Lifespan- Primitive Reflexes

Crossed Extension

noxious stim to sole of foot causes flexion then extension of contralateral leg.

1-2 months

when is the crossed extension reflex integrated

flexor withdrawal

noxious stim to foot causes flexion of knee to withdraw from stimulus

1-2 months

when does the flexor withdrawal reflex integrate

standing balance and walking, safety (all upright motor skills)

if the cross extension and/or flexor withdrawal reflexes persist, what does it interfere with?

Positive support reflex (primary standing reaction)

baby suspended in vertical with feet touching a solid surface; extension at hips, knees, and ankles and bouncing in attempt to support weight

1-2 months

when is the positive support reflex (primary standing reaction) integrated

inability to support weight on own, rigid stance, lack of reciprocal gait/stepping

if the positive support reflex persists, it can interfere with

galant

stimuli to the back, such as stroking one side of the spine; infant curves spine and buttock towards stimuli

3 months

when does the galant reflex integrate

movement, balance, muscle tone, coordination, excessive fidgeting, bedwetting, tactile hypersensitivity, attention deficits, potential scoliosis/poor posture, gait abnormalities, dyslexia, dislike of exercise/tight clothing, back pain

if the galant reflex persists, it can interfere with

rooting

corner of infant's mouth is touched or stroked; infant will turn their head toward the stimulus and open their mouth with tongue thrusting (sticking tongue out of mouth)

3 months

when does the rooting reflex integrate

tongue control, excessive drooling, forward tongue, difficulty swallowing and chewing

if the rooting reflex persists, it can interfere with

stepping reflex (primary walking or dancing reflex)

hold the baby upright with his/her feet touching a flat surface; baby will move his/her legs as if she/she is walking or trying to take steps, even though the baby is too young to walk

3-4 months

when is the stepping reflex (primary walking or dancing reflexes) integrate

walking will look robotic

if the stepping reflex (primary walking or dancing reflex) persists, it can interfere with

Tonic Labyrinthine Reflex

with head and neck in flexion, arms and legs go into flexion (fetal position); with head and neck extension arms and legs go into extension

4 months

when does the tonic labyrinthine reflex integrate

crawling, creeping, sitting, pull to stands, poor balance and posture

if the tonic labyrinthine reflex presists, it interferes with

moro reflex

baby's head shifts position abruptly or falls backward; baby will extend and abduct UE's extend fingers, and slightly extends the neck and spine, after initial phase, UEs adduct and come in front of their body

3-5 months

When does the moro reflex integrate?

hypersensitivity or over-reactive to various stimuli, balance problems, difficulty concentrating, headaches, insecurity, generalized anxiety, poor tolerance to change

if the moro reflex persists, it can interfere with

startle reflex

a sudden change in the positioning of the baby's head and extremities due to an abrupt sound, bright light, or change in temperature; baby's will extend LE and UE causing them to jerk outwards, may cry and then flex the arms and legs back in

3-5 months

when does the startle reflex integrate

over sensitive to stimulus resulting in poor impulse control, sensory overload, anxiety, social immaturity, poor balance, motion sickness, unable to adapt to change

if the startle reflex persists, it can interfere with

asymmetrical tonic neck reflex

turning the child's head to one side with jaw over shoulder; causes extension at arm and leg of face side and flexion of arm and leg of occipital side

4-5 months

when does the asymmetric tonic neck reflex integrate

poor balance, poor eye movement, increase in learning problems, decreased ability to multitask, prone propping, crawling, sitting, fine motor skills, difficulty crossing midline, rolling can lead to torticollis

if the asymmetrical tonic neck reflex persists, it can interfere with

palmar grasp reflex

apply pressure to palm of hand; finger flexion to grasp object in palm

4-7 months

when does the palmar grasp reflex integrate

intentional grasp and release of objects (fine motor skills), ability to bear weight on open hands for prone propping, belly crawling, creeping, pull to stand

if the palmar grasp reflex persists, it can interfere with

sucking reflex

place gloved finger, pacifier, bottle nipple in mouth; rhythmically sucking

5 months

when does the sucking reflex integrate

eating, drinking, speech impairments, drooling, risk for choking, tendency to suck thumb

if the sucking reflex persists, it can interfere with

head/neck on body

passively rotate head in supine; body follows head by trunk rotating into sidelying

4-6 months

when does the head/neck on body reflex integrate

complete voluntary rolling

if the head/neck on body reflex persists, it can interfere with

body on head/neck

passively rotate trunk/body into sidelying; head follows trunk and rotates to the same side

5 years

when does the body on head/neck reflex integrate

complete voluntary rolling

if the body on head/neck reflex persists, it can interfere with

gag reflex

stimulates back of the throat; tongue thrusts forward

6 months

when does the gag reflex integrate

intraoral hypersensitivity, difficulties eating, drinking, risk for choking, impaired speech, poor nutrition

if the gag reflex persists, it can interfere with

symmetrical tonic neck

passive or active motion of the neck/head into flexion or extension; in neck flexion= arms will flex, legs will extend; in neck extension= arms will extend, legs will flex

8-9 months

when does the symmetrical tonic neck reflex integrate

crawling, belly crawling, creeping, prone movement, sitting and standing balance, sit to stand, walking, coordination

if the symmetrical tonic neck reflex persists, it can interfere with

plantar grasp reflex

pressing the thumb against the sole of the foot or stroking the bottom of the foot medially; lateral surface of the foot bend. Flexion and adduction of all toes as if the toes were grasping the object

9 months

when does the plantar grasp reflex integrate

balance, ability to walk, standing activities

if the plantar grasp reflex persists, it can interfere with

Babinski reflex

firmly stroke sole of foot heel to toes, in lateral to medial curve; great toe extends and other toes splay

24 months

when does the babinski reflex integrate

landau reflex

with child in prone position and suspended in space with support under chest, passive or active neck extension will cause back and legs to extend.

standing balance and walking

if the babinski reflex persists, it can interfere with

3-12 months

when does the landau reflex integrate

slows development of prone extension, sitting and standing

if the landau reflex persists, it can interfere with

primitive reflexes

most are present at birth; 27-28week premies have many; should be integrated by 8-9 months

righting reaction, equilibrium/tilting reaction, protective reaction

postural "reactions" once thought to be reflexes

righting reaction

slight perturbation (well within base of support)

equilibrium/tilting reaction

moderate perturbation (close to edge of base of support)

protective reaction

extreme perturbation (beyond base of support)

head righting

ability to maintain head vertical in all planes with disturbance of center of mass

trunk righting

ability to maintain upright trunk in all planes with further disturbance of center of mass

tilting reaction, equilibrium reaction

what are trunk righting reactions

tilting reaction

ability to maintain upright trunk in all planes with further disturbance of center of mass- when on moving surface

equilibrium righting

ability to maintain upright trunk in all planes with further disturbance of center of mass- when on stationary surface with perturbation

protective extension reactions

in sitting will extend UE to prevent falling; should have mastered all directions by 12 months

stepping reaction, parachute reaction

what are different protective extension reactions

stepping reaction

protective extension reactions; in standing will extend LE

parachute reaction

protective extension reaction; when suspended by PT and moving head toward ground, child will extend UEs to prevent head hitting on the floor