Term
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Definition
Begins 28 wks gestation 3 mos supine w/ head in the midline & the hands on the chest Using your finger, stroke the perioral skin @ the corner of mouth, moving laterally toward the cheek, upper lip & the lower lip, in turn directed head turning toward the stimulated side. "1. Absent in depressed babies, particularly those depressed by barbiturates
2. Turning away from the stimulus will occur in satiated babies
3. Asymmetry may indicate insult to one side of the brain, or facial injury
4. Persistence can interfere w/ sucking" |
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Term
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Definition
begins 28 wks gestation 2-5 mos supine w/ head in the midline Place a finger or nipple into the infant’s mouth Rhythmical sucking movements "1. Poor sucking (weak, slow, w/ short periods) is found in apathetic babies. Suck may even be absent.
2. Barbiturates seem to depress sucking. (breast fed baby whose mother is receiving drugs may be affected)
3. Sucking is often less intense and less regular during first few days.
4. Failure to obtain or late persistence of sucking reflex may indicate general depression of the CNS or sensorimotor depression.
5. Persistence inhibits voluntary sucking movements." |
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Term
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Definition
Begins 28 wks gestation 5-6 mos supine w/ head in the midline, arms on chest. Support infant’s head & shoulders w/ hands allow head to drop back 20-30 degrees w/ respect to trunk, stretching neck muscles. Abduction of the UE’s w/ extension of the elbows, wrist, & fingers, followed by subsequent adduction of the arms @ the shoulders & flexion @ the elbow "1. Asymmetry may indicate insult to one side of the brain, injury to the peripheral nerves of the extremity of injury to the muscles of the extremity.
2. Failure to obtain or late persistence indicates general depression of the CNS or sensorimotor depression.
3. Different from the Startle reaction which can be elicited by a loud noise or sudden light, & consists of a flexor movement only." |
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Term
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Definition
Begins 28 weeks gestation 2-5 mos supine w/ head in the midline Grasp child’s wrists & pull toward sitting position, stretching the shoulder adductors & arm flexors. Flexion of the shoulders, elbows, wrist & fingers "1. Easily obtainable in the neonate.
2. Asymmetry may indicate insult to one side of the brain or injury to shoulder muscles or peripheral nerves.
3. Persistence after 4-5 mos will inhibit voluntary reach & grasp.
4. Allows infant to hold rattle when placed." |
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Term
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Definition
begins 28 wks gestation 1-2 mos supine w/ head in midline & LE’s extended. Hold one leg @ knee, maintaining the extremity in extension, apply firm pressure to sole of the foot. Flexion, adduction & then extension of opposite lower extremity as if to push the examiner away "1. Asymmetry may indicate insult to one side of the brain, injury to peripheral nerves of the extremity of muscle weakness.
2. Failure to obtain or late persistence may indicate general depression of the CNS or sensorimotor dysfunction.
3. Persistence prevents reciprocal kicking & subsequently affects later walking." |
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Term
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Definition
Begins 28 wks gestation 1-2 mos supine w/ head in the midline, legs relaxed & semiflexed Noxious stimulus, such as a pin prick to sole of one foot. Withdrawal of stimulated leg from the stimulus/ "1. Asymmetry may indicate insult to one side of the brain, injury to peripheral nerves of the extremity muscle weakness
PTHP 9152
30
2. Failure to obtain or late persistence may indicate general depression of the CNS or sensorimotor depression." |
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Term
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Definition
Begins 28 wks gestation 9 mos supine w/ head in midline & legs relaxed. Firm pressure against volar surface or infant’s foot, directly below toes. Plantarflexion of all toes. "1. Asymmetry may indicate insult to one side of the brain.
2. Failure to obtain or late persistence indicates general depression of the CNS or sensorimotor depression.
3. Should disappear before standing erect w/ support.
4. Exaggeration of response @ age-appropriate time is insignificant." |
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Term
| proprioceptive placing UE |
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Definition
Birth 2 mos Support infant in the vertical position w/ examiner’s hands under the arms & around the chest. Move child so that the dorsum of one hand presses against protruding edge like a table top. Extremity flexes & the head is brought above the table. The extremity then extends w/ wrist extended & fingers extended & abducted, & placed on the surface. Fingers may remain fisted in the newborn, & only extremity & wrist extended "1. Asymmetry may indicate insult to one side of the brain, peripheral nerve injury, primary muscle weakness
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2. May be obtained @ any age as a withdrawal response if traction exerted against hand to point of discomfort." |
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Term
| proprioceptive placing LE |
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Definition
Begins 35 wks of gestation 2 mos Hold the child in a vertical position w/ examiner’s hand under the arms & around the chest. Support the head of the young infant. Lift the child so that the dorsum of one foot presses against edge of table. Infant’s foot is lifted by flexion in knee & hip above table. The leg then extends & the foot is placed squarely on the table top. "1. Asymmetry may indicate insult to one side of the brain, muscle weakness or peripheral nerve injury.
