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How Understanding Primitive Reflexes Changes Everything for Special Needs Children

Updated: Oct 21, 2020

Primitive Reflexes are the Root Cause of Developmental Delays

The retention of primitive reflexes (also referred to as "survival reflexes") in children, typically cease by 24 months of age and can be caused by a variety of factors, with the birth process being a key factor in the integration of these reflexes. Consequently, retained primitive reflexes are usually the result of…

  • Traumatic birth experience.

  • Birth by C-section.

  • Early falls or traumas.

  • Lack of tummy time.

  • Delayed or missed creeping or crawling.

  • Chronic ear infections.

  • Head trauma.

  • Vertebral subluxations.

There are 70 known primitive reflexes, and eight of those reflexes are most commonly present in cases of Functional Disconnection Syndrome (FDS). Retention of these reflexes can inhibit a child’s social, emotional, and cognitive development. Some retained reflex symptoms can even overlap, which compounds the other symptoms.

In typical development, a child's primitive reflexes are replaced by the postural reflexes which control tiny equilibrating mechanisms the brain needs for balance and coordination…after we have learned to sit, stand, and move from an upright position.

These reflexes enable us to live in harmony with gravity, to maintain a steady visual image even when we are moving (or the object is moving) and to edit nonessential stimuli which enables greater focus upon essential stimuli. They also play a major role in proprioception.

One study reported that proprioceptive difficulties among children may contribute to (1) decreased motor planning and postural control and (2) lead to disruptive behaviors that negatively affect their participation in daily tasks.

Proprioception, or the body's ability to sense itself in space, can be quite complicated, especially in children with academic, social, or behavioral issues like "ADHD," "Asperger’s," and "sensory processing disorders." Proprioceptive dysfunction has often been observed in such children, since they experience difficulty (1) knowing where their body is in space and (2) understanding social boundaries when playing and interacting with other children.

Since proprioception is guided by receptors in the body (skin, muscles, joints) that connect with the brain through the nervous system, a person knows what his/her body is doing even without sight. While vision definitely plays a crucial role in the ability to sense one’s body in space, it is not necessary in order for a person to understand body ownership. In fact, proprioception may already be present in newborns.

Children with processing disorders frequently report feeling scattered or disconnected…which may be related to a faulty sense of proprioception. Children who are clumsy, uncoordinated, and sensory deficient are often experiencing proprioceptive dysfunction. The most common signs of proprioceptive dysfunction are:

  • Sensory deficient: Pushes/writes too hard, plays rough, bangs or shakes feet while sitting, chews, bites, and likes tight clothes.

  • Poor motor planning/control & body awareness: Difficulty going up and down stairs, frequently bumps into people and objects, and difficulty riding a bike.

  • Poor postural control: (1) Slumps, unable to stand on one foot, and needs to rest head on desk while working. (2) These children often self-regulate by engaging in behaviors that provide proprioceptive input (e.g. toe walking, crashing, running, or flapping their arms).

Tasks that involve heavy resistance and input for the muscles and joints are essential to regulating proprioception. There is encouraging evidence suggesting the sensorimotor cortex that governs proprioception is not permanent and can be changed through external exercises.

Consequently, whenever the sense of proprioception is engaged (as is the case in numerous other neurological disorders), there is hope that it can be improved with the use of sensory integration therapies that specifically target proprioceptive stimulation. For example, "frog jumps," "bear hugs," and climbing monkey bars are just a few activities that may help a child struggling with proprioceptive dysfunction.

The following is a description of eight primitive reflexes and signs of their retention:

The Palmar Reflex (birth to 5-6 months) is activated by the automatic flexing of a baby's fingers to grasp an object. If this reflex is retained after 6 months, symptoms can include:

  • Poor fine motor skills and manual dexterity.

  • Inappropriate pencil grip and poor handwriting.

  • Copying is easy but the task of spelling and writing words is difficult.

  • The child often sticks their tongue out while writing.

  • Difficulty processing ideas on to paper.

  • Poor posture when playing piano or working with the hands.

  • Poor posture and/or back pain when working at a desk or computer.

The Moro Reflex (birth to 4 months) is activated to respond to unexpected changes within a child’s environment and acts as their "fight or flight" reaction. Typically, this reflex is replaced by the adult startle reflex. If this reflex is retained after 4 months, symptoms can include:

  • Over-sensitivity/over-reaction to sensory stimulus especially to bright lights.

  • Tires easily under fluorescent lights.

  • Prone to sensory overload.

  • Dislike of loud noises.

  • Easily distracted.

  • Poor impulse/emotional control.

  • Anxiety.

  • Mood swings.

  • Social immaturity.

  • Motion sickness.

  • Allergies and lower immunity.

  • Poor balance and coordination (particularly during ball games)…which leads to poor sequencing and memory skills.

  • Difficulty reading black print on white paper.

  • Dislike of change causing child to be clingy or shy.

The Rooting Reflex (birth to 3-4 months) is activated during the act of breastfeeding…a light touch on the cheek, or stimulation to the edge of the mouth automatically causes a baby to turn its head toward the side of stimulation and open its mouth with an extended tongue to accept the nipple into its mouth.

