Reflexes

Question 1

Rooting Reaction

Answer 1

Onset: 28 weeks gestation
Integration: 3 mo
Position: child supine with head midline, hands on chest
Procedure: stroke corner of the mouth, move laterally toward cheek
Response: head turning to stimulated side, upper lip stim opens the mouth and retroflex the head. Lower lip mouth opens, jaw drops. All instances infant tries to suck on finger.

Question 2

Sucking

Answer 2

Onset: 28 weeks gestation
Integration: 2--5 months
Position: supine, head in midline
Procedure: place finger on ripple into the infants mouth. 
Response: Rhythmical sucking movements.

Question 3

Moro

Answer 3

Onset: 28 weeks gestation
Integration: 5-6 mo
Position: Child supine, head in midline, arms on chest.
Procedure: Drop head back 20-30 degrees with respect to the trunk.
Response: ABduction of UE with extension of wrist, fingers, elbows. Followed by ADduction of shoulders, and flexion at the elbow.

Question 4

Plantar Grasp

Answer 4

Onset: 28 weeks gestation
Integration: 9 mo
Position: supine, head midline, legs relaxed
Procedure: firm pressure against volar surface of infants foot, directly below toes.
Response: plantar flexion of all toes.

Question 5

Palmar Grasp

Answer 5

Onset: Birth to 2 months
Integration: 4-6 mo
Position: supine, head midline, arms free
Procedure: place examiner finger into palm of infant from ulnar side and gently press into palm.
Response: infant fingers flex around examiner finger.

Question 6

Primary Standing (Neonatal Positive Supporting)

Answer 6

Onset: 35 weeks
Integration: 1-2 mo
Position: support infant in vertical position, hands under arms and around the chest.
Procedure: allow feet to make firm contact with flat surface
Response: Simultaneous contraction of flexors and extensors so as to bear weight on LE. Child supports minimal body weight, characterized by partial flexion of the hips/knees.

Question 7

Proprioceptive placing - Legs

Answer 7

Onset: 35 weeks of gestation
Integration: 2 mo
Position: Child in vertical position, support head of young infants.
Procedure: lift child so that dorsum of foot brushes against edge of table.
Response: Knee and hip flexion lift foot above table. Then leg extends and foot is placed squarely on the table top.

Question 8

Proprioceptive placing - Arms

Answer 8

Onset: Birth or earlier
Integration: 2 mo
Position: Child in vertical position.
Procedure: lift child so that dorsum of hand brushes against edge of table.
Response: Extremity flexes and hand is brought above table, then extremity extends with wrist extended and fingers extended and abducted, places hand on surface. Fingers may remain fisted in newborn.

Question 9

Primary Walking (Spontaneous Stepping)

Answer 9

Onset: 27 weeks gestation
Integration: 2 mo
Position: Child in vertical position.
Procedure: Feet touching table top, incline child forward, and move forward to accompany stepping.
Response: make alternating rhythmic, coordinated stepping movements

Question 10

Asymmetrical Tonic Neck Reflex (ATNR)

Answer 10

Onset: Birth to 2 mo
Integration: 4-6 mo
Position: supine, head midline, can do sitting, quad, standing depending on age.
Procedure: Follow an object from one side to the other, turn head slowly to one side and hold this extreme position with jaw over shoulder.
Response: Arm and leg on jaw side extend, skull side flexes.

Question 11

Symmetrical Tonic Neck Reflex (STNR)

Answer 11

Onset: 4-6 mo
Integration: 10-12 mo (?)
Position: ventral position supported by trunk over examiners knee, or 4 point position.
Procedure: ventroflexes, then dorsiflexes the head
Response: ventroflexion = flex UE, extend LE, dorsiflexion is vice versa.

Question 12

Landau

Answer 12

Onset: 3-4 mo
Integration: 12-24 mo
Position: support child horizontally in the air in prone. one hand under the lower thorax.
Procedure: position in space
Response: Head extends, back and hips extend in sequence.

Question 13

Labyrinthine Righting

Answer 13

Onset: Birth to 2 mo
Integration: persists through life
Position: hold child vertically under arms and around chest, free in space
Procedure: tilt body anteriorly, posteriorly, and laterally from vertical 45 degrees or more so the head drops those directions.
Response: head orients to vertical position and is steady, maintained in proper orientation to the environment.

Question 14

Neck Righting on Body

Answer 14

Onset: 4-6 mo
Integration: 5 years, when child can get to standing without rotation
Position: Supine, head in midline
Procedure: Flex childs head and turn slowly to one side. Hold in extreme position (jaw over shoulder). Repeat on opposite side.
Response: child will turn in direction of head turning, rotation of shoulders, trunk, and then pelvis to side or prone.

Question 15

Body Righting on Body

Answer 15

Onset: 4-6 mo
Integration: inhibited by child, 4-5 years
Position: Supine, head in midline
Procedure: Flex one leg and rotate it across the pelvis to the opposite side.
Response: the child will turn to prone segmentally (trunk, pectoral girdle, head)

Question 16

Parachute Reaction (Positive Support)

Answer 16

Onset: 6-9 mo
Integration: persists throughout life
Position: support in vertical
Procedure: feet make firm contact with flat surface
Response: simultaneous contraction of the the LE flexors/extensors for full WB on LE. Hips/knees extended.

Question 17

Parachute Sideways (protective extension - sideways)

Answer 17

Onset: 7 mo
Integration: persists throughout life
Position: sitting with legs out front
Procedure: push child to one side with enough force to cause child to lose balance
Response: ABduct arm on side opposite force, extension of elbow, wrist and fingers before contact is made with the table. Weight taken onto palm and fingers.

Question 18

Parachute Backwards (protective extension - backward)

Answer 18

Onset: 9-10 mo
Integration: persists throughout life
Position: sitting, legs in front
Procedure: push child backward with enough force to lose balance
Response: extends arms backwards. Backward extension of both arms. Frequently element of trunk rotation and it’s only seen in one arm.