tonic neck reflex cerebral palsy

Postureis the attitude assumed by body either when the body is stationary or when it is moving. This site needs JavaScript to work properly. There are many causes of seizures in babies. Jones M & Gray S (2005) Assistive technology: Positioning and Mobility. Nat Commun. Oral motor impairment can affect: Apraxia, an inability of the brain to effectively transmit proper signals to the muscles used in speaking, is one type of speech impairment common to Cerebral Palsy. What is the latest research on the form of cancer Jimmy Carter has? Trost JP, Schwartz MH, Krach LE, Dunn ME, Novacheck TF. The combined examination is also useful in developed countries because many developmental disorders such as cerebral palsy appear in nonrisk groups whereas others are not detected by metabolic screening programs. [QxMD MEDLINE Link]. Specific reflexes that do not fade away or those that dont develop as the child grows can be a sign of Cerebral Palsy. 2006 Feb. 48(2):90-5. Oskoui M, Gazzellone MJ, Thiruvahindrapuram B, Zarrei M, Andersen J, et al. For example, the "dystonic attacks" with kinetic type of asymmetric tonic neck reflex (ATNR) and versive tonic . [QxMD MEDLINE Link]. 74(4):336-43. Verrall TC, Berenbaum S, Chad KE, Nanson JL, Zello GA. Children with Cerebral Palsy: Caregivers' Nutrition Knowledge, Attitudes and Beliefs. Because Cerebral Palsy is the result of brain injury, and because the brain continues to develop during the first years of life, early tests may not detect the condition. Definition of the concept of "childhood cerebral palsy" (CP), the structure of the defect, classification<br> <br><br>The first clinical description of cerebral palsy was made by W. Little in 1853. The site is secure. FOIA 2005 Aug. 47(8):571-6. This website has been created and is ATTORNEY ADVERTISING sponsored by Stern Law, PLLC. Delgado MR, Tilton A, Russman B, Benavides O, Bonikowski M, Carranza J, et al. This means that they still show signs of the reflex past the usual timeline. [QxMD MEDLINE Link]. When the choice doesnt come automatically, the child makes very conscious moves, which can be confusing. Review the patient's equipment or need for equipment such as adaptive and communication devices (eg, computer-assisted speech programs), orthotics (eg, ankle-foot orthoses, walkers, wheelchair), and/or seating (may require straps to keep in place). (n.d.). Bethesda, MD 20894, Web Policies They develop the strength, coordination, and balance to accomplish the task when mastering it without the use of their hands. Jones MW, Morgan E, Shelton JE, Thorogood C. Cerebral palsy: introduction and diagnosis (part I). Vincer MJ, Allen AC, Joseph KS, Stinson DA, Scott H, Wood E. Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Take note, though, that not all occupational therapists believe in the connection between developmental delays and the presence of retained ATNR. Dev Med Child Neurol. Thus, spastic hemiplegic cerebral palsy includes the following classic physical presentations: Arm generally affected more than leg; possible early hand preference or relative weakness on one side; gait possibly characterized by circumduction of lower extremity on the affected side, Visual-field deficits (eg, homonymous hemianopsia) and strabismus. Cognitive and sensory deficits c. Diagnosis: i. Parents should be discouraged in forcing the child in a position if the child feels uncomfortable. If a baby has cerebral palsy, they will find it difficult to control muscle. However, some caution against making a diagnosis too early, and warn that other conditions need to be ruled out first. The chair should be therefore appropriately adapted for ability, ensuring sufficient control of the childs posture yet at the same time it should encourage the child to develop as much independent sitting ability as possible facilitating at the same time daily activities such as eating, playing and learning[3]. Gait abnormalities may include the crouch position with tight hip flexors and hamstrings, weak quadriceps, and/or excessive dorsiflexion. 2008 Dec 14. Eur J Paediatr Neurol. [QxMD MEDLINE Link]. Philadelphia: FA Davis Company. Learn more about meningitis in babies here. All rights reserved. The clinical significance of asymmetric tonic neck reflex, Moro, palmar grasp, plantar grasp, Galant, Babinski, Rossolimo, crossed extensor, suprapubic extensor, and heel reflex, alone or in combination, as well as their contribution to the early diagnosis and differential diagnosis of cerebral palsy, have been demonstrated in a number of studies. Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, Child Neurology SocietyDisclosure: Have stock (managed by a financial services company) in healthcare companies including Allergan, Cellectar Biosciences, CVS Health, Danaher Corp, Johnson & Johnson. 28(4):183-91. Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study. Early diagnosis also helps families qualify for government benefit programs to pay for such measures. Altered postural tone (hypertone, low tone or fluctuating tone), common in children with Cerebral Palsy, affects their ability to organize and control voluntary movements effectively, producing abnormal patterns that compromise their performance during daily live activities and increase the risk of secondary complications such as contractures and deformities, pressure sores, briefing difficulties, swallowing impairments, pain etc. [QxMD MEDLINE Link]. Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study. 2008 Dec. 23(12):1464-6. [QxMD MEDLINE Link]. Seizure Characteristics and Background Amplitude-Integrated Electroencephalography Activity in Neonatal Rats Subjected to Hypoxia-Ischemia. 0000002090 00000 n Dev Med Child Neurol. Learn more here. Patients with spastic (pyramidal) cerebral palsy evidence spasticity (ie, a velocity-dependent increase in tone) and constitute 75% of patients with cerebral palsy. Learn about the symptoms and what to do. What are five (5) ways parents of a 2-year-old can child proof their home? 382 0 obj <> endobj Neurological insults, such as cerebral palsy and post-cerebrovascular accident (CVA), damage the nervous system's sensorimotor integration, manifested with the reemergence and disinhibition of primitive stereotyped reflexes. Pediatr Neurol. For example, if the child is habitually in an abnormally straight or extended position in lying (Fig.1 Global Pattern of Extension) it may be helpful to put him into a more bent or more flexed, symmetrical position. Symmetrical tonic neck reflex and Asymmetrical tonic neck reflex. [QxMD MEDLINE Link]. They typically manifest as decreased ability to chew and swallow, and may also involve choking, coughing, gagging, and vomiting. Tran NN, Desai J, Votava-Smith JK, Brecht ML, Vanderbilt DL, Panigrahy A, Mackintosh L, Brady KM, Peterson BS. The asymmetrical tonic neck reflex is activated as a result of turning the head to one side. Magnetic resonance image (MRI) of a 9-day-old girl who was born at full term and had a perinatal hypoxic-ischemic event. 0000015299 00000 n Bookshelf Infants with cerebral palsy may have significantly delayed gross motor milestones or show an early hand preference when younger than 1.5 years, suggesting the relative weakness of one side (eg, reaching unilaterally). [QxMD MEDLINE Link]. As a child grows, these changes affect skeletal and joint development, which may lead to impairment and possibly deformities. 121, Novi, Michigan 48375 (USA). By contacting MyChild or Stern Law, PLLC in any way, including by a link from this website, you certify that you agree to our Terms of Use, Privacy Policy and Disclaimer and wish to be contacted regarding your inquiry. patient's head is turned, the arm and leg on . [QxMD MEDLINE Link]. We avoid using tertiary references. Very early treatment, if possible before the age of 6 months, gives a child the best chance of improvement for the following reasons: (1) In the infant, motorbehaviour is largely Prior results do not guarantee a similar outcome. 0000009947 00000 n It is worth noting that this reflex does not present with characteristic features of a seizure, such as jerking or stiffening. Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. A history of early frequent spontaneous abortions, parental consanguinity, and a family history of neurologic disease (eg, hereditary neurodegenerative disease) is also important. 1992 Jun. 40(3):168-74. Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo T, Carmeli E. Front Neurol. Supine lying, side lying and prone position should be alternated during the day often to prevent pressure sores and avoid body stiffness. Tonic neck reflex. WebMD does not provide medical advice, diagnosis or treatment. Physio is mostly used for dystonic cerebral palsy and hand, focal and generalised dystonia. Hutton JL, Pharoah PO. Tao FB, Xu J, Deng GZ, Ni JF, Zhang HB, Wu XK, Yin HP, Xu ZY. Symmetric tonic neck, palmar grasp, tonic labyrinthine, and foot placement reflexes are also noted. Ari S Zeldin, MD, FAAP, FAAN Staff Pediatric Neurologist, Naval Medical Center San Diego Regional variation in survival of people with cerebral palsy in the United Kingdom. Clin Obstet Gynecol. It is a common condition and can also occur on its own in the womb. Altered postural tone (hypertone, low tone or fluctuating tone), common in children with Cerebral Palsy, affects their ability to organize and control voluntary movements effectively, producing abnormal patterns that compromise their performance during daily live activities and increase the risk of secondary complications such as contractures and Washington, DC: American College of Obstetricians and Gynecologists; 2003. 2015 Aug. 6:7949. This may be observed by the child's tendency to keep the elbow in a flexed position or the hips flexed and adducted with the knees flexed and in valgus, and the ankles in equinus, resulting in toe walking. Primarily physical, abnormal gait, abnormal positioning of limbs ii. Foot Equinus, or toe walking, and varus or valgus of the hindfoot is common in cerebral palsy. Good positioning includes some basic general principles: It is very important to remember that children with Cerebral Palsy may manifest with a variety of different clinical features, for example children with spastic quadriplegia can show global pattern of extension or global pattern of flexion or asymmetric postures, therefore the general principles mentioned above should be adjusted to the specific positions useful to modify/improve the childs pattern of posture and movement. Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. Cochrane Database Syst Rev. Matuszkiewicz M, Gakowski T J Speech Lang Hear Res 2021 Mar 17;64(3):935-948. (2020). 0000007667 00000 n Another vital factor that contributes to retained ATNR is the birth process. Wyatt K, Edwards V, Franck L, Britten N, Creanor S, Maddick A, et al. [QxMD MEDLINE Link]. 0000001729 00000 n Patients have signs of upper motor neuron involvement, including hyperreflexia, clonus, extensor Babinski response, persistent primitive reflexes, and overflow reflexes (crossed adductor). By choosing the right basic chair, adapted for the individual childs needs, the child can be enabled to maintain a stable, symmetrical sitting posture so that the child can use the hands for play, feeding, communication and learning. MeSH Zafeiriou DI, Tsikoulas IG, Kremenopoulos GM. Disabil Rehabil. Trunk muscles might relax too much, making it difficult to maintain a tight core; this can result in impaired posture and an inability to sit or to move from a sitting to standing position. Standing position contribute as well to: Hambisela_Module_3In: Getting to Know Cerebral Palsy: A learning resource for facilitators, parents, caregivers, and persons with cerebral palsy, Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. The typical child no longer has to rely on the hands for support, can reach out in any direction to get toys and is able to develop and practice manipulative hand skills when sitting. 2009 May. Age of diagnosis ii. After evaluation, the therapist may establish a case of ATNR that didnt integrate properly. Postural control requires achieving normal developmental milestones and includes the maturing of postural reactions (righting, protective and equilibrium reactions), the integration of primitive reflexes (Asymmetrical Tonic Neck Reflex, Symmetrical Tonic Neck Reflex, Tonic Labyrinthine Reflex), as well as normal muscle tone, normal postural tone and intentional voluntary movements[1]. Hyperreflexia are excessive reflex responses that cause twitching and spasticity. Moreover, infants with 5 or more abnormal postural reactions have developed either cerebral palsy or developmental retardation as reported in a number of studies. 0000016037 00000 n [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. 0000000016 00000 n Examination of the patient at 1 year revealed findings consistent with a mixed quadriparetic cerebral palsy notable for dystonia and spasticity. 2008 Nov. 89(11):2108-13. 