Reflexes and Stereotypies Web

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InfantReflexes andStereotypies



Infant reflexes andstereotypies are very

important in the processof development



Importance of Infant Reflexes

• Reflexive movements occur during the last 4months of prenatal life and the first 4 months

after birth – Reflexes occur subcortically (below the level ofthe higher brain centers)

– E.g., palmer grasp



Infant vs. Lifespan Reflexes

• Most “infant” reflexes do not last beyond thefirst year

• Reflexes that endure are called “lifespan”reflexes – Knee-jerk reflex

– Flexor-withdrawal reflex



Role of the Reflexes in Survival

• Infant reflexes are calledpr im i t ive ref lexes – Asymmetric tonic neck

reflex – Symmetric tonic neck reflex – Moro reflexes

• Startle reflex

• Primitive reflexes arerepressed by 6 months ofage

• Primitive reflexes areimportant for – Protection – Nutrition

• Sucking reflex• Rooting reflex

– Survival• Labyrinthine reflex



Role of Reflexes inDeveloping Future Movement

• Postural reflexes – Prevalent belief: automatic movement is

“practice” for future voluntary movement • Other experts believe these reflexes may not be

related to future motor development

– Emanate from higher brain centers

– These reflexes disappear when voluntarybehavior surfaces



• When the stepping reflex is stimulated,walking may begin at an earlier age

• Link between stimulation of the reflexpreceding the disappearance phase and earlymovement

• Small amounts of practice can lead tosignificant results




Infant Reflex Future Voluntary

MovementCrawling Crawling

Labyrinthine Upright posture

Palmar grasp Grasping

Stepping Walking




Reflexes as Diagnostic Tools

• Can help determine the level of neurologicalmaturation – Reflexes are age-specific in normal, healthy

infants• Moro reflex

– May signify a cerebral birth injury if lacking or

asymmetrical• Asymmetric tonic neck reflex

– May indicate cerebral palsy or other neurologicalproblem



Reflex Concern when lacking, weak,

asymmetrical or persistingMoro Cerebral birth injury

Asymmetric

tonic reflex

Cerebral palsy; other neural

damage




• Milani Comparetti NeuromotorDevelopment Examination

– Measures several infant reflexes from birthto 24 months

– Purpose: develop profile of child’s

movement in relation to what is expected ata specific age

– Useful in determining motor delay




• Primitive Reflex Profile – Quantification of the level of

presence or strength of primitivereflexes

• Asymmetric tonic neck reflex• Symmetric tonic neck reflex• Moro reflex




Pinpointing the Numberof Infant Reflexes

• Different terminologies used for same reflexby experts

– Rooting reflex = search reflex; cardinal pointsreflex

• Reflexes are often poorly defined and morecomplex than once thought – Palmar grasp vs. traction response



Primitive Reflexes ~Palmar Grasp

• The palmar grasp reflexis one of the mostnoticeable reflexes toemerge

• Appears in utero• Endures through the 4 th month postpartum

• Negative palmer grasp: neurological problems;spasticity

• Leads to voluntary reaching and grasping

May predict handedness in adulthood



Primitive Reflexes~ Sucking

• Occurs pre-andpostnatally

– Babies are born withblisters on lips

• Stimulated bytouching the lips



Primitive Reflexes ~Moro Reflex

• Palm of hand lifts back ofhead

• Hand is removed suddenly

so that head begins to fall – Head is supported

• Moro reflex precedes thestartle reflex and causes

the arms and legs to extendimmediately rather than flex• Disappears at 4-6 months



Primitive Reflexes~ Startle

• Similar to the Moro reflex• May not appear until 2-3 months after Moro

disappears• Elicited by a rapid change of head position,

by striking the surface that supports the baby,

loud noise• Causes the arms and legs to flex immediately



Primitive Reflexes ~ Asymmetric Tonic Neck Reflex

• Causes flexion on oneside and extension onthe other

• Not always seen innewborn

• Facilitates the

development ofbilateral bodyawareness



Primitive Reflexes ~ SymmetricTonic Neck Reflex

• Limbs respondsymmetrically

• Its persistence mayimpede other motormilestones

P i i i R fl



Place baby in a sittingposition ~ tip forward

Neckflexes

Armsflex

Legsextend

Place baby in a sittingposition ~ tipbackward

Neckextends

Armsextend

Legsflex

Primitive Reflexes ~SymmetricTonic Neck Reflex



Primitive Reflexes ~Plantar Grasp

• The toes appear to begrasping

• Stimulus is touching theball of the foot

• This reflex mustdisappear before the

baby can stand or walk



Primitive Reflexes ~Palmar Mandibular Reflex

• Makes the eyes close,the mouth open, and/orneck flexes which tiltsthe head forward

• Also called the Babkinref lex

• Stimulus is pressure toboth palms



Primitive Reflexes ~Palmer Mental Reflex

• Elicits a facial responsewhen the base of thepalm is scratched

• Lower jaw opens andcloses



Postural Reflexes ~Stepping

Stepping reflex is a forerunner to walking



Postural Reflexes ~ Head-and-Body Righting

• The head “rights” itselfwith the body when thebody is turned to oneside – Body follows head

• Precursor to rolling

movements• Body righting may notbe evident beforemonth 5

P t l R fl



Postural Reflexes ~ParachutingReflexes

• Propping reflexes• Related to upright

posture• This reflex is a

conscious attempt tobreak a potential fall



Stereotypies

• Another form of movement observable duringinfancy

• Characterized by patterned, stereotyped,highly intrinsic, and involuntary movements ofthe body

• Believed to precede more complex voluntarymovements

Reflexes and Stereotypies Web

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