Developmental Reflexes and Postural Control

rcolo

infants prefer faces and patterns with _____ contrast (black and white)

3

infants can track slow moving objects by ____ months

5 months

at what age does color vision develop?

spontaneous movement

movements not caused by known external stimuli

reflexive movement

stereotypical responses elicited by specific external stimuli

similar

the current theory is that spontaneous movement is the building blocks and _____ to some voluntary movements

4; 6

primitive/neonatal reflexes typically integrate between ____ and ____ months of age

righting reactions

maintain or restore the normal position of the head in space (eyes parallel to the horizon) and its normal relationship with the trunk and limbs

equilibrium reactions

maintain balance when COG is disturbed

protective reactions

prevent injury when unable to restore balance

sucking reflex

touch roof of mouth and baby will suck

- develops 28-34 weeks gestation

- integrates at 5 months

rooting reflex

stroke the corner of the mouth, baby turns towards stimulus and opens mouth

- develops at 28 weeks gestation

- integrates at 3 months

flexor withdrawal

pain to sole of foot, baby will pull LE into flexion to get away

- develops at 28 weeks gestation

- integrates 1-2 months

crossed extension

pain to foot while holding LE into position, baby will pull opposite leg into flexion and add and try to push you away

- develops at 28 weeks gestation

- integrates at 1-2 months

positive support

balls of feet contact support surface, baby's legs will extend to bear weight

- develops at 35 weeks gestation

- integrates at 1-2 months

stepping

when held upright touch baby's feet to surface, rhythmic stepping will occur

- develops at 37 weeks gestation

- integrates at 3-4 months

galant

in ventral suspension stroke paraspinals on one side, baby SBs toward stimulated side

- develops at 28 weeks gestation

- integrates at 3 months

moro

when startled or when head is allowed to drop backward, baby will abd/extend and then add/flex the extremities

- develops at 28 weeks gestation

- integrates 3-6 months

ATNR

turn head to side, baby will extend on face side and flex on skull side (en guarde)

- develops 20 weeks gestation

- integrates 4-5 months

palmar/plantar

touch palm or ball of foot, baby will close hand or curl toes around object

- develops 28 weeks gestation

- integrates:

- palmar: 4-7 months

- plantar: 9 months

tonic labyrinthine

prone or supine position

supine: extend neck and limbs

prone: flex neck and limbs

- develops by 2 weeks

- integrates 4 months

landau

ventral suspension, baby extends head, back, and hips in sequence (superman)

- develops about 3 months

- integrates 12-24 months

STNR

in supported sitting, flex or extend head

arms will flex and legs will extend (head flexes) or opposite

- develops 4-6 months

- integrates 8-12 months

- basis for crawling

parachute

support child in prone and lower toward support surface

baby will extend arms with open hands

- develops 8-9 months

- should not go away (protective)

babinski

firm stroke along lateral border of sole, big toe extends and others fan out

- should integrate within 2 years

- abnormal after age 2

difficulty eating if head turn, may cause scoliosis

if the ATNR doesn't integrate what will be hard for the baby?

difficulty releasing voluntarily

if the palmar/plantar grasp doesn't integrate what will be complicated?

difficulty with midline control and tracking

if the rooting reflex doesn't integrate what will be complicated?

walking, too much extension of LEs

if positive support doesn't integrate what will be complicated?

poor trunk control, possible scoliosis

if galant doesn't integrate what will be complicated?

difficulty with sitting balance

if moro doesn't integrate what will be complicated?

phasic bite

A reflex that is characterized by a rhythmic opening and closing of the jaw when the gums are stimulated. Appears around 28 weeks gestation.

- if the baby clamps down, this is not normal

impacts rolling, need asymmetrical pattern

if tonic labyrinthine doesn't integrate what will be complicated?

postural control

Controlling the body's position in space for the dual purposes of stability and orientation

postural orientation

ability to maintain relationship between body segments and between body and environment for a task

postural stability

ability to control the COM in relationship to the BOS

2

infants cannot sustain their head flexion/extension until about ____ months with their eyes 30 degrees below the horizontal

3

infants can sustain and track with their head by about _____ months

6

smooth visual tracking occurs by about _____ weeks

14

vision is adultlike by about _____ weeks

vision

primary system to start

feedback correction and anticipatory postural strategies

vestibular

drives postural activity to regulate head control and reference gravitational forces

- hasn't had practice working until birth

- develops later

somatosensory

triggers postural activity related to body positioning and righting

- collects information, learning to interpret

labyrinthine righting reflex

tilt infant in vertical suspension with eyes covered

- baby should orient their head to vertical

- onset birth-2 months

optical righting reflex

same as labyrinthine without eyes covered

BOH (body righting reflex acting on head)

body contacts surface

lift head away from surface (so they don't suffocate)

- onset birth-2 months

NOB (neck righting reflex)

turn head of infant in supine

body turns toward head

- onset 34 weeks, integrates 4-6 months

BOB (body righting reflex on body)

flex leg over supine body

upper body follows in log roll

symmetry

goals of righting reactions in pediatric PT are to improve ______ of reactions to both sides, midline control, and coordination of transitional movements

protective extension

a primitive reflex that develops shortly after birth in response to the new environment of gravity

-automatic reactions to a rapid loss of balance or weight shifting (protect from injury during a fall)

- most distinguishable at 10-12 months

- remains active throughout life

anterior, lateral, posterior

what order does protective extension occur in development?

equilibrium reaction

torso elongates on weight bearing side

torso lateral flexes to non-weight bearing side

extremities may abd on non-weight bearing side (shift more weight)

- may be some rotation

proactive balance control

- Feed-forward Control

- Anticipatory balance

- Postural responses in anticipation of a voluntary movement that may destabilize in order to maintain stability.

- Volitional shifts in COM

reactive postural adjustments

-development in standing is variable

-increased latency in children ages 4-6 years (period when visual dependence in transitioning to add somatosensory input)

-adult like response by 7-10 years