Ch. 2 - Primitive Reflexes

Question 1

The purpose of this reflex is to assist with early eye-hand regard, provides vestibular stimulation, and changes the distribution of muscle tone. What primitive reflex am I?

Answer 1

Asymmetric Tonic Neck reflex - ATNR

Question 2

The purpose of this reflex is for orientation allowing child to search and grasp for nipple so they can take breast of bottle without hands. What primitive reflex am I?

Answer 2

Rooting reflex

Question 3

The purpose of this reflex is to obtain nourishment. What primitive reflex am I?

Answer 3

Sucking and Swallowing reflex

Question 4

How can you elicit the palmar grasp reflex? What response should you get?

Answer 4

Elicit - insert finger into pal of hand from ulnar side. Press finger against palm.
Response - quick flexion of the fingers followed by sustained finger extension.

Question 5

How can you elicit the sucking and swallowing reflex? What response should you get?

Answer 5

Elicit - place index finger in mouth

Response - rhythmical sucking and swallowing

Question 6

How can you elicit the rooting reflex? What response should you get?

Answer 6

Elicit - with head in neutral, lightly touch corner of mouth; touch upper lip; touch lower lip.
Response - movement of head, mouth, and lounge toward stimulus with neck flexion, extension, or rotation. Infant tries to suck stimulating finger.

Question 7

How can you elicit the ATNR reflex? What response should you get?

Answer 7

Elicit - rotation of head

Response - arm and leg of ‘jaw’ side extends. arm and leg of ‘skull’ side flex.

Question 8

How can you elicit the plantar grasp reflex? What response should you get?

Answer 8

Elicit - press thumb into ball of infants foot or stand child with pressure on ball of foot.
Response - automatic curling/flexion reaction of toes.

Question 9

How can you elicit the flexor withdrawal and crossed extension reflex? What response should you get?

Answer 9

Elicit - infant supine. noxious stimulus to foot/sole
Response - extension of toes. ankle DF, hip and knee flexion or total pattern of withdrawal on homolateral side. Opposite side may also withdrawal or could show crossed extension.

Question 10

How can you elicit the galant reflex? What response should you get?

Answer 10

Elicit - infant prone (on hand or supporting surface). scratch fingernail along paravertebral line about 1 inch lateral of vertebrae.
Response - incurving/lateral curvature of trunk on stimulated side.

Question 11

How can you elicit the moro reflex? What response should you get?

Answer 11

Elicit - sit child with head in midline and UE on chest. Support head, then suddenly drop head backwards 30°. Catch head when it drops back.
Response - First: Ext and And of UE with opening of hands and crying; Second: Add and Flexion of UE (embrace). LE usually extend.

Question 12

How can you elicit the primary standing (positive support) reflex? What response should you get?

Answer 12

Elicit - 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.

Question 13

How can you elicit the spontaneous stepping reflex? What response should you get?

Answer 13

Elicit - support infant in vertical position, incline infant forward.
Response - stepping with stereotyped rhythm and heel-to-gait. DF is strong. No balancing or associated movements in extremity.

Question 14

How can you elicit the tonic labyrinthine reflex (TLR)? What response should you get?

Answer 14

Elicit - change of orientation of the head in space (flex or ext); position of head in relation to gravity while prone and supine.
Response - in prone flexor tone will predominate with arms flexed by the child’s chest. In supine extensor tone will predominate.

Question 15

How can you elicit the symmetric tonic neck reflex (STNR)? What response should you get?

Answer 15

Elicit - flexion or extension of he head (neck)

Response - with neck flexion the UE flex and LE extend. with neck extension UE extend and LE will flex.

Question 16

How can you elicit the landau reflex? What response should you get?

Answer 16

Elicit - place child in horizontal suspension

Response - child’s head, legs, and spine extend.

Question 17

How can you elicit neonatal neck righting? What response should you get?

Answer 17

Elicit - place child in supine. turn head and observe trunk movement.
Response - rolls like a log, no segmental dissociation.

Question 18

How can you elicit neonatal body righting reflex? What response should you get?

