PRIMITIVE REFLEXES

PREPARED BY: AIMEE BEVERLY A. BIDONG,

PTRP
 REFLEX REACTION
• REFLEX

– CONVEYS A STEREOTYPED RESPONSE TO A STIMULUS.

– RESPONSE VARIES IN CHILDREN.
– DIVIDED INTO:
• SPINAL
• BRAINSTEM
• MIDBRAIN
• AUTOMATIC MOVEMENT REACTION
• CORTICAL
 SPINAL LEVEL
 SPINAL REFLEXES ARE MEDIATED BY
AREAS OF THE C.N.S. DIETERS’  POSITIVE REACTIONS PERSISTING
NUCLEUS WHICH IS IN THE LOWER BEYOND 2mo OF AGE MAY BE
THIRD OF THE PONS. INDICATIVE OF DELAYED
MATURATION OF THE C.N.S.
 PHASIC OR MOVEMENT REFLEXES
 NEGATIVE REACTIONS ARE
 COORDINATE MUSCLES OF NORMAL.
THEEXTREMITIES IN PATTERNS
OFEITHER TOTAL FLEXION OR
 APEDAL CREATURE
EXTENSION.
– FLEXOR WITHDRAWAL
– EXTENSOR THRUST
 NORMAL WITHIN 1ST 2mo.
– CROSSED EXTENSION
 BRAINSTEM LEVEL
 BRAINSTEM REFLEXES ARE MEDIATED
BY AREAS FROM DIETERS’ NUCLEUS
TO THE RED NUCLEUS WHICH SITS AT
THE MOST CAUDAL LEVEL OF THE
BASAL GANGLIA.
 STATIC POSTURAL REFLEXES
 EFFECTS CHANGES IN DISTRIBUTION
OF MUSCLE TONE THROUGHOUT THE
BODY IN RESPONSE CHANGE OF THE
POSITION OF HEAD AND BODY IN
SPACE
 NORMAL WITHIN 1ST 4-6mo
 POSITIVE REACTIONS PERSISTING
BEYOND 6mo OF AGE MAY BE
INDICATIVE OF DELAYED MOTOR
MATURATION OF THE C.N.S.
 APEDAL CREATURES
– ATNR
– STNR
– TONIC LABYRINTHINE SUPINE/ PRONE
– ASSOCIATED REACTION
– POSITIVE SUPPORTING
– NEGATIVE SUPPORTING
 MIDBRAIN LEVEL
 RIGHTING REACTIONS ARE
INTEGRATED AT THE MIDBRAIN LEVEL – NECK RIGHTING
ABOVE THE RED NUCLEUS NOT – BODY RIGHTING
INCLUDING THE CORTEX – LABYRINTHINE RIGHTING
– OPTICAL RIGHTING
 WORKS TOWARD ESTABLISHING OF
NORMAL HEAD AND BODY – AMPHIBIAN
RELATIONSHIP IN SPACE AS WELL AS IN
RELATION TO EACH OTHER.

 PERSIST THROUGHOUT LIFE

 QUADRUPEDAL CREATURE
 AUTOMATIC MOVEMENT REACTIONS
 NOT STRICTLY RIGHTING – MORO REFLEX
REFLEXES BUT WHICH ARE – STARTLE REFLEX
REACTIONS PRODUCED BY – LANDAU
CHANGES IN POSITION OF – PARACHUTE
THE HEAD

 INVOLVE EITHER THE

SEMICIRCULAR CANALS OR
LABYRINTHS OR NECK
PROPRIOCEPTORS
 CORTICAL LEVEL
• MEDIATED BY EFFICIENT – SUPINE
INTERACTION OF CORTEX, BASAL – PRONE
GANGLIA AND CEREBELLUM.
– FOUR-FOOT KNEELING
– SITTING
• HUMAN BIPEDAL STAGE
– KNEEL-STANDING
• OCCUR WHEN MUSCLE TONE IS – STANDING-HOPPING
NORMALIZED AND PROVIDE BODY
ADAPTATION IN RESPONSE TO
CHANGE OF COG.

