Development: The head-to-toe continuum and life course

Simply formulated, development is the continuous process of personal adaptive change: driven by nature and nurture. Genetic determinants, available substrate, a permissive environment, sufficient stimulus and social and family guidance are essential for the fullest self-actualization and participation throughout the life course. Neuromaturational theory suggests that motor development takes place in a cephalocaudal direction, from proximal to distal. Dynamic Systems theory posits that motor development occurs as the end product of multiple internal and external components or subsystems. Neuronal group selection theory recognizes the interaction of genetics and environment (nature-nuture) leads to a dynamic regulation of neural networks by cell migration and neuronal growth. There are three general categories for theories of human development: endogenous, exogenous and constructivist. Endogenous perspectives focus on causes that "come from within” like genetics, or the developmental milestone stages described by Erik Erickson that all persons are expected to experience regardless of environmental influences. Exogenous perspectives stress the influence of the environment on the person to determine developmental outcomes such as the theories of Behaviorism from BF Skinner. Although, constructivist perspectives propose development as a synthesis of progressive organization and reorganization that is constructed in the process of adapting.Each clinician must develop a paradigm as a collection of understandings of the processes and methods to positively intervene. Educational experience and interdisciplinary patient and family collaborations provide for problem definition. Rehabilitative care is designed to enable normal development and age appropriate experiences.