Nurse Kathy is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?
A. Persistent rooting
B. Bilateral parachute
C. Absent moro reflex
D. Unilateral grasp
Correct Answer: B. Bilateral parachute
The parachute reflex appears to be normal at about 9 months of age. Persistence of primitive reflexes past 4 to 6 months or absence before this time when they should have been present is predictive of cerebral palsy. The presence of 5 or more abnormal reflexes correlated with the development of cerebral palsy or mental delays.
Option A: The rooting reflex, mouth turning toward an object, is seen in response to light stroking on the cheek or bringing an object into the patient’s visual field. Rooting begins at 32 weeks gestation and decreases after one month.
Option C: The absence of the Moro reflex suggests CNS dysfunction. The Moro reflex is a protective response to the abrupt disruption of body balance and is elicited by pulling up on the arms with an infant in the supine position. The reflex develops by 28 weeks gestation and disappears by six to nine months.
Option D: The grasping reflex can be elicited by providing sustained pressure on the palmar aspect of the hand, resulting in flexion of the patient’s fingers grasping the object providing the pressure. This reflex develops by 28 weeks gestation and disappears by six months.