Pediatric principles of motor development, reflexes, and righting reactions

Question 1

cephalocaudal principle

Answer 1

head to toe
0-6 months: head and neck control, then upper body
6-12 months: trunk, legs to sit, stand, cruise, walk

Question 2

proximal to distal principle

Answer 2

center/core of body (head and trunk) develops first, then distal (hands/feet)
ex: need wrist and thumb before isolated finger control

Question 3

mass to specific (differentiation) principle

Answer 3

baby progresses from the entire use of the body to using specific body parts
ex: rolling (whole body/log roll to segmented roll)

Question 4

rooting reflex

Answer 4

@28 weeks gestation; integrated @3 mo
test: stroke baby’s mouth –> head/mouth/tongue will move towards the stimulation
*searching; survival to find food

Question 5

suck/swallow reflex

Answer 5

@28 weeks gest; int @2-5 mo
test: place finger in the mouth –> strong, rhythmical sucking
*eating food

Question 6

traction reflex

Answer 6

@28 weeks gest; int @2-5 mo
test: pull baby up by forearms and pull to sit –> head lag, UE flexion, reflexive grasp
*enhances reflexive grasp

Question 7

moro reflex

Answer 7

@28 weeks gest; inter @6 mo
test: rapidly drop the baby’s head backward –> immediate arms out, then arms in and crying
*alarm system, fight/flight response

Question 8

plantar reflex

Answer 8

@28 weeks gest; integ @ 9 mo
test: put pressure on bottom of foot –> toes curl
*prep for standing, tactile input
not integrated: inc in sensitivity, delayed walking

Question 9

galant reflex

Answer 9

@32 weeks gest, int @2 mo
test: hold in prone suspended and stroke down side of back –> lateral trunk flexion on the stimulated side
*trunk stabilization, lateral movement for crawling

Question 10

palmar grasp

Answer 10

@37 weeks gest, int @6mo
test: press into palm –> fingers curl
*increase tactile stim on hands, grasp/release, hand manipulation, crawling

Question 11

ATNR

Answer 11

@37 weeks gest, int @6 mo
test: supine, rotate head to one side –> face side arm extension
skull side arm flexion (think like in warrior 2 looking over your extended arm)
*hand eye coordination, crossing midline, poor handwriting and reading comprehension

Question 12

TLR (tonic labyrinthine reflex)

Answer 12

@37 weeks gest, int @ 6 mo
test:
in prone –> increased flexor tone
in supine –> increased extensor tone
*diff extending head in prone or sitting up in supine because the increase in extensor tone will make it difficult to flex the neck

gravity, muscle tone

Question 13

STNR

Answer 13

@4-6mo, int @8-12 mo
test: place in crawling position and flex the head –> arms will flex, legs extend (puppy pose)
place in crawl and ext head –> arms will ext, legs bend
think: the arms do same as what you are doing to the head
*precursor to crawling, diff sitting from supine because requires neck flexion (and if the LEs are extended this resists the movement of sitting up), poor muscle tone and POSTURE

Question 14

landau reflex

Answer 14

@3-4 mo, int @12-24 mo
“superman”
test: hold baby in prone suspended –> total extension of body
*postural control, breaks up flexor tone

Question 15

neck righting reaction

Answer 15

neck acting on body
test: supine, turn head to 1 side –> entire body log rolls in direction of head (NON SEGMENTAL; body moves as 1 unit)
*facilitates rolling, maintains alignment, precursor to crawling

Question 16

body righting reaction

Answer 16

body acting on body
test: supine, bend 1 hip/knee towards chest –> SEGMENTAL rolling

Question 17

optical head righting

Answer 17

birth - 2 mo
never integrated
uses VISUAL system
orients head in space
test: hold baby upright and tilt off center –> center their head using vision

Question 18

labyrinthine head righting

Answer 18

never integrated (starts 2mo)
NO visual cues
test: cover eyes and tilt them off center –> they will center their head using their vestibular system

Question 19

protective reactions (4)

Answer 19

1. downward (4 mo) - lower baby toward ground –> extend their LEs
2. forward (6 mo) - tip baby forward –> extend UEs
3. sideways (7 mo) - tip baby to the side –> UE ext and abduct
4. backwards (9 mo) - tip baby back –> UEs extend

Question 20

equilibrium reactions (4)

Answer 20

1. prone tilt (5 mo)
2. supine tilt (7-8 mo)
3. quadruped tilt (9-12 mo)
4. standing tilt (12-21 mo)
   test: place in that position on a tilt board and raise it to 1 side
   response: spine will curve on the raised side; both arms will extend and abduct
   *postural adjustments; maintain equilibrium
   think about a surf board

Question 21

motor development

Answer 21

1. crossing midline
2. laterality (hemispheric specialization)
3. bilateral integration (coordination)
4. fine motor and dexterity
5. visual motor integration
6. oral motor control