PRIMITIVE REFLEX AND SURVIVAL REFLEX

What is Primitive Reflex ?

Primitive reflexes are completely developed at birth and are characterized by an innate movement that starts as early as 25–26 weeks of pregnancy and is mediated by the brainstem. If they persist over six months of age, it may lead to an immature behavioural style.

Primitive reflexes are replaced by voluntary motor activity when the central nervous system matures.(1)

What is reflex Integration?

The process by which a child's fundamental reflexes—automatic motions that start in the birth canal throughout the first few months of life—become more integrated or suppressed as they grow older is known as reflex integration. It’s about moving from automatic responses to intentional ones, allowing a child to navigate the world more efficiently.

What causes unintegrated reflexes?

Unintegrated, active childhood reflexes can be caused by:

• Lack of enough proper movement in early childhood:
• Stress of the mother during pregnancy, breech birth, birth trauma, Caesarean or exposure to sonograms.
• Environmental toxins and plastics; complications with vaccinations; exposure to electronic pollution.

Why are reflexes integration important?

Integrating reflexes is key for the ability to learn easily, manage our emotions and impulses, and meet life’s challenges with greater ease. Incomplete integration of childhood reflexes can be mild to severe, and contributes to anxiety; depression; ADD; ADHD; autism; learning disorders; developmental delay; sensory-integration disorders; vision and hearing problems; behavioral challenges; extreme shyness; lack of confidence; addiction; inefficient, effortful work and constantly feeling overwhelmed. Neurodevelopmental Movement helps children and adults complete the reflexes and transform challenges into strengths.

BY SONIA STORY

• Reflex movements are the first foundations of the nervous system.
• Unintegrated reflexes trigger the “fight or flight” response, creating chronic stress.
• When reflexes are active, body parts cannot easily move independently
• Active reflexes cause aches and muscle tension, weak muscle tone, fatigue and the need for great amounts of effort to complete tasks.

KEY CHILDHOOD REFLEXES AND CONSEQUENCES OF UNINTEGRATION

Fear Paralysis Reflex

• FPR emerges in the 5th to 8th week of womb life, and ideally is integrated before birth.
• FPR is most likely a protective mechanism in the face of danger and may help us learn to cope with stress.
• FPR is a “freezing” reaction similar to a deer caught in the headlights.
• here is tightening of the jaw and eye muscles; limb muscles contract and pull in toward the core. The breath is held, and there may be a significant drop in heart rate.
• Those who study reflexes do not always agree on what triggers FPR, but in general we can think of the FPR as a response to a perceived threat.
• If the FPR is not fully integrated at birth, it can cause lifelong challenges related to fear.
• There is an underlying anxiety preventing an individual from moving forward toward meaningful goals. When the Fear Paralysis Reflex is unintegrated it interferes with the integration of successive reflexes, especially the Moro Reflex.

Possible long-term effects of an active Fear Paralysis Reflex

• low tolerance to stress
• anxiety seemingly unrelated to reality
• hypersensitivity to touch, sound, specific frequencies of sound, changes in visual field.
• Dislike of change or surprise/poor adaptability
• Fatigue
• Elective mutism - the persistent failure to speak in specific situations where speaking is expected, despite the ability to speak otherwise
• Holding breath
• Fear of social embarrassment
• Insecure. Lack of trust in oneself.
• May become socially isolated and withdrawn.
• Overly clingy or may be unable to accept or demonstrate affection easily
• Fear of school
• Compulsive traits/OCD
• Negativism, defeatist attitude
• Won’t try new activities, especially where comparison occurs or excellence is expected
• Depression
• Temper tantrums
• Controlling or oppositional behavior, especially at home
• Immediate motor paralysis under stress - can’t think and move at the same time
• Reduced muscle tone
• Eating disorders
• Craves attention
• Aggressive behavior borne out of frustration and confusion
• Poor balance

ROOTING REFLEX

• Emergence: 24-28 weeks in utero
• Activity during birth: Fully present
• Integration: 3 to 4 months

The rooting reflex occurs when the corner of a baby’s mouth or cheek is touched, prompting them to turn their head towards the touch with an open mouth and extended tongue, ready to suck.

This reflex varies in strength — it’s weaker or disappears just after feeding and stronger when the baby is hungry.

Possible long-term effects of a rooting reflex

• hypersensitivity around the lips and mouth and their tongue may stay too far forward in the mouth, causing difficulty in managing solid foods.
• A child may still drool or have speech and articulation problems.

PALMAR REFLEX

• Emergence: 11 weeks in utero
• Activity during birth: Fully present
• Integration: 2 to 3 months

The palmar reflex is triggered by a light stroke or pressure on the palm. The infant responds by closing the hand and grasping.

