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Onset: Birth to 2 months

Integration: Persists through life

Position: Hold child vertically under the arms, tilting child in space.

Procedure: Tilt child’s body in all directions.

Response: Head orients to vertical position and is steady, maintained in proper orientation to environment .

Significance: Persistence will prohibit antigravity behaviors; this is the starting point for the Landau reflex

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Onset: Prenatal

Integration: Second trimester as mature neck righting develops

Position: Place child supine with head in midline.

Procedure: Lift and turn child’s head to side.

Response: Childs body follows ‘’like a log,’’ that is, nonsegmentally

Significance: Often persists in the presence of spasticity; will prohibit normal de-rotative rolling.

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Onset: Prenatal

Integration: By end of third postnatal month

Position: Place child supine with head in midline

Procedure: Hold one leg straight; apply firm pressure or noxious stimulus to sole of foot.

Response: Flexion, adduction, and then extension of the opposite leg

Significance: Represents spinal cord neural networks that will lay the foundation for reciprocal pattern of locomotion

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Onset: Prenatal

Integration: 2 to 5 months

Position: Place child supine with head in midline.

Procedure: Grasp child's wrists and pull toward sitting position.

Response: Flexion of shoulders, elbows, wrist, and fingers occur.

Significance: Persistence will inhibit voluntary use of arms.

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Onset: Prenatal

Integration: 9 months

Position: Place child supine with head in midline and legs relaxed.

Procedure: Place firm pressure against volar aspect of foot, directly below toes.

Response: Plantar flexion of toes occurs.

Significance: Indicates an immature attempt to maintain stability; should disappear in standing, coinciding with mature postural equilibrium

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Onset: Prenatal

Integration: 3 months

Position: Place child supine with head in midline.

Procedure: Using your finger, stroke the perioral skin at the corner of the mouth, moving laterally toward the cheek, upper lip, and lower lip.

Response: Infant turns head toward stimulus; if to lower lip, mouth tends to open.

Significance: Is rarely absent when infant is not satiated; absence may indicate CNS depression.

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Tonic Labyrinthine Reflex (Prone, Supine)

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Tonic Labyrinthine Reflex (Prone, Supine)

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Onset: Prenatal

Integration: 6 months

Position: 1. Prone 2. Supine

Procedure: Observe the child's tone and posture in prone and supine positions. Child in prone, lift head; evaluate presence of flexor tone. Child in supine, pull-to-sit, noting presence of extensor tone.

Response: Prone, flexor tone dominates; child will not lift head. Supine, extensor tone dominates; child will not flex into pull-to-sit.

Significance: Persistence will preclude ability to roll and to develop antigravity behaviors.

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Onset: Birth to 2 months.

Integration: 4 to 11 months.

Position: Place child supine with head in midline and hands free.

Procedure: Place index finger into the infants hands with pressure over the metacarpal heads.

Response: Fingers will flex around the examiner's.

Significance: Cannot utilize volitional reach and grasp until integrated.

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onset: arms at birth; legs at prenatal

integration: end of third postnatal month

position: hold child upright in vertical suspension

procedure: brush dorsum of child's hand or foot against tabletop

response: limbs lift in flexion. followed by extension as if to place it on the table

significance: seen in CNS damage

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onset: prenatal

integration: 5 to 6 months

position: place child supine with head in midline

procedure: support infant's head and shoulders with hands and allow head to drop back 20 to 30 degrees with respect to trunk, stretching neck muscles

response: abduction of upper extremities with extension of elbows, wrist, and fingers occurs, followed by subsequent adduction of the arms at the shoulders and flexion at the elbows

significance: part of any standard neurological assessment of newborns; often the adduction component is variable, total absence of this reflex is usually suggestive of neurological abnormality

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onset: prenatal

integration: by end of third postnatal month

position: place child supine with head in midline and legs relaxed

procedure: apply noxious stimulus, such as pinprick, to sole of foot

response: stimulated leg reacts with flexion at hip, knee, and ankle, withdrawing the extremity

significance: a withdrawal to a painful stimulus persists throughout life; however, it localizes to a jerk of the ankle; the reflex is correctly named for the total withdrawal of the limb and is integrated in early life

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onset: near birth

integration: by end of third postnatal month

position: support child as in vertical suspension as described previously, but lean infant's body weight forward

procedure: hold infant upright in vertical suspension, touching feet to support surface. Lean infant slightly forward to elicit stepping

response: alternating stepping movements occur

significance: may persist, such as with spastic diplegia

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Asymmetric Tonic Neck reflex (ATNR): Onset: 2 months

Integration:4 to 6 months

Position: place child supine, have child turn head to one side.

Response: Extension of the arm and leg to which the face is turned occurs, along with flexion of the opposite limbs, producing an apparent “en guarde” fencing posture.

Significance: In normal development probably is responsible for early linkages between eyes and hands. Is not uncommonly apparent in the motor behavior of adults and children with CNS damage; when present and obligatory, prevents symmetrical behaviors, hand to mouth, and may contribute to the development of scoliosis.

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Onset: Prenatal

Integration: By end of third postnatal month

Position: Support infant in vertical suspension with your hands under arms and around trunk.

Procedure: Allow feet to make contact with support surface. Response: Co-contraction of lower extremity muscles occurs, with limb support of minimal body weight.

Significance: Indicates normal muscle tone; if persists, may be associated with high muscle tone, as in spastic diplegia.

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Onset: Prenatal

Integration: 2 to 5 months

Position: Place child in supine with head in midline.

Procedure: Place finger or nipple into the infantt's mouth.

Response: Rhythmic suckling movements occur; lips, tongue, and jaw move synchronously, first down and forward, then up and back.

Significance: Rarely suppressed in nonsatiated infant; absense may indicate CNS depression.

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Galant's Response (Incurvation of the trunk)

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Galant's Response (Incurvation of the trunk)

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Onset: Prenatal

Integration: By end of third postnatal month

Position: Place infant prone ( in horizontal suspension) over your hand.

Procedure: Stroke with pressure along paravertebral line.

Response: Trunk curves with shortening on the stimulated side.

Significance: May be useful in early evaluation of children with spina bifida to determine where trunk muscles are innervated.