Primitive Reflexes and Reflex Integration
What are primitive reflexes?
Primitive reflexes are involuntary movements or responses that are present in infants, usually in the early stages of development. These reflexes are controlled by the brainstem and spinal cord, and they are essential for survival and development in the first few months of life. These reflexes help infants adapt to their environment and ensure that their basic motor functions needed for survival are working properly. As a child grows, these reflexes should integrate into more voluntary motor control and disappear, usually by 6 months to a year, although some may persist longer in certain situations. If primitive reflexes persist beyond the typical time frame, it can be indicative of developmental delays or neurological concerns.
When primitive reflexes persist beyond the expected age (usually beyond 1 year), it can be a sign that the nervous system has not fully matured or that there may be neurological or developmental concerns. These reflexes are meant to be integrated into voluntary, controlled movements as the brain and body develop, so if they remain active, they can interfere with normal motor development, coordination, and even behavior.
What happens when primitive reflexes remain active past 1 year of age?
Here are some potential impacts of retained primitive reflexes:
Motor Coordination Issues: Persistent reflexes can disrupt the development of more complex motor skills like walking, running, and fine motor skills (such as writing or using utensils). Children might struggle with balance, coordination, and muscle control.
Speech and Language Delays: Reflexes like the sucking and rooting reflexes are tied to feeding, and their persistence could indicate delays in speech development as well. Children with retained reflexes may experience difficulties with articulation, expressive language, or overall communication.
Learning and Attention Challenges: Retained reflexes can lead to issues with focus and attention, particularly in academic settings. For example, a child may have difficulty sitting still, focusing on tasks, or following instructions.
Postural Problems: Retained primitive reflexes may cause postural instability or difficulties with body awareness. This can lead to challenges in maintaining proper posture, affecting balance and the ability to sit properly or walk confidently.
Social and Emotional Concerns: Persistent primitive reflexes can also impact social interactions and emotional regulation. Children might struggle with emotional control, be more easily overwhelmed by new situations, or show signs of frustration due to difficulties in tasks that come naturally to other children. Specifically, the Moro reflex (startle reflex) might cause problems with emotional regulation and heightened sensitivity to stimuli, leading to anxiety or difficulty concentrating.
Sensory Processing Issues: Reflexes can also affect sensory integration, leading to either hypersensitivity (overreacting to sensory input) or hyposensitivity (underreacting to sensory input). Children may show unusual responses to sounds, textures, or visual stimuli.
What does reflex integration look like in occupational and physical therapy sessions?
Occupational and physical therapists develop activities and exercises that focus on the specific reflexes that need integration. The goal is to help the child gain voluntary control over movements that were once automatic.
These activities might include:
Movement-based Exercises: These activities require the child to move in specific ways to activate and integrate reflex patterns. For example, helping a child practice coordinated movements like rolling, crawling, or other movements aimed to target specific reflex patterns.
Balance and Coordination Activities: Activities that challenge the child’s balance and coordination can help integrate reflexes that impact posture and motor control. Examples include standing on one leg, walking across stepping stones, or performing tasks that require hand-eye coordination, such as tossing and catching a ball.
Fine Motor Activities: For reflexes that interfere with hand movements (like the palmar grasp reflex), the therapist might introduce activities such as squeezing tongs, cutting with scissors, or using tools, such as theraputty, to improve fine motor skills and finger dexterity.
Regulation/Calming Strategies:
Certain reflexes such as the Moro Reflex, may cause over-sensitivity to stimuli and an exaggerated startle response. To help integrate this reflex, therapists may teach regulation/calming strategies such as deep breathing exercises, rhythmic movement, or other methods to help the child regulate their nervous system in response to stressful stimuli.
