- May 6, 2024
Primitive Reflexes: The Basics
Primitive reflexes are automatic movements that occur during infancy (and some in utero) that help us survive. The integration of primitive reflexes lay the foundation of the nervous system by developing the lower levels of the brain and triggering functional movements. The lower levels of the brain (pons, medulla, mesencephalon) are often referred to as the “survival brain”, vs. the “thinking brain” which refers to our cortical, cognitive brain. The survival brain is just as it states - there to help us stay safe and survive. This is the type of brain majority of animals have, where they are constantly surveying their environment to understand whether they are safe, or if they need to be ready to fight or run.
Human infants grow the longest outside of the womb - where majority of brain development occurs; whereas other mammals can walk and move almost instantly after birth. This is why receiving a variety of sensory inputs during the infantile stage of humans is so important. Environmental inputs such as movement, sounds, touch, smells, and gravity play a huge role in how our brain develops and learns to understand the world. Primitive reflexes aid by triggering the brain to process the information. Sensory input comes in to the infant, the brain processes the input, and sends out a motor response (or the reflex movement). This “reflex arc” occurs over and over, with lots of repetition, until the information is understand, and the reflex integrates — paving the way to more advanced, intentional movements and higher level brain development. Once primitive reflexes integrate (most are integrated between 12-18 months) the postural reflexes that remain for safety develop and help us move into an upright, bipedal posture, that helps us to develop our cognitive or “thinking brain”.
There are many primitive reflexes, but we have found that the majority of kids with neurodevelopmental differences may need integration of the core 8-10 reflexes. The ones that have the most to do with postural stability. Tonic neck reflexes, Moro, Hand, Foot, and mouth reflexes make the biggest impact on kids that demonstrate learning challenges, motor skill delay, communication challenges, behavior issues, and sensory processing challenges. Let’s dive in to the details of each of these core primitive reflexes and what you may see in regards to symptoms of each.…
Rooting Reflex
You can observe the rooting reflex in action when an infant is trying to locate food. A stroke to the cheek will automatically result in the infants head turning towards the stimulation & opening their mouth. This reflex is normally integrated by month 4. If it remains unintegrated past this period, it can result in speech delays, eating problems (picky eaters too), fine motor delays and other health issues. The Rooting Reflex is closely related to the Palmar reflex in the hand. You may notice children when performing fine motor tasks, such as writing, will move their mouths & tongue.
Symptoms of a retained Rooting Reflex include:
* Drooling
* Speech and articulation problems
* Difficulty with textures; picky eating
* Prolonged thumb sucking
* Difficulty swallowing & chewing
Palmar Grasp Reflex
You may notice an infant grasp a finger when put into their palm? This is the palmar (aka grasp) reflex in action. The Palmar Reflex typically integrates by 6 months of age making way for improved hand control, fine motor skills, and speech (remember its tied closely with the rooting reflex).
Symptoms of an unintegrated Palmar Reflex include:
* Poor fine motor skills
* Poor handwriting and/or pencil grip
* Movements in tongue while writing
* Poor dexterity
* Dysgraphia
* Speech and language problems
Babinski Reflex
Symptoms seen if unintegrated include:
poor stability and balance
challenges with oral motor skills
challenges with articulation
poor bilateral integration
poor postural control
delay in gross motor skills
Asymmetric Tonic Neck Reflex (ATNR)
This is an interesting reflex to notice in infants -- think "bow and arrow". When an infant turns their heads to one side you'll notice one arm bend and the other straighten, and the legs will do the same. ATNR has a significant impact on visual depth perception and eye-hand coordination. In several research studies there has been shown a significant correlation between ADHD, learning disabilities, and an unintegrated ATNR reflex. The ATNR should be integrated by 6 months of age in a typical child.
Common symptoms of an unintegrated ATNR include:
* Hand-eye coordination problems
* Difficulty with catching a ball
* Poor balance
* Immature handwriting
* Math and reading problems
* Learning challenges in school
* Difficulty with crossing the midline
* Poor depth perception
Spinal Galant Reflex
It is thought that the Spinal Galant reflex helps the baby "wiggle" out of the birth canal. As you might imagine a child born via c-section would not have the same experience. Spinal galant is also associated with urination and bladder control. This reflex is particularly seen in young children who are sensitive to clothing textures & tags on clothing touching their skin. They are usually fidgety in chairs and unable to sit still.
Common symptoms for an unintegrated Spinal Galant reflex include:
* Fidgeting and wiggly
* Bedwetting past toilet training (approx 5 yrs)
* Poor concentration and attention problems
* Possible scoliosis, one hip higher than the other
* Hypersensitive to touch on their torso
Symmetric Tonic Neck Reflex (STNR)
The STNR allow the two sides of the body to work symmetrically together. It must be at least partially integrated in order for the child to crawl. If your child crawled in a funky way (one leg dragging behind, army crawl, skipped crawling altogether) they may have a retained STNR. An unintegrated STNR may contribute to learning challenges in school. You will notice challenges with copying items from a blackboard (ie, looking up and down). STNR also helps with visual processing near and far.
Common symptoms of an unintegrated STNR include:
* Low muscle tone
* Vision and tracking problems
* Poor eye/hand coordination
* Sloppy eater
* Problems looking near & far, ex. copying from chalkboard
* Hyper active or fidgety
* Slumped posture when seated in chair
Tonic Labyrinthine Reflex (TLR)
The TLR is an important primitive reflex for head control. It is the foundation for movement and helps with rolling, crawling, and later standing upright. It is typically integrated by 3.5 years of age.
Common symptoms of an unintegrated TLR include:
* Dyspraxia
* Poor posture
* Muscle tone issues (hyper- or hypo-)
* Spatial problems
* Speech & auditory difficulty
* Poor balance
* Poor body awareness
Landau Reflex
The Landau reflex is one major reason its important for an infant to have tummy time. Lifting the head off the ground and against gravity not only contributes to good upright posture, but it stimulates the vestibular system. The Landau helps build core strength and postural muscles, as well as neural connections in the brain through sensory stimulation.
Common symptoms with unintegrated Landau reflex:
* Weak core
* Stiff, awkward gait
* Poor posture
* Difficulty with coordination like hopping, skipping, jumping
* Learning challenges
* Possible depression
* Sensory processing issues
Moro Reflex
The Moro reflex is initiated through both vestibular movement (movement of the head) and sensory stimulation. The Moro is, in my opinion, the most important reflex to integrate. When Moro is unintegrated other reflexes will not integrate. The Moro reflex is seen when a newborn is startled by an unexpected noise or uncomfortable sensory stimulation (cold touch, pain, etc). You will notice the infants upper back arch and both arms open to the side. This reflex is typically integrated by 4 months of age. The Moro can cause a host of problems when unintegrated, especially sensory processing issues. The reflex triggers our "fight or flight" system placing the child into a state of stress majority of the day (if unintegrated). When the body is in "fight or flight" mode the brain cannot work well (difficulty learning, poor social skills) and the digestive system can be a problem as blood rushes towards our muscles in a stressed state.
Common symptoms in an unintegrated Moro Reflex include:
* Hypersensitive to sensory stimuli
* Overreacts to situations
* Emotional immaturity
* Sensory processing disorder
* Emotional outbursts
* Poor balance and coordination
* Easily distracted
* Poor digestion, food sensitivities
* Motion sickness
* Sensitive to light, sounds, touch
* Withdrawn and/or timid, shy
* Impulsive and/or aggressive