care of children with special needs manual on the by...

CARE OF CHILDREN WITH SPECIAL NEEDS

Manual on theManagement of Childrenwith Gross Motor Delay

By

Family Health Development DivisionMinistry of Health, Malaysia

OCTOBER, 2001

OKU-101A/2002

i

MOH/K/ASA/24.01(GU)

ii

Family Health Development Division, Ministry of Health, 2001

This manual is one of the six manuals on the Care Of Children With Special Needs publishedby the Family Health Development Division, Ministry of Health. All rights are reserved bythe Division but the document may, however, be freely reviewed, abstracted, reproducedand translated, but neither for sale nor for use in conjunction with commercial purposes.The views expressed in this manual by named contributors are solely the responsibility ofthose contributors.

Reprint November 2005Reprint 2007

PREFACE

National policies and programme for the disabled have been formulated and implemented byvarious organizations. The Ministry of Health, as the organization responsible for prevention ofcauses of disabilities and rehabilitation, began implementing rehabilitation services at the healthcentres for Children with Special Needs in 1996. The aim is to maximize the potential of childrenwith special needs in order for them to be as independent as possible and enjoy a better qualityof life.

One problem identified in the rehabilitation programme was the lack of training manual andstandard guideline for reference. A series of six manuals in the management of Children WithSpecial Needs have been produced or in the process of preparation. These included:

• Manual On The Management Of Children With Gross Motor Delay [(published in October2001, OKU-101A/2002)]

• Manual On The Management Of Children With Fine Motor Delay [(published in January2002, MOH/K/ASA/30.02 (GU)]

• Manual On Activities Of Daily Living (Self–Help Skills) For Children With Special Needs[published in October 2002, MOH/K/ASA/31.02 (GU)]

• Manual On The Management Of Children With Visual Impairment [published in September2003, MOH/K/ASA/35.03 (G.U.)]

• Manual On The Management Of Children With Communication Problems [published inMarch 2004, MOH/K/ASA/35.03 (GU)]

• Manual On The Management Of Children With Personal & Social Problems [publishedin December 2004, MOH/K/ASA/37.04 (GU)]

Knowledge in normal development is crucial in the understanding of rehabilitation for childrenwith special needs. Information on normal developmental milestones can be obtained from“Senarai Semak Perkembangan Dan Panduan Stimulasi Awal Kanak-Kanak Bawah 1 Tahun”,published by Family Health Development Division in 2001. Key information on normaldevelopmental milestones and stimulation activities were tabulated according to age. It can beused as quick reference by primary care providers for all newborn children through first year oflife.

While this manual provides further detail in the management of children with gross motordelay. It contains the following information:

1. Warning signs of gross motor delay2. Handling and Positioning3. Stimulation activities for children with gross motor delay4. Rehabilitative Equipment for gross motor function

It can be used by primary care provider’s i.e. public health nurses and therapists, as a guideto manage children with gross motor delay. It can also be used as health education materialto guide teachers and parents who care for these special children.

iii

CONTENTS

No.

1.

2.

3.

4.

5.

6.

7.

8.

Topic

Introduction1.1. Definition Of Gross Motor Delay1.2. Action To Be Taken By Public Health Nurse

Warning Signs Of Gross Motor Delay At Various Ages

Handling And Positioning3.1. Method of Correct Handling (Lifting & Carrying)3.2. Methods of Correct Positioning3.3. Range of motion Exercises

Stimulation Activities

Rehabilitative Equipment For Gross Motor Function

Appendix6.1. Other Associated Developmental Problems6.2. Normal Gross Motor Development

Reference & Biblography

Acknowledgement & Contributors

Page

135

7

13172125

31

43

495153

57

59

iv

INTRODUCTION

1.1 Definition of Gross Motor Delay1.2 Action To Be Taken By Public Health Nurse

3

INTRODUCTION

4

Case Definition

5

OBJECTIVE

( (

WARNING SIGNS OF GROSSMOTOR DELAY AT VARIOUS AGES

9

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ssorG lamroNsenotseliM rotoM S gninraWeuqinhceT tnemsessA deriuqer noitcArefer ot nehW / sngi

43

10



53

11



73

63

12



93

04

HANDLING AND POSITIONING

3.1 Method of Correct Handling ( Lifting & Carrying)3.2 Methods of Correct Positioning3.3 Range - of - Motion Exercises

15

HANDLING AND POSITIONING

16

POSITIONING

17

METHOD OF CORRECT HANDLING (LIFTING & CARRYING)

