17. Case History and Primitive Reflexes

Question 1

When does gross motor development occur?

Answer 1

First 12 months of life - at the same time as visual development

Question 2

Gross motor development is directly related to what?

Answer 2

Visual skills development

Question 3

What are the 5 things you need to find out for developmental history?

Answer 3

Age they sat up
Age they crawled
Age they walked
Age of first words

Question 4

What are some reasons that kids will miss developmental milestones?

Answer 4

Too much modern baby equipment
Less tummy time
Different sensory experiences for premature babies
Orphanages

Question 5

What are the predictors of motor, visual and/or developmental delays during pregnancy?

Answer 5

Viral infection
Alcohol/drug abuse
Accident or infection
HTN
Smoking
Severe stress

Question 6

What are the predictors of motor, visual and/or developmental delays at birth?

Answer 6

Prolonged labor
Forceps extraction
Cesarean
Fetal distress
Prematurity

Question 7

What are the predictors of motor, visual and/or developmental delays as a newborn?

Answer 7

Low weight
Incubation
Problems feeding

Question 8

What are the predictors of motor, visual, and/or developmental delays in infancy?

Answer 8

Absence of crawling
Late learning to walk
Late learning to talk

Question 9

What are the predictors of motor, visual, and/or developmental delays in childhood?

Answer 9

Motion sickness
Difficulty riding a bike
Difficulty reading/writing
Difficulty telling time
Poor eye-hand coordination

Question 10

At what score do you expect a binocular dysfunction with the COVD quality of life checklist?

Answer 10

Greater than 20

Question 11

For kids, a score greater than ___ on the CISS is likely for CI.

Answer 11

16

Question 12

For adults, a score greater than __ on the CISS is likely for CI.

Answer 12

21

Question 13

What are the 5 stages of gross motor development?

Answer 13

Whole body flexion/extension
Separation of head from body
Separation of top from bottom
Separation of right from left sides
Crossing the midline

Question 14

When does the Moro reflex emerge?

Answer 14

9-12 weeks in utero

Question 15

When should the Moro reflex be inhibited?

Answer 15

2-4 months of age

Question 16

What triggers the Moro reflex?

Answer 16

Any unexpected occurrence

Question 17

What is the response of the Moro reflex?

Answer 17

Startle/freeze - fight or flight

Question 18

What are some problems that may arise if the Moro reflex is retained?

Answer 18

Vestibular problems
Poor oculomotor and perception
Poor pupil reaction to light
Hypersensitivity to sounds

Question 19

How is the Moro Reflex assessed?

Answer 19

Duck and pigeon walk

Question 20

What exercises are done for the Moro reflex?

Answer 20

Starfish
Seal and Otter
1/2 body roll
Full body roll
Duck and pigeon with stick
Bear walk

Question 21

When does the Tonic Labryinthine Reflex (TLR) emerge?

Answer 21

When head enters birth canal

Question 22

When is the TLR inhibited?

Answer 22

Gradually from 6 weeks to 3 years

Question 23

What problems arise is the TLR is retained?

Answer 23

Head movement alters muscle tone - poor balance
Difficulty judging space, distance, depth, and velocity
Impedes development of head righting reflexes
Vestibulo-ocular reflex arc impaired
Lack of “creeping” on hands and knees

Question 24

How do you test for TLR?

Answer 24

Patient raises both legs, both arms, and head simultaneously - if they leave body parts on the floor, can’t hold the pose, or can’t answer basic questions indicates poorly integrated TLR

Question 25

What activities are suggested to integrate TLR?

Answer 25

Same as Moro (seal/otter, body rolls, etc)

Question 26

When does the Spinal Galant Reflex emerge?

Answer 26

20 weeks in utero

Question 27

When should the Spinal galant reflex be inhibited?

Answer 27

3-9 months of life

Question 28

What does a retained Spinal Galant Reflex cause?

Answer 28

Fidgety child - hip flexion toward side of the stimulus

Question 29

What behaviors may indicate a retained Spinal Galant Reflex?

Answer 29

Elastic waistband causing fidgeting
Bedwetting past 5 years old
Poor concentration
Poor short term memory
Hip rotation to one side when walking

Question 30

How do you test for Spinal Galant Reflex?

Answer 30

With pt on hands and knees, stroke down lower back with pencil - watch for movement

Question 31

What exercises are done for Spinal Galant Integration?

Answer 31

Hip twists
Angels in the snow
Lizard Crawl

Question 32

When does the Asymmetric Tonic Neck reflex emerge?

Answer 32

18 weeks in utero

Question 33

When should the Asymmetric Tonic Neck reflex be inhibited?

Answer 33

6 months of age

Question 34

What does the Asymmetric Tonic Neck Reflex look like?

Answer 34

Movement of baby’s head to one side causes the same side arm to extend and the opposite knee to flex

Question 35

What is the score from the COVD quality of life survey that will likely indicate a reason for referral for VEE?

Answer 35

Greater than 25

Question 36

After what age are Primitive Reflexes considered aberrant?

Answer 36

After 12 months