Primitive motor reflexes

Reflex

involuntary muscle reaction to a certain type of stimulation; occur subcortically

primitive

_____ reflexes are important for protection, nutrition, and survival; typically integrated, modified, and incorporated into more complex patterns to form voluntary movements

Postural

____ reflexes are related to the development of later voluntary movement

Righting Responses

infant tried to maintain vertical orientation of their head in relation to body or gravity

Equilibrium Reactions

Infant adjusts body as needed due to changes of orientation in space

Protective Responses

UEs or LEs rspond in order to prevent fall

Flexor Withdrawal and Crossed Extension Reflexes

Stimulus: infant supine, noxious stimulus to foot/sole

Response: extension of toes, ankle dorsiflexion, hip and knee flexion or total pattern of withdrawal on the same side; opposite side may also withdraw or could show ross extension

Purpose: to protect body from damaging stimuli

If presists: if reflex is stronger than positive support (weight bearing) standing is not possible

Galant Reflex

Stimulus: Infant prone on hand or supporting surface. Run fingernail along paravertebral line about 1 inch later to vertebrae

Response: incurving of trunk toward stimulated side

Purpose: Preparation for movement similar to walking and crawling

If persists: delayed symmetrical trunk stabilization or delayed independent movements of head for sitting, crawling, and walking, prolonged bed wetting

Primary Standing Reflex

Stimulus: support child in vertical position with hands around thorax. Allow feet to make firm contact with surface

Response: Infant bears partial weight. Hips and knees are partially flexed. Can trigger increased extension from legs to trunk to head. Child may stand on toes.

Purpose: Fetal locomotion, must be integrated for more mature LE movements

Stepping reflex

Stimulus: support infant in vertical position to activate standing reflex. Incline infant forward

Response: stepping movement. DF is strong. No balancing or associated movements in extremity

Purpose: fetal locomotion; early UE supported true walking will not be present until 6-10 months with foot flat pattern and disorganized movements

Palmar grasp reflex

Stimulus: Infant supine, head midline. Insert finer into palm of hand from ulnar side. Press finger against palm.

Response: quick flexion and add fingers (catching phase) followed by sustained finger flexion (holding phase)

Purpose: Grasp of a toy

If persists: child could have difficulty releasing

Plantar grasp reflex

Stimulus: infant supine, head midline. Press thumb into ball of infants foot

Response: automatic curling reaction of the toes

Purpose: used to evaluate integrity of sacral cord segments

If persists: will inhibit independent standing and walking. Persistent strong toe clawing is abnormal

Rooting reflex

Stimulus: head in neutral; lightly touch corner of mouth; touch upper lip; touch lower lip

Response: movement of head, mouth, and tongue towards stimulus with neck flexion, extension, or rotation. Infant tries to suck stimulating finger

Purpose: orientation reflex allowing child to search and grasp for food source so can take breast or bottle without hands. Precursor for head movement.

If persists: leads to feeding problems, can't suck properly

Sucking and Swallowing reflex

Stimulus: supine with head in neutral. Place index finger in mouth

Response: rhythmical sucking and swallowing

Purpose: obtain nourishment

If persists: will inhibit voluntary suck. If weak or absent, child is deprived of normal oral sensory stimulation resulting in poor nutrition, tongue movements, and vocalization

Moro Reflex

Stimulus: sit child with head in midline and UE on chest. Support head, then suddenly drop head backwards 30 degrees. Catch head when it drops back.

