Primitive Reflexes Test

Question 1

Rooting Reflex

Answer 1

Onset: 28 weeks gestation
Integration: 3m
Trigger: Stroke finger laterally at corner of mouth, then upper lip, then lower lip.
Response: Turning of head, opening the mouth and extending neck, opening mouth and dropping jaw
Purpose: Allows infant to search for and grasp breast of bottle; precursor to head shaking, nodding, and neck righting reaction.

Question 2

Suck-Swallow Reflex

Answer 2

Onset: 28 weeks gestation
Integration: 2-5 m
Tigger: Place finger or nipple in infant’s mouth
Response: Strong rhythmical sucking movements followed by swallowing
Purpose: To obtain nourishment

Question 3

Moro Reflex

Answer 3

Onset: 28 weeks gestation
Integration: 5-6 m
Trigger: Bring infant to sitting position, then drop head 30º backward
Response: Extension and abduction of UE and opening of hands. Crying, flexion and adduction of UE across chest resembling an embrace.
Purpose: To break flexion patterns born at birth.

Question 4

Traction Reflex

Answer 4

Onset: 28 weeks gestation
Integration: 2-5 m
Trigger: Grasp the forearm of a young infant and pull it to sitting position, or touch the pal of an older infant
Response: Flexion of shoulders, elbows, wrists, and fingers
Purpose: Allows infant to momentarily grasp an object; assists with pull to sitting position at neck, shoulders, and elbows.

Question 5

Crossed Extension Reflex

Answer 5

Onset: 28 weeks gestation
Integration: 1-2 months
Trigger: Apply a noxious stimulus or pressure to the ball of the foot while holding the knee down
Response: Sequence of flexion, adduction, and extension of the contralateral limb; the response may be accompanied by extension and abduction of the toes
Purpose: Protective response to a noxious stimulus to the sole of the foot; used with the positive supporting reaction to help maintain balance on one leg in later life

Question 6

Flexor Withdrawal Reflex

Answer 6

Onset: 28 weeks gestation
Integration: 1-2 m
Trigger: Apply a pinprick to the sole of the foot
Response: Extension of the tows, dorsiflexion of the ankle, and flexion of the knee and hp joints of stimulated leg
Purpose: A protective mechanism against noxious stimuli to the sole of the foot.

Question 7

Plantar Grasp Reflex

Answer 7

Onset: 28 weeks gestation
Integration: 9 m
Trigger: Press thumb into ball of infant’s foot; when infant is standing, apply pressure to ball of foot from supporting surface
Response: Flexion of toes on stimulated foot.
Purpose: Probable precursor to balance in standing position.

Question 8

Galant Reflex

Answer 8

Onset: 32 weeks gestation
Integration: 2 m
Trigger: Gently scratch fingernail or swab stick along a line parallel to the spine and 3cm lateral to the spine. Begin at the level of the 12th rib and continue to the iliac crest.
Response: Curving of the trunk toward the stimulated side with the production of skin folds.
Purpose: Precursor to symmetrical sitting and normal development of motor milestones.

Question 9

Neck on Body Reflex

Answer 9

Onset: 34 weeks gestation
Integration: 4-5 m
Trigger: Rotate the head to one side
Response: The body turns as a whole unit toward the side to which the head is turned.
Purpose: To learn to roll from a supine to a sidelying position.

Question 10

Body on Body Reflex

Answer 10

Onset: 34 weeks gestation
Integration: 4-5 m
Trigger: Flex one leg toward the chest and rotate it across the body to force the infant to turn over.
Response: The head and trunk will follow, as a whole unit, the direction of turn of the pelvis.
Purpose: To learn to roll from a supine to a sidelying position.

Question 11

Proprioceptive Placing - LE

Answer 11

Onset: 35 weeks gestation
Integration: 2 m
Trigger: Press the dorsum of the foot against the edge of a table.
Response: Hip and knee flexion and ankle dorsiflexion followed by extension of the hip and knee.
Purpose: To provide the infant with a primitive form of walking which allows stepping over an object.

Question 12

Neonatal Postural Support Reflex

Answer 12

Onset: 35 weeks gestation
Integration 1-2 m
Trigger: Allow feet to make firm contact with a flat surface.
Response: Hips and knees partially flex and assume only partial weight bearing.
Purpose: Allows infant to bear partial weights; precursor to spontaneous stepping.