2. May be obtained @ any age as a withdrawal response if traction exerted against hand to point of discomfort." |
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Term
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Definition
Begins 37 wks gestation 2 mos Support child upright, feet touching the table surface. Incline the child forward & gently move the child forward to accompany any stepping. Child will make alternating, rhythmical & coordinated stepping movements. "1. Premature infants walk in toe-heel fashion, full term infants walk, heel-toe.
2. Asymmetry may indicate insult to one side of the brain, muscle weakness or peripheral nerve injury.
3. Stepping reaction is integrated in parallel w/ neonatal positive supporting." |
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Term
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Definition
Birth 6 mos Prone & supine Observe the child’s tone & posture in prone & supine. Child in prone, lift head up, evaluate presence of flexor tone. Child in supine, push up to sitting position w/ examiner’s hand on back of child’s head, evaluate presence of extensor tone. "Prone-flexor tone dominates, child will not lift head & support weight on arms.
Supine-extensor tone dominates, child will not flex in pull to sit." "1. If dominates posture & persists, motor development will be delayed.
2. Child will not be able to lift head to clear airway in prone.
3. Child will not be able to bring hand to mouth in supine.
4. Persistence prevents all activities requiring a controlled balance between flexors & extensors." |
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Term
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Definition
Birth to 2 mos 4-6 mos Place child sitting w/ head in midline. Can also test in sitting, quadruped or standing, depending on child’s age. Have child follow an object from one side to the other. Turn the head slowly to one side, & hold this extreme position w/ jaw over the shoulder. Arm & leg on jaw side extend. Arm & leg on skull side flex. "1. In full term infants, UE’s participate more strongly than LE’s.
2. Disappears as neck righting w/ rotation appears.
3. Must be integrated for child to roll over.
4. Asymmetry may indicate insult to one side of the brain, peripheral nerve injury or primary muscle weakness.
5. Response is never totally obligatory in a normal infant.
6. Persistence beyond 6 mos is indication of CNS dysfunction.
7. The many problems that may be noted w/ an impossible ATNR include: inability to engage hands in midline, scoliosis, subluxation or dislocation of hip on skull side, inability to grasp & regard an object @ the same time, inability to balance well enough to walk unaided." |
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Term
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Definition
4-6 mos 10-12 mos Place child in ventral position supported by the trunk over the examiner’s knee, or place child in four point position. Examiner passively first ventroflexes then dorsiflexes the child’s head. Ventroflexion of the head produces flexion of the UE’s, extension of the LE’s. Dorsiflexion of the head produces extension of the UE’s & flexion of the LE’s. "1. Integration of this reflex coincides w/ crawling in four point position.
2. May be used to get infant into four point position, grasp & regard an object @ the same time, inability to balance well enough to walk unaided." |
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Term
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Definition
Birth to 2 mos 4-6 mos Place infant supine w/ head in midline & hands free. Place index finger of examiner into the hands of the infant from the ulnar side & gently press against the palmar surface. Infant’s fingers will flex around the examiner’s index finger. "1. Following development of grasp reflex, infant begins to reach & utilize crude palmar grasp.
2. Asymmetry may indicate insult to one side of the brain, primary muscle weakness or peripheral nerve injury." |
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Term
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Definition
3-4 mos 12-24 mos Examiner supports child horizontally in the air in prone position w/ one hand under the lower part of the thorax. Position in space. Head extends, back & hips extend in sequence. "1. This in not an isolated reaction, produced by labyrinthine righting, optical righting, body on body, body on head & neck righting.
2. Never invariably present even during the second half of the first yr.
3. Poor quality of response seen in children w/ congenital myopathies, or hypotonia.
4. Breaks up total flexor pattern seen @ birth, promotes extension." |
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Term
| labyrinthine neck righting |
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Definition
Birth to 2 mos Persists throughout life Examiner holds the child vertically under the arms & around the chest, free in space. Blind fold child. Tilt body anteriorly, posteriorly, & laterally from the vertical 45 degrees or more so that the head drops forward, backward & sideways. Head orients to vertical position & is steady, maintained in proper orientation to environment. "1. Needed for head control as child moves in space, body can turn freely around head.
