Downward parachute

Stimulus: Downward momentum toward a solid surface
Response: in the upper extremities: Extension of shoulders and elbows to support self
Response in the lower extremities:  Extension of hips and knees to support self.
Normal age of response: 4 months through adulthood

Source:  Dreeben p. 424

Protective in Standing

Staggering response at 15 to 18 months

Stimulus:  Loss of equilibrium
Response: Placement of lower extremities to reestablish equilibrium

Stepping strategy

Source: Dreeben p. 424

Protective Reactions in Sitting

Forward at 6 months
Lateral at 7 moths
backwards 9 months

Stimulus: Loss of equilibrium
Response: Extension of the arm to support the body and keep from falling

Source: Dreeben p. 424

Tilting Reactions

Onset
In prone 5 to 7 months
In supine 7 to 9 months
sitting  8-11 months
quadruped 9-12 month
standing 12 to 18 months

Stimulus:  instability at the base of support
Response:  Abductions of arm, leg and concavity of the spine toward the upward side

normal are of response: 5 months through adulthood

Source:  Dreeben p. 424

Labyrinthine Righting

Normal age of response 1 month through adulthood
Stimulus: Body tilted with respect to upright with eyes blindfolded
Response:  Head orients to upright position


Source: Dreeben p. 424

Optical righting

Normal age of Response:  1 month through Adulthood
Stimulus:  Body tilted with respect to upright position
Response:  Head orients to upright position

Source: Dreeben p. 424

Body Righting on Body

Onset:  4th month
Stimulus: Body in contact with solid horizontal surface
Response: The body orients itself to gravity.
Integration: 5 years


Source: Dreeben p. 424

Body Righting on Head BOH

Onset:  4th month
Stimulus: Body contract with solid horizontal surface
Response: Head orients to upright position
Integration: 5 years

Source: Dreeben p. 424

Neck on Body

Onset:  Birth
Stimulus:  Head turned to the side
Response: Body tuns to the side following the head
Integration:  6 months

Source:  Dreeben p.  424

Landau Reflex

Onset: 3rd Month
Stimulus: In a prone Position when passively flexing the head
Response: the body flexes
Stimulus: In supine when the passively extending the head
Response:  The body extends; the arms are extended
Integration:  18 months

If the reflex persist
child may have difficulty developing various body movements
The Landau reflex is absent in children with cerebral palsy and gross motor retardation


Source:  Dreeben p. 423

Traction Response

Onset: 1 Month
Stimulus:  Traction on the upper extremities as in pull to sit
Respond: Body tightens
Integration:  5 months
If the reflex persists
 May have difficulty grading the upper-extremity response to traction


Source: Dreeben p. 423

Sucking Reflex

Onset: 28 weeks of gestation
Stimulus: Object in mouth
Response: begins to suck
Integration: 2 months
Negative Effects if Persistent
may have difficulty developing more mature oral motor patterns
similar to the rooting reflex

Source:  Dreeben p. 423

Flexor Withdrawal Reflex

Onset:  Birth
Stimulus:  Noxious stimulus (pressure or pain) to the sole of the foot or the palm of the hands
Response:  The foot or hand withdrawals away from the stimulus
Integration: 2 months
Negative Effects if Persistent
may have hypersensitivity to sensory stimuli


Source: Dreeben p. 423

Babinski Reflex

Onset:  Birth
Stimulus:  Stroking the lateral aspect of the plantar surface of the foot
Response:  Extension and fanning of the toes
Integration: 12 months
Negative Effects if Persistent
difficulty with balance in standing
Weight bearing on his or her feet

Source Dreeben p. 423

Walking Reflex

Onset: 38 weeks of gestation
Stimulus: Supported upright position with soles of feet on a firm surface
Response:  Reciprocal flexion/extension of the legs.
Integration: 2 months
Negative Effects if Persistent
Standing and walking
Balance reactions and weight shift in standing
Development of smooth, coordinated reciprocal movements of lower extremities