• NORMAL 6 MONTHS ON
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
SUCKING 3 MONTHS INTRODUCE A SUCKING ACTION OF TRAIN CORRECT
FINGER INTO MOUTH LIPS AND JAW FEEDING

ROOTING 3 MONTHS TOUCH BABY’S HEAD TURNS

CHEEK TOWARDS STIMULUS

CARDINAL POINTS 2 MONTHS 1. TOUCH CORNER 1. BOTTOM LIP DESENTISIZE FACE BY

OF MOUTH LOWERS ON BABY’S OWN TOUCH
2. CENTER OF SAME SIDE AND AND OTHER
UPPER LIP IS TONGUE MOVES STIMULATION BY
STIMULATED TOWARD POINT THERAPIST
3. CENTER OF OF STIMULATION.
BOTTOM LIP IS 2. LIP IS ELEVATE
STROKED 3. LIP IS LOWERED
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
GRASP 3 MONTHS PRESS FINGER OR FINGERS FLEX AND WT BEARING
OTHER SUITABLE GRIP OBJECT STIMULI OVER
OBJECT INTO PALM WHOLE HAND, HAND
FROM ULNAR SIDE OPENING
HAND OPENING 1 MONTH STROKE ULNAR AUTOMATIC
BORDER OF PALM OPENING OF HAND
AND LITTLE FINGER
FOOT GRASP 9 MONTHS PRESS SOLE OF THE GRASPING WT BEARING
FOOT BEHIND THE RESPONSE OF FEET
TOES
PLACING REMAINS BRING THE CHILD LIFTS LIMB UP USE IN PROVOKING
ANTERIOR ASPECT TO STEP ONTO TABLE EARLY STEP
OF FOOT/ HAND
AGAINST THE EDGE
OF TABLE
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
PRIMARY WALKING 2 MONTHS HOLD BABY UPRIGHT INITIATES WT BEARING
AND TIP FORWARD, RECIPROCAL FLEXION
SOLE OF FOOT AND EXTENSION OF
PRESSES AGAINST LEGS
TABLE
GALANT’S TRUNK 2 MONTHS STROKE BACK FLEXION OF TRUNK TRAIN TRUNK
INCURVATION LATERAL TO THE TOWARDS SIDE STABILITY
SPINE STIMULUS
AUTOMATIC SITTING 2 MONTHS PRESSURE IS PLACED CHILD PULLS TO TRAIN CHILD’S OWN
ON THE THIGHS AND SITTING FROM RISING
THE HEAD IS HELD IN SUPINE
FLEXION. SUPINE
POSITION.
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
MORO 0-6 MONTHS BABY SUPINE AND ABDUCTION AND TRAIN VERTICAL
BACK OF HEAD IS EXTENSION OF HEAD STABILITY, USE
SUPPORTED. DROP ARMS. HANDS GRASP, USE PRONE
HEAD BACKWARDS OPEN. FOLLOWED POSITION OR
BY ADDUCTION OF FLEXION POSITION
ARMS
STARTLE REMAINS OBTAINED BY ELBOW IS FLEXED DESENTISIZE TO
SUDDEN LOUD AND THE HAND NOISE
NOISE OR TAPPING REMAINS CLOSED
THE STERNUM
LANDAU 3 MONTHS TO 2 ½ CHILD HELD IN EXTENSION OF MAY BE USE IN
YEARS VENTRAL HEAD, SPINE AND THERAPY TO
SUSPENSION, LIFT LEGS AS WELL AS ACTIVATE EXTENSOR
HEAD ARMS AND MUSCLES
SHOULDER
 REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
LANDAU STRONG 10 MONTHS WHEN THE HEAD IS THE HIP, KNEES AND WT BEARING, JOINT
DEPRESSED ELBOWS FLEX COMPRESSION,
KNEE SPLINTS AND
CALIPERS
FLEXOR 2 MONTHS SUPINE, HEAD MID- UNCONTROLLED
WITHDRAWAL POSITION, LEGS FLEXION RESPONSE
EXTENDED- OF STIMULATED LEG
STIMULATE SOLE OF
FOOT