2. Allows child to lift head from prone & supine.
3. Starting point for chain reaction reflexes in space (landau)." |
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Term
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Definition
Birth – 2 mos – complete by 8 mos Persists Examiner holds the child vertically under the arms & around the chest, free in space. Tilt body anteriorly, posteriorly, & laterally from the vertical 45 degrees or more so that the head drops forward, backward & sideways. Head orients to vertical position & is steady, maintained in proper orientation to environment. "1. Rights head & body in relation to space.
2. Supplement tactile, proprioceptive & labyrinthine reactions." |
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Term
| body righting reaction acting on head (BOH) |
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Definition
Birth – 2 mos – completely established by 8 mos Persists Difficult to isolate, observe along w/ labyrinthine & optical. Observe developmental activities. Rights head in relation to body. "1. Important in head control in relation to body in all positions, prone, supine, sitting, all 4’s & standing.
2. Twitchell feels this reflex is responsible for initial head righting @ birth, not labyrinthine neck righting.
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3. All 3 reactions (labyrinthine neck righting, optical & BOH combine to facilitate head control in pull to sitting) head control in sitting, head control in prone." |
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Term
| neck righting acting on body NOB |
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Definition
4-6 mos 5 yrs – when child can get to standing w/out rotation. Place child supine, head in midline. Flex child’s head and turn slowly to one side. Hold in extreme position w/ jaw over shoulder. Repeat on opposite side. Child will turn in direction of head turning, rotation of shoulders, trunk & then pelvis to side or prone. "1. Needed for child to roll supine to prone & prone to supine.
2. Indicates rotation around body axis developed in child.
3. Asymmetry may indicate insult to one side of the brain." |
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Term
| Body righting reaction acting on body (BOB) |
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Definition
4-6 mos Inhibited by child, 4-5 yrs Place child supine, head in midline. Flex one leg & rotate it across the pelvis to the opposite side. The child will turn to prone segmentally, first the trunk, then pectoral girdle & then head. "1. Asymmetry may indicate insult to one side of the brain.
2. Modifies the neck righting reflex.
3. Important in acquisition of sitting, all fours position & standing.
4. Persistence beyond five yrs indicates general depression of the CNS.
5. Absence results in lack of rotational patterns." |
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Term
| protective extension downward LE |
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Definition
4 mos Persists Hold around waist. Plunge downward. Legs externally rotate & abduct, feet dorsiflex in preparation for standing. "1. Preparation for standing.
2. Breaks falls.
3. Abnormal position of LE’s indicates increased tone; internal rotation, adduction & plantarflexion of feet." |
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Term
| protective extension sideways (sideward) =( UE |
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Definition
7 mos Persists throughout life Place child in sitting position w/ legs out in front. Examiner pushes child on one shoulder w/ enough force to displace center of gravity & cause child to lose balance. Child will abduct arm on side opposite force, w/ extension of elbow, wrist & fingers before contact is made w/ the table. Weight is taken on open palm & fingers. "1. Asymmetry may indicate insult to one side of the brain, primary muscle weakness or peripheral nerve injury.
2. Needed for sitting w/ & w/out hand support.
3. Failure to obtain indicates general depression of the CNS." |
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Term
| protective extension forward UE |
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Definition
6-7 mos Persists throughout life Examiner supports infant in vertical position in space w/ hands around the infant’s body. Plunge child downward toward a table or other flat surface. The child will extend & abduct arms, fingers extended & spread as if to break a fall. "1. Needed for sitting w/ arm support & four point kneeling.
2. Asymmetry may indicate insult to one side of the brain, muscle weakness or peripheral nerve injury." |
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Term
| protective extension backward UE |
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Definition
| 9-10 mos Persists throughout life Symmetrically sitting posture w/ legs out in front. Examiner pushes child backward w/ enough force to displace center of gravity & offset balance. Child extends arms backward. Full reaction is backward extension of both arms. Frequently an element of trunk rotation comes in & reaction is seen in one arm only. 1. Asymmetry may indicate insult to one side of the brain, peripheral nerve injury or primary muscle weakness |
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Term
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Definition
6 mos Persists throughout life Place the child in prone on a tilt board. Slowly tilt board internally to the right & left. Child will curve against the displacement of center of gravity, concavity of the spine upward toward the tilt, the upper arm & leg may abduct. "1. Modifies righting reflexes.
2. Asymmetry may indicate insult to one side of the brain or muscle weakness.
3. Necessary part of balance mechanism for sitting & supporting prone on hands.
4. Labyrinths must be intact for tilting to be present." |
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Term
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Definition
7-8 mos Persists throughout life Place child supine on a tilt board, center of rotation of board longitudinally along body axis. Slowly tilt board laterally, left & right. Child’s trunk is curved against the cavity of the spine upward. The head is rotated w/ the face toward the upper side. Slight abduction of the upper arm & leg may be seen. "1. Reactions in supine & sitting are needed for sitting w/out support.