Source: Dreeben p.422

Positive Support Reflex

Onset:  35 weeks gestation
Stimulus:  Weight placed on balls of feet when upright
Response:  Stiffening of legs and trunk into extension
Integration:  2 months
Negative Effects if Persistent
Standing and walking
Balance reactions and weight shift in standing
Can also lead to contractures of ankles into plantarflexion

Source:  Dreeben p. 422

Startle Reflex

Onset:  28 weeks of gestation
Stimulus: Loud, sudden noise
Response:  Similar to Moro response but elbows remain flexed and hands closed.
Integration: 5 months
Negative Effects if Persistent
Sitting balance
Protective responses in sitting
Eye - Hand coordination
Visual tracking
Social interaction, attention

Source:  Dreeben p. 422

Moro Reflex

Onset: 28 weeks of gestation
Stimulus:  Mead dropping into extension for a few inches
Response: Arms abduct with fingers open, then cross trunk into adduction; cry
Integration: 5 months
Negative Effect if Persistent
Balance reactions in sitting
Protective responses in sitting
Eye hand coordination
Visual tracking

Source: Dreeben p. 422 

Rooting Reflex

Onset:  28 weeks of gestation
Stimulus:  Touch on cheek
Response: Turning head to same side with mouth open
Integration:  3 months
Negative Effects if persistent
Oral motor development
Development of midline control of head
Optical righting, visual tracking and social interaction

Source: Dreeben p. 422

Plantar Grasp Reflex

Onset: 28 weeks of gestation 

Stimulus:  Pressure to base of toes

Response: Toe flexion 

Negative Effects if Persistent

Ability to stand with feet flat on a surface 

Balance reactions and weight shifting in standing

Source: Dreeben p. 422

Palmar Grasp Reflex

Onset: Birth

Stimulus: Pressure in palm on ulnar side of hand

Response: Flexion of fingers causing a strong grip

Integration: 4 month

Negative Effects if Persistent:
Ability to grasp and release objects voluntarily
weight bearing on open hand for propping crawling and protective responses

Source:  Dreeben p. 421

Galant Reflex

Onset:  30 weeks of gestation

Stimulus: Touch to the skin along the spine from shoulder to hip

Response: Lateral flexion of the trunk to the side of the stimulus

Integration: 2 months

Negative Effects if Persistent:
Development of sitting balance
Can lead to scoliosis

Source:  Dreeben p. 421

Tonic Labyrinthine Reflex TLR

Onset: Birth

Stimulus: Position of labyrinth in inner ear - reflected in head position

Response: Supine position; Body and extremities are held in extension
                  Prone position - body and extremities are held in flexion

Integration: 6 months
Negative Effects if Persistent:
Ability to initiate rolling
Ability to prop the body on the elbows with extended hips when prone
Ability to flex the trunk and hips to come to a sitting position from the supine position
Often causes full body extension, which interferes with balance in sitting or standing

Source:  Dreeben page 421

Symmetrical Tonic Neck Reflex STNR

Onset: 4-6 months

Stimulus:  Head position, flexion or extension

Response: When head is in flexion, arms are flexed and legs are extended; when head is in extension, arms are extended and legs are flexed.

Integration: 8-12 months

Negative Effects if Persistent:
Ability to prop the body on the arms in prone position
Crawling reciprocally
Sitting balance when looking around
Attaining and maintaining hands and knees position
Use of hands when looking at the object in hands ( in sitting)

Source:  Dreeben page 421

Asymmetrical Tonic Neck Reflex ATNR

Onset: Birth

Stimulus: Head position turned to one side

Response: Arm and leg on face side are extended; arm and leg on scalp side are flexed; spine is curved with convexity toward face side

Integration: 6 months

Negative Effects if Persistent:
  Feeding
Visual tracking
  Midline use of hands
  Bilateral hand use
  Rolling Development of crawling
  If ATNR persist, it can also lead to skeletal deformities such as scoliosis, hip subluxation, and hip dislocation

Source: Dreeben page 421

Progression in Sitting Balance

1. Sitting in the corner of a sofa 2. Sitting in a corner chair or a beanbag 3. Side sitting with one arm propped over a bolster or half-roll 4. Sitting with arms forward and supported on an object such as a pillow or a ball 5. Sitting in a highchair