Retained Primitive Reflexes: Could they be impacting your child's development?

You know those special moments when your baby wraps their teeny fingers around your thumb? Or the cute fencing position your baby gets into when they turn their head to the side? Those are 2 of the many primitive reflexes (palmar and asymmetric tonic neck reflex) your baby is born with. These reflexes typically disappear on their own, but sometimes they don't, and development can get hung up.

Reflexes are stereotyped, or automatic, responses to sensory stimuli, like a touch to the palm or turning of the head. They appear in infancy, and most of them integrate by age 1.

Some of the main primitive reflexes include:

• Moro ("startle"): Earliest of the reflexes to emerge, and forms a cornerstone for life. Characterized by rapid inhalation and sudden movement of the arms upward, followed by a cry. It is an involuntary reaction to threat. It is typically replaced by the adult startle reflex by four months of age.
• Palmar: Emerges at 11 weeks in utero, characterized by involuntary grasp with light touch to the palm. Reflex fades away as refined finger control and ability to release develop, around 6 months old.
• ​Rooting/sucking: The rooting reflex assists in the act of breastfeeding and is activated by stroking a baby’s cheek, causing her to turn and open her mouth. It should integrate by 4 months of age.
• Tonic Labyrinthine Reflex (TLR): This reflex is the basis for head management and helps prepare an infant for rolling over, creeping, crawling, standing and walking. It is characterized by the legs stiffening, straightening, and the toes pointing when tilting an infant’s head backwards while placed on the back. The hands also become fisted and the elbows bend. It should integrate gradually as other systems mature and disappear by 3 1/2 years old.
• Asymmetrical Tonic Neck Reflex (ATNR): Links turning of the head to one side with extension of the arm and leg on that side, and flexion of the limbs on the opposite side. This reflex ensures free passage of air when a baby is on the belly, and forms the basis of later reaching movements and hand eye coordination. This reflex should stop by 6 months.
• Spinal Gallant: Characterized by twitching or flexion when the skin along the side of an infant's spine is stroked. The infant will swing towards the side that was stroked. This reflex helps with the birthing process and should inhibit between 3 and 9 months.
• Symmetric Tonic Neck Reflex (STNR): Present briefly after birth and then reappears around six to nine months.  This reflex helps the body divide in half at the midline to assist in crawling. It is characterized by the arms bending and legs extending as the head is brought towards chest. It should disappear by 11 months.

Reflexes are thought to help a baby learn and refine motor behavior.

As a baby matures, the higher centers of neurological control take over and the brain replaces these involuntary movements with voluntary ones. The reflexes fade away, or "integrate" as us child development nerds call it.

But they don't always integrate optimally.

They may be partially or fully retained, or re-emerge at some point in life.

If that is the case, it can impact a child's performance in a variety of areas.  

Symptoms of retained reflexes include, but are not limited to:

• Picky eating
• Bed wetting
• Toe walking
• Poor short term memory
• Motion sickness
• Poor fine and/or gross motor skills
• Lisps
• Speech articulation issues
• Poor muscle tone
• Poor posture
• Inability to sit still
• Limited attention
• Impulsivity
• Balance issues
• Poor visual tracking
• Social and emotional immaturity
• Many other developmental delays related to disorders like ADHD, autism, sensory processing disorders, and learning disabilities

Some factors that can contribute to retained reflexes include:

• Traumatic birth
• C-section
• Falls
• Traumas
• Lack of early movement and floor time
• Delayed or skipped creeping or crawling
• Chronic ear infections

If your child experiences developmental delays, it might be worth considering the possibility of retained primitive reflexes. ​

They are simple to test for, and there are exercises that may help. Bring it up with your pediatrician, or OT/PT/ST if your child receives any specialist services. ​