2. • Maturation of reflexes is absolutely essential
for motor learning & development.
• According to reflex hierarchy model, specific
reflexes & postural reactions are associated
with distinct function of each level of lower
& higher motor centers.
• Equilibrium reactions are more sophisticated
than righting reactions & involve total body
response to a slow shift of center of gravity
outside base of support.
• Reactions appear in orderly sequence such
as in prone, supine, sitting, quadruped and
standing.
3. • Maturation of these reactions in these postures lag behind
the attainment of movements in the next developmental
postures. For e.g. equilibrium reactions mature in sitting
position when the child is creeping, and matures in
quadruped position when the child walks.
• In the hierarchy model of motor control, the motor
behaviors of the midbrain are complex behaviors that align
the body respect to the gravity.
• This particular function is termed righting and is composed
of a series of movements that bring the body to an upright
position from a recumbent position.
4. • Righting reactions are believed to be mediated at
mid brain level & are brought about by complex
sensory signals arising from variety of sources such
as eyes, cutaneous & proprioceptive sensory
receptors of body.
• Stimuli of these reactions are complex set of sensory
signals that indicates discomfort or malalignment of
head or body segment.
• Infant gains progressive control over reflexive
behavior as higher center of nervous system
matures & exerts on integrating & controlling
influence over physiologic process of lower levels of
nervous system.
5. • Highest level of motor control hierarchy is cortical
level.
• Two functions, equilibrium or balance reactions and
the volitional functions are thought to be mediated
at this level.
• Balance reactions vary considerably in their form &
arise from complex set of sensory signals.
• When one rights body, one assumes new posture in
which COM is higher above support surface; for e.g.
moving from prone position to sitting.
6. • On the other hand, when one balances, one
attempts to preserve and maintain the current
posture; for e.g. maintaining the hands – and –
knees posture.
• Moving body up against force of gravity to assume
new posture is righting.
• In addition to balance reaction, volitional
function, which inhibits and controls the reflexes
and also initiates purposeful action, is mediated at
cortical level.
8. Global primitive
Tonic labyrinthine
reflex (prone,
supine and side
lying)
Asymmetrical tonic
neck reflex
Symmetrical tonic
neck reflex
Galant reflex
Moro reflex
Neonatal neck on
body righting reflex
Neonatal body on
body righting reflex
9. Local transitional
Positive supporting
reaction of arms
Positive supporting
reaction of legs
Protective
staggering
Instinctive grasp
Instinctive
avoidance
Visual placing of
arms and legs
Protective
extension of the
arms and legs
10. Global transitional
Landau reflex
Labyrinthine
righting reaction
Neck on body
righting reaction
Body righting on
head
Body righting on
body
Optical righting
16. • Sucking and swallowing:
• Age span is from 28 weeks of gestation till 3 – 4
months after birth.
• Stimulus: applying light touch and pressure inside
the mouth.
• Response: closing of the lips and rhythmical sucking
and swallowing pattern.
17. • Critical for proper nourishment & weight gain.
• Stimulates normal tongue, lip and cheek movements,
along with providing a strong rhythmical sequence &
experience of sucking in an organized, flexed posture.
• Allows infant to gain critical sensory & motor
information regarding oral motor patterns.
• Later infant develops volitional or mature patterns of
sucking.
• Absent or asymmetrical response will affect infant’s
ability to thrive, poor nourishment and deprivation of
sensory input & oro-motor function.
• Prolonged response will affect the development of
volitional sucking and alter the normal sequence of lip,
cheek, and tongue sensory and motor development
necessary for sound and speech production.
18. Rooting:
• Age span is from 28 weeks of gestation till 3 – 4 months
after birth.
• Stimulus: light touch at the mouth and moving towards
the left, right, upward and downward direction.
• Sensory input: tactile
• Response: opening of the mouth, protrusion of the
tongue and attempt to suck with the light touch, and
turning of the head along with/ towards the movement of
the stimulus.
19. • The rooting reflex stimulates various tongue positions,
lateralization, elevation, and depression. The head turning
stimulates the primitive rotation patterns in the neck.
•
• Abnormal response will affect the orientation of mouth, mouth
opening, tongue movement, poor sensory motor experience,
nourishment and speech development.
