KIN 362 Chapter 4

At ____ months, a baby stands alone.

10

The Crawling Reflex should disappear around _____ months. If it is retained some results may include developmental delays related to poor muscle tone, a tendency to slump while sitting, and the inability to sit still and concentrate.

11

At ____ months, a baby can walk alone.

12

At ____ months, babies lift their head in a prone position.

2

The Labyrinthine Righting Reflex appears at approximately ____-____ months of age and lasts throughout most of the first year of life. It is considered important to attainment of upright posture. If an infant is placed in a prone position, breathing may be inhibited to the point of ________________. A newborn doesn't have sufficient voluntary capabilities to raise or turn the head to improve breathing. However, the involuntary labyrinthine reflex enables the infant to "right" or elevate the head to restore the head to a position more conductive to breathing and, thus, survival.

2-3, suffocation

At ____ months, a baby lifts its shoulders (turns head).

3

Postural reactions begin at around ____ months. They help to maintain posture in a changing environment. They provide an automatic movement that is "practice" for future voluntary movement (walking reflex). These reflexes disappear when voluntary behavior surfaces.

4

At ____ months, a baby rolls over and sits unsupported.

5

At ____ months, a baby gets on hands and knees.

7

At ____ months, a baby creeps on hands and knees.

8

At ____ months, a baby pulls to stand and cruises furniture.

9

Which reflex prepares the baby for future transitional movements like turning from back to front and vice versa? It helps to later develop hand-eye coordination. It also helps in activities that require crossing the mid-line of the body.

Asymmetrical Tonic Neck Reflex

With which reflex do infants start in a supine position? The stimulus to turn head to one side. The response is the same-side arm and leg extend.

Asymmetrical Tonic Neck Reflex (Fencing Reflex)

With the ____________ reflex some brain injuries of the CNS disorders may include: Amyotrophic lateral sclerosis (ALS or Lou Gehrig disease), brain tumor or injury, meningitis, multiple sclerosis (MS), spinal cord injury, defect, or tumor, and stroke.

Babinski

With the _____________ reflex, the stimulus is the stroke of the sole of the foot from the heel to toe. The response is that the big toe moves upward or toward top surface of the foot. The other toes fan out.

Babinski

Which reflex was first described by Joseph Felix Babinski in 1886? This reflex is normal in children up to 2 years old and may disappear as early as 12 months. For adults, a positive sign indicated that this reflex has "returned"--and the person most likely has an injury to the central nervous system.

Babinski Reflex

Which reflex is important and prepares the baby for crawling and walking? It encourages movement and development of range of motion in the hips. There are varying opinions about when this reflex should "inhibit" or disappear (from 4 weeks, between 3 and 9 months, up to 12 months). If it persists, it may affect a child's posture coordination, attention, and ability to sit still. Retention of this reflex has also been associated with bedwetting.

Galant Reflex

The _______________ reflex is shown when an infants middle or lower back is stroked next to the spinal cord. The response is that the baby will respond by curving his or her body toward the side which is being stroked.

Galant Reflex (Swimming Reflex)

With which reflex can involuntary swimming-like movements be elicited days after birth? Absence of this reflex may indicate spinal cord lesion. Recognition of this reflex has contributed to the popularity of infant swim programs. However, there is no scientific basis for effect on voluntary swimming later in life.

Galant or Swimming Reflex

Which examination measures several infant reflexes from birth to 24 months? Its purpose is to develop a profile of a child's movement in relation to what is expected at a specific age. It is useful in determining motor delay.

Milani Comparetti Neuromotor Development Examination

Which reflex is one of the most useful for diagnosing an infant's neurological maturation? An asymmetric startle reflex may indicate a fractured clavicle or birth injury to nerves of the arm. Absence of this reflex implies underlying neurological damage. This reflex often exists at birth and disappears at 4-6 months.

Moro Reflex

With which reflex does the infant start in a supine position? The stimulus is a sudden loud noise or by raising the head slightly and allowing it to drop (head is supported). The response is the arms and legs extend immediately.

