Reflexes Flashcards
Purposes of primitive reflexes
initiate movements that form the building blocks for intentional movements; Present for protection, nutrition, and survival
2 examples of reflexes for nutrition. 1 example of reflex for survival
Nutrition - Sucking & Rooting reflexes; Survival - Moro reflex
Various forms of trauma can inhibit the normal integration of reflexes:
Injuries at birth or after; Drugs ingested in utero or through breast milk; Allergies; Physical and emotional overstimulation; Blinking lights and media overload; Lack of opportunity for movement
Indicates cerebral birth injury if not present of asymmetrical
Moro reflex
Reflex that can indicate CP or other neurological problem
ATNR
Moro Reflex
Onset = birth, integration = 4 months
Gently lift baby’s head off mat. Release head suddenly and allow to fall backward, but quickly supported again. Response: Arms should move sideways with the palms up and the thumbs flexed
Moro reflex- functional/ global implications if not integrated:
Functional implications:
1. Motion sickness
2. poor balance/coordination
3. delayed equilibrium & righting responses
4. auditory hypersensitivity/poor auditory discrimination
5. difficulty w/ transitions
6. hypersensitivity may be seen in only one sense
Global manifestations:
Dislike change, Allergies, lowered immunity, ear infection, parents walk on eggshells, need to control, poor stamina, low self-esteem, difficulty making decisions, “glued” to mom, sedentary
What does the infant automatically do during the birthing process
Push, turn and wriggle movements which are generated by infant reflexes.
These reflexes are progressively integrated following natural birth
In the assessment, what do you always ask about?
BIRTH HISTORY
- baby born to term?
- Method of delivery
- complications?
- Mom’s health history
At what time do most infant reflexes integrate?
in the first year
Do reflexes become more or less dominant
They become less dominant and replaced by conscious movements
What is the best place for development?
In mother/father’s arms
During the 1st year of life, what position do baby’s love to be in
-Lie on tummies and backs
-Move freely
-Be held, moving with adult
They can develop sensory skills relating to touch, balance and proprioception, as well as an emotional attachment
What is a disadvantage of “Baby containers”
alters hip development.
Reflexes in the first year are not fully achieved and problems emerge. Babies are inactive in a fixed position
What is the best place for baby to play
FLOOR!!
What emerges when infant reflexes integrate
postural reflexes emerge
What happens if infant reflexes do NOT integrate
postural reflexes will be negatively affected
When are postural reflexes in place?
by 3-4 years, with some variation
What is one example of a postural reflex
Head-righting reflex
Landau Reflex
Coming in for Landau! Onset= 4 months Integration= 12 months; Test: Suspend infant horizontally in prone ; Response: ext head, neck, and trunk
Landau Reflex helps develop?
posture, sitting and walking, inhibit TLR
What happens if Landau is not integrated?
poor muscle tone, chronic neck/back pn, tension and hyperext of legs with stiffness of lower body, affects development of balance, inability to flex leg correctly, vertical eye tracking, limit field of vision, poor at sports, stiff and awkward movement of lower half, difficulty jumping and hopping
STNR Reflex
Onset: 6 months
Integration: 11 months
Test 1: child is sitting on knees, tip forward
Test 1 response: Neck and arms flex up to protect face, legs separate and extend
Test 2: Place in sitting
Test 2 response: neck and arms extend, LE flex to create a slowed fall
STNR helps develop?
allows to defy gravity and assume quadruped; dissociate UE and LE; integrates when they begin crawling and rocking back and fourth in quadruped
What happens if STNR is not integrated?
W sitting (inhibits STNR); poor posture; hands in pockets; bunny hop instead of crawl; difficulty sitting still; falls out of chair; clumsy; poor balance; behavior problems; poor eye hand coordination; difficulty copying; difficulty sitting to do fine motor activity
Define Reflex
An involuntary motor response to a sensory stimulus. They thought or planning.
Where do reflexes originate?
In the brainstem
What is the general age , when most reflexes should be integrated?
Usually by age 3, however postural reflexes evolve and stay with us much longer.
What are 2 lifespan reflexes?
- Knee-jerk
2. Flexor withdrawal
“Infant” reflexes do not persist past _______?
The first year
ATNR “Fencing Pose” onset & integration
birth
6 months
ATNR Testing procedure
child on back, gently turn head to one side
ATNR response
UE flexion on opposite side of head turn and UE extension on side head is turned toward
How ATNR helps development
- Helps develop muscle tone
- Provides vestibular stimulation
- Develops balance
- Decreases chances of breech birth
- Initiates eye hand activities
- Helps initiate rolling
What happens when ATNR not integrated
Delayed eye-hand skills
- Poor midline development
- Difficulty crossing midline with hands and eyes
- Difficulty with auditory processing
- Poor organization
- When reaching, one arm extends, other retracts
- One leg left behind during crawling
- Turning body while drawing/writing
- Not spontaneously using non-dominant hand to assist
Spinal Galant onset & integration
32 weeks gestation
3 months
Spinal Galant Testing Procedure
Stroke down the back from below the shoulder to the base of the lumbar region at a distance of ½ inch from the spine, first on one side, then on the other. Repeat the procedure up to 3 times (repetition beyond this can fail to elicit the reaction
even though the reflex is present).
Spinal Galant Response
Infant will laterally flex toward stimulated side.
How spinal galant helps development
-Thought to take an active part in birthing process by stimulating lumbar region causing rotational movement of hips.
What happens if spinal galant is underdeveloped?
- Contributes to hyper-tonicity
- Strong ATNR and STNR
- Impeded cross patterns for crawling and creeping
What happens if spinal galant is not integrated?
- Fidgeting
- Bed Wetting
- Poor concentration and short term memory
- Hip rotation to one side when walking
- Child may only wear sweatpants (worn low) to avoid stimulation of lumbar region.
TLR onset & integration
utero
36 months
TLR testing procedure
Place child on back, and lift up into sitting position.
Place child on tummy.
TLR responses
sitting up–> flexor tone dominates.
tummy–> extensor tone will dominate
How TLR helps development
- A response to gravity: Movement of head above the spine: extension. Movement of the head below the spine: flexion.
- If Moro reflex isn’t integrated, TLR probably won’t be either.
What happens if TLR is not integrated?
Flexor TLR:
- Slouched posture
- Low muscle tone
- Dislike of physical activity
- Stuck in flexion
Extensor TLR:
- Toe walking
- High muscle tone
- Dislike of physical activity
- Stuck in extension
- Poor organizational skills
- Motion sickness