20. Palmar grasp:
• Age span is from 23 weeks of gestation till 4 – 6 months
after birth.
• Stimulus: applying light touch & gentle pressure by
pressing thumb or index finger to ulnar side of infant’s palm
at or below metacarpophalangeal joints.
• Sensory input: tactile, proprioceptive
• Response: swift flexion & adduction of digits &
predominant flexor tone in palm to maintain strong grasp.
21. • Provides tactile sensory information of objects placed or
inserted into palm of hand.
• Reflexive tonic fisting of fingers provides mechanism for
catching & holding objects & appears to parallel sequence
of development for volitional use of the fingers, thumb &
hand.
• Voluntary grasp develops when infant gains voluntary
control of intrinsic muscles following elongation of tendons
& other soft tissues of the forearm & hand.
• Elongation may occur as result of weight bearing in prone
at 2 – 3 months & lateral weight shifting in later stages.
22. • At 3 months, grasp is voluntary only when contact is made
with an object along ulnar side of hands.
• At 5 months, the infant develops the voluntary palmar
grasp using index, middle, ring and little finger.
• At 6 – 7 months, the thumb adducts and the index and
middle finger demonstrates a more prominent role in grasp
than ulnar digits.
• At 9 months, opposition emerges, providing the infant with
more precise control of smaller objects.
• Abnormal response affects the sensory awareness of hand,
voluntary grasp and release and manipulation skills.
23. Plantar grasp:
• Age span is from 25 weeks of gestation till 9 – 12
months after birth.
• Stimulus: light touch and pressure to the
metatarsophalangeal groove in the sole.
• Sensory input: tactile, proprioceptive
• Response: flexion and adduction or curling of the
toes.
24. • Provides infant with pressure and tactile
information from the foot and from the surface
of contact. The infant utilizes the reflex to
increase lower extremity primitive stability in
standing.
• In comparison to other tonic primitive reflexes,
the plantar grasp presence is retained longer
after birth. The most consistent response is noted
from birth to 9 months, with a gradual decrease
in intensity from 9 to 12 months.
• Abnormal response will affect standing and
walking.
25. Upper limb placing:
• Age span is from birth till 2 months.
• Stimulus: in supported vertical or prone
suspension with occluded vision or gaze
distraction, applying firm pressure and gentle
stretch over the dorsum of the hand by placing
it against the underside of any edge or table
rim.
• Sensory input: tactile, proprioceptive
• Response: flexion of elbow and the shoulder,
followed by an extension of wrist and elbow
and placing the palm over the flat surface.
26. • Activates muscle groups through ranges of flexion &
extension in upper limbs, providing greater mobility in
upper limb patterns of movements such as extended non
volitional reach and volitional hand to mouth maneuvers.
• Placing response may also interact with development of
weight bearing on forearms & extended arms for proposed
sitting & creeping.
• Becomes less evident as visual placing reaction of arms
emerges around 3 months.
• Abnormal response will result in uneven weight bearing,
impaired reaching, imbalance in flexor & extensor
synergies & volitional movement of upper limb.
27. Lower limb placing
• Age span is from 35 weeks of gestation till 2
months after birth.
• Stimulus: in supported upright suspension and
with vision occluded, applying light pressure and
stretch over the dorsum of the foot by touching
the dorsum underneath a flat edge.
• Sensory input: tactile, proprioceptive
• Response: plantarflexion of ankle and flexion of
the hip and knee followed by placing of the foot
over the edge or level surface.
28. • Placing of lower limbs activates muscle groups through
range of synergistic motion that provides infant with
greater mobility.
• Interacts with associated non volitional movement patterns
such as stepping reflex.
• Combination of two primitive phasic motor patterns
provides the infant with basic experiences of non volitional
primitive reciprocal leg movements & reflexively stepping
over an obstacle.
• Abnormal response will result in asymmetrical weight
bearing, delay in crawling, standing & walking
29. Stepping or automatic walking:
• Age span is from 37 weeks of gestation till 2
months after birth.
• Stimulus: in supported upright suspension,
making feet contact with flat surface & tilting
body forward.
• Sensory input: tactile, proprioceptive, vestibular
• Response: dorsiflexion of ankle, toe extension,
partial flexion of hip & knee followed by
plantarflexion of ankle & extension of hip & knee.