Response: first stage = extension and abduction of UE with opening of hands and crying, second stage = adduction and flexion of UE (embrace). LE usually extend

Purpose: Breaks up physiological flexion; startle reflex; must be integrated for head control, sitting, righting, and equilibrium reactions

If absent in 1-3 month old could signify neuro dysfunction

If persists: could signal neuro dysfunction, increased startle response, anxiety, poor balance, poor coordination

Tonic Labyrinthine Reflex (TLR)

Stimulus: position of head in relation to gravity

Response: if head moves forward, flexor tone will predominate with arms flexed by the child's chest. If head moves backwards, extensor tone will predominate

Purpose: allows baby's posture to adapt to that of the head and breaks up physiological flexion

If persists: will interfere with movement that requires smooth grading of flexor and extensor muscles

Symmetric Tonic Neck Reflex (STNR)

Stimulus: Flexion and extension of the head (neck) on hands and knees

Response: with neck flexion, the upper extremities will flex and lower extremities will extend. With neck extension, the upper extremities will extend and the lower extremities will flex.

Purpose: assists in the development of bilateral patterns of body movement. Allows child to move up against gravity and assume quadruped. Integrates as child begins to crawl and can lift the buttocks from the heels without flexing the neck. Integrated when rocking back and forth on hands and knees.

If persists: interferes with advanced reciprocal crawling. Impairs dissociation between the two lower extremities transitioning between quadruped to sitting to kneeling to standing and vice versa.

Asymmetric Tonic Neck Reflex (ATNR)

Stimulus: Rotation of the head

Response: Arm and leg on the "jaw" side extends, arm and leg on the "skull" side flex

Purpose: assists with early eye-hand regard, provides vestibular stimulation, changes the distribution of muscle tone.

If persists: may impair ability to roll and use hands smoothly together at midline, poor visual regard for objects being held, poor balance. May impair creeping or crawling. Baby loses balance and/or falls when rotates his head from midline

Landau Reflex

Stimulus: place child in horizontal suspension

Response: child's head, legs, and spine extend

Purpose: breaks up total flexion pattern seen at birth. Won't see until around 3 months old

If absent after 3 months old: could signify neurologic dysfunction

Neonatal Neck on Body Reflex

Precursor to righting reactions

Stimulus: place child in supine position. Turn head and observe trunk movement

Response: Rolls like a log. No segmental dissociation

Purpose: important at birth - child follows rotation of head down birth canal. Allows child to roll supine to side

If persists: will prevent segmental rolling which requires trunk rotation

Neonatal Body on Neck Reflex

Precursor to righting reactions

Stimulus: place child in supine position. Flex, adduct, and IR hip across body, observe trunk movement

Response: rolls like a log. no segmental sequences

Purpose: important for birth - child follows rotation of head down birth canal. Allows child to roll supine to side

If persists: will prevent segmental rolling

Head Righting Reflex

Persists throughout life

Stimulus: place child in vertical suspension. Tilt the child anterior, posterior, and laterally from vertical

Response: the head orients to the vertical position and maintains

Purpose: helps child with finding the upright position with the horizon. Won't see until 2-3 months

If absent after 3 months: could signify neurologic dysfunction

Anterior Protective response

Persists throughout life

Onset: 5-6 months

Stimulus: place child in vertical suspension. Plunge the child downward head first

Response: child should extend and abduct the arms with fingers spread

Purpose: to break a fall. necessary for prop sitting

If absent: could signify neurologic dysfunction or developmental delay

Lateral Protective Response

Persists throughout life

Onset: 7-8 months

Stimulus: place child in sitting. Gently push the child laterally at the shoulder or tilt laterally

Response: child should extend and abduct the arms with fingers spread to the side of the fall

Purpose: to break a fall. necessary for independent sitting

If absent after 9 months; could signify neurologic dysfunction or developmental delay

Posterior Protective Responses

Persists throughout life

Onset: 9-10 months

Stimulus: place child in sitting. gently push the child backwards at the shoulders or tilt posteriorly

Response: child should extend and abduct the arms with fingers spread backwards

Purpose: to break a fall. Necessary for independent sitting

If absent after 12 months: could signify neurologic dysfunction or developmental delay

not

primitive reflexes are ___ usually recognizable in neuro typical adults; can re-appear and effect motor movements in individuals with UMNL