Reflexes and developmental milestones Flashcards
What are primitive reflexes?
response to stimulus that occurs without conscious thought (involuntary movement)
Present in newborns
Integrate (disappears) by 6 months so voluntary movement can be attained
What happens if primitive reflexes stay too long or are absent?
Persistence of reflexes: impact motor development, impacts neurological system
Absence: concerned about development of neurological system
What is the ATNR?
asymmetrical tonic neck reflex Onset: present at birth (20 weeks pma) Integration: 4-6 months Stimulus: turn head to side Response: facial arm extends and abducts, occipital arm flexes and abducts (fencing posture)
How would non integration of ATNR affect function?
reaching, feeding, sitting, posture, attention
need to get rid of it so you can gain voluntary control of arms
What is the rooting reflex?
Onset: present at birth (28 weeks pma)
integration: 3 months
Stimulus: touch the perioral area of hungry infant
Response: turns head and lips towards stimulus with the mouth open and a trial of sucking the finger (food finding)
What happens to rooting reflex if baby isn’t hungry?
may have weaker response or none at all
What is the palmar grasp reflex?
Onset: present at birth (28 weeks pma)
Integration: 4-7 months
Stimulus: pressure on palm of hand
Response: flexion of fingers (grasps)
What happens if palmar grasp reflex isn’t integrated?
can’t use hands because they will be in a fist, writing affected
Need to be able to grasp and release voluntarily
What is the plantar grasp reflex?
Onset: present at birth
Integration: 9 months
Stimulus: pressure to ball of foot
Response: flexion of toes (grasps with toes)
What I plantar grasp isn’t integrated?
will have trouble with walking and balance
What is the galant reflex (trunk incurvation)?
Onset: birth (28 weeks pma)
Integration: 3 months
Stimulus: in prone, stroke paravertebral skin
Response: lateral curvature of trunk on stimulated side, shifts hips toward side
What if galant reflex isn’t integrated?
affects upright posture
What is moro reflex?
Onset: birth (28 weeks pma)
Integration: 3-5 months
Stimulus: head drop backward
Response: abduction and extension of arms, splaying of fingers, followed by flexion and adduction of arms, child typically cries
What is moro reflex isn’t integrated?
has affect on behavior in general
What is startle reflex?
stimulus is loud noise with same response
What is the automatic waling/reflex stepping?
Onset: present at birth (37 weeks pma)
Integration: 3-4 months
Stimulus: supported standing, lean child forward
Response: high stepping movements with regular rhythm
What is the STNR?
Symmetrical tonic neck reflex
Onset: 4-6 months after birth
Integrates: 8-12 months
Stimulus: flexion or extension of head in quadruped position
Response: Head flexion= arms flex and hips extend, Head extension= arms extend and hips flex
What is flexor withdrawal reflex?
Onset: 28 weeks pma
Integrates: 1-2 months
Stimulus: noxious to sole of foot
Response: flexion and withdrawal of stimulated leg
What is crossed extension reflex?
Onset: 28 weeks pma
Integrates: 1-2 months
Stimulus: noxious to sole of foot
Response: flexion of stimulated leg and then extension of opposite leg with adduction
What is positive support reflex?
Onset: 35 weeks pma
Integrates: 2 months
Stimulus: supported standing
Response: legs support weight
What are consequences of persistent primitive reflexes?
poor hand eye coordination difficulty with reaching and grasping feeding difficulty delay in acquisition of motor milestones poor postural control
What are syndromes that have absent or persistent primitive reflexes?
TBI, CP, genetic syndromes, developmental delay
Why is tummy time important?
important for infant motor development, encourages postural control
What are gross motor developments for neonates?
Fetal position (physiological flexion)
May be able to extend neck to drag face from side to side in prone.
Head bobs when held in sitting or upright position- no head control
Movements are reflexive
What are the average ages for gross motor milestones: belly crawl, hands/knees crawl, cruise, ascend stairs, walk alone, and descend stairs?
Belly crawl- 6.8 mo hands/knees crawl- 8.1 mo cruise: 9.3 mo ascend stairs: 11 mo walk alone: 11.9 mo descend stairs: 12.5 mo
What are average ages for standing without support, standing with assistance, walking with assistance, and standing alone?
sitting w/o support: 6 mo
stand with assistance: 7.6 mo
walking with assistance: 9.2 mo
stand alone: 11 mo
What is average age for crawling?
2 months
What is average age for sitting?
6-7 months
T/F: the average age for creeping is 8-10 months?
True
T/F: the average age for walking is 10-12 months?
False: 14-18 months
What is average age for pull to stand?
9-10 months
What is average age for independent stance?
12-13 months
What are developmental milestones for rolling?
1-2 months: roll side lying-> supine 4 months: prone-> supine 4-5 months: supine-> side lying 6-8 months: supine-> prone 9 months: development of segmental rotation rather than log rolling
When does a child start to gallop? Skip?
Gallop at 4 years
Skip at 5-6 years
How old is a child if they can creep up and down stairs? Walk up/down stairs with hand held, throw ball?
8-15 months
15-18 months
If a child can run stiffly how old are they?
20 months
What should a child be able to do at 2.5 years?
walk up/down stairs without support, kick ball forward
What can a child do at 3 years versus 3.5 years?
3 years: runs well, walk up stairs alternating feet, catches ball with arms and body
3.5 years: walk down stairs alternating feet, jumps up with both feet, hops on one foot
What are gross motor “red flags”?
persistence of reflexes lack of leg movements "stuck" in head/neck/trunk hyperextension extremely floppy spasticity athetoid movement extremely rigid inability to achieve midline head/extremities only unilateral movements "bunny hops" instead of creeping walks on toes with adducted legs social-emotional cognitive fine motor communication
What are walking milestones?
walk between 9-15 months
50% walk independently by 11.5 months
90% of kids will walk by 15 months
gait fully mature by age 7
If a child can sit independently, roll independently (prone to supine and back), bears weight in prone on extended arms, and can maintain supported standing how old are they?
6 months old
If a child has good sitting balance, moves in and out of sitting, begins pulling to stand and cruising, takes steps with hands held, and has independent mobility by creeping how old are they?
9 months