30. • Typical development of stepping reflex appears to
diminish the physiological flexor tone of the newborn
infant, especially in the lower limbs, by providing phasic
extensor tone up to knee level.
• Emergence and the disappearance of this reflex can be
modified by internal, external and functional tasks such
as parental handling and concluded that this reflex can
be retained as a learned response rather than being
dependent on cortical maturation.
• Abnormal response will affect reciprocal leg movement,
coordination, weight bearing and imbalance in flexor and
extensor tone.
31. Galant Reflex
• Age span is from 32 weeks of gestational age till 2 months
after birth.
• Stimulus: Para spinal stroking with gentle pressure from
12th rib to iliac crest in prone position or prone suspension.
• Sensory input: tactile
• Response: Incurvation of trunk towards the stimulation
side and visible appearance of skin folds.
32. • Survival purpose of reflex may be to avoid obnoxious
contact.
• In utero and after birth, the reflex provides a way for
infant to avoid touch by flexing or arching away from
stimulus.
• Infant experiences asymmetrical movement patterns that
begin dissociation process of one side of trunk from other
side in frontal plane.
33. • Assists in development of non-volitional antigravity
asymmetrical movements.
• In combination with other reflexes, galant appears to
interact in process of primitive non volitional rolling by
stimulating lateral flexion of trunk and righting of
head.
• Abnormal response will result in trunk stability &
flexibility, postural asymmetry & midline activity.
34. Moro’s reflex
• Age span is from birth till 5 – 6 months.
• Stimulus: sudden change in the position of the head or
dropping of the head backwards in relation to the
trunk in semi reclined position with upper trunk
supported.
• Sensory input: tactile, proprioceptive, vestibular.
• Response: abduction and extension of the upper
extremity and extension of the lower extremity
followed by adduction and flexion of the upper
extremity and flexion of the lower extremity.
35. • Assists infant to assimilate combination of sagittal & frontal
plane movement in a more upright position.
• Hypothesized to assist the infant to overcome effects of
physiological flexion by experiencing extensor postures in
arms.
• Presence in newborn assists mother to identify when infant
is disoriented in space or has not received proper support
needed for head & trunk.
• 28 weeks of gestation- response is limited to only extension
of fingers
32 weeks- abduction & extension of the arms, opening of
fingers & grimacing.
37 weeks of gestation- newborn will have full response.
36. • Disappears as infant develops nonvolitional &
volitional flexor activity against gravity in head &
shoulder girdle, volitionally props on extended arms or
have non volitional protective responses when weight
is shifted forward.
• Abnormal response will affect development of flexor &
extensor synergies, voluntary grasp & release, head
control, trunk stability, development of protective &
equilibrium reactions & invariably affects motor
milestones.
37. Neonatal neck righting on body:
• Age span is from 34 weeks of gestation till 4 – 5 months after birth.
• Stimulus: in supine position, gentle rotation of the head to each side.
• Sensory input: proprioceptive
• Response: log rolling of the body towards head rotation.
• This reflex may assist in the birth process. It disappears as the mature
form of neck righting acting on body emerges.
38.
39. Neonatal body righting on body:
• Age span is from 34 weeks of gestation till 4 – 5 months after
birth.
• Stimulus: in supine position, flexion of the knee and adduction
of the hip across the body.
• Sensory input: tactile, proprioceptive.
• Response: log rolling of the body towards hip adduction.
40. • Disappears as mature form of body righting acting on
body emerges.
• Along with the neonatal body righting on body reflex,
this( neck on body) response appears to provide
primitive rotational movement patterns of head & trunk
& appears to be closely related to mature patterns of
righting reactions that stimulate mature rotational trunk
movements where shoulder & pelvis rolls in segments.
• Abnormal response in these two reactions will affect
trunk stability, segmental rotation & activation of
volitional movement patterns.
41.
42. Flexor withdrawal
• Age span: 28 weeks of gestation till 1 – 2 months after
birth.
• Stimulus: noxious stimulus such as light scratch or pinch
over the sole of foot in supine position.
• Sensory input: tactile (noxious)
• Response: extension of toes, dorsiflexion of ankle & hip
& knee flexion occurs at stimulated foot to withdraw limb
from noxious stimulus.
