Primitive reflexes 101

Understanding Primitive Reflexes: Identification, Effects, and Treatment

Primitive reflexes are automatic movements that originate in the brainstem and develop in utero to help infants survive and develop. As a child matures, these reflexes should integrate into more sophisticated motor and cognitive functions. However, when they persist beyond their expected timeframe, they can contribute to developmental delays, learning challenges, and sensory processing difficulties. This article explores how to identify common primitive reflexes, what happens when they are not integrated, and how to help children overcome these challenges.

Common Primitive Reflexes and Their Effects

1. Moro Reflex (Startle Reflex)

Identification: A sudden movement, loud noise, or unexpected stimulus causes the infant to throw their arms out, open their hands, and then quickly pull their arms back in.

Effects of Retention: Anxiety, hypersensitivity to stimuli, difficulty with emotional regulation, poor balance, and motion sickness.

Treatment: Activities like starfish exercises (spreading arms and legs wide, then bringing them back in), slow rhythmic movements, and deep pressure activities can help integrate the Moro reflex.

2. ATNR (Asymmetrical Tonic Neck Reflex)

Identification: When the head turns to one side, the arm and leg on that side extend while the opposite arm and leg flex.

Effects of Retention: Poor handwriting, difficulty crossing the midline, challenges with reading and tracking, poor hand-eye coordination.

Treatment: Activities like cross-crawl exercises, ball games that encourage bilateral coordination, and midline crossing exercises such as figure-eight tracing can help integrate the ATNR.

3. STNR (Symmetrical Tonic Neck Reflex)

Identification: When the head moves up, the arms straighten, and the legs bend; when the head moves down, the arms bend, and the legs straighten.

Effects of Retention: Poor posture, difficulty transitioning from sitting to standing, challenges with crawling and coordination, trouble copying from the board in school.

Treatment: Activities such as cat-cow stretches, crawling exercises, and yoga movements like downward dog can help integrate the STNR.

4. TLR (Tonic Labyrinthine Reflex)

Identification: When the head tilts backward, the body extends and stiffens; when the head tilts forward, the body flexes and curls in.

Integrated Retained

Effects of Retention: Poor muscle tone, difficulties with balance, weak core strength, and challenges with spatial awareness.

Treatment: Core strengthening exercises, rolling activities, and balance work (such as standing on one foot) help integrate the TLR.

5. Spinal Galant Reflex

Identification: Stroking along one side of the spine causes the body to flex toward that side. Apply light pressure using a pencil to the paraspinals.

Effects of Retention: Restlessness, bedwetting, poor concentration, and sensitivity to tight clothing.

Treatment: Exercises that encourage core stability, such as side-lying activities, slow trunk rotations, and rhythmic body movements, can help integrate this reflex. Slow snow angels while lying supine has also been shown to help integrate this reflex.

6. Palmar Grasp Reflex

Identification: 

Effects of Retention: Poor fine motor skills, weak hand control, difficulties with handwriting and tool use.

Treatment: Hand strengthening exercises, squeezing stress balls, finger isolation activities, and sensory play with different textures.

Why Addressing Primitive Reflexes Matters

When primitive reflexes are not fully integrated, they can interfere with higher-level motor control, learning, emotional regulation, and overall development. Children who struggle with retained reflexes may exhibit clumsiness, difficulty concentrating, hyperactivity, anxiety, and academic challenges. Fortunately, targeted exercises and therapy can help retrain the nervous system to integrate these reflexes and promote smoother developmental progress.

Conclusion

Understanding and addressing primitive reflexes can be a game-changer for children facing developmental challenges. If you suspect retained reflexes are affecting a child’s ability to function, occupational therapy, neurodevelopmental exercises, and structured movement programs can support integration. By helping children develop foundational motor skills, we pave the way for stronger learning, behavior, and sensory processing skills.

Would you like a personalized reflex screening or guidance on exercises?

You can buy the Mini-course I created on reflexes for $5 (HERE).