The usual suspects: the first stage to not ignore
Why motor concerns matter: motor concerns and the negative cycle
Developmental check points: a proactive approach
- 0-3 months
- 3-6 months
- 6-9 months
- 9-12+ months
- Developmental check points at 0-3 months
- Evaluation, assessment, and management
- Supine, side lying, prone, supported upright (antigravity vs gravity-assisted movements)
- Mobility, postures, rom, positioning, state regulation, feeding correlations (how the body is impacting feeding and feeding impacting the body)
- Positioning
- Evaluation, assessment, & clinical reasoning
- Clinical implications and the feeding implications
- Common trends
- Evaluation, assessment, and management
- What to assess and observe
- Clinical implications & common trends
- Evaluation, assessment and management
- Primitive tonic reflexes
- Integration
- Impact on positioning
- Norms
- Clinical implications
- When to refer out
Feeding: one of the first infant milestones
- 0-3 months
- Breast/bottle
- Develop oral motor strength
- Enhance sensory tolerance
- Improve swallowing coordination
- Establish self-feeding skills
- Promotor nutritional balance
- Optimize breathing patterns
- Increase airway stability
- Promote postural alignment
- Encourage tongue rest posture
- Increase communication confidence
Lingual developmental milestones
Assessment of NNS and NS patterns
- Oral motor exam
- Non-nutritive sucking pattern
- Nutritive sucking pattern
- Therapeutic benefits
- AAP recommendations
Bottles
- Bottle types
- Nipple shapes and flow rates
- Active vs passive feeder
- Functional latch with bottle and breast
- Positioning to support oral motor
- Positioning to support oral motor
- Why to pay closer attention?
0-3 month milestone skills checklist
Motor concerns 3-6 months
Pre-solids gross motor foundation
- Recommendations for positioning
- Expected skills clinical trends with h/o feeding difficulties (“extensor baby”; decreased out of midline movements, postural compensations
- How to assess
- Expected skills (gm and oral motor)
- Techniques to facilitate optimal oral motor skills for solids
- 0-3 months (newborn)
- 4-6 months (supported sitter)
- 7-9 months (crawler/independent sitter)
- 10-12 months (beginner walker)
- Improve articulation
- Develop resonance and voice control
- Enhance speech fluency
- Strengthen oral motor skills for speech
- Increase communication confidence
- Initial positive oral touch
- Tongue extension and retraction
- 0-3 months
- 3-6 months
- 6-9 months
- 9-12+ months
Case study #2
Multidisciplinary approach & team member collaboration
Closing statements