Primitive reflexes Flashcards
What are developmental milestones
physical and behavioral skills expected in children with normal development by certain ages
Consists of: gross motor fine motor cognitive language social, and self-care skills.
What is failure to thrive
inadequate physical growth of a child for its age.
common cause is wrong infant nutrition and feeding practices.
What are primitive reflexes
Reflexes normally present in infancy and early childhood. that resolve as the child develops inhibitory pathways to the subcortical motor areas.
Persistence of primitive reflexes indicates impaired brain development.
List the primitive reflexes
Stepping reflex
- 2 month resolution
Asymmetrical tonic neck reflex (ATNR)
-3–4 months
Plantar grasp
-3 months
Palmar grasp
-3-6 months
Moro reflex (startle reflex) - 3-6 months
Reflexes which assist in feeding
-4 months
Babinski sign
-12 months
Landau reflex
-24 months
What is the stepping reflex
Resolved at 2 months
infant is held upright and its feet are set onto the examining table
→ infant will place one foot in front of the other (stepping motion), with alternating flexion and extension of the legs.
Term infant: heel-to-toe stepping pattern
Pre-term infant: tip-toe stepping pattern
What is the Asymmetrical tonic neck reflex (ATNR)
Resolved at 3-4 months
The infant’s head is turned to one side
→ extension ipsilateral arm and leg plus
flexion of the contralateral arm and leg (fencing posture)
Significance
ATNR aids in development of hand-eye coordination
Persistent ATNR has been linked to ADHD
What is the plantar grasp reflex
Resolved at 3 months
infant’s foot is stroked from the toe to the heel
→ plantar flexion (curling in) of the infant’s toes
Significance
Abscence is a symptom of CP
What is the palmar grasp
Resolves at 3-6 months
palm is stroked → closure of it’s palm
Significance
The presence of palmar grasp on only one side indicates an ipsilateral brachial plexus/peripheral nerve injury
The absence of a palmar reflex at birth can be a symptom of cerebral palsy
What is the Moro reflex
Resolved at 3-6 months
infant is held in the supine position and the head is supported by the examiner’s hand.
The infant’s head is then suddenly allowed to fall back
→ abduction and extension of the arms,
opening of the hands, followed by adduction of the arms and flexion of the elbows
Significance
The absence of Moro reflex on ONE SIDE indicates
1.An ipsilateral brachial plexus injury
2.An ipsilateral fractured clavicle
Total absence of Moro reflex indicates brain injury (e.g., birth asphyxia, intracranial hemorrhage)
What are the reflexes assisting feeding
Rooting, reflex, snout
Resolve at 4 months
Rooting reflex: the cheek of the infant is stroked → turns its head to the ipsilateral side and opens its mouth
Sucking reflex: the roof of the infant’s mouth is touched with a finger → infant starts to suck the finger
Snout reflex: tap infant’s closed lips in midline → puckering of lips
Significance
reappearance in an adult suggests
central neurodegenerative/vascular disease of
FRONTAL LOBES (frontal release signs)
What is the babinski sign
Resolved at 12 months
Stroke lateral border of the sole of the foot from heel to toe →
dorsiflexion of the foot, fanning of the toes, and extension of the great toe
Significance of babinski sign
Presence or persistence of the Babinski sign beyond 12 months = UPPER MOTOR NEURONE LESION
