infant reflexes Flashcards
What are Infant Reflexes?
- Involuntary stereotyped movement responses to a particular stimuli.
- Dominant movement form during the last 4 months of prenatal life and first 4 months after birth.
- Occur subcortically (below the level of the higher brain centers)
Infant vs. Lifespan Reflexes
- Most “infant” reflexes do not last beyond the first year.
- Infant reflexes may not completely disappear.
– May be inhibited by maturing CNS.
– May be integrated into new movements. - Reflexes that endure are called “lifespan” reflexes
Why is the study of infant reflexes important?
Dominant form of movement for last 4 months prenatally and first 4 months
* critical for human survival.
* believed to be foundation for later voluntary movements.
* Appearance and disappearance helpful in diagnosing neurological disorders
Role of the Reflexes in Survival
-Human infants essentially helpless
-Primitive reflexes occur during gestation or at birth and most are repressed by 6 months of age
-important for protection,
nutrition, and survival
Postural reflexes
related to the development of later voluntary movement.
– Reflexes integrated, modified, and incorporated into more complex patterns
– Automatic movement is “practice” for future voluntary movements.
– Some believe reflexes may not be related to future motor development
Reflexes as Diagnostic Tools
-Reflexes can determine level of neurological maturation.
-Reflexes should be tested carefully and only by trained professionals
Milani Comparetti Neuromotor
Development Examination
-– Measures several infant reflexes from birth to 24 months.
– Develops profile of child’s movement in
relation to what is expected at a specific
age.
– Especially valuable with children suspected of motor delay
Primitive Reflex Profile
– Quantification of the level of presence or strength of primitive reflexes
– 3 reflexes: moro, asymmetric tonic neck, symmetric tonic neck
– 5 point classification system (0 for absent, 4 for so strong it dominates individual).
Pinpointing the Number of Infant Reflexes
– Rooting reflex = search reflex; cardinal points reflex
- poorly defined and more
complex than once thought
Primitive Reflexes
- Palmar Grasp
- Sucking
- Search
- Moro
- Startle
- Asymmetric Tonic Neck
- Symmetric Tonic Neck
- Plantar Grasp
- Babinski
- Palmar Madibular
- Palmar Mental
Primitive Reflexes ~ Palmar Grasp
Stimulus /Response
S: Palm stimulated
R: 4 fingers (not thumb) close
Duration - 5 months gestation - 4 months postpartum
Concerns -No palmer grasp may indicate
neurological problems (spasticity)
Other -One of the most noticeable reflexes May lead to voluntary reaching / grasping May predict handedness in adulthood
Primitive Reflexes ~ Sucking
Stimulus /Response
S: touch of lips
R: sucking action
Duration- In utero - 3 months postpartum
Concerns- No reflex problematic for nutrition
Other -Often in conjunction with searching reflex
Primitive Reflexes ~ Search
Stimulus /Response
S: touch cheek
R: head moves toward stimuli
Duration -Weeks prenatal - 3 months postpartum
Concerns- No reflex problematic for nutrition No reflex or lack of persistence may be sign of CNS or sensorimotor dysfunction.
Other- Often in conjunction with sucking reflex. Contributes to head/body-righting reflexes
Primitive Reflexes ~ Startle
Stimulus /Response
S: Same as Moro
R: Arms and legs flex
Duration 2-3 months after Moro disappears – 1 year
Other Less severe startle reflexes elicited
through lifespan
Primitive Reflexes ~ Moro
Stimulus /Response
S: Suddenly but gently lower baby’s head
S: Hit surface beside baby
R: Arms and legs extend
Duration- Prenatal – 4-6 months postpartum
Concerns -May signify CNS dysfunction if lacking May signify sensory motor problem if persists May delay sitting & head control if persists May indicate injury to one side of brain if asymmetical
Other -Reaction time increases with age
Preceeds startle refle
Primitive Reflexes ~ Moro
Primitive Reflexes ~ Asymmetric Tonic Neck
Stimulus /Response
S: Prone/supine position, turn head to one side
R: Limbs flex on one side, extend on other side
Duration- After birth – 3 months
Concerns Facilitates bilateral body awareness
Facilitates hand-eye coordination
Other- Also called ‘bow and arrow’ or ‘fencer’s’position
Primitive Reflexes ~ Symmetric Tonic Neck
Stimulus / Response
S: Baby sitting up and tip forward
R: Neck and arms flex, legs extend
S: Baby sitting up and tip backward
R: Neck and arms extend, legs flex
Duration- After birth – 3 months
Concerns- Persistence may impede many motor skills and cause spinal flexion deformities
Primitive Reflexes ~ Plantar Grasp
Stimulus /Response
S: Touching the ball of foot
R: Toes grasp
Duration- Birth – 1 year
Other -Must disappear before the baby can stand or walk.
