1. Disorders of Motor Development in Terms of Neuroscience Pediatric Course - Pathophysiology

2. Developmental Milestones Development depends on maturation of the nervous system. Motor - Gross motor Hand skills - Fine motor Cognitive Social Language

3. Developmental Patterns Cephalocaudally – HEAD to TOE progression; Proximodistally – INSIDE to OUTSIDE progression; GENERAL to SPECIFIC progression; Factors influencing readiness  Maturity level  Previous practice  Prerequisite skills  Body management skills  State of physical fitness  Interest

4. Causes of Developmental Delay Genetic causes (like Down syndrome) Complications of pregnancy and at birth (like prematurity or infections) Chronic or serious diseases Hearing loss (congenital or due to chronic ear infections) Environmental factors (e.g. lack of stimulation) Others

5. Steps of Neurological Assesment in Infants Mental status Motor functioning Sensory functioning Reflexes Cranial and other nerves

6. Cerebral Palsy First described 1966-1975 Non-specific term that include disorders characterized by early onset and impaired movement and posture. May include perceptual problems, language deficits, and intellectual involvement.

7. Causes of Cerebral Palsy Time (% of cases) Prenatal (44%) First trimester Second trimester Labor and delivery (19%) Perinatal (8%) Childhood (5%) Not obvious (24%) Causes Teratogens, chromosomal abnormalities, genetic syndromes, brain malformations Intrauterine infections, problems in fetal/placental functioning Preeclampsia, complications of labor and delivery Sepsis/CNS infection, asphyxia, prematurity Meningitis, traumatic brain injury, toxins

8. Clinical Classification of Cerebral Palsy Spastic - hypertonicity with poor posture control Dyskinetic/athetoid - slow, writhing movements that are uncoordinated and involuntarily. Ataxic - wide-based gait Mixed-type/dystonic - combination of spasticity and athetosis

9. Clinical Manifestations Delayed gross motor development A universal manifestation of CP Abnormal motor performance Alterations in muscle tone Abnormal postures Reflex abnormalities Associated disabilities and problems

10. Therapeutic Management Physical therapy Occupational therapy Speech-language therapy Surgical intervention Medication