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93 Cards in this Set
- Front
- Back
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What is the starting position of the rooting reflex? |
Infant is in supine with head in the midline
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How to elicit the rooting reflex? |
Using index finger, gently stroke the perioral skin at the corner of the mouth moving laterally toward the cheek, then upper lip and finally the lower lip.
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What is correct positive response of the rooting reflex?
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- head should move toward the side being stimulated |
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When upper lip is stimulated, during the rooting reflex? |
opening of the mouth and extension of the head |
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When lower lip is stimulated, during the rooting reflex?
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there is opening of the mouth and the jaw drops and sucking of the stimulating finger results. |
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What response is the precursor to head shaking, nodding and necking righting? |
With stimulation of the lower lip, there is opening of the mouth and the jaw drops and sucking of the stimulating finger results. |
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Reasons for negative rooting reflex? |
- infant is satiated -stimulus is too noxious or infant is preoccupied - maybe be general depression of the CNS or a sensorimotor dysfunction |
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Reasons for an asymmetrical rooting reflex? |
- one side of brain injured or facial nerve or muscle injury |
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Why is the rooting reflex important?
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Allows infant to search and grasp with his mouth in order to take his mother’s breast or a bottle without using his hands. Elicits neck righting reaction enabling infant to roll over. Enhances level of expression, head movement and possibly smiling.
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What is the starting position of the sucking-swallowing (s-s) reflex? |
Supine with head in the midline. Same as Rooting Reflex.
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How to do the s-s? and Correct response? |
- Place index finger into child’s mouth - Examiner should feel a strong rhythmical sucking movement. As the reflex becomes controlled by voluntary action, the pattern is not as rhythmical.
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What is the negative response of s-s? |
-weakness or absence - inhibits the development of voluntary sucking, in turn interferring w/ tongue movements which are needed for sound accurate production |
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What is the starting position of the moro reflex? |
Supine with head in the midline and UE on the chest.
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How to elicit the moro reflex? |
Place one hand under the head and the other under the upper part of the trunk. Start to bring the infant into sitting then drop head back 30 degrees suddenly. |
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What is the first phase of a correct moro reflex?
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The first phase results in extension and abduction of the UE and opening of the hands.
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What is the second phase of a correct moro reflex? |
-The second phase results in flexion and adduction of UE across the chest. Both phases are accompanied with ext. of the LE. - crying is an expected response |
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Why is moro reflex important? |
It breaks up predominant flexion posture of newborn. It helps UE move away from the body so baby can reach an object.
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If moro reflex does not disappear or does not appear? |
-Landau reaction does usually not appear nor do protective extension or tilting reactions. - Asymmetry of the response may indicate brain damage on one side or peripheral nerve or muscle injury
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What is the starting position of the traction reflex? |
Place infant in supine position and grasp forearms.
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How to elicit traction reflex? |
Pull infant to sitting position by grasping forearms.
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What is correct positive response? |
Total flexion response of the UE sufficient enough for infant to support his weight.
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What is negative response of traction reflex? |
No flexor tone induced.
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Importance of traction reflex? |
With integration, the infant learns to reach for objects and gain voluntary control of grasping.
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Child development if traction reflex does not disappear or does not appear? |
Persistence of traction response will inhibit voluntary control of grasping. Asymmetry may indicate insult to one side of the brain or injury to shoulder muscles or peripheral nerves. With persistent traction response, development is delayed and depends on visual input, but results in delayed grasp and a weak grasp, in which grasp is accomplished with wrist flexion AND finger flexion.
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Correct starting position of the crossed extension reflex? |
Infant is supine with head in the midline. Extend one leg and hold at the knee. Footwear off.
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How to elicit crossed ext reflex? |
Apply firm pressure to the ball of the foot on the stabilized side.
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Correct crossed ext reflex? |
The unfixed leg will flex, adduct, then extend and is often accompanied by extension and abduction of the toes.
