Primitive Reflexes Integration
Primitive Reflexes Most Commonly Addressed
This a short list of common reflexes that we work to remediate during early stages of care and how to integrate them!
Primitive reflexes work on a specific time clock and should come online and go away at certain times during development. The persistence of these reflexes past their specific time can cause developmental issues as the child grows, even into adulthood. Working to rid a persistent reflex is all about frequency; the more you can work the reflex, the better outcomes and the faster you will see changes.
Working reflexes – Primitive reflexes are automated responses that occur to help a child thrive at a young age because we are only born with about 20-25% of our total adult brains. These can all be activated with specific stimuli if they are still present. As a reflex is checked, it will gradually get stronger and stronger and then will suddenly stop (runs on a bell-curve). Getting a reflex to the point that it goes away is the end goal, but may not be possible early in care.
DISCLAIMER ; This page is not meant to diagnose or treat any type of conditions. It is only available to help parents that are going through our program or help connect some dots for parents that are looking for help. Many conditions that are common with persistent primitive reflexes have a variety of other causations besides primitive reflexes.
Tonic Labyrinthine Reflex (TLR)
- Tonic Labyrinthine Reflex (TLR): This reflex has a lot to do with development of our vestibular system or balance centers in the inner ear and brain (should be gone 3-3.5 years of age).
- What this reflex looks like: Poor balance and coordination throughout the reflex exercise. excessive swaying forward/backward or side to side.
- Common issues if persistent: Poor muscle tone, toe walking, poor balance, motion sickness, body orientation issues, and other movement issues
- Remediation: This can be done either by eliciting the reflex (as shown above). With eyes closed move the child’s head into different positions OR an exercise called “Rolly Polly’s.”
Rolly Polly’s – Begin in a seated cannonball position, with chin tucked to the chest. Roll backward with chin tucked to the chest and then roll back to seated allowing the head to fall back as the body rolls forward. With younger kids the head motion can be difficult, just the movement back and forth is still beneficial.
Asymmetric Tonic Neck Reflex (ATNR)
- Asymmetric Tonic Neck Reflex (ATNR): This is an important reflex during the birthing process, as well as development of hand eye coordination, and crawling patterns (should be gone by 6 months).
- What this reflex looks like: This reflex is best tested on hands and knees. As the head is rotated to one side the opposite arm bends at the elbow. Test each side 5-10 times, reflex will become more apparent with multiple repetitions if present.
- Common Issues if persistent: Difficulty in hand-eye coordination, handwriting, crossing midline, and visual tracking skills
- Remediation: Work the reflex by turning the head passively for the person when they are on hands and knees OR Lizard exercise (or variations).
Lizard exercise is fun but can be difficult initially. As the head turns one way the same arm/leg extends/lengthen and the opposite ones flex/bend, this simulates the reflex. The patient alternates between these two variations and we recommend most patients use a metronome app during this exercise to help coordinate the motion.
Symmetric Tonic Neck Reflex (STNR)
- Symmetric Tonic Neck Reflex (STNR): This reflex helps in a number of developmental body movements. This reflex comes online at 6-9 months of age and is important in crawling and learning to stand (Should be gone 9-11 months of age).
- What this reflex looks like; Also best checked on hands and knees. Look all the way to the ceiling, and then all the way through legs. As heads look down both arms will bend, and legs will extend (butt pops up in the air). This is best checked passively or with someone helping through the motion (like shown in pictures).
- Common Issues if persistent; Tendency to slump while sitting, poor muscle tone, inability to sit still and concentrate, poor hand-eye coordination, and w-sitting.
- Remediation; A great way to elicit this reflex is using the yoga move cat-cows, or just stimulating the reflex someone can assist.
Fear Paralysis Reflex
- Fear Paralysis Reflex: This is a very early protective response that comes online around weeks 5-8 in utero, and is commonly persistent in premature infants, and can potentially be dangerous if not integrated (This reflex should be gone by birth).
- What this reflex looks like: This reflex is a freeze response similar to a deer in headlights that occurs with loud sounds or sudden stimulus.
- Common Issues if persistent: Anxiety, poor self-esteem, embarrassment, phobias, or other abnormal psychological conditions.
- Remediation: This exercise is more difficult to get rid of because it can be potentially dangerous to elicit due to the rapid drop in heart rate, and blood pressure. We do not recommend parents check for this one. At home, work is individualized if persistent, for each kid.
- Morrow Reflex: This is the reflex that comes online for protection once fear paralysis leaves. This is another type of startle response that is important early on for the protection of the child (Should be gone 2-4 months of age).
- What this reflex looks like: Sudden startle response with a loud noise, causing jump and increased heart rate. We all have some kind of startle response to an extent. This is an abnormally large response, that happens multiple times in a row (like clapping behind the head).
- Common Issues if persistent: Hypersensitivity, hyperactivity, anxiety, poor impulse control, sensory overload, social and emotional immaturity.
- Remediation: Specialized care and stimulation specifically for the child. OR starfish exercises.
This exercise begins just like the rolly polly one. Instead of rolling backward legs should extend out and arms open up on either side slowly coming back and then closing into a ball once more.
- Rooting reflex: This reflex is important at birth to help the baby latch onto mom during breastfeeding, or just to turn towards food in general. (Should be gone 3-4 months of age).
- What this reflex looks like: Small twitches or head turns while the skin around the mouth is touched with a soft object (paintbrush is what we use).
- Common Issues if persistent: Picky eating, thumb sucking, speech, and articulation problems.
- Remediation: Sensory stimulus around the lips, usually brushing like shown in the picture. Should brush all the way around the lips, and are looking for small twitches in the muscles around the mouth.
Palmar Grasp Reflex
- Palmer grasp Reflex: Just like the name suggests, this reflex is important in learning to grab a hold of objects from a young age (Should be gone 5-6 months of age).
- What this reflex looks like: The hand closes when something is placed into the palm.
- Common Issues if persistent: Poor fine motor skills, poor manual dexterity, poor handwriting skills.
- Remediation: Stimulus to the palm of the hand. Usually around the base of the thumb, but can go across the palm as well. Once again looking for small twitches, or sometimes the reflex can be so strong it’ll totally close the hand.
Babinski’s Reflex (Plantar Reflex)
- Babinski’s Reflex: An abnormal response of the foot, and a common reflex to persist.
- What this reflex looks like: As you stroke the outside of the foot from the heel to toe, all the toes will extend up, instead of curling down.
- Common Issues if persistent: Toe walking, issues walking, balance problems.
- Remediation: Stimulate the reflex by stroking the bottom of the foot to the point that the toes begin to curl down instead of extending up.
Spinal Galant Reflex
- Spinal Gallant Reflex: This reflex is largely for the birthing process, helping the child slide through the birth canal more easily (Should be gone 4-9 months).
- What this reflex looks like: As you stroke down either side of the spine from head to toe, the child will curve into the movement.
- Common Issues if persistent: One side or both side posture issues, fidgeting, bed wetting, clothing issues, poor concentration, and poor short term memory.
- Remediation: Activate the reflex by stroking down the spine, caterpillar exercises, OR snow angel exercise.
Snow angel exercise is just like it sounds the child performs a snow angel. Preferably we have parents try and get the child to do this exercise on the carpet with as much skin exposed as possible to increase the stimulation to the back.