20 terms

Neonatal Reflexes/primary motor patterns and Infant reflexes and reactions

The content of these flashcards were taken from O'Sullivan & Siegelman National Physical Therapy Examination (NPTE) Review and Study Guide version 2009, pages 248-249, and Scott Guiles Scorebuilders pages 110 - 111 version 2009
Babinski Reflex
- 0 - 12 Months
- Stroke lateral aspect of the plantar surface of foot
- RESPONSE: Get extension and fanning of toes
Flexor withdrawal
- 0 - 2 Months
- Sharp, quick pressure stimulus to the sole of the foot or palm of hand
- RESPONSE: Get withdrawal of stimulated extremity
Crossed extension
- 0 - 2 Months
- Sharp, quick pressure stimulus to the sole of the foot
- RESPONSE: Withdrawal of stimulated lower extremity and extension of opposite leg
Galant or Trunk incurvation reaction
- 0 - 2 Months
- Sharp stroke along paravertebral line from scapula to top of iliac crest
- RESPONSE: Lateral trunk flexion towards the stimulated side
If persists, it will interfere with:
- Development of sitting balance
- Can lead to scoliosis
Primary Standing Reaction (Positive support reflex)
- 0 - 2 Months
- Hold infant in supported standing
- RESPONSE: Infant supports some weight and extends LE (Stiffening of legs and trunk into extension)
- If this reflex persits, it will interfere with:
- Walking by causing extension of all joints of the LE and not allowing disassociation of flexion and extension
- Standing
- Balance reactions and weight shifting
- Can lead to contractures of ankles into plantarflexion
Primary Walking (Stepping) Reflex
- 0 - 2 Months
- Hold infant in supported standing, tilt trunk forward slightly
- RESPONSE: Reciprocal stepping motions in LE ( reciprocal flexion and extension of LE)
- If this reflex persists, it will interfere with:
- standing and walking
- Balance reactions and weight shifting in standing
- Developmental of smooth, coordinated reciprocal movements of LE
Palmar Grasp Reflex
- 0 - 4 Months
- Pressure stimulus agains the palm
- RESPONSE: Grasping of objects with slow release (flexion of fingers causing a strong grip)
- If this reflex persists, it will interfere with:
- Ability to grasp and release objects voluntarily
- Weight bearing on open hand for propping, crawling, and protective responses
Moro Reflex
- 0 - 4 Months
- Sudden extension of neck (head dropping into extension suddenly for a few inches)
- RESPONSE: Flexion, abduction of shoulders, extension of elbows, and then extension, abduction of shoulders, flexion of elbows. (Arms abduct with fingers open, then cross into adduction), CRY!
If this reflex persists, it will interfere with:
- Balance reactions in sitting
- Protective reactions in sitting
- Eye-hand coordination, visual tracking
Asymmetrical Tonic Neck Reflex ( ATNR)
- 0 - 5 or 6 Months
- Rotation of the head
- RESPONSE: Extension of face side extremities
Flexion of skull side extremities
Spine curved with convexity towards face side
If this reflex persists, it will interfere with:
- grasping and hand to mouth activities (feeding)
- visual tracking
- midline use of hands, and bilteral use of hands
- rolling
- development of crawling
-may result also in: scoliosis, hip subluxation and dislocation
- 0 - 3 Months
- Touch on the cheek (perioral region)
- RESPONSE: Head turns to that side with mouth opening
-important feeding reflex
If persists, it will interfere with:
- Oral motor development
- Development of midline control of head
- Optical-righting, visual tracking, social interaction
Tonic Labyrinthine Reflex ( TLR)
- 0 - 6 months
- Prone position = Maximal flexor tone ( UE + LE held in flexion)
- Supine position = Maximal Extensor tone ( UE + LE held in extension)
If persists, it will interfere with :
- Ability to initiate rolling
- Ability to prop on elbows with extended hips when prone
- Ability to flex trunk and hips to come to a sitting position from supine
- Often causes full body extension, which interferes with balance in sitting or standing.
Neonatal Neck righting (NOB = Neck righting on Body)
- 0 - 6 Months
- Turn head when infant is in supine
- RESPONSE: Body log rolls towards the same side
Startle Reflex
- 0 - 6 Months
- Loud, sudden noise, sudden light or cold stimulus
- RESPONSE: causes a sudden jerking of whole body or extension and abduction of UE, followed by adduction of the shoulders
If persists, it will interfere with:
- Sitting balance
- Protective responses in sitting
- Eye-hand coordination, visual tracking
- Social interaction, attention
Placing reactions
- 0 - 6 Months
- Drag dorsum of foot or back of hand against edge of table
- REPSONSE: Get placing of foot or hand unto table top
Plantar Grasp Reflex
- 0 - 9 Months
- Pressure stimulus to sole or Lowering of feet to floor
- RESPONSE: curling or toes (Toe flexion)
If persists, it will interfere with:
- Ability to stand with feet flat on surface
- Balance reaction and weight shifting in standing
- MUST BE integrated BEFORE walking occurs
Symmetrical Tonic Neck Reflex (STNR)
- 6 - 8 Months
- Extension of cervical joints (Head in Extension) = UE extension and LE flexion
- Flexion of cervical joints (Head in flexion) = UE flexion and LE Extension
If reflex persists, it will interfere with:
- Ability to prop on arms in prone position
- Attaining and maintaning hands-and-knees position
- Crawling reciprocally
- Sitting balance when looking around
- Use of hands when looking at the object in hands in sitting position
- Development of stable quadruped position and creeping
Landau's Reaction
- 4 - 18 Months
- If infant is held in ventral suspension (prone suspension)
- RESPONSE: Extension of neck, trunk, and hips
Protective Extension
- Quick displacement of trunk in a downward direction while held or while sitting in a forward, sideward or backward direction. (persists through life)
- RESPONSE: Extension of legs in downward and extension of arm in the sitting position to catch weight
- Downward begins at 4 months
- Sideward begins at 6 months
- Forward begins at 7 months
- Backward sitting at 9 months
Tilting Reactions
- Slow shifting of BOS or slow displacement of body in space - RESPONSE: Lateral flexion of spine toward elevated side of support, Abduction of extremities on elevated side, and sometimes trunk rotation. (persist throughtout life)
- Prone tilting reaction begins at 5 months
- Supine tilting reaction begins at 7 months
- Sitting tilting reaction begins at 8 months
- Quadruped tilting reaction begins at 12 months
Traction or Pull to sit
- pull infant to sit from supine
- RESPONSE: UE will flex and there will be a head lag until about 4 - 5 months