Milestones and Characteristics (Prenatal Motor Reflexes)

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What is a reflex?
A reflex is a predictable motor response elicited by tactile stimulation, movement/position/pressure sensation, or disturbance of balance
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What are the levels of reflex development?
Apedal, Quadrupedal, Bipedal
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What are the levels of CNS maturation for each reflex level?
Apedal: spinal cord and brainstem; Quadrupedal: midbrain; Bipedal: cortical
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What are the resulting levels of development per level?
Apedal: prone, supine; Quadrupedal: crawling; sitting; Bipedal: standing, walking
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Enumerate the kinds of primitive reflexes
Rooting, ****-swallow, traction, Moro, startle, palmar grasp, Babinski, plantar grasp
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Onset-integration: rooting
28 wks gestation - 3 mo
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Onset-integration: ****-swallow
28 wks g - 2-5 mo
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Onset-integration: Traction
28 wks g - 2-5 mo
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Onset-integration: Moro
28 wks g - 9 mo
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Onset-integration: Startle
7 mo - 1 yr
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Onset-integration: Palmar grasp
37 wks g - 4-6 mo
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Onset-integration: Babinski
Observed at birth - 4 mo (gone)
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Onset-integration: Plantar grasp
28 wks g - 9 mo
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Stimulus: Rooting
stimulation of side of cheek or upper/lower lip
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Response: Suck-swallow
rhythmical sucking and swallowing
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Relevance: Traction
enchances momentary reflexive grasp
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Response: Moro
arm extension and abduction to arm flexion and adduction
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Relevance: Startle
reaction to feeling of insecurity
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Relevance: Palmar grasp
tactile input to hand
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Stimulus: Babinski
swirl on sole of foot
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Stimulus: Plantar grasp
press on ball of feet
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Enumerate the spinal reflexes
Flexor withdrawal, Extensor thrust, Crossed extension
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Onset-integration: Flexor withdrawal
28 wks g - 2 mo
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Onset-integration: Extensor thrust
6 - 9 mo
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Onset-integration: Crossed extension
disappeares before 2nd mo
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Stimulus: Flexor withdrawal
supine, legs relaxed; hips extended and knees flexed; stimulate sole of foot
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Stimulus: Extensor thrust
supine, legs relaxed; pressure on ball of foot and spreading of toes
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Stimulus: Crossed extension
stimulate inner thigh
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Response: Crossed extension
Opposite leg adducts, extends, and internally rotates; plantar reflex
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Enumerate the brainstem reflexes
Asymmetric tonic neck, Symmetric tonic neck, Tonic labyrinthine supine; Tonic labyrinthine prone, Positive supporting reaction, Negative supporting reaction
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Onset-integration: Asymmetric tonic neck
37 wks g - 4-6 mo
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Response: Asymmetric tonic neck
arm and leg on occiput side flexes; arm and leg on chin side extends
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Relevance: Asymmetric tonic neck
promotes visual hand regard
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Onset-integration: Tonic labyrinthine supine
>37 wks g - 6 mo
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Relevance: Tonic labyrinthine supine
facilitates total body extensor tone
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Onset-integration: Tonic labyrinthine prone
>37 wks g - 6 mo
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Onset-integration: Symmetric tonic neck
4-6 mo - 8-12 mo
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Stimulus: Symmetric tonic neck
infant in quadruped; extend/dorsiflex head
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Response: Symmetric tonic neck
flex of hips and knees; extension of arms
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Onset-integration: Positive supporting reaction
2 - 4 mo
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Onset-integration: Negative supporting reaction
2 -4 mo
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Stimulus: Positive supporting reaction
hold under arms in vertical position, balance on soles of feet; maintain position
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Stimulus: Negative supporting reaction
upright, hold in standing, bounce several times then hold in space
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Enumerate the balance reactions
Righting, Protective/Parachute
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Enumerate the righting reactions
Neck righting on body (NOB), Body righting on body (BOB), Landau, Labyrinthine/optical righting
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Onset-integration: NOB
4-6 mo - 5 yr
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Response: NOB
shoulder and hip follows automatically
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Relevance: NOB
maintain head-body alignment; ambulation
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Onset-integration: BOB
4 mo - 5 yr
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Stimulus: BOB
supine, flex 1 hip and knee to chest
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Response: BOB
segmental rolling of upper trunk
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Onset-integration: Landau
3-4 mo - 12-24 mo
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Stimulus: Landau
prone; raise body
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Response: Landau
extension of head, trunk and extremities
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Stimulus: Optical righting
suspended vertically, tilt head and body at 45º to side, forwards, and back
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Relevance: Optical righting
