How Primitive Reflexes Impact Occupational Performance

Have you ever seen your child gasp when surprised or quickly pull their hand away from something hot? These are reflexes, automatic responses the body makes to sensory input. Reflexes are more than just reactions; they play a key role in your child’s development, affecting how they move, learn, and grow. In this blog, we’ll help you understand what reflexes are, how they influence your child’s everyday activities, and simple ways you can support healthy reflex integration through play. 

What Are Primitive Reflexes? 

Reflexes are automatic actions the body makes in response to sensory input, like blinking when something comes close to your eyes. They help regulate important body functions such as breathing, heart rate, and blood pressure. Reflexes also protect us in situations that are painful or threatening, triggering responses like “fight or flight.” In babies, primitive reflexes are especially important; they help with early survival tasks like moving through the birth canal or latching onto a bottle. These early reflexes form the foundation for a child’s nervous system, which helps the brain process information from the senses. As children grow, reflexes don’t fully disappear; rather, they are inhibited and move into the background to allow for voluntary, purposeful movement. Under stress and fatigue, they can re-emerge and be helpful for survival or success.  

How Do Primitive Reflexes Impact Performance? 

Moro Reflex 

The Moro reflex is present at birth and is often called the ‘startle reflex.’ This reflex initiates a response when we feel danger through movement, sound, or vision. An impacted Moro may cause sensory defensiveness, sound sensitivity, or movement sensitivity. 

If the Moro reflex is impacted, you might notice your child: 

• Appears to always be in “fight or flight” 

• Has frequent emotional outbursts or anxiety 

• Difficulty with transitions, changes, or surprises 

• Is overly sensitive to loud sounds or bright lights 

• Has trouble with eye tracking and visual focus 

• Appears uncoordinated or tires easily 

• Has food sensitivities or strong texture preferences 

Asymmetrical Tonic Neck Reflex 

The ATNR reflex coordinates the extension of an arm and a leg in response to the head being turned. This reflex is responsible for all the kicks and wiggles you feel in your belly while growing your child! It helps with early movement and making sure the airway is open during tummy time. It is also one of the first eye-hand coordination movements as it ensures the baby’s appropriate arm is being used to grasp an object they are looking at. 

If the ATNR is impacted, you might notice your child: 

• Struggle to cross the midline of their body 

• Trouble with eye-hand coordination 

• Seems clumsy or awkward during sports 

• Have trouble with handwriting or fine motor tasks 

• Reverse letters or numbers when writing 

• Have poor eye tracking or trouble focusing from near to far 

Symmetrical Tonic Neck Reflex 

The STNR reflex assists with balance, muscle tone, and developing antigravity control. It helps a baby learn to crawl, pull themselves to stand, and develop visual perceptual skills. Kids whose STNR is impacted may skip crawling or butt scoot instead. 

If the STNR is impacted, you might notice your child: 

• Poor posture and balance 

• W-sitting (legs out to the side in a “W” shape) 

• Trouble with crawling or skipped crawling 

• Messy eating habits 

• Struggles with eye tracking or shifting focus 

• Poor depth perception 

• Difficulty swimming 

Tonic Labyrinthine Reflex 

The TLR reflex helps develop head and neck control. The TLR prepares the body for rolling over, crawling, and eventually standing and walking. 

If the TLR is impacted, you might notice your child: 

• Poor balance and coordination 

• Weak head control and poor posture 

• Fearful or sensitive to movement 

• Stiff or jerky movements 

• Toe-walking or W-sitting 

• Poor eye-hand coordination 

• Trouble processing vision and auditory input 

• Lacking a sense of direction and spatial awareness 

Spinal Galant 

The Spinal Galant reflex is fully developed at birth and helps the baby get down the birth canal. It supports early movement and coordination, especially in the hips, to prepare for crawling and walking. It also contributes to balance and the development of the middle ear. 

If the spinal galant is impacted, you might notice your child: 

• Be constantly wiggling or unable to sit still 

• Avoids leaning back against a chair 

• Difficulty with attention, focus, and concentration  

• Bed wetting beyond the age of 5 

• Skin sensitivities 

• Difficulty with fine motor coordination 

How Can I Work on Primitive Reflexes? 

As occupational therapists, we take a whole-child approach, considering how reflexes might be affecting your child’s ability to engage in play, school, or everyday activities. When addressing primitive reflexes, using a play-based approach that supports your child’s functional skills is key. Here are a few examples of how this might look: 

• Using coping strategies to help manage the Moro reflex, especially during moments of “fight or flight.” 

• Practicing swinging a bat to support the integration of the ATNR reflex, which can improve coordination for sports and physical play. 

• Engaging in crawling activities to support the STNR reflex, which can enhance mobility and body coordination. 

It’s completely normal for infants to rely on these reflexes early on, but they should fade as your child grows. If you’re noticing persistent reflex patterns or challenges, it’s a good idea to talk with your pediatrician or connect with an occupational therapist who specializes in child development. 

We hope you find this post helpful. Click HERE for more resources.

Have a question for us or a topic you want to learn more about? Send us a message HERE or leave a comment!