Portfolio Part 1

1. CU Denver Anschutz MedicalCampus Physical Therapy
Human Growth and Development Portfolio
Samantha Jensen
10/13/2014
This portfolio is being developed to be used as a study aide for the Human Growth and Development course. The information within
has been derived from power points, documents and lecture discussions as well as from the pages of the Functional Movement
Development text.

2. Samantha Jensen 2
HG&D Portfolio: Part 1
Reflexes and Reactions
Definitions
Reflexes: automatic movements in response to sensation,or a sensory stimulus
1. Primitivereflexes: appear prenatally or atbirth, areintegrated at approximately 4-6 months of age (exceptions: plantar
grasp and STNR)
2. Attitudinal reflexes: stimulus is head/neck position (e.g. ATNR, STNR, TLR)
a. Subcategory of primitivereflexes, never obligatory in typically developingchildren
Reflex Integration: when the reflex is no longer obligatory or the most common response to the stimulus
Primitive Reflex
Neonatal Positive Supporting
Onset Integration Position Stimulus Response
35 weeks gestation 1-2 months Support infantin
vertical position with
examiner’s hands under
the arms and around
the chest
Allowfeet to make firm
contact with tabletop or
other flatsurface
Simultaneous
contraction of flexors
and extensors so as to
bear weight on lower
extremities
 Child may only
supportminimal
amount of body
weight
 Characterized by
partial flexion of hips
and knees
Attitudinal Reflexes
Asymmetrical tonic Neck Reflex (ATNR)
Onset Integration Position Stimulus Response
Birth to 2 months 4-6 months Placechild supinewith
head in midline;can
test or observe in other
positions (sitting,
quadruped, standing)
1. Have child actively
turn head by
followingan object
from sideto side
2. Passively turn
child’s head slowly
to one sideand hold
in extreme position
with jawover
shoulder
Arm and leg on face
sideextend, arm and
leg on skull sideflex
(fencer’s position)
Symmetrical Tonic Neck Reflex (STNR)

3. Samantha Jensen 3
HG&D Portfolio: Part 1
Onset Integration Position Stimulus Response
4-6 months 8-12 months Placechild in ventral
position supported by
trunk over examiner’s
knee or placein
quadruped position
Examiner passively
flexes then extends the
child’s head and neck
1.Head and neck flexion
produces flexion of
the upper extremities
and extension of the
lower extremities
2.Head and neck
extension produces
extension of the
upper extremities and
flexion of the lower
extremities.
Tonic Labyrinthine Reflex Prone (TLR)
Onset Integration Position Stimulus Response
Birth ~6 months Prone Prone positioning Flexor tone dominates,
child has difficulty
extending to lifthead,
neck or trunk; cannot
supportweight on arms
Tonic Labyrinthine Reflex Supine (TLR)
Onset Integration Position Stimulus Response
Birth ~6 months Supine Supine positioning Extensor tone
dominates, child will
not flex in pull to sit
Postural Reactions
Automatic postural reactions providethe foundation for posture, balance,locomotion and prehension. These reactions appear
duringinfancy and remain throughout the lifespan.They occur in response to changes in the body’s orientati on and pattern of
weight distribution in thebase of support.
Category Stimulus Response Notes
Protective Fastor largemovement of
center of gravity
Extremities move out into
extension to catch person
Head and trunk righting Change position of body in
space
Produce alignmentof the body
with the environment or
alignment in space.Keep the
head and trunk aligned with
each other.
Uses three systems:
 Visual
 Vestibular
 Somatosensory
(proprioceptiveor tactile)
Equilibrium Slow shiftof the center of
gravity.
Find balancein responseto
shiftin center of gravity
 Orderly sequence:
Prone supinesitting 
quadruped  standing
 Lags behind attainment of
movement in the next
higher developmental
posture.

4. Samantha Jensen 4
HG&D Portfolio: Part 1
Illustrationsof attitudinal reflexes are shown to the left with a timeline of when
these reflexes can be observed.
Below arepictures of babies demonstratingthese reflexes.
An illustration to the left depicts the protective extension postural reaction
occurringin multipledifferent positions.
Illustrationsof the equilibriumreactions aredepicted to the left.
Below, pictures demonstrate examples of head and trunk rightingreactions.
These includeneonatal neck on body (NNOB), neonatal body on body (NBOB),
optical rightingand landau.Notpictured is labyrinthinerighting.

