神经心理行为发育.docx
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神经心理行为发育.docx
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神经心理行为发育
神经心理行为发育
Neuropsychologicaldevelopmentbasesoncentralnervoussystemmaturation
Newborn390g,8%ofweight
9m660g
2yr900-1000g
7yr1350-1400
Adult1400g,4%ofweight
NervousReflexinInfants
1.unconditionalreflex:
existingatbirthanddisappearingbefore6mafterbirth
Rootingreflex.Areflexseeninnewbornbabies,whoautomaticallyturntheirfacetowardthestimulusandmakesucking(rooting)motionswiththemouthwhenthecheekorlipistouched.Therootingreflexhelpstoensurebreastfeeding.
Mororeflex.Mororeflexisoneoftheinfantilereflexes.Thisreflexisaresponsetounexpectedloudnoiseorwhentheinfantfeelslikeitisfalling.
Itisbelievedtobetheonlyunlearnedfearinhumannewborns.
Itisnormallypresentinallinfants/newbornsupto4or5monthsofage.
Graspreflex.Whenyoutouchthepalmofyourbaby'shand,thefingerswillcurlaroundandclingtoyourfingeroranobject.
Thisisagoodreflextoallowthebabyto"hold"theirhand.
Thisreflexalsomakesitdifficulttoobtainhandprintsuntilitdisappearsatabout6months
Stepreflex.Whenyoutouchthepalmofyourbaby'shand,thefingerswillcurlaroundandclingtoyourfingeroranobject.
Thisisagoodreflextoallowthebabyto"hold"theirhand.
Thisreflexalsomakesitdifficulttoobtainhandprintsuntilitdisappearsatabout6months
Necktonicreflex(颈强直反射)Inthesupineposition,theexaminerturnsthebaby'sheadtooneside,extendingtheupperandlowerlimbsonthesamesideasthebaby'sface,andflexingtheupperandlowerlimbsontheoppositeside.
3-4mondisappear
2.tendonreflex:
Knee-reflex:
1yr.negativeoraccentuation亢进
Achillestendonreflex跟腱反射:
1yr.negativeoraccentuation
3.Superficialreflex
Abdominalrefelex
Elicitation:
Stroketheskinoftheabdomenfromthelateralendtowardsthemidline
Response:
Contractionoftheabdominalmusclesofthesamesidetowardsthesiteofstimulation.<1yr.negative
Cremasterreflex提睾反射
Elicitation:
Stroketheskinofthemedialsideofthethighfromabovedownwards
Response:
Contractionofcremastericmuscle&elevationofthetesticleonthestimulatedside.<1yr.negative
4.Pathologicreflex
1.Babinskisign:
positivearound1yr(alsocalledsolereflex)
TheBabinskireflexappearswhenthesideofthefootisstroked,causingthetoestofanoutandthehalluxtoextend.
Thereflexiscausedbyalackofmyelinationinthecorticospinaltractinyoungchildren.
TheBabinskireflexisasignofneurologicalabnormality,e.g.uppermotorneuronelesioninadults.
2.Kernigsign:
Inthesupineposition,withthehips&kneesinflexedposition,extendtheknees.Normallythisispossibleupto140°.
Itisrestrictedinmeningitis.
positivebefore4m
3.Chvosteksign:
Strikethecheekbetweenthezygomaticarchandthemouthwiththefingertipsorapercussionhammer
Chvosteksignmaybepositiveinnewbornwithoutanyhypocalcemia
positiveinnewborns
Sleepofinfancy
Fornewborn,REMis½ofsleep.Forpremature,REMis85%ofsleep,wholesleeptimeisabout16-20hrs
Sleepcycleofnewbornisabout50mins,3-4hrsofsleepandthen1-2hrsofwakestage
Fornewborns,dayandnightsleeptimeisbasicallyequal
Changesinexternallightintensityfromtheageof1-2monthsadjustsleepphase
2-3monthsisacriticalperiodforinfantstoestablishcircadiansleepphases
Onsetofdeepsleep(stageIIIandIV)at3-6monthsofage
At9monthsofage,sleeplastsabout6-8hours
nightwalking夜醒:
normalphenomenon,aprotectivemechanism
activesleep,orremsleep,protectsagainsttemperature,breathing,andhunger
Sleepdevelopment
Toddlersleep:
12-14hours
30%ofchildrenhavedifferentdegreesofsleepproblems
Pre-schoolsleep:
11-12hours
Modeclosetoadult,90minutes/cycle
School-agesleep:
9-11hours
Thestructuretendstobestable,andthereisbasicallynoshortperiodofsleepduringdaytime
Adolescentsleep:
8-10hours
BothdeepsleepandREMsleepareshortened
感知觉发育
1.Vision
Newborn:
Togaze(blinkreflex),Torecognizefacialexpressions(smiles)assimilar,evenwhentheyappearondifferentfaces.
3m:
voluntarymusclemovementsgeneratepredictablevisualsensations,movingheadtofollowobjectwitheyes.
6m:
voluntarymusclemovementsgeneratepredictabletactileandvisualsensations,findingobjectandcatchingit.
9m:
visualdepthperceptiondeveloping—locatesobjectaccurately.
12m:
todifferentiatesimplefigures.
18m:
todifferentiatecomplicatedfigures
2yr:
eyescoordinatewell.TodifferentiateVerticalandtransverselines
3yr:
toimitatecircle
4yr:
square,5yr:
triangle,6yr:
diamond
6yr:
todifferentiate6from9、bfromd
2.Audition
Whenababycanhear?
Newbornbutnotatonce,at3-7daysafterbirth.
amnioticfluid
Howdoseauditiondevelop?
(keyage:
newborn,3-4m,5-6m,9m,1yr,2yr.)