43. • Reflex appears to protect infant’s foot from noxious stimuli
& considered to be strong protective reflex that may also
assist in balancing flexor & extensor tone in legs.
• Assists in dissociation of toes from ankle, flexion of hip,
knee, ankle & extension of toes.
• Initiates lower extremity mobility in phasic synergistic
patterns by activating muscle groups through full range of
motion to assist in their physiological development.
• After it disappears, infant begins to bear weight on feet.
• Abnormal response will affect weight bearing, weight
shifting, standing & walking
44. Crossed extension:
• Age span is from 28 weeks of gestation till 1 – 2 months after birth.
• Stimulus: after holding the knee in extension and gently pressing it
against the supporting surface, applying noxious stimuli over the ball of
the foot.
• Sensory input: tactile (noxious)
• Response: flexion of the opposite knee, adduction of the hip followed
by extension of the knee
45. • Interacts with volitional movement patterns to facilitate
weight bearing in one leg & maintaining balance during
physically challenging motor act.
• In combination with positive supporting reaction, this reflex
appears to reinforce non volitional extensor tone in weight
bearing leg when non weight bearing leg is lifted off the
support surface.
• Stimulates asymmetrical movements of legs instead of only
symmetrical flexion of physiological flexion of newborn.
• Interacts with volitional locomotor skills such as creeping,
crawling & walking.
• Abnormal response will affect reciprocal leg movement,
creeping, crawling, standing and walking.
46. Tonic labyrinthine reflex:
• Age span is from birth till 4 – 6 months.
• Stimulus: prone, supine or side lying position.
• Sensory input: vestibular
• Response: in prone, predominant flexion of neck, shoulder,
trunk, hip & knee.
In supine, predominant extension of neck, shoulder, trunk, hip &
knee.
In side lying, predominant extension of non weight-bearing side
of body & predominant flexion of weight bearing side of the
body.
47. • Tonal distribution in TLR supine and prone appear to
provide a reflexive dissociation of the front from the
back portions of the body; while TLR side lying provides
a reflexive dissociation of one side of the body from the
other.
• The intensity of tonal distribution appears stronger in
the proximal musculature such as the shoulders and
hips, causing the body to fixate or hold.
• This fixation provides a reflex based stability that
interacts with the volitionally developing stability
patterns.
48. • The TLR diminishes as the more mature labyrinthine
neck righting reaction gains influence in the motor
system.
• Abnormal response will cause the infant to be stuck in
either supine or prone position, preventing rolling and
any further achievement in motor development.
49. Asymmetrical tonic neck reflex:
• Age span from birth till 4 – 6 months.
• Stimulus: active or passive rotation of the neck to
either side.
• Sensory input: proprioceptive.
• Response: predominant extensor tone towards the
face side (extension at elbow and knee) and
predominant flexor tone towards the skull side
(flexion at elbow and knee).
50. • Some researchers have classified ATNR as a part of a
complex group of tonic or static reflexes that allows the
body to maintain posture against the force of gravity.
• Facilitates emergence of nonvolitional asymmetrical
patterns of fixation in either flexion or extension on
either side of body.
• Assists infant in developing volitional spinal rotation,
lateral weight shift & trunk & limb dissociation.
• May provide initial nonvolitional movement patterns
required for future ability of crossing midline of body
with limbs, along with contributing to nonvolitional
postural organization required for prone locomotor skills
such as crawling & creeping.
51. • Enables infant to reflexively focus visual attention on
extended arm & fisted hand in order to interact &
generate volitional hand regard which is thought to lead to
eye – hand coordination , grasp, reaching & ability to use
one hand for skilled & gross motor tasks.
• ATNR is also thought to expedite survival of infant by
assisting in birth process.
• Prior to actual birth process, it is hypothesized to assist
fetus in adjusting to uterine cavity & in orienting spatially
at entrance to birth canal.
• Frequency & intensity of ATNR progressively diminishes
during 3rd , 4th , 5th & 6th months.
• Disappearance coincides with emergence of more mature
neck righting reaction.
52. Symmetrical tonic neck reflex:
• Age span is from 4 – 6 months till 8 – 12 months.
• Sensory input: proprioceptive
• Stimulus: flexion and extension of the head in midline in prone
suspension.
• Response: with flexion of the head, predominant flexor tone at
upper extremity and upper trunk and predominant extensor
tone at pelvis and lower extremity.