5. Samantha Jensen 5
HG&D Portfolio: Part 1
DevelopmentalGross Motor Milestones
Month Prone Supine Sitting Standing
1
(Physical flexion)
Lifts head and turn head
to side.
Hips flexed, head to the
side.
Arms flexed with hands
by face.
Back rounded, head
forward.
Positivesupport.Partial
flexion in hips and knees
2
(Maximum
asymmetry)
Head at 45°.
Prone musculature
elongated.
Head to side.Presence
of ATNR. Arms out
further. Less tightness
at hip and knee flexion.
Head lagin pull to sit.
Rounded.
Decreased weight
bearingand possible
onset on astasia.
3
(Symmetry/ anti-
gravity flexion)
Increased head shoulder
control 45°-90°.
Increased spinal
extension, lower pelvis.
Prop up on forearms.
Head rotation.
Head and hands to
midline.
Head to midline.Initial
head lag.
Astasia or minimum
support
4
(Increased
symmetry)
Increased extension,
bilateral adduction of
scapula.Firstpartof
Landau reflex.
Elbow support. May roll
with lateral weight shift.
Head in midlinewith
chin tucked. Hands to
knees. Spine flattens.
Minimal head lag.
Sits with support. More
extended upper spine.
Weight in supported
standing. Standingwith
2 hands held. Static
standingwith extension.
5
(Increased
flexion/extension
control)
Extended arms.
Reachingin prone.
Rolling.Increased
lordosis.
Increased abduction
control.Hands to feet.
Rollingsideto side.
Pivoting.
Begins prop sit,which
leads to lower hip
extension. Arms up in
high guard to increase
balance.No head lag.
Full weight on legs with
hand s or trunk held.
May releaseextension
and may flex at knees.
6
(6-12 months big
in change in
thoracic
development)
Increased extension
through hips.Side play
with lateral head
righting.Pivoting.May
push hips and knees.
Independent rolling.
Foot to mouth. May
demonstrate protective
extension. Buttocks off
floor.
Begin to sit
independently. Easy to
fall with weight shift.
Smaller baseof support.
May begin bouncing.
7 All fours rocking.Belly
crawling.May fall with
four-pointreaching.
Sit with rotation. Begin transitioningfrom
four-pointto sit.
May pull to stand (UE
pattern used).
8 Four pointcreeping
prone transitioningto
sit.
Supine to sit. Lots of UE
and LE movement.
Long-sitting which
stretches the
hamstrings.
Refined four-point
transitioningto sit.
May try to cruise.Tall
kneeling. Stand holding
on. Begin half kneel to
stand.
9 Refined four-point. Increased pelvic and
femoral dissociation
(fractionation).W-
Pull to stand to half
kneel. Rotation with
cruising.Hold with one

6. Samantha Jensen 6
HG&D Portfolio: Part 1
sitting. hand. Legs work more.
Stepping with support.
Increased hip flexion.
Heel-toe play.
10
(Transitions)
Creep up steps (can’t go
down)
Protected extension to
back.Very functional.
Climb.Half-kneel play.
Mobility between
pelvis,thorax,and
femurs.
11 Bench sitting.Chair
sitting.
Stand with one hand.
Cruisebetween 2
surfaces.More climbing
to getting down.
12 Push toys- may let go.
Independent stand.
Independent steps.
Squat to stand with
minimal support.High
guard.
18 Creeps up and down
stairs.
Transition to standing
from sittingon floor.
Pull or carry toy while
walking.Walking
sideways or backwards.
Develop a run-likewalk.
Momentary 1-foot
balance.Beginningarm
swingand heel strike.
24
(2 years)
Up and down stair one
foot ata time with rail
support. Jump off a step
(2 foot takeoff). Stand
on one foot 1-3
seconds.Kick a large
ball.Begin to run. Begin
to jump (alternating
feet).
36
(3 years- highest
activity level at
any age in human
lifespan)
Pedalinga tricycle. Climbinga junglegym.
Start, stop and turn
whilerunning. Tandem
and one foot standing
for at least3 seconds.
Up stairs,alternating
feet.
48
(4 years)
Hop on one foot 4-6
times (girls appear to
have better balancein
childhood).Rhythmic
galloping.Up and down
stairs alternatingfeet.

7. Samantha Jensen 7
HG&D Portfolio: Part 1
Bounces and catches
ball under control.Kicks
10-inch ball toward
target. Runs 10 feet and
stops well.
60
(5 years)
Bikes usually without
trainingwheels.
Stand on either foot 8-
10 seconds.Walk
forward on balance
beam. Hop 8-10 times
on one foot. 2-3 foot
standingbroad jump.
Skip on alternatingfeet.
Kick a rollingball.Roller
skates.
72
(6 years)
Stand on one foot for
longer than 10 seconds
eyes open or closed.
Walk on a balancebeam
in all directions.
Running. Jumping,
Throwing. Catching. Can
incorporategame
playing skills.
84
(7 years)
Jumping jacks.Standing
longjump of about 42
inches.

8. Samantha Jensen 8
HG&D Portfolio: Part 1
Vital Signs
Age Mean Heart Rate Mean Respiratory Rate Mean Blood Pressure
1 year 120 beats/min 20-40 breaths/min 90/56 mm Hg
2 years 110 beats/min 25-32 breaths/min 91/56 mm Hg
6 years 100 beats/ min 21-26 breaths/min 96/57 mm Hg
10 years 90 beats/min 20-26 breaths/min 102/62 mm Hg
16 years 80 beats/min (girls)
75 beats/min (boys)
16-20 breaths/min 117/67 mm Hg
Adult 74-76 beats/min 10-20 breaths/min 120/80 mm Hg
Older Adult 74-76 beats/min *Data unavailable 150/85 mm Hg