Rooting

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

Rooting

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

sucking

onset: 28 weeks gestation
integration: 2-5 months

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

sucking

stimulus: place finger or nipple in infant's mouth

sucking

response: rhythmical _______ movements

Rooting

onset: 28 weeks gestation
integration: 3 months

rooting

Moro

onset: 28 weeks gestation
integration: S-6 months

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

Moro

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

Moro

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

Neonatal neck righting

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

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

Neonatal neck righting

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

Neonatal neck righting

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

Neonatal neck righting

Neonatal body righting

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

Neonatal body righting

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

Neonatal body righting

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

Neonatal body righting

Spontaneous Stepping

onset 27 weeks gestation
integration: 2 months

Spontaneous Stepping

Spontaneous Stepping

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

spontaneous stepping

response: child will make alternating rhythmical stepping movements.

Asymmmetrical Tonic Neck Reflex (ATNR )

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

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

Asymmmetrical Tonic Neck Reflex (ATNR )

stimulus: supine, sitting, quadruped or standing,

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

Asymmmetrical Tonic Neck Reflex (ATNR )

Symmetrical Tonic Neck Reflex

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

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

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

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

Symmetrical Tonic Neck Reflex

Grasp Reflex

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

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.

Grasp Reflex

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

Grasp Reflex

response: hand will close around object and arm will flex

Tonic Labyrinthine

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

Tonic Labyrinthine

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

Tonic Labyrinthine

midline (prone •extension,supine •flexion)

Tonic Labyrinthine

response: change in flexor or extensor tone

Tonic Labyrinthine

first part

Tonic Labrinthine

second part

Instinctual grasp
.

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

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

Instinctual grasp

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

Instinctual grasp

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

mature grasp

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

instinctual grasp Associated movements

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

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

instinctual grasp Associated movements

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

instinctual grasp Associated movements

response: non used hand mirrors or otherwise moves during activity

Labyrinthine head righting

onset: birth to 2 months
integration: persists throughout life

Lybrinthine head righting

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

Lybrinthine head righting

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

Lybrinthine head righting

Optical Righting

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

Optical Righting

significance:

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

Optical Righting

stimulus: same as labyrinthine righting, without blindfold

Optical Righting

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

Body Righting acting on the head

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

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.

Body Righting acting on the head

stimulus:observe while testing for labyrinthine and optical righting

Body Righting acting on the head

response: head rights in relation to body

Neck righting acting on the body

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

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

Neck righting acting on the body

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

Neck righting acting on the body

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

Body righting acting on the body

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

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

Body righting acting on the body

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

Body righting acting on the body

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

Body righting acting on the body

Amphibian REflex

onset: 6 months
integration: persists

Amphibian REflex

significance: Prereqisite for crawling and creeping

Amphibian REflex

stimulus: child in prone, lift 1 hip

Amphibian REflex

response: automatic flexion of same side UE and LE

Amphibian REflex

Protective Extension -

Sideward (UE)

Protective Extension -

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

Protective Extension -

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

Protective Extension -

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

Protective Extension Backward

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

Protective Extension Backward

significance:
1. needed for sitting balance and trunk rotation

Protective Extension Backward

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

Postural fixation -

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

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

Postural fixation -

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

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

Tilting reaction

(equilibrium reaction)4 point

Tilting reaction

onset: 9-12 months
integration: persists

Tilting reaction

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

Tilting reaction

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

Tilting reaction

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

Tilting reaction

Tilting reactions standing

(equilibrium reactions)

Tilting reactions standing

onset: 12-21 months
integration: persists throushcut life

Tilting reactions standing

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

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

Tilting reactions standing

Tilting reactions standing

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

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

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.

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.

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.