1. Spinal Galant Reflex,  Spinal Pereze Reflex and Tonic Labyrinthine Neck Reflex (TLR)
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2. Spinal Galant Reflex
Person/child lies on side or stomach -touched on the right or left side of the spine (Not touching on spinal column itself) - Causes flexion (rotation to 45 degrees) of the body to the side of the touch
Could also respond by raising and extending the leg
Should be present with equal strength bilaterally
15th to 18th week in utero
Starts to function from 5th to 6th month in utero
Actively present at birth
Active from 3rd month to 9th month of infant’s life
Helps fetus to turn the head down for the birthing process
Conducting body vibrations in the fetus
Developing vestibular system
Activation of the S. G. sometimes extends into ATNR
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3. Pulgar Marx Reflex (1955)
When both sides of the spine are stroked simultaneously
Flexion of both legs, lordosis of the spine, elevation of the pelvis
Lifting of the head, loud crying – could lead to apnea
Emptying the bladder
Relaxation of the rectum with bowel movement
Hypertonia after for a few seconds
Inhibited by 2 to 3 months of age
Sometimes seen in Asperger Syndrome
Children with history of continued soiling during the day above age 5
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4. Influences in Development
Homolateral one-sided movement
Gross motor coordination – front-back, up-down, prepares for stand- and walking
Precise motor coordination
Activates semi-circular canals, Auditory Processing
Differentiated, controlled, and goal oriented side bending for movements of reaching and escaping with whole body
Future physical and mental skills, such as concentration and motivation
In utero important for bringing sound and vibrations into the infant’s body, preparing for auditory skills
If both sides of infant is touched simultaneously, experiences chaos.
Assists with ATNR and STNR in facilitating the birth process
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5. Auditory
Assists with primitive reactions to sounds from the mother’s womb
Also makes radiation of soundwaves possible via body vibrations
4th month in utero assists in development of physiological and anatomical hearing
4 stages of hearing:
Resonance through proprioception
Sounds of nature, low frequency sounds (20 to 3000Hz). Includes mother’s heartbeat, breathing, digestion. Mentions specifically Mozart and Gregorian Chants
Sounds of birds and animals – foundational for speech development
Human speech, higher frequency sounds after 5 ½ months in utero
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6. When Not Integrated
Fidgeting, poor concentration, ADD, decrease in short-term memory, inability to persist even for a short time, and fatigue.
Difficulty sitting still for any length of time (ants in the pants); restless
Lack of coordination in motor activity
Low motivation for motor development
Scoliosis, lordosis, incorrect hip posture
Bedwetting, incontinence, IBS, feeling uncomfortable in tight clothing, belts
Leaning back against a chair may activate it
Distracted during attentive activities
Prefer loose clothing tight clothing may trigger reflex
Spastic Colitis in adults
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7. Spinal Galant Reflex  

8. Test Four point kneeling position – “table” position
Using light brush (back of nail), stroke down the back from below the shoulder to the base of the lumbar region at a distance of ½ inch from the spine
First one side, then the other
Repeat the procedure up to 3 times
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9. Scoring
0 = No response 1 = Movement outwards, beyond 45 degrees, and may effect the client’s balance 2 = Undulation or movement of the hip outwards to 45 degrees 3 = Undulation or movement of the hip outwards to 30 degrees 4 = Fully integrated Hypersensitivity – ticklishness – may also be present
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10. Intervention Ideas Passive and active stimulation of the knees - RMT
Rolling the bottom from side to side – passive or active
Cat arches – emphasis on lumbar spine
Sagging and arching the lumbar spine
Isometric pressure
Modified core activation type exercise
Exercise on the back with pelvic tilting
Client sidelying, therapists hands on hip and shoulder, provide resistance with side contractions and while elongating. (RMT)
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11. TLR and Spinal Galant Home Program - Video
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12. Spinal Pereze Reflex Person / child is in prone
Touch on back from tailbone to neck
Backward arching movement of the trunk/torso, flexion of upper and lower limbs, lifting of head and pelvis
Sometimes accompanied by screaming
Emerges at birth
Active until 2nd to 3rd month of life
Integrated with whole body month by 6th month
Can stay physiologically active until 2nd year of life
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13. Spinal Perez

