PEDIATRICS REFLEXES
PRIMITIVE/SPINAL REFLEXES
AGE OF INTEGRATION
STIMULUS RESPONSE RELEVANCE
NAME AGE
ONSET
Automatic Hold baby upright & tip Reciprocal lexion & Weight bearing in
Stepping Birth 2 Months forward, sole of the extension of the legs development of
Re lex foot presses against the standing
table
Movement of the
Rooting 28 Weeks Stroke the corner of the tongue, mouth Allows searching for
Re lex 3 Months mouth, upper lip and and/or head towards and locating feeding
lower lip the stimulus source
Place index inger
Suck-Swallo 28 Weeks 2 - 5 Months inside infant’s Strong rhythmic Allow ingestion of
w Re lex Gestation mouth with head in sucking nourishment
midline
Traction 28 Weeks
Re lex Gestation 4 - 6 Months Grasp infant's forearm Complete lexion of Enhance momentary
and pull to sit UE re lective grasp
Palmar Maintain pressure on Massed lexion of Increase tactile input to
Grasp Re lex Birth 4 - 6 Months the ball of the hand ingers the palm of hand
Apply pressure with
Plantar 28 Weeks 9 Months thumb on infant's ball Toe lexion Increase tactile input to
Grasp Re lex Gestation of the foot the sole of the foot
Babkin Evolves into the
(Palmar Deep pressure to the Eye close, mouth voluntary
Mandibular) Birth 3 Months palms of both hands opens and/or neck eye-hand-mouth
Re lex lexes (Tilts head coordination necessary
forward) for food intake
Firm, painful stroke Flexion or extension
Babinski Birth 9 - 10 Months along lateral border of of big toe, fanning of Presence of re lex later
Re lex sole from heel to toe other toes may indicate disease
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AGE OF INTEGRATION
STIMULUS RESPONSE RELEVANCE
NAME AGE
ONSET
Hold infant in prone
suspension, gently Lateral trunk lexion Facilitates lateral trunk
Galant Re lex 32 Weeks 2 Months scratch or tap along & wrinkling of the movement necessary
Gestation side of spine with skin on the for trunk stabilization
inger from shoulder to stimulated side
buttock
Flexor Protective response
Withdrawal 28 Weeks 1 - 2 Months Pinprick at the sole of Mass lexion using predominant tone
Re lex Gestation the foot ipsilateral LE
Supine with head in If persist interferes with
Extensor mid-position one leg Uncontrolled weightbearing and
Thrust Birth 2 Months extended opposite leg extension of the standing development
Re lex lexed. Stimulate sole of lexed leg
foot of lexed leg
Supine head in Flexion of If persist interferes with
Crossed mid-position; legs contralateral lower weight bearing and
Extension 28 Weeks 2 Months extended – noxious extremity followed standing development
Re lex Gestation stimulus to ball of foot by abduction and
of the extended extension (scissor
extremity position)
May interfere with
Sudden arm sitting balance,
Startle Re lex Birth Persist Sudden loud noise extension or protective reactions in
abduction, crying sitting, eye-hand
coordination, social
interaction
BRAINSTEM REFLEX
If persist may interfere
Positive Contact to the ball of Rigid extension with standing &
Supportive Birth 6 Months the foot in upright (co-contraction) of walking, balance
Reaction standing position the lower extremities reaction & weight shift
in standing & can lead
to ankle PF contractures
Flexion of arm & leg If persist may interfere
on skull side and with feeding, visual
Asymmetric Rotate infant’s head to extension of arm & leg tracking, midline use of
Tonic Neck Birth 6 Months one side, hold for 5 on face side (fencing hands, bilateral hand
Re lex seconds posture – shoulder use, rolling,
ABD & ER)
(Bow & Arrow Posture
development of
– Shoulder ABD & IR) crawling
If persist may interfere
with propping on arms
in prone, hands and
Symmetric 4-6 Flexion or extension of knees position,
Tonic Neck Months 8 - 12 Months the head with head With head extension: reciprocal crawling,
Re lex lexion: FLX of UE; EXT EXT of UE; FLX of LE sitting balance when
of LE looking around, hand
use when looking at
object at hand when
sitting
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AGE OF INTEGRATION
STIMULUS RESPONSE RELEVANCE
NAME AGE
ONSET
Supine position: If persist may interfere
Increase EXT tone / with, initiation of
Tonic Supine position, EXT of all limbs rolling, propping on
Labyrinthine Birth 6 Months Prone Position Prone: Increased FLX elbows with hips
Re lex tone / FLX of all extended in prone, trunk