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What is a negative crossed ext reflex? |
no response or a persistent response after 1-2 months |
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What happens if the response is not integrated by 1-2 months? |
-individual’s posture and the infant won’t demonstrate good reciprocal movements in the LE and thus affecting ability to walk. |
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Why is the crossed ext reflex important for TBI patients? |
This reflex accounts for the hyperextend knee in the hemiplegic gait due to reappearance after TBI.
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What is the starting position of the flexor withdrawal reflex? |
Place in supine with the head in the midline and the extremities relaxed. Footwear off
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How to elicit the flexor withdrawal reflex? |
Apply noxious stimulus (pin prick, scratch or pinch) to the sole of the foot.
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Correct response of the flexor withdrawal reflex? |
Such stimulus results in dorsiflexion of the ankle, extension of the toes and total flexion of the extremity on the same side.
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Childs development if reflex doesn't disappear or does not appear? |
-Persistence can interfere with postural maturation and continual development.
-Abnormally strong flexor withdrawal will prevent weight bearing or standing. Absence equals inadequate CNS response or peripheral nerve injury or mm. weakness.
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What is the correct position of the plantar grasp reflex? |
- Place infant in supine with the head in the midline. Footwear off. |
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How to elicit the plantar grasp reflex? |
Place thumb into the ball of the foot. Very little pressure is needed to induce response.
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What is correct response of plantar grasp? |
-Infant will react by “grasping” stimulus with the toes by flexing them. -This is the last primitive response to become integrated.
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Why is plantar grasp reflex key for development? |
Helps determine sacral lesion level. Needs to be integrated in order to stand erect with support and eventually walk.
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What happens if plantar grasp reflex doesn't disappear or does not appear? |
Failure or late persistence of plantar grasp indicates depression of the CNS or sensorimotor deficit. Asymmetry results from insult to one side of the brain.
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What is the starting position of galant reflex? |
Place infant in Prone over your hand or on a supporting surface
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How to elicit galant reflex? |
-Gently scratch with your fingernail along a line approx. 3cm from the vertebra from the 12th rib to the iliac crest. -Do this test on each side of the vertebra.
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Correct response of galant reflex? |
Infant will show an incurving of the trunk toward the stimulated side.
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Why is galant reflex important? |
Integration precedes symmetrical stabilization of trunk and independent head movement.
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What happens to child development, if galant reflex doesn't dissappear or does not appear? |
Persistent galant reflex can cause scoliosis if occurring continuously on one side and can cause considerable delay in the development of symmetrical stabilization of the trunk and independent movements of the head.
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Starting position of the neonatal neck righting? |
Place infant in supine with the head in the midline.
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How to elicit? and Correct response of neonatal neck righting? |
-Rotate head to one side
- The body follows the head in a rolling pattern (like a log). The body follows as a whole (“the log”).
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Importance of neonatal neck righting? |
Allows infant to role from supine to sidelying.
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Effects of child development if reflex doesn't disappear or does not appear? |
Persistence of neonate forms of these reflexes prevents or delays the development of segmental rolling and further developmental milestones.
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How to elicit the second neonatal body righting? |
Flex one leg up toward the chest and rotate that leg across the body to force the baby to roll over.
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Correct positive response of the 2nd neonatal body righting? |
The thorax, chest and head will follow the pelvis as a whole (“the log”).
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What happens if child has problems with the 2nd neonatal body righting? |
Persistence of neonate forms of these reflexes prevents or delays the development of segmental rolling and further developmental milestones.
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What is the starting position of the proprioceptive placing reflex? |
Hold child vertically.
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How to elicit the proprioceptive placing reflex? |
Lift child so that dorsum of foot presses against the edge of a table to stretch the ankle dorsiflexors.
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Correct response of proprioceptive placing reflex? |
The LE responds by flexing the hip and knee and dorsiflexing the ankle as if to clear the table. This is immediately followed by extension of the extremity so that the foot is placed squarely on the table.
