Primitive reflexes are automatic movements that originate in the brainstem. They help with essential early skills such as breastfeeding, responding to sensory input, and learning how to move against gravity. According to trusted pediatric therapy organizations such as AOTA, ASHA, and NBCOT, these reflexes play a critical role in early development and typically integrate as the brain matures.
When they don’t fully integrate, they can affect coordination, emotional maturity, handwriting, attention, posture, and more.
Most Common Retained Primitive Reflexes
Below are the reflexes our therapists see most often in children who are struggling with motor coordination, sensory processing, or academic tasks.
1. Moro Reflex (Startle Reflex)
What it is:
A sudden “startle” response triggered by loud noises, quick movements, or changes in head position.
What retention may look like in children:
- Big reactions to stress or unexpected events
- Difficulty with transitions
- Sensitivity to sound or light
- Anxiety or emotional overwhelm
- Trouble sitting still or calming down after excitement
Real-world example:
A child might have a meltdown at school after a fire alarm or struggle when routines change unexpectedly.
2. ATNR – Asymmetrical Tonic Neck Reflex (The “Fencer’s Pose”)
What it is:
When a baby turns their head, the arm and leg on that side extend while the opposite side bends.
What retention may look like:
- Difficulty crossing midline (e.g., writing across a page)
- Messy handwriting
- Trouble tracking words while reading
- Challenges with bilateral coordination (using both hands together)
Real-world example:
A child may switch hands during tasks, lose their place while reading, or lean heavily to one side at a desk.
3. STNR – Symmetrical Tonic Neck Reflex
What it is:
A reflex that helps babies transition from lying down to crawling.
What it looks like when retained:
- “W-sitting”
- Poor sitting posture
- Difficulty copying from the board
- Clumsiness during transitions
- Fatigue during writing or fine-motor tasks
Real-world example:
A child may slump over the desk, frequently change positions, or avoid seated schoolwork.
4. TLR – Tonic Labyrinthine Reflex
What it is:
This reflex influences whole-body muscle tone based on head position.
Signs of retention:
- Poor balance
- Weak core strength
- Difficulty judging speed or distance
- Frequent falls or tripping
- Challenges with playground activities
Real-world example:
A child may avoid climbing, swinging, or sports because their body feels “heavy” or uncoordinated.
5. Spinal Galant Reflex
What it is:
Stroking the low back causes the baby’s hips to wiggle or rotate.
Signs of retention:
- Difficulty sitting still
- Bedwetting not related to toileting delays
- Distractibility, especially with tight clothing or chair backs touching the spine
- Frequent shifting or wiggling at school
Real-world example:
A child constantly adjusts their waistband or leans forward in their seat to avoid back contact.
How Retained Reflexes Affect Daily Life
When primitive reflexes linger, kids may appear “disorganized,” inattentive, uncoordinated, or emotionally sensitive—but it’s not their fault. Their nervous system is simply working overtime.
Retention can impact:
- Handwriting (difficulty with spacing, pressure, endurance)
- Reading (tracking words, eye movements)
- Self-regulation (emotional ups and downs)
- Balance and coordination
- Dressing, grooming, and feeding skills
- Classroom performance (attention, posture, copying)
Understanding the “why” behind the struggle often brings immense relief to parents—and provides a clear starting point for improvement.
How PedsTeam Addresses Retained Primitive Reflexes
At PedsTeam, we use research-supported, child-friendly strategies drawn from trusted sources such as AOTA, ASHA, NBCOT, and established pediatric therapy practices.
Our approach includes:
1. Comprehensive Evaluation
We look at movement patterns, posture, sensory responses, coordination, attention, and daily-life function—not just individual reflexes.
2. Targeted Therapy Interventions
Therapists use playful, intentional activities that support reflex integration while building strength, body awareness, and motor planning. Activities may include:
- Crawling variations
- Balance and vestibular play
- Core strengthening
- Crossing-midline tasks
- Fine-motor and visual-motor exercises
- Sensory regulation strategies
3. Home Programming
Families receive simple, doable exercises to complete at home—usually just a few minutes a day.
4. Advanced Training
‘We are proud to highlight that one of our therapists is currently training in Assessment and Integration of Primitive Reflexes for Improved Independence in Daily Activities through Harkla. This specialized coursework deepens our team’s ability to evaluate and support reflex integration using evidence-informed, developmental methods.
5. Collaboration and Communication
We regularly collaborate with parents, teachers, pediatricians, and other providers to create consistent support across home, school, and therapy.
What Parents Can Do at Home
While individualized guidance from a therapist is ideal, here are some general activities that support healthy development:
- Play on the floor: crawling, rolling, tummy time—even for older children.
- Encourage cross-body movements: passing a ball across midline, marching with opposite arm/leg, drawing large figure-8s in the air.
- Limit prolonged screen time to promote movement-based exploration.
- Engage in sensory-rich play: swinging, climbing, pushing/pulling, jumping games.
- Build core strength with simple activities like wheelbarrow walks, crab walks, or yoga poses.
Remember, every child is unique. If you suspect retained reflexes are affecting your child’s daily life, a professional evaluation is the best next step.
FAQ: Common Parent Questions
1. How do I know if my child has retained primitive reflexes?
Look for ongoing challenges with coordination, attention, posture, reading or writing, or emotional regulation. A pediatric OT or PT can complete a thorough assessment to determine if reflexes are involved.
2. Can a child “grow out of” retained reflexes?
Sometimes—but not always. If a reflex remains active past its expected integration period, the child may need intentional movement-based therapy to support integration.
3. Is reflex integration therapy safe?
Yes. When performed by trained pediatric therapists, these activities are gentle, play-based, and developmentally appropriate.
4. How long does it take to see changes?
Every child is different. Some families notice improvements within weeks, while others see gradual progress over several months. Consistency—especially with home exercises—makes a big difference.
5. Are retained reflexes related to ADHD or sensory processing difficulties?
Retained reflexes don’t cause these conditions, but they can contribute to similar challenges, such as attention, fidgeting, or difficulty staying organized.
We’re Here to Help Your Child Thrive
If you’re noticing signs that your child may be struggling with motor coordination, attention, posture, or sensory overwhelm, PedsTeam is here to help. Our caring therapists in Southaven, MS use evidence-informed practices—and now advanced training in primitive reflex assessment—to support your child’s independence and confidence.
Contact PedsTeam today to schedule an evaluation or learn more about our speech, occupational, and physical therapy services. Together, we can help your child build the skills they need for a bright, successful future.
