A 9-month-old infant is held in horizontal prone suspension and tilted sideways. There is no extension of the arms and legs to protect against falling (no parachute or protective response). This reflex should normally appear at what age, and its absence here suggests what?

• A Appears at 3 months; absence suggests visual impairment
• B Appears at 12 months; absence is normal at this age
• C Appears at 6 months; absence suggests motor developmental delay ✓
• D Present at birth; its absence suggests spinal muscular atrophy

Explanation

The parachute (protective extension) reflex develops at about 6 months and, unlike primitive reflexes, persists throughout life. Its absence at 9 months is abnormal and indicates delayed maturation of postural responses, seen in cerebral palsy and motor delay. Visual impairment affects visually guided reaching but the protective response also has labyrinthine inputs, so it is typically retained. Spinal muscular atrophy presents earlier with proximal floppiness, not isolated loss of this reflex.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.