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Primitive reflexes
From Wikipedia, the free encyclopedia

Primitive reflexes are reflex actions originating in the central nervous system that are
exhibited by normal infants but not neurologically intact adults, in response to particular
stimuli. These reflexes disappear or are inhibited by the frontal lobes as a child moves
through normal child development.[1] These primitive reflexes are also called infantile,
infant or newborn reflexes.

Older children and adults with atypical neurology (for instance, people with cerebral palsy)
may retain these reflexes and primitive reflexes may re-appear in adults because of certain
neurological conditions including, but not limited to, dementia, traumatic lesions, and
strokes.[2][3] An individual with cerebral palsy and typical intelligence can learn to suppress
these reflexes, but the reflex might resurface under certain conditions such as during an
extreme startle reaction. Reflexes may also be limited to those areas affected by the atypical
neurology, such as individuals whose cerebral palsy affects only their legs retaining the
Babinski reflex but having normal speech; in individuals with hemiplegia, the reflex might be
seen in the foot on the affected side only.

Primitive reflexes are primarily tested with suspected brain injury to test the functioning of
the frontal lobe. If they are not being suppressed properly they are called frontal release signs.
Atypical primitive reflexes are also being researched as potential early warning signs of
autistic spectrum disorders.[4]

Contents
[hide]

 1 Adaptive value of reflexes

 2 Moro reflex
 3 Walking/stepping reflex
 4 Rooting reflex
o 4.1 Sucking reflex
 5 Tonic neck reflex
 6 Palmar grasp reflex
 7 Plantar reflex
 8 Galant reflex
 9 Swimming Reflex
 10 Babkin reflex
 11 Other primitive reflexes tested in adults
 12 References
 13 External links
[edit] Adaptive value of reflexes
Reflexes vary in utility. Some have a survival value. A perfect example would be the rooting
reflex, which helps a breastfed infant find the mother's nipple. Babies display it only when
hungry and touched by another person, not when they touch themselves. There are a few
reflexes that probably helped babies survive during human evolutionary past like the Moro
reflex. Other reflexes such as sucking and grabbing help establish gratifying interaction
between parents and infants. They can encourage a parent to respond lovingly and feed more
competently. They can also help parents comfort their infant because they allow the baby to
control distress and the amount of stimulation they receive.[5]

[edit] Moro reflex

Main article: Moro reflex

The Moro reflex in a four-day-old infant: 1) the reflex is initiated by pulling the infant up from the
floor and then releasing him ; 2) he spreads his arms 3) he pulls his arms in ; 4) he cries (10 seconds)

Moro reflex

This is sometimes referred to as the startle reaction, startle response, startle reflex or embrace
reflex. It is more commonly known as the Moro response or Moro reflex after its discoverer,
pediatrician Ernst Moro.

The Moro reflex is present at birth, peaks in the first month of life and begins to disappear
around 2 months of age. It is likely to occur if the infant's head suddenly shifts position, the
temperature changes abruptly, or they are startled by a sudden noise. The legs and head
extend while the arms jerk up and out with the palms up and thumbs flexed. Shortly
afterward the arms are brought together and the hands clench into fists, and the infant cries
loudly.[6] The reflex normally disappears by three to four months of age,[7] though it may last
up to six months.[8] Bilateral absence of the reflex may mean damage to the infant's central
nervous system while a unilateral absence could mean an injury due to birth trauma such as a
fractured clavicle or injury to the brachial plexus. Erb's palsy or some other form of paralysis
is also sometimes present in such cases.[7] A way to experiment to see if the reflex is present
is to hold the infant horizontally on their back and let the head drop slightly or produce a
sudden loud sound against the surface. In human evolutionary past, the Moro reflex may have
helped the infant cling to his mother while she carried him around all day. If the infant lost its
balance, the reflex caused the infant to embrace its mother and regain its hold on the mother’s
body.[5]

[edit] Walking/stepping reflex

Walking reflex

The walking or stepping reflex is present at birth; though infants this young can not support
their own weight, when the soles of their feet touch a flat surface they will attempt to 'walk'
by placing one foot in front of the other. This reflex disappears at 6 weeks as an automatic
response and reappears as a voluntary behavior at around eight months to a year old.