Moro Reflex

With which reflex is the stimulus to touch the palm with a finger or an object? The response is the hand closes tightly around the object.

Palmar Grasp Reflex

Which reflex is one of the most well-known infant reflexes? It may also be the first to emerge. It normally appears in utero, as early as the 5th month of gestation, and is evident through the 4th month postnatally. The grasping action will likely persist after that time, but it will be voluntary, not reflexive. It is believed to play an important role in the acquisition of early forms of voluntary reaching and grasping.

Palmar Grasping Reflex

Which reflex is the stimulus to apply pressure simultaneously to both palms? The response is the mouth opens, the eyes close, and/or the neck flexes which tilts the head forward. It is normally present at birth and disappears around _____ months.

Palmar Mandibular Reflex (or Babkin Reflex), 3

Which reflex is a negative response within the first months of life is suggestive of a neurological abnormality? The absence of this reflex from 3 months of age and on correlates with the development of spastic cerebral palsy. This reflex must disappear before the baby can stand or walk.

Plantar Grasp Reflex

With which reflex is the stimulus to apply slight pressure to the ball of the foot, usually with the fingertip? The response is that all the toes of that foot flex. The toes curl around the stimulating object as if attempting to grasp, as in the Palmar Grasp Reflex of the hand.

Plantar Grasp Reflex

Which reflex is the forerunner to walking? Movement occurs involuntarily and subcortically. It is a critical antecedent to optimal development of voluntary walking. These reflexes usually disappear or get integrated into a child's voluntary motor skills. This reflex usually goes away about age ____ months. The positive supporting reflex usually gets integrated by around age 6 months.

Stepping/Walking Reflex, 2

With which reflex do infants start in a supported sitting position? The stimulus is they extend their head and neck or flex their head and neck. The response is the arms extend and the legs flex, or arms flex and legs extend.

Symmetrical Tonic Neck Reflex

The first is the ______________ propping response, which begins at 4-5 months, and involves your infant extending his arms when he is held in a sitting position, allowing him to assume a tripod position.

anterior

With the retained righting reflex, normally, infants on their backs with their heads tilted will respond by ____________ their backs and __________________ stiffened legs. Those who have cerebral palsy may extend this reflex beyond the first few months of birth.

arching, straightening

____________ movements are the well-coordinated extension of the elbow, wrist, and finger joints, as with the kick. They are not as rhythmical and repetitious as leg kicks. It takes several months for infants to begin opening fingers independently in anticipation of grasping objects. Spontaneous movements are influenced by __________________ constraints.

arm, environmental

Which reflex may indicate cerebral palsy or other neurological problems?

assymetric tonic neck reflex

__________________ __________________ in infants is an early sign of cerebral palsy.

asymmetrical response

__________________ reflex is when you blink before eyes are touched or when sudden bright light appears. It persists into adulthood.

blinking (corneal)

______________ is the first reflex we have.

breathing

___________ reflex is when you cough because your airway is stimulated. It persists into adulthood.

cough

The ______________ reflex is initially observed as the symmetrical tonic neck reflex (STNR) which is present briefly after birth. It disappears before more voluntary creeping begins. It helps the body divide in half at the midline to assist in crawling. As the head is brought toward the chest, the arms bend and legs extend.

crawling

With the _____________ reflex, the stimulus is a baby is place prone on the floor or table and the soles of the feet are stroked alternately. The response is that the legs and arms move in a crawling-like action. It is believed to be essential to the voluntary creeping movement. It is observed from birth to 3-4 months.

crawling reflex

After the first breath comes the first ________.

cry

____________ is vital to the survival of the baby. This is the only way they can communicate their needs to their caregivers.

crying

With ______________ ________________, an infant starts in a supine position. The stimulus is to turn the head to one side or turn the legs and pelvis to the other side. The response is the body follows the head in rotation or the trunk and head follow in rotation. This reaction usually appears by 4-5 months, and involves your infant's body turning to follow the direction of his head when it turns, helping him learn to roll over.