34(6):547-51. Extensor thrust. N Engl J Med. These types of seizures are most common in the newborn period. Efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy: a randomised controlled trial. Babies may demonstrate this reflex up to 9 months old. Would you like email updates of new search results? The attorney responsible for this Website is Kenneth A. Stern of the law firm, Stern Law, PLLC, 2011 Jun. Magnetic resonance image (MRI) of a 16-month-old boy who was born at term but had an anoxic event at delivery. Pediatrics 1979; 64:225. Baltimore, Md: Brookes Publishing; 2001. Dyskinetic (extrapyramidal) cerebral palsy is characterized by extrapyramidal movement patterns, abnormal regulation of tone, abnormal postural control, and coordination deficits. Dolk H, Pattenden S, Johnson A. Cerebral palsy, low birthweight and socio-economic deprivation: inequalities in a major cause of childhood disability. It is divided into two types: Dysarthria is another speech impairment common to Cerebral Palsy. Delgado MR, Hirtz D, Aisen M, et al. 2005 Mar;32(3):218; author reply 218-9. doi: 10.1016/j.pediatrneurol.2004.10.006. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. Based on clinical and research evidence, it is widely accepted and common practice for the general goals of seating and positioning to include: Moreover, adequate positioning facilitate eye contact, child communication and social interaction. Certain primitive reflexes are present at or shortly after birth, but disappear at predictable stages of development as the child grows. Results: Asymmetrical skull deformity was observed in 44 children, 24 showing right and 20 showing left flat occipital deformity. Chapter I: What is Cerebral Palsy? Atonic seizures involve a sudden loss of muscle tone and typically cause a person to become limp. startxref [QxMD MEDLINE Link]. Signs are clinically identifiable effects of brain injury or malformation that cause Cerebral Palsy. 0000038398 00000 n 0000001180 00000 n Zafeiriou DI. 0000019820 00000 n Underdeveloped or lacking postural and protective reflexes are warning signs for abnormal development, including Cerebral Palsy. 2000 Jan;22(1):75-6. doi: 10.1016/s0887-8994(99)00110-1. Abnormal muscle tone is the most frequently observed symptom. Amy Kao, MD Attending Neurologist, Children's National Medical Center However, they do know it occurs in some babies that do not receive enough oxygen.Learn more about cerebral palsy here. [Full Text]. . Hemming K, Hutton JL, Pharoah PO. 0000035316 00000 n Eur J Paediatr Neurol. Thus, the classic physical presentations of dyskinetic cerebral palsy include the following: Early hypotonia with movement disorder emerging at age 1-3 years, Deep tendon reflexes usually normal to slightly increased, Risk of deafness in those affected by kernicterus, These patients with dyskinetic cerebral palsy may have decreased head and truncal tone and defects in postural control and motor dysfunction such as athetosis (ie, slow, writhing, involuntary movements, particularly in the distal extremities), chorea (ie, abrupt, irregular, jerky movements) or choreoathetosis (ie, combination of athetosis and choreiform movements), and dystonia (ie, slow, sometimes rhythmic movements with increased muscle tone and abnormal postures, eg, in the jaw and upper extremities). Startle reflex: Any . . A doctor will discern signs of a health concern during the exam and testing. 0000003832 00000 n Eur J Paediatr Neurol. 2008 Aug 28. Reaching the milestone later than expected, or reaching it but with low quality of movement (such as favoring one side while crawling), are possible signs of Cerebral Palsy. Muscle tone How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction. Hoda Z Abdel-Hamid, MD Associate Professor, Department of Pediatrics, University of Pittsburgh School of Medicine; Director of EMG Laboratory and Neuromuscular Program, Director of Pediatric MDA Clinic, Division of Child Neurology, Childrens Hospital of Pittsburgh, University of Pittsburgh Medical Center The brain injury or malformation that caused Cerebral Palsy impairs the ability of the central nervous system to coordinate muscle movement. The general medical history should include a review of systems to evaluate for the multiple complications that can occur with cerebral palsy (see Complications under Prognosis). Some cognitive impairment is found in about 28% of these patients. London: Mosby. The child may present as either hypotonic or, more commonly, hypertonic with either decreased or increased resistance to passive movements, respectively. Abnormal primitive reflexes may not function properly in children with Cerebral Palsy, or they may not disappear at specific points in development as they do with children with no impairment. Positive parachute reaction. It may also be abnormal if it occurs every time the baby's head is turned (see Fig. 11(1):11-7. [QxMD MEDLINE Link]. Patients with cerebral palsy may show increased