REFLEXES
Definition ;
Stereotype movement which can be elicited by application of stimulus
to the periphery
Importance of reflexes:
1- Diagnostic role:
More reflex ------more hypertonia ------No Movement
2- Therapeutic role Iniate elbow flexion-------ASTNR
3- Serve process of motor development
Putting toy on the side of the child-----------turn head
--------------extension of head--------------- eye hand coordination
CLASSIFICATION OF
REFLEXES
According to level of CNS maturation
According to type of stimulus
ACCORDING TO LEVEL OF
CNS MATURATION
 Spinal Level (Spinal reflexes)
 Brain Stem Level(Brain Stem reflexes)
 Midbrain Level(Midbrain reflexes)
 Cortical Level (Cortical reflexes)
a- (Spinal reflexes) Primitive reflexes , phasic reflexes
Movement reflexes A- beta reflexes:
 Flexor with drawl (nociceptive reflex)
 Starting position : Supine lying position, head in midline position,

 Stimulus :
upper , lower limb extended
Painful Scratching on sole of foot
 Response : Mass Flexion or uncontrolled flexion
 Age positive : from birth to 2 month
 b- extensor thrust :
 Starting position : Supine lying position, head in midline position,

upper extended, lower ,one is flexed, other extended
 Stimulus ; painful stimulus on the sole foot of flexed
 Response: Uncontrolled extension of leg
 Age: From birth to 2 Month
 Crossed extension:
 Starting position : Supine lying position, head in midline position,

upper , lower limb extended
 Stimulus ; Tapping on medial aspect of thigh
 Response: Extension , adduction, internal rotation of opposite
scissor
 Age: birth to 2 months
B ) B R A I N S T E M R E F L E X E S ( S TA T I C
POSTURAL REFLEXES)(TONIC
REFLEXES)(PRIMITIVE REFLEXES)
 Changing position of the body or head in the space will change
distribution of the tone.
1- asymmetrical tonic neck reflex (ATNR):
 Starting position : Supine lying position, head in midline position,

upper , lower limb extended
 Stimulus ; Turning the head to one side
 Response: Face head : extension of upper and lower limb

occipital side: flexion in upper and lower limb
 Age: birth to 4- 6 months
 ASTNR interfere with ( ROLLING, FEEDING, both hand use)
2- symmetrical tonic neck reflex (STNR):
 Starting position : Quadriped or prone on my leg
 Stimulus ; Flexion of head
 Response: Flexion of upper limb and extension in lower limb
 Or vice versa
 Age: birth to 4- 6 months
3- Tonic labyrinthine supine (TLS):
 Starting position : head in midline position,
 Stimulus ; Supine lying position,
 Response: increase of extension tone in all over the body
 Age: birth to 4 months
3- Tonic labyrinthine prone (TLP):
 Starting position : head in midline position,
 Stimulus ; Prone lying position,
 Response: increase of flexor tone in all over the body
 Age: birth to 4 months
4- +ve Supporting reaction:
Starting position :Standing with his back on my face
Stimulus ; Hold the child from pelvic or axilla and bounce him on sole
of foot.
Response: Lower limb extension, adduction, internal rotation plantar
flexion (scissors).
Age: from 3 to 8 Months
5 -Ve Supporting reaction:
Stimulus : Child in weight bearing with leaning forward
Response: Semi flexion of lower limb with few steps forward
Age: From 8 to continue throughout life
MIDBRAIN REFLEXES
RIGHTING REACTION
 A) Neck Righting;
 Starting position : Supine lying position, head in midline position, upper , lower
limb extended
 Stimulus ; Rotation of the head to one side
 Response: Rotation of the body as a whole following head
 Age: birth to 6 months
 B) Body righting acting on body:
 Starting position : Supine lying position, head in midline position, upper , lower
limb extended
 Stimulus ; Turning the head to one side
 Response: Segmental rotation of the body
 Age: from 6-18 months
 C) Labyrinthine righting on head:
 First: Starting position: prone in space with blind folded
 Stimulus: prone in space on my hand with blind folded
 Response: raising head to normal position
age from 1-2 month
then continue
 Second: Starting position: supine lying
 Stimulus: Supine in space on my hand with blind folded
 Response: raising head to normal position
then continue
age from 6 month s
 Third: Starting position: Holding child from pelvis blind folded
 Stimulus: tilting the body to right side
 Response: raising head to normal position
age from 6-8 month
then continue
 Fourth: Third: Starting position: catching the child from trunk
 Stimulus: tilting the body to Left side
 Response: raising head to normal position
then continue
age from 6-8 month
 D) Optical righting acting on head:
 THE SAME LIKE LABRYINTHINE (POSITIONS ,
RESPONSES) WITHOUT EYE BLIND FOLDED
 Amphibian Reaction :Starting position: Prone head in midline ,legs
extended , arm extended overhead
 Stimulus: lift pelvis on one side
 Response: Automatic flexion of hip ,knee ankle on the same side
Age from 6 month then continue
 Automatic Movement Reactions:
 Moro Reflex
 Starting position: Semi recline
 Stimulus: Drop head backward
 Response: Extension, abduction, external rotation of arms, extension,
adduction fingers
 Age: Normal from birth to 4 months
 Landau Reflex : Starting position: prone in space with holding under
thorax
 Stimulus: raise head active or passively
 Response: Spine and leg extend
 Age: Normal from 6 months to 2or 2.5 years
 Protective extensor Thrust( Parachute reaction)
 Starting position: Prone , arms extended over head
 Stimulus: Suspend the child from ankle or pelvis suddenly move
child to floor
 Response: Immediate Extension , of arms,, fingers to protect head
 Age: Normal from 6 months continue through out life
CORTICAL REFLEXES OR
EQUILBRIUM REACTION
 SUPINE
 Starting position: supine on tail board
 Stimulus: Tilt board to one side
 Response: Righting head, thorax extension, abduction of arms,
legs on raised side
 Age: Normal from 6 months continue through out life
 Prone:
Starting position: Prone on tail board
 Stimulus: Tilt board to one side
 Response: Righting head, thorax extension, abduction of arms,
legs on raised side
 Age: Normal from 8 months continue through out life
 Sitting: Starting position: Sitting on chair
 Stimulus: pull child to one side
 Response: Righting head, thorax extension, abduction of arms,
legs on raised side
 Age: Normal from 12 months continue through out life
 Kneel Standing : Starting position: Kneel standing
 Stimulus: pull child to one side
 Response: Righting head, thorax extension, abduction of arms, legs on
raised side
 Age: Normal from 15 months continue through out life
 Hopping 1, 2and 3:Starting position: Standing holding from upper
arms
 Stimulus: Move to lift or right, forward, backward
 Response: Righting head, thorax extension, hopping steps to sideway,
forward, backward to maintain equilibrium
 Age: Normal from 15 to 18 months continue through out life
 Dorsiflexion: Starting position : Standing holding from axilla
 Stimulus: Tilt child backward
 Response: Righting head, dorsiflexion of feet
 Age: Normal from 15 to 18 months continue through out life
 See- saw:
 Starting position: Standing holding hand , foot with flex hip knee
 Stimulus: pull arm gently forward and to lateral side
 Response: Righting head, thorax extension, slightly abduction of
flexed knee
 Age: Normal from 15 months continue through out life
 Simian position Starting position: Squatting
sitting
 Stimulus: Tilt child to one side
 Response: Righting head, thorax extension, abduction of arms,
legs on raised side
 Age: Normal from 15 to 18 months continue through out life