derotative righting

_________________ is one of the dual purposes of reflexes that deals with motor and cognitive development. It is skillful, intentional behavior.

development

With Retained Palmar Mandibular Reflex, there may be poor manual ________________ because the reflex prevents independent thumb and finger movements. There also might be the lack of "pincer" grip, which affects pencil grip when writing. There might be _______________ difficulties continuing relationship between hand and mouth movement via the Babkin response prevents development of the independent muscle control at the front of the mouth/affect articulation. The palm of the hand may remain hypersensitive to tactile stimulation. The child may make movements with the __________ when trying to write or draw.

dexterity, speech, mouth

Many of the reflexes do not completely _______________. First, they are inhibited by the maturing nervous system. Second, they are integrated into new movement behaviors.

disappear

Most infant reflexes do not last beyond the __________ year.

first

_________ reflex is when you gag when the throat or back of mouth is stimulated. It persists into adulthood.

gag

Reflexes resist _______________, which is an extremely simple form of learning, in which an animal/individual/organism, after a period of exposure to a stimulus, stops responding.

habituation

Some consequences of reflex abnormalities include: aberrant motor development, poor lateralization, ______________ (spasticity) or _______________ (lack of tone) muscles, vestibular (balance) dysfunction, poor binocularity, eye motor difficulties, and ______________ problems.

hypertonic, hypotonic, perceptual

Rate limiters or controllers are ______________ constraints that inhibit or slow the attainment of a motor skill. They are rapidly changing during early childhood periods.

individual

Each reflexive movement is an __________________ response to a particular stimulus.

involuntary

_________________ responses are movements that are results of an unconscious effort by an individual.

involuntary

________________ is spontaneous, rhythmical, coordinated, resembling positioning and timing of an adult walking step, and have a pattern of muscle use that is also coordinated. Sometimes infants kick only one leg. Sometimes infants kick both legs alternately, as in walking. Somethings infants kick both legs in unison rather than in sequence.

kicking

What are the 2 lifespan reflexes?

knee-jerk reflex and flexor-withdrawal reflex

Which reflex is when the infant is supported upright? The stimulus is to tilt the infant. The response is the head moves to stay upright. The head tilts in the opposite direction of body tilt.

labyrinthine righting reflex

Next, ______________ propping, appearing at 6-7 months, causes him to extend his arm to the side if he is tilted.

lateral

Reflexes that endure are called ______________ reflexes.

lifespan

The ____________ reflex may signify a cerebral birth injury if lacking or assymetrical.

moro

To walk, you must be able to stand. To stand, you must be able to hold your trunk upright. To hold your trunk upright, you must be able to hold your head erect. There is maturation of the central nervous system, development of muscular strength and endurance, development of posture and balance, and improvement of sensory processing. This is in later infancy and is termed "____________ _______________."

motor milestones

Fundamental __________ ___________ are the building block to so many things. They are cumulative and sequential and lead to future complex motor skills. They are specific movements that lead to general actions.

motor skills

Infantile reflexes are tested and observed by the medical team to evaluate __________________ function and development. It there are absent or abnormal reflexes in an infant, persistence of a reflex past the age where the reflex is normally lost, or redevelopment of an infantile reflex in an older child or adult may suggest significant neurological problems.

neurological

Persistence may indicate _________________ problems. This would include when infants exhibit a reflex with he or she should not or when infants do not exhibit a reflex when he or she should.

neurological

Reflexes can help determine the level of __________________ maturation. Reflexes are age-specific in normal, healthy infants.

neurological

If the Asymmetrical Tonic Neck Reflex perseveres past the normal time of disappearance, cerebral palsy or other neural damage could be indicated. It is rare in ____________ but occasionally can be elicited in infants up to 3 months old. This reflex should be gone by around ____-____ months.