18

HANDLING ATHETOID CHILD - HANDLING UPPER LIMBS IN SITTING

19

HANDLING UPPER LIMBS - IN SITTING

20

METHOD OF HANDLING - LOWER LIMBS

21

METHOD OF CORRECT POSITIONING

POSITION IN LYING

22

POSITIONING IN SITTING

24

POSITIONING IN STANDING

25

RANGE - OF - MOTION EXERCISES

26

RANGE OF MOTION EXERCISES - UPPER LIMBS

28

RANGE OF MOTION EXERCISE - LOWER LIMBS

STIMULATION ACTIVITIES

33

STIMULATION ACTIVITIES

34

STIMULATION ACTIVITIES FOR HEAD CONTROL

35

STIMULATION ACTIVITIES TO ENCOURAGE ROLLING OVER

36

STIMULATION ACTIVITIES TO ENCOURAGE CRAWLING

37

STIMULATION ACTIVITIES TO ENCOURAGE SITTING

38

TYPES OF SITTING POSITION

39

STIMULATION ACTIVITIES TO ENCOURAGE STANDING WITH SUPPORT

36

STIMULATION ACTIVITIES TO ENCOURAGE WALKING

40

REHABILITATIVE EQUIPMENTFOR GROSS MOTOR FUNCTION

45

REHABILITATIVE EQUIPMENT FOR GROSS MOTOR FUNCTION

46

SUGGESTED IMPROVISED REHABILITATIVE EQUIPMENT FOR GROSSMOTOR FUNCTION AT HOME

APPENDIX

51

OTHER ASSOCIATED DEVELOPMENTAL PROBLEMS

53

NORMAL GROSS MOTOR DEVELOPMENT

54

NORMAL GROSS MOTOR DEVELOPMENT

55

SITTING

STANDING

REFERENCE & BIBLOGRAPHY

59

REFERENCES LIST & BIBLOGRAPHY

Bluma S. et. Al. (1976). A Parent’s Guide to Early Education. The PortageProject, Wisconsin

Jegard, S. et. Al. (1981). A Comprehensive Program for Multi - HandicappedChildren. Alvin Buckworld Centre

Kementerian Kebajikan Masyarakat Dari Buku Panduan “Training DisabledPeople In the Community - WHO. RHB / 83.1. Latihan Orang Cacat DalamKomunity;

Robert Deller. A Curriculum Guide For Teaching Young MentallyHandicapped Children. Malaysian Care

World Confederation for Physical and Occupational Therapist. (1993).Promoting the Development of Young Children with Cerebral Palsy. WorldHealth Organization.

David Werner. Disabled Village Children. Second Editions: November1988, January 1994, July 1996. Hesperian Foundation.

Denver Developmental Screening Test.

Ronald S. Illingworth. The Development of the Infant and Yong Child Normaland Abnormal. Ninth Edition (1987). Medical Division of Longman GroupUK. Ltd.

Finnie R. N. (1997) Handling the Young Child with Cerebral Palsy at Home.Third Edition, Butterworth - Heinemann, Oxford.

Wan Asma WI, Mannual of Child Development and DevelopmentAssessment in Children: A Practical Approach of Multidiscipline

ACKNOWLEDGEMENT & CONTRIBUTORS

CONTRIBUTORS

Name

Dr. Wan Asma Wan Ismail

Dr. Sofiah bt Ali

Dr. Faridah Abu Bakar

Puan Hamidah Ishak

Puan Hanusah Mohd Nor

Puan Rahimah Yasmin Mydin

Puan Siti Fatimah btMuhamad

Cik Tan Mee Har

Encik Jaharuddin Samsudin

Puan Maznah Haris

Puan Cheoh Siew Tin

Puan Siti Rauyah Suradi

Encik Bustaman Hassan

Puan Noraini Othman

Mohd Yusof Tawil

Dr Aminah Bee Mohd Kassim

Editors

Dr Aminah Bee Mohd Kassim

Madam Cheoh Siew Tin

Designation

Consultant CommunityPaediatrician

Neuropaediatrician

State Family Health Officer

Physiotherapist

Physiotherapist

Physiotherapist

Physiotherapist

Physiotherapist

Occupational Therapist

Public Health Sister

Public Health Nurse

Public Health Nurse

Grafic Artist

Committee member (NGO)

Committee member (NGO)

Principal Assistant Director

Principal Assistant Director

Public Health Sister

Place

Medical Centre, HospitalUSM, Kota Bahru.

Hospital Kuala Lumpur

Department of Health, Perak

Hospital Kuala Lumpur

Hospital TAR Klang

Hospital Ipoh

Hospital Bahagia, Ulu Kinta,Ipoh

Hospital Pulau Pinang

Hospital Ipoh

LM Selama Health Officer,Taiping, Perak

Maternal & Child Health Clinic,Klang

Health Clinic, Bandar Mas,Johore

Health Education Department,Hospital Kuala Lumpur

National Committee,Community BasedRehabilitation

National Committee,Community BasedRehabilitation

Family Health DevelopmentDivision, Kuala Lumpur.

Family Health DevelopmentDivision, Ministry of Health

Family Health DevelopmentDivision, Ministry of Health

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