TOPIC 7

SKILL LABORATORY PRACTICE MODULE

BLOCK : NEUROBEHAVIOR AND SPECIAL SENSE SYSTEM
TOPIC : DEVELOPMENTAL REFLEXES

GENERAL OBJECTIVES
At the end of skill practice, the student will be able to demonstrate how to eliciting
developmental reflexes including primitive reflexes.
METHODS
• Presentation
• Demonstration
• Coaching
• Self practice

EQUIPMENT
• Learning guide
• Mannequin

REFERENCE
Swaiman KF. Neurologic examination after the newborn period until 2 years of age. Dalam:
Swaiman KF, Ashwal S, Ferriero DM, penyunting. Pediatric neurology. Edisi ke-4. 2006.
USA;Mosby Elseveir; hlm 37-46.

LEARNING GUIDE

DEVELOPMENTAL REFLEXES

Introduction
Developmental reflexes are patterned responses that are achieved by certain ages. General
development of the nervous can be assessed by eliciting these reflexes. The abnormalities may
be the continued presence of a reflex that should have system dissipated, absence or poor
manifestation of the expected response or a response that is not symmetric. Primitive reflexes
are stereotypic motor responses to various stimuli that develop before birth and disappear during
early infancy in a predictable pattern.
Those reflexes are palmar grip, plantar grip, gallant, asymmetric tonic neck, suprapubic extensor,
crossed extensor, rossolimo, heel, moro and babinski.
Not all reflexes discussed.

0 1 2

PREPARATION
As Greet the baby’s parents respect fully and with kindness, introduce your
self
 Informed-consent before procedure: ask the baby's parents for permission to
do reflex examination

Wash your hand

1. GALANT REACTION
Put the baby in prone position
Scratching the skin of the infant’s back from the shoulder downward 2-3 cm
lateral to the spinous processes
If the child is stroked paravertebrally with one finger , its body curves.
The concavity proceeds toward the direction of the stimulus; the pelvis is
raised.
The corresponding leg and arm are stretched, the opposite extremities are
curved.
This reaction is often also called the spinal reaction.
Disappear at age 4 month

2. GLABELLA REACTION
Put the baby in supine position
Applied a pressure to the middle of the forehead
The reaction is both eyes will closed.

3. MORO REACTION
Put the baby in supine position
 Lay the child upon one forearm and support its head with the other hand
Than the hand holding the child’s head is lowered.
The child’s head falls into the opened hand.
The child opens his mouth, the arms are lifted and opened, his fingers are
stretched apart like a fan.
Then the mouth is closed again, the arms are bent and joined together again
in front of the child’s body.
Disappear at age 6 month

4. ASYMMETRIC TONIC NECK REACTION

Put the baby in supine position

Rotation of the infant’s head to one side for 15 seconds
If the child’s head is turned to one side , the extremities of the’ facial side’ are
stretched, and the extremities of the ‘occipital side’ are bent.
This is the so called “ fencer’s position”.
Disappear at age 3 month

5. PALMAR GRASP REACTION

Put the baby in supine position
Placing the index finger in the palm of the infant
The reaction is flexion of fingers, fist making
As long as the stimulus remains, the hand may remain closed.
Disappear at age 6 month
6. PLANTAR GRASP REACTION
Put the baby in supine position
Pressing a thumb against the sole just behind the toes
The reaction is flexion of toes
When the contact is removed, the toes spread apart
Disappear at age 15 month

7. PARACHUTE REACTION
The examiner’s holds the infant with both hands around the waist at the trunk
and lowers its head relatively fast to the surface below.
Before the head reaches the surface, the arms are extended
(optical readiness to jump), and later the transfer of body weight to the arms
occurs.
Appear at 9 month old
 8. Crossed Extensor
Put the baby in supine position
Passive total flexion of one lower extremity
Extension of the other lower limb, with adduction and internal rotation into
talipes equines
Disappear at age 6 weeks

Scoring system
0 : If student didn’t do the instruction
1 : If student do the instruction but not correct
2 : If student do the whole instruction with correct