newborns, 4-6

With the ______________ reflex the stimulus is protective abduction of arms, extension of elbows and wrists and spreading of fingers, a normal defense reflex, is elicited when an infant is held in vertical suspension and is tilted abruptly forward toward the floor, and is seen in the first 8-12 months of age. The response is if motor nerve development is normal, the infant will extend arms, hands, and fingers on both sides of the body.

parachute

Infants are born with a ____________ ______________ reflex. This is when the muscles of their legs contract in a straight standing position when the balls of their feet make contact with a solid surface.

positive support

Lastly, _____________ propping, causes him to extend his arms backwards if he is tilted backward.

posterior

Reflexes related to the development of later voluntary movement are known as ________________ reflexes. They are thought to be a basis for future movements that, unlike reflexes, emanate from a stimulation initiated by the higher brain centers.

postural

________________ reflexes emanate from higher brain centers. These reflexes disappear when voluntary behavior surfaces. The prevalent belief with them is that automatic movement is "practice" for future voluntary movement. Other experts believes these reflexes may not be related to future motor development.

postural

_________________ and ________________ reflexes are related to the development of later voluntary movement and are thought to be a basis for future movements.

postural, locomotor

The Moro or Startle Reflex terms can be used interchangeably or the Moro Reflex _____________ the Startle Reflex. You may have heard some fellow parents or parenting experts refer to the Moro reflex as the "startle reflex." These two terms mean the same thing and refer to the same basic phenomenon: a baby is experiencing a natural, startled response as they become accustomed to the world around them.

precedes

Reflexes often appear in a relatively ______________ sequence and time frame during typical development.

predictable

_________________ reflexes are used predominantly for protection, nutrition, and/or survival.

primitive

The _______________ _______________ _______________ is the quantification of the level of presence or strength of primitive reflexes. It contains the assymetric tonic neck reflex, symmetric tonic neck reflex, and moro reflex.

primitive reflex profile

Beginning at different ages, the ____________ responses help your child learn to sit.

propping

With the ________-______ reflex the stimulus is that the baby is tipped backward. The response is supporting the arms flex in an effort to maintain the upright position.

pull-up

_______________ reflex is when the pupils should both constrict equally when bright light appears. It persists into adulthood.

pupillary

As we get older we develop regulated breathing, but we never lose our ______________ breathing.

reflexive

__________________ movement is a stereotypical response elicited by a specific external stimuli.

reflexive

With ____________ Symmetrical Tonic Neck Reflex, there is poor posture, tendency to "slump" when sitting at a desk or table, "W" leg position when sitting on the floor, poor eye hand coordination, messy eater, difficulties with readjustment of binocular vision (cannot change focus easily from blackboard to desk), slow at copying tasks, and poor swimming skills.

retained

With ______________ Assymetrical Tonic Neck Reflex, balance may be affected as a result of head movements to either side. There is _______________ (one sided), instead of normal cross pattern movements (walking, marching, skipping, etc.). There is difficulty crossing the midline. There is mixed ________________ (the individual may use left foot, right hand, left ear, or may use left and right hand interchangeably for the same task). There is poor handwriting and poor expression of ideas on paper.

retained, homolateral, laterality

____________ reflex is when you sneeze when nasal passages are irritated. It persists into adulthood.

sneeze

_________________ movements are not caused by known external stimuli.

spontaneous

Infants also exhibit a _____________ reflex at birth. Infants move their legs in a walking pattern when they are supported in a standing position and tilted slightly forward.

stepping

With the _______________ reflex the stimulus is you place the soles of feet on a flat surface. The response is the walking pattern of legs.

stepping reflex

Infantile reflexive movements occur quickly after the onset of ____________. They involve a single muscle or a specific group of muscles (not whole body). They cannot be ____________________ at any one time. Persistence past normal age may indicate ________________ problems.

stimuli, extinguished, neurological

Abnormal presence of infantile reflexes can occur in adults with: ____________ and ____________ ______________ from trauma. Abnormal infantile reflexes are usually discovered by the health care provider during exams performed for other reasons, and the affected individual (or the parents in the case of an infant) may not have been aware of the condition.

stroke, brain damage

What are some constraints that exist during the reflexive period?

structural, functional, environmental physical, environmental sociocultural, and task: goals, rules, and equipment.

