When you hear the word reflex, you may picture your doctor using the little hammer to hit your knee. Yes, the doctor is testing your knee reflex but that is a different topic than that of the primitive reflex. We are all born with primitive reflexes and each serve a purpose. Primitive reflexes assist in development from the birthing process through the early stages of life. After these reflexes have “served” their purpose, they are re-integrated into our systems as the body matures with improved movement patterns, strength, and coordination.
If primitive reflexes are slow to re-integrate or are retained, your child may demonstrate various characteristics depending on the reflex present such as difficulty with balance, coordination, focusing, fine motor coordination, and bed wetting, to name a few. Though your child may demonstrate some of these characteristics, it is not to say that primitive reflexes are the primary cause, but they can be contributors. Let’s break down six common reflexes and how they may affect your child.
Asymmetrical Tonic Neck Reflex (ATNR)
What is it? Also known as the “fencer’s” reflex because of the baby’s positioning. When triggered, it resembles that of a fencing stance. When the baby’s head is turned to one side, the arm and leg on the side to which the head is turned will extend straight out, while the opposite arm and leg are pulled in.
When is it present? The ATNR is present at birth and typically integrates around 6 months.
What is it’s purpose? The ATNR assists the baby during the birthing process for successful navigation through the birthing canal. It can help decrease the chances of a breech birth. Post birth, it helps develop muscle tone, provides vestibular stimulation, develops balance, initiates eye-hand activities, and helps initiate rolling.
What if the ATNR is retained? There may be a delay in motor milestones, delayed eye-hand skills, poor midline development and crossing of the midline (right side crossing the midpoint of the body to the left side & vise versa), and difficulty sharing information between right and left hemispheres. There can be difficulties with auditory processing and visual perceptual skills. There may be a discrepancy between oral and written performance. Poor organization and handwriting may be seen, along with difficulty copying from the board, or missing parts of the line when reading. Other characteristics may be difficulty catching balls, decreased balance, and being poor at sports.
MORO Reflex
What is it? Also known as the “startle” reflex which can be set off by excessive information in any of the baby’s senses. This can be demonstrated by both arms extending upwards with hands opened, having a short freeze, then slowly returning to a position with hands clasped in front of the body, and crying.
When is it present? The MORO reflex is present at birth and should integrate by 4 months.
What is it’s purpose? It’s an involuntary reaction to a threat and the earliest form of the fight or flight response. The MORO reflex allows the adrenal glands to avoid being constantly turned on resulting in adrenal fatigue and causing asthma, allergies, and chronic illness.
What if the MORO reflex is retained? There may be over sensitive and overreactive responses to sensory stimuli resulting in poor impulse control and sensory overload. Anxiety and social immaturity may be seen along with mood swings, hyperactivity, difficulty adapting to change and difficulty with new or stimulating experiences. Other characteristics may be poor balance and coordination, motion sickness, and sensitivities to foods.
Symmetrical Tonic Neck Reflex (STNR)
What is it? The STNR helps the body divide in half at the midline to assist in crawling. As the head is brought toward the chest, the arms bend and legs extend. When the head is tilted back, the arms extend and the legs bend.
When is it present? The STNR emerges between 6-9 months and typically integrates by 11-12 months.
What is it’s purpose? The STNR allows the child to assume the quadruped position or hands and knees position. It allows dissociation between upper and lower extremities. The STNR integrates as the child begins to crawl and when rocking back and forth on hands and knees.
What if the STNR is retained? Some characteristics may be “W” sitting which can inhibit reflex integration, poor posture and balance, bunny hopping instead of crawling, and difficulty sitting still. A child may be clumsy, have hand in their pockets, have a tendency to slump when sitting, and have behavior problems. There may be poor eye-hand coordination, difficulty with copying, difficulty sitting for fine motor activities, and may have a tendency to be far sighted.
Tonic Labyrinthine Reflex (TLR)
What is it? The TLR is the basis for head management and helps prepare an infant for rolling over, creeping, crawling, standing, and walking. Essentially, when the infant’s head is tilted back, the legs and arms extend with straightened legs and arched back. When the head is tilted forward, the body responds in a “flexing/curling” motion, with arms and legs tucked in.
When is it present? The TLR is present prenatally and integrates around 1 year, but can take up to 3 years.
What is it’s purpose? The TLR provides the baby with the means of learning about gravity and mastering head and neck control outside the womb. It is important for giving the baby the opportunity to practice balance, increase muscle tone, and to develop the proprioceptive and balance senses. The TLR interacts with other reflexes to help the infant to start developing coordination, posture and correct head alignment.
What if the TLR is retained? There may be poor balance, motion sickness, orientation and spatial difficulties, visual processing issues, and poor posture. A child may have difficulty judging space/distance/depth/speed, and demonstrate a lower ability performing sports activities. They may have poor muscle tone, and may walk on toes.
Spinal Galant Reflex
What is it? The Spinal Galant Reflex happens when the skin along the side of an infant’s back is stroked. If the right aspect is stroked, the result is side flexion or bending of the lumbar spine away from the input, with the hip rising on the side of the input, & vise versa when the left aspect of the back is stroked.
When is it present? The Galant reflex is present at birth and usually integrates from 3-9 months.
What is it’s purpose? The Galant reflex helps with the birthing process with movements of the hip to help the baby work its way through the birth canal.
What if the Spinal Galant reflex is retained? A child may demonstrate bed wetting, clumsiness, poor concentration and short term memory. They may have hip rotation to one side when walking. They may avoid stimulation to their lumbar (low back) region. They may have difficulty sitting still. It can contribute to developing scoliosis and may affect fluency and mobility in physical activities and sports.
Palmar Reflex
What is it? When the surface of the palm is stroked, the fingers (excluding the thumb) flex/close toward the palm, attempting to clasp whatever object may be causing the stimulation.
When is it present? The Palmar reflex develops in the womb and is present at birth. It usually integrates around 5-6 months.
What is it’s purpose? It helps to develop fine motor skills and sensory input. It also helps to enhance stereognosis, which is the ability to recognize objects by touch.
What if the Palmar reflex is retained? A child may have poor fine motor skills, manual dexterity, poor handwriting and pencil grasp. When having to perform finger movements/activities, they may avoid and slump down in their chair. They may have difficulty processing ideas onto paper. They may stick out their tongue when writing or performing other fine motor tasks.
Primitive reflexes are good and they serve an important purpose, but if they are not retained back into their systems, a child may demonstrate characteristics that may bring added difficulties. Again, retained primitive reflexes are not always the primary cause of issues, but can be contributors to characteristics seen. If you have concerns regarding retained primitive reflexes in your child, reach out to your Pediatrician and/or local Occupational Therapist. Be on the lookout for exercises that may help with primitive reflex reintegration.
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