Reflexes

Moro Reflex

What it looks like: Sudden head drop backward causes arms to abduct & extend, then quickly adduct & flex (embracing motion); baby may cry.
How to test: Hold infant semi-reclined, allow head to drop back a few inches briefly & catch.
Response: Arms spread out then hug in.
Onset: 28 weeks gestation.
Integration: 5–6 months.
Impact if persists: Poor head control, impaired sitting balance, over-sensitivity to movement & sound, delayed protective responses.

Landau Reflex

What it looks like: When held horizontally prone (face down in air), baby extends head, trunk, and legs (superman posture).
How to test: Hold baby prone, support under belly, lift in air.
Response: Head lifts, back arches, legs extend.
Onset: 3–4 months.
Integration: 12–24 months.
Impact if persists: Poor posture, difficulty sitting upright, low trunk strength, delayed motor skills.

Plantar Grasp

What it looks like: Toes curl downward when ball of foot is pressed.
How to test: Apply pressure to sole at metatarsal heads.
Response: Toes flex.
Onset: 28 weeks gestation.
Integration: 9 months.
Impact if persists: Toe-walking, poor standing balance, delayed walking.

Palmar reflex

What it looks like: Fingers close around an object placed in palm.
How to test: Place finger or object in infant’s palm.
Response: Fingers flex (grasp).
Onset: Birth.
Integration: 4–6 months.
Impact if persists: Poor voluntary grasp & release, trouble holding writing tools, fine motor delays.

Spontaneous Stepping

What it looks like: Baby makes stepping movements when held upright on a surface.
How to test: Hold baby upright, feet touching flat surface, lean forward slightly.
Response: Rhythmic stepping.
Onset: Birth.
Integration: 2 months.
Impact if persists: Abnormal gait pattern, poor balance, delayed voluntary walking.

Traction

What it looks like: Pulling baby to sit by arms causes flexion of shoulders, elbows, wrists, fingers.
How to test: Grasp baby’s wrists, pull gently to sit.
Response: Flexion of UE joints.
Onset: 28 weeks gestation.
Integration: 2–5 months.
Impact if persists: Weak head/trunk control, poor UE strength for pulling to sit.

Rooting

What it looks like: Touching corner of mouth makes baby turn head & open mouth toward stimulus.
How to test: Stroke corner of mouth.
Response: Turns head, opens mouth.
Onset: 28 weeks gestation.
Integration: 3 months.
Impact if persists: Oral sensitivity, poor swallowing, speech/articulation issues.

ATNR (Asymmetrical Tonic Neck Reflex)

What it looks like: Head turned to one side → arm & leg on face side extend, skull side flexes.
How to test: Rotate baby’s head to one side.
Response: Fencing posture.
Onset: Birth.
Integration: 4–6 months.
Impact if persists: Poor hand-eye coordination, difficulty rolling, handwriting issues.

STNR (Symmetrical Tonic Neck Reflex)

What it looks like: Neck flexed → arms flex, legs extend; neck extended → arms extend, legs flex.
How to test: In ventral suspension or quadruped, flex/extend neck.
Response: Arms & legs move in pattern.
Onset: 4–6 months.
Integration: 8–12 months.
Impact if persists: Poor crawling, trouble moving from sit to stand, slumped sitting posture.

TLR (Tonic Labyrinthine Reflex)

What it looks like: In prone, body flexes; in supine, body extends.
How to test: Place child in prone & supine, observe tone & posture.
Response: Flexor tone in prone, extensor tone in supine.
Onset: Birth.
Integration: 6 months.
Impact if persists: Difficulty rolling, sitting up, poor balance/posture.

Neonatal Neck Righting

What it looks like: Turning baby’s head causes whole body to roll in same direction.
How to test: Turn head to side in supine.
Response: Body rolls as a unit.
Onset: Birth.
Integration: 4–5 months (replaced by mature body righting).
Impact if persists: Poor segmental rolling, delayed trunk rotation.

Body Righting

What it looks like: When head or shoulder is turned, trunk rotates segmentally to align body.
How to test: Flex one leg across body or turn head.
Response: Segmental rolling.
Onset: 4–6 months.
Integration: 5 years.
Impact if absent: Poor trunk rotation, trouble rolling, balance issues.

Protective Extension Forward

What it looks like: Arms extend forward to protect when falling forward.
How to test: Tip child forward in sitting or suspended prone.
Response: Arms extend to catch self.
Onset: 6–7 months.
Integration: Persists throughout life.
Impact if absent: High risk of face injuries, poor sitting balance.

Protective Extension Backwards

What it looks like: Arms extend backward when tipping backward.
How to test: Tip child backward in sitting.
Response: Arms extend behind to catch.
Onset: 9–10 months.
Integration: Persists throughout life.
Impact if absent: Falls backward, poor protective reactions.

Protective Extension Sideways

What it looks like: Arms extend to side when tipped to side.
How to test: Tip child sideways in sitting.
Response: Arm on that side extends to catch self.
Onset: 7 months.
Integration: Persists throughout life.
Impact if absent: Falls sideways, unsafe sitting/balance.

Protective Extension Downward

What it looks like: Legs extend when baby is lowered feet first toward floor.
How to test: Hold upright, lower quickly toward floor.
Response: Legs extend, prepare to stand.
Onset: 4 months.
Integration: Persists throughout life.
Impact if absent: Poor standing prep, delayed walking.

Equilibrium Reaction

What it looks like: Whole-body adjustments to maintain balance when base of support shifts.
How to test: Tilt supporting surface (prone, supine, sitting, quadruped, standing).
Response: Trunk curves, limbs extend/abduct to balance.
Onset: Varies:

• Prone: 6 months

• Supine: 7–8 months

• Sitting: 7–10 months

• Quadruped: 9–12 months

• Standing: 12–21 months
  Integration: Persists throughout life.
  Impact if absent: Poor balance, frequent falls, limited safe movement.

Flexor Withdrawal

What it looks like: Sudden flexion of hip, knee, ankle when sole of foot is stimulated.
How to test: Apply noxious stimulus to sole of foot in supine.
Response: Withdrawal of stimulated leg.
Onset: Birth.
Integration: 1–2 months.
Impact if persists: Interferes with standing & walking, abnormal reflexive leg pulling.