EXTENSOR THRUST 2 MONTHS SUPINE, HEAD MID- UNCONTROLLED

POSITION, ONE LEG EXTENSION OF
EXTENDED, STIMULATED LEG
OPPOSITE LEG
FLEXED

CROSSED EXTENSION 2 MONTHS SUPINE, HEAD MID- OPPOSITE LEG

POSITION, LEGS ADDUCTS, EXTENDS
EXTENDED- INTERNALLY ROTATE
STIMULATE MEDIAL AND FOOT PF
LEG BY TAP
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
ASYMMETRICAL RARE 6 MONTHS Pt. SUPINE, ARMS EXTENSOR TONE ON USE BOTH ARMS
TONIC NECK REFLEX USUALLY AND LEGS FACE SIDE AND TOGETHER AND
PATHOLOGICAL EXTENDED- TURN FLEXOR TONE ON TRAIN HEAD IN
HEAD TO ONE SIDE SKULL SIDE MIDLINE
SYMMETRICAL RARE AND USUALLY 1. Pt. IN 1. UE FLEXOR TONE CORRECT WT
TONIC NECK REFLEX PATHOLOGICAL QUADRUPED AND LE BEARING ON HANDS
POSITION- EXTENSOR TONE AND KNEES. IF
VENTROFLEX 2. UE EXTENSOR CORRECT
HEAD TONE AND LE ABNORMAL
2. Pt. IN FLEXOR TONE POSTURE IN ALL
QUDRUPED DEVELOPMENT
POSITION- THEN IGNORE STNR
DORSIFLEX HEAD
TONIC PATHOLOGICAL SUPINE, ARMS AND EXTENSOR TONE OVERCOME
LABYRINTHINE LEGS EXTENDED- DOMINATES EXCESSIVE
SUPINE SUPINE POSITION EXTENSION
TONIC 3 MONTHS TURN Pt. PRONE- FLEXOR TONE OVERCOMES
LABYRINTHINE PRONE POSITION DOMINATES EXCESSIVE FLEXION
PRONE
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
POSITIVE 3 MONTHS HOLD PATIENT IN INCREASE OF EXCESSIVE ANTI-
SUPPORTING STANDING POSITION- EXTENSION IN LEGS GRAVITY RESPONSE
PRESS DOWN ON
SOLES OF FEET
NEGATIVE 3-5 MONTHS HOLD IN WT CHILD “SINKS” DEVELOP STANDING
SUPPORTING BEARING POSITION ASTESIA
NECK RIGHTING 5 MONTHS SUPINE, ROTATE BODY ROTATES AS A STIMULATE BODY
HEAD TO ONE SIDE WHOLE IN SAME ROTATIVE REACTIONS
DIRACTION AS THE
HEAD
ASSOCIATED PATHOLOGICAL HAVE Pt. SQUEEZE CLENCH OFOTHER DEVELOP HAND
REACTION AN OBJECT HAND FUNCTION
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
LABYRINTHINE HEAD 2-6 MONTHS 1.HOLD HEAD RAISES TO DEVELOPMENTAL
RIGHTING/ BLINDFOLDED Pt. IN NORMAL POSITION, TRAINING
VESTIBULAR PRONE POSITION, IN FACE VERTICAL,
RIGHTING SPACE, AS HEAD MOUTH
DROPS HORIZONTAL
2. AS ABOVE IN
SUPINE
OPTICAL 6 MONTHS AS ABOVE AS ABOVE
BLINDFOLDED