14. Influences on Development
Basis for whole body coordination
Links between limbs and head through core of body, front and back
Becomes a part of Tendon Guard Reflex and STNR
Influences the work of cerebrospinal fluid pumping system and cranial movement
Affects integration of brainstem, diencephalon, and brain hemispheres
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15. When Non-Integrated
If reflex is hyperactive – hyperactivity of auditory and tactile systems
Disorders in sensory processing
Impulsive tendencies in behavior, ADHD
Narrow visual field, inadequacy or increased feelings of fear, also phobia
Lack of internal control, emotional delay
Bedwetting, incontinence, allergies
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16. Spinal Perez Primitive Reflex Inhibition Exercise -Video
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17. Tonic Labyrinthine Reflex (TLR)
Activated by head position in space (forwards or backwards)
Tone of neck and leg flexors increase in prone position
In supine position, tone of back and leg extensors is increased.
Emerges in utero about 12 weeks, present at birth, integrated by 3 to 4 months
In flexion position at 12th week
Assures proper position of infant for birthing process
Active from 2nd month, up to the 4th month
Moro and TLR closely linked in early months – both are vestibular in origin, both activated by head movement
Head control takes over by 6 months – essential pre-requisite for development of all functions - prime initiator of movement, tone and balance (Cephalo-Caudal)
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18. The Infant Adapting to new gravitational conditions after delivery
Early primitive reaction to pull of gravity
Develop muscle tone and proprioception
Practice balance
Causes involuntary muscle tone changes when moving forward or backward
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19. Influences on Development
Whole body muscle tone – helps the neonate to “straighten out”
Changes in head position relative to the body’s midline
Trains neuro links between proprioceptive system and ear labyrinth system
Allows infant to react to changes in gravity
Basis for stability, equilibrium, muscle tone, proprioception and balance
Up-Down and Front-Back Motor System
Prepares infant for rolling over, then crawling on all fours, standing, and walking
Assists in Head Righting Reflex for forward and backward motions
May also have an influence in the regulation of muscle growth and body weight.
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20. When Not Integrated
Chronic Muscle Reactivity – “trips” the vestibular system in it’s actions and interaction with other systems
Disorders in posture, muscle tone (hyper and hypo- patterns) and vestibular-proprioceptive system
Gravitational Insecurity (Ayers 1979 to 1982) – “throws” center of balance
May experience fear of heights
Prevent crawling phase – also impact on STNR (remaining locked to override TLR)
Child may not be interested in movement activity and sports, lack of adequate conscious movements
Difficulty judging space, distance, depth, and velocity
May experience difficulties with time and space perception, cause and effect links, organizing actions and behavior
Difficulty holding head up
Weak neck muscles, hunched posture
Sense of direction will be impacted – think astronauts
Will impede head righting reflexes, leading to difficulties with vestibulo-ocular reflex
Standing for any length of time not integrated
“Bowing” of the body – tendency to stand with head poked forward – poor posture
Jerky and “stiff” in movement patterns
Poor development of praxis – sequencing and timing
Toe walking
Eye muscles may be affected, even cross eyed.
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21. TLR in adults Will impact retaining of other primitive reflexes
Balance difficulties
Fear of heights
Muscle tone
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22. Figure-Ground Effect
Cannot easily separate and categorize conflicting visual information
Walking up an open stair case
Crossing over a slatted bridge, where water can be seen through the boards
May have difficulty re-adjusting eyes from far to near distances – temporary “blind spot” in visual information
Effects spatial perception – also impacting in having difficulty locating sound –become disoriented
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23. Vestibulo-Ocular Reflex (VOR)
Ability to maintain gaze despite head rotation
Integrated by 6 yrs old
Balance affected by visual information and vision affected by balance
Together with proprioception – 3-way system of “mismatch”
Hold pencil ruler length midline to eyes in front of child
Ask child to keep vision focused on pencil while moving head side to side (VOR1)
Move pencil side to side, keep vision on pencil while moving head to opposite side. (VOR2)
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24. VOR TEST 1 and 2  

25. Vestibular Ocular Reflex VOR Exercises - Video
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26. TLR Test Stand with feet together
Arms straight at the sides of the body
Slowly tilt client’s head back into extended position
Ask client to close eyes
Stand behind to support in case there is any loss of balance
After 10 secs, ask client to slowly move the head forward as if to look at toes
Maintain for 10 secs
Repeat sequence up to 3 to 6 times
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27. TLR Testing  

28. Scoring
0 = No response 1 = Loss of balance and / or massive alteration of muscle tone in attempt to maintain balance. This may be accompanied by dizziness or nausea, and in adults, feelings of panic. 2 = Near loss of balance, alteration of muscle tone and / or disorientation as a result of the testing procedure 3 = Disturbance of balance during test and / or alternation of muscle tone at the back of the knees 4 = Integrated
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29. Tonic Labyrinthine Reflex: "The Meatball” - Video
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30. Intervention Ideas Prone extension/superman/superwoman
SWINGS!: net swing, parachute swing, bolster, platform
Rolling head first, body follows in crawling position
Prone over ball
Ball pushes
Cat arches
Cycling for adults and older children
Vestibular stimulation: rotation, rolling and rocking, initially done with eyes closed
Stretching and flexion exercises performed on the floor in supine and prone with eyes closed
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31. RMT Ideas Cycling in the air with legs in supine position slowly
Must feel tension and activation in neck – no hurt though
Put hands under buttocks if pain in the back.
Lift head in supine, breathing out slowly for 7 to 8 secs
Move head side to side breathing out slowly for 7 to secs
Can add pressure / resistance
Press head gently into the floor
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32. https://maudeleroux.com/
Maude Le Roux, OTR/L, SIPT, IMC
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