Question 13

Spontaneous Stepping Reflex

Answer 13

Onset: 37 weeks gestation
Integration: 2 m
Trigger: Allow the feet to touch a supporting surface, lean forward slightly
Response: Alternate stepping movements with both legs with a rhythmic heel-toe pattern
Purpose: May facilitate learning to walk

Question 14

Tonic Labyrinthe Reflex (TLR)

Answer 14

Onset: Birth
Integration: 6 m
Trigger: Place in prone then supine position with head in midline
Response: In prone position, greater flexor tone; in supine position, greater extensor tone
Purpose: Ability to gain head control and rolling skills

Question 15

Proprioceptive Placing Reflex, UE

Answer 15

Onset: Birth
Integration: 2 m
Trigger: Press dorsum of had against edge of table
Response: Shoulder and elbow flexion, followed by extension of shoulder and elbow with finger extension and abduction
Purpose: Allows infant to support weights on forearms for creeping.

Question 16

Asymmetric Tonic Neck Reflex (ATNR)

Answer 16

Onset: Birth
Integration: 4-6 m
Trigger: Turn head actively r passively to one side and then the other
Response: Bow and arrow or fencing position of UE. Skull side flexes, chin side extends or vice versa.
Purpose: Enhances eye/hand awareness and development of a coordinated body rolling movement.

Question 17

Symmetric Tonic Neck Reflex (STNR)

Answer 17

Onset: 4-6 m
Integration: 8-12 m
Trigger: Flex and extend the neck
Response: During flexion of the neck, flexion of UE and extension of LE; during extension of the neck, extension of UE and flexion of LE
Purpose: Promotes four-point kneeling position

Question 18

Palmar Grasp Reflex

Answer 18

Onset: Birth
Integration: 4-6 m
Trigger: Insert finger into palm from ulnar side and press finger against palm.
Response: Quick flexion and adduction of the fingers (catching phase) followed by sustained flexion of the fingers (holding phase).
Purpose: Allows grasping and holding of objects.

Question 19

Phasic Bite Reflex

Answer 19

Onset: 28 weeks gestation
Integration: 2-5 m
Trigger: Apply pressure to the gum line
Response: Up and down movement of the jaw

Question 20

Gag Reflex

Answer 20

Onset: 34 weeks gestation
Integration: Never
Trigger: Pressure to the middle to back of the tongue
Response: Gag
Purpose: Protect airway

Question 21

Body on Neck

Answer 21

Onset: birth-6m
Integration: Lifelong
Trigger: Contact surface with chest
Response: Head goes into extension

Question 22

Optical Righting

Answer 22

Trigger: When held upright, tilt in all directions. OR observe natural head movements while the child is supine or prone. In supine, pull child to sitting position.
Response: Attempt to right the head against gravity.
Purpose: Combined with the labyrinthine head righting reaction, the optical righting reaction results in vertical head righting

Question 23

Landau Reaction

Answer 23

Trigger: Suspend the infant horizontally.
Response: Extension of the neck, spine, hips, shoulders; retraction of the scapula. This position is known as the pivot prone position.
Purpose: Assists extension of neck when prone and breaks the flexor posture that is present at birth. Promotes ability to support upper body on forearms and bands to prepare for standing.

Question 24

Proprioceptive Reaction: Forward

Answer 24

Trigger: Lower toward flat surface or displace center of gravity forward with sharp push
Response: Flexion of shoulders with elbow extension; extension and abduction of fingers
Purpose: Protect against falling forward

Question 25

Proprioceptive Reaction: Sideward

Answer 25

Trigger: Displace center of gravity sideward with sharp push
Response: Abduction of contralateral shoulder with elbow extension; extension and abduction of fingers on contralateral side
Purpose: Protect against falling sideward

Question 26

Proprioceptive Reaction: Backward

Answer 26

Trigger: Displace center of gravity backward with sharp push
Response: Hyperextension of both shoulders and extension of elbows
Purpose: Protect against falling backward

Question 27

Tilting Reactions: Sitting and Four-Point Kneeling

Answer 27

Trigger: Tilt the equipment forward, backward, or sideward
Response: Lateral curvature of spine so that concave side of curve is toward the upwardly tilted surface
Purpose: Maintain balance when the base of support is unstable; precursor to creeping, standing, and walking