Most reflexes occur _______________ and are therefore processed in lower brain areas as the brain stem.

subcortically

_________________ means below the level of the higher brain centers.

subcortically

The _______________ reflex can also be called the "rooting" or "searching" reflex.

sucking

With the ______________ reflex, the stimulus is a touch to the face above or below the lips. Also important in maintaining sufficient nourishment for the infant is the search or rooting reflex, which functions in conjunction with the sucking reflex. An infant's head turns in the direction of the stimulus. The __________ reflex helps the infant locate the source of nourishment. The ______________ reflex then enables the baby to ingest the food. The response is that the sucking motion begins.

sucking reflex, search, sucking

Reflexes are the built-in responses that facilitate _______________. They allow "______________" with the environment. They result in sensory consequences (adaptation). They provide building blocks for future movement.

survival, dialogue

What are the 2 dual purposes of reflexes?

survival/protection

_______________/______________ is one of the dual purpose of reflexes that activates the sympathetic nervous system. It helps avoid harm or signal need for help.

survival/protection

With the Symmetrical Tonic Neck Reflex, the limbs respond __________________. It is present briefly after birth, then reappears around ____-____ months to assist with crawling. Persistence in this reflex can impede other motor milestones. It may impede voluntary head raising when the infant is in the prone or supine position. It will inhibit reaching and grasping, unsupported sitting, balance for walking, and virtually all major motor milestones. Spinal flexion deformities may occur as well.

symmetrically, 6-9

What happens with the Symmetrical Tonic Neck Reflex when you place a baby in a sitting position and tip him or her backward?

the neck extends, arms extend, and legs flex

What happens with the Symmetrical Tonic Neck Reflex when you place a baby in a sitting position and tip him or her forward?

the neck flexes, arms flex, and legs extend

Various forms of ___________ can inhibit the normal integration of reflexes. Factors that may inhibit the development of normal movement patterns include: injuries at birth or after, drugs ingested in utero or through breast milk, allergies, physical and emotional overstimulation, an unsafe environment, blinking lights and media overload, and simple lack of opportunity for movement (Babies carried around constantly in plastic car seats or other forms of bodily restraint do not gain the necessary practice time to develop normal movement patterns.).

trauma

The appearance and disappearance of infant reflexes are a part of ____________ development.

typical

The pull-up reflex may be related to the attainment of ______________ posture. It may not be observable until the 3rd month of infancy and generally disappears by the first birthday.

upright

The Palmar Grasp Reflex is one of the most noticeable reflexes to emerge. It appears in ___________ and endures through the ______ month postpartum. With negative palmar grasp there is neurological problems and spasticity. It leads to voluntary reaching and grasping. It may predict handedness in adulthood.

utero, 4th

It is important to always keep in mind the presence of individual _______________ in all aspects of development.

variability

With Retained Moro Reflex, there can be _______________ problems (travel sickness, impaired coordination, and balance), oculomotor and _____________-perceptual problems (inability to ignore irrelevant stimuli within the visual field), dislike change or surprise-poor adaptability, reactive hypoglycemia, excessive reaction to stimuli, difficulty accepting criticism as this individual finds it difficult to change, cycle of hyperactivity followed by excessive fatigue, and a weak ________ and a low self esteem: insecurity/dependency and need to control or manipulate events.

vestibular, visual, ego

The original theory on spontaneous behaviors is that they are extraneous and have no purpose. The current theory is that they are the building blocks and are similar to some _________________ movements. Some examples are spontaneous arm movements (resemble reaching) and spontaneous kicking (resembles adult walking).

voluntary

With later infancy, you gain ________________ control of movements. There is an understanding of the environment and objects in the environment. There are meaningful interactions with others. There are _______________ reactions.

voluntary, postural

__________ reflex is when you yawn because you need additional oxygen. It persists into adulthood.

yawn