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
Baby will flex all fingers to grasp a fingertip placed against the palmar surfaces.
Disappears at 3-4 months
Plantar Grasp Reflex
Toes will curl when the sole is touched at the base of the toes
Disappears at 6-8 months
Moro (Startle) Reflex
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
Disappears at 4 months
Positive Support Reflex
Hold baby around trunk and lower until feet touch surface
Legs should extend to help baby “stand” for 20-30 seconds
Appears between birth and 2 months, disappears at 6 months
Placing and Stepping Reflex
Hold baby upright from behind and place one sole touching tabletop
Hip and knee of that leg should flex as opposite foot steps forward
Pattern should alternate
Disappears at variable ages
Rooting Reflex
Stroke perioral skin at the corners of the baby’s mouth
Baby should turn head, open mouth, and suck towards stimulated side
Disappears at 3-4 months
Trunk Incurvation/Galant Reflex
Support baby prone and stroke one side of the back, 1 cm from midline, from shoulder to buttocks
Spine should curve to stimulated side
Disappears at 2 months
Landau Reflex
Suspend baby prone with one hand, head should lift up and spine should straighten
Disappears at 6 months
Parachute Reflex
Suspend baby prone and lower head slowly toward surface
Arms and legs should extend in a protective fashion
Appears at 4-6 months and should not disappear
References
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 6th ed. Philadelphia: W.B. Saunders Company; 2010.
Bickley LS, Szilagyi PG. Bates' guide to physical examination and history taking. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2009.
Kleigman, R., Stanton, B., Schor, N., Behrman, R. Nelson Textbook of Pediatrics, Saunders, 2011