal regions.
• It is dynamic, spiral/iterative, and involves developing minds and bodies, while emphasizing neuroplasticity.
• Neuroplasticity in development refers to changes in the nervous system as a result of typical developmental processes.
• Postnatal development involves myelinogenesis and continues through adolescence, implying ongoing brain maturation and organization after birth.
• Prenatal development includes cell birth, migration, differentiation, maturation, and synaptogenesis in the first trimester, which is critical for nervous system formation.
• Environmental exposures have the greatest impact during critical periods of development.
• Neuronal pruning and synapse refinement lead to a 40% decrease in synaptic density, indicating efficient brain circuitry development.
• Reactive neuroplasticity refers to the nervous system's ability to restructure in response to insults or injuries, guided by principles like "use it or lose it," specificity, repetition, and intensity.

Stages of Psychosocial Development

• Erik Erikson proposed these stages.
• These include Trust vs. Mistrust, Autonomy vs. Shame & Doubt, Initiative vs. Guilt, Industry vs. Inferiority, Identity vs. Role Confusion, Intimacy vs. Isolation, Generativity vs. Stagnation, and Integrity vs. Despair.
• Infant interventions address sensory processing issues, motor skill development, and provide positional/postural support.

Factors and Levels Impacting Development

• Child factors encompass neurodevelopmental integrity and general health.
• Dynamic systems theory states that performance emerges from the interaction and cooperation of various systems.
• Caregiving practices, including parenting style, family structure, and discipline philosophy, play a role.
• Culture influences the timeline for achieving milestones.
• Geopolitical context, encompassing education, access to resources, and healthcare, also influences this.
• Foundational knowledge refers to paradigms and overarching principles.
• Applied knowledge organizes concepts to explain phenomena and practice, like the PEO model and Model of Human Occupation.
• Practice frames of reference guide evaluation, intervention, and outcome procedures, such as sensory integration or motor control.

Frames of Reference in OT

• The developmental frame of reference uses linear progression of milestone acquisition and external factors. Play groups are used to encourage development.
• The biomechanical frame uses alignment to external forces, like providing seating prescriptions to promote joint integrity for neuromotor disorders.
• Motor control uses practice to improve skills like CIMT for cerebral palsy.
• The rehabilitation frame allows for adaptations using environmental modifications.
• The Neurodevelopmental frame uses facilitation and inhibition for cerebral palsy.
• The sensory integration uses goal directive tasks to improve function for ADHD.
• The Behavioural frame uses environment and reinforcement like applied behaviour analysis for autism spectrum disorders.
• The Cognitive frame uses cognitive strategies for planning.
• The Cognitive Behavioural frame aims to reframe maladaptive thoughts to promote emotional regulation, like using the Alert Program.

Data Gathering in OT

• The context includes family, school, and initial concerns along with client's needs, wants, and expectations.
• Tools for data gathering include COPM, paediatric activity card sort (CAPE/PAC), childhood occupational self-assessment (COSA), and informal interviews.

Formal Assessment in OT

• This includes standardized and occupation-centred assessments.
• Bayley Scales identify developmental delays in infants ages 1-42 months.
• The Paediatric Evaluation of Disability Inventory (PEDI) evaluates functional abilities.
• The School Function Assessment measures a student's performance in school.
• Sensory-profile 2 evaluates sensory processing patterns.
• The Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) assesses motor skills.
• The Vineland Adaptive Behaviour Scales assesses communication, daily living, socialization, and motor skills.
• Symbolic and Imaginative Play Checklist assesses a child's ability to engage in symbolic and imaginative play.
• Children Helping Out: Responsibilities, Expectations, Supports - assesses household task participation.
• Assessment guides include diagnosis, baseline performance, treatment, provides documentation of change, used to determine eligibility and for program evaluation,.
• Standardised admin and scoring has uniform procedures for administration and scoring, defined population for testing, reliability and validity and a fixed protocol.
• Norm Referenced compares a child's performance with a normative sample using standardised admin and scoring.
• Criterion-Referenced compares a child's performance with a specific set of criteria.

Common Play Assessments

• The Revised Knox Preschool Play Scale is an observational assessment for children birth-6 years.
• The Test of Playfulness (ToP) examines intrinsic motivation, internal control, freedom to suspend reality, and framing for ages 6 months to 18 years.
• The Test of Environmental Supportiveness (TOES) complements ToP, using a Likert scale to evaluate human and non-human elements.
• The Bayley Scales of Infant Development measures cognitive, motor, language, and social-emotional development in 1-42 months.
• The Symbolic and Imaginative Play Developmental Checklist is a background checklist, while the Child-Initiated Pretend Play Assessment is norm- referenced for two observational sessions looking at initiations play.

Neurophysiologic Modulation

• Development in infants is characterized by modulation of arousal and activation of organized patterns of behavior from birth to 2-3 months.
• Sensorimotor modulation occurs between 3-9 months.
• Self-control develops between 12-48 months.
• Self-regulation of behaviour develops at 3 years+.

Motor Development Sequence

• Development proceeds cephalocaudally, proximo-distally, and from mass to specific movements.
• Progresses from gross motor to fine motor control, moving from bilateral to unilateral to bilateral coordination.

Perceptual & Object Manipulation Skills

• Develops with age, including exploration of textures.
• Skills develops with age as they adjust grips.

Fine Motor Development

• Hand skills develop from 0-6 months, establishing release and grasp.
• Skills develop from 6 months - 3 years+.
• Handwriting, spelling, grammar and organisation of written tasks gets more clear.

Middle School Development

• Skills are nearly mature by middle school.

Therapeutic Use of Self

• This includes use of your personality, insights, perceptions and judgements as a tool.
• Intentional Relationship Model anticipates, identifies and uses interpersonal skills to gather feedback, advocate, empathize, encourage, problem-solve and create a collaboration.

Common Conditions

• ADHD affects attention, activity level, and impulsivity; 3-5% of school aged children have it.
• Development Coordination Disorder (DCD - a learning disability) - 4-10% of school age population has it.
• Dyslexia is a learning disability with reading, writing and comprehension.
• Dygraphia is a learning disability impacting various aspects of writing.

Development of Mental Health

• Atypical psychosocial development can be termed emotional disturbance, behavioral disorder, mental illness, or mental disorder.
• One in seven children aged 4-17 experience mental health concerns.

Protective Factors (MH)

• Protective factors in mental health, include attachment to a caring adult, family harmony, boundaries and limits, economic security and strong cultural identity.

Risk Factors (MH)

• Risk factors in mental health, include difficult temper, prenatal exposure, parental mental illness difficult temper, genetic predisposition, developmental vulnerability, physical ill-health, prenatal exposure to alcohol and family violence.

Interventions for MH Disorders in Childhood

• Interventions include developing skills, sensory supports, cognitive interventions, CBT, aLERT Program, social skills training, behavioural.

Educational Supports with NDIS

• Educational supports with NDIS (National Disability Insurance Scheme) include literacy programs, assistive technology,transition support etc

NDIA Principles

• Individualized support tailored to needs, early intervention for best outcomes, collaboration between families, professionals and community are all principles for early childhood.

OT Assessments With NDIS

• These include assessments for Tasks, Abilities etc.