OT Refex development in depth Flashcards


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created 10 years ago by tracey_brown4238
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updated 10 years ago by tracey_brown4238
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1

Rooting

stimulus: stroke around the mouth starting at the cormer of the
mouth and moving toward the cheek

2

Rooting

response: infant opens mouth and turns face toward the stimulated side
followed by attempted suck

3

sucking

onset: 28 weeks gestation
integration: 2-5 months

4

sucking

significance:
1. poor _____ is found in apathetic babies.
OR may even be absent
2. Barbituates seem to depress this
3. ____ is often less intense and less regular during
the first few days
4. failure to obtain or late persistance of this
reflex may indicate general depression of the CNS or sensorimotor depression
S. persistance inhibits voluntary _____movements

5

sucking

stimulus: place finger or nipple in infant's mouth

6

sucking

response: rhythmical _______ movements

7

Rooting

onset: 28 weeks gestation
integration: 3 months

8

rooting

...

9

Moro

onset: 28 weeks gestation
integration: S-6 months

10

Moro

Significance:
1. Asymmetry may indicate insult to 1 side of brain, injury to peripheral nerves of the extremity or injury to the muscles of the extremity

2. Failure to obtain or late persistence indicates general depression of the CNS or sensorimotor depression

3. different from startle reaction which consists of flexion only & can be elicited by a loud noise or sudden light

11

Moro

stimulus: support child in sitting and allow head to drop back 20-30 degrees, stretching the neck muscles

12

Moro

response: abduction of the UE with extension of wrists, fingers & elbows

13

Neonatal neck righting

onset:34 weeks gestation
integration: inhibited by neck righting with rotation of the body at 4 months

14

Neonatal neck righting

Significance:
1. Needed for child to roll back to side

2. Asymmetrical response to 1 side is considered abnormal

3. May be important in the birth process

4. Obligate neck righting whenever the child rolls is Never normal

5. persistence prevents segmental rolling & acquisition of Other developmental skills involving rolling & rotation

15

Neonatal neck righting

response: the child's body follows, body turns as a whole

16

Neonatal neck righting

stimulus: in supine, turn the child's head to the side

17

Neonatal neck righting

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18

Neonatal body righting

onset: 34 weeks gestation inte ration: 4-5 months
integration: 4-5 months

19

Neonatal body righting

stimulus: supine head in midline, flex one lag and rotate leg across chest to encourage rolling

20

Neonatal body righting

response: child's trunk and head will follow, body will follow as a whole

21

Neonatal body righting

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22

Spontaneous Stepping

onset 27 weeks gestation
integration: 2 months

23

Spontaneous Stepping

...

24

Spontaneous Stepping

stimulus: in supported standing, tilt child forward and move child forward

25

spontaneous stepping

response: child will make alternating rhythmical stepping movements.

26

Asymmmetrical Tonic Neck Reflex (ATNR )

onset: birth to 2 months
integration: 4-6 months

27

Asymmmetrical Tonic Neck Reflex (ATNR )

Significance:
1. in full term infants, UE Participate more than LE
2. disappears as neck righting &rotation appear

3. Must be integrated for child to roll over

4. Asymmetry may indicate insult to one side of the brain,peripheral nerve injury or primary muscle muscle weakness

5. response is never totally obligatory in a normal infant

6. Persistence beyond 6 months is an indication of CNS dysfunction

7. The problems that may be noted with persistence include inability to engage hands in midline and scoliosis

28

Asymmmetrical Tonic Neck Reflex (ATNR )

stimulus: supine, sitting, quadruped or standing,

29

Asymmmetrical Tonic Neck Reflex (ATNR )

response: arm and leg on jaw side extend, arm and turn head to one side leg on skill side flex

30

Asymmmetrical Tonic Neck Reflex (ATNR )

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31

Symmetrical Tonic Neck Reflex

onset: 4-6 months
integration 10-12 months probably

32

Symmetrical Tonic Neck Reflex

significance:
1. integration of STNR coinsides with creeping (4 point)flex or extend the child’s neck & head
2. May be used to facilitate 4 point but will encourage
bunny hop and not alternating creep

33

Symmetrical Tonic Neck Reflex

stimulus: place child in prone over examiners knee or in 4 point flex or extend the child’s neck and head

34

Symmetrical Tonic Neck Reflex

response: flexion of head and neck
•flexion of UEs & extension of LE’s
extension of head/neck
•extension of UE’s and flexion of LE’s

35

Symmetrical Tonic Neck Reflex

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36

Grasp Reflex

onset: birth to 2 months
integration: 4-6 months

37

Grasp Reflex

significance:
1. following development of grasp relfex, infant will begin to
reach for objects
2. unless this is integrated the child will be able to
grasp but not observe object held
3. asymmetry may indicate insult to 1 side of the brain, primary
muscle weakness or peripheral nerve injury.

