Reflexes Flashcards
Primitive reflexes
- an automatic movement pattern that occurs in response to a specific touch or potision stimuli - brainstem origin of reflexes
Purpose of primitive relflexes
- infants depend on primitive reflexes for survival and early learning - support the birthing process - some emerge in tuero, some emerge at birth, and others emerge within a few months of life and should be integrated by 1 year (2 at the most)
Integrative
Organizes brain and body functions
Attention
Awakening of senses and awareness
Learning
Sets pattern of how child engages new experiences
Sensor-motor integration
Purposeful / voluntary motor response to a sensory stimuli
Reflex maturation
Each reflex has its own time table - emerging: involuntary - active running: involuntary - maturing: beginning of voluntary control - integration: voluntary control / choice
Causes of retained reflexes
“Greater the severity of the reflex, the motor efficiency was lower” - premature births / NICU - young birth mothers - alcohol/drug use - multiple births - c section - skipping of milestones - trauma / chronic stress - inadequate movement - misalignment of cranial bones or cervical spine
Symptoms of retained moro
- car sickness - poor stamina - doesn’t maintain eye contact - sensitive to light / sound - allergies - adverse reaction to prescription drugs - anxiety or nervousness - mood swings - poor math sense
Symptoms of retained galant
- bed wetting - poor endurance - attention difficulties - hip rotation to one side / scoliosis - poor concentration - poor gross motor coordination - poor posture - poor short-term memory - fidgeting/hyperactivity
Symptoms of retained flexion withdrawal
- UE and LE coordination deficits - toe walkers - standing and walking
Symptoms of ATNR
- balance may be affected as result of head movements to either side - difficulty crossing the midline - hand dominance issues - poor ocular “pursuit” movements, esp at the midline - visual-perception probs - dyslexia - reading, listening, hand writing, and spelling difficulties
STNR
- transitional primitive reflex - transitions the baby from lying on the floor to being able to crawl - integrates 9-11 months - reflex transition into the rocking movement, which results in creeping?
Symptoms of retained STNR
- poor, hunched posture - headaches from muscle tension in neck - difficulty writing and reading - difficulty sitting still - “W” sitting - difficulty copying from blackboard - vision disorders - difficulty staying on task - when asked to crawl: bear walks or scoots
To crawl or not to crawl
- Vestibular, proprioceptive, and visual systems connect together for the first time 2. Teaches eyes to cross midline 3. Mature reflexes and convergence 4. Learn depth in space 5. Increase UE strength and coordination 6. Develop bilateral coordination 7. Develop palmar arches
To crawl or not to crawl
- Vestibular, proprioceptive, and visual systems connect together for the first time 2. Teaches eyes to cross midline 3. Mature reflexes and convergence 4. Learn depth in space 5. Increase UE strength and coordination 6. Develop bilateral coordination 7. Develop palmar arches
Challenges in coordination can lead to
- reading and writing difficulties - language and speech delays - disorganization - fidgeting - poor concentration - low muscle tone, muscle weakness - chronic body aches - poor endurance and fatigue
Reflex testing - ATNR
Child to get on all fours with the arms straight, fingers pointing forward and the head in neutral. With their weight over their hands, the parent rotates the child’s head left or right. If their elbow bends on the opposite side of head rotation (like a wawa) OR the weight shifts posteriorly (off the hands), then the reflex is prolly present
Reflex testing - rooting
Lightly stroke from the outer corner of the nose downward beyond the corner of the mouth - movement of the mouth or turning of the head indicates the rooting reflex - if stimulation above the central area above the top lip results in pursing the lips this indicates the suck reflex
Reflex testing - palmar reflex
- Standing with the feet together, elbows bent and away from body with palms facing upward. Gently stroke along the creases of the palm from between the thumb and index finger toward the heel of the hand. Repeat 2-3x. If the thumb, fingers or elbows move inward then this reflex is prolly there 2. Keeping the arms straight out in front, ask the child to wriggle all 10 fingers as though they were playing piano. Watch for excessive wrist flapping being used instead of the smaller muscles of the hand or movement of the tongue and mouth. This reflex, if retained, can contribute to difficulty in writing and increased energy expenditure while writing or performing tasks
Reflex testing - palmar reflex
- Standing with the feet together, elbows bent and away from body with palms facing upward. Gently stroke along the creases of the palm from between the thumb and index finger toward the heel of the hand. Repeat 2-3x. If the thumb, fingers or elbows move inward then this reflex is prolly there 2. Keeping the arms straight out in front, ask the child to wriggle all 10 fingers as though they were playing piano. Watch for excessive wrist flapping being used instead of the smaller muscles of the hand or movement of the tongue and mouth. This reflex, if retained, can contribute to difficulty in writing and increased energy expenditure while writing or performing tasks
Reflex testing - TLR
Lying face down on ground with palms facing down ask the person to hold the head off the ground and raise the legs simultaneously keeping the legs straight (Superman) - if they are unable to keep their legs straight then Sagittarius TRL is prolly present
Reflex testing - STNR
With the person on all fours with the weight forward over their hands, the parent flexes the neck fully (looking down) and hold for 5 seconds, then slowly extend the neck (looking up) and hold for 5 seconds. Repeat 3x. - if child alters their body position in any way then reflex is prolly present - look for shifting weight backward, arching back, bending arms.
Reflex testing - galant reflex
With the person on all fours, lightly stroke down one side of the lumbar spine twoards the sacrum (from occipital to sacrum tests for Perez reflex). - if they move their back (typically arching or away from the stroke) then the reflex is prolly present
Moro
Galant
Flexor withdrawal
Traction response
Plantar grasp
Positive support
Stepping/walking
Asymmetrical tonic
Symmetrical tonic