orient head in space; face vertical
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What part of the brain is responsible for NOB and BOB
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What part of the brain is responsible for Landau reaction?
Automatic movement
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What part of the brain is responsible for optical righting?
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Enumerate the protective reactions
Parachute downward, Parachute sideways, Parachute forward, Parachute backward
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Onset-integration: Parachute downward
4 mo - persists
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Onset-integration: Parachute forward
6-7 mo - persist
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Stimulus: Parachute downward
rapidly lower infant to surface while suspended vertically
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Relevance: Parachute downward
Accurate placement of lower extremities to surface
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Stimulus: Parachute forward
plunge child downward head first
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Response: Parachute forward
Extension of upper extremities and neck, open hand
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Onset-integration: Parachute sideward
6-11 mo - persist
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Stimulus: Parachute sideward
tip to side in sitting
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Relevance: Parachute sideward
for independent sitting
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Onset-integration: Parachute backward
9-12 mo - persist
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Response: Parachute backward
extend arms backward
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Relevance: Parachute backward
unilateral facilitate spinal rotation, prevent falling
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What is the relevance of equilibrium reactions?
for equilibrium without arm support; facilitate postural adjustments in all positions
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Enumerate the equilibrium reactions
Prone tilting, Supine and sitting tilting, Quadruped tilting, Standing tilting
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Onset-integration: Prone tilting
5 mo - persist
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Response: Prone tilting
curve trunk against displacement of gravity; upper arm and leg abduct
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Onset-integration: Supine and sitting tilting
7-8 mo - persist
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Onset-integration: Quadruped tilting
9-12 mo - persist
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Enumerate other cortical level reflexes
Kneel standing, Hopping, Dorsiflexion, Seesaw, Simian
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Onset-integration: Kneel standing
15 mo - persist
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Stimulus: Kneel standing
Kneel-standing position, pull or tilt to one side
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Response: Kneel standing
righting of head and thorax, abduction and extension of arms on raised side; protection reaction on lower side
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Onset-integration: Hopping
15-18 mo - persist
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Stimulus: Hopping
hold standing by upper arms, move infant forward , backward and side to side
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Response: Hopping
righting of head and thorax; hopping steps
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Stimulus: Dorsiflex
hold infant under axilla; tilt backward
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Response: Dorsiflex
righting of head and thorax; dorsiflexion of feet
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Stimulus: Seesaw
child standing, hip and knee flexed, hold hand and foot; gently pull arm forward and slightly laterally
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Response: Seesaw
slight abduction and fall extension of manually flexed knee to maintain equilibrium
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Stimulus: Simian
standing, tilt to one side
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Response: Simian
abduction and extension of arm and leg on raised side
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What is the relevance of postural reactions?
it is associated with later voluntary movements
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Enumerate other postural reactions
Pull-up, Crawling, Primary stepping reflex, Swimming
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Onset-integration: Pull-up
3-4 mo - 1 yr
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Stimulus: pull-up
infant in upright sitting, help by one or both hands; tip baby forward and backward
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Onset-integration: Crawling
Present at birth - 3-4 mo
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Stimulus: Crawling
baby-prone pressure to sole of foot or both feet alternately
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Response: Crawling
returned pressure and extensor thrust of opposite leg; crawling motions of upper extremities
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Onset-integration: Primary stepping reflex
Present during 1st 6 wks - 5 mo
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Onset-integration: Swimming
11th day after birth - 4 mo
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Stimulus: Primary stepping reflex
erect body placed forward on flat surface
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Stimulus: Swimming
prone on water
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Response: Swimming
rhythmical flexion and extension of arms and legs
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Response: Primary stepping reflex
Crude walk-like movents
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What indicated the persistence or reemergence of these primitive reflexes?
CNS dysfunction
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What areas of reflex development may CNS dysfunction affect?
motor milestone attainment, patterns of movements, musculoskeletal alignment, function
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Other cards in this set

Card 2


What are the levels of reflex development?


Apedal, Quadrupedal, Bipedal

Card 3


What are the levels of CNS maturation for each reflex level?


Preview of the front of card 3

Card 4


What are the resulting levels of development per level?


Preview of the front of card 4

Card 5


Enumerate the kinds of primitive reflexes


Preview of the front of card 5
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