2. Asymmetry may indicate insult to one side of the brain, or muscle weakness." |
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Term
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Definition
| 9-12 mos Persists throughout life Place child in quadruped position on the tilt board facing lengthwise or crosswise, the longitudinal body axis located directly over the center of rotation of the board. Tilt laterally to the left & right, then tilt anterior-posteriorly. To laterally tilt, the body is flexed against the tilt w/ the concavity of the spine upward. The head is slightly rotated so that the face turns toward the upper side. The arm & leg on the lower side extend & abduct. To anterior tilt, arms extended & legs flexed, head is extended & trunk moves backward. |
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Term
| tilting reaction standing |
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Definition
12-21 mos Persists throughout life Place child standing facing lengthwise or crosswise on the tilt board. The body axis should be over the center of rotation of the board. Tilt laterally to the left & the right then antero-posteriorly. To lateral tilt: body is flexed against the tilt w/ the cavity of the spine upward. Upper leg is flexed & upper arm abducted. The lower leg is extended & strongly braced. To anterior tilt: the spine extends, displacing the body backward, legs are extended, arms are extended and retracted. To posterior tilt: the spine flexes, displacing the body forward, legs extend, arms are flexed at the shoulders and extended at the elbows. "1. Labyrinths must be intact for tilting to be present.
2. Asymmetry may indicate insult to one side of the brain, or primary muscle weakness.
3. Needed for child to stand & walk independently." |
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Term
* Lips show lateral closure, closing tightly
at the corners
* Jaw movements separate from tongue and
lip activity
* Lower lip pulls in to remove food
* Upper lip cleans spoon
* Unstable jaw movements with cup
* Begins to show coordinated suckswallow-
breathe pattern
* Transfers bolus from side to center of the
tongue and from center to the side |
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Definition
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Term
* Decrease in up-and-down jaw movements
when drinking from a cup
* Upper incisors used to clean lower lip
* Lip closure while swallowing liquids and
solids is common
* Uses a well-controlled and graded bite |
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Definition
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Term
* Suck-swallow-breathe pattern coordinated
during long drinking sequences
* Cleaning movements integrated with
chewing
* Refining swallowing skills present at 10-
12 months
* Can learn to suck through a straw |
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Definition
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Term
* Movements smoother than at 15 months
but otherwise much the same
* Minimal loss of food during chewing
* Uses external jaw stabilization with the
rim of a cup |
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Definition
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Term
* Tongue cleans lips
* Transfers bolus across midline of the
tongue
* Excellent coordination of swallowing with
breathing pattern
* Drinks from a straw regardless of
experience
* Loss of liquid when drinking from a cup is
rare |
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Definition
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Term
* Uses tongue to clean the area between
gums and cheeks |
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Definition
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Term
| birth S and L development |
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Definition
cry of discomfort
suckling sounds |
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Term
| 1 month speech and language |
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Definition
cry of discomfort(start of differentiation),
inconsistient regard of others |
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Term
| 2 months speech and language |
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Definition
definite differentiion of crys, between hunger, need for change, attention,
facial expressions-alert, smiles |
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Term
| 3 months speech and language |
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Definition
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Term
| 4 months speech and language |
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Definition
| recognizes and responds to own name |
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Term
| 5 months speech and language |
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Definition
| mama-baba (frequent and clear) |
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Term
| 6 months speech and language |
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Definition
begins to chew solid foods,
responds to negative commands,
initiates babbling towards others |
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Term
| 7 months speech and language |
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Definition
begins to recognize names of fam
appropriate gestures to simple comands (up, bye bye, come)
begins to vocalize when called by name
"no"used to express dislikes |
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Term
| 8 months speech and language |
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Definition
| recognizes names of familiar objectsexpresses desires by "want" sounds |
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Term
| 9 months speech and language |
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Definition
understands simple directions,
sustains interest in activities for ~ 1 min
first real word is usually name of family member |
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Term
| 10 months speech and language |
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Definition
| uh oh (uses exclaimations) |
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Term
| 11-12 months speech and language |
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Definition
using some appropriate verbal responses on command (bye-bye)
2-3 words consistiently ( dad, ball, mama,) |
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Term
| 13-14 months speech and language |
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Definition
| comprehension of words grows rapidly, identifies pics when named, uses 5-7 words consistently |
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Term
| 15-18 months speech and language |
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Definition
| points to body parts when named, imitates animal sounds, |
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Term
| 20-24 months speech and language |
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Definition
| active vocabulary 10-20 words, beginning of simple sentences 2-3 words (I want food) |
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