[edit] Rooting reflex

The rooting reflex is present at birth;[14] it assists in breastfeeding, disappearing at around
four months of age as it gradually comes under voluntary control. A newborn infant will turn
his head toward anything that strokes his cheek or mouth, searching for the object by moving
his head in steadily decreasing arcs until the object is found. After becoming used to
responding in this way (if breastfed, approximately three weeks after birth), the infant will
move directly to the object without searching.

Rooting reflex
[edit] Sucking reflex

The sucking reflex is common to all mammals and is present at birth. It is linked with the
rooting reflex and breastfeeding, and causes the child to instinctively suck at anything that
touches the roof of their mouth and suddenly starts to suck simulating the way they naturally
eat. There are two stages to the action:

1. Expression: activated when the nipple is placed between a child's lips and touches their
palate. They will instinctively press it between their tongue and palate to draw out the milk.
2. Milking: The tongue moves from areola to nipple, coaxing milk from the mother to be
swallowed by the child.

[edit] Tonic neck reflex

Tonic neck reflex

Main article: Asymmetrical tonic neck reflex

The tonic neck reflex, also known as asymmetric tonic neck reflex or 'fencing posture' is
present at one month of age and disappears at around four months. When the child's head is
turned to the side, the arm on that side will straighten and the opposite arm will bend
(sometimes the motion will be very subtle or slight). If the infant is unable to move out of this
position or the reflex continues to be triggered past six months of age, the child may have a
disorder of the upper motor neurons. According to researchers, the tonic neck reflex is a
precursor to the hand/eye coordination of the infant. It also prepares the infant for voluntary
reaching.[5]

[edit] Palmar grasp reflex

Grasp reflex

The palmar grasp reflex appears at birth and persists until five or six months of age. When an
object is placed in the infant's hand and strokes their palm, the fingers will close and they will
grasp it. The grip is strong but unpredictable; though it may be able to support the child's
weight, they may also release their grip suddenly and without warning. The reverse motion
can be induced by stroking the back or side of the hand.

[edit] Plantar reflex

Main article: Plantar reflex

A plantar reflex is a normal reflex that involves plantar flexion of the foot (toes move away
from the shin, and curl down. An abnormal plantar reflex (aka Babinski Sign) occurs when
upper motor neuron control over the flexion reflex circuit is interrupted. This results in a
dorsiflexion of the foot (foot angles towards the shin, big toe curls up). This also occurs in
babies under ~1 year, because of low myelination of the corticospinal tracts. As these tracts
develop to adult form, the flexion-reflex circuit is inhibited by the descending corticospinal
inputs, and the normal plantar reflex develops.[9]. Also known as the Babinski reflex, this is a
sign of neurological abnormality, e.g. upper motor neurone lesion, in adults.[10]

[edit] Galant reflex

Galant Reflex

Main article: Galant reflex

The Galant reflex, also known as Galant’s infantile reflex, is present at birth and fades
between the ages of four to six months. When the skin along the side of an infant's back is
stroked, the infant will swing towards the side that was stroked. If the reflex persists past six
months of age, it is a sign of pathology. The reflex is named after the Russian neurologist
Johann Susman Galant.[11]

[edit] Swimming Reflex

An infant placed face down in a pool of water will begin to paddle and kick in a swimming
motion. The reflex disappears between 4–6 months. Its survival function is to help the child
stay alive if it is drowning so a caregiver has more time to save it. Although the infant will
begin to paddle and kick, placing them in water is very risky. They swallow a large amount
of water at the same time. It is advisable to postpone swimming lessons in infants until they
are at least three months old.[5]

[edit] Babkin reflex

An infant demonstrating the Babkin reflex: he opens his mouth when pressure is applied to both
palms (8 seconds).

The Babkin reflex[12] occurs in newborn babies, and describes varying responses to the
application of pressure to both palms. Infants may display head flexion, head rotation or
opening of the mouth, or a combination of these responses. Smaller, premature infants are
more susceptible to the reflex, with an observed occurrence in a child of 26 weeks
gestation.[13] Named for Russian neurophysiologist, Boris Babkin.

[edit] Other primitive reflexes tested in adults

As mentioned these are generally referred to as frontal release signs although this may be a
misnomer. They include the palmomental reflex, snout reflex, glabellar reflex or "tap", in
addition to some of those mentioned above.

