Category Archives: OT Pediatric Assessments

Primary or primitive reflexes

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There are number of specific reflex activities so called infantile automatisms, found in the normal newborn that disappear in early infancy. Reflexes are an involuntary muscle reactions to a certain type of stimulation and their absence in the neonate, or the persistence of some beyond their expected time of disappearance may indicate severe central nervous system dysfunctions.

Go to next page to watch a few videos about primary reflexes (from Rijeka University School of Medicine)

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References

Capute AJ, Shapiro BK, Palmer FB, Accardo PJ, Wachtel RC. Primitive reflexes: A factor in nonverbal language in early infancy. In : Stark, ed. Language Behavior in Infancy and Early Childhood. North Holland: Elsevier, 1981: 157-161.

Holt KS. Child development: Diagnosis and Assessment. London: Butterworth-Heinemann, 1991.

Illingworth RS. The development of the infant and young child: Normal and abnormal. Edinburgh: Churchill Livingstone, 1987.

http://www.primarymovement.org/background/index.html

 


Keep the baby upright and allow the soles of the feet to touch the surface of the table. Move the baby forward to accompany any stepping. Alternating stepping movements with both legs will occur. This response depends on arousal of the baby but it’s continuous absence can indicate paresis or be present in babies born by breech delivery. {youtube}LT1tGMXFk5s{/youtube}

 


With the baby in the supine position, turn the head to one side, holding the jaw over the shoulder. The arm and leg on the side to which the head is turned extend, while the opposite arm and leg flex. This response does not normally occur each time this maneuver is performed, and when it is elicted each time it is evoked it should be considered abnormal, at any age. It will persist beyond the time of expected disappearance in major cerebral damage.{youtube}SPR5aSQGlrQ{/youtube}


The sucking reflex is common to all mammals and is linked with the rooting reflex and breastfeeding. It causes the child to instinctively suck at anything that touches the roof of their mouth. You can test this reflex with a pacifier, baby’s finger or your finger. {youtube}KIgzqRaYJsg{/youtube}


 

With the baby’s head positioned in the midline and hands held against the anterior chest, stroke with your finger the perioral skin at the corners of the baby’s mouth and the midline of the upper and lower lip. In response, the mouth will open and turn to the stimulated side. This response will also occur with stimulation of the infant’s cheek at some distance from the corners of the mouth. Absence of this reflex indicates severe generalized or central nervous system disease. {youtube}NksbJQr5_xw{/youtube}


Starting in the supine position, the baby is pulled by the arms to the sitting position. The head and the arms are observed during the maneuver. The arms should remain partially flexed at the elbow and the head may lag behind the trunk. When the baby is in the sitting position, the head should be able to come to the upright position for at least a few seconds before dropping forward or backward.Watch the sternocleidomastoid muscles which should bilaterally anticipate the pull to sit; the head flexes for a moment before head lag occurs. {youtube}0v_ARjAghdY{/youtube}


Stimulate the palm of the baby’s hands and observe the reflex grasping of your finger. Stroke the sole of the foot, and the toes will flex and curl around your examining finger. Make sure that the response is not inhibited by unintended stimulation of the dorsal aspect of feet and hands. 

Persistence of the palmar grasp reflex beyond 6 months suggests cerebral dysfunction. It should be noted that babies normally hold their hands clenched during the first month of life. Persistence of the fisted hand beyond 2 months also suggests central nervous system damage{youtube}FV-qWSVNFt8{/youtube}


Hold the baby horizontally and prone in one of your hands. Stimulate one side of the baby’s back approximately 1 cm from the midline along a paravertebral line extending from shoulder to the buttocks. This produces a curving of the trunk toward the stimulated side, with shoulders and pelvis moving in that direction. Pelvic response to stimulation of the back and flanks should be symmetrical. This reflex is absent in transverse spinal cord lesions or injuries.{youtube}1pHtX08I40s{/youtube}

Adolscent / Adult Sensory Profile

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Originally developed by Brown, C. and Dunn, W. (2002). This self-questionaire for individuals 11 years of age or older measures possible contributions of sensory processing to the person’s daily performance patterns. The classification system is based on normative information http://www.sensoryprofile.com

Detailed information on Adolscent / Adult Sensory Profile from

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