Twu Infant Reflexes, Stimulus And Response

Front 1

Rooting

Back 1

Stroking the perioral skin at the corner of mouth and moving laterally towards cheek- Direct head turning towards stimulated side

Front 2

Sucking

Back 2

Place finger or nipple into infant’s mouth- Rhythmical sucking movements and swallowing

Front 3

Neonatal Neck Righting

Back 3

Turn child’s head first to one side then the other- Child’s body will follow the direction of the head turn, body turns as a whole

Front 4

Moro

Back 4

Allow child’s head to drop back 20-30 degrees with respect to trunk- Abduction of UE with extension of elbow, wrist, and fingers followed by subsequent Adduction of the arms at the shoulders and flexion at the elbows

Front 5

Traction

Back 5

Grasp child’s wrist and pull him towards sitting position -Flexion of shoulder, elbows, wrists, and fingers

Front 6

Plantar Grasp

Back 6

Firm pressure against volar surface of infant’s foot, directly below toes- Plantar flexion of all toes

Front 7

Palmar Grasp

Back 7

Place index finger into hand of infant from ulnar side and press against the palmar surface-Infant’s fingers will flex around the examiner’s index finger

Front 8

Flexor Withdraw

Back 8

Noxious stimulus such as pin prick to sole of one foot-Withdrawal of stimulated leg from that stimulus

Front 9

Crossed Extension

Back 9

Hold one leg at knee, maintaining the extremity in extension, apply firm pressure to sole of the foot-Flexion, ADduction, and then extension of opposite lower extremity as if to push the examiner away

Front 10

Extensor Thrust

Back 10

Stimulate sole of foot of flexed leg-Uncontrolled extension of stimulated leg (do not confuse with normal tickling response)

Front 11

Proprioceptive Placing (UE)

Back 11

Move child so that dorsum of one hand lightly presses against a protruding edge like a tabletop-Extremity flexed and hand is brought above the table; Extremity is then extended with wrist extended and fingers extended and abducted and places on the surface

Front 12

Proprioceptive Placing (LE)

Back 12

Lift child so that dorsum of one foot presses lightly against edge of table-Foot is lifted by flexion of knee and hip above table; Leg the extends and foot is placed squarely on the table top

Front 13

Positive Supporting (neonatal)

Back 13

Allow feet to make firm contact with table top or flat surface-Simultaneous contraction of flexors and extensors so as to bear weight on the LE; child supports only minimal amount of body weight; characterized by partial flexion of hips and knees

Front 14

Positive Support – weight bearing (mature)

Back 14

Allow feet to make firm contact with table top or flat surface-Simultaneous contraction of flexors and extensors for full weight bearing on the LE; hip and knee are extended

Front 15

Spontaneous Stepping

Back 15

Support child upright, feet touching the table surface, incline child forward and gently move the child forward to accompany any stepping-Child will make alternating, rhythmical and coordinated stepping movements

Front 16

Visual Placing (UEs)

Back 16

Advance child toward supporting surface such as tabletop-Child will lift hand, extend and place it on the support with fingers extended and Abducted

Front 17

Visual Placing (LEs)

Back 17

Advance child toward supporting surface such as tabletop-Child will immediately orient, and place foot on top of table or supporting surface

Front 18

Galant

Back 18

Gently stimulate along paravertebral line about 3 cm from midline and from shoulder down to buttocks. Stimulate on both sides, give stimulus repeatedly-Incurvation of the trunk to that side

Front 19

Tonic Labyrinthine

Back 19

Observe the child’s tone and posture in prone or supine; evaluate presence of flexor tone in prone and extensor tone in supine-Prone: flexor tone dominates; child will not lift head and support weight on arm-Supine: extensor tone dominates, child won’t flex in push to sit

Front 20

Asymmetrical Tonic Neck (ATNR)

Back 20

Turn head to one side and have child hold in this extreme position with jaw over the shoulder-Arm and leg on jaw side will extend and arm and leg on skull side will flex

Front 21

Symmetrical Tonic neck (STNR)

Back 21

Examiner first passively ventroflexes then dorsiflexes the child’s head-Flexion of the head and neck produces flexion of the UE, extension of LE. Extension of head and neck produces extension of UE and flexion of LE

Front 22

Amphibian

Back 22

Lift pelvis under ASIS on one side while pt is in prone-Automatic flexion of arm, hip and knee on same side

Front 23

NOB (neck on body)

Back 23

Stretch to proprioceptors of neck (flex child’s head and turn slowly to one side; hold and repeat to opposite side-Child will turn in direction of head turning, rotation of shoulder, trunk, then pelvis to side or prone (log manner). Occurs first in log manner, and later proceeds to segmental manner

Front 24

BOB (body on body)

