Levels :

1. Spinal reflexes- primitive reflexes

2. Brainstem reflexes- tonic reflexes
3. cortical reflexes- midbrain reflexes
Spinal reflexes
1. Flexor withdrawl- pin prick to sole of foot- toes extend, foot
dorsiflexes, entire leg flexes
Onset- 28wks of gestation
Integrated- 1-2 mnths
2. Crossed extension- pain stimulus to ball of foot fixed in
extension- opp L/L flexes, then adducts and extends
Onset- 28wks of gestation
Integrated- 1-2 mnths
3. traction- pull from supine to sitting- grasp and total flexion
of U/L
Onset- 28wks of gestation
Integrated- 2-5 mnths
4. Moro- suddenly drop pt backwards- extension,
abduction of U/L, hand opening and crying followed
by flexion, adduction of arms across chest
Onset- 28wks of gestation
Integrated- 5-6 mnths
5. Startle- sudden loud sound- sudden extension/
abduction of arms and crying
Onset-birth
Integrated-persists
6. Grasp- maintain pressure to palm of hand/ ball of
foot- maintained flexion of fingers/toes
Onset- palmar: birth, plantar: 28wks of gestation
Integrated- palmar 4-6 mnths, plantar: 9 mnths
Brainstem reflexes
1. ATNR- rotation of the head to one side- flexion of limbs on
occipital side and extension on jaw side
Onset-birth
Integrated- 4-6 mnths
2. STNR- flexion/ extension of head- with flexion: U/L
flexion and L/L extension. With head extension: U/L
extension and L/L flexion
Onset-4-6 mnths
Integrated- 8-12 mnths
3. TLR- prone/ supine position: with prone flexion of all 4
limbs. With supine extension of all 4 limbs
Onset-birth
Integrated- 6 mnths
5. Positive supporting: contact to the ball of foot in
upright- rigid extension of L/L
Onset-birth
Integrated- 6 mnths
6. Associated reactions: resisted voluntary movt in any
part of the body- involuntary movt in the resting
extremity.
Onset-birth- 3mnths
Integrated- 8-9 years
Midbrain reflexes
1.NOB: tested in supine. Passively turn head to one side- log
rolls to align the body with the head
Onset-4-6 mnths
Integrated-5 years
2. BOB: tested in supine. Passive rotation of upper/ lower
trunk- remaining body rolls to align.
Onset-4-6 mnths
Integrated- 5 years
3. Labyrinthine head righting. Occlude vision, alter body
position by tipping body in all directions- head orients to
vertical position with mouth horizontal
Onset-birth-2mnths
Integrated-persists
4. Optical righting: alter body position by tipping body
in all directions- head orients to vertical position with
mouth horizontal
Onset-birth-2 mnths
Integrated-persists
5. Protective extension: displace COG outside the BOS-
U/L or L/L extend and abduct to support and protect
the body against falling
Onset-arms: 4-6mnths, legs: 6-9 mnths
Integrated-persists
6. Equilibrium reactions- tilting: displace the COG by tilting/
moving the support surface- curvature of the trunk towards
the upward side along with extension abduction of limbs
on that side and protective extension on the opp side
Onset-prone 6mnths. Supine 7-8 mnths. Sitting 7-8 mnths.
Quadruped 9-12 mnths. Standing 12-21 mnths
Integrated-persists
7. Equilibrium reactions- postural fixation: apply a displacing
force to the body, altering its COG in its relation to the
BOS- curvature of the trunk towards the external force
with extension abduction of limbs on that side to which the
force is applied.
Onset-prone 6mnths. Supine 7-8 mnths. Sitting 7-8 mnths.
Quadruped 9-12 mnths. Standing 12-21 mnths
Integrated-persists