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Assessment of primitive reflexes is important to evaluate normal neural development. Absence or persistence of any of the following reflexes may indicate a neurodevelopmental pathology or CNS disease.

Palmar Grasp Reflex

  1. Baby will flex all fingers to grasp a fingertip placed against the palmar surfaces.
  2. Disappears at 3-4 months

Plantar Grasp Reflex

  1. Toes will curl when the sole is touched at the base of the toes
  2. Disappears at 6-8 months

Moro (Startle) Reflex

  1. Hold baby’s trunk as if in a seated position, while stabilizing the head and neck. Abruptly lower baby toward a supine position. Baby should abduct both arms symmetrically and bring them back toward the midline • Absence or abnormality of this reflex may indicate significant neurodevelopmental pathology
  2. Disappears at 4 months

Positive Support Reflex

  1. Hold baby around trunk and lower until feet touch surface
  2. Legs should extend to help baby “stand” for 20-30 seconds
  3. Appears between birth and 2 months, disappears at 6 months

Placing and Stepping Reflex

  1. Hold baby upright from behind and place one sole touching tabletop
  2. Hip and knee of that leg should flex as opposite foot steps forward
  3. Pattern should alternate
  4. Disappears at variable ages

Rooting Reflex

  1. Stroke perioral skin at the corners of the baby’s mouth
  2. Baby should turn head, open mouth, and suck towards stimulated side
  3. Disappears at 3-4 months

Trunk Incurvation/Galant Reflex

  1. Support baby prone and stroke one side of the back, 1 cm from midline, from shoulder to buttocks
  2. Spine should curve to stimulated side
  3. Disappears at 2 months

Landau Reflex

  1. Suspend baby prone with one hand, head should lift up and spine should straighten
  2. Disappears at 6 months

Parachute Reflex

  1. Suspend baby prone and lower head slowly toward surface
  2. Arms and legs should extend in a protective fashion
  3. Appears at 4-6 months and should not disappear

References

  1. Swartz MH. Textbook of Physical Diagnosis: History and Examination. 6th ed. Philadelphia: W.B. Saunders Company; 2010.
  2. Bickley LS, Szilagyi PG. Bates' guide to physical examination and history taking. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2009.
  3. Kleigman, R., Stanton, B., Schor, N., Behrman, R. Nelson Textbook of Pediatrics, Saunders, 2011