Reflex Evaluation Checklist for Pediatric Occupational Therapy

AADHIRaA PAEDIATRIC THERAPY SERVICES

Reflex Evaluation Checklist for Pediatric Occupational Therapy

Child’s Name: __________________________ Date: _________________ Age: __________

Primitive Reflexes

Reflex

How to Assess

Expected Response

Response Observed

Comments

Moro Reflex

Gently drop head backward or make a sudden loud noise.

Arms and legs spread out, and then quickly retract.

Rooting Reflex

Gently stroke the child’s cheek or corner of the mouth.

Head turns towards the stimulus and mouth opens.

Sucking Reflex

Place a finger or pacifier in the child’s mouth.

Sucking motion should occur.

Palmar Grasp Reflex

Place a finger in the child’s palm.

Child grasps the finger tightly.

Babinski Reflex

Stroke the sole of the foot from heel to toe.

Toes fan out and the big toe dorsiflexes.

Tonic Neck Reflex

Turn the child’s head to one side while lying on their back.

Arm and leg on the side of the head turn extend; opposite side flexes.

Stepping Reflex

Hold the child upright with feet touching a flat surface; lean forward.

Stepping motions with the legs should be observed.

Reflex

How to Assess

Expected Response

Response Observed

Comments

Righting Reactions

Tilt the child’s body to one side while sitting or lying down.

Child attempts to right their body to a vertical position.

Equilibrium Reactions

Gently tilt or shift the child’s body while sitting or standing.

Child adjusts posture to maintain balance.

Protective Reactions

Gently push the child off balance while sitting or standing.

Arms or legs extend to prevent falling.

Postural Reflexes

Instructions for Use:

  1. Preparation: Ensure the child is comfortable and explain the procedures to the parent/caregiver if necessary.
  2. Assessment: Perform each reflex assessment as described in the "How to Assess" column.
  3. Documentation:
    • Record the child’s response in the "Observed Response" column.
    • Note any deviations, concerns, or relevant observations in the "Notes" column.
  4. Analysis: Review the observed responses to determine if the reflexes are within typical developmental patterns.
  5. Follow-Up: Plan appropriate interventions based on the assessment findings.

  

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