53. • Tonal distribution in STNR assists in creation of balance
between extensor & flexor musculature necessary for
nonvolitional postural stability against gravity.
• This distribution reflexively dissociates top of body from
bottom half along transverse axis.
• STNR also provides infant with added feedback &
proprioceptive awareness of head in space, body in
transverse axis & bilateral upper & lower limbs during
flexion & extension movements.
54. • Dissociation in infant interact with development of
volitional stability patterns in prone & in quadruped
position.
• Infant begins to experiment with graded control of
downward movement of head & resulting tonal changes.
• Thus, nervous system of the infant experiences
nonvolitional balance between flexor & extensor
musculature between arms & legs when either in prone
or on all-four.
• This nonvolitional stable base interacts with developoing
volitional prone skills such as prone on elbows, prone on
extended arms, on all-fours, creeping & crawling.
55. • Peak intensity of response is thought to be from 6 to 8
months, which corresponds to disappearance of TLR &
emergence of optical & labyrinthine righting reactions.
• Disappears before infant volitionally crawls or creeps
with reciprocal movements of upper & lower
extremities.
• Abnormal response in ATNR & STNR will result in
asymmetrical posture, inability to roll, midline activities,
abnormal fluctuation in flexor & extensor tone & delay
in normal motor development
56. Neonatal positive supporting reaction:
• Age span is from 35 weeks of gestation till 2 months after
birth.
• Stimulus: in vertical suspension with support under the arms,
slow lowering of the body to make the feet firm contact with a
flat surface.
• Sensory input: tactile, proprioceptive
• Response: partial extension of the lower extremities and an
attempt to bear weight on the flat surface.
57. • Response provides partial activation or coactivation
within ankle, knee & hip joint ranges to provide stability.
• Counteracts flexor tone by activating extensor tone in
legs. Once activated, the primary standing reflex initiates
a sequence of extension, proceeding from legs to trunk
to head.
• Partial weight bearing is essential for infant to gather
sensory & motor feedback in preparation for parallel
development of volitional standing & walking.
• Abnormal response will affect trunk stability, weight
bearing, standing and walking
58. Traction reflex:
• Age span is from 28 weeks of gestation till 2 – 5
months after birth.
• Stimulus: grasping the infant’s forearm in supine
position and pulling up and forwards into a sitting
position.
• Sensory input: tactile, proprioceptive
• Response: flexion of shoulder, elbow, wrist and
fingers. Reflex grasping on therapist’s finger.
Complete head lag in neonate, partial lifting by 2
months and complete lifting by 5 months.
59. • Increased flexor tone in the shoulders, elbows, wrist and
fingers generates coactivation of flexor muscle synergies
in a distal to proximal progression to provide stable
flexor tone base in arms & hands.
• In horizontal position- provides stability to arms in order
to reinforce or allow momentary grasp to hold on or to
cling to prevent falling.
• Abnormal response will affect coactivation of upper
limbs and voluntary reaching and grasping.
60. Natal avoiding reflex:
• Age span is from 3 weeks after birth till 2 – 3 months.
• Stimulus: comfortably relaxed in supine or supported
sitting with vision occluded, light touch over the
dorsum of the hand moving from proximal to distal.
• Sensory input: tactile
• Response: slight withdrawal of hands with abduction
and extension of fingers and mild pronation of
forehand.
61. • Automatic withdrawal of infant’s hand from light touch
stimulus may be protective response that allows infant
to escape noxious stimuli by moving away from it.
• Interacts with instinctive avoiding reactions during
development of other volitional & non volitional
movements that enhances release of objects from
hands.
• Abnormal response will affect weight bearing on hands,
voluntary grasp & release & manipulation skills.
63. Instinctive grasp reaction
• Age span is from 4 – 6 months after birth till 9 – 11
months.
• Stimulus: in a comfortable, supine or in supported
sitting position with vision occluded, applying light
touch over the dorsum of the hand at radial and ulnar
side, moving from proximal to distal.
• Sensory input: tactile
• Response: at radial side – supination of forearm,
groping and grasping in a radial palmar grasp. At ulnar
side – pronation of forearm, groping and grasping in a
ulnar palmar grasp.
64. • Considered a transitional motor pattern, occurring after
primitive reflexes & before mature pattern of non volitional
& volitional movement develops.
