1.  Righting reactions

2.  Protective reactions

3.  Equilibrium reactions

1.  Vertical righting reactions

• Allow child to orient head in space so eyes and mouth are in horizontal plane regardless of body position
• Examine with child upright, prone and supine

2.  Rotational righting reactions

• Assist in restoring the boyd alignment to a neutral anatomical psition when segments of the body have been rotated

- Onset:  2.5 to 6 months

- Integration:  Maintained through adult life

- Procedure:  Support child under axilla and tilt 35-40° laterally, anteriorly and posteriorly

- Resonse:  Alignment of head with vertical is complete response, maintaining head in alignment with body is partial response

- Onset:  1.5 to 4 months

- Integration:  Maintained throughout life

- Procedure:  Place child prone and observe cervical and trunk extension

Response:  Head lifted to 45° is appropriate response for 4 month old, by 6-7 months child should be able to extend entire trunk and pelvis so an upward concavity is observed (Landau response)

- Onset:  4 to 6 months

- Integration:  Maintained through life

- Procedure:  Place child in supine and observe head lifting off surface, may elicit by pulling child to sit and observe for chin tuck

- Response:  Child lifts head off surface spontaneously while in supine, child tucks chin partially or completely during pull to sit

*Complete chin tuck not observed in all healthy babies until 8-10 months old

- Purpose:  To restore body parts to normal alignment following rotation of some body segment

- Types:  Non-segmental rolling ('log rolling'), segmental rolling

- Onset:  Birth

- Integration:  6 to 12 months

- Position:  Supine

- Procedure:  Passively turn infant's head, passively flex and adduct lower extremity, elicit head turning with a toy

- Response:  Upon head turning or flexion and adduction of LE, the rest of the infant's body rotates 'like a log' in non-segmental fashion

- Onset:  6 to 12 months

- Integration:  Maintained throughout adult life

- Procedure:  Same as for non-segmental rolling

- Response:

• Upon passive head rotation or LE flexion and adduction there may be no response
• Upon Upon active inititation of rolling, mature response includes distinct rotation between the shoulder and pelvic girdle
• Head and trunk rotation about the central axis of the body

- Reactions consist fo extension mvoements of the extremities in teh same direction of a displacing force which shifts teh body's COG

- All are maintained throughout life

- Synonymous with 'parachute' or 'propping' reactions

- Reactions are facilitated by input from:

• Vestibular system
• Somatosensory system
• Visual system

Downward Protective Reaction

- Onset:  4 months

- Integration:  Maintained throughout adult life

- Procedure:  Hold child in vertical position, thrust feet first toward surface

- Response:  Extension and abduction of both legs in preparation for weight bearing

- Onset:  6 to 7 months

- Integration:  Maintained throughout adult life

- Procedure:  Hodl infant securely about chest, move infant forward toward surface in head-first position

- Response:  Arm extension and abduction bilaterally

Possibly the presence of hemiplegic CP or a brachial plexus injury

- Onset:

• Forward:  6 to 11 months
• Lateral:  6 to 11 months
• Backward:  9 to 12 months

- Procedure:  With infant positioned in sitting gently push laterally, forward or backward to elicit protective response

- Response:  Child extends arm to side, front or behidn to prevent self from falling

- Amount of force used to disrupt balance

- Speed of displacing force

- Point of application of displacing force

*Protective responses are highly context dependent and serve as a bridge to more complex, mature equilibrium responses

- Complex responses to changes of posture or movement which seek to restore disturbed balance

- Movement of trunk and extremities in direction opposite of the force wihch is causing displacement

- Stimulus can be a push, pull or tilt of supporting surface

- Response can be very subtle or large

- Onset:

• Prone:  5 to 9 months
• Sitting:  7 to 8 months
• Quadruped:  8 to 12 months
• Standing:  12 to 21 months

- Procedure:  Tilt supporting surface, displace COG by physical push or pull

- Prone:  Abduction and extension or extremities, with curvature of trunk

- Sitting:  Trunk extension or flexion to A/P displacement, abduction and extension of extremities to lateral displacement with trunk rotation

- Quadruped:  Similar to responses in prone

- Standing:  Ankel dorsi/plantarflexion, hip flexion or extension, trunk flexion or extension