reflexes, indicating the presence of an upper motor neuron lesion. The tonic neck reflex is a movement where a baby looks to the side with one arm extended and the other bent; it may look like they are imitating holding a sword or firing an arrow. It is common for a child to experience different types of impaired muscle control in opposite limbs. Reaching the expected developmental benchmarks of infancy and childhood sitting, rolling over, crawling, standing and walking are a matter of great joy for parents, but what if a childs developmental timetable seems delayed? The child might also experience: Your child may also show some characteristics similar to ADD and ADHD but this theory needs more research. persistent palmar grasp, Moro, asymmetric tonic neck reflexes. Use cabinet locks, doorknob covers, and gates where Nelson KB. Pascual-Pascual SI, Pascual-Castroviejo I. Sitting becomes a truly functional position for play when a child is about 8-9 months old. 0000007232 00000 n 84(16):1660-8. Strauss D, Shavelle R, Reynolds R, Rosenbloom L, Day S. Survival in cerebral palsy in the last 20 years: signs of improvement?. 424 0 obj <>stream However, these signs may resemble usual, everyday movements and may be difficult to spot. 0000010701 00000 n The type of equipment prescribed will depend on the childs age, specific pattern of posture and movement, childs stage of development and whether or not deformities are present. Arch Dis Child. Balance impairment is most often associated with ataxic, and to a lesser degree, spastic Cerebral Palsy. 0000003141 00000 n Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Many signs and symptoms are not readily visible at birth, except in some severe cases, and may appear within the first three to five years of life as the brain and child develop. 2006 Feb 28. Many workers in the field of cerebral palsy are agreedthat anearly diagnosis is ofgreat importance andthat better and quicker results can be expected from early treatment. doi: 10.1016/j.pediatrneurol.2004.01.012. Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Support is needed to control posture and provide secure base and for some children standing frames are ideal. Even something as simple as sitting requires coordination of many muscles; some flexing while others relax. The asymmetrical tonic neck reflex ( ATNR) is a primitive reflex found in newborn humans that normally vanishes around 6 months of age. 2009 Jan 21. Deep brain stimulation for dystonia due to cerebral palsy: A review. 0000022962 00000 n Accessibility Clinically relevant copy number variations detected in cerebral palsy. 2018 Mar. 0000013712 00000 n Hambisela Manual, Getting to Know Cerebral Palsy - Cerebral Palsy Parent Training, Module 3, Positioning and Carrying (pp. N Engl J Med. Cerebral Palsy is a symptom rather than a specific disease. Children with cerebral palsy may have an early period of hypotonia followed by hypertonia. These are detailed below. If a baby hears a loud sound or senses a sudden movement, they may throw their head back and suddenly stiffen and extend their arms. Learn more about epilepsy in children here. Severe hypoxic-ischemic injury to the medial aspect of the cerebellar hemispheres, medial temporal lobes, bilateral thalami, and bilateral corona radiata is observed in this image. Allen MC, Capute AJ. Blackmore AM, Boettcher-Hunt E, Jordan M, Chan MD. Parents or caregivers should not worry when they notice this behavior. Hemiplegia is characterized by weak hip flexion and ankle dorsiflexion, an overactive posterior tibialis muscle, hip hiking/circumduction, supinated foot in stance, upper extremity posturing (that is, often held with the shoulder adducted, elbow flexed, forearm pronated, wrist flexed, hand clenched in a fist with the thumb in the palm), impaired sensation, impaired 2-point discrimination, and/or impaired position sense. Comparison of botulinum toxin type A injection and soft-tissue surgery to treat hip subluxation in children with cerebral palsy. Developmental Disabilities in infancy and Childhood. 4. Intention tremors, where a task becomes more difficult as it gets closer to completion, is one such sign. Best Pract Res Clin Obstet Gynaecol. The .gov means its official. Impaired or delayed fine motor skills are an indicator of possible Cerebral Palsy. [Full Text]. Dabney KW, Lipton GE, Miller F. Cerebral palsy. [Full Text]. [Full Text]. 91(3):254-8. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. The child should feel comfortable. When refering to evidence in academic writing, you should always try to reference the primary (original) source. 2001 Oct. 15(4):359-63. Poor equilibrium, delayed protective response. Philadelphia, Pa: WB Saunders; 2001. Pediatrics. The earlier a diagnosis is made, the sooner a child can be enrolled in early intervention programs and treatment protocols. Dev Med Child Neurol. 355(7):685-94. Various sources state that early hand preference falls between 6-18 months. No information provided by you will be treated as confidential unless and until 1) you request legal services and 2) an attorney-client relationship has been established by an Engagement Letter provided by us and signed by you. Primarily a seating system should ensure that your child has: Different types of chairs and pushchairs or strollers provide different amounts of support and stability and the chair required by a particular child will depend upon the abilities and problems of that child. The Gross Motor Function Classification System, or GMFCS, a five-level system commonly used to classify function levels, uses balance while sitting as part of its severity level system. Pseudocolpocephaly and decreased volume of the white matter posteriorly were consistent with periventricular leukomalacia. Online ahead of print. If legal services are sought, individuals will be directed to Stern Law, PLLC and ONLY when an attorney-client relationship has been established as explained below, will legal services be provided by Stern Law, PLLC, and/or other law firms with which they may affiliate. 0000009170 00000 n [QxMD MEDLINE Link]. As many as 15 babies per 1,000 experience a seizure. Effectiveness of an anesthetic continuous-infusion device in children with cerebral palsy undergoing orthopaedic surgery. Medscape Education, Congenital Cytomegalovirus Team-Based Care, encoded search term (Cerebral Palsy) and Cerebral Palsy, CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy), Third Nerve Palsy (Oculomotor Nerve Palsy), There's Purpose Behind Babies' Movement in the Womb, Antenatal Corticosteroids: Fresh Answers to Old Questions, Gait Disorders: When the Patient Can't Walk the Walk, Maternal Chronic Conditions Predict Cerebral Palsy in Offspring. The position should enable the child to experience more normal pattern of movements. A childs inability to sit without support can be a sign of Cerebral Palsy. The eight clinical signs include muscle tone, movement coordination and control, reflexes, posture, balance, gross motor function, fine motor function and oral motor function. 2022 Oct;37(10-11):851-863. doi: 10.1177/08830738221115982. It is quick and easy to perform, both in nonhospital environments and in underdeveloped countries, where time and specific recourses are limited. If you have concerns about the developmental progress of your child, talk to your child's pediatrician. Epub 2022 Aug 2. 2009 Jun. 2021. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association: Role of the asymmetrical tonic neck reflex in hand visualization in normal infants., Archives of Medical Science: Persistence of primitive reflexes and associated motor problems in healthy preschool children., Australasian Journal of Early Childhood: Retained primary reflexes in pre primary-aged Indigenous children: The effect on movement ability and school readiness., Handbook of Neurolinguistics: Brain Lateralization across the Life Span., Integrated Learning Strategies: ATNR: Studies Show 50% of Kids with a Retained ATNR Primitive Reflex Struggle with Dyslexia., International Journal of Environmental Research and Public Health: Primitive Reflex Activity in relation to the Sensory Profile in Healthy Preschool Children., International Journal of Neuroscience: Asymmetric tonic neck reflex and symptoms of attention deficit and hyperactivity disorder in children., JOURNAL OF NEUROPHYSIOLOGY: POSTURAL REFLEXES AND GRASP PHENOMENA IN INFANTS., Journal of Speech, Language and Research: Developmental Language Disorder and Uninhibited Primitive Reflexes in Young Children., Optometrists Network: What are Retained Primitive Reflexes?, Physical Therapy and Rehabilitation Science: Primitive Reflex Integration in Intensive Physical therapy and Gross Motor Function in Children with Cerebral Palsy: A Case Report., PLoS ONE: Biomechanics of fencing sport: A scoping review., Rhythmic Movement Training International: Asymmetrical Tonic Neck Reflex., Stanford Medicine: Neuro/Reflexes..

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