Answer 18

Elicit - place child in supine. flex, adduct and IR hip across body, observe trunk movement.
Response - Rolls lik a log. no segmental sequences.

Question 19

How can you elicit labyrinthine head righting? What response should you get?

Answer 19

Elicit - place child in vertical suspension. tilt child anterior, posterior, and laterally from vertical.
Response - the head orients to the vertical position and maintains position.

Question 20

How can you elicit anterior protective response? What response should you get?

Answer 20

Elicit - place child in vertical suspension. plunge child downward head first.
Response - child should extend and abduct the arms with fingers spread.

Question 21

How can you elicit lateral protective (parachute) response? What response should you get?

Answer 21

Elicit - place child in long sitting. gently push child laterally at the shoulder of tilt laterally.
Response - child should extend and abduct the arms with fingers spread to the side of fall.

Question 22

How can you elicit posterior protective (parachute) response? What response should you get?

Answer 22

Elicit - place child in sitting. gently push child backwards at shoulders or tilt posteriorly.
Response - child should extend and abduct the arms with fingers spread backwards.

Question 23

If anterior/lateral/posterior protective (parachute) responses are absent, what could be signified?

Answer 23

possible neurologic dysfunction or developmental delay.

Question 24

If landau reflex or labyrinthine head righting is absent what is signified?

Answer 24

neurologic dysfunction.

Question 25

If neonatal body or head righting reflex persists beyond 4-5 months?

Answer 25

will prevent segmental rolling

Question 26

If symmetric tonic neck reflex persists what would be expected results?

Answer 26

• interferes with advanced reciprocal creeping.
• impairs dissociation between the two LE and transitions between quadruped to sitting to kneeling to standing and vice versa.
• if strong influence, a baby will not be able to creep; will bunny hop versus true creeping/crawling.

Question 27

If asymmetric tonic neck reflex persists what would be expected results?

Answer 27

• may impair ability to roll, use hands smoothy together at midline, poor visual regard when holding objects, poor balance.
• may impair creeping/crawling
• baby loses balance and/or falls when rotates head from midline; frustrating and causes excessive fatigue.

Question 28

If tonic labyrinthine reflex persists what would be expected results?

Answer 28

• interfere with movement that requires smooth grading (flexors and extensors)
• Supine, compromised ability to raise head against gravity, this affects anti-gravity movement (bringing feet and hands together and rolling.
• Prone, compromised ability to raise head, extend spine, bear weight on elbows. This limits tummy time for crawling and developing movements in pelvis and shoulders needed for moving in/out of various body positions.
• limits options for exploring.
• this will effect social and cognitive gains.

Question 29

If moro reflex persists what would be expected results?

Answer 29

• could signal neuro- dysfunction

- increased startle response, anxiety, poor balance, poor coordination.

Question 30

If sucking and swallowing reflex persists what would be expected results?

Answer 30

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

Question 31

If rooting reflex persists what would be expected results?

Answer 31

• leads to feeding problems

- can’t suck properly

Question 32

If the galant reflex persists what would be expected results?

Answer 32

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

Question 33

If the flexor withdrawal and crossed extension reflex persists what would be expected results?

Answer 33

• if stronger than positive support standing is not possible.
• could indicate sensorimotor delay.

Question 34

The purpose of this reflex is to evaluate integrity of sacral cord segments. What am I?

Answer 34

plantar grasp reflex

Question 35

The purpose of this reflex is to allow baby’s posture to adapt to that of the head. What reflex am I?

Answer 35

tonic labyrinthe reflex

Question 36

The purpose of the reflex is to break up physiological flexion; must be integrated for head control, sitting, righting, and equilibrium reactions. What reflex am I?

Answer 36

moro reflex

Question 37

The purpose of this reflex is to assist in the development of bilateral patters of body movement. What reflex am I?

Answer 37

symmetric tonic neck reflex

Question 38

The purpose of this reflex is important at birth - child follows rotation of head down birth canal. What reflex am I?

Answer 38

neonatal neck/body righting