Back 24

Contact of body with supporting surface (flex one leg and rotate it across the pelvis to the opposite side)-Maintains same directional orientation of all segments of the body. Provides derotation of body segments. Occurs first in log manner, and later proceeds to segmental manner

Front 25

Labyrinthine Righting (LRR)

Back 25

Gravity acting on Otoliths-Orient head upright and main eyes in horizontal positing

Front 26

Optical Righting (OR)

Back 26

Vision-Orient head upright and main eyes in horizontal positing

Front 27

BOH

Back 27

Contact of body with supporting surface-Maintain head and body in same directional orientation. Along with LRR, help neonate to lift and turn head in prone

Front 28

Landau

Back 28

Support child horizontally in the air in prone position with one hand under the lower part of the thorax, position child in space-Head extends, back and hips extend in sequence

Front 29

Protective Extension: UE forward (parachute reaction)

Back 29

Plunges the child downward toward a table or other flat surface-Child will extend and abduct arms, fingers extend and spread as if to break a fall

Front 30

Protective Extension: UE sideways

Back 30

In sitting, pushes child on one shoulder with enough force to displace COG an cause child to lose balance-Child will abduct arm on side opposite force, with extension of elbow, wrist, and fingers before contact is made with the table. Weight is taken on open palm and fingers

Front 31

Protective Extension: UE backwards

Back 31

In symmetrical sitting with legs out in front, examiner pushes child backward with enough force to displace COG and offset balance-Child extends arm backward. Full reaction is backward extension of both arms. Frequently an element of trunk rotation comes in and reaction is seen in one arm only.

Front 32

Protective Extension: LE downward

Back 32

Plunge the child downward, feet first, towards a table or other flat surface-Child will extend knees along with hip Abduction and lateral rotation, ankle dorsiflexion to break a fall

Front 33

Protective Extension: LE Staggering Reaction

Back 33

In standing, push the child in all directions (forward, backward, and sideways)-Child makes correction movements of flexion and extension, adduction and abduction of limbs to restore COG. Child takes one or more steps forward or backward to correct. Child sidesteps or crosses one foot over the other to correct.

Front 34

Tilting/ Balance Reactions: Prone

Back 34

Place child prone on a tilt board and slowly tilt it laterally to the right and left-Child will curve against the displacement of COG, concavity of the spine upward toward the tilt, the upper arm and leg may ABduct

Front 35

Tilting/ Balance Reactions: supine

Back 35

Place child supine on a tilt board and slowly tilt it laterally to the right and left-Child’s trunk will curve against the tilt, with the concavity of the spine upward. The head is rotated with the face toward the upper side. Slight Abduction of the upper arm and leg may be seen.

Front 36

Tilting/ Balance Reactions: sitting

Back 36

Sitting on tilt board facing crosswise or lengthwise, with the vertical body axis directly over the center of rotation of the board; slowly tilt the board to the right and left then antero-posteriorly-To lateral tilt, the body remains upright and is flexed against the tilt, with the concavity of the spine upward, the neck is flexed laterally and the head is slightly rotated with face toward the upper side. The arms and legs on the upper side are Abducted while those on the lower side are Adducted and extended. -To anterior tilt, the body remains upright, the spine extends and limbs are retracted. -To posterior tilt, the body remains upright with the spine flexing and the limbs are advanced

Front 37

Tilting/ Balance Reactions: all fours

Back 37

Quadruped position on tilt board facing crosswise or lengthwise, with the longitudinal body axis directly over the center of rotation of the board; slowly tilt the board laterally to the right and left, then antero-posteriorly-To lateral tilt, the body is flexed against the tilt with the concavity of the spine upward. The head is slightly rotated so that the face turns toward the upper side. The arm and leg on the upper side flexes and the arm and leg on the lower side extends and abducts-To anterior tilt, arms extended and legs flex, head is extended and trunk moves backwards-To posterior tilt, shoulders and hips extend, elbow and head tend to flex and trunk moves forward

Front 38

Tilting/ Balance Reactions: standing

Back 38

Standing on tilt board facing crosswise or lengthwise, with the body axis directly over the center of rotation of the board; slowly tilt the board laterally to the left and the right then antero-posteriorly-To lateral tilt body is flexed against the tilt with the concavity of the spine upward. Upper leg is flexed and upper arm abducted. The lower leg is extended and strongly braced-To anterior tilt, the spine extends, displacing the body backward, legs extend, arms extend and are retracted-To posterior tilt, the spine flexes, displacing the body forward, legs extend, and arms are flexed at the shoulders and extended at the elbows

Front 39

Postural Fixation

Back 39

With a stable base of support the child receives an external destabilizing force-Elongation of trunk on weight bearing side as the weight shift occurs; same as tilting reactions expect they occur during voluntary activity or because of external forces having been applied to the body when the base of support itself is stable