AMPHIBIAN 4-6 MONTHS Pt. PRONE, HEAD IN AUTOMATIC FLEXION

MID-POSITION, LEGS OUTWARD OF HIP
EXTENDED, LIFT AND KNEE ON SAME
PELVIS ON ONE SIDE SIDE
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE THERAPY
BODY RIGHTING 4-6 MONTHS SUPINE- ROTATE ACTIVE DEROTATION DEVELOPMENTAL
DEROTATIVE HEAD OR ONE KNEE AT WAIST TRAINING
ON SIDE PASSIVELY

ROTATIVE 6-10 MONTHS ROTATE HIP AND ACTIVE SEGMENTED

KNEE OR ARM OR ROTATION
HEAD ACTIVELY

SUPINE AND PRONE 6 MONTHS Pt. ON TILT BOARD. LATERAL CURVING OF

ARMS AND LEGS HEAD AND THORAX +
EXTENDED, TILT PROTECTIVE
BOARD TO ONE SIDE REACTION IN LIMBS
ACCOMPANY TRUNK
REACTION
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE
FOUR-POINT KNEELING 7-12 MONTHS Pt. IN QUADRUPED LATERAL CURVING OF
POSITION, TILT TOWARDS HEAD AND THORAX.
ONE SIDE ABDUCTION-EXTENSION
OF ARM AND LEG ON
RAISED SIDE AND
PROTECTIVE REACTIONS
ON LOWERED SIDE
SITTING 9-12 MONTHS Pt. SEATED ON CHAIR- TILT HEAD AND THORAX CURVE
Pt. TO ONE SIDE ABDUCTION-EXTENSION
OF ARM AND LEG ON
RAISED SIDE OTHER
PROTECTIVE REACTIONS
MAY ACCOMPANY THIS
KNEEL-STANDING 18 MONTHS Pt. IN KNEEL-STANDING FORWARD- EXTENDS HEAD
POSITION, PULL OR TILT Pt. AND BACK
TO ONE SIDE BACK- FLEXES HEAD AND
(ANTEROPOSTERIOR) TRUNK
 REFLEX REACTION
REFLEX REACTION NORMAL UNTIL STIMULUS RESPONSE
STANDING 12-18 MONTHS Pt. IN STANDING POSITION. TRUNK AS ABOVE
TILT SIDEWAYS. TILT
ANTEROPOSTERIORLY

