A 14-month-old child with spastic diplegia holds a tiptoe standing posture with curled toes when supported in standing. This position is most characteristic of which reflex?

A 14-month-old child with spastic diplegia holds a tiptoe standing posture with curled toes when supported in standing. This position is most characteristic of which reflex?

• A. Proprioceptive placing reaction
• B. Moro reflex
• C. Plantar grasp reflex
• D. Traction response

Answer: (C)

Persistent plantar grasp reflex is suggested here. When the plantar surface of the foot is stimulated, the toes curl tightly as if grasping the stimulus. This primitive reflex normally integrates by about 9 to 15 months; if it remains active at 14 months, especially in a child with cerebral palsy, it can contribute to a toe-walking posture with curled toes. The other reflexes don’t produce this specific toe curling in standing: proprioceptive placing involves limb replacement on a surface rather than toe curling; the Moro reflex is a startle pattern of arm movement; the traction response involves pulling on the arm to elicit shoulder/elbow flexion.

Persistent plantar grasp reflex is suggested here. When the plantar surface of the foot is stimulated, the toes curl tightly as if grasping the stimulus. This primitive reflex normally integrates by about 9 to 15 months; if it remains active at 14 months, especially in a child with cerebral palsy, it can contribute to a toe-walking posture with curled toes. The other reflexes don’t produce this specific toe curling in standing: proprioceptive placing involves limb replacement on a surface rather than toe curling; the Moro reflex is a startle pattern of arm movement; the traction response involves pulling on the arm to elicit shoulder/elbow flexion.