• Appears to orient hand to an object without use of vision.
• Considered to be precursor in development of voluntary
control over radial palmar grasp, thumb & forefinger or
middle finger grasp & finally pincer grasp.
• Instinctive grasp reaction is composed of three major
stages.
Orientation: 4 – 6 months
Groping: 6 – 8 months
Grasping: 8 – 11 months
65. • Supination or pronation of forearm enables the
infant to reflexively anticipate and adjust the grasp to
spatial orientation of the object.
• The ability to grasp on the radial side of the hand
also depends on the infant’s ability to begin to
fractionate or dissociate the fingers from the grasp
reflex.
66. Instinctive avoiding reaction:
• Age span is from 3 – 5 months after birth till 6 –
7 years.
• Stimulus: in a comfortable, supine or in
supported sitting position with vision occluded,
applying light touch over the dorsum of the hand
at radial and ulnar side, moving from proximal to
distal.
• Sensory input: tactile
• Response: a variety of hand movements to avoid
the stimulus such as flexion, extension, radial
and/or ulnar deviation and rotation etc.
67. • The instinctive avoiding reaction becomes less evident as the
transition to voluntary grasp and release occurs at 5 – 6
months.
• Abnormal response will affect weight bearing on hands,
voluntary grasp and release and manipulation skills.
68. Body righting acting on head
• Age span is from birth till 5 years.
• Stimulus: placing the child prone on flat surface.
• Sensory input: visual, tactile, proprioceptive,
vestibular.
• Response: orientation of the head to midline.
69. Labyrinthine righting reaction:
• Age span is from birth and persists for life.
• Stimulus: in supported vertical suspension with
occluded vision, tilting the child at 30˚ – 45˚ in anterior,
posterior and laterally to each side. After tilting to each
direction for 3 – 5 seconds, the child is brought back to
vertical.
• Sensory input: vestibular.
• Response: righting of the head or tilting of the head
towards vertical.
70.
71. Optical righting reaction
• Age span is from birth and persists for life.
• Stimulus: in supported vertical suspension, tilting the
child at 30˚ – 45˚ in anterior, posterior and laterally to
each side. After tilting to each direction for 3 – 5
seconds, the child is brought back to vertical.
• Sensory input: visual, vestibular.
• Response: righting of the head or tilting of the head
towards vertical.
72. Landau
• Age span is from 2 – 4 months after birth till 12 – 24
months.
• Stimulus: Supported prone suspension for 5 – 10
seconds, followed by slow raising and lowering the
body in horizontal position.
• Sensory input: proprioceptive, vestibular.
• Response: with head flexion, hips knees and elbows
are flexed. Extension of neck, shoulders, adduction of
scapula, extension of upper and lower trunk and
partial extension of the hip.
73. Neck righting on body
• Age span is from 4 – 6 months after birth till 2 – 5 years.
• Stimulus: rotation of the head to either side in supine
position.
• Sensory input: tactile, proprioceptive, vestibular.
• Response: segmental rolling of thorax or upper trunk
followed by lower trunk and pelvis to the side of the
head rotation.
74. Body righting on body
• Age span is from 4 – 6 months after birth till 2 – 5
years.
• Stimulus: flexion of knee and adduction of hip across
the body to either side.
• Sensory input: tactile, proprioceptive, vestibular.
• Response: segmental rolling of pelvis and lower
trunk followed by thorax and upper trunk towards
the side of hip adduction. Head orients to midline
75. • Emerging transitional reactions enable neck, trunk
and proximal muscles to coactivate, allowing
proximal stability for support of new positions and
movements within & between postures.
• Vertical righting reactions:
assists in maintaining head & trunk alignment for
stable midline through development of non volitional
coactivation of neck & trunk muscles for flexion,
extension, & lateral flexion at midline.
Enables child to maintain vertical alignment with the
center of mass.
76. • Horizontal righting reactions:
stimulates elongation on the weight bearing surface &
shortening on non weight bearing side.
Assists in activating mobility of proximal & weight bearing
joints along with segmentation around the central body
axis and through the proximal joints.
Produces chain reaction of head extension & extension
synergy through the trunk from a head to foot progression.
• Rotational righting reactions:
activate the muscle responsible for turning the body
around the central axis.
