How Can Occupational Therapy help to Integrate Primitive Reflexes?

Primitive reflexes are the building blocks of human development. Present at birth, these automatic movements are essential for survival and early neurological development. However, when these reflexes persist beyond infancy, they can interfere with motor coordination, learning, behaviour, and emotional regulation.

Occupational Therapy (OT) plays a critical role in identifying and integrating retained primitive reflexes, especially in children presenting with sensory, motor, or developmental delays. In this blog post, we'll explore what primitive reflexes are, how they impact a child’s development, and how Occupational Therapists help support reflex integration through evidence-informed therapy.

What Are Primitive Reflexes?

Primitive reflexes are automatic, involuntary movement patterns originating in the brainstem. They emerge in utero or shortly after birth and are typically integrated (inhibited) by the time a child turns one.

Common primitive reflexes include:

• Moro Reflex (Startle Reflex) – In response to sudden stimuli.

• Asymmetrical Tonic Neck Reflex (ATNR) – Triggered by head turning, affecting limb positioning.

• Symmetrical Tonic Neck Reflex (STNR) – Involves head and arm/leg coordination.

• Tonic Labyrinthine Reflex (TLR) – Affects posture and balance based on head position.

• Palmar Grasp Reflex – Triggered by touching the palm.

• Spinal Galant Reflex – Stimulated by touch along the back.

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When these reflexes are not integrated as expected, they may interfere with the development of higher-level motor skills, attention, handwriting, reading, and behaviour.

Signs of Retained Primitive Reflexes

Some children with retained primitive reflexes may demonstrate:

• Poor posture or core strength

• Difficulty sitting still or focusing

• Delays in gross or fine motor development

• Poor coordination or balance

• Trouble with handwriting or pencil grip

• Sensory sensitivities or emotional dysregulation

• Challenges with reading or visual tracking

• Clumsiness or frequent tripping

  
  

Parents and educators often notice these concerns in early childhood or as school demands increase.

The Role of Occupational Therapy in Reflex Integration

Occupational Therapists are trained to assess developmental milestones and neuromotor patterns, including the presence of retained primitive reflexes. Therapy interventions are then customised to help facilitate the integration of these reflexes, allowing the child’s nervous system to progress toward more mature, voluntary movements.

1. Assessment and Screening

OTs use clinical observations and standardised screening tools to identify retained reflexes. Common assessments may include:

• Reflex-specific movement tests (e.g., ATNR test in quadruped)

• Gross and fine motor skill evaluations

• Postural control and balance tests

• Sensory processing and coordination assessments

  
  

2. Individualised Reflex Integration Programs

Once identified, the therapist creates a tailored intervention plan that includes specific exercises and movement patterns designed to replicate and integrate the reflex. Examples include:

• Moro Reflex: Starfish exercises to reduce startle response

• ATNR: Lizard crawl or arching patterns to promote cross-body movement

• STNR: Rocking on hands and knees, modified yoga poses

• TLR: Core stability and vestibular input activities

These activities are repeated regularly to encourage neural maturation and promote the brain-body connection.

3. Core Strength and Postural Control

Since many retained reflexes impact posture and stability, therapy often targets:

• Trunk and core strengthening

• Balance and bilateral coordination

• Proprioceptive and vestibular input (movement-based sensory systems)

Improving postural control helps reduce compensatory movements and supports motor planning.

4. Incorporating Reflex Work into Daily Routines

OTs guide parents and educators to incorporate therapeutic activities into home and classroom routines. Short daily exercises, such as crawling patterns or visual-motor tasks, can accelerate progress and promote consistency.

Why Early Intervention Matters

When primitive reflexes are retained, they can act like “neurological roadblocks,” making it harder for a child to access higher-level skills like reading, writing, or emotional regulation. Early intervention with Occupational Therapy can:

• Support improved academic performance

• Enhance attention and focus

• Promote confidence in gross and fine motor tasks

• Reduce behavioural outbursts and frustration

• Support sensory integration and emotional wellbeing

Is Reflex Integration Evidence-Based?

Research into primitive reflex integration is emerging. While not all methods are equally supported by large-scale studies, there is growing recognition that retained reflexes can impact function, and that movement-based therapy approaches, such as those used by OTs, show promise in promoting integration.

OTs use a developmental and functional approach, ensuring that therapy is evidence-informed, goal-focused, and tailored to the individual child.

Final Thoughts

If your child is struggling with coordination, focus, handwriting, or emotional regulation, retained primitive reflexes may be playing a role. An assessment with a qualified Paediatric Occupational Therapist can help uncover the root causes and provide a personalised therapy plan.

At Youth OT, we are passionate about helping children thrive by addressing the underlying factors that impact development. Our team uses a blend of play-based therapy, movement strategies, and parent education to support reflex integration and developmental success.

Book an Assessment

Want to learn more? Contact Youth OT to book an initial assessment with one of our experienced paediatric therapists.

📞 1300 704 734

🌐 www.youth-ot.health