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Why is not having proprioceptive placing a bad deal for growth? |
-Aids in the development of proprioception. This is a primitive form of ambulation, allowing the baby to step over objects in his path if he were supported by an adult.
-Delays or prevents development of gait?
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What is the starting position of the neonatal positive supporting reflex? |
Support the child in a vertical position with your hands under the arms and around the thorax.
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How to elicit the neonatal positive supporting reflex? |
Allow the soles of the feet to make firm contact with the table top.
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What is the correct response of neonatal positive supporting reflex? |
Some weight bearing most likely with some hip and knee flexion.
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What is ASTASIA? |
keep in mind that there is a period in normal development that includes non-weight bearing.
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What is negative response of neonatal positive supporting reflex? |
no weight bearing |
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Why is neonatal positive supporting reflex so important for normal growth? |
Intended as posture preparatory for motion, not for full weight bearing or independent standing. Prerequisite for spontaneous stepping.
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What is starting position of spontaneous stepping reflex? |
Hold infant vertically.
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How to elicit the spontaneous stepping reflex? |
Allow feet to touch ground, then incline the infant forward and slowly move him anteriorly to accompany any stepping.
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What is correct response of spontaneous stepping reflex? |
First a positive supporting response takes place, then the infant appears to be walking. A full-term infant will “walk” with a heel-toe pattern whereas a premature infant will “walk” with a toe-heel pattern.
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What is ABASIA? |
Be aware of the normal occurrence of a non stepping period called ABASIA.
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What is the usefulness of spontaneous stepping reflex? |
Experts disagree as the the usefulness of this reflex. Proponents say that in children, whose mothers exercised their infants daily with spontaneous stepping “exercise,” walked earlier than a group of infants who were not exercised to maintain this reflex.
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What is the problem is this reflex doesn't dissappear or does not appear? |
Asymmetry can be the result of insult to one side of the brain, muscle weakness or peripheral nerve injury. If the spontaneous stepping reflex is stronger than the positive supporting reflex, athetosis (slow, writhing, involuntary control of the extremities) is suggested. If the opposite results, spasticity occurs.
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What is the starting position of the tonic labryinthine reflex? |
Place infant in prone and then supine with the head in the midline and let extremities rest by the side. The position of the head and its relationship to gravity triggers the reflex.
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How to elicit TLR? |
First note tone in both prone and supine. If there are no differences, passively move extremities in both positions and note if there is more tone in one or the other. In supine, 1) bring the child to a sitting position with your hand behind his head or shoulders, noting if there is resistance to head and shoulder flexion, 2) resistance of shoulders to forward flexion can be tested with the upper extremities brought forward and across the chest, if TLR is present, resistance will be felt and the arms will be pulled backwards, 3) when pulling a child into a sitting position by the forearms, increased extensor tone in the neck and trunk will result in the head being pulled backward instead of forward. . Tests in prone can be done by 1) extending the head and noting resistance, 2) pulling arms upward and noting resistance
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What is the correct response of TLR? |
Supine position produces extensor facilitation and flexor inhibition. Prone produces opposite response.
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What is the negative response of TLR? |
The presence of an obligatory TLR prevents motor development. When prone, the child can’t lift his head and support his weight on forearms and can’t roll from prone to supine. When supine, the child can’t lift his head to come to a sitting position. He can’t bring his hands to the midline and consequently can’t place his hands in his mouth or suck his fingers. He can’t role to prone. All these motor acts are prevented by overpowering extensor tone.
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Why is the TLR important? |
Beginning of stimulation of labyrinth in inner ear for child to begin to orient head/body to the effects of gravity.
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What happens to development if TLR reflex doesn't disappear or does not appear? |
Because a dominant TLR may impair the ability of a child to gain head control and rolling skills, all further developmental milestones will be difficult or impossible to attain. A persistent obligatory TLR can result in flexion and extension contractures and kyphosis in a sitting child. Persistence in childhood or adulthood will result in difficulty with bilateral motor coordination, crossing the body midline and motor planning skills.
