Monitoring the development of infants and children at risk of disability. Recommendations of the Children and Youth Rehabilitation Section of the Polish Rehabilitation Society

Jolanta Taczała; Lidia Perenc; Małgorzata Szmurło; Olga Wolińska; Iwona Maciąg-Tymecka; Piotr Majcher

doi:10.5114/areh.2021.102363

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Functional diagnosis and rehabilitation planning for infants at risk of disability

Monitoring the development of children up to 36 months of age, medical evaluation scheme

Age of the child/type of assessment		1 month	2 months	4 months	6 months	9 months	12 months	18 months	24 months	36 months
Posture symmetry:		SP/ PP	SP/ PP	SP/ PP	SP/ PP	SP/ PP/ PSIT	SIT/ ST	SIT/ ST	SIT/ ST	SIT/ ST
Movement pattern symmetry		SP/ PP	SP/ PP	SP/ PP	SP/ PP/ rotations	Creeping, rotations	Crawling, rising up	Walking	Walking, running	Walking, running
Trunk muscle tone – central stabilization		Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	Correct/ incorrect
Muscle tone disorders (Tardieu scale): UL/LL		Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL
Selectivity of movements: UL/LL		–	–	–	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL	Correct/ incorrect UL/LL
Global Movement Assessement, (Prechtl method)		Correct/ incorrect	Correct/ incorrect	Correct/ incorrect	–	–	–	–	–	–
	GMs	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No
	FMs	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No
Red Flags – RFs)	COM	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No
	COG	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No
	SO–EM	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No	Yes/ No

Criteria for rehabilitation of premature babies for individual therapists

Age/Therapy	Physiotherapy	Psychological therapy	Speech therapy	Occupational therapy
1 month	Red Flags¹Parents’ care mistakes which perpetuate incorrect posture and movement patterns of the newborn; Posture asymmetry (fixed) ^*; Incorrect GMA	Red FlagsHigh levels of parental stress	Red FlagsFeeding disorders	Red FlagsDisorders of the daily activities of the infant ^***
2 months	Red FlagsParents’ care mistakes which perpetuate incorrect posture and movement patterns; Posture asymmetry (fixed) ^; Persistent extension pattern ^*; Incorrect GMA	Red FlagsHigh levels of parental stress	Red FlagsFeeding disorders, abnormal oral reflexes	Red FlagsDisorders of the daily activities of the infant ^***
4 months	Red FlagsPersistent asymmetry of posture and movements ^; Persistent extension pattern ^; Low muscle tone of the trunk; High muscle tone of limbs; Incorrect GMA	Red FlagsHigh levels of parental stress	Red FlagsFeeding disorders, abnormal oral reflexes; monotonous vocalization	Red FlagsDisorders of the daily activities of the infant ^***
6 months	Red FlagsPersistent asymmetry of posture and movements ^; Persistent extension pattern ^*; Low muscle tone of the trunk; High muscle tone of limbs	Red FlagsLack of smile to the caregiver, no distinction between friends and strangers	Red FlagsOpen mouth, poor saliva control, monotonous vocalization	Red FlagsDisorders of the daily activities of the infant ^***
9 months	Red FlagsAsymmetry of the sitting posture; Low muscle tone of the trunk; High muscle tone of limbs Lack of selectivity UL/LL	Red FlagsConcentration on objects and not on people, lack of interest in the environment, problem with stabilizing the phase of the day and night	Red Flagsnot making sounds to get attention	Red FlagsDisorders of the daily activities of the infant ^***
12 months	Red FlagsAsymmetry of the sitting/standing posture; Low muscle tone of the trunk; High muscle tone of limbs; Lack of selectivity UL/LL	Red FlagsLack of seeking comfort from the caregiver in the event of illness, fatigue or pain	Red FlagsNo reaction to the name	Red FlagsDisorders of the daily activities of the infant ^***
18 months	Red FlagsAsymmetry of sitting/standing/posture and during walking; Low muscle tone of the trunk; High muscle tone of limbs; Lack of selectivity UL/LL	Red Flagsno common field of attention, the child focus on objects rather than people	Red Flagsnot able to speak some words	Red FlagsDisorders of everyday activities, inability to play together
24 months	Red FlagsAsymmetry of sitting/standing/posture and during walking; Low muscle tone of the trunk; High muscle tone of limbs; Lack of selectivity UL/L	Red Flagsno symbolically represented games and role-playing, no common field of attention	Red Flagsnot able to speak many words	Red FlagsDisorders of everyday activities, lack of ability to play in dependently and together
36 months	Red FlagsAsymmetry of sitting/standing/posture and during walking; Low muscle tone of the trunk; High muscle tone of limbs; Lack of selectivity UL/L	Red Flagsno games with symbolic pretending, no contact with peers, behavioral disturbances in social contacts	Red Flagslack of ability to build 3–4 word sentences, speech incomprehensible by the environment	Red FlagsDisorders of everyday activities, inability to use cutlery or crayons efficiently

Monitoring the development of infants and children at risk of disability. Recommendations of the Children and Youth Rehabilitation Section of the Polish Rehabilitation Society

Figures & Tables

Fig. 1.

Monitoring the development of children up to 36 months of age, medical evaluation scheme

Criteria for rehabilitation of premature babies for individual therapists

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