Primitive Reflexes

Primitive Reflexes

Primitive reflexes are automatic, involuntary movements essential to a baby’s survival in the first few weeks of life. These reflexes are quickly inhibited as higher centers of the brain develop and voluntary responses dominant. Primitive reflexes persisting beyond 6-12 months of life are considered abnormal.

Normal neural development shows a progressive inhibition of the primitive reflexes and progressive development of new skills such as gross motor skills, fine motor skills, crawling, walking, balance, coordination, and speech. Children who have a number of persistent primitive reflexes present with neuro-developmental disorders. The severity of the neuro-developmental delay depends upon the strength of the persistent primitive reflex and depending upon the number of persistent primitive reflexes, as well as other factors.

Below you will find common signs and symptoms associated with a persistent primitive reflex. The list is not exhaustive or complete, but is intended to offer some insight regarding the importance of primitive reflex testing and remediation.

The take home message on these reflexes is that they can be remediated and proper neural development can proceed once this neurological obstacle is overcome. This is part of the field of “Brain Based Therapies”.


The Moro Reflex emerges at 9 weeks in utero and is the earliest form of “fight or flight” (reaction to stress) which is fully present at birth and is usually inhibited between 2-4 months of life.

  1. Over reactive
  2. Hypersensitive
  3. Stimulus bound
  4. Difficulty with ball games


The Spinal Galant emerges at 20 weeks in utero, is actively present at birth and inhibited by 3-9 months. If fully retained, or only retained on one side may affect posture, gait and other forms of locomotion and is responsible for fidgeting, bedwetting, poor concentration and short-term memory, and hip rotation to one side when walking. When retained can interfere with the development of amphibian and segmental rolling reflexes.

  1. Inability to sit still or remain silent
  2. Poor concentration
  3. Continued bed wetting above the age of 5 yrs


Asymmetrical Tonic Neck Reflex (ATNR) emerges 18 weeks in utero to stimulate the balance mechanism and increase neural connections ATNR. It assists the birth process and is reinforced by the birth process. It is fully present at birth and develops eye-hand coordination, trains one side of the body at a time and extends ability to focus from 17 cm to arms length. It is inhibited about 6 months of life (so that focus on distant objects can develop). It ensures free passage of air when baby is in the prone position and increases extensor muscle tone.

  1. Handwriting: expression of ideas in written form
  2. Eye tracking problems; difficulty crossing the midline
  3. Ambilaterality or cross laterality


The Tonic Labyrinthine Reflex (TLR) (Forwards version) emerges in utero, is fully present at birth and is inhibited by 4 months and is closely linked to the Moro as both are vestibular in origin and activated by movement of the head. When retained it can lead to spatial problems, motion sickness, poor posture & muscle tone, visual perceptual difficulties, poor sequencing skills and a poor sense of time. The Tonic Labyrinthine Reflex (TLR) (Backwards version) emerges at birth and is inhibited gradually from 6 weeks to 3 years and is involved in the simultaneous development of postural reflexes, symmetrical tonic neck reflex and the Landau reflex can result in poor balance and coordination, organizational skills and stiff jerky movements if retained.

  1. Poor balance, rigid or floppy muscles (seen in PE or in running)
  2. Oculo-motor dysfunction, tracking, convergence, reestablishment of binocular vision
  3. Visual perceptual difficulties
  4. Possible auditory problems
  5. Organizational problems
  6. Poor sense of time and rhythm


The Symmetrical Tonic Neck Reflex (Flexion & Extension) emerges at about 6-9 months of life and is inhibited about 9-11 months. If retained affects posture, hand eye coordination and swimming skills. Also results in the tendency to slump when sitting at a desk, ape-like walk, “clumsy child” syndrome, difficulties with binocular vision, slowness at copying tasks and messy eating habits.

  1. Posture lies on desk when writing
  2. Poor eye hand coordination
  3. Problems with refocusing from far to near distance
  4. Clumsy