38

Grasp Reflex

stimulus: supins or sitting with hands free, place a finger or toy in child's palm

39

Grasp Reflex

response: hand will close around object and arm will flex

40

Tonic Labyrinthine

onset: birth integration:around 6 months
integration:around 6

41

Tonic Labyrinthine

stimulus: prone,,upine move child's head in

42

Tonic Labyrinthine

midline (prone •extension,supine •flexion)

43

Tonic Labyrinthine

response: change in flexor or extensor tone

44

Tonic Labyrinthine

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first part

45

Tonic Labrinthine

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second part

46

Instinctual grasp
.

onset: begins 4 months develops to 11 months
integration: persists

47

Instinctual grasp

significance:
1. orientation of hand to contact stimulus, vision not required
2. well coordinated movement of the limb occurs in space only after development of the instinctive grasp reaction
& its integaation with visual mechanisms

3. when developed completely, true pincer grasp with opposition of the thumb and index finger can occur with radial approach

48

Instinctual grasp

stimulus: any position in which the hands are free; touch the hand and move the toy or object slightly

49

Instinctual grasp

response: child will orient hand to stimulus, adjust hand, grope for the
object and eventually grasp the object.

50

mature grasp

the childs hand will be facing the object appropriately prior to grasp

51

instinctual grasp Associated movements

onset: birth to 3 months
integration: 8-9 years

52

instinctual grasp Associated movements

significance
1. Tonic increase in muscle activity in nonused hand indicates
brain damage
2. asymmetry may indicate insult to one side of thbrain, primary muscle weakness or peripheral nerve injury
3. late persistance may indicate general depression of CNi
4. persistance will interfere with development of a preferrred hand or helping hand

53

instinctual grasp Associated movements

stimulus: one handed activity ex. sqeeze a ball, sequential thumb
finger opposition or alternating motion of the forearm

54

instinctual grasp Associated movements

response: non used hand mirrors or otherwise moves during activity

55

Labyrinthine head righting

onset: birth to 2 months
integration: persists throughout life

56

Lybrinthine head righting

stimulus: starting in vertical, examiner tilts child (blindfolded)anteriorly, posteriorly, laterally

57

Lybrinthine head righting

response: childs head orients to vertical position and is steady and maintained in proper orientation to the environment

58

Lybrinthine head righting

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59

Optical Righting

onset: birth to 2 months, complete by 8 months
integration: persists

60

Optical Righting

significance:

1. rights head & body in relation
2. suppliments tactile, proprioceptive reactions and begins to incorporate spatial relationships

61

Optical Righting

stimulus: same as labyrinthine righting, without blindfold

62

Optical Righting

response: same as labyrinthine righting -with visual prompt rather than solely vestibular/proprioceptive

63

Body Righting acting on the head

onset: birht to 2 months, completely established by 8 months
integration: persists

64

Body Righting acting on the head

significance:
1. important in head control in relation to body in all positions: prone, supine, sitting 4 point and standing
2. Labyrinthine and optical head righting as well as this response combine to facilitate head control in pull to sit, sit and prone.

65

Body Righting acting on the head

stimulus:observe while testing for labyrinthine and optical righting

66

Body Righting acting on the head

response: head rights in relation to body

67

Neck righting acting on the body

onset: 4-6 months
integration: S years or when child can get to standing without rotation

68

Neck righting acting on the body

significance:
1. needed for child to roll supine to prone and viceversa
2. roaation around body axis is important to balance
3. asymmetry indicated necrological difficulties and balance
difficulties can be predicted

69

Neck righting acting on the body

stimulus: place child in supine head in midline, turn childs head to one side.