limbs & hip lexion from
supine to sitting
Resisted voluntary Involuntary If persist may interfere
Associated Birth to 3 8 - 9 Years old movement in any part movement in resting with, development of
Re lex Months of the body extremity hand function
MIDBRAIN REFLEXES
Neck Tested in supine; Turn
4-6 Log rolls, aligning
Righting on 5 Years old head passively to one Initiates rolling
Months body to the head
Body (Nob) side
Unrotated body
Body 4-6 Tested in supine, segment follows the Facilitates trunk
Righting on Months 5 Years old Passive rotation of rotation in align rotation
Body (BOB) upper or lower trunk body segments
Body on Birth - 2 Supine & Prone Supine: Head lexes
Head Months 5 Years old position Prone: Head extended Neck co-contraction
Labyrinthine Birth - 2 Persist Occlude vision: Infant Orientation of the Orients head in space:
Righting Months in vertical suspension head to vertical maintains face vertical
tilt body in all direction position with mouth
horizontal
Tip body in all Orientation of the
Optic Birth - 2 directions to change head to vertical
Persist
Righting Months body position (no position with the
visual occlusion) mouth horizontaal
EQUILIBRIUM REACTIONS
Rapidly lower infant Allows accurate
Downward 4 Months Persist toward supporting Extension of UE placement of UE in
Parachute surface while in anticipation of a surface
vertical suspension
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AGE OF INTEGRATION
STIMULUS RESPONSE RELEVANCE
NAME AGE
ONSET
Tip infant forward Sudden extension of Allows accurate
Forward 6-9 toward supporting placement of UE in
Months Persist UE, hand opening &
Parachute surface while in anticipation of a surface
neck extension
vertical suspension to prevent fall
Protects body to prevent
Quickly & irmly tip Backward arm fall; supports body for
Backward 9 - 10 Persist infant to the side to off extension or arm unilateral use of
Parachute Months balance backward extension to one side opposite arm
Quickly & irmly tip Protects body to prevent
Sidewards infant to the side to off fall, supports body for
Parachute 7 Months Persist balance while in sitting Arm extension & unilateral use of
abduction to the side opposite arm
Equilibrium Position infant in prone Curving of the spine Maintains equilibrium
- Tilting (tilt board), slowly toward the raised without support,
Reactions 5 Months Persist raise one side of the side (opposite to the facilitates postural
(Prone) supporting surface pull of gravity); Abd adjustments in all
& Ext of arms & legs position
Position infant in Curving of the spine Maintains equilibrium
Equilibrium supine / sitting (tilt toward the raised without arm supports,
- Tilting 7-8 Persist board), slowly raise side (opposite to the facilitates postural
Reactions Months one side of the pull of gravity): Abd adjustments in all
(Supine) supporting surface & Ext of arms & legs position
Equilibrium Position infant in Curving of the spine Maintains equilibrium
- Tilting 12 - 21 standing (tilt board), toward the raised without arm support,
Reactions Months Persist slowly raise one side of side (opposite to the facilitates postural
(Standing) the supporting surface pull of gravity): Abd adjustments in all
& Ext of arms & legs position
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AUTOMATIC MOVEMENT REACTIONS
AGE OF INTEGRATION
STIMULUS RESPONSE RELEVANCE
NAME AGE
ONSET
First phase: Arm Ext Facilitates ability to
Moro Re lex 20 Weeks 2 - 5 Months Rapidly drop infant’s & Abd, hand opening depart from dominant
Gestation head backward Second Phase: Arm lexor posture:
Flx & Add protective response
Prone position, arm
Protective extended over head; Immediate Ext of
Extension Birth - 6 Persist suspend infant in air by arms with Abd & Ext Protective reactions to
Thrust Months ankle or pelvis & move of ingers to protect prevent fall
head suddenly towards head
loor
Hold infant in
horizontal prone Complete extension Breaks up lexor
Landau 3-4 12 - 24 suspension: head of the head, trunk & dominances; facilitates
Re lex Months Months raised actively or extremities prone extension
passively
Pathologic
Re lex Stroking of the lateral Extension of the big
(+) aspect of the sole of the toe and fanning of the Possible UMNL
Babinskin foot 4 lesser toes
on (B)
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