Pediatrics-Reflex and developmental milestones

Question 1

Rooting reflex

Answer 1

Stimulus: Touch side of their cheek

Response: Turning of head to side of stimulus with mouth open

Normal age of response:
28 weeks of gestation to 3 months

Question 2

Moro reflex

Answer 2

Stimulus: Head dropping into extension suddenly for a few inches (feels like they are falling)

Response: open their arms (abduction)–> bring them back to their chest (horizontal adduction)+ cry

Normal age of response:
28 weeks of gestation to 5 months

Question 3

Sucking reflex

Answer 3

Stimulus: Roof of mouth is touched

Response: Initiate sucking

Normal age of response:
28 weeks of gestation to 5 months

Question 4

Plantar grasp reflex

Answer 4

Stimulus: Pressure to base of toes
Response: Toe flexion

Normal age of response:
28 weeks of gestation to 9 months

Question 5

Stepping reflex

Answer 5

Stimulus: Supported upright position with soles of feet on a firm surface

Response: Reciprocal flexion/extension of legs (stepping motions)

Normal age of response:
38 weeks of gestation to 2 months

Question 6

Palmar grasp reflex

Answer 6

Stimulus: Pressure in palm of hand on ulnar side

Response: Flexion of fingers causing strong grip

Normal age of response:
0-4 months

Question 7

Asymmetrical tonic neck reflex (ATNR)

Answer 7

Stimulus: Head position, turned to one side

Response:
Face side: Arm and leg extend,
Scalp side: arm and leg flex

Normal age of response:
0-6 months

Question 8

Tonic labyrinthine reflex (TLR)

Answer 8

Stimulus: Head position (extension in supine; flexion in prone)

Response:
supine: body and extremities in extension
prone: body and extremities in flexion

Normal age of response:
0-6 months

Question 9

Symmetrical tonic neck Reflex (STNR)

Answer 9

Stimulus: Head position, neck flexion or extension

Response:
head in flexion:
arms flexed and legs extended
head is in extension: arms extended and legs flexed

Normal age of response:
6-9 months

Question 10

Babinski reflex

Answer 10

Stimulus: Stroking lateral aspect of the sole of the foot

Response: Fanning of toes and extension of great toe

Normal age of response:
1-2 years

Question 11

0-3 months

Answer 11

Head control development

Develop ability to control head in all positions (e.g. able to turn head to follow toy in supine)
++ random kicking in supine

Head right and reflex stepping (when held in standing)

Pelvis and legs must be a stable base of support for prone propping

Requires full support in sitting

Question 12

4-5 months

Answer 12

Pelvis and legs stabilize in prone and prop up on extended elbows

Feet to hands and mouth in supine

Good head control in supported sitting

Can weight bear if supported in standing

Able to follow objects (180 degrees) with eyes, laughing

Question 13

5 months

Answer 13

Can roll from prone to supine

Demonstrates head control in supported sitting

Question 14

6-7 months

Answer 14

7 months: sitting independently
Can roll from supine to prone

Have control of arms and upper trunk

Able to reach for an object
utilizing only one hand

Can roll from supine to prone

Independent getting into sitting

Sitting: uses hands for play and exploration

Standing with support with good alignment

Able to bounce in standing (this promotes mobility and walking)

May start commando (belly) crawling

Question 15

8-9 months

Answer 15

9 mo: Crawling: on hands and knees
ease of movement

Can get into 4-point position from prone

Can pivot in sitting

Demonstrate rocking in 4 point which is the precursor to crawling

Can pull to stand at furniture
Able to stand at furniture, stand alone, cruise sideways

Can lower into sitting from supported standing

Question 16

9 months:

Answer 16

Have control of lower trunk and pelvis

Able to transfer objects from one hand to another (fine motor behaviour)

Question 17

10-11 months

Answer 17

No longer stays in prone and supine

Can stand hands free for a few seconds

Can crawl up stairs

Bear walks (hands and feet)

Can walk with hands held

Develops pincer grasp

Question 18

12-15 months

Answer 18

Stand & Walk independently

12 months – holds a cup by handle while drinking

Throws a ball with whole body movement (not dissociated)

Walks backwards and sideways a few steps

Question 19

16 – 24 months

Answer 19

Can squat and transition back up to standing

Walks up/down the stairs with handheld

Propel/steer push toys

Initiates kicking a ball

Question 20

2-2.5 years

Answer 20

Walk on tiptoes

Jump with 2 feet

Stands on one foot

Controlled kick of a ball

Throw and catch a large ball

Running and ascend/descend stairs slowly

Rides tricycle

Question 21

3-5 years

Answer 21

Becoming functionally independent

Climb stairs 1 foot/step

Walk a straight line with heel touching toe

Controlled faster running with controlled stop and jump/hop on 1 foot

Ride a bike

Throwing to targets

Somersaults

Dress and eat independently

Question 22

Grasp Development

Answer 22

5-6 mo: Palmar grasp

7-8 mo: Raking grasp (finger flexion to make a bowl)

8-9 mo: Radial digital grasp (3 fingers: Thumb, I/F, M/F)

10-12 mo: Pincer grasp