Selected primitive reflexes in children with cerebral palsy: consistency of response

The purpose of this study was to determine the consistency of reflex responses of subjects in varying behavioral states. The following selected primitive reflexes were examined in children with spastic quadriplegic cerebral palsy: tonic labyrinthine, asymmetrical tonic neck, symmetrical tonic neck, crossed extension, and Moro. Our hypothesis was that a subject's reflex responses would vary as a function of his behavioral state. Ten children, ages 3 to 6 years, participated in the study. Reflex responses were elicited using a specified protocol. A behavioral-state scale was defined, and the subject's behavioral state was noted before each reflex stimulus was applied. Each subject completed eight test sessions. Test sessions were videotaped with portable video equipment. Results of the study indicated a significant inverse relationship between progression on the behavioral-state scale and consistency of reflex responses; the higher the numerical rating, the less the consistency of response. Findings of our study support those who recommend optimal states for testing and indicate that caution should be used when interpreting test results based on a single examination.