A suppressed central nervous system may indicate developmental delays and if this reflex is retained after 4 months, symptoms can include:

  • Tongue sits too forward in the mouth which can cause dribbling or problems with speech.

  • Difficulty with solid foods.

  • Thumb sucking.

  • Hypersensitivity around lips and mouth.

  • Poor manual dexterity when speaking.

  • Hormonal imbalances.

The Asymmetrical Tonic Neck Reflex (ATNR) (birth to 6 months) is activated when a baby's head is turned to one side and the arm and leg on that side straighten, while the opposite arm and leg pull in. It should be fully present at birth and assists the baby’s active participation in the birthing process.

This connection between touch and vision helps establish distance perception and hand-eye coordination. (e.g. ATNR locks vision on to anything that catches the attention). If this reflex is retained after 6 months, symptoms can include:

  • Poor at sports.

  • Poor hand-eye coordination.

  • Poor distance perception.

  • Easily distracted.

  • Difficulty catching a ball.

  • Poor bilateral integration (integrated use of both sides of the body).

  • Poor balance and clumsiness.

  • Awkward pencil grip and poor handwriting.

  • Unable to cross the vertical midline (ex.: a right-handed child may find it difficult to write on the left side of the page).

  • Difficulty copying from a blackboard.

  • Discrepancy between oral and written performance.

  • Poor visual tracking (necessary for reading and writing).

  • Misses parts of a line when reading.

  • Difficulty establishing a dominant hand, eye, or ear.

  • In adults: chronic shoulder and/or neck problems.

The Spinal Galant Reflex (birth to 3-9 months) is activated when the skin along the side of a baby's back is stroked, causing them to swing towards the side that was stroked. It plays an active role in the birth process, with movements of the hip helping the baby to work its way down the birth canal.

Simultaneous stimulation down both sides of the spine activates a related reflex, which causes urination (e.g. the stimulation of bed sheets can activate this reflex). If this reflex is retained after 9 months, symptoms can include:

  • Bedwetting long after toilet training has been successfully completed.

  • Inability to sit still (the "ants in the pants" child who wriggles, squirms, and constantly changes body position).

  • Poor attention and concentration.

  • Difficulty coordinating normal walking gait.

  • Poor posture.

  • Can contribute to the development of scoliosis (curvature) of the spine.

  • Clumsiness while trying to manipulate objects.

  • Poor flexibility and mobility in physical activities or sports.

The Symmetrical Tonic Neck Reflex (STNR) (6-9 months to 9-11 months) is also known as the crawling reflex, and presents briefly after birth and then reappears at 6 to 9 months. This reflex helps the body divide at the midline to assist in crawling…as the head is brought towards chest, the arms bend and legs extend. If this reflex is retained after 11 months, symptoms can include:

  • Ability to crawl occurs later than normal.

  • Poor hand-eye coordination.

  • Poor muscle tone (especially of the spinal muscles).

  • Tendency to slump at a desk.

  • Poor posture.

  • An ape-like walking pattern.

  • Focusing requires more effort, particularly on things that are close up.

  • The eyes fatigue sooner than normal when focusing on near, then far objects.

  • Copying from the whiteboard may be slow and tedious, causing them to miss large portions of classroom information.

  • Poor organization and planning skills.

  • Inability to sit still.

  • Poor concentration.

The Landau Reflex (4-5 months to 9-11 months) assists with postural development (but since it is not present at birth, it is not technically considered a primitive reflex). Lack of stimulation in the pre-frontal cortex causing attention, organization and concentration problems. It is activated when a baby lifts his head, causing the entire trunk to flex. If this reflex is retained after 12 months, symptoms can include:

  • Poor short term memory.

  • Poor motor development.

  • Low muscle tone.

  • Poor posture.

  • Short-term memory difficulty.

  • Tension in the back of legs; toe walker.

  • Weak upper body.

  • Difficulty swimming the breaststroke.

  • Difficulty performing a somersault; knees buckle when the head tucks under.

The Tonic Labyrinthine Reflex (TLR) (enuetero to 4 months) is activated when a baby is placed on their back and their head is tilted backwards. This causes their legs to straighten and stiffen, their toes to point, their hands to become fisted and their elbows to bend. The TLR forms the foundation of the vestibular system (sense of balance and position in space) and helps prepare the baby for rolling over, creeping, crawling, standing, and walking. If this reflex is retained after 3.5 years, symptoms can include:

  • A "floppy" child.

  • Susceptible to motion sickness.

  • Difficulty judging space, distance, depth, and speed.

  • Poor self-orientation and spatial difficulties.

  • Visual problems.

  • Tendency to walk on toes.

  • Poor balance.

  • Difficulty coordinating movement.

  • Sports performance below capability.

  • Poor muscle tone.

  • Poor concentration.

  • Fatigue while reading or when working or studying at a desk.

  • Poor posture when working over a desk.

If your child is displaying any of these symptoms, please click here for more information.

Recommended Resource:

Brain Balance: I worked as a program director at the Brain Balance Center in Austin and have personally seen their program transform the lives of children (and their families). I have the highest regard for their organization and their results (BTW, I'm not a paid spokesman, just a fan of their work). You can also check out our additional resources here.

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