[edit] References
1. ^ "Primitive & Postural Reflexes" (php). Retrieved 2008-10-23.
2. ^ Rauch, Daniel (2006-10-05). "Infantile reflexes on MedLinePlus". MedlinePlus. Retrieved
2007-10-11.
3. ^ Schott JM, Rossor MN (2003). "The grasp and other primitive reflexes". J. Neurol.
Neurosurg. Psychiatr. 74 (5): 558–60. doi:10.1136/jnnp.74.5.558. PMID 12700289.
4. ^ Teitelbaum O, Benton T, Shah PK, Prince A, Kelly JL, Teitelbaum P (2004). "Eshkol-
Wachman movement notation in diagnosis: the early detection of Asperger's syndrome".
Proc. Natl. Acad. Sci. U.S.A. 101 (32): 11909–14. doi:10.1073/pnas.0403919101.
PMID 15282371.
5. ^ a b c d Berk, Laura E.. Child Development. 8th. USA: Pearson, 2009.
6. ^ Alex Gray; The American Academy of Pediatrics; Stephen P. Shelov; Robert E. Hannemann;
Wendy Wray (1998). Caring for Your Baby and Young Child: Birth to Age 5. London: Bantam.
ISBN 0-553-37962-3.
7. ^ a b Rauch, Daniel (MedlinePlus) (2006-10-05). "MedlinePlus Medical Encyclopedia: Moro
Reflex". Retrieved 2007-10-11.
8. ^ "Keeping Kids Healthy: Newborn Reflexes". 2001-10-14. Retrieved 2007-10-11.
9. ^ Khwaja, JIACM 2005; 6(3): 193-7: "Plantar Reflex"
10. ^ "Babinski's reflex". MedlinePlus. Retrieved 11 January 2010.
11. ^ "The Galant Reflex".
12. ^ Fleming S. Pedroso, MD, PhD; Newra T. Rotta, MD, PhD (2004). "Babkin Reflex and Other
Motor Responses to Appendicular Compression Stimulus of the Newborn". Journal of Child
Neurology 19 (8): 592–596. doi:10.1177/088307380401900805. PMID 15605468.
 13. ^ Arthur H. Parmelee Jr. M.D. (May 5, 1963). "The Hand-Mouth Reflex of Babkin in
Premature Infants". Pediatrics 31 (5): 734–740.

14 - Odent M. The early expression of the rooting reflex. Proceedings of the 5th International
Congress of Psychosomatic Obstetrics and Gynaecology, Rome 1977. London: Academic
Press, 1977: 1117-19.

[edit] External links

 "PediNeuroLogic Exam - Movies of infant reflex testing". Retrieved 2007-10-11.

 "Medri Vodcast: Neonatology - Movies of the neurological examination of the newborn

infant". Retrieved 2008-05-02.

[hide][hide]

v•d•e

Nervous system physiology: neurophysiology - reflex

midbrain: Pupillary light reflex · Accommodation reflex

Cranial nerve pons/medulla: Jaw jerk reflex · Corneal reflex · Caloric reflex test/Vestibulo-ocular
reflex/Oculocephalic reflex · Pharyngeal (gag) reflex

upper limb: Biceps reflex C5/C6 · Brachioradialis reflex C6 · Extensor digitorum reflex
Stretch
C6/C7 · Triceps reflex C7/C8
reflexes
lower limb: Patellar reflex L2-L4 · Ankle jerk reflex S1/S2 · Plantar reflex L5-S2

Primitive
Galant · Gastrocolic · Grasp · Moro · Rooting · Stepping · Sucking · Tonic neck
reflexes

Lists general · alphabetical · by organ

Bainbridge reflex · Bezold-Jarisch reflex · Coronary reflex · Mammalian diving reflex ·

Oculocardiac reflex
Cardiovascular Baroreflex Reflex bradycardia · Reflex tachycardia

Respiratory Churchill-Cope reflex

Acoustic reflex · H-reflex · Golgi tendon reflex · Optokinetic · Startle reaction ·

Other
Withdrawal reflex (Crossed extensor reflex)

Categories: Reflexes | Pediatrics

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