STAGGERING REACTION 12-18 MONTHS 1. MOVE TO LEFT/ RIGHT 1. HOPPING SIDEWAYS

SIDE PUSH/ HOLDING 2. HOPPING FORWARD
UPPER ARM 3. HOPPING BACKWARD
2. MOVE FORWARD
3. MOVE BACKWARD
PARACHUTE 5-10 MONTHS PRONE- SUDDEN TIP IMMEDIATE EXTENSION OF
DOWNWARD ARMS WITH ABDUCTION
SITTING- SUDDEN TIP AND EXTENSION OF
DOWNWARD FINGERS TO SAVE AND
STANDING- SUDDEN TIP THEN PROP THE CHILD
DOWNWARD
Developmental milestone
 Milestone: speech
AGE ACTIVITY
NEWBORN CRY
4 MONTHS COOS, SQUEAL, CHUCKLE, LAUGH
7 MONTHS 1 SYLLABLE
10 MONTHS 2 SYLLABLES
14 MONTHS 1 WORD
18 MONTHS POINT BODY PARTS, IDENTIFY PICTURES
2 YEARS OLD 2 WORDS SENTENCE
3 YEARS OLD 3 WORDS SENTENCE, STUTTERS
4 YEARS OLD REPEAT 4 DIGITS, PAST TENSE
5 YEARS OLD COUNT 1-10, FLUENT
6 YEARS OLD GRAMMAR
 MILESTONES: PERSONAL/
AGE
SOCIAL ACTIVITY
NEWBORN HABITUATION STATE DEPENDENCE
4 MONTHS RECOGNIZES “BOTE”
7 MONTHS HOLDS BOTTLE, STRANGER AND SEPARATION
10 MONTHS PEEK A BOO, FINGER FEEDS, LOVE AFFAIR WITH THE WORLD
14 MONTHS USES SPOON WITH OVER PRONATION
18 MONTHS DRINKS CUP NEATLY
2 YEARS OLD PULLS ON GARMENT, USES SPOON WELL
3 YEARS OLD TOILET TRAINED, POURS FROM PITCHER
4 YEARS OLD DRESS WITH SUPERVISION
5 YEARS OLD DRESS WITHOUT SUPERVISION, BRUSH TEETH
6 YEARS OLD SHOELACES
7 YEARS OLD EATS WITH FORK AND KNIFE
 MILESTONE: GRASP MOTOR
AGE ACTIVITY
NEWBORN FLEXOR TONE, AUTOMATIC REFLEX WALKING
4 MONTHS PRONE→SUPINE AND HEAD MIDLINE
7 MONTHS SUPINE→PRONE AND CERVICAL LORDOSIS
10 MONTHS CREEPS, CRUISES, PIVOT IN SITTING, LUMBAR LORDOSIS
14 MONTHS WALKS WITH HIGH GUARD
18 MONTHS WALKS WITH LOW GUARD, BACKWARD WALK
2 YEARS OLD JUMPS ON BOTH FEET IN PLACE
3 YEARS OLD PEDAL TRICYCLE
4 YEARS OLD HOPS
5 YEARS OLD TIPTOE, SKIPS
6 YEARS OLD BICYCLE (BI-SIX-CLE), SKATES
7 YEARS OLD REFINEMENT OF SKILLS
 MILESTONE: FINE MOTOR
AGE ACTIVITY
NEWBORN PALMAR GRASP
4 MONTHS CRUDE PALMAR GRASP
7 MONTHS INTERMEDIATE GRASP/ TRANSFER CUBE HAND-HAND
10 MONTHS PINCER GRASP
14 MONTHS HOLDS CRAYON IN FULL LENGTH (SCRIBBLES)
18 MONTHS HOLDS CRAYON IN BUTT END (DUMP RAISIN IN BOTTLE)
2 YEARS OLD PENCIL SHAFT BET. THUMB AND FINGERS
3 YEARS OLD OVERHAND THROW
4 YEARS OLD UNDERHAND THROW/ SCISSORS
5 YEARS OLD DIAGONAL THROW/ BRUSH TEETH
6 YEARS OLD MATURE CATCH/ THROW
 ADDITIONAL
AGE ACTIVITY
6 MONTHS SIT WITH SUPPORT
8 MONTHS SIT WITHOUT SUPPORT
5 MONTHS PULL TO SIT
10 MONTHS PULL TO STAND
3 YEARS OLD WALKING MATURE
7 YEARS OLD WALKING NORMAL/ ESTABLISHED
5 YEARS OLD TANDEM WALKING STABLE
3 YEARS OLD TANDEM WALKING UNSTABLE
2 YEARS OLD START RUNNING
3 YEARS OLD RUNNING WELL
2 YEARS OLD JUMPING BOTH FEET
4 YEARS OLD HOPS
5 YEARS OLD SKIPS
 ADDITIONAL
AGE ACTIVITY
2 YEARS OLD STAIRS UP AND DOWN
3 YEARS OLD STAIRS ALT. UP
4 YEARS OLD STAIRS ALT. DOWN
2 YEARS OLD VERTICAL LINE
3 YEARS OLD CIRCLE
4 YEARS OLD CROSS, SCISSORS
5 YEARS OLD TRIANGLE
6 YEARS OLS RHOMBUS HORIZONTAL
7 YEARS OLD RHOMBUS VERTICAL
8 YEARS OLD BIG CROSS
9 YEARS OLD CYLINDER
10 YEARS OLD CUBE
FIN