70

Neck righting acting on the body

response: child will turn in direction head is turned, first shoulder, then trunk & finally pelvis & LE

71

Body righting acting on the body

onset: 4-6 months
integration: inhibited by child at 4-5 years

72

Body righting acting on the body

significance:
1. modified neck righting
l. important to acquisition and maintainance of sitting,4 point & standing
3. absence results in lack of rotational patterns necessary
to balance and fine motor control
4. persistance beyond 5 yrs indicates immaturity of CNS

73

Body righting acting on the body

stimulus: in supine, flex one leg and move it across the body

74

Body righting acting on the body

response: child will turn over segmentally, pelvis, trunk, shoulder, head

75

Body righting acting on the body

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76

Amphibian REflex

onset: 6 months
integration: persists

77

Amphibian REflex

significance: Prereqisite for crawling and creeping

78

Amphibian REflex

stimulus: child in prone, lift 1 hip

79

Amphibian REflex

response: automatic flexion of same side UE and LE

80

Amphibian REflex

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81

Protective Extension -

Sideward (UE)

82

Protective Extension -

onset: 7 months integration: persists
stimulation: child is sitting, then tilted to the side with enough force to change center of gravity

83

Protective Extension -

significance:
1. needed for sitting with and without hand support

84

Protective Extension -

response: child will abduct arm on side opposite force, extension of elbow wriat & fingers allow contact with table (open palm)

85

Protective Extension Backward

onset: 9-10 months integration: persists
stimulus: long-sit, child is pushed backward displacing center of gravity

86

Protective Extension Backward

significance:
1. needed for sitting balance and trunk rotation

87

Protective Extension Backward

response: arms extended backward, one or both arms; where 1 arm is used rotation of trunk is on

88

Postural fixation -

prone, supine, sitting (also 4 point and standing)

89

Postural fixation -

onset 6-8 months integration: persists
stimulus: from prone, supine or sitting encourage child to reach for
something which is just out of reach

90

Postural fixation -

Significance:
1. Preservation of center of gravity
2. Weight shift and precursors to fine motor skills
Cannot develop adequately without this

91

Postural fixation -

response: child will be able to maintain prone, sitting or supine
without loss of balance or position and return to orig nal position without support

92

Tilting reaction

(equilibrium reaction)4 point

93

Tilting reaction

onset: 9-12 months
integration: persists

94

Tilting reaction

significance:
1. vestibular system (labyrinths)must be in tact
2. necessary for creeping and standing

95

Tilting reaction

stimulus: place child in 4 point on tilting board, tilt left, right or forward, backward

96

Tilting reaction

response: limbs on downward side flexed and upward side extended, face towrd upward side

97

Tilting reaction

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98

Tilting reactions standing

(equilibrium reactions)

99

Tilting reactions standing

onset: 12-21 months
integration: persists throushcut life

100

Tilting reactions standing

stimulus: child is standing, displace body weight in one direction or another

101

Tilting reactions standing

response: initially, limbs flexed 6n direction of tilt and extended awayfrom tilt.
eventually limbs away from tilt cross over support leg/side

102

Tilting reactions standing

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103

Tilting reactions standing

significance:
1. needed to stand and walk independently
2. helps maintain upright position intact vestibular system required for reaction to present

104

Rooting

significance:
1. helps infant locate food
2. absent in depressed babies, particularily those
depressed by barbituates
3. turning away from stimulus will occur in atiated babies
4. asymmetry may indicate insult to 1 de of brain or facial injury
5. persistence can interfere w/sucking

105

Neonatal body righting

Significance:
1. Needed for child to roll supine to side & sit to supine

2. Asymmetry is not normal

3. Persistence prevents segmental rolling and acquisition of other developmental milestones involving rotation.

106

Tonic Lybrith

Significance:

1. If TL dominates posture & persists, motor developmentwill be delayed

2. Child will not be able To lift head and clear airway in prone
3. Child will not be able to bring hands to midline (mouth)in supine

4. persistance prevents all activities requiring controlled balance between flexors and extensors.

107

Lybrinthine head righting

significance:
1. needed for head control as child moves through space, body can turn freely around head
2. allows child to lift head from prone and supine
3. important to child's eventual visual perceptual spatial orientation.