Facilitates segmentation between pelvis & upper trunk
77. • Transitional righting reactions that assist with
rotational movement in horizontal posture are
replaced by volitional movement patterns at
approximately 2 – 5 years of age.
• Abnormal response in any righting reaction will
result in fluctuation in flexor and extensor tone,
asymmetrical posture, inability to develop protective
and equilibrium reactions, inability in head control
and lack of trunk stability, impaired sensory
modulation and lack of progress to further motor
development.
78. Positive supporting reaction of arms
• Age span is from 4 – 6 months after birth and persists for
life.
• Stimulus: placing the infant into supported prone position.
• Sensory input: tactile, proprioceptive.
• Response: by 3 months, weight bearing on forearms with
elbows flexed, head and chest elevated. By 4 – 6 months,
weight bearing on arms with shoulders in forward flexion,
wrists and elbows in extension. Beyond 6 months, weight
bearing on hands with elbows and wrists extension.
79. Positive supporting reaction of legs
• Age span is from 6 – 9 months after birth and persists for
life.
• Stimulus: supported standing position on a flat surface.
• Sensory input: tactile, proprioceptive
• Response: full weight bearing on both feet with hips and
knees extension.
80. • Support reaction occurs when segments of the body
make tactile contact with a firm surface, facilitating co-
activation of the appropriate musculature surrounding
the weight bearing joints.
• These reactions alert biomechanical and the sensory
receptor subsystems of a change in posture when
surface areas of the body contact with a weight bearing
surface in the environment.
• According to some researchers, at every level of
development, the extremities support new postures non
volitionally before any purposeful movement.
81. Visual placing reaction of arms
• Age span is from 3 – 4 months after birth and persists for
life.
• Stimulus: in supported prone or inclined suspension,
applying firm pressure and gentle stretch over the
dorsum of the hand by placing it against the underside of
any edge or table rim.
• Sensory input: visual, tactile, proprioceptive.
• Response: flexion of elbow and shoulder, followed by an
extension of wrist and elbow and placing the palm over
the flat surface with mature weight bearing.
82. Visual placing reaction of legs
• Age span is from 3 – 5 months after birth and persists
for life.
• Stimulus: in supported upright suspension, applying
light pressure and stretch over the dorsum of the foot
by touching the dorsum underneath a flat edge.
• Sensory input: visual, tactile, proprioceptive.
• Response: plantarflexion of ankle and flexion of the hip
and knee followed by placing of the foot over the edge
or level surface with mature weight bearing.
83. • These placing reactions assist the child to seek out a base for weight
bearing and propping and also assist to return to a support base
following weight shift or movement transition. They serve as a backup if
equilibrium reactions are not available to recover balance.
84. Forward parachute
• Age span is from 6 – 9 months after birth and persists
for life.
• Stimulus: in supported prone suspension, tilting the
child rapidly in a forward, downward and inclined
direction.
• Sensory input: vestibular.
• Response: flexion of the shoulders, extension of the
elbow, wrist and wide abduction and extension of the
fingers.
85. Sideways parachute:
• Age span is from 7 – 8 months after birth and persists for life.
• Stimulus: in a sitting position with legs extended forward,
placing the hand over lateral trunk and rapid displacement of
center of mass sideways.
• Sensory input : vestibular
• Response: abduction of the opposite shoulder, extension of
the elbow, wrist, extension and abduction of the fingers.
86. Backward parachute:
• Age span is from 9 – 12 months after birth and persists for life.
• Stimulus: in a sitting position with legs extended forward, placing
the hand over the abdomen and rapidly displacing the center of
mass backward.
• Sensory input: vestibular
• Response: extension of the shoulders, elbows, wrists and extension
and abduction of the fingers.
• Abnormal response in any parachute reaction will result in
asymmetrical weight bearing, lack of weight shifting and lack of
development of equilibrium reactions.
88. Equilibrium in prone
• Age span: 5 – 6 months after birth and persists for life.
• Stimulus: placing the child in prone on an unstable surface
and tilting anteriorly, posteriorly and sideways.
• Sensory input: visual, proprioceptive, vestibular.
