Primitive Reflexes: An Introduction by Helen Hawes

Reading Time: 6 minutes

Primitive Reflexes

An Introduction


What are primitive reflexes?

We are all born with primitive reflexes.  They are a baby’s first response for basic human survival.  These should gradually become ‘integrated’ in sequential order, typically within the first year, making way for postural reflexes.  These are more mature patterns of response controlling balance, coordination, and sensory motor development, all of which play a huge role in achieving optimal functioning.  When reflexes fail to integrate, they are said to be retained.

The brain is divided into upper and lower sections, with each part having different functions.  Retained reflexes inhibit the development of new neural pathways and connections between the different areas of the brain affecting how the child functions daily.  The impact of this is dependent upon the severity of retention as reflexes can be fully or partially retained.

Our reflexes are a key indicator of the structure and function of the brain and failure to integrate suggests a delay in maturity of the central nervous system, often referred to as neurological dysfunction or neurodevelopmental delay, linked directly to our vestibular, proprioceptive and postural systems.  These should work in sync to enable individuals to perform every day tasks effectively.  When there are gaps in the neurological foundation, children will fail to achieve their full potential as they face difficulties resulting from several/many of the following ‘symptoms’ depending on the number of, and severity of those retained reflexes:


  • Handwriting that is messy, unclear, poorly spaced, uneven in size
  • Difficulty reading, poor visual tracking, misses letters/words, dyslexia, dysgraphia, dyscalculia
  • Delays in speech, poor pronunciation
  • Difficulty sitting still at a desk
  • Poor short term memory
  • Difficulty in comprehending verbal instructions
  • Difficulty copying from the board


  • Poor emotional regulation, frequent meltdowns and/or tantrums
  • Hyperactive/hypoactive
  • Shy/timid
  • Poor attention, focus and concentration
  • Picky eaters

Motor skills

  • Poor balance
  • Poor coordination, struggles to catch a ball, ride a bike, kick a football
  • ‘Clumsy’, bumps into things, trips, falls, knocks drinks over
  • Difficulty performing movement skills e.g. jumping, hopping, climbing, skipping, leaping, running
  • Poor fine motor skills typical for their age e.g. difficulty handling small items, threading laces, poor pencil grip
  • ‘W’ sitting, poor posture
  • Toe walking
  • Reluctant to join in challenging physical activity


  • Hypersensitive to sensory input, sensory overload, easily distracted
  • Hyposensitive to sensory input, under responsive to pain & temperature
  • Issues with clothing, seams on socks/tights, dislike of tags, belts, waistbands
  • Hypersensitive to touch, very ticklish
  • Often in fight or flight mode, emotional, fears/phobias

Why are primitive reflexes retained?

Primitive reflexes sometimes fail to integrate when the brain and body go into survival mode, usually after damage to the higher brain centres takes place.  This can happen because of perceived trauma or injury such as a difficult birth, c-section delivery, a fall or chronic ear infection.

Babies and young children now spend longer than ever in car seats, baby rockers and walkers, they sleep on their backs and spend less time on their tummies.  This inhibits development of key muscle groups affecting the physical skills needed to support learning, behaviour and emotional regulation.


What happens when primitive reflexes are retained?

When primitive reflexes don’t integrate, they are said to be ‘retained’ and can cause a whole wealth of difficulties for the child from failing to hit developmental milestones such as crawling and walking to struggles with academic learning and emotional regulation.  Retained primitive reflexes can have a detrimental impact on our immune system, sleep, energy levels, emotional regulation, impulse control, concentration, balance, coordination, and sensory perceptions.

When primitive reflexes are retained, we see an effect on developmental progress resulting in lack of inhibition, poor muscle tone, delays in postural control and delayed motor development, often leading to learning delays or difficulties with day-to-day tasks.


“Without training in primitive reflex integration, uncoordinated children may never

reach the motor skills level of their peers.”



Many of the symptoms of retained primitive reflexes overlap with those of ADHD and so often can be mistaken, but in most cases of ADHD, there is usually at least one retained primitive reflex.  This is also true for other conditions such as autism and sensory processing disorders.