Primitive Reflexes ~ Babinski
Stimulus /Response
S: Stroke bottom or lateral portion of foot
R: Great toe turns downward
Duration- Birth – 4 months
Concern- Test of the pyramidal tract (i.e. ability to perform conscious / voluntary movement)
Primitive Reflexes ~ Palmar Mandibular
Stimulus /Response
S: Pressure to both palms or hair to hand
R: Eyes close, mouth opens, and/or neck
flexes (which tilts the head forward)
Duration- Birth – 3 months
Other- Also called the Babkin reflex
Primitive Reflexes ~ Palmar Mental
Stimulus / Response
S: Scratch base of palm
R: Lower jaw opens and closes
Duration Birth – 3 months
Postural Reflexes ~ Stepping
Stimulus /Response
S: Infant upright with feet touching surface
R: Legs lift and descend
Duration- After birth – 5-6 months
Concerns- Essential forerunner to walking
Other- Sometimes called walking reflex
Developmental changes in reflex over time
Postural Reflexes
- Stepping
- Crawling
- Swimming
- Head and Body Righting
- Parachuting
- Labyrinthine
- Pull Up
Postural Reflexes ~ Crawling
Stimulus /Response
S: Prone position on surface, stroke
alternate feet
R: Legs and arms move in crawling action
Duration -Birth – 3-4 months
Concerns -Precursor to later voluntary creeping
Postural Reflexes ~ Swimming
Stimulus /Response
S: Infant held horizontally
R: Arms and legs move in coordinated
swimming type action
Duration -2 weeks after birth – 5 months
Other -Recognition of reflex led to popularity of infant swim programs
Postural Reflexes ~ Head and Body Righting
Stimulus /Response
S: Supine, turn body in either direction
R: Head “rights” itself with the body
S: Supine, turn head in either direction
R: Body “rights” itself with the head
Duration- Head:1-6 months; Body: 5 months-1 year
Concerns -Related to voluntary rolling movements
Postural Reflexes ~ Labyrinthine
Stimulus /Response
S: Baby held upright, tilted in one direction
R: Baby tilts head in opposite direction
Duration -2-3 months – 1 year
Concerns -Related to upright posture
Other -Also considered primitive reflex
Postural Reflexes ~ Parachuting
Stimulus /Response
S: Off balance in upright position
R: Protective movement in direction of fall
Duration- 4 months – 1 year
Concerns -Assessed in preterm babies as markers of neurological development
Related to upright posture
Other- Also called propping reflex
Occurs downward, sideways, & backward
postural Reflexes ~ Parachuting
Postural Reflexes ~ Pull Up
Stimulus / Response
S: Sitting/standing, hold hands, tip in one
direction
R: Arms flex or extend in to maintain
upright position
Duration -3 months – 1 year
Concerns- Related to upright posture
Stereotypies
Characterized by patterned, stereotyped,
highly intrinsic, and involuntary movements of the body
Lourie (1949)
– Unusual movements are inherent and crucial to
life of a healthy child
– Decrease tension and anxiety
– Provide stimulation for development of later voluntary movements
Thelen (1979)
– Serve no purpose
– Not regulated by the nervous system
– Infants spent up to 40% of time exhibiting
stereotypies (peaks at 24-42 weeks).
– Grouped stereotypes by body region
Common stereotypes
– Single leg kick
– Two-leg kick
– Alternate leg kick
– Arm wave
– Arm wave with object
– Arm banging against a surface
– Finger flexion