This reflex should disappear over time to allow for the development of more refined hand movements, such as pinching small objects between the thumb and index finger, which is necessary for self-feeding tasks like picking up cereal.

Possible long-term effects of a palmar reflex

A persisting palmar reflex can lead to difficulties with manual dexterity by hindering independent movements of the thumb and fingers. As a result, a child might struggle to develop the pincer grip — essential for holding items between the fingers — which can affect tasks like pencil grip and handwriting.

Additionally, the child’s palm may become hypersensitive because it remains closed frequently.

MORO REFLEX

It is an involuntary response present in its complete form by 34th week (third trimester) and remains in incomplete form in premature birth.

It normally disappears after 3 or 4 months. This reflex is characterized by rapid abduction and extension of arms following which both arms come close together, accompanied by crying.

This reflex Demonstrated by pulling half-way to a sitting position from supine and suddenly letting the head fall back to a short distance. Also sudden movement of neck initiates this reflex.

Possible long-term effects of an active Moro reflex

• Sleep disturbances
• Easily triggered anger or emotional outbursts
• Poor self-esteem
• Poor balance and coordination
• constant hunger and weak immune system due to over production of stress hormones
• Poor digestion
• Asthma, allergies and infections
• Hypersensitivity to light, movement, sound, touch and smell
• Difficulties with vision, reading or writing
• Impulsive and/or unable to attend to tasks
• Difficulty with visual perception
• Easily fatigued

Tonic labyrinthine reflex (TLR):

The Tonic Labyrinthine Reflex (TLR) reflex observed in utero and following birth is activated with movement of the head.

Head flexion causes flexion of the arms and legs or extension of the head causes extension of the arms and legs.

These movements directly impact muscle tone of the arms, legs, neck, and trunk. TLR is important for head management and postural stability.

The TLR reflex is typically integrated at 3-4 months old.

Possible long-term effects of an active tonic labyrinthine reflex

• Spatial problems
• Motion sickness
• Poor posture
• Easily fatigued
• Muscle tone too weak or too tight
• fear of heights
• ‘W’ leg position when floor sitting
• Tendency to be cross eyed
• stiff, jerky movement
• Toe walking
• Difficulty following directional or movement instructions.

ATNR Reflex

The Asymmetrical Tonic Neck Reflex (ATNR) observed following birth divides the body into left and right sides.

It is important in developing cross pattern movements.

The ATNR reflex is activated with movement of the head. When the head is turned to one side of the body, the arms and legs on that side will extend and then the arms and legs on the opposite side will flex.

The ATNR reflex typically integrates at 4-6 months old.

Possible long-term effects of an active asymmetrical tonic neck reflex

• Dyslexia
• Difficulty with reading or hand writing
• Poor sense of direction
• Confused handedness
• focus and balance difficulties
• Difficulty crossing midline

STNR

The Symmetrical Tonic Neck Reflex (STNR) reflex divides the body into top and bottom portions.

The onset of this reflex is around The STNR reflex is around 6-9 months and helps prepare babies to crawl. It is activated with movement of the head.

Flexion of the head causes flexion of arms and extension of legs while extension of head causes extension of arms and flexion of legs.

The STNR reflex is typically integrated at 9-12 months.

Possible long-term effects of an active symmetrical tonic neck reflex

• poor posture
• Poor eye-hand coordination
• Difficulty recognizing social cues
• Difficulty with writing and reading
• Poor depth perception
• Frequent fidgeting
• Challenges with memorization
• Messy eating

Spinal Galant Reflex

The Spinal Galant reflex is present in utero and during birth.

It assists with the birthing process and later on, crawling and creeping.

This reflex is activated with when a stimuli is applied to the lower back. Applying a stroke of deep pressure down one side of a child's spine will cause a hip twitch on the same side.

The Spinal Galant reflex is typically integrated at 3-9 months old.

Possible long-term effects of an active Spinal galant reflex

• Bedwetting or poor bladder control
• Hip rotation to one side
• Poor posture
• Fatigue
• Poor concentration
• Poor short-term memory
• Irritable Bowel syndrome

REFERENCES

1. Jaiswal M, Morankar R. Understanding Primitive Reflexes and Their Role In Growth And Development: A Review. Int Healthcare Res J 2017;1(8):243-247.
2. Reflex Integration in Children -yourtherapysource.com/blog1/2024/08/14/reflex-integration-in-children
3. The Importance of Integrating Reflexes by Sonia Story
4. Reflex Integration Activities for Occupational Therapy Created by Emma Stumm, OTS
5. Primitive Reflex Integration: A Comprehensive Guide for Parents and Practitioners from an OT expert