The diagram below shows the reflexes which are most likely to become retained and highlights how it impacts on a child’s development and behaviour.

Primitive Reflex Purpose of reflex Appears Should integrate by Signs of retention
Fear Paralysis Reflex Physical paralysis to perceived danger In the womb At birth Sensitivity to sensory information, clumsiness, balance issues, difficulty with visual perception, low stress tolerance, may ‘freeze’ in difficult situations, anxiety, possible panic disorders, dislike of eye contact, shyness, difficulty expressing verbal language
Moro Reflex Primitive fight or flight reaction (works with fear paralysis reflex so in many cases, often both are retained) Birth 2 to 4 months Hypersensitive to light & sound, hyper reactivity, poor impulse control, may show signs of aggression, sensory overload, social & emotional immaturity, physically timid, poor muscle tone & stamina.  Visual tracking & perception issues, chronic illness.
Rooting Reflex Automatic response to turn towards the breast Birth 3 to 4 months Fussy eating, thumb sucking, dribbling, speech and articulation problems, hypersensitive around mouth & to textures of food
Palmer Reflex Automatic flexing of fingers to grab Birth 5 to 6 months Difficulty with fine motor skills, poor manual dexterity, messy handwriting, poor visual coordination.  Speech & language difficulties. May stick tongue out when performing difficult tasks.  May show aggression.
ATNR To assist baby through birth canal and develop cross pattern movements Birth 6 months Poor hand eye coordination, struggle with sports, difficulty with handwriting, trouble crossing vertical midline, poor visual tracking for reading and writing.  May not have established a dominant hand, may switch hands when writing.  Can’t think & write at the same time.  Difficulty with visual tracking & shifting focus resulting in problems when copying from a board
Spinal Gallant Reflex Assist baby with birth process Birth 3 to 9 months Unilateral or bilateral postural issues, fidgeting, inability to sit still, often mistaken for ADHD.  Dislikes back against chair, hypersensitive to touch so may dislike clothes & tags, bed wetting, poor concentration, poor short-term memory.  May struggle with fine motor control. Difficulty with focus and comprehending verbal instructions
TLR Basis for head management and postural stability using major muscle groups In utero 3 ½ years Poor muscle tone, tendency to walk on toes, ‘W’ sits, poor posture & head control, jerky movements, poor balance, motion sickness, spatial perception issues & lack of sense of direction, poor hand eye coordination, difficulties with visual perception & tracking.  Difficulties with auditory processing. Disorganised, poor short-term memory, emotional and behavioural difficulties
Landau Reflex Assist with posture development 4 to 5 months 1 year Poor motor development, poor posture, low muscle tone, difficulty with short term memory, weak upper body, difficulty with focus & attention. May walk on toes
STNR Preparation for crawling 6 to 9 months 9 to 11 months Tendency to slump while sitting, poor muscle tone, tendency to wrap legs around chair, ‘W’ sits, inability to sit still and concentrate, poor balance. Visual difficulties with binocular vision, perception, tracking & switching focus. Poor spatial awareness, problems with spacing and lining columns in maths. Similar characteristics to ADHD & ADD


*The above content is taken from the following sources:

What can be done to help a child with retained primitive reflexes?


Children will not ‘grow out of’ retained primitive reflexes.  Without the right interventions, children will continue to experience a disconnect in neural pathways and subsequent challenges on a daily basis.

With the right testing, it is possible to establish if a child has any delay in the reflexes maturing and becoming embedded.  Only then can the appropriate interventions be put in place to support the child’s development, helping them to develop and integrate other systems to support higher learning and complete everyday tasks more efficiently.

This is achieved through participation in specific exercises over a period of weeks or months, depending on whether the reflex is fully or partially retained and how many reflexes are being addressed.

If you think your child may show signs of having one or more retained primitive reflexes, consult with your local healthcare provider who should be able to refer you to an occupational therapist for relevant advice and support.



Sporty Futures is a trading name of School PPA Cover Ltd.  School PPA Cover Ltd is not a health care provider and therefore can not diagnose or treat a specific condition or learning delay.    If you seek professional support for your child, please contact a relevant, qualified professional who can begin with a diagnosis.


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