• Response: with anterior tilt, posterior concavity of the
spine and extension and abduction of all four limbs; with
posterior tilt, anterior concavity of the spine and
extension and abduction of all four limbs; with lateral tilt,
concavity of the spine towards the opposite side, righting
of the head towards vertical and extension and abduction
of the limbs of opposite side.
89. Equilibrium in supine
• Age span: 7 – 8 months after birth and persists for life.
• Stimulus: placing child in supine on an unstable surface
and tilting anteriorly, posteriorly and sideways.
• Sensory input: visual, proprioceptive, vestibular.
• Response: with anterior tilt, posterior concavity of the
spine and extension and abduction of all four limbs; with
posterior tilt, anterior concavity of the spine and
extension and abduction of all four limbs; with lateral tilt,
concavity of the spine towards the opposite side, righting
of the head towards vertical and extension and abduction
of the limbs of opposite side.
90. Equilibrium in sitting
• Age span is from 7 – 8 months after birth and persists for
life.
• Stimulus: placing the child in sitting position on an
unstable surface and tilting anteriorly, posteriorly and
sideways.
• Sensory input: visual, proprioceptive, vestibular
• Response: with anterior tilt, posterior concavity of the
spine and extension and abduction of all four limbs; with
posterior tilt, anterior concavity of the spine and
extension and abduction of all four limbs; with lateral tilt,
concavity of the spine towards the opposite side, rotation
of the spine away from the direction of weight shift,
righting of the head towards vertical and extension and
91. Equilibrium in quadruped
• Age span is from 9 – 12 months after birth and persists for
life.
• Stimulus: placing the child in quadruped on an unstable
surface and tilting anteriorly, posteriorly and sideways.
• Sensory input: visual, proprioceptive, vestibular
• Response: with anterior tilt, extension of the spine and
extension and abduction of all four limbs, shifting of center
of mass posteriorly; with posterior tilt, flexion of the spine
and extension and abduction of all four limbs, shifting of
center of mass posteriorly; with lateral tilt, concavity of the
spine towards the opposite side, rotation of the spine away
from the direction of weight shift, righting of the head
towards vertical and extension and abduction of the limbs
of opposite side.
92. Equilibrium in standing
• Age span is from 12 – 21 months after birth & persists for
life.
• Stimulus: placing child in standing on an unstable surface
& tilting anteriorly, posteriorly & sideways.
• Sensory input: visual, proprioceptive, vestibular.
• Response: with anterior tilt, extension of spine & extension
&abduction of all four limbs, shifting of center of mass
posteriorly; with posterior tilt, flexion of spine & extension
& abduction of all four limbs, shifting of center of mass
posteriorly; with lateral tilt, concavity of spine towards
opposite side, rotation of spine away from direction of
weight shift, righting of head towards vertical & extension
and abduction of the limbs of opposite side.
93. • Equilibrium responses are primary components of
mature reactions & their appearance is parallel to
efficiency of motor control of children in different planes
of movement.
• Mature reaction emerges as child gains motor control of
body so that they do not have to rely on arms & legs for
assuming & retaining postures in prone, supine, sitting,
kneeling, half kneeling & standing.
• Complete maturity of equilibrium reactions is expected
at 4 – 5 years of age when child gains muscular
development, trunk stability & anticipation of changes in
center of mass.
94. • Antigravity control of flexor musculature is needed for
these reactions to be expressed.
• Once flexion of the head, shoulders and hips against gravity
develops, equilibrium in supine emerges, followed by
equilibrium in prone, sitting, quadruped, kneeling, half
kneeling and standing.
• As infants experience feedback secondary to alteration in
the base of support, they learn to anticipate postural
adjustments needed for weight shifting and preventing a
fall.
• Abnormality in any equilibrium reaction will affect the
balance and will result in delayed response to any
displacing force and frequent falls and injuries.
95. Reflex must be present Prior to
Labyrinthine righting on head Prone on elbow
Trunk extension in sitting
Body righting on body Rolling to prone
Equilibrium reactions in prone Prone weight bearing on extended arms
Parachute reaction ( sideways ) Sitting with head support
Parachute reaction ( forward ) Quadruped
STNR Quadruped
96. Reflex must be integrated Prior to
Hand grasp Prone on elbow
Immature neck righting Body righting
ATNR Segmental rolling
STNR Creeping
Moro All parachute and equilibrium reactions
Foot grasp Walking
