Pediatric PT - Reflexes and Milestones

What is the tonic labyrinthine reflex?

Extremities flex to midline with head flexion OR extremities extend with head extension

When does the tonic labyrinthine reflex appear?

12 weeks GA

When/why does the tonic labyrinthine reflex integrate?

At 3-4 months old, integrates with head control

What is the asymmetrical tonic neck reflex (ATNR)?

When the infant turns their head, the same arm extends and abducts while the opposite arm flexes and abducts; “fencer’s pose”

When does the ATNR appear?

20 weeks GA

When does the ATNR integrate?

At 4-5 months old

What is the flexor withdrawal reflex?

The flexion of a leg in response to noxious stimulus at the sole

When does the flexor withdrawal reflex appear?

28 weeks GA

When does the flexor withdrawal reflex integrate?

1-2 months old

What is the crossed extension reflex?

When there is a noxious stimulus at the sole of one foot, the opposite leg will extend (while the ipsilateral leg flexes)

When does the crossed extension reflex appear?

28 weeks GA

When does the crossed extension reflex integrate?

Around 1-2 months old (becomes dormant, then reactivates later in life)

What is the rooting reflex?

The child’s head and lips turn in response to a cheek stroke

When does the rooting reflex appear?

28 weeks GA

When does the rooting reflex integrate?

At 3 months old

What is the Galant reflex?

Lateral trunk flexion to the stimulated side in response to stroking paravertebral skin

When does the Galant reflex appear?

28 weeks GA

When does the Galant reflex integrate?

Around 3 months old

What is the Moro reflex?

“Startle reflex”; when the head drops backward, arms abduct and extend and the fingers splay

When does the Moro reflex appear?

28 weeks GA

When does the Moro reflex integrate?

At 3-5 months old

What is the suck-swallow reflex?

When the jaw and tongue move to suck and swallow in response to stimulus (touch and liquid) on lips and inside mouth

When does the suck-swallow reflex appear?

At 28-34 weeks GA

When does the suck-swallow reflex integrate?

At 5 months old

What is the palmar grasp reflex?

Fingers flexing in response to pressure on the palm

When does the palmar grasp reflex appear?

28 weeks GA

When does the palmar grasp reflex integrate?

At 4-7 months old

What is the plantar grasp reflex?

The flexion of toes in response to supported standing or pressure applied just distal to metatarsal heads

When does the plantar grasp reflex appear?

28 weeks GA

When does the plantar grasp reflex integrate?

At 9 months old

What is the positive support reflex?

When the legs extend to support weight in response to the balls of the feet being in contact with a firm surface

When does the positive support reflex appear?

35 weeks GA

When does the positive support reflex integrate?

At around 1-2 months old

What is the automatic walking reflex?

AKA reflex stepping; high, regular stepping movements in response to being held upright and tipped forward with feet supported

When does the automatic walking reflex appear?

37 weeks GA

When does the automatic walking reflex integrate?

At 3-4 months old

What is the Landau reflex?

When neck extension makes all extremities extend whether prone or supine; when neck flexion in suspension makes all extremities flex

When does the Landau reflex appear?

At 2-3 months old

When does the Landau reflex integrate?

At 12-24 months old

What is the symmetrical tonic neck reflex?

STNR; When the arms flex and hips extend in response to neck flexion in supine OR when the arms extend and hips flex in response to neck extension in prone

When does the STNR appear?

At 4-6 months old

When does the STNR integrate?

At 8-12 months old

What is the parachute reflex?

When arms extend in response to being quickly moved downward and forward due to being suspended or rotated

When does the parachute reflex appear?

At 8-9 months old

When does the parachute reflex integrate?

Around 1 year old