Primitive Reflexes


Does my child have retained reflexes?

There are more types of primitive reflexes. More in-depth check is done during your one-to-one assessment at centre. But if you would like to know what are the chances that you child may have retain reflexes, take this free online check now.
You may read about more types of reflexes here.

The Primitive Tonic Reflexes appear in infancy and are integrated into normal movement patterns as the infant develops during the first 6-12 months of life. These reflexes are thought to help the infant learn to organize motor behavior. Integration refers to the inhibition by higher centers of neurological control which modify the reflex in such a way that the pattern of response is no longer stereotypical.

The reflex does not disappear; it may reactivate under stress or during activities requiring great strength. If these primitive reflexes are persistently displayed beyond the expected or typical developmental time period, their presence has been considered an indication that underlying developmental or neurological issues may exist. When these reflexes do not integrate, they may interfere with a child’s development of more advanced motor skills. If such a delay or disruption in motor skills exists, there may be an impairment in the child’s occupational performance.

Symptoms when Primitive Reflexes Remain:

  • Autism
  • Autism Spectrum Disorders
  • Asperger’s
  • Hemispheric Imbalance
  • Sensory Disorders
  • Hyper Activity
  • ADHD
  • Speech Disorders
  • Social Disorders
  • Asthma
  • Dyslexia
  • Dysgraphia
  • Dyscalculia
  • Immune Problems
  • Other Health Issues
  • Other Learning Disabilities

Impact of Primitive Reflex on Learning Abilities
(sample of 3)

Asymmetrical Tonic Neck Reflex (ATNR)
Onset: 0-2 months
Integration: 4-6months
Response: Arm and leg on the “jaw” side extends. Arm and leg on the “skull” side flex.

If persists, may impair ability to roll, use hands smoothly together at midline, poor visual regard for object(s) being held, poor balance. May impair creeping or crawling. Baby loses balance and/or falls when rotates his head from midline; very frustrating and causes excessive fatigue.
Sample Integration Exercise Video

Impact of ATNR reflex on learning abilities:

  • Poor Isolation of Individual Body Movements- Ongoing influence by the ATNR may have affected the child’s earlier success with creeping or crawling. The skill of crawling has a developmental sequence of its own. In the beginning the baby simply uses his arms to push himself backward. Ultimately the baby should use quick alternating movements of their arms/legs while only two of four limbs are touching the surface; indicative of intact balance, strength, and ability to isolate movement. Children with poor isolation of individual body parts may also show poor grading and accuracy when moving.
  • Poor Sitting Posture- Child may sit asymmetrically in a chair; the arm and leg on the “jaw” side of the face extend & torso rotates away from midline. Because child is not upright and centered in a chair, he/she appears “inattentive” and perhaps “disruptive” when sitting at a table with peers.
  • Attention & Focus- When child turns his/her head, their whole body may also turn. This is very distracting and may interfere with task compliance. The child will be less capable at performing multiple actions. For example, he may not be able to use his eyes to scan the classroom (with a stable head) while folding his paper in one-half (using both hands together) as directed by the teacher.
  • Impaired Pre-writing & Writing- Writing requires isolated and precise movement of individual body parts; the continued presence of the ATNR interferes with this. When the child rotates his head away from midline, one arm will be influenced to extend and the other to flex. This will impair the stabilization of the paper with non-dominant hand and controlled use of writing tools with the dominant hand. The child may compensate with an immature pencil grasp and need frequent reminders from their teacher to hold his paper. Copying from one source (ex: the board) to another (ex: paper on their desk) requires dissociation of the eyes from the head; the continued presence of the ATNR will also affect this.
  • Impaired Scissor Use- Rather than holding the paper at midline and cutting forward, the child may use scissors to cut “laterally”. The non-dominant hand may tightly clutch paper versus lightly grasping and shifting as needed. This impairs independence, precision, and speed.
  • Fasteners/Tying/Musical Instruments- The solid foundation for using both sides of the body for different movements is missing. Hands are unable to work together smoothly; eyes struggle to view what hands are manipulating.
  • Impairments in Reading- Reading requires quick and smooth eye movements; child may have very poor ability to dissociate eye from head movement to quickly localize, scan, track, and shift their gaze between targets. The child may lose his/her place and have difficulty locating specific letters, words, or sentences on a page.
  • Keyboard Use- Will impair ability to keep both hands properly positioned at midline on the home row keys; may need to persist with hunt and peck method.
  • Impairments in Gait- When turning their head off midline while walking, the child’s entire body follows. This interferes with walking in a controlled manner and remaining with peers during physical education/ group movement activities. May appear “disruptive” when required to walk in a line at school.
  • Running- Poor reciprocal arm swing; arm fencing posture may present because running requires extra strength and endurance. Overall speed and accuracy will be reduced. May not keep up with peers during movement games and physical education.
Symmetrical Tonic Neck Reflex (STNR)
Onset: 4-6 months
Integration: 8-12 months
Response: With neck flexion the upper extremities will flex and the lower extremities will extend. With neck extension the upper extremities will extend and the lower extremities will flex.

If persists, Interferes with advanced reciprocal creeping. Impairs dissociation between the two lower extremities and transitioning between quadruped to sitting to kneeling to standing and vice versa. If strongly influenced by the STNR a baby will not be able to creep; will bunny hop versus true creeping/crawling on the floor.
Sample Integration Exercise Video

Impact of STNR reflex on Learning abilities:

  • Decreased Strength & Balance- Ongoing influence by the STNR may have affected the child’s earlier success with creeping or crawling; the child may have used the Bunny Hop method which requires less balance, strength, and control. Without these pre-requisites, equilibrium or optimal balance will not be realized. Balance is not just necessary for gymnastics, it is also needed for basic skills such as kicking a ball, going up/down stairs, and stepping down from a curb.
  • Sitting- Slouches while sitting in a chair; slumps at his/her desk. More likely to fall out of chair than other classmates.
  • Floor Sitting- More likely to W sit. This may lead to overstretching in some muscle groups and tightness in others. Over time, this may further limit the child’s flexibility and ability to spontaneously sit in a variety of sitting postures.
  • Walking- May predispose children to walk up on their toes rather than flat feet.
  • Writing- Places their head on their non-writing arm on the desk while writing with their dominant hand. Very slow copying skills; each time child’s head moves up (extends) or down (flexes) there will be movement in the arms that may interfere with the motor act of writing.
  • Ball Handling Skills- Are immature; difficulty with throwing and catching. Strong hands are need for sports such as playing baseball or basketball.
Tonic Labyrinthine-Prone & Supine (TLR)
Onset: Birth
Integration: 6 months
Response: In prone flexor tone will predominate with arms flexed by the child’s chest. In supine extensor tone will predominate.

If persists, will interfere with movement that requires smooth grading of flexor and extensor muscles. In supine child will have compromised ability to raise head up against gravity; this will affect anti-gravity control for movements such as bringing feet and hands together and rolling. In prone (on belly) child will have compromised ability to raise head, extend spine, and bear weight on elbows. This, in turn, will limit time spent on his/her tummy for crawling and developing the movement in their pelvis and shoulders that sets the stage for moving in and out of various body positions (sitting to stand). Without such ability, the baby will be without options for exploring. This will affect social and cognitive gains.
Sample Integration Exercise Video

Impact of TLR reflex on learning abilities:

  • Walking- May present as extra cautious; the child lacks strong arms necessary to protect from trips and falls.
  • Sitting- Slouches while sitting in a chair; can sit upright for short periods.
  • Writing- Leans down over the page when writing.
  • Balance- Difficulty with stairs, curbs, bus steps and managing uneven terrain.