Newborn:
Soundat50~70dBcausingdifferentbreatherate,blink,tofrownat3-7daysafterbirth.
3~4m:
voluntarymusclemovementsgeneratepredictableaudiblesensations,movingheadtofollowvoice.
5~6m:
toshowfavoritismtomother’svoice.
9m:
tolocatedthesoundsourceandknowdifferentmeaningofwords.
1yr:
aspecialrespondtothenameofhimself.
2yr:
understandingsomeorders.
3.OlfactionandTaste
Newborn:
smellingmilksmelltolookformammarypapillaornursingbottle.
3m:
differentiatinggoodsmellornot.
7~8m:
delightingtofragrance.喜欢香味
ANewbornhasdifferentfacialexpressionswhengivethemsomethingwithsweettasteandsourtaste.
4~5m:
totastefoodsensitively
actility(skinsensation)
tactilesensation:
sensitivenessinnewborn
temperaturesensation:
sensitivenessinnewborn(cryingnotescaping)
painperception:
dullorslowinnewborn
运动发育
Grossmotorskills
Includeliftingone'shead,rollingover,sittingup,crawling,andwalking
Grossmotordevelopmentusuallyfollowsapattern.
Generallylargemusclesdevelopbeforesmallerones,thus,grossmotordevelopmentisthefoundationfordevelopingskillsinotherareas(suchasfinemotorskills).
Developmentalsogenerallymovesfromtoptobottom.Thefirstthingababyusuallylearnstocontrolishiseyes.
LawofdevelopmentofGrossMotor
1.Uptodown(korullalaw)(head,chest,waist,legs)
2.Neartofar
3.Forwardtobackward
4.Fromgeneralizationtoconcentration
5.Fromdiscordancetoconcordance
1.lifthead:
3m
2.rollover:
6m
3.sit:
7m
4.creep:
8m
5.stand:
9-11m
6.deliberatestep:
10m-12m
7.walkalone:
15m
Finemotorskills
Includetheabilitytomanipulatesmallobjects,transferobjectsfromhandtohand,andvarioushand-eyecoordinationtasks.
Finemotorskillsmayinvolvetheuseofveryprecisemotormovementinordertoachieveanespeciallydelicatetask.
Someexamplesoffinemotorskillsareusingthepincergrasp(thumbandforefinger)topickupsmallobjects,cutting,coloring,writing,orthreadingbeads.
Finemotordevelopmentreferstothedevelopmentofskillsinvolvingthesmallermusclegroups.
1.Graspobject:
5m
2.Transferobject:
6~7m
3.Thumb-fingergrasp:
9-10m
4.scribbles:
12-15m
3.Languagedevelopment
ThepreconditionofLanguagedevelopment
1.auditoryperceptionnormally
2.phonatoryorganfunctionally
3.thefunctionofbrainnormally
4.Languageacquisitiondependscriticallyonenvironmentalinput.
TheprocessofLanguagedevelopment
pronunciation(voice)
Understand(Verbalreception)
Expression(talking)
Receptivelanguage,theunderstandingofothers'speech,appearstohaveagradualcourseofdevelopment:
6months.
Expressivelanguage,theproductionofwords,movesrapidlyafteritsbeginning:
1.5yrs
"vocabularyexplosion"ofrapidwordacquisitionoccurringin:
2-2.5yrs
Grammaticalrulesandwordcombinationsappear:
2yrs.
Masteryofvocabularyandgrammarcontinuegraduallythroughthepreschoolandschoolyears.
Adolescentsstillhavesmallervocabulariesthanadultsandexperiencemoredifficultywithconstructionslikethepassivevoice.
4.psychologicaldevelopment
1)cognition:
Senseandperception----precondition
attention
memory
thinking
imagination
2)emotion
3)will
cognition
Atheoryofcognitivedevelopment--Geneticepistemology(JeanPiaget,1896-1980.apsychologist.Switzerland)
1.Sensorimotorstage0-2yr:
Amajormilestoneistheachievement(about9mo)ofobjectconstancy--Objectpermanence
2.preoperationstage2-7yr:
Milestone:
magical(Symbolic)thinking
3.concreteoperationstage7-12yr:
Milestone:
Permanentlaw
4.formaloperationstage12yr-:
Milestone:
abstraction
Personal-socialskill
Acquiredduringgrowthanddevelopment
self-care ability &interpersonal skill
Include:
self-serviceability,knowingoneself,acclimatization(adaptenvironment),communicatewithothers.
Smileandstopcryingwhencomfort:
2-3m
Socialreactivelaugh:
3-4m
Bebashful:
6m
Likelookingintothemirrorandpeekaboo:
9-10m
Pointandsaydemands,imitategestures:
12-18m
Self-controlandplaythemselves:
18m
Self-careability:
2y
Learnrules:
3y
Roleplaygames:
5y
一静、二笑三玩手,四月大笑、五听声认母
六月开始认生熟。
观察成人认识物
此时月龄七、八、九,十个月再见会招手
一岁会玩小把戏,主动交际渐成熟
Theevaluationofneuropsychologicaldevelopment-------Psychometry(usingaquantificatexperimentalmethodtoevaluatethesenseandperception,motor,languageandpsychologicaldevelopmentofchildren.)
Intelligentquotient,IQ
Developmentquotient,DQ
Animportantparameterofpsychometry
Measurement
IQisanartificialmeasureofrelativeintelligencedevelopment.
mentalage(MA)
IQ=-----------------------x100
chronologicalage(CA)
DQistheresultofmentaldevelopmentevaluationofinfants.
developmentalitems:
perception,movementandlanguage.
DQisusedtotestthedegreeofdevelopmentachievedbychildren.
Dev
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