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

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.

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

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.

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.

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

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.

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

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.

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

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

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