Risk Factors for Motor Delays

Jessica McMurdie, OTR/L

January 3, 2020

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What are the risk factors for motor delays?

 

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Risk Factors for Motor Delays

Let's talk about some of the risk factors for motor delays.

  • Medical and birth history
  • Neurological problems 
  • Retained primitive reflexes
  • Visual impairment
  • Hypotonia (low muscle tone)
  • Decreased strength & endurance
  • Increased joint flexibility
  • Short limbs: arm and/or leg length discrepancy

The first one is medical and birth history. Medical problems might include prematurity, prior hospitalizations, chronic infections, ear problems that will impact balance. Neurological problems can be cerebral palsy and hemiplegia. Retained primitive reflexes, visual impairment, as well as hypotonia, or low muscle tone, are other issues. Some children might have lower muscle tone in different parts of their bodies like in their extremities which might make it difficult for them to prop on their arms or walk. This is commonly seen in children with Down syndrome for example. Decreased strength and endurance, as well as, increased joint flexibility or laxity are also common problems. The ligaments holding the bones together have a lot more slack, and in cases of decreased joint stability, you may see kids with flat feet or dislocations of their shoulders or hips. The other aspect is short limbs or having an arm or a leg length discrepancy.

In Figure 1, we have Baby M who you will see throughout this presentation as she is our case study. She was born prematurely. Her mom went into labor at 29 weeks, and when she was delivered, she had an APGAR score of one out of 10.

Figure 1. Baby M- APGAR 1/10.

As a refresher on APGAR, A is for appearance, P is for pulse or heart rate, G is for grimace, which is reflexes, A is for activity for muscle tone, and R is for respiration, or breathing rate and effort.

 


jessica mcmurdie

Jessica McMurdie, OTR/L

Jessica is the owner and clinical director of Stepping Stones Therapy Network, a successful pediatric OT practice in the Seattle area. She also shares her pediatric expertise on her popular blog: Play It Forward Therapy www.playitforwardtherapy.net
Jessica has two decades of experience working with children and their families in hospital, school, birth to three and outpatient settings. She holds dual degrees in Spanish and Occupational Therapy from the University of WA and specialty certification in Sensory Integration from the University of Southern California.    Jessica is a nationally, award-winning small business owner recognized as an Emerging Leader by the American Occupational Therapy Association and the U.S. Small Business Administration.  She is a contributing author to the best-selling book, “The OT Manager”(2019, 6th Edition). For more pediatric activities and education to inspire your practice, visit www.playitforwardtherapy.net

 


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