Reflexes and Reaction

Question 1

rooting

Answer 1

time: birth-3/4mo
procedure: gently stroke cheek on one side moving laterally from cheek, upper lip, lower lip
response: baby will turn head to source of stimulation and will open mouth, latch on

Question 2

sucking

Answer 2

time: birth-3/4mo
procedure: put finger or nipple into infant’s mouth
response: rhythmical sucking

Question 3

moro

Answer 3

time: birth-4/5mo
procedure: hold baby with their hands on chest and drop them back 20-30 degrees
response: babies arms and legs will go out and come back in (abduction of UE and extension of elbows/wrists/fingers, then adduction of UE)

Question 4

palmar grasp

Answer 4

time: birth-3/4mo
procedure: place your index finger into infant’s hand from the pinky side and gently press into palm
response: infant’s fingers will flex around your finger

Question 5

plantar grasp

Answer 5

time: 3mo-7/8mo
procedure: press finger below infant’s toes
response: plantar flexion of all toes (will curl around your finger)

Question 6

flexor withdrawal & crossed extension

Answer 6

time: birth-4mo
procedure: bad/somewhat painful stimulus on sole of babies foot

response: withdrawal of stimulated leg
response of crossed extension: contralateral leg will extend

Question 7

spontaneous stepping/standing

Answer 7

time: birth-1/2mo
procedure: support child upright, feet touching surface, incline child forward
response: alternating/rhythmic/coordinated stepping movements like riding a bike

Question 8

asymmetrical tonic neck (ATNR)

Answer 8

time: 1/2mo-3/4mo (strongest at 2mo)
procedure: child in supine, turn the head slowly to one side and hold this position
response: arm and leg on jaw side extend; arm and leg on skull side flex

Question 9

developmental significance of ATNR

Answer 9

• Response is NEVER OBLIGATORY in a normal infant
• Persistence beyond 6 months is indication of CNS dysfunction

an obligatory ATNR can result in: Inability to engage hands in midline; scoliosis; subluxation or dislocation of hip on skull side; inability to grasp and regard object at the same time; inability to separate movements of the head from movements of the arms and trunk. If not integrated, will prevent rolling to prone.

Question 10

symmetrical tonic reflex (STNR)

Answer 10

time: 5mo-6mo
procedure: passively flex and then extend child’s head
response: flexion of head (chin tuck) produces flexion of UE and extension of LE. extension of the head produces extension of UE and flexion of LE

Question 11

developmental significance of STNR

Answer 11

• May be used by infant to get into 4-point position
• Integration coincides with creeping of 4-point position
• Persistence prevents the child from moving trunk and extremities in rotational patterns when head is moved in a sagittal plane

Question 12

tonic labyrinthine reflex

Answer 12

time: Present in preterm infants—born less than 37-week gestation Full term infants may or may not have it

procedure: supine - push into seated position with therapists’ hand on back of child’s head.
Evaluate presence of extensor tone by amount of pressure of infant’s head and trunk pushing back
Prone - lift head to 90*.
Evaluate presence of flexor tone by amount of pressure of infant’s head pushing down

response: supine - everything extends (stiff board)
prone - everything flexes

Question 13

developmental significance of tonic labyrinthine reflex

Answer 13

• Child will not be able to lift head to clear airway in prone
• Child will not be able to bring hands to mouth in supine
• If dominates, motor development will be delayed

Question 14

landau (superman)

Answer 14

time: 4mo-7mo
procedure: lift child on belly in the air
response: head, back, and hips extend

Question 15

neonatal neck righting

Answer 15

time: birth-4mo (replaced by body righting reactions)
procedure: supine, turn child’s head to one side (test both directions)
response: trunk may initially swing in opposite direction then will follow the direction of the head turn

Question 16

body right on body (BROB)

Answer 16

time: 4mo-6mo
procedure: flex one leg and rotate it across pelvis to opposite side
response: child will turn to prone segmentally (first trunk, then pelvis, then head)

Question 17

body righting on head (BROH)

Answer 17

head leads roll, not body part

Question 18

protective extension (parachute) - forward

Answer 18

time: emerges at 5mo, present at 6mo and remains
procedure: support child standing and plunge child forward
response: Child will extend head, extend and abduct arms and fingers as to break a fall; weight is taken on extended arms

Question 19

protective extension (parachute) - sideways

Answer 19

time: emerges at 7mo, present at 8mo and remains
procedure: child sitting with legs out front, examiner pushes child on one side or the other with enough force to displace center of gravity over base of support and causes child to lose balance

response: Child will abduct arm on side of opposite force with extension of elbow, wrist, and finger
Weight is taken on open palm and fingers

Question 20

protective extension (parachute) - backward

Answer 20

time: 9 months, present at 10 months and remains
procedure: sitting w legs out front, push child backward with enough force to displace center of gravity off base of support

response: Child extends arms backward
Full reaction is backward extension of both arms
Frequently an element of trunk rotation comes in and reaction is seen in 1 arm only

Question 21

equilibrium reaction - supine

Answer 21

time: 7mo

procedure: Placing child supine on tilt board, center of rotation of board longitudinally
Slowly tilt board laterally left and right

response: Trunk will curve upward against the tilt
Head will rotate and face upper side
Slight abduction of upper arm and leg

Question 22

equilibrium reaction - prone

Answer 22

time: 6mo

procedure: Child is prone on tilt board
Tilt board left and right

response: Child will curve upward against displacement of center of gravity, the upper arm and leg may abduct in an attempt to bring center of gravity back over base of support

Question 23

equilibrium reaction - sitting

Answer 23

time: 8mo

procedure: Child is sitting on tilt board
Tilt board left and right, anterior and posterior

response:
Lateral tilt - Neck will flex laterally, Head slightly rotated with face toward the upper side, Arm and leg on upper side abducted, Arm and leg on lower side adducted
Anterior tilt - Spine extends, Limbs retract
Posterior tilt - Spine flexed, Arms are flexed at shoulders, Elbows extended, Flexion of trunk is the most important

Question 24

equilibrium reaction - quadruped

Answer 24

time: 9mo

procedure: Child quadruped on tilt board
Tilt board left, right, anterior and posterior

response:
Lateral tilt - Body flexed against tilt with spine upward, Head rotated so face is toward upper side
Anterior tilt - Arms extended and legs flex, Head extended and trunk moves back
Posterior tilt - Shoulders and hips extend, Elbows and head tend to flex, and trunk moves forward, Curving of trunk is most important element

Question 25

equilibrium reaction - standing

Answer 25

time: 10mo

procedure: Child standing on tilt board
Tilt board left, right, anterior, and posterior

response:
Lateral tilt - Body flexed, Upper leg abducted, Upper arm abducted, Lower leg extended with knee extension
Anterior tilt - Spin extends
Legs extend, Arms extend or flex at shoulders and extend at elbows
Posterior tilt - Shoulders and hips flex, Elbows and head tent to flex and trunk moves forward, Extension of trunk is most important