Neonatal Reflexes 07
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Neonatal Reflexes
By Courtney Plaster
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Neonatal Reflexes
Neonatal reflexes are inborn reflexes which are present at birth and occur in a predictable fashion. A normally developing newborn should respond to certain stimuli with these reflexes, which eventually
become inhibited as the child matures.
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What do Primitive Reflexes Have to do With Speech Pathology?
• Most primitive reflexes begin to occur in utero through the early months of the child’s postnatal life.
• These reflexes are then replaced by voluntary motor skills.
• When the reflexes are not inhibited, there is usually a neurologicalproblem at hand.
• In those individuals with cerebral palsy and neurogenic dysphagia, the presence of primitive reflexes is a characteristic (Jacobson, p.44).
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Moro Reflex
• Stimulated by a sudden movement or loud noise.
• A normally developing neonate will respond by throwing out the arms and legs and then pulling them towards the body (Children’s Health Encyclopedia).
• Emerges 8-9 weeks in utero, and is inhibited by 16 weeks (Grupen).
Normal Moro Reflex
Abnormal Moro Reflex
wborn_n_23.m
wborn_ab_23.m
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Palmar Grasp
• Stimulated when an object is placed into the baby’s palm.
• A normally developing neonate responds by grasping the object.
• This reflex emerges 11 wks in utero, and is inhibited 2-3 months after birth.
• A persistent palmar grasp reflex may cause issues such as swallowing problems and delayed speech (Grupen).
Normal Palmar Grasp
Abnormal Palmar Grasp
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Babinski (Plantar) Reflex
• Stimulated by stroking the sole of the foot:– toes of the foot should fan out– the foot itself should curl in.
• Emerges at 18 weeks in uteroand disappears by 6 months after birth (Grupen).
Normal Babinski
Abnormal Babinski
wborn_ab_21.m
wborn_n_21.m
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Asymmetric Tonic Neck Reflex
• The child is placed on their back and will:– make fists– turn their head to the right.
• This reflex is present at 18 wks in utero
• Disappears by 6 months after birth (Grupen).
Normal Tonic Neck Reflex at 3 Months
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Tonic Labyrinthine Reflex
• Arms and legs extend when head moves backward (away from spine), and will curl in when the head moves forward.
• Emerges in utero until approximately four months post-natally.
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Galant Reflex
• The neonates back is stimulated– their trunk and hips should move
toward the side of the stimulus.
• This reflex emerges 20 wks in utero and is inhibited by 9 months.
• This turning of the torso aides in neonatal and toddler movement, such as crawling and walking.
• However, if the reflex persists, it can effect walking posture (Grupen).
Normal Galant Reflex
Abnormal Galant Reflex
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wborn_ab_24.m
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Stepping Reflex
• Neonate will make walking motions with legs and feet when held in an upright position with the feet touching the ground.
• This reflex appears at birth, lasts for 3-4 months, then reappears at 12-24 months.
Normal Stepping Reflex
Abnormal Stepping Reflex
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newborn_ab_25.mov
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Landau’s Reflex
• When neonate is placed on stomach, their back arches and head raises.
• Emerges at 3 months post-natally and lasts until the child is 12 months old.
• If this reflex does not occur, it is an indication of a motor development issue– generalized intellectual
impairment – cerebral palsy
• (Neonatal Reflexes).
Normal Landau Reflex at 6 Months
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Rooting Reflex
• The baby’s cheek is stroked:– they respond by turning their
head towards the stimulus– they start sucking, thus
allowing for breastfeeding.
• This reflex is inhibited anywhere between 6 and 12 months of age. (Neonatal Reflexes)
Normal Rooting Reflex
Abnormal Rooting Reflex
ewborn_n_22.mo
wborn_ab_22.m
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Primitive Reflexes and Swallowing
• Some primitive reflexes interfere with achievement of swallowing.– If the Moro Reflex is strong…
• there can be many interruptions with feeding if the child is constantly reacting to noises or sudden movements
– A present Tonic Labyrinthine Reflex …• may cause problems with the holding and/or positioning for feeding, • can also change the position of hypopharanx, leaving less room in the
esophagus for food to travel.
– A strong Asymmetric Tonic Neck Reflex…• can cause constant lateral head turning which may cause problems for
feeding (Jacobson, p.44).
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Normally Persisting Reflexes• Although it is important that many of these reflexes become inhibited
as a child matures, there are also those reflexes that remain throughout a healthy persons life.
– The ‘knee-jerk’ reflex, • stimulated by a tap on the tendon located just below the knee while person is
sitting• an involuntary upward swinging of the lower leg and foot is a response.
– The acoustic reflex, • stimulated by loud noise. • The stapedius muscle contracts in response to this stimulus to protect the
ear from possible trauma caused by loud sounds.
– The pharyngeal reflex, or ‘gag’ reflex
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What Do Abnormal or Persistent Primitive Reflexes Indicate?
• The normal emergence and inhibition of primitive reflexes is extremely important in neonates.
• However, these reflexes should disappear and allow for voluntary skills to replace them.
• Those children who exhibit abnormal reflex patterns most likely suffer from a neurological problem which can result in..
– dysphagia, – delayed speech – reading problems
• The reemergence of primitive reflexes in adults with a formally mature and healthy neurological system can indicate a problem in the central and/or peripheral nervous systems.
• Thus, testing for the presence of primitive reflexes in adults can determine if there may be neurological breakdown.
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ReferencesChildren’s Health Encyclopedia (2006). Neonatal Reflex. Retrieved September 19,
2007 from http://www.answers.com/topic/neonatal-reflexes?cat=health
Grupen, Rob. Developmental Reflexes and Neurological Structure in Infant Behavior: PowerPoint. Retrieved September 19, 2007.
Jacobson, Barbara H. & Johnson, Alex F., (eds.) (1998). Medical Speech-Language Pathology: A Practicioner’s Guide. New York: Stuttgart.
Neonatal Reflexes. Retrieved September 19, 2007 from http://findarticles.com/p/articles/mi_g2602/is_0004/ai_2602000404
Larson, Paul D. & Stensaas, Suzanne S. (2005). Pedineurologic Exam; A Neurodevelopmental Approach. Retrieved September 19, 2007 from http://library.med.utah.edu/pedineurologicexam/html/home_exam.html.