Developmental Reflexes

Question 0

Crossed Extension Reflex

Answer 0

Stimulus: noxious stimuli to ball of foot of extremity fixed in extension tested in supine
Response: opposite lower extremity flexes, then addicts and extends
Patients with hemiplegia, lifting involved leg off ground during ambulation results in increased extensor tone in involved leg

Onset: 28 weeks gestation
Integrated: 1-2 months

Question 1

Asymmetrical Tonic Neck Reflex

Answer 1

Stimulus: rotation of head to one side
Response: flexion of skill limb, extension of jaw limb

If reflex severe, must look away from object in order to grasp

Onset: birth
Integrated: 4-6 months

Question 2

Equilibrium Reactions

Answer 2

Stimulus: displace center of gravity
Response: curvature of trunk toward upward side with extension and abduction of the extremities on that side. Protective extension on opposite side.

Reactions will be absent if marked spasticity.

Onset: prone- 6 months, supine and sitting- 7-8 months, kneeling- 9-12 months, standing- 12-21 months
Integrated: persists

Question 3

Grasp

Answer 3

Stimulus: pressure to palm or ball of foot under toes
Response: maintain flexion of fingers or toes

Onset: palmar- birth, plantar- 28 weeks gestation
Integrated: palmar- 4-6 months, plantar- 9 months

Question 4

Landau’s Reflex

Answer 4

Stimulus: lift under thorax in prone
Response: head and back and legs will extend. If head pushed into flexion, extensor time will disappear

Onset: 3 months
Integrated: 2 years

Absent in individuals who demonstrate strong flexor spasticity

Question 5

Moro Reflex

Answer 5

Stimulus: sudden change in position of head in relation to trunk (ex. Drop patient backward from sitting)
Response: extension and abduction of upper extremities with hand opening & crying. Then flexion, adduction, & arms across chest

Onset: 28 weeks gestation
Integrated: 5-6 months

Question 6

Optical and Labyrinthe Righting Reflexes

Answer 6

Stimulus: alter body position by tipping body in all directions. Labyrinthe- vision is occluded
Response: head orients to vertical position and mouth horizontal

Onset: birth-2 months
Integrated: persists

Question 7

Positive Supporting Reaction

Answer 7

Stimulus: contact to ball of foot in upright position
Response: rigid extension of lower extremities with ankle plantar flexion and inversion, toes clawing, & hip internal rotation
Variations: cerebral palsy- adductor spasm, hemiplegia- hip abduction, ambulation will be disrupted by inability to dorsiflex foot or to properly move leg joints

Onset: birth
Integrated: 6 months

Question 8

Protective Extension Reaction

Answer 8

Stimulus: displace center of gravity outside base of support
Response: arms and legs extend and abduct to support & protect body against falling, protective extension downward, followed by forward, sideward, & backward protective extension

Onset: arms- 4-6 months, legs- 6-9 months
Integrated: persists

Question 9

Rooting Reflex

Answer 9

Stimulus: side of face stimulated with light touch
Response: turns head toward stimulus and opens mouth

Onset: present in premature infants
Integrated: 3 months

Question 10

Symmetrical Tonic Neck Reflex

Answer 10

Stimulus: flexion or extension of head
Response: head flexion- flexion of arms & extension of legs; head extension- extension of arms & flexion of legs

Onset: 4-6 months
Integrated: 8-12 months

Strongly influences ability to assume quadruped and crawl

Question 11

Tonic Labyrinthe Reflex

Answer 11

Stimulus: prone or supine
Response: prone- flexor tone, supine- extensor tone

Onset: birth
Integrated: 6 months

May be impossible to turn side lying from supine because the extensor time limits flexion of shoulder or hip on one side, which is needed to turn over

Question 12

Traction Reflex

Answer 12

Stimulus: grasp forearm & pull up from supine into sitting
Response: grasp & total flexion of upper extremity & head will lag behind

Onset: 28 weeks gestation
Integrated: 2-5 months