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Starting position of the proprioceptive placing of UE? |
Hold newborn upright under the axilla so that the dorsum of the hand is pressed up against the edge of a table.
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How to elicit the proprioceptive placing of UE? |
Pressure on dorsum of the hand is enough to elicit response.
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Correct response of UE propriceptive placing? |
Flexion followed by extension of the elbows. The wrist and fingers usually extend and the fingers abduct. The fingers may remain fisted in the newborn with the shoulder, elbow and wrist extending. As with the feet, the hands move to rest on the top of the table.
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Importance of UE propriceptive placing? |
It is still under investigation |
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Starting position of Asymmetric Tonic Neck Reflex? |
Place infant in supine, head in midline
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What is ATNR also known as? |
postural fixation reflex elicited by turning the head (Bow and Arrow Position)
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How to elicit ATNR? |
Using a visual stimulus, encourage infant to follow it through an arc of 180 degrees and observe the posture of both the upper and lower extremities. There are seven testing activities that can be performed by a child 6 years or older: Just know the infant one for PT 898 1) Railroad track or arm extension test, 2) Quadruped position - note degree of elbow flexion, 3) Supine position - note degree of elbow flexion, 4) Walking on heels, 5) Standing on one foot - note position of UE in relation to head, 6) Tandem walking - note relation of UE to head, 7) Walking on balance beam.
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Correct response of ATNR? |
When the head is turned to the left, the right extremities will be flexed while the left extremities are extended. Should be seen with active rotation of the head, but should be tried passively if there is no active response.
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Negative response of ATNR? |
Should be concerned if ATNR is present in more than half of the tests. If it only appears once, note, but don’t state in chart. An obligatory response is never normal.
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What happens to child’s development if reflex doesn’t “disappear” or does not appear? |
If obligatory, or retained after time of integration, symmetry of posture will not be attained. An obligatory ATNR will prevent the infant from touching and exploring his own body, will not allow him to bring his hands to the midline or to his mouth thus limiting self feeding and dressing as well as developing body image. Such obligatory ATNRs can result in structural deformities such as scoliosis, subluxations or dislocations of the hip of the flexed leg. Visual tracking will be limited to the chin side thus affecting reading and writing.
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What is the starting position of symmetric tonic neck reflex? |
1) place child in ventral suspension, 2) place child in your lap, 3) place child in the all fours position. Can be done in supine.
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How to elicit the STNR? |
Flex and extend the head and note the response of the extremities. If no response is seen, passive manipulation of the extremities with the head flexed or extended may demonstrate some tone change depending on head position.
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Correct response of STNR? |
When the head is extended, extensor tone predominates in the UEs while flexor tone predominates in the LEs. With flexion of the head, the reverse is found. With adults, flexion of the head results in flexion of all extremities and just the opposite with head extension.
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Negative response of STNR? |
Persistent or obligatory STNR.
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Importance of STNR? |
Promotes four point kneeling in the developmental sequence by breaking up the stronger and more dominant pattern of extension which is strongly developed by 6 months of age.
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What happens to child’s development if reflex doesn’t “disappear” or does not appear? |
The presence of STNR causes difficulties with walking and going from floor to standing. A persistent obligatory STNR may cause spinal flexion deformities. The infant will not creep normally, but instead will ‘bunny hop’. He will “w” sit when watching TV or playing with toys. |
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What is the starting position of palmer grasp? |
Place child supine with head in the midline.
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How to elicit palmer grasp reflex? |
Insert finger into palm of the hand from the ulnar side and press gently against the palmer surface.
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Correct palmer grasp response? |
1) Catching phase consists of quick flexion and adduction of the fingers, 2) Holding phase consists of sustained flexion of the fingers when traction is maintained on the flexor tendons.
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Developmental problems of delayed or persistent grasp reflex? |
If grasp predominates, there will be difficulty in reaching for and grasping objects. Once grasped, there will be difficulty in releasing object.
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