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Updated: Jul 9, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Insights
Pediatricians can detect motor handicaps early by tracking primitive reflexes, which appear at birth. Monitoring these reflexes and motor milestones helps identify developmental delays in infants.
Area of Science:
- Neurodevelopmental Pediatrics
- Infant Motor Function Assessment
Background:
- Primitive reflexes are the earliest neurodevelopmental markers available for study.
- Motor milestones predict future motor function but appear later than primitive reflexes.
Purpose of the Study:
- To highlight the importance of primitive reflexes as early neurodevelopmental markers.
- To equip pediatricians with a neuromotor tool for early detection of motor handicaps.
Main Methods:
- Clinical evaluation of the quantitative and qualitative aspects of primitive reflexes.
- Following the appearance and suppression times of primitive reflexes during the first six months of life.
- Observing sequential office visits for infant neuromotor assessments.
Main Results:
- Exaggeration or delayed suppression of primitive reflexes precedes delayed or deviant motor milestones.
- Primitive reflexes are available at birth for clinical evaluation.
- Infants are closely followed during the first six months of life.
Conclusions:
- Familiarity with primitive reflexes aids pediatricians in early detection of motor handicaps.
- Standardization of intrauterine primitive reflex profiles may identify high-risk fetuses.
- Non-invasive roentgenographic techniques can foster the study of intrauterine primitive reflexes.
Abstract:
While motor milestones--the neurodevelopmental functional end point of the transitioning of the immature and mature primitive reflexes into volitional activity--have been highlighted in predicting future motor function, the primitive reflexes represent the earliest neurodevelopmental markers available for study. By pediatricians becoming familiar with their quantitative and qualitative aspects coupled with the time of their appearance and suppression, they will have this neuromotor tool available for the early detection of a significant motor handicap. Primitive reflexes II have been highlighted since they are available at birth to be clinically evaluated and followed during sequential office visits during the first 6 months of life, the time during which infants are more closely followed at office visits. Delay or deviancy (nonsequential appearance) of motor milestones are preceded by an exaggeration or delayed suppression of the primitive reflexes. It is anticipated that the study and standardization of an intrauterine primitive reflex profile will eventually lead to the identification of a high-risk fetus. This endeavor will be fostered by the further development and refinement of non-invasive roentgenographic techniques.
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