Primitive Reflexes Flashcards
Give all 6 primitive reflexes that start at 28 weeks of gestation.
Rooting, Sucking, Moro, Plantar Grasp, Flexor Withdrawal, and Crossed extension
Which reflexes begin at birth?
Palmar Grasp, ATNR, Tonic Labyrinthine, and some Associated movements
Give the integration time, stimulus, and response for the rooting reaction.
Integration: 2-5 months; 7 months while sleeping
Stimulus: Corner of mouth stroked outwards
Response: Lower lip drops at corner; Tongue moves towards stimulus; head turns toward side of mouth that was stimulated
What would be a normal response to the rooting reaction? What is abnormal?
Normal: Assists in finding nipple
Abnormal: prolonged may adversely effect control of oral motor musculature, feeding, & speech
What is the integration, stimulus, and response for the sucking reflex?
Integration: 2-5 months
Stimulus: Finger or nipple placed in infants mouth
Response: Rhythmical sucking
When looking at the sucking reflex give the normal and abnormal responses.
Normal: Important for feeding and self calming
Abnormal: Absence-> problems with feeding and calming; Persistence-> contributes to oral motor coordination problems with feeding and speech
What is the difference in nutritive sucking and non-nutritive sucking?
Nutritive: Draws out milk by creating negative suction in oral cavity
Non: Can perform minutes after birth, complex sequential pattern with definable components, beneficial with self calming.
The Moro Reflex is integrated around what time? What stimulates that and what is the response?
Integration: 3-5 months
Stimulus: Child is semi-reclined with head in midline. Support the infants head and shoulders and allow the head to drop back 20-30 degrees. Neck muscles are stretched.
Response: ABD/Ext of arms then ADD/Flex or arms
What is the normal response of the Moro reflex trying to accomplish? What would be considered abnormal and why?
Normal is trying to hold on to mommy
Abnormal: Asymmetry may indicate brain injury, peripheral nerve injury, or muscle injury. If this persists it will interfere with normal movement.
When does the Palmar Grasp reflex become integrated? What is the stimulus and response?
Integration: 4-9 months
Stimulus: Pressure against plan of hand from ulnar side to middle of palm.
Response: Fingers flex around finger or object
Normal response in the palmar grasp is significant why? Why is it bad if the response is abnormal?
Normal: Early experience of active closing of hand
Abnormal: If persists precludes normal hand function
After onset at 28 weeks gestation, the plantar grasp is integrated at ____ months. The stimulus for this reflex is ______ and the response is ________.
9-12 months
Pressure against sole of foot behind toes
Flexion of all toes
The ATNR is integrated at how many weeks? When is it the strongest?
Integration: 4-6 months
Strongest at 2 months old
What stimulus is given to get a response from ATNR?
Stimulus: Rotation of infants head to one side (actively or passively)
Response: Archers pose
Why is it important that a baby have a normal ATNR response? Why is it bad if they have an abnormal response?
Normal allows for hand eye coordination and visual regard, disappears when neck righting reaction with rotation appears.
Abnormal: Must be integrated for rolling, hands to mouth or midline, and creeping
When does Symmetrical Tonic Neck Reflex (STNR) begin and integrate? What is the stimulus and response? Why is this significant?
Onset: 4-6 months
Integration: 10 ish months
Stimulus: Neck flexion or extension while infant prone or quad
Response: Neck Flexion-UE flex and LE ext
Neck Ext- UE Ext and LE Flex
Significance: Must be integrated to achieve adequate 4 point position for creeping
When will the Tonic Labyrinthine Reflex be integrated? What is the stimulus/response?
Integrated: 6 months
Stimulus/Response: Flexor and extensor tone dependent on position changes— Prone= increased flexor tone; Supine= increased extensor tone
What is the issue with TLR if it persists?
May cause motor delays- unable to lift head in prone, unable to bring heads to mouth in supine and unable to move against gravity
Give the onset, integration, stimulus, and response for Positive Support Reaction.
Onset: 35 weeks gestation
Integration: 1-2 months
Stimulus: Lower child in vertical suspension so feet make flat contact with hard surface (cutaneous and proprioceptive input to ball of foot)
Response: Contraction of flexors and extensors in LE in order to support weight. Should come down on heels not toes!
If a child’s positive support reflex looks normal what will you see? What is hindered with the persistence of this reflex?
Normal: Indicator of muscle tone
If persistent then GMS are decreased
What is the name of the condition when positive support goes away at 2 months? Is bouncing considered part of the reflex?
Astasia
No bouncing is not part of the reflex!
What is the onset, integration, stimulus, and response for automatic stepping?
Onset: 27 weeks
Integration: 2 months
Stimulus: Child supported in vertical suspension with feet touching surface and inclined forward.
Response: Alternating rhythmical reciprocal “walking” with heel strike
What is considered normal and abnormal for automatic stepping?
Normal: Represents early use of neural circuits used for locomotion
Abnormal: Prevents functional locomotion with balance and equilibrium reactions
Explain what you know about Flexor Withdrawal
Onset: 28 weeks gestation
Integration: 1-2 months
Stimulus: Legs extended with noxious stimulus to sole of foot
Response: Withdrawal of stimulated leg from stim
This is normal for protection, it is abnormal if it decreases norma gait
Give all the information we should know for crossed extension.
Onset: 28 weeks gestation
Integration: 1-2 months
Stimulus: One leg held into ext; sole of foot stimulated
Response: Flexion followed by ext and ADD of contralateral leg with toe ABD.
Normal reaction is to push examiner away for protection; abnormal will decrease GMS
What information is important for the galant response?
Onset: 32 weeks gestation
Integration: 2 months and may persist
Stimulus: Moving stimulus on skin along paravertebral (shoulders to buttocks)
Response: Incurvatum with hip swing towards stimulus
Most common reflex in babies and is abnormal if scoliosis results due to trouble stabilizing at midline
Explain UE Placing reactions.
Onset: Birth
Integration: 2 months
Stimulus: Vertical position, press dorsum of hand against table edge
Response: UE flexes to clear table edge and then extends to WB on hand
Explain LE placing reactions
Onset: 35 weeks gestation
Integration: 2 months
Stimulus: Same as UE but push dorsum of foot into table edge
Response: Same as UE but WB on plantar surface of toot
Why are both placing reactions important?
Normal: Protective mechanism
Abnormal will decrease GMS
What information is important for associated movements?
Onset: Birth- 3 months
Integration: 8-9 years
Stimulus: Instruct child to squeeze rubber squeaky toy for 15 seconds
Response: Observe overflow with other arm
Why is it important that associated movements not be abnormal?
Abnormal: tonic increase in muscle activity of opposite extremity could indicate brain damage. Lack of coordination or late persistence could indicate depression of CNS or sensorimotor depression.
