In long sitting, children with Down syndrome have delayed which PER response and absent which PERs?

• A. Forward; Lateral and Backward
• B. Lateral; Forward and Backward
• C. Backward; Forward and Lateral
• D. Forward; Lateral and Forward

Answer: (A)

Protective extension reactions are automatic postural responses that help a child catch themselves when balance is lost. In long sitting, there are three directions to expect: forward, lateral (to the side), and backward.

In children with Down syndrome, trunk control is often reduced due to hypotonia, so these protective responses develop later. The pattern typically seen is that the forward protective extension is delayed, and the lateral and backward protective extensions may be absent. This is why the best answer states that the forward PER is delayed and the lateral and backward PERs are absent.

Interpreting the other patterns would imply different timing or presence of these responses that don’t align with the typical Down syndrome profile in long sitting.